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2000-08-03

Healthcare, Seniors and the Pharmaceutical Industry

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As issue and lobby groups such as the NRA and the anti-abortion right are fine-tuning their demands in the lead-up to the November elections, senior citizens and issues pertaining to their health seem very much on the back burner. [includes rush transcript]

Recent surveys have shown that on average seniors are being charged retail prices that are double the prices charged by prescription drug makers to their most favored customers, such as the Department of Defense and Veteran Affairs. And when it comes to the major parties stance on the prescription drug industry, it seems as if campaign cash and connections from the major drug companies will block any push for comprehensive Medicare coverage, this when 45 million people don’t have healthcare and 90 million don’t have prescription drug coverage.

Guests:

  • Pedro Rodriguez, with Action Alliance, the largest senior citizens’ association in Philadelphia. Call: 215 557 0751
  • Dr Joel Chinitz, a member of the Philadelphia Physicians for Social Responsibility and the medical director of the Physician Assistant Program Philadelphia University. Call: 215 557 0751

Transcript

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: We move into our last segment of this hour, and that is the issue of healthcare. Juan?

JUAN GONZALEZ:

Well Amy, recent surveys have shown that, on average, seniors are being charged retail prices that are double the prices charged by prescription drug makers to their most favored customers, such as the Defense — Department of Defense and Veterans’ Affairs. But when it comes to — yet when it comes to the most — to the stances of the parties on the prescription drug industry, it seems as if campaign cash and connections from the major drug companies will block any push for comprehensive Medicare coverage.

This comes at a time when 45 million people don’t have healthcare and 90 million don’t have prescription drug coverage. So, we’re going to deal with some of these issues today with Pedro Rodriguez with the Action Alliance, the largest senior citizens’ association in Philadelphia. First, Pedro —

PEDRO RODRIGUEZ:

How are you doing?

JUAN GONZALEZ:

Welcome. What do you see in terms of both the platforms of the Republicans and the Democrats — but we’re here at the Republican Convention — in terms of dealing with this immense crisis of prescription drugs for seniors?

PEDRO RODRIGUEZ:

Well, in terms of speaking of the Republicans’ pronouncements on this issue, it’s total hypocrisy — total, total hypocrisy, very raw hypocrisy — by trying to appeal to the senses of senior citizens across the land in this very severe crisis that we’re facing today in the United States.

The fact of the matter is that the Republican-controlled Congress had the opportunity to resolve this issue on a number of occasions, and they have failed to do so. They have failed miserably to do so. And they are curtailing to the will of the pharmaceutical industry, which is now spending $30 million on a campaign, television and in-print campaign, to mislead the American people on this particular issue. So we’re not surprised to see what’s emerging out of the FU Center here in Philadelphia, from the Republican National Convention.

Where we are encouraged is that, from what we can see, a lot of the seniors will keep pressing on to resolve this issue. There are two main ways to resolve this issue right now. And if the Republicans wanted to do so, they could do so. One is to expand Medicare and add a Part D that will create a universal, voluntary prescription drug coverage that will really make prescription coverage as part of Medicare. Medicare is a great health program, but it’s obsolete in the sense that it doesn’t have prescription drug coverage. And the second thing that they can do, if they have the will to do it, is put a stop to this skyrocketing prices that the pharmaceuticals continue to charge unabated in this country. It is inconceivable that the same drug manufactured in the United States in the same package with the same labeling is sold 60 percent less in Canada or in Mexico. That is inconceivable.

JUAN GONZALEZ:

Dr. Joel Chinitz, is with us also. He’s a member of the Philadelphia Physicians for Social Responsibility and medical director of the Physician Assistant Program at Philadelphia University, is it?

DR. JOEL CHINITZ:

That’s correct.

JUAN GONZALEZ:

Now, can you tell us — I know that in the southern parts of the United States, along the border, many people travel into Mexico to buy prescription drugs — the same thing, people going into Canada. What is the — how is this possible that this can continue to function, as Pedro was saying, the same drugs being so markedly cheaper in other countries?

DR. JOEL CHINITZ:

Well, I certainly agree with everything that Pedro has said. And I agree that the prices are clearly much higher. In fact, they’ve gone up by 85 percent from ’93 to ’98. One only needs to pick up the newspaper and see a double-spread advertisement for one of the high-priced drugs that are being marketed extensively. One only needs to go to a medical setting to see the kinds of perks that are given to physicians, or in some cases where I’ve gone to get medications to give to patients in the homeless clinic, and I’ve gone to some of my friends in private practice who have opened up their drug sample cabinet, and there are thousands and thousands of things —

JUAN GONZALEZ:

What are those perks?

DR. JOEL CHINITZ:

Well, the perks can range from anything to a free pen to a free trip to attending a conference, and attending a conference — you know, being transported 3,000 miles, being hosted and wined and dined in doing that. And that’s the extreme, and that’s clearly for those who use larger amounts of the medication. Now, overall, I don’t think that’s the major part of the problem.

I certainly can’t speak with any, you know, background or insight into the pharmaceutical industry. But, you know, I’m part of what’s called the Ad Hoc Committee to Defend Healthcare, and what we’re seeing is, whatever the Republicans are offering, whatever the Democrats are offering, are really just tinkering around the edges of a healthcare system which really needs to be built. We need a healthcare system, and that’s lacking at the moment. And I think the pharmaceutical component of that is only one fraction.

