The Washington PostDemocracy Dies in Darkness

Democrats’ ‘missed opportunity’ to talk about drug prices

From left, Sen. Michael Bennet, Sen. Kirsten Gillibrand, former HUD Secretary Julian Castro, Sen. Cory Booker,  and former Vice President Joe Biden before the second of two Democratic presidential debates.
From left, Sen. Michael Bennet, Sen. Kirsten Gillibrand, former HUD Secretary Julian Castro, Sen. Cory Booker, and former Vice President Joe Biden before the second of two Democratic presidential debates. (Carlos Osorio/AP)

The soaring cost of prescription drugs is among voters’ greatest concerns, but the issue drew little attention from the Democratic candidates during this week’s presidential debates.

The low wattage trained on the issue during nearly six hours of debate Tuesday and Wednesday contrasts with the attention President Trump and his top aides are showering on the issue. That partisan gap poses risks for Democrats who might forfeit the advantage they have long held when voters are asked which party they trust to fix health-care problems, according to health policy analysts and pollsters.

“I was pretty darn flabbergasted . . . that none of them brought up prescription drugs,” said Celinda Lake, a veteran Democratic pollster. “It was a missed opportunity . . . It’s such a hot issue. It is the number one health-care issue voters think Democrats are better on. Trump is trying take it away from us. He gets it.”

Fewer than half the 20 Democratic candidates mentioned drug costs during the two nights of televised debates. Those who broached the issue did so in passing, and fewer still talked about what they would do to make medicine more affordable.

“There is such a disconnect between what the polling shows voters want, and where the debate is,” said Dan Mendelson, founder of Avalere Health, a Washington-based consulting firm.

Polls show that the American public wants the government to improve health care more than any other issue. And in one survey late last year by the Harvard School of Public Health and Politico, respondents were asked to choose the aspects of health care they considered extremely important for the government to address. Lowering prescription drug prices was listed by 92 percent of those surveyed — more than any other issue.

In last year’s midterm elections, Democratic gains that gave the party the House majority are widely attributed to their portrayals of Republican opponents as trying to take away Americans’ health care. Through much of 2017, the GOP-led Congress tried and failed to repeal large segments of the Affordable Care Act.

Now, the White House is attempting to reframe the narrative to portray Trump as working hardest on behalf of Americans having trouble affording the health care they need.

On Wednesday, the administration revealed the outlines of a plan that could eventually allow certain drugs to be imported from Canada and, perhaps, other countries where they are sold at lower prices. Health and Human Services Secretary Alex Azar called importation, an idea long opposed by many Republicans, “an important piece of a much broader vision President Trump is delivering on drug pricing

That day’s edition of a news summary produced by the White House carried the headline, “The left complains about high drug prices. President Trump is actually fixing it.” Last month, Azar and Joe Grogan, director of the White House’s Domestic Policy Council co-wrote an op-ed published in the New York Post under the headline, “How Team Trump is keeping drug prices down.”

The Democratic candidates “are so off with where the voters are, and the administration is so on with where the voters are,” said Mendelson, who worked in the White House Office of Management and Budget under former president Bill Clinton.

Watching the debates, he said, “I was sitting there beating my couch.”

Lake said the debate’s format, limiting answers to one minute or less with moderators focused on drawing out differences among the candidates, may have blunted talk of lowering drug prices — an issue on which the Democrats’ positions do not vary significantly.

She also said that “Democrats have under-talked about the prescription drug issue for a long time.”

Lake said proponents of far-reaching Medicare-for-all plans and advocates of more moderate options both stand to gain from talking about how to make drugs more affordable. “And it’s really a big miss if you’re thinking about the general election,” she said, with Trump already stressing the issue.

This week, as nearly half the debate participants briefly mentioned drug costs, they often projected empathy for consumers but did not offer a remedy.

“Ask the American people,” New York Mayor Bill de Blasio said. “They are sick of what the pharmaceutical companies are doing to them.” He then pivoted to a broadside against health insurers.

South Bend, Ind., Mayor Pete Buttigieg mentioned drug costs at the end of a list of ways that he said the current president “thinks you are a sucker” because Americans’ paychecks are not increasing as fast as their costs.

Sen. Mike Bennet (Colo.) and Montana Gov. Steve Bullock each briefly invoked a long-standing party position that the government should negotiate Medicare drug prices. And Sen. Bernie Sanders (Vt.) repeated his demonization of the pharmaceutical industry, with a call to “get rid of the profiteering of the drug companies.”

Former Vice President Joe Biden said that his health plan, which largely expands upon the Affordable Care Act, “calls for controlling drug prices,” saying the government would set prices for certain new drugs and then limit increases to the rate of inflation. It was the most detailed explanation of the two nights.

Once considered a far-left idea, ‘public option’ insurance swerves into the mainstream

Voters have big health-care worries, but not the ones Democrats are talking about

Why Vermont’s single-payer effort failed and what Democrats can learn from it