"The Ugliest Night I Have Ever Seen" - 60 Minutes on How the Medicare Drug Benefit Bill Was Passed

The legendary television news magazine, 60 Minutes, just did an expose of how the US Medicare Part D prescription drug benefit bill was passed. It is well-known that US drug prices have continued to increase since this bill, which prevented Medicare from negotiating the prices it paid on behalf of patients for drugs.

The vote for the bill came in the wee morning hours, in a process that a Republican congressman who opposed the bill described as "the ugliest night I have ever seen in 22 years."

It is worth reading the full transcript of the story, but what I found most striking were the number of relationships it cataloged between congresspeople, staffers, and other federal officials and the pharmaceutical industry. These included:

• Bill Tauzin (Republican - Louisiana), who "steered it [the bill] through the house," within a few months "began discussions with the pharmaceutical industry to become its chief lobbyist in Washington." Tauzin had an "extremely rare" tumor removed, and was treated "with a new medicine, Avastatin, that had never been used on that form of cancer. The treatment was succesful , and as a result Tauzin felt he owed his life to the drug industry." [but apparently not to the surgeon - Ed] "After serving out his congressional term, he accepted a $2 million-a-year job ... as president of PhRMA - Pharmaceutical Research and Manufacturers of America."
• Medicare Chief Actuary Richard Foster said he "was told to withold the new numbers" that gave an honest estimate of the cost of the new drug benefit, and said "the person who told him to withhold Congress from getting the revised estimates was Medicare boss Tom Sculley." But, "Sculley was the administration's lead negotiator on the prescription drug bill, and at the time was also negotiating a job for himself with a high-powered Washington law firm, where he became a lobbyist with the pharmaceutical industry."
• Multiple former federal legislators helped lobby for the bill, including "former senators Dennis Deconcini (D-Arizona), and Steve Symms (R-Idaho), and former congressmen like Tom Downey (D-New York), Vic Fazio (D-California), Bill Paxon (R-New York), and former house Minority Leader Robert Michel (R-Illinois)."
• "John McManus, the staff director of the Ways and Means subcommittee on Health. Within a few months, he left Congress and started his own lobbying firm. Among his new clients was PhRMA, Pfizer, Eli Lilly and Merck. "
• "Linda Fishman, from the majority side of the Finance Committee, left to become a lobbyist with the drug manufacturer Amgen. "
• "Pat Morrisey, chief of staff of the Energy and Commerce Committee, took a job lobbying for drug companies Novartis and Hoffman-La Roche. "
• "Jeremy Allen went to Johnson and Johnson. "
• "Kathleen Weldon went to lobby for Biogen, a Bio-tech company. "
• "Jim Barnette left to lobby for Hoffman-La Roche. "

One Republican congressman who opposed the bill commented thus about Billy Tauzin's new job, "I mean, when you're pushing so hard for a bill that's controversial and you have to keep the machine open for three hours to get the one vote necessary to pass it, and then, within a matter of months you go to work for the industry that's gonna benefit from it, it does cause you some concern."

Well, if nothing else, this case shows that it is not only physicians and medical academics who have issues with conflicts of interest involving the pharmaceutical and biotechnology industries.

It also suggests that simplistic arguments between advocates of private insurance and single-payer government financed insurance, each claiming that their approach would solve all our health care problems, completely miss the point.

What would help to solve our problems is to get rid of the conflicts that interest that affect health care policy, not just academics and policy experts paid on the side by commercial health care firms, but legislators and legislative staff working to impress their eventual commercial employers, when they are supposed to be representing the public.

See also the post on PharmaGossip, and the post on PharmaLot.