The last several days the local newspaper (Juneau Empire) has carried full-page ads by PhRMA opposing the Medicare prescription drug benefit bill currently winding its way through Congress. A quick web search indicates that the ad is nationwide. The ad is a lying sack of sh*t, putting up a logical strawman in place of real debate. The real debate is whether the federal government should negotiate for volume discounts on commonly used prescription drugs, not patient choice as described in the ad.
Let’s look at the ad in depth:
“Today, for the first time ever, 90% of seniors have comprehensive prescription drug coverage.”
Compared to what, when? Who is defining “comprehensive”? How many seniors had prescription drug coverage before?
“The program is only a year old, but it’s already making a difference. Real savings for seniors. A wide choice of plans – not a one-size-fits-all. The medicines seniors need for the care they deserve.”
This statement has nothing to do with volume discount pricing. The program may have produced some savings for seniors (debatable), but this statement would lead you to conclude that all possible savings have been achieved, which is not true. True, there is a wide choice of plans, but having reviewed several of them, I can’t help but notice the words “quality” and “affordability” aren’t being used as selling points. So what if you have a choice of 90 different plans, if you can only afford the payments for three of them, and those three suck (I’ll define suck as having a return on investment by the insured of less than $0.50/dollar and administrative/overhead rates of greater than 20%)?
“The Medicare debate going on in Congress is really about patient choice. Restricting access to critically important medicines for tens of millions of seniors and disabled Americans would be a huge mistake.”
Enter the strawman. If you can’t argue that volume discounts are bad, then reframe the debate. We now have, according to the ad, “a wide choice of plans”. We have, according to the ad, “patient choice”. What we don’t have is the lowest price for the best product, despite claims that the “free market” would produce this effect.
“And it won’t save any money either. The Congressional Budget Office (CBO) estimates legislation recently passed by the U. S. House “would have negligible impact on federal spending.”
Since when is “negligible impact on federal spending” a bad thing? So, bulk discounts have negligible effect on federal spending, but what effect would they have on individual spending. A 5% discount on prescription drugs may not have an effect on the whole federal budget (especially since prescription drugs are such a small fraction of the federal budget, compared to, say, the occupation of Iraq), but it certainly would have an effect on an individual’s budget. Especially if out-of-pocket prescription costs are a significant percentage of the monthly bills.
“Shouldn’t doctors and patients – not Washington bureaucrats – decide when new breakthrough medicines are needed?”
Actually, neither of these groups, as presented, should decide when new medicines are needed. This is another logical fallacy, selectively excluding potential solutions. Neither doctors, patients, or generic “bureaucrats” are qualified to make the decision. However federal subject matter experts (a subset of “bureaucrats”) are qualified, by training and experience, to determine how federal research funds are distributed.
It defies reason and the free market to restrict the ability of the federal government to negotiate the best possible price for prescription drugs.