Using Savings from Drug Pricing Reform to Expand Medicare

Published in RINewsToday on June 7, 2021

Ahead of President Biden’s first address to a joint session of Congress on April 28 and as the Democratic administration considers policies to slash rising drug costs, the U.S. Government Accountability Office (GAO) released a 65-page report finding that the U.S. pays more than two to four times higher prices for a selected sample of 20 single source, brand name drugs than Australia, Canada and France. The latest GAO report, commissioned by Sen. Bernie Sanders (I-Vt.), found that Americans, suffering from blood clots, bronchitis, emphysema and Hepatitis C, were paying more for life-saving treatments than patients in these industrialized countries. 

“This important GAO study confirms what we all already know: the pharmaceutical industry is ripping off the American people,” said Sen. Sanders in a statement announcing the March 29th release of the GAO report, “Prescription Drugs: US Prices for Selected Brand Drugs Were Higher on Average Than Prices in Australia, Canada and France.”

“The time is long overdue for the United States to do what every major country on earth does: negotiate with the pharmaceutical companies to lower the outrageous price of prescription drugs. I would urge the president to put this proposal in the American Families Plan and use the savings to expand and improve Medicare for older Americans. We can no longer tolerate the American people paying, by far, the highest prices in the world for prescription drugs,” says the Vermont Senator who chairs the Senate’s Budget Committee.

U.S. Paying Outrageous Drug Prices

The GAO study found that in 2020, the U.S. paid 4.36 times more than France, 4.25 times more than Australia and 2.82 times more than Canada for the selected drugs, which represent a sample of the drugs with the highest Medicare Part D expenditures and use. The researchers noted that the publicly available data for the comparison countries were gross prices that did not reflect potential discounts. As a result, the actual differences between U.S. prices and those of the other countries were likely much larger than GAO estimates.

According to the GAO report, while France and Australia operate universal, publicly funded health systems that include prescription drug coverage, both Canada and the U.S. have a significant number of people who do not have prescription drug coverage. But even when comparing the full cash retail prices of selected drugs, the prices quoted to individuals without prescription drug coverage, GAO found that prices were two to eight times higher in the U.S. than the same drugs from pharmacies in Canada. 

For instance, GAO found that the cash price of Epclusa (28 tablets), which treats Hepatitis C, or an infection that attacks the liver, is $36,743 in the U.S. but $17,023.63 in Canada. The cash price of Harvoni (28 tablets), which also treats Hepatitis C, is $46,570.33 in the U.S. but $19,084.54 in Canada. In another example, GAO cited that the cash price of Incruse Ellipta Inhalation Powder (30 inhalations), which treats chronic obstructive pulmonary disease (COPD), or a group of lung diseases which block airflow and make it difficult to breath, is $411.33 in the U.S. but $53.31 in Canada.

Because France and Australia have universal health systems that cover prescription drugs, Australians would pay up to a $28.09 copay for a month supply of these medicines, while patients in France would pay anywhere from $0 to $34.03 for the drugs. The maximum copay that high income seniors with prescription drug coverage in Ontario, Canada would pay for the drugs is $4.67.

Robbing Peter to Pay Paul

On April 23, 48, organizations, led by Indivisible, Social Security Works and Public Citizen, called on Biden to include bold drug pricing reforms in American Families Plan to expand Medicare, and the result of a new polls supports this legislative action. 

Drug pricing reform will produce upward of $450 billion in savings over 10 years, note the organizations, urging Biden to use these savings to reinvest in Medicare. The call for adding dental, vision and hearing benefits to Medicare, lowering the Medicare eligibility age to 50 and creating an out-of-pocket cap for medical expenses.

Alongside the letter, the organizations released the findings of a new poll from Data for Progress, widespread public support across party lines for expanding and improving Medicare. The poll’s findings noted that 86% of Americans, including 82% of Republicans, support adding dental, hearing and vision benefits to Medicare. It also found that three-quarters of Democrats, a majority of independents, and nearly half of Republicans support lowering the Medicare eligibility age to 55. 

“Allowing Medicare to negotiate drug prices down saves money for the federal government, which is the largest buyer of prescription drugs in the world,” said Alex Lawson, Executive Director of Social Security Works. “We must pump those savings back into Medicare to expand eligibility and add benefits that equalize Medicare with private insurance,” he says.

“Lowering the Medicare eligibility age to 50, capping out-of-pocket costs, and expanding benefits to include dental, hearing, and vision would improve access to care for millions of Americans. Far too many Americans have lost their insurance or put off needed care due to the COVID-19 crisis,” said Eagan Kemp, Health Care Policy Advocate for Public Citizen. “The Biden Administration and Congress have a chance to deliver important progress at a crucial time,” he says.

