Tuesday, October 31, 2017
[Editors Note: Today we begin a series of Scholarly Voices posts reflecting on the past year since the 2016 election. Why? We, the editors, realized that we were exhausted from the political rollercoaster of the past year, and that we needed to find a way to re-charge our batteries. We asked some of our wisest colleagues if they could contribute reflections on the year since the 2016 election, thoughts about where we find ourselves at this moment, and what the future might hold. Happily, many of them agreed to write! We begin this series with a contribution from Fran Quigley, who directs the Health and Human Right Clinic at Indiana University McKinney School of Law and the advocacy group People of Faith for Access to Medicines. His new book is Prescription for the People: An Activist’s Guide to Making Medicines Affordable for All.]
by Fran Quigley, Indiana University McKinney School of Law
For the last few years, I have been happily locked into hedgehog (“the fox knows many things, the hedgehog one big thing”) mode. My advocacy, writing, and even much of my teaching have all been focused on the crisis in access to medicines, where millions are suffering and dying because the medicines to treat them are priced out of reach.
In this realm, where profits have trumped people under all of the recent U.S. political regimes, one does not need the recent elections to find cause for despair.
But expressing despair is not the assignment our esteemed blog editors have handed us. They ask for hope, and hope can be found in this hedgehog’s nest, too.
Start with the Trump phenomenon itself. In drug pricing as in other populist issues, