What's Worse, The Senate, The Supreme Court, The Drug Companies Or The Republican Party?

"All Of The Above" Is Not Allowed This Time

Senate rules are arcane, serpentine and, most of all, outmoded and anti-democratic. From the first hint New Hampshire and Delaware would insist on a Senate representing geography rather than people in 1774 during the first continental congress, even before the Declaration of Independence, the anti-democratic nature was apparent. Patrick Henry of Virginia said at the tine that “A precedent ought to be established now that it would be great injustice if a little colony should have the same weight in the councils of America as a great one.” That evening John Adams wrote in his diary that the first day of the First Congress had exposed a fault line. “This is a question of great importance. If we vote by colonies, this method will be liable to great inequality and injustice, for 5 small colonies, with 100,000 people in each, may outvote 4 large ones, each of which has 500,000 Inhabitants. This will lead us into such a field of controversy as will greatly perplex us.” A compromise was reached that eventually led to the creation of an anti-democratic Senate that should never have existed and that we’re still stuck with today.

Knaves like McConnell and Schumer use it to thwart the will of the people, to enrich its members and celebrate American dysfunction. It should have been abolished long ago. Today the senate is being used to allow bribe-paying drug companies to prevent cheaper drug prices. There’s a national consensus, for example, that the pharmaceutical barons have to stop ripping people off with the bloated and arbitrary price of insulin. And yet the Senate is using its procedures as an excuse for letting this national consensus be trampled on, slipping through the cracks, while senators collect their bribes. Schumer himself has taken $1,480,522 in bribes from the drug companies, not as much as McConnell's $1,971,780, but still plenty.

Somehow Schumer, who’s in charge, claims it is a priority— a “very, very high priority” no less— while he buries it under an avalanche of procedural hurdles, while (did I mention this already?) senators collect their bribes. And that’s even before you get to the House, just as corrupt as the Senate but also filled with far right ideologues with a different agenda.

But even if an insulin cap does get through the Senate, the GOP-controlled House is unlikely to support such a measure.

Rep. Brett Guthrie (R-KY), chairman of the Energy and Commerce Health subcommittee [and a recipient of $1,329,180 in bribes from the drug makers], said he’s concerned insulin caps would lead to shortages.

“We aren’t preventing people from getting access to the drugs. So we want it to be absolutely affordable; we will absolutely negotiate with anybody on that. But we also want to make sure we don’t make it a shortage either,” Guthrie said.

After President Biden called for a $35 insulin cap in his State of the Union, Energy and Commerce Committee Chairwoman Rep. Cathy McMorris Rodgers (R-WA) called the move “socialist” and a “federal mandate” that hurts competition.

She voted against a similar bill last year when Democrats controlled the House.

Too bad the voters in Spokane aren’t aware of the role their reactionary congresswoman is playing in the cost of medicines. There are a dozen counties in her eastern Washington congressional district, mostly red, but two of which are swing districts. She won them all, not just QAnon-infected hellholes like Franklin and Adams counties but relatively sane places like Spokane and Whitman counties. In all, she beat Democrat Natasha Hill 188,646 (59.7%) to 127,585 (40.3%). I bet if you asked the vast majority of McMorris Rodgers supporters in WA-05 if there is a connection between high drug prices and their votes they would look at you like you were crazy. By the way, in case you were wondering, McMorris Rodgers has taken $1,136,452 in bribes from the drug industry she is working to protect even if it means killing her own constituents.

A very different kind of candidate is running for Congress on the other end of Washington, Jason Call. He's nothing like McMorris Rodgers or Brett Guthrie. In fact, he's nothing like the vast majority of members of Congress. A former Democratic Party official, he's running as a Green Party candidate (and has been endorsed by Blue America). Yesterday, he told me that "There are some industries (many, even) that have become essential to human survival in the modern age, to the degree that morality (or if you prefer, constitutionality) demands they be justly and equitably accessible to all people. At the forefront of these is the pharmaceutical industry. We only need look at the insulin case over the last decade to see how unjust-- to the point of ruthlessness and inhumanity-- the private pharmaceutical industry is. Insulin costs at most $4 per vial, yet Eli Lilly increased prices to over $320 per vial in 2019 (also the current price cap is only for Medicare patients). The insulin parent was sold in 1923 for a single dollar by the developers, for the exact reason that it should be widely and cheaply available to the public."

He continued, "Much of the basic biomedical research done on pharmaceuticals is publicly funded at our colleges and universities. This research becomes part of the commons-- essentially free for pharmaceutical companies to take and further develop into the designer drugs that we have become familiar with. And then they move on to patents and price gouging. Consider the impact this has had on both public perception of the health industry (particularly the oversight agencies like the CDC and the NIH) and how that translates into diminished public health efficacy. People need to trust that the motives for government health policies aren’t to enrich industry donors. How much more effective would COVID vaccine policies have been if a large portion of the public didn’t think it was a scam to enrich Pfizer? Furthermore, we saw that Baylor University developed not one, but two COVID vaccines that were then provided free to developing nations so they could manufacture their own low cost vaccines for mass distribution because the US companies refused to give up their patented formulas. Nationalize the pharmaceutical industry. The public funds the research, the public research agencies can develop the products. We can cut out the profiteers and ensure that Americans are afforded life, liberty, and the pursuit of happiness through life saving medications that aren’t forcing them to choose between their health and eating or paying rent."

