Maligning pharmaceutical enterprises is a curious perennial dance, one that becomes even more active during presidential campaign seasons. That always struck me as odd, since it seems a sign of societal advance that we can complain about the price of something that saves lives and improves living conditions rather than lamenting its nonexistence.
Regardless, the U.S. Chamber of Commerce’s Global Intellectual Property Center (GIPC) offers an instructive corrective entitled “4 Charts Explain the Economics of Drug Development.” It is worth the brief examination and passing on to others, because it helps rebut many of the politicized myths that threaten the goose that lays the golden eggs:
“It’s not just the science that goes in to developing medicines that’s complicated. The economics that drive the industry, allowing resources to be available so people can have access to beneficial new medicines is complicated, too.”
Each chart is worth 1,000 words, but the four broad takeaways are: (1) It takes ten years and $2.6 billion to bring a single drug to market; (2) In 2014, pharmaceutical companies spent $51.2 billion on research & development; (3) Only a few drugs, however, become commercial successes; and (4) The end result is that pharmaceuticals’ enormous investments result in people living longer and better lives.
Something to keep in mind as sometimes silly presidential campaigns get even sillier, at least in terms of maligning the innovative pharmaceutical industry.
When even The New York Timesissues lamentations as the consequences of ObamaCare become more clear, it’s obvious that things aren’t going well:
Health spending grew faster than the economy in 2014, and the federal share of health spending grew even faster, as major provisions of the Affordable Care Act took effect. Total spending on health care increased 5.3 percent last year, the biggest jump since 2007, and accounted for 17.5 percent of the nation’s economic output, up from 17.3 percent in 2013, the Department of Health and Human Services said in its annual report on spending trends.”
But not to worry. The Obama Administration assures us that things are fine:
The spending report comes as the Obama administration is already on the defensive over rising premiums and deductibles on insurance policies sold through the health law’s exchanges. Last month, United Health Group, one of the nation’s largest health insurance companies, significantly lowered its profit estimates and blamed the federal health care law. Obama Administration officials said Wednesday that the rise in health spending last year did not undermine their conviction that the Affordable Care Act had been a boon for the nation.”
Of course, this is the same administration that assured us just hours before the Paris terrorist attacks that ISIS is contained, not to mention that “if you like your doctor, you can keep your doctor, period.” Per Nancy Pelosi’s claim, we’re finding out what’s in ObamaCare, and the only question is whether this or the Iran nuclear accord – which we’re now told Iran didn’t even sign – will prove the worse of Obama’s two signature “achievements” as time progresses.
As ObamaCare enters the real world and departs Barack Obama’s “If you like your doctor, you can keep your doctor” fantasy world, it is already proving a slow-motion disaster for Americans. This week, The Wall Street Journal featured a front-page article entitled “Rising Rates Pose Challenge for Health Law,” and the news is grim:
Insurers have raised premiums steeply for the most popular plans at the same time they have boosted out-of-pocket costs such as deductibles, copays and coinsurance in many of their offerings. The companies attribute the moves in part to the high cost of some customers they are gaining under the law, which doesn’t allow them to bar clients with existing health conditions. The result is that many people can’t avoid paying more for insurance in 2016 simply by shopping around – and those who try risk landing in a plan with fewer doctors and skimpier coverage.”
The report proceeds to describe the magnitude with greater specificity, and it is astonishing:
Premiums for individual plans offered by the dominant local insurers are rising almost everywhere for 2016, typically by double-digit percentage increases, according to a Wall Street Journal analysis of plan data in 34 states where the Healthcare.gov site sells insurance. More than half of the midrange ’silver’ plans are boosting the out-of-pocket costs enrollees must pay, while more than 80% of the less-expensive ‘bronze’ plans are doing so.”
Meanwhile, a new Gallup survey released this week shows that the percentage of Americans rating their healthcare quality as excellent or good has plummeted from 62% in 2010 when ObamaCare was enacted to 53% now. The survey also reveals that the percentage who are satisfied with healthcare costs has actually declined from 26% in 2009 to 21% today.
As experience with ObamaCare increases with implementation, the situation promises to get worse by the day. Obama, Harry Reid and Nancy Pelosi passed, now we’re staring at the reality of what was in it.
