- The Washington Times - Tuesday, October 24, 2000

One of the hottest issues in the presidential debates between Al Gore and George W. Bush is the high price of prescription drugs and the hardship this is causing for the nation's low-income elderly and disabled. Political momentum is building fast for some sort of government-sponsored solution. What few Americans understand is that such a solution may cause even greater hardship.
There is much talk of adding a prescription drug benefit to the Medicare program. Yet, numerous examples show what happens when the government controls health-care prices: Access to the most effective care and the best drug treatments is limited, resulting in worse care for the very people the policy is trying to help.
A prime example is the U.S. Veterans Affairs (VA) pharmacy benefit program. In order to control costs, the VA maintains a list of prescription drugs that doctors may prescribe. This list is called a formulary. The VA is slow to add new drugs to the formulary, keeping new drugs off its formulary for at least a year after they gain Food and Drug Administration (FDA) approval.
A recent report by the White House's National Economic Council identified 31 drugs most commonly used by elderly and disabled Medicare recipients. A comparison of this list against the VA formulary reveals that only 12 of those 31 drugs are available to VA patients. For example, Robert Goldberg of the Ethics and Public Policy Center notes: "VA patients with pancreatic cancer are not allowed to receive Gemzar, the newest drug for that disease, as a matter of course. They must 'fail' on other drugs first."
These types of formulary limitations may place the elderly at particular risk. Elderly patients tend to have more side effects and tend to react less predictably to certain drugs. If the momentum for adding a prescription drug benefit continues, about 38 million Medicare participants could be subjected to the kind of mistreatment being suffered by our veterans, and also by the citizens of Canada.
The Canadian government takes about seven months longer than the FDA to approve a drug. A recent study by the Canadian Medical Association Journal found that, despite improvements in recent years, the process remains considerably longer than the government's own performance target. The Canadian system of price controls also delays entry of pharmaceutical drugs into the country. In general, a new drug cannot be sold for an amount greater than the price for a similar drug treatment, even if it is more effective. For this reason, drug producers may choose not to sell their products in Canada.
In April of this year, Canada's National Post reported that, after years of bureaucratic delay, about 15,000 Canadian patients with an incurable form of non-Hodgkin's lymphoma finally got their first new weapon against the disease in nearly 15 years. The drug had been approved for use in the United States two years earlier. In 1999 alone, an estimated 2,500 Canadians died of the disease.
While more affluent Canadians are able to travel to purchase needed health care treatments and prescription drugs, low-income Canadians are forced to suffer under a government system that provides no options for better care and outlaws most private health care.
The most frightening aspect of the plans being proposed for America is that the most vulnerable populations the low-income elderly and disabled will face the greatest dangers under a government-controlled prescription drug benefit program. "In my own experience, a 64-year-old male patient had controlled peptic ulcers for more than five years when the [Canadian] government required that he be switched to an older, less effective drug," Dr. William McArthur wrote for the National Center for Policy Analysis last May. "Within three days, he required hospitalization and a lifesaving blood transfusion. After 10 days in the hospital and several more transfusions, he was discharged and placed on the same drug he had taken originally."
Allowing government bureaucrats, rather than doctors and their patients, to make important health care decisions jeopardizes the health of our nation's 38 million elderly and disabled citizens. Following the same, dangerous path as Canada and the U.S. government's own VA health-care program is a prescription for disaster that should not be imposed on our most vulnerable populations.

Naomi Lopez Bauman, author of a new study written for the Hispanic Business Research Center titled, "What Americans Should Know Before Letting Government Control Medicare's Medicine Cabinet," is a health-care specialist in San Francisco.

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