CMR, Insulin, and Drug Prices
Does she really "share a goal"?
According to the Spokesman article from April 1st, “House passes $35-a-month insulin cap as Dems seek wider bill”.
Public opinion polls have consistently shown support across party lines for congressional action to limit drug costs.
Eastern Washington’s U.S. Representative McMorris Rodgers not only voted against the $35-a-month insulin cap, but saw fit to rail against it in a 3 minute floor speech you can watch here. She starts with “We all share the goal of reducing the cost of insulin”. If that’s true, she certainly isn’t demonstrating any appetite for it. The insulin bill, she says, is “price fixing” and a “socialized medicine approach”. This bill, according to her, would “lead to fewer cures” and result in “higher costs someplace else”.
Let’s stop and consider those vacuous assertions. How will putting a cap on the cost of insulin, “lead to fewer cures” and “higher costs someplace else”? Overall drug costs must, in McMorris Rodgers’ world, be a zero-sum game: if you cap the price of insulin in her system, then the lost insulin revenue resulting from the price cut will simply reappear somewhere else. Evidently, in her world, there is no elasticity in drug company profits, drug companies and their investors in her world must have a fixed or growing profit margin. Moreover, if these private companies don’t enjoy a high profit margin then they’ll quit innovating, quit looking for “cures” (as if drug company excess profits were always spent on the next “cure” rather than advertising, detailing drugs to physicians, and legal efforts to lengthen patent protection on existing medications). McMorris Rodgers’ simplistic, zero-sum world of drug pricing is imaginary economics.
This is the same Congressperson who, with most of the rest of the Republican Party, stone-walled a bill to allow Medicare to negotiate drug prices. According to their thinking, drugs are priced in a “free market” and giving Medicare the power to negotiate price with drug companies would violate “free market” principles. A free market requires a buyer and a seller each with the freedom to walk away from the negotiation. For an insulin-dependent diabetic walking away from a negotiation about the price of insulin means debility and death. That’s not a free market. Giving Medicare the power to negotiate drug prices is a form of collective bargaining on behalf of otherwise powerless individual patients. (Consider, of course, that the notion of collective bargaining, a method of giving a lot of small players a voice against the big players in an economy, is anathema in Republican ideology.)
If, according to McMorris Rodgers, she shares the goal of reducing the cost of insulin, what is she doing to achieve that goal? In her floor speech she touts her bill (this year it is dubbed H.R. 19, the “Lower Costs, More Cures Act of 2021”) to rein in “pharmacy benefit managers” (PBMs). To be sure, Pharmacy benefit managers need reining in. But with her nearly eighteen years tenure in the U.S. House what headway has she made? She has put this legislation forward for years, including under a Republican majority Congress and Republican president—with no significant progress. If an eighteen year veteran “shares a goal” we might expect more than words.
To close on this topic, I offer a letter-to-the-editor written by Bill Siems, a letter published in the Spokesman on April 7:
Cathy McMorris-Rogers loves the phrase “putting more money in your pocket” to explain her passion for legislation she supports, such as the Trump-era tax cuts which mostly benefitted the wealthy (permanently) but did (temporarily) lower rates for us ordinary taxpayers.
However on March 31 her “money in your pocket” passion was inoperative for a bipartisan bill to cap insulin costs at $35 per month for the millions of Americans who need this lifesaving medication, many of whom have to ration their use because US prices are eight times the average for wealthy nations.
Not only did CMR not join other Republicans in voting for the measure, but she spoke strongly against it. Her reasons: price caps never work, and controlling insulin prices will simply make other things more expensive. No doubt her diabetic constituents struggling to control their disease will take comfort from that thought.
Despite CMR the measure passed and went on to do battle in the Senate, where hopefully there will be some Republicans whose opposition to price controls can allow an exception in the case of a life-saving medication.
Keep to the high ground,