For some time now, Barack Obama and his apologists have trumpeted slowing healthcare costs as somehow attributable to ObamaCare. Never mind that the declines predated Obama’s election, and that even The Washington Post gave him three Pinocchios in its Fact Checker analysis of this claim on November 5 of last year:
Healthcare inflation has gone down every single year since the law [ObamaCare] passed, so that we now have the lowest increase in healthcare costs in 50 years – which is saving us about $180 billion in reduced overall costs to the federal government and in the Medicare program.”
To illustrate how he played the role of rooster taking credit for the sunrise, healthcare cost inflation reached 7% in 2003, but plummeted to approximately 2% before Obama even took office.
Growth in national health spending, which had dropped to historic lows in recent years, has snapped back and is set to continue at a faster pace over the next decade, federal actuaries said Tuesday… The jump comes after five consecutive years of average spending growth of less than 4% annually – a rate touted by the Obama Administration as the lowest since the government began tracking health spending in the 1960s and a sign that the health law’s Medicare provisions were helping rein in health costs.”
Chalk up yet another failure of ObamaCare, which helps explain why it remains so unpopular among Americans as we “find out what’s in it” in the words of Nancy Pelosi.
Adding to the parade of horribles attending the Obamacare rollout that Ashton mentions below is this fact: the websites are inconvenient to consumers because — unlike virtually any other e-commerce transaction — you have to build an account and start submitting personal information before you are so much as allowed to browse your possible options. Reporting in the Washington Examiner, Philip Klein notes that this isn’t a design flaw; it’s an intentional barrier to sticker shock:
As originally envisioned, Healthcare.gov (which serves the residents of 36 states) was supposed to enable individuals to shop for health insurance starting Oct. 1, 2013, just as they would shop for airline tickets on Orbitz.
But unlike Orbitz, Healthcare.gov makes consumers seeking information on their available choices go through a multi-step process to create an account and then log in and enter personal information.
Administration officials imposed these extra steps because they didn’t want consumers to see the base price of the health insurance plans offered – which are inflated by new regulations – before the system could collect their income data and calculate what they’d pay in premiums after receiving government subsidies.
For a program that’s supposedly so benevolent, it’s interesting how often getting the public to accept Obamacare either requires legal compulsion or outright evasion.
On the heels of Homer’s nod to Quin below, George Will chimes in on yesterday’s Supreme Court ObamaCare decision with a nod to my broader point. Namely, that the Court’s commerce clause ruling constitutes a significant new precedent in constitutional jurisprudence. Entitled “Conservatives’ Long-Term Victory,” Will laments that ObamaCare’s individual mandate managed to survive, but asserts that conservatives won a “substantial victory”:
By persuading the court to reject a Commerce Clause rationale for a president’s signature act, the conservative legal insurgency against Obamacare has won a huge victory for the long haul. This victory will help revive a venerable tradition of America’s political culture, that of viewing congressional actions with a skeptical constitutional squint, searching for congruence with the Constitution’s architecture of enumerated powers. By rejecting the Commerce Clause rationale, Thursday’s decision reaffirmed the Constitution’s foundational premise: Enumerated powers are necessarily limited because, as Chief Justice John Marshall said, ‘the enumeration presupposes something not enumerated.’”
Ultimately, Will notes, ObamaCare’s fate “rests on public opinion.” Nevertheless, we are in agreement that yesterday’s lasting achievements should not be overlooked or minimized by understandably disappointed conservatives and libertarians.
Reuters explains how a new Health and Human Services regulation announced today on the state-directed health insurance exchanges lays the groundwork for a total government takeover of the healthcare industry.
In a 642-page final rule, the government provides guidance on how states should establish exchanges, qualify health plans for participation and determine the eligibility of both individuals and small businesses that want to use exchanges to provide health coverage to their employees.
Industry and consumer groups welcomed the regulations, saying they provided states with the flexibility necessary to meet consumer needs for choice and quality protections. They also said the regulations shift policy focus to the state level, where the new rules must be implemented.
That is, until States drown in a sea of future regulations interpreting and implementing this “final” rule. At that point, States will be happy to cede control over policy details to federal bureaucrats so long as the money keeps flowing.
As an example, just look at the rush by States to accept extra-legal requirements like the Common Core curriculum standards from the Department of Education in exchange for No Child Left Behind waivers. Implementation of ObamaCare will be no different. Unless the law is repealed, elements like health care exchanges and IPAB will eventually turn over all healthcare decisions to central planners; first in state capitols, then in Washington, D.C.
