Opponents Try To Undo Health Bill Deals
While top members of the House and Senate are struggling to put together health care overhaul bills on Capitol Hill, elsewhere in Washington, patient advocates and other groups are trying to take apart some of the deals already cut with top health care industry groups.
Earlier this spring, President Obama and Senate Finance Committee Chairman Max Baucus announced a series of deals with many of Washington's top health care players — including groups representing doctors, drug makers, hospitals and health insurers.
In exchange for those groups agreeing to voluntarily trim spending over the next decade, Congress wouldn't make deeper cuts as part of the health care overhaul process.
Plus, the health care groups wouldn't launch multimillion-dollar lobbying and advertising campaigns against the bills. On that score, the deals have pretty much succeeded. But now patient advocates and others say lawmakers have given away too much to health care special interests.
"Our coalition has not embraced one bill at this time, and that's because of cost containment," or, more specifically, the lack thereof, said Ralph Neas, CEO of the National Coalition on Health Care.
Neas, whose group is nonprofit and nonpartisan (its honorary co-chairmen include former Presidents Jimmy Carter and George H.W. Bush) is more than a bit skeptical of the promises made by the health industry groups to cut $2 trillion over the next 10 years. "We said that's a magnificent commitment. But I come from a civil rights background. Voluntary efforts don't work. There's got to be some enforceability," Neas said.
As an example, he points to the $80 billion pledged by the brand-name pharmaceutical industry, which stands to make a lot more money from a lot more newly insured patients if a major overhaul becomes law. Said Neas, "If they're going to get these hundreds of billions of dollars, trillions of dollars over the next 10 or 20 years, they should be paying more than $80 billion."
Many patient and consumer groups are particularly unhappy about provisions now included in both House and Senate health bills that would give brand-name makers of expensive biotech drugs 12 additional years on the market before cheaper generic copies could be made and sold.
Former GOP Congressman Bill Thomas is among them. "It is outrageous to provide them 12 years — just outrageous," said Thomas, now a senior adviser to a Washington law firm and a part-time scholar at the American Enterprise Institute.
That's not what the drug industry says, of course. "Critics ignore the tremendous costs and challenges involved in researching and developing such complex and cutting-edge medicines," said Ken Johnson, senior vice president of Pharmaceutical Research and Manufacturers of America, the brand name drug industry group.
"Development costs for innovative biologics can exceed $1.2 billion, plus another $450 million to build specialized manufacturing facilities," Johnson said.
Meanwhile, patients who need expensive biotech drugs are caught in the middle.
Anne Collins of Arlington, Va., has psoriatic arthritis, a complication of psoriasis. She claims Simponi, the new biologic drug she takes, is nothing short of a miracle. "I probably wouldn't be here today, because I probably wouldn't be able to walk, if I didn't take this drug," she said at a recent news conference.
But it costs $2,000 to fill each monthly prescription for her medicine. And while her insurance pays most of the cost for now, "I blew through all of my benefits last year, and I will do so again," because the policy that covers her only provides $40,000 annually for prescription drugs.
Yet it will be years, if ever, before there's a less expensive generic version of the medication.
Thomas said since both the House and Senate bills now have 12-year patent extensions for the biotech drugs, there's only one way to force the drug makers to bargain: Put other things in the health bills they like even less.
"You've got to move amendments that put them at risk so when you close the door and you want to talk about the 12 years, they don't thumb their nose at you, they actually see what their risk is," he added.
One possibility is language allowing people to import lower-cost drugs from other countries — an issue drug makers despise. And there's no shortage of members who'd like to offer that amendment when the health care overhaul bills reach the House and Senate floors.
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The debate over health care is focusing even more sharply on the cost. Part of the reason for President Obama's overhaul is to control how much Americans pay for health care. That's a tough goal, not least because it can threaten the profits of powerful health care companies. The Obama administration made deals with the industry early this year. Now some health care advocates say the White House and Congress gave away too much.
NPR's Julie Rovner has the story.
JULIE ROVNER: Back in May, President Obama announced with much fanfare a deal he cut with many of Washington's top health care players, including groups representing doctors, drug makers, hospitals, and health insurers.
President BARACK OBAMA: Over the next 10 years, from 2010 to 2019, they are pledging to cut the rate of growth of national health care spending by 1.5 percentage points each year, an amount that's equal to over $2 trillion dollars.
ROVNER: Later, some of those groups would cut more specific deals offering voluntary cuts in exchange for lawmakers agreeing not to cut their industries even deeper as part of the health overhaul. The deals were intended to prevent past enemies of the overhaul effort from launching multi-million dollar lobbying and advertising campaigns against the bills, and the deals have pretty much succeeded. But now patient advocates and others say lawmakers have given away too much to the health care special interests.
Mr. RALPH NEAS (National Coalition on Health Care): Our coalition has not embraced one bill at this time, and that's because of cost containment.
ROVNER: More specifically, the lack of cost containment. Ralph Neas is CEO of the National Coalition on Health Care, a nonpartisan group. He's more than a bit skeptical of the promises made by the health industry groups.
Mr. NEAS: We're going to cut $2 trillion voluntarily from our costs over the next 10 years. We said that's a magnificent commitment, but I come from a civil rights background. Voluntary efforts don't work. There's got to be some enforceability.
ROVNER: Neas says a case in point is the $80 billion pledged by the brand name pharmaceutical industry, which stands to make lots more money from lots more newly insured patients if a major health overhaul bill becomes law.
Mr. NEAS: If they're going to get these hundreds of billions of dollars, trillions of dollars over the next 10 or 20 years, they should be paying more than $80 billion.
ROVNER: Many patient and consumer groups are particularly unhappy about provisions now included in both House and Senate health bills that would give brand name makers of expensive biotech drugs 12 additional years on the market before cheaper generic copies could be made and sold. Former Republican congressman Bill Thomas is among them.
Mr. BILL THOMAS (Former Republican Congressman): It is outrageous to provide them 12 years, just outrageous.
ROVNER: That's not what the drug industry says, of course. Ken Johnson is senior vice president of PhRMA, the brand name drug company's industry group.
Mr. KEN JOHNSON (Senior Vice president, PhRMA): Unfortunately, critics ignore the tremendous costs and challenges involved in researching and developing such complex cutting edge medicines. Development costs for innovative biologics can exceed $1.2 billion plus an additional $450 million to build specialized manufacturing facilities.
ROVNER: Meanwhile, patients who need expensive biotech drugs are caught in the middle. Anne Collins(ph) has psoriatic arthritis, a complication of psoriasis. She says the biologic drug she takes is nothing short of a miracle.
Ms. ANNE COLLINS: I probably wouldn't be here today because I wouldn't be able to walk if I didn't take this drug.
ROVNER: But it costs $2,000 to fill each prescription, and while her insurance pays most of the cost for now…
Ms. COLLINS: I blew through all of my benefits last year, and I will do so again.
ROVNER: Since her policy only covers $40,000 worth of drugs each year. But there won't be a cheaper generic version of her drug for years, if ever. Former Congressman Thomas says since both the House and Senate bills now have 12-year patent extensions for the biotech drugs, there's only one way to force the drug makers to bargain.
Mr. THOMAS: You've got to put them at risk. You've got to move amendments that put them at risk, so when you close the door and you talk about, you want to deal with the 12 years, they don't thumb their nose at you, they actually see what their risk is.
ROVNER: In other words, add other things to the health bills that the drug industry hates even more, things like allowing cheaper drugs to be imported from other countries. There's no shortage of members who'd like to offer that amendment.
Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright National Public Radio.
