I’m proud to present an independent research project by one of Sunlight Foundation’s summer semester interns, Lindsay Young. Lindsay dives into the health care debate and tries to find the truth. – Nisha Thompson
You can’t read or watch the news without being bombarded with contradictory facts and opinions about health care. It is such an expansive issue that the details can be overwhelming. Having my chance to intern at the Sunlight Foundation, I found great resources like Open Congress, OpenSecrets, and MAPlight. They let you research bills and campaign contributions as well as sort out health care myths. It was difficult to find reliable information and informed opinions but here is my quest for the “truth” behind the health care debate.
Through my research I have found that the debate is complicated and I decided to look at the influence of one industry: the pharmaceutical industry. I used this sector as a case study of health care politics, as they are an example of how special interests wield the money, power, and influence that can make the conversation skewed and a real debate difficult.
I was surprised when I looked into the history of public health in the days before the formal health care lobby. Popular rhetoric aside, the US has a prime tradition of government health care. Quarantines were the most effective form of early health care. Mandated quarantines in cities and ports prevented the spread of disease more effectively than any contemporary medical treatment. The most direct example of state-sponsored public health care occurred when the government combated smallpox by disseminating free vaccines.
Until the advent of germ theory, private medical care consisted of crude techniques that were ineffective and dangerous. It is difficult to claim that the government has historically taken a hands-off approach to medical care because state-administered quarantine and vaccination programs were perhaps the first large-scale medical successes in modern history. Today, vaccinations make up a multi-billion dollar market. It makes sense to be more vigilant about how the government invests in this market. This requires informed discourse among citizens.
This is why I choose to look at the influence of the pharmaceutical industry. They are a powerful player, with a specific agenda, and their influence is a big part of the debate. For example, Pfizer made $19 billion in profits last year and its employees made $1.9 million in campaign contributions in the last election cycle. Patents keep drug prices high so the companies that develop them can recoup research and development costs. These profits also are a way of creating legal monopolies, the current system cannot be considered a genuine free market. This lack of competition can be harmful and is a political creation. Drug companies, of course, preserve the rules that sustain these protections through lobbying. The status quo is profitable for the pharmaceutical industry.
The role pharmaceutical industry performs in our health care system can’t be diminished, what they do is important, but it seems strange that Congress could be so intent on protecting the profits of such a select group. That is, it seems odd until you look at the money that is pouring into the political system. The health care industry has made $234,598,993 in political contributions since January. The pharmaceutical industry alone has given $4,214,265.
In turn, the government subsidizes pharmaceutical research and development. Some believe that the industry is overly sheltered from the market. Prices for drugs are artificially inflated in hopes of spurring innovative new treatments. However, the industry spends 11% more of its income on advertising than it does on research and development. Inflated costs are passed on to those that need medicine. This causes some to argue that the extensive market protections of “Big Pharma” do not benefit the consumers at all. In such a thriving industry, there must be multiple ways to increase access to prescription medication.
One of the most popular proposals to lower the cost of drugs is allowing pharmaceuticals to be bought back from nations such as Canada. These US-made medications are sold in other countries for much less money, and re-importing them would encourage more competitive prices here. This is one reform that receives bipartisan support from many people of all political leanings, but is not supported in Congress. H.R. 3200 – America’s Affordable Health Choices Act – does not include the option of buying drugs from Canada. Power and campaign contributions seem like the most rational explanation to why there is no way to buy back U.S. drugs from approved nations.
Money is so influential in the political system because it often determines what voices decision-makers hear. Access to key congressmen during critical times seems to depend on campaign contributions rather than the merits of argument. For example, while congresspersons were drawing up health care plans, the National Republican Senatorial Committee hosted a health care roundtable/fundraiser, for which PACs were charged between $2,000 and $5,000 to attend. That is a high price to pay for access to the people that will determine the future of America’s health care, and one that the average citizen can’t afford, but large companies can.
The health care debate needs to examine all options, even those opposed by well-connected industries. The pharmaceutical industry is just one example of the larger problem of money distorting democracy. It seems that there is a disproportional emphasis on groups that want to protect their own interest rather than a sincere debate over the merits of opposing plans. There are genuine, bipartisan concerns that can be addressed through the political process. But only when citizens are informed about health care issues can the political system more forward.
 Chapman, Carleton B. and Talmadge, John M. “The Evolution of the Right to Health Concept in the United States.” Pharos, vol. 34, 1971, 30-51.