President Trump brought down the price of prescription drugs. Or so he says. At Monday night’s reelection rally in Mississippi for Republican Sen. Cindy Hyde-Smith, he told the audience, “Drug prices are starting to come down.”
Perhaps he should tell it to Hedda Martin, a disabled dog walker from Grand Rapids, Mich. Martin, 60, experienced her 15 minutes of fame over the Thanksgiving break, after a letter she received from Spectrum Health’s Richard DeVos Heart & Lung Transplant Clinic, denying her a heart transplant, went viral.
It’s not that Martin isn’t a medical candidate — she is. Her finances, however, did not meet Spectrum’s standards. According to the hospital, Martin needed to show proof she could pay for the immunosuppressive drugs she will need to take for the remainder of her life to prevent her body from rejecting the transplanted heart. She couldn’t do that. In lieu of that, Spectrum suggested “a fundraising effort of $10,000.”
Martin and her family quickly publicized the letter, putting it up on Facebook and GoFundMe. It went viral — in 2018, many of us are still capable of being shocked by a medical practitioner bluntly admitting to prioritizing patients’ financial resources over their immediate medical needs. Within days, Martin had her money. Martin got lucky: Studies show few medical fundraising campaigns meet their goals.
There is something repellent about crowdfunding medical care — no matter how well intentioned, it encourages supplicants to market themselves or their loved ones, in a real life version of “Survivor.” GoFundMe and other sites like it also can’t fix the fact that in the United States we pay significantly more for the exact same medications as people do in other countries. The U.S. government — unlike almost every other first-world nation — does not negotiate with pharmaceutical companies to determine the price of prescription medications. An analysis published by Reuters this year found Americans can expect to pay three times as much for 20 bestselling drugs as British patients, and six times as much as Brazilians.
Moreover, we split the cost of medically needed drugs differently. Great Britain’s National Health Service, for example, offers low co-payments and broad exemptions — people over the age of 60 and cancer patients, for instance, pay nothing for NHS prescriptions. In the United States, on the other hand, Medicare and other insurance plans frequently leave their enrollees responsible for sometimes significant co-pays — the Detroit Free Press reports the Medicare plan Martin is on comes with a $4,500 annual deductible.
People can’t keep up with the costs. A survey released this past weekend by pharmaceutical price comparison site GoodRx, found 2 out of 5 Americans — almost all of whom possessed health-care coverage — said they found themselves financially stressed by the cost of their prescriptions. One of 3 said they have declined to fill a prescription because of the expense. For those without insurance, it’s worse. Last week there was a protest outside the Cambridge, Mass., offices of pharmaceutical company Sanofi, led by two women whose adult diabetic children died after they lost their health insurance and attempted to ration their insulin supply. The Boston Globe reported Sanofi “is one of three insulin manufacturers that in recent years have marked up prices by as much as 5,000 percent.”
No surprise, this is all roiling our politics — hence Trump’s pronouncement. To be fair, he’s not done nothing. On Monday, for instance, the Trump administration announced they would seek to change rules that force insurance companies offering Medicare Plus policies to cover all drugs for a number of specific diseases and medical conditions, including immunosuppressive drugs of the sort Spectrum claimed Martin couldn’t guarantee she could afford. The idea is that this would allow insurance companies to drive a harder bargain.
But the majority of Americans aren’t eligible for Medicare. For them, Trump’s bully pulpit jawboning is not up to the task. An Associated Press investigation of pharmaceutical costs found between January and July of this year, “there were 96 price hikes for every price cut.” Little wonder 70 percent of Americans say they support Medicare-for-all. The bill introduced by Sen. Bernie Sanders (I-Vt.) would allow the government to bargain with pharmaceutical companies for pricing, like in every other industrialized country, as well as an end to deductibles and co-pays. And, of course, that would eventually cover everyone, not just seniors.
Moreover, Sanders is not waiting around till Washington sees the light and agrees with the public. By complete coincidence, the same day Spectrum placed a dollar sign on Martin’s life, Sanders and Rep. Ro Khanna (D-Calif.) debuted legislation on pharmaceutical pricing. If the price of a patented drug was more than the median price of the drug in Germany, Canada, Japan, France and Britain, the federal government could immediately allow generic competition, despite the existence of a patent. This would no doubt be welcomed by people with organ transplants: according to a study published this summer in the American Journal of Transplantation, when generic substitutes debut for a branded immunosuppressive medicine, a majority of kidney, heart and liver transplant patients using Medicare Part D to pay their bills will switch over to it within a year.
None of this is mentioned in the letter Spectrum sent Martin. Why would it be? Spectrum clearly accepts the American medical system as it is and considers the money Martin will need to ensure her transplant doesn’t fail her problem and her problem alone. People who defend the U.S. health-care model like to insist the United States enjoys the best medical system in the world. But taking financial biopsies for granted hardly qualifies as groundbreaking, state-of-the-art care. If you are in any doubt about that fact, read the letter Spectrum sent to Hedda Martin.