Yesterday, Sheryl Stolberg and Rebecca Robbins wrote that “The pharmaceutical industry, which suffered a stinging defeat last year when President Biden signed a law authorizing Medicare to negotiate the price of some prescription medicines, is now waging a broad-based assault on the measure— just as the negotiations are about to begin. The law, the Inflation Reduction Act, is a signature legislative achievement for Biden, who has boasted that he took on the drug industry and won… the provisions allowing it to negotiate prices are expected to save the government an estimated $98.5 billion over a decade while lowering insurance premiums and out-of-pocket costs for many older Americans.”

On Tuesday, Johnson & Johnson became the latest drugmaker to take the Biden administration to federal court in an attempt to put a halt to the drug pricing program. Three other drug companies— Merck, Bristol Meyers Squibb and Astellas Pharma— have filed their own lawsuits, as have the industry’s main trade group and the U.S. Chamber of Commerce.

The suits make similar and overlapping claims that the drug pricing provisions are unconstitutional. They are scattered in federal courts around the country— a tactic that experts say gives the industry a better chance of obtaining conflicting rulings that will put the legal challenges on a fast track to a business-friendly Supreme Court.

The legal push comes just weeks before the Centers for Medicare & Medicaid Services is scheduled to publish a long-awaited list of the first 10 drugs that will be subject to negotiations. The list is due out by Sept. 1; the makers of the selected drugs have until Oct. 1 to declare whether they will participate in negotiations— or face steep financial penalties for not doing so. The lower prices will not take effect until 2026.

Earlier this month, the chamber asked a federal judge in Ohio to issue an injunction that would block any negotiations while its case is being heard.

"Scales of Injustice" by Nancy Ohanian

Lawrence Gostin, an expert in public health law at Georgetown University, said the Supreme Court might be sympathetic to some of the industry’s arguments. In particular, he pointed to a claim by drugmakers that by requiring them to negotiate or pay a fine, the law violates the Fifth Amendment’s prohibition on the taking of private property for public use without just compensation.

“The Supreme Court is openly hostile to any perceived violation of the Fifth Amendment,” Gostin said, adding, “It would not surprise me at all to see these cases go up to the Supreme Court and have them strike it down.”

For Biden and his fellow Democrats, that would be a painful blow. The president and Democrats have long campaigned on reducing drug prices and plan to make it a central theme of their 2024 campaigns.

…Republicans opposed the drug pricing provisions, which they regard as a form of government price control. But the politics of the issue are treacherous for them. Because so many Americans are concerned about high drug prices, it is hard for Republicans to come to the industry’s defense, said Joel White, a Republican strategist with expertise in health policy.

Instead, Republicans are focused on another priority of the drug industry: scrutinizing the practices of pharmacy benefit managers, which negotiate prices with drug companies on behalf of health plans. The drug companies say that by taking a middleman’s cut, the pharmacy benefit managers are contributing to the high cost of prescription medicines.

For drugmakers, the stakes of the legal challenges are bigger than just their business with Medicare, their biggest customer. The industry fears that Medicare will, in effect, set the bar for all payers, and that once the government’s lower prices are made public, pharmacy benefit managers negotiating on behalf of the privately insured will have more leverage to demand deeper discounts.

In conjunction with its legal campaign, the pharmaceutical industry is waging a public relations offensive. The industry trade group that filed one of the lawsuits, the Pharmaceutical Research and Manufacturers of America, known as PhRMA, is running advertisements targeting pharmacy benefit managers, and industry executives are publicly arguing that the drug pricing provisions will lead to fewer cures. The implication is clear: Lower prices will mean a dent in revenues, which will discourage companies from developing certain drugs.

…Until now, Medicare has been explicitly barred from negotiating prices directly with drugmakers— a condition the industry demanded in exchange for supporting the creation of Part D, the Medicare prescription drug program, which was signed into law 20 years ago by President George W. Bush.

Under the Inflation Reduction Act, the government will select an initial set of 10 drugs for price negotiations based on how much the Part D program spends on them. More drugs will be added in the coming years.

Experts expect the initial list of drugs to include oft-prescribed medicines like the blood thinners Eliquis and Xarelto; cancer drugs like Imbruvica and Xtandi; Symbicort, which treats asthma and chronic obstructive disorder; and Enbrel, for rheumatoid arthritis and other autoimmune disorders.

…The United States spends more per person on drugs than comparable nations, in part because other countries proactively control drug pricing. Surveys show that many Americans forego taking their medicines because they cannot afford them.

Experts say the Medicare negotiation program is likely to translate into direct savings for seniors, initially in the form of reduced premiums made possible by reduced drug spending. And when lower prices take effect in 2028 for drugs administered in clinics and hospitals under another Medicare program, known as Part B, that could mean lower out-of-pocket costs for seniors covered by traditional Medicare who do not have supplemental insurance.

Backers of the Inflation Reduction Act say that in addition to saving money for the government and patients, the negotiations will inject much-needed transparency into the complicated process of determining drug prices. If a company declines to negotiate, it must either pay a hefty excise tax or withdraw all of its drugs from both Medicare and Medicaid.

There wasn't a single word in the NY Times report about the members of Congress taking any money from the drug industry. Yet, since 1990, incumbents and candidates to the House and Senate have taken $318,701,729 from the drug companies-- not counting more subtle bribes from lobbyists. ANyone think that might have played a role in drug pricing in America?