Adds Mary Small, Legislative Director for Indivisible, “With the consequences of the COVID-19 pandemic still being felt in our communities, now is a crucial moment to expand public health care coverage and deliver savings on prescription drug prices to the American people. Lowering the Medicare eligibility age to 50 will be an essential step toward reducing the racial health inequities by increasing coverage to communities of color and low-income folks.”  She adds, “Allowing Medicare to negotiate prescription drug prices and then reinvesting those savings back into the program to expand services further strengthens our path toward universal coverage for all.” 

Last Thoughts

Garnering applause, Biden put high drug costs on his Administration’s radar screen at his recent address before Congress. “Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower drug prescription prices. It won’t just help people on Medicare. It will lower prescription drug costs for everyone,” said the 46th President of the United States. “We’ve talked about it long enough. Democrats and Republicans, let’s get it done this year,” he said.

But actions speak louder than words, say Washington Insiders.  They note that Biden’s American Families Plan, did not include any proposal to slash pharmaceutical costs or lower the Medicare eligibility age. Is it possible for Biden to lower the drug prices in the United States, making the prices more comparable to other industrialized countries and to even expand Medicare, in the face of fierce opposition from Republicans, moderate Senate Democrats and pharmaceutical companies?  

According to the latest KFF Health Tracking Poll released June 3, 2021, the findings indicate that “nearly nine in 10 (88%) favor allowing the federal government to negotiate for lower prices on medications, including three-fourths (77%) of Republicans, nine in 10 independents (89%) and 96% of Democrats.” However, support dwindles “when the public hears argument made by pharmaceutical companies that it could lead to less research and development for new drugs, or that access to newer prescriptions could be limited,” say the researchers.

Will political pressure sway a divided Congress before the upcoming midterm elections to hammer out a bipartisan solution to put the brakes to the nation’s skyrocketing drug costs and to provide more American’s affordable health care through an expanded Medicare program. Its wait and see.

Rhode Island Senate must take a stand against hatred

Published in RINewsToday on May 31, 2021

“In recent days, we have seen that no community is immune. We must all stand together to silence these terrible and terrifying echoes of the worst chapters in world history, and pledge to give hate no safe harbor.” — Statement of President Joe Biden on the rise of antisemitic attacks, May 28, 2021

Over two decades ago, “Never Again” was on the mind of the Rhode Island General Assembly. Lawmakers in both chambers geared up to fight antisemitism by passing the companion legislative proposals, “Genocide and Human Rights Education Act,” sending the bill Rhode Island Governor Lincoln Almond for his signature.  The enacted legislation required the Rhode Island Department of Education to “develop curricular material on genocide and human rights issues and guidelines for the teaching of that material. 

In 2011, Rhode Island lawmakers passed the “Genocide Education in Secondary Schools Act which called for genocide curriculum materials being available, that put a spotlight on the Holocaust, Armenian, Cambodia, and Darfur.  Six years later, enacted legislation would require that the Holocaust and genocide be taught in the state’s public middle and high schools. 

House bill raises awareness of the Holocaust and Genocide

Just weeks ago, 73 Rhode Island House lawmakers (2 choosing not to vote) passed H-5650, a legislative proposal sponsored by Rep. Rebecca Kislak (D-District 4, Providence) to create a Genocide and Holocaust Education Commission to raise awareness of the Holocaust and Genocide. The legislation formalizes a commission to implement a 2016 law introduced by now House Majority Whip Katherine S. Kazarian (D-District 63, East Providence) and Sen. Gayle L. Goldin (D-District 3, Providence) to require public middle and high schools to teach students about Genocide and the Holocaust.  

“So many Rhode Islanders’ families are from communities that have been impacted by Genocides. Listening to each other’s stories and learning about those diverse histories will help us see the humanity in one another and build stronger communities. This bill will establish a commission to provide support to our educators and raise awareness of genocides that have affected Rhode Islanders and have shaped our communities’ histories,” said Kislak.  

Under Kislak’s bill, the Holocaust and Genocide Education Commission will gather and disseminate Holocaust and genocide information, work with the Department of Education to update and promote statewide Holocaust and genocide education programs and promote public awareness of issues relating to Holocaust and genocide education.

As hate crimes have been rising in our own country over the last few years, it’s particularly important that students are taught about the catastrophic atrocities that have been committed when the seeds of hate are planted,” said Kazarian, who is cosponsoring this bill. All eight of the East Providence lawmaker’s great-grandparents are survivors of the Armenian genocide. “My family’s own history involving the Armenian genocide has shown me that these events in history should never be forgotten. It is important that our children recognize and understand how such terrible events can occur in society, and more importantly, how to stop them from happening,” she says.

Rep. Nathan W. Biah Sr. (D-Dist. 3, Providence), who fled Liberia in 1991 at age 20 to escape a war in which genocide occurred, is also a cosponsor.

