- Associated Press - Saturday, February 14, 2015

DENVER (AP) - By her own admission, the online video that Congresswoman Diana DeGette released last year with fellow lawmaker Fred Upton is “kind of hokey.”

The soundtrack is pure infomercial, and the overarching message is just as sunny: that a Republican (Upton) and a Democrat (DeGette) actually want to work together and improve the way the U.S. fights disease.

“Fred and I don’t agree on everything, but we do agree on this: America can be - it must be - the health care innovation capital of the world,” said DeGette, of Denver.

Their primary goal, they said, is nothing less than reducing the time it takes to get breakthrough drugs from the laboratory and into the hands of needy patients.

“Our efforts for 21st-century cures is now under way,” said Upton, of Michigan.

Without question, it’s an ambitious undertaking.

Since the video’s release last spring, the two lawmakers and their allies have held eight hearings, hosted about 20 round table discussions and accepted more than 100 issue papers from the medical community.

But now - with their policy experts getting down to the painstaking work of actually writing the legislation - it remains an open question whether the promise of their collaboration actually has a chance of becoming law.

Not only does the proposal face the usual array of political obstacles, but reforming medical research means negotiating with dozens of well-funded special-interest groups - each with a separate, and often conflicting, agenda.

It’s enough of a challenge that DeGette described her effort with Upton as a harbinger of whether the newly elected 114th Congress can turn Capitol Hill into a functioning legislature again.

One sign that the initiative has a shot is its deliberate exclusion of policies related to the Affordable Care Act - a.k.a. “Obamacare” - which observers said would be the fastest way to kill it.

But the journey hasn’t been a hug-fest either.

Last month, Upton released a 393-page ” discussion document” that sought to condense the pair’s research into a workable rough draft of the legislation.

Though not critical of the document, DeGette nonetheless has withheld support.

“I didn’t want to give the misimpression to the outside world that this was something that I actually approved of every little thing,” DeGette said.

However, she quickly added that she was committed to passing the bill - and that her staff has continued to meet with Upton’s team to hammer out the language.

“Fred understands, and I understand, that if we don’t have each other, then you can’t pass the bill,” she said.

The small impasse, however, speaks to the fragility of trying to guide a complex piece of legislation through Congress - even on an issue as universally supported as fighting disease.

The most obvious barrier is the hyper-partisanship that has paralyzed Congress in recent years.

Though DeGette was diplomatic in her response to Upton’s draft, fellow Democrat Frank Pallone of New Jersey skewered the document - saying it would “create more problems for our health care system than it solves.”

But DeGette said she’s heard worse.

“There are other people on my side of my aisle who say ‘Why would you give (Republicans) a win?’ ” DeGette said.

This political pressure, however, speaks to the reason why Upton released a draft of the bill in the first month of the new Congress.

With the coming 2016 election - and a host of other controversial issues in the wings - any major legislative effort must show “proof of life” before this fall.

“If you’re thinking of getting anything done, you almost have to do it in the first five or six months of the current Congress. I think he (Upton) was trying to take advantage of that,” said David Moore, a lobbyist for the Association of American Medical Colleges.

Another potential obstacle is a basic philosophical disagreement between Democrats and Republicans on how to spur innovation.

Is it more effective to reduce regulatory requirements on drug companies and medical researchers? Or should lawmakers increase the funding of the U.S. Food and Drug Administration and the National Institutes of Health?

The DeGette-Upton initiative seeks to do some of both, but the specifics of that balancing act could prove troubling. Already, Pallone has complained that the effort does not “include any real dollars to fund additional basic research” at NIH.

But if Upton and DeGette were to steer more money toward NIH, it could invite opposition from Tea Party conservatives.

To underscore the tension, a draft of the bill mentions new NIH funding but does not cite a specific dollar figure, according to aides.

Also included: one initiative that would make it easier for medical researchers to share data, and another provision that would create new incentives for drug companies to develop cures for “complex diseases” such as Alzheimer’s.

For his part, Upton has remained positive.

“Diana and I are still meeting with patients and experts, seeking feedback as we continue working together on legislative language,” he said. “We both look forward to being able to say at the end of the year that, together, we got the job done.”

Yet even success has its pitfalls. With so few bills moving through Congress nowadays, a measure that shows some promise of passage has the potential of becoming a magnet for every lawmaker’s pet project.

“There’s a risk that a lot of special interests will jump on the only moving (legislative) vehicle and slip in a lot of riders,” said Nandini Gopinadh, a policy analyst with the Alliance for Natural Health USA. “We have to be really watchful of this legislation …. that’s the danger with bills that are this dense.”

In particular, her organization has raised concerns that the effort ultimately could become a “gift” to the brand names of the pharmaceutical industry.

The fears are not without merit.

Among all U.S. industries, the biggest donors to DeGette and Upton in the last two years have come from the pharmaceutical and health field, according to the Center of Responsive Politics, a nonpartisan campaign watchdog.

These donations totaled more than $216,000 for DeGette and about $622,000 for Upton, who chairs the House Energy and Commerce Committee.

Asked about the contributions, DeGette simply said that “just because they gave me a campaign check doesn’t mean they have my vote.”

Amanda Jezek, a lobbyist with the Infectious Diseases Society of America, cited one section of the draft as proof that Upton and DeGette were trying to spur the pharmaceutical industry without giving away too much.

That provision tries to prod the pharmaceutical industry into developing new antibiotics. Because these medications are not as profitable as so-called “designer drugs,” the bill would allow pharmaceutical companies to find their profits another way. In exchange of developing the antibiotics, pharmaceutical companies could transfer the exclusive rights for that drug to another, more profitable medication - a nice payday for the industry.

However, as a safeguard, the companies also would be required to make a donation to the NIH.

“There is definitely a strong interest from the committee to try to strike the right balance,” Jezek said.

One expert who helped inform the bill in its early stages was Dr. Dan Theodorescu, director of the University of Colorado Cancer Center at the Anschutz Medical Campus.

He spoke at one of the roundtables last year and spoke highly of the bill’s push to develop a clearinghouse for medical data that researchers nationwide could access.

“The richness and the power of this (database), when we have millions of patients (in it), would be huge,” he said.

“I really firmly believe that the country that gets a grasp on bio-medicine is going to be the country that leads the world in science over the next 50 to 100 years,” he said.

___

Information from: The Denver Post, https://www.denverpost.com

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