Both Presidential Candidates Support Prescription Drug Reimportation

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Both Democratic presidential nominee Sen. Barack Obama (Ill.) and Republican presidential nominee Sen. John McCain (Ariz.) support prescription drug reimportation but cite the need to ensure the safety of medications purchased from other nations, CQ HealthBeat reports. At the annual conference of the Generic Pharmaceutical Association last month, advisers to both candidates said that recent cases of contaminated heparin and other products from China highlight the need to ensure the safety of medications purchased from other nations.

Obama campaign adviser Neera Tanden said, "We have not changed our position on this issue, but obviously there have been concerns in countries like China," adding, "Our plan does not envision importing drugs from China ... but from countries with strong records of safety, like Canada and Europe."

McCain campaign spokesperson Brian Rogers in an e-mail said that McCain understands the need to have a "properly documented" prescription drug supply chain, adding that as president McCain would require all medications purchased from other nations to "meet state and federal standards for safety." According to Rogers, FDA would require additional funds to ensure the safety of such medications.

FDA Center for Drug Evaluation and Research Director Janet Woodcock said that the agency would require $225 million in additional funds to inspect such medications (McCarthy, CQ HealthBeat, 10/27).

Editorials

Summaries of recently published editorials that addressed issues related to health care in the presidential election appear below.

* Dayton Daily News: U.S. voters should "know where the two presidential candidates stand on how to insure some or all of the 45 million uninsured and to keep costs down," a Daily News editorial states. "The changes that both Sen. Barack Obama and Sen. John McCain are talking about are so big and fundamental that estimates about costs are just wild guesses," the editorial states, adding, "If you really overturn the current system, people's behavior will change in ways that computer models haven't even begun to anticipate." According to the editorial, experts "say that Sen. Obama's plan would be much more costly than Sen. McCain's but that Sen. Obama's would bring more uninsured people into the system." During the second presidential debate, "McCain said access to health care was a responsibility," and "Obama said it was a right," the editorial states, adding, "Ideally, it should be considered a right," but "getting there is tough and becoming tougher" as a result of the recent economic downturn (Dayton Daily News, 10/25).

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* New York Times: "The nation's health care system is desperately in need of reform," and Obama and McCain "are offering starkly different ideas for how to fix that system," a Times editorial states. The editorial states, "We believe that Mr. McCain's plan ... is far too risky" and "is likely to erode employer-provided group health insurance and push more people into purchasing their own insurance on the dysfunctional open market." According to the editorial, "Obama's plan is a better start than Mr. McCain's," but "it is still not likely to help all Americans who need and deserve affordable, high-quality medical care." The editorial states, "Obama's plan is the better one because it would cover far more of the uninsured, spread risks and costs more equitably and result in more comprehensive coverage for most Americans," adding, "We fear Mr. McCain's plan would jeopardize employer-based coverage without providing an adequate substitute." The editorial concludes, "At a time when so many employers are reducing or dropping coverage, that is not a risk that the country can afford to take" (New York Times, 10/28).

Opinion Pieces

Several newspapers recently published opinion pieces that addressed issues related to health care in the presidential election. Summaries appear below.

* Gilbert Omenn, Detroit News: Obama's plan "permits everyone to keep health insurance they have and like, while offering others affordable options through large-group plans rather than the notoriously expensive and selective individual insurance market that the McCain plan relies on," Omenn -- a professor of internal medicine, human genetics and public health at the University of Michigan Medical School -- writes in a News opinion piece. He adds that "it is bewildering that John McCain chooses the individual market when large-group private insurance is available around the country." The piece concludes, "Health care reform has been unfinished business for 70 years in this country," and when "this divisive campaign is over, I hope Obama's centrist principles and comprehensive elements will provide a foundation for a bipartisan solution that most Americans will support and Congress could pass in 2009" (Omenn, Detroit News, 10/28).

* Alan Beattie/Krishna Guha, Financial Times: The candidates' health care plans "go in radically different directions," but "in some ways they face the same problem: ensuring that both relatively high-risk and relatively healthy people get good and cost-efficient coverage," columnists Beattie and Guha write in the Financial Times. Obama "thinks government intervention can overcome market failures," while McCain "wants to increase competition to make health care work more like other markets," the authors write, adding that "experts say both plans are vulnerable to costing more than advertised while leaving some people uninsured, for different reasons." Beattie and Guha conclude, "The low profile health care has in the election may not be because voters think it does not matter, but because they are skeptical federal government will do much about it" (Beattie/Guha, Financial Times, 10/27).

* David Cutler/J. Bradford DeLong, Forbes: "Obama wants to address the health care crisis head-on" and "will try many strategies and be guided by results, not predetermined ideological conviction," according to a Forbes opinion piece by National Bureau of Economic Research associates Cutler, the Otto Eckstein professor of applied economics at Harvard University and an adviser to Obama, and DeLong, an economics professor at University of California-Berkeley. Obama's strategies "fall into four general areas": "information"; eliminating "perverse incentives in medical care"; helping the "small players -- individuals and small firms -- get the same deals as large buyers"; and making prevention a greater priority, the authors write. "As the reforms take hold, costs will drop," and as "costs drop, insurance will become more affordable," they write. On the other hand, "We are skeptical of the value of McCain's plan for three reasons:" the "tax increase McCain proposes and the resulting dislocations it creates are the last thing American businesses need now"; the private insurance market is "nowhere near as rosy as McCain makes it out to be"; and the plan "has a huge financial hole -- between $1 and $2 trillion over the next decade," according to Cutler and DeLong. They write, "Obama's health care reform plan is much better for the country, and much more likely to be successful" (Cutler/DeLong, Forbes, 10/28).

* Uwe Reinhardt, Philadelphia Inquirer: It is troubling "that McCain appears to believe that a mere $5,800 can buy American families the protection they need against the costs of illness," Princeton University health care economist and professor Reinhardt writes in an Inquirer opinion piece. He cites the annual employer survey from the Kaiser Family Foundation and the Health Research and Educational Trust, which found an average family premium for employer-sponsored coverage of more $12,600 per year. Reinhardt asks, "What kind of coverage, then, could an annual premium of $5,800 get you, even if your whole family were healthy? And what if one or more members had a chronic illness, or had had a bout with cancer?" He writes, "If you are uninsured or fear that you might lose your coverage, go to the candidates' Web sites and carefully check out" their proposals, adding, "Leave aside any ideological baggage and clichés, such as socialized medicine -- which Sen. Barack Obama's plan ... certainly is not." Reinhardt concludes, "And then support the health plan that you believe protects your own family best" (Reinhardt, Philadelphia Inquirer, 10/28).

* Sen. Sheldon Whitehouse (D-R.I.)/Newt Gingrich, Washington Times: Next year "must be the year that Congress and the president, whoever he may be, pursue meaningful and thorough health reform," according to a Times opinion piece by Whitehouse and Gingrich, former House Speaker and founder of the Center for Health Transformation. "To be sure, every American deserves health insurance," but "[r]ight now, simply having health coverage is no guarantee of quality care," they write. The authors continue, "First and foremost, we must make a serious investment in health information technology," adding that "health IT will allow us to capture data and then determine which treatments work and which do not." In addition, the authors write that "we must change the way we pay for care" so that "[w]e ... pay more for what we want more of, and less for what we want less of." They add, "We will never cover the uninsured or resolve the looming budgetary nightmare without" such efforts (Whitehouse/Gingrich, Washington Times, 10/28).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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