The Public Policy

Health Care and Our President-Elect

Four areas of immediate concern.

By 11.6.08

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Yesterday, Wednesday, I woke up, shaved, and drove to work. My EZ Pass still worked.

Barack Obama is our President-Elect.

Please note the possessive -- "our" -- because he will shortly be the new President of the United States. The whole United States. Red states and blue states. He's our president regardless of political affiliation or policy position. It also means he's obligated to listen to the opinions of all Americans -- not just those who agree with his agenda.

Here are a few things he should keep in mind as he contemplates health-care reform.

First, drug importation is still an unsafe, unsound idea. Contaminated heparin from China killed nearly 100 people earlier this year. And barely a month ago, customs officers in Brussels seized over 2 million counterfeit anti-malaria drugs coming from India -- Europe's largest ever counterfeit drugs seizure. The World Health Organization estimates that fake drugs now account for 10 percent of all drugs on the world market.

The FDA is insufficiently funded to monitor all of the sites where imported drugs are produced. Th
e Government Accountability Office reported that the FDA inspects less than 10 percent of overseas facilities each year. At that rate, each of these sites is inspected only once every 13 years. That's a lot of time to produce and ship substandard medicines.

This is why it is terribly risky to legalize the importation of foreign drugs.

Second, Part D is still a resounding success and the non-interference clause, which prevents the federal government from meddling with drug prices, should stand. The projected cost of Part D to taxpayers over the next decade has dropped $117 billion since last summer -- from $915 billion to $798 billion.

An overwhelming 87 percent of Part D enrollees are happy with the program, according to a recent Harris Interactive poll. This because Part D was structured to allow private insurers to compete without government interference -- and today enrollees have a wider choice of drugs, better services, and lower premiums than anyone ever expected.

The Department of Veterans Affairs stands in stark contrast. Its prescription drug formulary contains less than 65 percent the nation's 300 most-popular prescription drugs. The most popular Part D plan, by contrast, covers over 90 percent of them. Even the nonpartisan Congressional Budget Office has concluded that in order to save money through direct price negotiations, Medicare would have to limit access to drugs.

Third, the drug pipeline is not as dry as many argue. Seven-hundred and fifty novel approaches to beating cancer are currently under development, and over 277 medicines to overcome heart attacks and strokes are undergoing testing. Considering that just 25 years ago, the only treatment for a heart attack was bed rest, drugs that can stop a heart attack represent an enormous leap forward. Just a few short years from now, it's likely that doctors will brandish an arsenal of new medicines to fight hypertension and cholesterol.

Unfortunately, pharmaceutical innovation remains misunderstood. Even though patent protections provide the incentives needed to continue producing these life-saving therapies, many in Washington seem intent on eroding patent protections as a means of reducing drug prices.

Finally, Americans still cannot buy health insurance competitively across state lines. This is something a McCain administration would have pushed for, but that ship has sailed. Expanding access to private insurance by eliminating state boundary laws would increase competition among providers, driving down costs and improving services.

It's now Thursday -- which means the weekend is within sight. Let's take that opportunity to sit back and reflect on all the work we need to do -- together -- to reform American health care for all of us and with all of us as partners.

That's change we can all support.

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About the Author

Peter Pitts is partner/director of global health at Porter Novelli, a senior fellow at the Center for Medicine in the Public Interest, and a former FDA associate commissioner.