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President Obama writes a new health reform prescription

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By Dana Milbank
Wednesday, December 16, 2009

On the campaign trail, Barack Obama vowed to take on the drug industry by allowing Americans to import cheaper prescription medicine. "We'll tell the pharmaceutical companies 'thanks, but no, thanks' for the overpriced drugs -- drugs that cost twice as much here as they do in Europe and Canada," he said back then.

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On Tuesday, the matter came to the Senate floor -- and President Obama forgot the "no, thanks" part. Siding with the pharmaceutical lobby, the administration successfully fought against the very idea Obama had championed.

"It's got to be a little awkward," said Sen. Tom Carper (D-Del.).

It's even more awkward for millions of Americans who are forced to pay up to 10 times the prices Canadians and Europeans pay for identical medication, often produced in the same facilities by the same manufacturers, simply because the U.S. government refuses to rein in drug prices.

Those favoring cheaper prescriptions amassed an impressive ideological coalition, from socialist Sen. Bernie Sanders (I-Vt.) to conservative Sen. David Vitter (R-La.). But they were no match for industry-friendly senators backed by the administration, who on Tuesday night easily voted down "reimportation," as it is called.

No surprise here: Lawmakers, and the White House, are addicted to drug money. The industry has pumped upwards of $130 million into federal elections over the past decade and is now among the top 10 donors, according to the Center for Responsive Politics. At the same time, the White House needed the industry to spend its millions of dollars in advertising money on support of the health-care legislation, not against it.

The drug-money addiction could explain why the administration struck a sweetheart deal with the industry, which offered to give up $80 billion in revenue in exchange for an understanding that the government would not push for deeper concessions. The White House was determined not to go back on the deal -- even though the industry had demonstrated bad faith by raising prescription prices nearly 10 percent this year. So when Sen. Byron Dorgan (D-N.D.) brought his reimportation proposal to the floor, the administration pushed back with a letter from Food and Drug Administration chief Margaret Hamburg warning of "significant safety concerns."

One after the other, the drug industry's friends from pharmaceutical-manufacturing states New Jersey, Delaware and North Carolina went to the floor Tuesday to cite the FDA letter.

Sen. Robert Menendez (D-Bristol-Myers Squibb) warned that "you may have a heart attack" because of counterfeit medicine from abroad.

"This is a matter of life or death," agreed Sen. Frank Lautenberg (D-Merck).

Carper (D-AstraZeneca) cited "remaining safety and soundness and health concerns," while Sen. Kay Hagan (D-GlaxoSmithKline) voiced "serious doubts that we can adequately ensure the safety of the drug supply."

These arguments don't hold up well, considering that 40 percent of the active ingredients in American prescription drugs come from India and China, and that the latter slipped tainted heparin past the FDA. But fright was about the best argument opponents could use to defeat a popular proposal that would save the federal government $19 billion over 10 years, according to the Congressional Budget Office. Consumers would save many times that.

That's why the drug industry has been fighting for a decade against congressional efforts to allow reimportation. Obama co-sponsored one such proposal in the Senate. He also said during his presidential campaign that he wanted to "let Medicare negotiate for lower prices" for drugs. White House Chief of Staff Rahm Emanuel, when he was in Congress, also championed reimportation. Yet now, after their successful battle against it, the two are expected to fight off a similar legislative effort to allow Medicare to negotiate for lower drug prices.

Even before the vote came, it had become clear that President Obama's aides had the votes to kill the proposal Senator Obama once co-sponsored. This, said Sen. John McCain (R-Ariz.), "contributes to the enormous cynicism on the part of the American people about the way we do business here." To Dorgan, he pledged: "I will be by his side as we go back and back and back again on this issue until justice and fairness is done and we defeat the special interests of the pharmaceutical industry which have taken over the White House and will take over this vote."

Dorgan, on the verge of losing another reimportation battle, raised his voice as he pleaded with colleagues. "The pharmaceutical industry has a lot of clout. I know that," he said. "I hope the American people have the ability to expect some clout on their behalf in the chamber of the United States Senate."

Tuesday's final clout tally wasn't even close. The drug companies won with nine votes to spare.


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