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  • Writer's pictureDavid M. Rubin


If one member of the United States Senate ought to be working night and day to lower the price of prescription drugs, it's Tim Scott.

Consider the population of the state he represents. In South Carolina, one in six people lives in poverty (an income of $26,500 or less). More than 18 percent are 65 and older. Twenty percent say they are in poor or fair health, according to the Kaiser Family Foundation. Ten percent have been told by a doctor they are diabetic. Two-thirds are overweight or obese. US News ranks South Carolina 38th nationally in the overall health of its citizens.

Therefore, the cost of prescription drugs to treat the many ills besetting South Carolinians is a very serious matter. Yet South Carolinians, and residents of the other 49 states, pay more for drugs than the citizens of 32 comparison countries. Indeed, Americans pay four times more on average for our prescription drugs than foreigners pay.

Scott is very well positioned to address this inequity in drug pricing and the soaring cost of prescription drugs overall. He is the ranking member of the Senate Aging Committee. He is the author of the recent study "Putting Patients First: Innovative Solutions for Prescription Drugs and Older Americans."

But just as Scott recently undercut bipartisan efforts to reform police practices---he favored reform until he killed it---he plays the same game with drug pricing. He seemingly takes the side of consumers, and then he delivers for his real client, Big Pharma.

As proof, consider this: When Republicans controlled the Senate, Senator Chuck Grassley, then the Chair of the Senate Finance Committee, put forward the "Prescription Drug Pricing Reduction Act of 2019." It passed in his committee on a bipartisan vote of 19 to 9. Scott was one of the nine to vote against it, and the bill went nowhere.

His seven-page report "Putting Patients First" makes clear what Scott's objections are to controls on prescription drug prices. Big Pharma, he argues, needs big profits to fuel the research and development to produce new, life-saving drugs. Efforts to reduce these profits, Scott claims, will actually hurt the health of the American public. If Big Pharma's profits are curtailed, the drug companies will cease their R&D operations, new drugs will disappear, new plants won't open, jobs will be lost, and the entire American economy will suffer.

He is so opposed to bringing down drug prices that he claims price controls "can ruin an economy" and lead the U.S. down the road to becoming "a Venezuela or Russia." (No joke.)

The drug profits Scott champions are astronomical. From 2000 to 2018, the 35 largest pharmaceutical companies reported $11.5 trillion in revenue, $8.6 trillion in gross profits, and $1.9 trillion in net income. This is hardly an industry that needs Scott's help.

After defending Big Pharma in most of the report, Scott turns to his "innovative solutions" for reducing prices. His suggestions are feeble or incomprehensible.

He wants to "modernize" Medicare Part D coverage of prescription drugs, whatever "modernize" means. He doesn't say. He seems blissfully unaware of how incredibly complicated Part D is for the consumer. Its competing plans cover an ever-changing set of drugs at ever-changing prices. It's a life's work to sort it all out.

He proposes "Value Based Arrangements", wherein health care providers are rewarded for patient outcomes. Somehow this is supposed to lower drug prices. He doesn't say how.

He says he supports a cap on out-of-pocket drug costs for seniors, yet he had a chance to advance that idea in the 2019 Grassley legislation that he voted against. This is typical Scott behavior. Now that the Democrats are trying to include a similar cap in the Build Back Better legislation, Scott isn't lifting his voice or a finger to support it.

Scott and Big Pharma are, of course, opposed to permitting Medicare to negotiate the prices of prescription drugs on behalf of enrollees, even though this is routine in foreign countries where governments DO negotiate on price. By law Medicare cannot engage in such bargaining. (This shows how strong the Big Pharma lobby is.) Such bargaining could lower prices here, given Medicare's market clout, just as bargaining lowers drug prices for citizens abroad. But Scott opposes it for Medicare enrollees. He is carrying Big Pharma's water.

Because South Carolina is a state with a large veterans population, Scott strategically ignores the fact that the VA can bargain with the drug companies to lower drug prices for vets. Scott seems OK with that, but not for the rest of us in Medicare. He hopes voters won't notice the cynical contradiction.

As he runs for re-election, Scott will frame his position favoring high drug prices as one that helps seniors by helping Big Pharma do its job. While Republicans are not good at governing, they are good at messaging. So let's stick them with the honest message about Scott's duplicitous position.

"Senator Scott thinks you should pay four times more for your drugs so that consumers living outside the U.S. can pay four times less. Senator Scott thinks this 'tax' on American drug purchasers is just fine, because it enriches his client, Big Pharma."

This is the truth of the matter. We pay through the nose for drugs. Big Pharma makes trillions from us. Foreign consumers get the benefit of the same drugs at cheaper prices because their governments bargain on their behalf. Ours cannot. Scott defends this.

So let's call it what it is: "The Scott prescription drug tax."

That sounds like a winning campaign argument for Scott, doesn't it?

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