“I have experienced the horrors of genocide firsthand. It’s a very tragic fact that genocide continues around the world today. Our students are citizens of the world and need to understand the impacts of genocide on their brothers and sisters wherever it occurs,” said Biah.

According to Marty Cooper, Chair of the Rhode Island Holocaust and Genocide Education Coalition, Rhode Island was one of the first states in the nation to require Holocaust and genocide education in its schools. “It is now in a position to be one of the first states to establish a formal commission to oversee Holocaust and genocide education as well as establish a Holocaust and genocide awareness month,” he says. 

“The establishment of a formal Rhode Island Commission on Holocaust and Genocide Education will ensure accountability and credibility. It will also establish a mechanism to disseminate information and material to schools and educators in regard to Holocaust and genocide issues. Equally important is the ability to monitor and assist in enforcing school compliance on the issue of Holocaust and genocide studies with students,” says Cooper.

“More importantly, a commission will stimulate much needed dialogue and discussion to address the issue of genocide. What atrocities, for instance, should be studied as a genocide?” adds Cooper. 

“After World War II, a strong mantra of “Never Again” came about in hopes of ending atrocities that left millions dead and misplaced because of the Holocaust. Unfortunately, atrocities still take place. We need more than the words “Never Again” to help end this madness. Education is significant element to hopefully bring an end to such hate, bullying and racism,” states Cooper. “Then “Never Again” can become a reality.”

S-840 Sub A held for further study 

As the 2021 General Assembly’s legislation session conclusion comes closer, lawmakers are considering a flurry of bills. While the House chamber has passed its measure, the Senate Education Committee recently recommended that S-840 Sub A, Godin’s companion measure, co-sponsored by Senators Joshua Miller (D-District 28, Providence/Cranston), Hanna Gallo (D-District 27, Cranston), Thomas Paolino (R- District 17, Lincoln, North Providence, and North Smithfield) and Meghan Kallman (D-District 15, Pawtucket) be held for further study.  Often times, this may be the polite way to kill this measure.  Closed door “horse-trading” between House and Senate leadership may resurrect the legislative proposal.  

“I look forward to the bill coming out of the senate education committee and coming up for a favorable vote,” said Cooper

According to a recently released Pew Center survey, nine out of ten American Jews say there is at least “some antisemitism in the U.S.,” and that 75 percent believe there is more antisemitism in the U.S. than there was five years ago. The survey also found that more than half of Jews surveyed say they personally feel less safe as a Jewish person in the U.S. than they did just five years ago.

The Pew survey findings are in line with a recent survey of Jewish American experiences with antisemitism fielded by the Anti-Defamation League (ADL) earlier this year, says Jonathan A. Greenblatt, ADL CEO and National Director. “The ADL survey found that well over half of Jewish Americans have either experienced or directly witnessed some form of antisemitic incident in the last five years, with 63 percent of respondents having either experienced or heard antisemitic comments, slurs or threats targeting others, an increase from 54 percent a year earlier,” he says.

“ADL is working closely with members of Congress to ensure that there is more funding for bolstering community security, training law enforcement in identifying and responding to hate crimes, and has partnered with community organizations, such as SCN, working to protect Jewish institutions.”

“We hope that this [Pew] report serves as a wake-up call to leaders across the country and on both sides of the aisle that antisemitism is still a harsh reality today and so we must continue to fight this ancient hatred through education, advocacy, enhanced security and greater awareness of the problem. ADL remains firmly and fully committed to rooting out antisemitism and hatred in all forms.”

Senate leaders must follow ADL to “root out antisemitism and hatred in all forms” in the Ocean State. One way is to pass S-840 Sub A.

One Year Later – Two Surveys Examine Impact of COVID-19

Published in RINewsToday on May24, 2021

Over the year the raging pandemic has impacted on the physical and mental health of Americans. With daily COVID case counts now the lowest since last year and hospitals seeing less coronavirus hospitalizations, most states, including Rhode Island, are now opening up.

According to the American Psychological Association’s (APA) latest Stress in AmericaTM poll (findings released on March 11, 2021), the nation’s health crisis is far from over. Just one year after the World Health Organization declared COVID-19 a global pandemic, many adults report increased negative behaviors, such as undesired changes to their weight and increased drinking, that may be related to their inability to cope with prolonged stress.

APA’s survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61 percent) experienced undesired weight changes—weight gain or loss—since the pandemic started, with 42 percent reporting they gained more weight than they intended. Of these individuals, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10 percent stated they gained more than 50 pounds, noted the poll’s findings.

Gaining Weight Bad for Your Health

Weight changes come with significant health risks, including higher vulnerability to serious illness from COVID-19.  According to the National Institute of Health, people who gain more than 11 pounds are at higher risk of developing Type II diabetes mellitus and coronary heart disease, and people who gain more than 24 pounds are at higher risk of developing ischemic stroke. 