JUAN GONZALEZ:

What are the other aspects of it?

DR. JOEL CHINITZ:

Well, the other aspects, you’ve already mentioned. There are 45 million people — 44.3 at this count — without any healthcare coverage at all. Many with lesser, you know, with limited coverage. And the number is going up by one million a year. Every time that there are some efforts made to control the quality, with patients’ bill of rights, if that increases the cost, that decreases the ability for people to get coverage. So it’s a self-defeating kind of thing.

The other thing is, there’s significant profit making through the whole healthcare system, not just — not just the pharmaceuticals. So that’s a great concern. When you have profit-making organizations in healthcare, the administrative — Pedro said Medicare is efficiently run. It’s got a three percent overhead. These operations have a 25 percent overhead. What these private organizations call the money that they’re actually spending for healthcare, it’s called a “medical loss.” So I think that gives you some concept of what’s happening there.

The other part of the problem is that for many millions of people, healthcare is linked to employment, and therefore what — while they’re trying to develop this market-based system of having something applicable to the consumer, the consumer is not actually the one who’s buying the product. It’s being bought by their employer, who obviously is interested primarily in the cost. And therefore, the available care goes down. What the individual is doing is paying more of their own money out of pocket for their own insurance.

AMY GOODMAN:

We’re talking to two people who specialize in the issue of healthcare, seniors in the pharmaceutical industry. Dr. Joel Chinitz, member of the Philadelphia Physicians for Social Responsibility, and Pedro Rodriguez with the Action Alliance, the largest senior citizens’ association in Philadelphia, here in the city of the first convention, and this year’s Republican Convention. So, you’ve described what the problems are. What are, exactly, the Republicans proposing, and what are your problems with that?

PEDRO RODRIGUEZ:

There are a number of problems when it comes to the Republicans dealing with the senior population in this country. One, that they are of course relying on the private market to resolve the issue of healthcare for senior citizens. The House of Representatives just a month ago tried to deal with the issue of prescription drug coverage, and they passed a bill which voucherizes the solution to this problem, giving the solution to the HMOs to handle it. It’s really a miserable attempt to resolve this issue, one, because Medicare HMOs are dumping seniors all over the United States. They say they’re not making enough money; they want to make more money. So why would you turn over a new problem to an industry that really doesn’t want to deal with that? That’s the Republicans’ solution to that end.

On the other hand, they have totally refused to deal in the House with the whole issue of prescription drug prices, what to do about putting a stop to the runaway prices that the pharmaceuticals keep charging seniors and the American people in this country. They’re not dealing with that issue. They’re failing to deal with that issue. And that’s an issue they will not address. To them, addressing the issue smacks of socialized medicine or price control. Actually, in actual lines, we don’t have trouble with either of those terms. I mean, a lot of our members went through price controls during World War II, and it worked then, so if it has to be price controls on pharmaceuticals, then so be it.

JUAN GONZALEZ:

Dr. Joel Chinitz, a few years ago, you never saw advertisements on television telling people, “Talk to your doctor about this drug.” All of a sudden, now, in the last few years, virtually every night on TV, everything from Viagra to any kind of new drug, suddenly there’s enormous advertising. This, of course, is an expense that these companies — the marketing expenses for these companies, and then these are put into the actual price of the drugs. How did this just develop all of a sudden in the last few years?

DR. JOEL CHINITZ:

Well, again, I’m not an expert on legislation, but I think this was something that was legislated. In other words, it became — and I guess, Pedro, you may know better than I —- I think in ’97, was then legislated that they could advertise directly to the consumer. So you’re seeing it in the newspapers, and you’re seeing it on the buses, and you’re seeing it on television and hearing about it on the radio. And they’re creating a market. They’re creating -—

JUAN GONZALEZ:

But what does that do to the doctor, now, who has a patient coming in who wants — because they’ve seen the advertisement on television, they want to tell the doctor what drug they need?

DR. JOEL CHINITZ:

OK. So what you’re saying, in essence, is that as more and more pressure is put on the physician to see more and more patients in what had been the twenty-minute visit, then the fifteen-minute visit, is now the eight-minute visit, soon it will be the six-minute visit. Within that six-minute period of time, the amount that’s to be accomplished in that encounter has grown.

Efforts to provide preventive care are recognized as very, very important. And yet a patient without significant knowledge and background who has been marketed for this particular product is going to want to have that kind of discussion. So clearly, it changes the balance of things. And we don’t — you know, I personally don’t think that’s the place to present medical needs.

AMY GOODMAN:

On that note, I want to thank you both very much for being with us, Dr. Joel Chinitz of the Philadelphia Physicians for Social Responsibility, Pedro Rodriguez with the Action Alliance, the largest senior citizens’ association in Philadelphia. How can people get in touch with you?

PEDRO RODRIGUEZ:

They can call our offices at (215) 557-0751. And we’re located at 1201 Chestnut Street in Philadelphia.

AMY GOODMAN:

And Dr. Joel Chinitz?

DR. JOEL CHINITZ:

Well, let me say, for the moment, if people want to join the ad hoc committee, I suggest they call Philadelphia Physicians for Social Responsibility at (215) 765-8703.

AMY GOODMAN:

And those numbers, as well as all contacts and websites, are on our website at democracynow.org, and you can also listen to the program again, if you missed any part of it, and tell friends who don’t hear Democracy Now!, either on their public access station or their community radio station, that they can get us by simply calling those stations.

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