Los Angeles Times
November 10, 2003
Import Canadian Prices, Not Drugs
Re “Open Door to Drug Imports,” editorial, Nov. 6: We don’t need to import drugs from Canada. Instead, we need to import Canadian drug prices.
Medicare already has in place mechanisms to control the fees and prices of physicians, hospitals, laboratories and other providers of health-care services and products. Although it is not a perfect process, rates are set to cover expenses and provide a fair profit. The system prevents excessive payments to providers.
If a bona fide prescription benefit were to be added to the Medicare program, the same fair rules would be applied to the pharmaceutical firms. Drugs are an essential element of modern health care. It’s time to include them in Medicare under a similar regulatory process that would ensure affordability.
Our system of funding Medicare has not prevented the development of newer medical technology. Likewise, it will not prevent the development of newer pharmaceutical agents. The drug companies will always strive to earn their share of the $1.66 trillion that we are already spending on health care.
Don McCanne MD
San Juan Capistrano
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The solution is not importing prescriptions but mandating fair-pricing practices. If a manufacturer can sell at reduced prices to Canadian pharmacies, the same prices should be available to pharmacies in the U.S.
Everyone is complaining about rising health-care costs, which stem from high drug costs, yet we turn our heads when the solution is so clear. In order to keep health insurance rates down, we have to keep drug prices down. This means that the manufacturers must be accountable for fair and equitable pricing.
Importation is a simple fix to some, without attempting to solve the problem. We have to lower the cost of medications by making the pricing the same for Canada and the U.S. Only when this happens will the costs of health care be controlled.
Charles S. Franklin
Pharmacist, La Quinta
http://www.latimes.com/news/opinion/letters/la-le-mcanne10.1nov10,1,3511530.story?coll=la-news-comment-letters
Comment: Virtually everyone agrees that access to health care is not complete unless patients have access to affordable prescription drugs. Politicians recognize this and promised us in the last election that prescription coverage would be included as a benefit under Medicare. But we are seeing that participants in the political process can use a popular mandate to advance their own nefarious ends.
If they were sincere on what we thought was their promise, we would already see significant benefits. Most importantly, Medicare beneficiaries would now have affordable access to prescription drugs. Also, the pharmaceutical industry would join the rest of the health care industry in being required to accept the fair pricing that only a regulatory environment can assure.
The free market has served to drive prices up to the maximum tolerated rather than bringing prices down through patient-friendly forces of competition. Furthermore, including prescription coverage would reduce the pressure for Medicare beneficiaries to move into private plans that have provided less value to the taxpayers than has the traditional Medicare program.
But, tragically, the process has moved to behind closed doors with only the ideologues invited in (plus the token presence of Sen. Baucus). Their goals are to protect the free-market pricing of the pharmaceutical firms, but, more importantly, to use this political opportunity to inflict near-fatal blows to Medicare, a program they hate primarily because it is a “government” program.
Through strategic leaks, we know what is happening behind those closed doors. The actual prescription benefit is largely a sham. Very few will benefit from the coverage. The administration of the benefit will be primarily by private middlemen rather than through the publicly-administered, traditional Medicare program. Measures are being included which prohibit the government from providing any regulatory input that might prevent the pharmaceutical firms from charging the maximum that the market will bear. Medicare premiums will be means-tested which will give the affluent a financial incentive to leave the traditional Medicare program. The intent is to then require the traditional program, with a concentration of high-cost, low-income enrollees, to compete with the private plans. This would result in the death spiral of the traditional program.
The political debate now centers around the privatization issue. Sen.Kennedy threatens to prevent its passage if the competition proposal is included. The House ideologues threaten to oppose it if competition is not included. Lost in this is the actual prescription coverage. It is grossly inadequate. But Sen. Kennedy believes that it should be passed because it will open the door to a program that can be repaired later. But he will not do this at the cost of destroying Medicare as a program of social insurance.
The ideologues seem to be willing to take a stand, challenging Sen. Kennedy
and colleagues to block it in the Senate. They can then take the issue to
the voters, claiming that it’s the Democrats who denied Medicare beneficiaries of their prescription benefit.
The issues are complex. But the voters need to understand them. Candidates must be confronted with a public that demands to know whether they support a
bona fide prescription program or if they are using this issue to take as word to the Medicare beast.
Medicare might be a beast, but it’s our beast.(Since this message has great urgency, please consider distributing it to those who do care about our Medicare program.)
Don McCanne