- The Washington Times - Friday, February 27, 2009

President Obama’s 2010 budget proposal introduced Thursday reopens some long-standing health care debates, including a plan to legalize the importation of foreign-made drugs and increased spending for a government-sponsored program designed to flag ineffective medical treatments.

Corrected:The administration’s $634 billion budget proposal for the Health and Human Services Department (HHS) includes a provision that “supports the Food and Drug Administration’s (FDA) new efforts to allow Americans to buy safe and effective drugs from other countries.” Democrats say the practice would lead to lower prescription drug prices, but most Republicans and drug manufacturers decry such action, saying it would be impossible to ensure the safety of pharmaceuticals made outside the United States.

It’s illegal to by most prescription drugs from other countries and bring them into the United States, where drug prices are among the most expensive in the world. But the law is rarely enforced, as thousands of Americans annually purchase pharmaceuticals from Canada, Europe and other countries.

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The vaguely worded budget proposal offers no details on how a drug-importation program would work. The administration calls for a “substantial increase” in the budget to strengthen the FDA’s food and medicine safety inspection efforts.

The president’s budget also calls for increased funding for the government’s so-called “comparative effectiveness research” program, which sifts through millions of patient medical records to determine which medicines and treatments work best. The information then is made available to doctors and patients.

Republicans and other critics of the program worry that such research could create a standardized “one-size-fits-all” approach in which patients would be denied treatment options. Drug companies also fear it would lead to the FDA ranking the effectiveness of drugs and banning those at the bottom of the list.

But Democrats say that such research is needed to ensure that doctors have access to the latest medical data on what treatments and therapies work best. They add that industry has no incentive to pull underperforming drugs from the market.

What shape these provisions eventually take in the final budget draft - or whether they’re included at all - is far from certain.

“The point of this in the budget is to make a statement that the president is willing to commit a lot of resources to this,” said Len Nichols, director of health policy that the New America Foundation, a nonpartisan Washington think tank. “This is the president’s opening gambit in a process that is a long and winding road.”

Despite the seemingly hefty $634 billion price tag, the administration will need more money to fully implement all of its health care reform plans.

“At an annual rate, this is not excessively large, and it comes in slowly” during the first few years, said Henry J. Aaron, a health care expert with the Brookings Institution, a Washington think tank. The administration “is going to tell Congress, ‘don’t try to go for excessively far-reaching modifications (to health care reform); plan prudently and move deliberately’ - and I think that’s exactly the right thing to do.”

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