Remember the line that President Obama used so often to soothe the anxieties of Americans worried about healthcare reform? “If you like your health insurance, you can keep it”? Well, things have gotten a litte more complicated since those earlier, more innocent days. Just ask Joel Ario, the HHS bureaucrat charged with overseeing Obamacare’s health insurance exchanges. According to The Hill’s Healthwatch Blog:
“If it plays out the exchanges work pretty well, then the employer can say ‘This is a great thing. I can now dump my people into the exchange and it would be good for them, good for me,’ ” Ario continued.
A kindly reminder from those of us not serving in the Obama healthcare politburo. If, like the majority of Americans, your employer provides your healthcare, you don’t get to choose whether or not you keep your current healthcare. And the government is putting its hand on the scales.
While House Republicans are planning on bringing the repeal of Obamacare to a vote next week, even the staunchest opponents of the healthcare law admit that a fullblown reversal isn’t coming anytime soon.
With that in mind, healthcare analyst Avik Roy lays out the practical implications for conservatives in a piece on National Review Online. Roy is sagacious across the board, but his delineation of the consequences for the 2012 presidential election are especially pertinent — and jarring:
We must remind ourselves of the electoral realities. For Republicans to succeed in repealing the Patient Protection and Affordable Care Act (PPACA), they will need to control the House, the Senate, and the White House. From a political standpoint, if Republicans are not able to achieve this in 2012, they are unlikely ever to repeal Obamacare.
This means that influential Republican activists must — must — coalesce around the most electable Republican presidential candidate who can articulate conservative health-care principles. This is no time for single-issue small-ball or personal score-settling. A GOP nominee who passes all the litmus tests but can’t win in November would only succeed in making Obamacare permanent. One who can win but isn’t capable of pushing for real health-care reform wouldn’t be much better.
Roy is right. Who the Republican nominee is in 2012 could well determine how free of a nation the United States is for the forseeable future. Vote accordingly.
As usual, Jay Cost has an eyebrow raising piece of analysis – today discussing in Technicolor detail how President Barack Obama’s narrow geographic popularity foretold of a need to govern from the center of the country; not the center of his party.
What he should have done instead was disarm his opponents. If he had built initial policy proposals from the middle, he could have wooed the moderate flank of the Republican party, marginalized the conservatives, and alleviated the concerns of those gettable voters in the South and the Midwest. This is precisely what Bill Clinton did between 1995 and 2000, and it is what the President’s promises of “post-partisanship” suggested.
Our system of government can only produce policy when geographically broad coalitions favor it. The Senate, more than any other institution, forces such breadth. Obama created breadth the wrong way. He watered down initially liberal legislation to prompt just enough moderate Democrats to sign on. Instead, he should have built policy from the center, then worked to pick up enough votes on either side. The left would have been disappointed, but the right would have been marginalized and, most importantly, Independent voters – who have abandoned the President in droves – might still be on board.
One of the great ironies of liberal politicians is that they so often discount the yen of conservative intellectuals to participate in policy making. People like Rep. Paul Ryan (R-WI) and former House Speaker Newt Gingrich (R-GA) are driven by ideas, and enjoy the process of fashioning policies that get as many of them enacted as possible.
But they are not necessarily “my-way-or-the-highway” types. Ryan’s Roadmap for America’s Future is a multi-decade plan for balancing the budget. Implicit in its longevity is Ryan’s willingness to work out compromises that preserve Social Security and Medicare while making them fiscally sound. For his part, Gingrich has always been the kind of politician willing to hammer out solutions with the other side, as he attempted to do with Bill Clinton.
People wonder why we don’t have bipartisan breakthroughs anymore. In part, it’s because politicians like Barack Obama don’t have the political sense to “spread the success around” turning their adversaries into cooperators.
Every once in a while, there is an article so good, it’s almost an injustice to splice any part of it for fear a reader won’t take the hyperlink and read the whole thing. Thankfully, Freedom Line Blog readers aren’t those types, but just to whet the appetite, here is a sample from an op-ed dissecting why government can never “reform” healthcare pricing.
Healthcare prices are fake, inflexible, and inflated because they are set not by the repeated interactions of buyers and sellers but by opaque acts of collusion between government bureaucrats and special interests. Even if this system were run by a benevolent genius who happened to set prices exactly “right” – whatever that means – these prices would be obsolete the moment they were published.
I don’t know the author, Bill Frezza, but I wish I did. A hat tip to you, Sir.