While the battle continues over a "patient bill of rights" and the odd notion that basic protections will bankrupt the health-care system, there is another thing Congress could do to stem spiraling costs.
With HMOs here and elsewhere blaming ever-rising drug costs for looming premium hikes, Congress could level the pill-popping playing field. It could do that by giving U.S. consumers a shot at buying medicine at the same cut-rate prices that the drugs sell for in Canada, Mexico and other countries.
The little-noticed International Prescription Drug Parity Act would accomplish that. It would amend a 1988 law that generally bars U.S. distributors and pharmacists from reimporting drugs that were made here but then sold in foreign countries.
Why would that cut costs for American patients?
Because of the outrageous price differences between some drugs sold to U.S. consumers and the very same drugs sold in foreign countries. Congressional sponsors point to several studies over the past decade that consistently show Americans -- and particularly senior citizens, some 35 percent of whom get no drug coverage under Medicare -- paying through the nose to heal the rest of the body.
Spending for prescription drugs here continues to skyrocket, jumping a whopping 13.2 percent in 1996, 14.1 percent in 1997 and 15.7 percent last year. The industry says most of that was attributable to more use of drugs as substitutes for medical procedures, and there is some truth to that.
But a lot of it also is because Americans, after being hooked by drug company ad blitzes, are then being gouged on the prices. One study showed U.S. patients paying 58 percent more than patients in Britain for the heartburn healer Zantac, and 278 percent more for the anti-anxiety drug Xanax. Another showed that for every dollar U.S. senior citizens pay for prescriptions, the elderly pay only 64 cents in Canada, 57 cents in France and 51 cents in Italy.
The prescription drug kingpins don't dispute the price differences. Instead, they try to explain them away, saying that drugs sell cheaply in developing countries because wages and living standards are low. In other industrialized nations, the industry points to government price controls that don't take into account the "high and growing costs" of research and development.
But in either case, U.S. consumers are paying more than patients elsewhere for the same medicines. And those prescription-drug expenditures are the fastest growing component in rising U.S. health-care costs.
The Drug Parity Act would combat that by letting pharmacies and wholesalers buy U.S. drugs being sold cheaply in other countries and reimport them for sale in the United States at those cheaper prices. A 1988 law currently bars that practice, and the pharmaceutical industry cites the prospect of counterfeit or outdated drugs in condemning a proposal that, just coincidentally, would cut into the industry's enormous profits.
But backers note that the Food and Drug Administration already has procedures in place for assuring the quality of drugs made elsewhere and imported here. Those same processes could assure the safety of American-made drugs reimported after being shipped overseas. After all, the bill would allow reimportation only of drugs approved by the FDA and manufactured in FDA-approved facilities.
"Why is the risk of importing counterfeit drugs any greater than in any other circumstance?" asks Dr. Peter Lurie, medical researcher of the advocacy group Public Citizen, which backs the legislation.
In fact, Lurie says, because the reimported drugs would have originated in the United States, one could argue that they would actually be safer than imported drugs originally made elsewhere but currently allowed in.
The legislation -- pushed in the House by Democrat Marion Berry, Independent Bernie Sanders and Republican Jo Ann Emerson -- has also been introduced in the Senate but hasn't had a hearing yet. When it does, expect the industry -- known for both its profits and its campaign contributions -- to squawk like a kid facing castor oil.
Drug-makers will cite the fact that they reinvest 21 percent of revenues in research and development -- ignoring all of the money they lavish on advertising and lobbying -- and that only one drug in five actually makes it to the market. They also cry that health plans are starting to put the budgetary squeeze on them.
But none of that should obscure the simple fact that Americans pay far more than others for popular drugs. The Drug Parity Act could cut those outrageous costs -- if Congress can get itself out from under the grip of drug-industry lobbyists long enough to pass it.
U.S. consumers deserve a shot at the best possible prices for medicine. They shouldn't have to subsidize an industry that treats them like both cash cows and second-class patients.