HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, December 12, 2009

Senate Stalled Over Drug Importation Proposal

A bipartisan proposal to allow the importation of less expensive drugs from Canada (and some other countries) has stalled the Senate debate over health care reform. A story in the New York Times by Robert Pear reports that approval of the proposal could destroy a deal between the White House and the pharmaceutical industry to lower drug costs:

The industry, represented by the Pharmaceutical Research and Manufacturers of America, or PhRMA, adamantly opposes legalizing additional imports and says the government could not guarantee the safety of imported medicines.

As members of Congress before last year’s election, President Obama and his chief of staff, Rahm Emanuel, supported efforts to allow drug imports. But now the Obama administration, like pharmaceutical companies and the Bush administration, is raising safety concerns.

The chief sponsor of the proposal, Senator Byron L. Dorgan, Democrat of North Dakota, said: “People are walking on eggshells. If we pass legislation allowing people freedom to import drugs, the pharmaceutical industry might not support the health care bill.”


In a letter to the Senate, Dr. Margaret A. Hamburg, the commissioner of food and drugs, expressed concern that imported drugs might be contaminated or counterfeit because the Food and Drug Administration “does not have clear authority over foreign supply chains.”
The Congressional Budget Office estimated that Mr. Dorgan’s amendment would save the federal government $19.4 billion over the next decade, because federal programs would spend less on medications.

'U.S. consumers are charged the highest prices in the world for drugs that sell for a fraction of the price in most other countries,' Mr. Dorgan said. “My amendment includes strong safeguards to prohibit drug counterfeiting and other practices that would put the consumer at risk. It applies only to F.D.A.-approved prescription drugs produced in F.D.A.-approved plants from countries with comparable safety standards.”

December 12, 2009 | Permalink | Comments (0) | TrackBack (0)

Wednesday, December 9, 2009

Controlling Individual Food Choices Of Those Who Are Dependant On Food Stamps

Dependence on government food stamps in the United States is soaring, according to a recent New York Times article. As more are relying on food stamps, the article reports, the stigma associated with food stamp use is fading.

The reality is that reliance on food stamps opens the door to judgments about individual food choices. In the running series Room for Debate, the Editors of the New York Times have collected a series of opinions from several different points of view in an article entitled Food Stamps: The Economics of Eating Well 

If people buy fresh vegetables or other relatively expensive though nutritious foods, they are considered to be living high on the hog at the taxpayers’ expense. But if they buy cheap foods like hot dogs they are criticized for poor health habits.

Despite these common complaints, does the system work? Are the current rules fair in regulating what people can buy and not buy? Or should the requirements be changed? Should un-nutritious products like soda be banned? Is there a better way to distribute free food and promote nutrition in this country?

December 9, 2009 | Permalink | Comments (0) | TrackBack (0)

Tuesday, December 8, 2009

Medicare Expansion An Alternative To Public Option?

Under a proposal being considered by Senate Democrats, people 55 to 64 will be allowed to buy insurance at subsidized rates under an expansion of the Medicare and Medicaid program. This proposal is part of an alternative to a government-run insurance plan. See The Wall Street Journal, Bloomberg, The New York Times, Yahoo!/The Associated Press, CNN, USA TODAY, The Politico (Washington).

December 8, 2009 | Permalink | Comments (0) | TrackBack (0)

Monday, December 7, 2009

'Cadillac Tax' Could Result in Employers Cutting Health Insurance Benefits

A new survey by the Mercer Group suggests that the 'Cadillac tax' proposed in the Senate Democrats’ health care bill could trigger many employers to cut health care benefits. According to Kaiser Health News, "[t]wo-thirds of employers would raise deductibles, change insurers or scale back coverage to avoid the so-called Cadillac tax on high-cost benefits ...."

The excise tax —which is placed on insurers, but is expected to be passed along to employers — could hit up to 19 percent of medical packages offered by employers in 2013, the first year it goes into effect, according to a separate Mercer analysis of data from 3,000 firms. Whether an employer’s benefits are subject to the tax depends on the combined cost of all medical benefits, including health, dental, vision and other benefits, such as worker and employer contributions to flexible spending or health savings accounts. Workers and employers can put pre-tax money into health savings accounts, helping cover deductibles, for example. If the combined total of all benefits exceeds annual thresholds of $8,500 for individuals or $23,000 for families, the difference would be subject to a 40 percent excise tax.

The Mercer survey (.pdf) of 465 employers – a nonscientific sample – also found that of the 63 percent who would make changes to avoid the tax:

-- 75 percent would raise deductibles or copayments to bring down premium costs.
-- 40 percent would add a lower cost health plan as an alternative.
-- 19 percent would terminate employer contributions to health or flexible savings accounts.

While employers aren’t yet changing benefits in response to the proposal, analysts say, the excise tax is one of their main concerns.


December 7, 2009 | Permalink | Comments (0) | TrackBack (0)