Democrats: Pass Medicare Price Negotiation or Suffer A Big Political Price – This Is What’s at Stake

As of press time, the US House is still fleshing out details to the Build Back Better (BBB) plan. Even though Democrats have majorities in both chambers of Congress and the presidency, a sticking point is cost, at least this is the excuse given by two holdout senators (Sen Joe Manchin-W Virginia and Sen Kyrsten Sinema-Arizona) and two or three congressmembers.

The likelihood is BBB will eventually be passed but not with the original content a vast majority of Democrats had wanted. Special emphasis should be placed on the word “majority” here because contrary to big media’s portrayal of a schism within the Democratic party on BBB, four or five holdouts in the entire Congress do not represent some large countering group with a countering agenda at all. Remember there are 211 Democrats in the US House; 48 Democrats in the US Senate, plus Vice President, and two independents who caucus with Democrats.

Within days (potentially before this issue is released) the US House could pass BBB. It will go to the Senate for debate, revisions could be made, or in theory, it could just sit there until the end of this congressional session that concludes at the end of 2022.

However, whatever comes out of the House in the next days or week – each proposal that’s left in or taken out of BBB, could still be handled in a number of different ways until the end of 2022. If the Senate decides to let the House’s BBB proposal to sit and they do nothing, it’s technically possible for the House to send another version. The House could also decide to send only parts of BBB (not as costly). The House could even send a single, stand-alone bill on a specific agenda.

These, and other options are available, but usually major bills (especially of the magnitude of BBB) do not get passed on an election year. So this explains the rush to get something major done before the end of 2021, before the midterm election year 2022.

Medicare Price Negotiation
Going over deadlines and options is to stress the importance that the issue of Medicare Price Negotiation, whether this feature remains or is omitted from BBB, should be looked at as a goal that must be done eventually.

Medicare Price Negotiation would greatly reduce the cost of many prescription drugs, depending on the provisions of the bill. It has been a central advocacy point for AARP and other consumer groups.

Having Medicare negotiate prices would accomplish two major goals:  a) lower the price of prescription drugs; and b) save Medicare an estimated $700 billion over 10 years.

And savings would be used to expand Medicare to include coverage for dental, eyes and hearing, as well as reducing the Medicare eligibility age from 65 to 60 years old.  This is the original plan, but could change.

A proposal that is extremely popular and could be leveraged politically
A vast majority of Americans support Medicare Price Negotiation. Medicare Price Negotiation is so popular that a smart strategy (if it fails via BBB) is to remove it from BBB and the other healthcare provisions then introduce them as a stand-alone bill. This gives Medicare matters a better chance at passing with Republicans no longer able to cite exorbitant cost as an excuse. A stand-alone bill would also put pressure on Republicans to take a position on this specific issue (popular among even Republicans) and not use other unpopular features in BBB as an excuse to reject it. This is perhaps the smartest way politically to move forward.

Why so much attention on the politics behind lowering drug prices?
So if lowering the cost of prescription drugs is so popular, why is the result the same each congressional session? Momentum hits a brick wall and little to no action is taken on this issue.

The reason is a simple one:  it’s all about politics and always had been. And this is where the attention should be focused.

We could cite drug after drug, their rising cost moving faster than inflation. But everyone already knows how expensive medication can cost for the chronically ill.

We could share real life stories of how chronically ill people and the elderly struggle to pay for medications they need. But such stories, even personal ones involving family and close friends, haven’t compelled politicians to act.

Inaction on this issue boils down to bad politics. Big Pharma is spending obscene amount of money lobbying to protect their interests, their profits.  Big Pharma is the biggest lobby in DC and is constantly pouring money like water into the campaign treasuries of politicians. And their investments are working.

As dire the situation is for people to be able to afford medicine they need or must forgo basics like food, rent or utilities, this is just overlooked. Big Pharma still manages to fend off most proposals to reform the industry.

A rare opportunity
Voters must consider what a rare moment this is. Lowering the cost of prescription drugs has been a popular idea even before the Obama administration. It had been used by Democrats as a selling point in the last midterm (2018) to win back Congress.

Not getting Medicare Price Negotiation passed considering Democrats have the majority going into the midterm could leave enough voters cynical and hurt the Democratic party. Certainly there are other accomplishments they can cite, but complete failure on improving access and cost of healthcare (remember that money in savings were to be used to expand Medicare enrollment and coverage) could be enough a disincentive to keep an average voter (not someone looking at big picture political consequences) on the couch on election day.

This is the new tough approach advocates for lowering prescription drugs should consider – stress that if nothing gets done, why should we vote for you. Don’t’ bother appealing to what’s fair or unfair, morally just, or that pricing doesn’t make sense. These all have fallen to deaf ears.

Perhaps making a stronger demand of politicians:  “lower prescription drugs and cost of healthcare or pay a political price” just might finally work.


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