American Consequences - September 2018

THE FINAL WORD

E verybody cares about health care. In the U.S., it’s about one-fifth of GDP, and total spending on it goes well over $3 trillion annually. People get sick – or even if they’re young and healthy, they know people who are really sick. It’s one of the few political issues that can generally grab anyone’s attention no matter their partisan affiliation, background, or socioeconomic status. Recent polling shows – to nobody’s surprise – health care is cited as the No. 1 issue of concern for those planning to vote in the midterm election. But health care is also a huge umbrella term for a vastly complicated system that includes everything from visits to your local internist to multibillion-dollar wonder drugs that can keep rare cancers at bay. Democrats and Republicans know they’ve got a very limited attention span with the general public, so to get people motivated to vote, they tend to push one or two major health care talking points at a time. This election cycle is no different. For the GOP, including the Donald Trump White House, the big push is to lower prescription drug prices. Across the aisle, the Democrats are more openly than ever advocating “Medicare for All,” which is really a euphemism for European-style single-payer health care. Let’s start on the GOP side. The cost of prescription drugs has been a major policy issue with the Republicans all year. President Trump has said that “fixing the injustice of

high drug prices is one of his top priorities.” A quick look at the numbers shows why the president has focused on this. Americans spent $323 billion ($450 billion based on list prices, before rebates and discounts) on prescription drugs in 2016, and that cost is growing at roughly 5% a year. And with the current regulatory distortions in place, high-priced new drugs that benefit 1% of insured beneficiaries will account for half of drug spending within five years. Many of the federal regulations in place – ones that create actual monopolies for certain drug companies – are the result of outdated or simply foolish FDA interventions. President Trump has been all over this problem. The U.S. Department of Health and Human Services put out the “American Patients First” proposal this past May, which outlined the scope of the problem and presented concrete steps to address it. The

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Democrats and Republicans know they’ve got a very limited attention span with the general public, so to get people motivated to vote, they tend to push one or two major health care talking points at a time.

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