Crane On Negotiating Drug Prices

Melissa Bean’s newsletter came out and gave me a bit of attention to which I’m always appreciative.

The newsletter (not available for linkage, but you can sign up at her site to the right) pointed out high level of PAC money Crane is pulling in (not mentioning that his fundraising is quite lethargic for a veteran member of Ways and Means) and how much of it is coming from the drug companies.

Now, I don’t demonize drug companies–neither does Bean–but the most bizarre part of the Medicare drug benefit is supported by Crane. Crane backed the provision banning the federal government from negotiating for drug prices through the new Medicare program.

Why would it be bad to get a bulk discount? My drug coverage gets one–why shouldn’t the federal government?

Did the PAC money cause Crane to vote that way? I don’t know.

But think about which is worse:

That he really believes this was a good bill?

or

That he sold out?

8 thoughts on “Crane On Negotiating Drug Prices”
  1. One of my brief forays into active politicking, back when I lived in Illinois, was to help get Phil’s even more dimwitted brother Dan out of my district over around Vermilion County. There was a third Crane, I think he was based in Indiana, but for a term or so they held some kind of record for being the only three brothers ever in Congress at the same time.

    We only managed to get shut of Dan when he got caught (1) paying off a sports bet to a Congressional page with a six-pack of beer (the page was underage) and then (2) having an Inappropriate Relationship with her while his wife was back home in Danville bearing his 17th or so child.

    The tale of all these children of Dr. George Crane, longtime medical/relationship advice columnist for the Indianapolis Star, is a fascinating one in a sick sort of way. Somebody with a strong stomach should do a biography of the clan.

  2. I actually can address why and some of the history behind the federal govt. negotiating prices w/pharmaceutical companes. But, please keep in mind this is a limited answer to a complex issue.

    1. The history: On the history front. This was not a controversial issue until the MMA was being debated. In a number variations of prescription drug bills sponsored by Democrats in the past, the same language preventing the govt. from negotiating discounts was included. Among the people to support this was Sen. Dick Durbin and a lot of other pretty liberal members. I might actually have a document on that, should you request it.

    2. Why it is not wise: Mark McClellan has stated the federal government doesn’t negotiatie prices. They fix them. The federal government would be negotiating for about 30 million customers. The largest private provider of prescription drugs negotiates for about 70 million and second largest — I believe — is 60 million people. They obviously have more purchasing power than the federal govt., but the federal govt. would undoubtly use its sovereign power to browbeat the drug companies into submission.

    The other companies would demand the same deal the feds get. That would mean defacto price caps on drugs.

    Today, the system basically works like this. For Medicaid, the states pay the average wholesale price, negotiated via market forces by the big PBM and HMO’s, and then gets a 15% discount. Some states, such as IL, have then passed supplemental rebates to get even more money back from drug makers. So, in this example, at least IL is getting a pretty good deal.

    Does this makes sense?

  3. I’m so relieved that there is a candidate out there that is not as absurd as Rep. Crane. He has totally lost touch with his district. I’ve met him and he won’t even answer questions directly. He doesn’t make eye contact and side-steps the issues.

    On the other hand, Melissa Bean, looks you straight in the eye and answers your questions before she knows how you feel so you know you’re getting a straight answer. Then she asks for your position and is willing to listen. What a wonder breath of fresh air. We really need this woman.

    Even though I’m finally working again after 1 1/2 years (because so many of the high tech jobs have left the country due to Crane’s vote) I still can’t afford all my medication. Something must be done and not just for the folks who have no money. There are many of us who have insurance and are paying dearly for it who can’t afford the extremely high deductibles that are required. If the cost of medication/insurance would go down it would make it easier to get the necessary items.

    I truly believe that Ms. Bean will help with this issue.

  4. As usual, Greg, we disagree. I’m not going to defend other decisions such as Durbins–in fact, the other day is one of the few times I really cited him.

    But my point would be that in some circumstances the federal government could be setting prices, but in this case, there are larger buyers. I just don’t see how the government could be the bad guy–in the long run this is a free trade issue and I’d rather see different mechanisms than introduced in the bill at all–that part of the bill is a problem in this context to me.

  5. AP, I’m just trying to give you some background on what the actors on this are saying. In the best sense of political science, I’m trying to give you the legislative history and rationale behind the decision in and objective fashion w/out taking a position.

    I remember seeing Durbin’s name in a handout. There were a lot of other including Schumer and Kennedy (well, I’m at least sure about Kennedy). I pointed out the dem. support to suggest the complaints had more to do with small “p” politics (whose Bill would be better) than some grand principle.

    In a way this system sounds as if it makes some sense. Govts. make their purchases based on the average whole sale price minus 15% (AWP-15%). Supplemental rebates drive govt. costs down even farther. Govt. gets steep discounts w/out setting prices. Any taxpayer has to like that. The bad news is that those of us who don’t have a PBM pay more.

    Does any of this make sense to you? Trigg is probably beating his head against a wall…

  6. And I appreciate it Greg–really. And I take your point about the politics of it and understand what you are saying. I wasn’t trying to be combative, as much as saying while I understand the argument, I doesn’t sway me. In terms of Crane, you can make that defense, but I’m still going to make fun oh him.

    Jeff can make fun of us all….

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