The high cost of prescription drugs has become one of the top political issues this year - candidate after candidate has expressed outrage over senior citizens forced to choose between buying food and buying medicine. It's a key issue In Minnesota's U.S. Senate race, with all of the major DFL candidates and Republican Senator Rod Grams calling for changes to make prescription drugs more affordable for seniors.
Prescription for Change
This report is the second of two parts in MPR's series Prescription for Change.
DEMOCRAT MARK DAYTON
was the first to use a publicity stunt to highlight the issue, when he started taking bus tours of seniors up to Canada to buy cheaper prescription drugs.
"I'm happy to be doing it for the benefit of these seniors in terms of what they can save - hundreds of dollars on prescription medicines - and to make a political statement how disgraceful it is that any of us have to go to a foreign country to get prescription medicines at reasonable prices," Dayton said.
The former state auditor had hit on what's become one of the most important issues for Minnesota's growing senior population, and one that may drive them to the polls this fall. The potential benefits for Dayton were clear, as many of the seniors who boarded the bus - including 69-year-old Eileen Lauer of St. Cloud - seemed genuinely grateful that Dayton was bringing attention to the issue, and sponsoring the bus trips.
"Well, that's very, very nice of him, I certainly say so, because I didn't think there was too many people around here that would do that, you know," Lauer said.
Less than a week after Dayton started his so-called "Rx Express", DFLer Rebecca Yanisch held a news conference at a St. Paul pharmacy to call for opening up the U.S. prescription drug market. Yanisch says seniors wouldn't have to travel to Canada to buy cheaper drugs, if the law were changed to allow doctors, pharmacists and wholesalers to buy and import FDA approved drugs in bulk from other countries.
"It's about competition, it's about free markets, it's about efficiencies, you know, let's make sure that anyone in the United States has access to the best price wherever that may be," Yanisch said.
The Minneapolis businesswoman has made the cost of prescription drugs one of her top campaign issues, and has the most detailed proposal of the DFL candidates running in the September primary. Yanisch says seniors who don't have drug coverage should form drug-buying cooperatives. She supports a law prohibiting drug companies that get government subsidies for research and development from charging higher prices in the U.S. than in other countries. Yanisch and the other three major DFL candidates - Dayton, trial attorney Mike Ciresi and state Senator Jerry Janezich - want to add a prescription drug benefit to Medicare. That's the one area in which Republican Senator Rod Grams agrees with the Democrats in the race. He's introduced legislation for a Medicare drug benefit called MEDS, short for Medicare Ensuring Prescription Drugs for Seniors. Under Grams' plan, seniors with incomes below about $12,000 a year - or couples with incomes of about $15,000 - could get prescription drugs for a 25 percent co-pay. Seniors with incomes above that would pay a monthly deductible of $150, plus a 25 percent co-pay.
"We help those who need the help the most, but we don't subsidize a prescription drug program for the rich in this country. I don't think that's what taxpayers want to do," Grams said.
By supporting a Medicare drug benefit, Grams differs from many of his Republican Senate colleagues, who want to subsidize drug coverage through the private sector. But Grams - who accepted a little more than $9,000 from the pharmaceutical industry in the last year - joins many Republicans in opposing a law that would prohibit pharmaceutical makers from charging more in the U.S. than they do in other countries.
"That's price control. That's price fixing. And you know, Moscow tried that. The Soviet Union tried it, and their system failed. So would I go out there and impose price controls on an industry? Now, if you can do it on medicine, can you do it on any other? So what they're proposing is, again, more government control, government take-over of an industry," Grams said.
The two Democrats who support the idea - Mike Ciresi and Mark Dayton - avoid the term price control. Dayton says the federal government has to step in to stop what he calls price gouging.
"We're talking about price ceilings rather than controls, we're talking about responsible corporate behavior, we're talking about a margin where they certainly will have enough for reasonable profit, and where r and d can be factored in. The drug companies spend more on advertising every year than they do on R&D," Dayton said.
Dayton disputes the pharmaceutical industry's argument that capping drug prices will hurt the development of groundbreaking new medications. Mike Ciresi makes a similar argument. Ciresi's campaign literature claims that he'll "battle the big drug companies, just as he took on and defeated big tobacco."
"I understand the need to invest in research and development. I've seen it, in representing businesses, I know how expensive it can be, and I know that you dig a lot of dry wells sometimes. OK? You put investment into things that don't end up being a product. But the tremendous profits that are being made by drug companies - and I also know how they can abuse the system, because I've been on the opposite side of the table from them in a lot of ways, so I know how they work and operate," Ciresi said.
Ciresi has sued the industry over defective birth control devices and a polio vaccine, but says he's never represented drug companies - although his firm did on a patent case. Ciresi wants to ban drug companies from advertising on TV, because he says that drives up prices by increasing the demand for brand name drugs rather than generics. The fourth DFLer in the race - Jerry Janezich - has the least detailed prescription drug proposal - he simply says Congress should use surplus dollars to pay for a Medicare drug benefit. But Janezich astutely notes the issue's significance in this year's elections.
"I consider it poll politics. Poll politics say it's a hot issue right now, and somebody's gonna get their butt handed to them in November unless something is addressed here," Janezich said.
A handful of seniors who gathered at the Minnesota Senior Federation office in St. Paul to talk about the issue agreed. 66-year-old Don Blood of Brooklyn Park says he's never been a single issue voter before, but he is now.
"If the charitable feeling wells up in their hearts and they want to do this for the good of humanity, or if they want to do it simply because they're concerned about our voting level, I really don't care. I don't care a whit. Just do it," Blood said.
Blood and the four other seniors were somewhat skeptical of the Senate candidates' proposals. 73-year-old Tom Medley of Bloomington - who tends to vote Republican - says Grams' MEDS plan would require all but the poorest seniors to spend $1,800 a year before the government would subsidize the bulk of drug costs.
"Sounds to me like Rod Grams is just throwing a bone or something. I don't know, maybe I don't agree with Don, I don't think any of 'em are really realizing exactly what the big problem is with prescription drugs," Medley said.
The seniors say a Medicare drug benefit would help, but bottom line is that drug prices are too high. Kate Stahl, 81, of Maplewood says the federal government already negotiates with drug companies to get lower prices for veterans, and it may have to force the industry to bring prices down to the levels found in other countries whose governments set price controls.
"Price control are two dirty words, for anybody, and they are for us too, because this is not price control. And if it is, then by cracky, our government is guilty of doing it right now," Stahl said.
The seniors say they do plan to vote in the September primary and the November election - and prescription drugs may be the issue that determines who they vote for in the Senate race.