This evening the Senate will vote on a proposal by Senators Olympia Snowe and Ron Wyden to replace the new Medicare drug benefit's competitive pricing model with a single payer drug system controlled by the government. Senator Wyden likes to compare his proposal to Costco getting a good deal for consumers on toilet paper.
Except that Wyden actually opposed his own proposal seven years ago when President Clinton introduced a Medicare drug benefit that barred the government from setting or negotiating prices for nearly half the prescription drug market. My new partner in crime at the Center for Medicine in the Public Interest Peter Pitts blogged on this at drugwonks.com:
Here's what Senator Ron Wyden (D, OR) had to say about the federal government negotiating prescription drug costs on October 28, 1999:
"What troubles me about plans to deal with prescription drug costs that involve price controls, we will have massive cost-shifting. If we have Medicare acting as the buyer for all the medicine, it may be possible for the Government to negotiate a discount. I have always said that might be possible. What troubles me about that approach is we will have the cost passed on to someone else who might be 26 or 27 -- maybe a divorced mom who has a couple of kids -- working as hard as they can, and all of a sudden they find out their prescription drug bill shoots up because Congress adopted an approach in this area that doesn't use marketplace forces."
And then he added for good measure …
"There is a right way and a wrong way to deal with the issue of affordable medication. The wrong way is to create a one-size-fits-all Federal regime and put the Government in the business of trying to orchestrate this entire program."
And here's what he just said, on March 13, 2006:
"At a time when the costs of this program and the costs of Government have gone through the stratosphere, one would think the Government would be doing everything possible to hold down costs. Yet, unfortunately, in the original prescription drug legislation, a bizarre restriction was put in place that literally bars the Government from being a smart shopper.
"I compare the Government's approach to buying prescription drugs under Medicare to somebody going into Costco and buying toilet paper one roll at a time."
Wyden was right the first time. And the problem with the Costco comparison of course is that Costco does not control 60 percent of the toilet paper market -- as the government would if the Snowe-Wyden proposal goes through -- and therefore does not, as a matter of course tell people to use the Kirkland (that's the Costco house brand for you outsiders) before stepping up to the Charmin' two-ply plush. And by the way, if you don't like Costco's limited selection of items for each type of good, you can go to Wal-Mart or Target or Kohl's or any number of department stores, etc. Don't like the drug you get under a single payer proposal the Wyden hated and now loves? Either pay out of pocket or die.
Which leads me to wonder what supposedly free market Republicans are thinking when they even consider supporting a measure that would make the government the largest purchaser of medicine in the universe. An AP story this week describes a memo describing how an organization called Americans United intends to use "polling, television advertisements, public events and more, hoping to serve as a sort of bearer of unwelcome news about the (Medicare) program."
According to the AP story, "...The objectives of the Americans United program, according to the memo, include: Drive down support ... to minuscule levels. Mobilize a popular insurrection ... that demands real change and threatens to exact a price on members of Congress who resist" fixing the program." Fixing the program, by the way, boils down to creating the sort of single payer system that Olympia Snowe proposes and some conservative Republicans, including those who might run for President, might vote for.
The kicker is that the "...organization draws heavy financial support from organized labor, and Senate Democratic leader Harry Reid of Nevada and House Democratic leader Nancy Pelosi of California have both met with prospective donors to demonstrate their personal interest in the group's efforts."
In other words, Republicans -- including those who would be the party's standard bearers -- are supporting a Medicare insurgency funded by the extreme left of the Democrat party. Worse, they are supporting the most massive centralization of government authority in recent history. And in doing so they are robbing seniors of necessary choices and the right of doctors to make important life and death decisions on behalf of their patients.
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