For the 18 percent of Americans who said they lost more weight than they wanted to, the average amount of weight lost was 26 pounds (median amount lost was 12 pounds). Adult respondents also reported unwanted changes in sleep patterns and increased alcohol consumption. Two in 3 (67 percent) said they have been sleeping more or less than desired since the pandemic started. Nearly 1 in 4 adults (or 23 percent) reported drinking more alcohol to cope with their stress.

“We’ve been concerned throughout this pandemic about the level of prolonged stress, exacerbated by the grief, trauma and isolation that Americans are experiencing. This survey reveals a secondary crisis that is likely to have persistent, serious mental and physical health consequences for years to come,” said Arthur C. Evans Jr, PhD, APA’s chief executive officer, in a March 21st statement announcing the results of the study’s findings. 

Evans calls on health and policy leaders to come together quickly to provide additional behavioral health supports as part of any national recovery plan.

The researchers found that the pandemic took a particularly heavy toll on parents of children under 18-years old. While slightly more than 3 in 10 adults (31 percent) reported their mental health has worsened compared with before the pandemic, nearly half of mothers who still have children home for remote learning (47 percent) say that their mental health has worsened; 30 percent of the fathers who still have children home said the same. 

APA’s study also found that parents were more likely than those without children to have received treatment from a mental health professional (32 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic began (24 percent vs. 9 percent). More than half of fathers (55 percent) reported gaining weight, and nearly half (48 percent) said they are drinking more alcohol to cope with stress.

As to essential workers, (either persons working in health care or law enforcement), the majority said that they relied on a lot of unhealthy habits to get through the year-long pandemic. Nearly 3 in 10 (29 percent said their mental health has worsened, while 3 in 4 (75 percent) said they could have used more emotional support than they received since the pandemic began. Essential workers were more than twice as likely as adults who were not essential workers to have received treatment from a mental health professional (34 percent vs. 12 percent) and to have been diagnosed with a mental health disorder since the coronavirus pandemic started (25 percent vs. 9 percent).

Furthermore, people of color noted that unintended physical changes occurred during the pandemic. Hispanic adults were most likely to report undesired changes to sleep (78 percent Hispanic vs. 76 percent Black, 63 percent white and 61 percent Asian), physical activity levels (87 percent Hispanic vs. 84 percent Black, 81 percent Asian and 79 percent white) and weight (71 percent Hispanic vs. 64 percent Black, 58 percent white and 54 percent Asian) since the beginning of the pandemic.

Black Americans were most likely to report feelings of concern about the future, say the researchers, noting that more than half said they do not feel comfortable going back to living life like they used to before the pandemic (54 percent Black vs. 48 percent Hispanic, 45 percent Asian and 44 percent white).  They also feel uneasy about adjusting to in-person interaction once the pandemic ends (57 percent Black vs. 51 percent Asian, 50 percent Hispanic and 47 percent white).

“It’s clear that the pandemic is continuing to have a disproportionate effect on certain groups,” said APA President Jennifer Kelly, PhD. “We must do more to support communities of color, essential workers and parents as they continue to cope with the demands of the pandemic and start to show the physical consequences of prolonged stress,” says Kelly.

COVID-19’s Impact on Seniors

A newly released AARP study, released on May 10, 2021, has found that more than a year into the coronavirus pandemic, most adults age 50 and older say that it has had a negative impact on their mental health. Researchers found that seven in 10 older adults reported an increase in sadness or depression due to the COVID-19 pandemic, and nearly 8 in 10 said they had increased concern about the future, worry or anxiety. Half of adults 50 and older reported feelings of anxiety in the last two weeks, and 56% noted difficulties falling asleep or staying asleep, say the study’s findings.

“If you are feeling stressed and anxious after the last year, you are far from alone!” said Alison Bryant, Senior Vice President of Research at AARP in a statement announcing the survey results. “As our survey highlights, most older adults’ mental health and wellbeing was affected by the pandemic—and some of the ways we coped might not have been great for our health, either. With many communities returning to normal, we hope older adults will consider taking steps to reclaim their health this spring and summer,” she said.

Coping with the COVID-19 pandemic

According to the AARP study findings, seniors are responding to the increased stress in a variety of ways. About one in four of the respondents reported they are eating comfort foods or “unhealthy foods” like chips and candy more often than before the pandemic. And 27 percent of people 50 and over have increased the time they spend praying or meditating. One in 10 survey respondents reported seeking mental health care in the last year, a third of whom did so specifically because of the pandemic. Overall, 15 percent of older adults said that experiencing the pandemic made them more likely to seek help from a mental health provider if they had concerns.

AARP’s survey also highlighted how the pandemic increased loneliness and isolation among those age 50 and over.  Among older adults, 58 percent reported feeling increased loneliness, and 62 percent were less likely to socialize with friends and family compared to before the pandemic.