The Conventions – Loud and Boisterous Events Devoid of Issues
We now have two duly nominated candidates for President of the United States. The first candidate, a forgone conclusion for the Republicans, and the second candidate, a surprise from anyone’s point-of-view but a surprisingly powerful candidate for the Democrats. Both conventions were more about the people than they were about where they stood on the important healthcare issues that affect you and me.
Given the lack of discussion on these issues, I’ll write more about what the party and the candidates have stood for in the past and where they are likely to stand if they are elected President.
One caveat is that in this polarized political environment, it is hard to maintain a bi-partisan view, both as a writer and a reader. I can honestly say that I have no preconceived allegiance to either of these candidates. It is no secret that I am a free market, small government, free choice champion. I don’t think that every problem we have in America requires government intervention. As I evaluate where I see each of these candidates going in their approach to our healthcare, it will be from the perspective of how it will affect older Americans.
Republicans – Since former President Trump has served four years as President, it gives me a good template for where he will go if he wins the election. Remember, he was determined to win the “fight” with big pharma. It was popular to fight big pharma, and he took advantage of its popularity. He used executive orders in an attempt to influence drug prices, which included:
Most favored nation – which guaranteed the U.S. would only pay the lowest price available in other developed countries for certain drugs covered by Medicare.
Allow the importation of drugs from other countries, primarily Canada.
Stop rebates to pharmacy benefit managers.
As you know, I despise the use of executive orders to bypass Congress and the judiciary. These executive orders faced a headwind of resistance and were not implemented to any meaningful degree. What they did show was Trump’s willingness to put political expediency ahead of solid long-range solutions. I would expect that these issues will again raise their heads if he wins the election.
Democrats – While Vice President Harris does not have a four-year history as President, she does have 3 ½ years as Vice President and certainly had some involvement in the Inflation Reduction Act, the cornerstone of her parties’ impact on healthcare. She has said a few alarming things about the drug price-fixing portion of the law (I’ll talk more about this in my next blog). She has touted that she would like to increase the number of drugs subject to price fixing, and the DNC’s platform supports expanding this number from 60 in this decade to 500! That’s a ten times expansion on an unproven program that has the potential for a myriad of unattended consequences.
I would be negligent if I didn’t remind you that Harris was a co-sponsor of Sen. Bernie Sander’s bill to turn over our healthcare to the government as the single-payer and, more recently, during her 2019 campaign for President, she again supported a government single-payer solution. She has since modified her stance on government-controlled healthcare in favor of offering a government option. It is interesting that Presidential candidate Harris has said that she wants to keep the sanctity of the doctor/patient relationship, yet she has championed, from my view, the biggest intrusion by the government into our healthcare by her support of a government single-payer system. While some may say that this approach will never come to fruition, it gives us some insight into what President Harris’ stance might be as she assesses changes to our healthcare system.
Some final thoughts – I hope that as the campaigns move forward, we get more clarity on where each candidate stands on important healthcare issues. I hope that during their debates they are asked some detailed questions and are expected to give detailed answers. There hasn’t been much success at getting detailed answers in previous debates, but I can always hope.
There is one thing I want to comment on. While these candidates might have different approaches when it comes to healthcare, it seems that there is one common theme: they both want to fight with and control “big pharma”. They never say pharmaceutical manufacturers or drug companies, it’s always big pharma. They want to portray drug companies as big, out-of-control, greedy behemoths that are the biggest problem for the high price of healthcare. It is interesting that, according to the non-partisan Government Accountability Office, prescription drug expenditures amounted to only 11% of total personal healthcare services in 2021. That percentage seems to be counterintuitive to “big pharma”.
I also think it’s important to point out that it was these hated drug companies that developed their research, development, and manufacturing abilities under a government-regulated healthcare environment that enabled them to quickly develop and manufacture the COVID-19 vaccines that saved millions of lives. The only way that happened was for the drug companies to be “big” enough to bring these resources into play when the country and world needed them the most.
The doctors, hospitals, insurance companies, and drug companies all have an interest in making healthcare more affordable and accessible. They will all be impacted by whoever wins the election and who controls the House and Senate. My hope is that Washington will shift its focus from all the enemies that need to be controlled to allowing the providers, payers, and innovators to focus on the patient and the ways they can extend and improve our lives.
Best, Thair