Sen. Rick Scott & Health Care

April 3, 2019

Dear Senator Scott:

I live in Clearwater, FL so I write to you today as an alert and engaged constituent.

You are an accomplished and admired American leader.  After volunteering for military service during the Vietnam era, you honorably served your country in the U.S. Navy as a radar technician aboard the USS Glover. You overcame significant social and economic obstacles to earn a J.D. from the SMU Dedman School of Law.

You are a former Chairman and CEO of one of the largest private sector health care corporations in America (Columbia/HCA).  You then admirably served two terms as Governor of Florida; and you now serve as one our two U.S. Senators from the Great State of Florida.

In fact, you have been recognized as a uniquely qualified American leader who ran the largest health care company in the world, and who cares deeply about the costs and quality of health care to consumers.

I tuned into watch and listen to Face the Nation (CBS) on March 31, 2019, eager to learn from your current perspectives on health care in America.

I was disappointed by your responses to Margaret Brennan’s questions about a renewed partisan focus to repeal the ACA (President Trump, March 26, 2019).  I was particularly concerned about your focus on drug prices as a key driver of excessive costs in our health care sector. While your observations contain some truth, you failed to disclose the background behind persistent high prices of ethical pharmaceuticals in the U.S.

On April 1, 2019, you were interviewed by Steve Inskeep from Morning Edition (NPR).

Mr. Inskeep attempted to draw out your unique expertise on some of the most critical issues facing our nation relative to our health care delivery system, noting that ‘President Trump says he wants Republicans to be known as the party of health care’.

You zeroed in on high prescription drug costs, and you cited a bill you are introducing, the “Transparent Drug Pricing Act” which aims to stop drug companies from charging more for medication in the U.S. than in other countries.

In both cases, you responded to some solid direct questions with sadly incomplete ‘softball’ answers.

I did not hear you mention the “non-interference” clause of the Medicare Modernization Act of 2003 which is frequently cited as the core reason for excessive drug costs in the U.S.

Medicare accounts for more than 25% of annual national retail prescription spending, and taxpayers currently pay nearly 70% more for drugs in the Medicare program than through the Veteran’s Administration, which has direct negotiating power with drug companies.

The Medicare Modernization Act of 2003 precludes the Secretary of Health and Human Services (HHS) from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. A simple act of Congress, supported by the executive branch, can repair this problem quickly.  In fact, a recent survey conducted by the Kaiser Family Foundation shows that over 90% of the public believes that allowing the federal government to negotiate drug prices for Medicare beneficiaries is needed.

As a highly accomplished expert in the field of health care, you are certainly familiar with a comprehensive study conducted by researchers at Harvard Medical School which examined peer-reviewed medical and health policy literature from January 2005 to July 2016. The study was published in the Journal of the American Medical Association (August 23/30, 2016, “The High Cost of Prescription Drugs in the United States”).

Their research studied scholarly articles addressing the sources of drug prices in the United States; examined the justifications and consequences of high prices; and investigated possible solutions for the pharmaceutical price conundrum we continue to face in America.

This independent professional research concluded that high U.S. drug prices are the result of U.S. government protected monopolies granted to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. They noted that the most realistic short-term strategies to address high prices include:

  • enforcing more stringent requirements for the award and extension of exclusivity rights;
  • enhancing competition by ensuring timely generic drug availability;
  • providing greater opportunities for meaningful price negotiation by governmental payers;
  • generating more evidence about comparative cost-effectiveness of therapeutic alternatives; and
  • more effectively educating patients, prescribers, payers, and policy makers about these choices.

Individuals in the U.S. are directly impacted by the cost of prescription drugs at the retail level, whether fully covered by their insurance provider; through a co-pay; or fully funded out of pocket.

Indirectly, each taxpayer in the U.S. helps to subsidize the cost of prescription coverage for current and retired local, state and federal government employees; veterans; and those of our neighbors who are eligible for Medicare/Medicaid benefits.  When drug prices are inflated due to a lack of appropriate government regulation, U.S taxpayers are subsidizing excessive profits which accrue to executives and shareholders of pharmaceutical companies.

It is – and has been – clear to me that our elected officials in Congress have failed the people of the U.S. over a rather long period of time.  Our elected representatives have failed to address the root causes of high drug prices which have been identified and delineated in (the previously cited) independent and non-partisan report published almost 3 years ago.

Senator Scott, I believe the great majority of my fellow Floridians join me to expect much more of you in this arena.

We count on you — A recognized expert in the field of health care — to give us the full, honest and unvarnished picture on these issues, and to support new and appropriate legislation which strategically addresses the rapidly changing operational landscape on which our economy and society operates.

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