New push for medical legislation expected

November 12, 2006|By Jonathan D. Rockoff | Jonathan D. Rockoff,Sun Reporter

WASHINGTON -- The Democratic takeover on Capitol Hill could provide a new push for health care and medical legislation next year, but passage of such measures is unlikely as long as President Bush is in the White House, analysts said.

Instead, the resurgent Democrats will probably make their mark by using hearings to raise awareness of the Medicare prescription drug benefit and other national health policy issues they believe can help them make further gains in the next elections.

"There is very little prospect that significant health care legislation will pass because you will still have Bush as president," said Drew E. Altman, president of the Kaiser Family Foundation, a health care research group. "To maneuver for political advantage in the 2008 presidential election, what [Democrats] will be trying to do is get their ideas back on the agenda."

Democrats named several health care and medical priorities during the campaign. They want to give Medicare the power to negotiate lower drug prices, for example, and they support unrestricted federal funding of stem cell research. They may tackle other objectives, such as expanding the government's coverage of uninsured children and allowing the importation from Canada of prescription drugs.

Sen. Edward M. Kennedy of Massachusetts, an advocate of health coverage for the poor, is expected to take over the chamber's health committee.

Though last week's elections largely hinged on Iraq, national polls by the Kaiser Family Foundation and other organizations showed that voters ranked health care among the top six concerns. Analysts expect that Democrats will try to raise health care's profile even higher during the next two years, because it's an issue they believe wins them support.

"If the Democrats believe people should vote for them, they do have to come up with some issues," said Jonathan Weiner, a professor at the Johns Hopkins Bloomberg School of Public Health. But given the partisanship in Washington, "it will be easier to come up with a wish list than to put solutions in place."

Democrats are expected to use their newfound powers running congressional committees to issue subpoenas for records and demanding that administration officials testify. Among possible committee chairmen are Rep. Henry A. Waxman of California, a longtime Food and Drug Administration watchdog, and Rep. Bart Stupak of Michigan, who has blamed his son's 2000 suicide on the drug Accutane.

"What they can try to do is portray a picture of FDA that might shock and dismay voters, to set the stage for the 2008 elections," said William Vodra, a former FDA lawyer who represents pharmaceutical companies. He expects Democrats to hold hearings on failings in FDA oversight of drugs.

Democrats might also hold hearings to accuse Republicans of political interference in scientific decision making. One line of inquiry may involve the FDA's approval of over-the-counter sales of the Plan B morning-after pill, whose repeated delays liberals blamed on conservative politics.

Republican sympathizers are already trying to undercut the expected Democratic moves, deriding them as political posturing.

"It will be like the worst days of the French Revolution, when everyone was worried they'd be found guilty and guillotined," said Peter J. Pitts, an associate FDA commissioner from 2002 to 2004. "It will ... have everything to do with scoring political points, not moving things forward."

An early, big fight will probably involve Medicare's prescription drug benefit for seniors, known as Part D.

The 2003 law that established the $31 billion program barred Medicare from negotiating with pharmaceutical companies over prices. If Medicare had that power, companies could lose billions of dollars.

With so much at stake, the industry gave $14.8 million to Republicans and $4.5 million to Democrats in the 2006 election, according to the Center for Responsive Politics. Even before Election Day, the industry began arguing that price cuts would curb their resources for developing new drugs. It's also asserting that government negotiations would amount to the imposition of price controls, which could lead to shortages.

Ken Johnson, a senior vice president at the Pharmaceutical Research and Manufacturers of America trade association, expects Democrats to quickly approve legislation giving the government negotiating authority.

"But after that, it's a long way to President Bush's desk, and we'll have ample opportunity to explain to Americans and Congress the downside of having the federal government negotiating on behalf of seniors," he said. A Medicare spokesman said the cost of Part D has proven to be significantly less than anticipated because of competition built into the program.

But Democrats say the savings are needed for use elsewhere in the tight federal budget, perhaps to eliminate or reduce the "doughnut hole" that forces seniors to pay up to $2,850 after using $2,250 worth of drugs before Part D starts paying for their drugs again.

"There really is a trade-off between how much you want to pay for existing drugs and how much you want to spend on developing new drugs. This will be the start of the national debate on that trade-off," said Paul B. Ginsburg, president of the Center for Studying Health System Change, a nonpartisan research group.

Similarly, Democrats are expected to push for more government oversight in other key areas, such as drug safety.

Drug regulators have weathered a storm of criticism since revelations about the painkiller Vioxx appeared in 2004. A government study panel, the Institute of Medicine, recommended giving the FDA the power to fine companies who ignore its rules and mandate changes to a drug's label.

Mark Senak, a pharmaceutical public relations executive who writes the Eye on FDA blog, said he expects Democrats to try to implement the panel's recommendations. Industry will likely counter that federal regulation is already the world's best.

jonathan.rockoff@baltsun.com

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