Wise to the game

July 15, 2002

NO ONE NEEDS to tell congressional leaders that older Americans are eager for help buying prescription drugs. Top dogs in both parties are banking on it.

At their leaders' urging, lawmakers spent the July Fourth recess boasting of their competing proposals for delivering the Medicare drug benefit many of them have been promising for years.

The GOP-led House kept its members in session nearly all night just before the recess to win narrow approval for its version of the legislation. The Democratic-run Senate plans to debate the topic this week.

FOR THE RECORD - An editorial July 15 in The Sun understated last year's profits for Pfizer. The correct total is $7.78 billion.
The Sun regrets the error.

But the odds are that Medicare beneficiaries whose hopes are buoyed by this flurry of activity will find it a cruel tease.

Strategists in each party believe they have more to gain by trumpeting their own plans than actually getting a bill passed. Republicans don't want to make the compromises required to gain Democratic support. Democrats set the bar for their backing high because they don't want the GOP to get credit for addressing the problem.

Voters should let Congress know they are wise to this game and expect better.

Compromise does not have to be difficult. Two of the most authoritative House voices on health matters -- Connecticut Republican Nancy L. Johnson and Baltimore Democrat Benjamin L. Cardin -- say party negotiators are growing steadily closer in their positions.

Mostly at issue is cost. The House bill calls for spending $320 billion over 10 years. Senate Democrats propose spending $450 billion over six. Splitting the difference is standard operating procedure on Capitol Hill.

A philosophical dispute remains over the nature of the benefit. Republicans want to subsidize the cost of private drug insurance for those who choose it. Democrats favor a uniform drug benefit that would come as a standard Medicare feature.

The standard benefit makes far more sense. Private insurers don't want to offer drug-only policies to the elderly for fear they won't make money. So there's no guarantee coverage would be available unless Medicare underwrites the risk. The GOP experiment with Medicare HMOs was a fiasco.

Adding a drug benefit to Medicare would allow the agency to negotiate discounts for its vast purchasing group. More must be done, however, to tackle drug prices.

The pharmaceutical industry, with its army of lobbyists and trunks full of campaign cash, gets away with charging sky-high prices that drive up the cost of health care for every age group. Medications can save money if they help patients avoid hospital care. But those savings evaporate when public and private insurance plans have to fork them over to drug companies that benefit from both federal research grants and lengthy patent protections.

Two bipartisan measures have emerged in the Senate to attack the price question. One would tighten patent laws so that low-cost generic drugs could reach the market more quickly. A second, less practical proposal would allow pharmacists to re-import U.S.-made drugs from Canada, where they are sold more cheaply because the government negotiates prices.

Pharmaceutical companies are leading money-makers, with three ranking among the 20 most profitable in the nation. Pfizer, which markets Lipitor, Viagra, Celebrex and Zoloft, came in fifth last year, with profits of $7.78 million.

The industry warns that any attempt to cut its profit margins would impede development of these popular drugs that can so dramatically improve the quality of life. But that Chicken Little wail has worn thin. Time to find out if the sky would really fall.

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