Democrats push health care reform, GOP pushes repeal

Lisa Neff, Staff writer

Americans filled 4.3 billion prescriptions last year, and they’re still ailing from the skyrocketing cost of drugs.

Democratic presidential candidates Bernie Sanders and Hillary Rodham Clinton gave voice to patient problems and consumer complaints this fall, with both issuing plans to rein in outrageous prices for prescription medicine.

“The pharmaceutical industry has become a health hazard for the American people,” said Sanders, an independent senator from Vermont. “We now pay, by far, the highest prices in the world for prescription drugs and one in five Americans … cannot afford to fill the prescriptions their doctors write.”

In 2014, an estimated 34 million people could not fill their prescriptions because of costs. Surveys now show that about 70 percent of Americans believe drug costs are unreasonable and that drug companies put profits before people.

Those polls were conducted before Turing Pharmaceuticals CEO Martin Shkreli made headlines in September for raising by more than 5,000 percent the price of Daraprim, a medication used to treat toxoplasmosis in AIDS patients. 

Within hours of Turing purchasing the right to retail Daraprim, the price for a pill that’s been sold for $13.50  went to $750.

“For Turing to charge insurance companies and self-pay individuals with a cost (so much) greater for the same drug is unconscionable,” said Scott Caruthers, chief pharmacy officer of the AIDS Healthcare Foundation, the largest global AIDS group.

AHF president Michael Weinstein said Turing’s greed “is likely to go down in history as the straw that broke the camel’s back on drug pricing.”

Shkreli announced in late September that he would lower the cost “in response to the anger.”

Sanders, an advocate of universal health care, in mid-September released a prescription drug plan that said the federal government should use its bargaining power to negotiate with companies for better prices; allow imports from licensed Canadian pharmacies; prohibit deals that keep generics off the market; and require drug companies to report information affecting pricing.

Clinton, as first lady, led an effort blocked by congressional Republicans that would have provided comprehensive, universal health care. She responded to Turing’s price-gouging almost immediately, pledging on Twitter a plan to reform the prescription drug market that would “both protect consumers and promote innovation — while putting an end to profiteering.”

Clinton has since issued a series of proposals to address rising drug costs, including a monthly $250 cap on out-of-pocket drugs to help patients with chronic or serious health conditions.

The candidate also proposed requiring that health insurance plans provide for three sick visits per year without counting toward a patient’s annual deductible and offering a refundable tax credit of up to $5,000 for families for excessive out-of-pocket care costs.

“When Americans get sick, high costs shouldn’t prevent them from getting better,” Clinton said in a statement. “With deductibles rising so much faster than incomes, we must act to reduce the out-of-pocket costs families face.”

A survey recently released by the Henry J. Kaiser Family Foundation found that employer-sponsored health insurance premiums rose about 4 percent in 2015, considered a moderate increase. But since 2010, both the share of workers with deductibles and the size of the deductibles have increased sharply — about seven times over the rise in worker wages.

A recent Kaiser analysis found comparable countries outperforming the United States on life expectancy at birth, cost-related barriers to health care access and the burden of disease, which takes into account years of lost life due to premature death and years of life lost to poor health.

The Obama administration expects to see improvements as more people have greater access to care under the five-year-old Affordable Care Act, which mandated insurance coverage, expanded eligibility for Medicaid, prohibited insurers from denying coverage for pre-existing conditions, provided for preventative care and lifted lifetime health benefit caps.

New data from the U.S. Census Bureau shows that the national uninsured rate dropped to a historic low of 9.2 percent in early 2015, with 15.8 million people gaining coverage since the health care marketplaces opened in 2013.

Still, the GOP focus in the health care debate is almost solely on repealing the Affordable Care Act. Congressional Republicans have voted more than 50 times to repeal all or parts of the law and, on Sept. 29, they voted again to advance legislation that would dismantle the ACA.

The House Ways and Means Committee chaired by Wisconsin Congressman Paul Ryan voted along party lines to repeal the mandate requiring Americans to get health insurance and also the mandate requiring larger companies to provide health benefits to employees.

Ryan, in a statement, said, “This bill is a big step toward dismantling Obamacare. … By tearing down many of the worst parts of the law — like forcing people to buy insurance only to later tax them for it — we would stop Obamacare in its tracks and start working toward a more affordable, higher-quality, patient-centered system.”

Wisconsin Gov. Scott Walker also wants the Affordable Care Act repealed, although health care advocates in the state maintain provisions have mostly benefited Wisconsinites.

“The ACA has dramatically reduced the number of uninsured in Wisconsin and improved access to preventive health care,” said Jon Peacock, research director for the nonprofit Wisconsin Council on Children and Families.

The WCCF said by the end of June, more than 230,000 Wisconsinites had signed up for a marketplace plan under the ACA and about 90 percent were eligible for tax credits to offset costs.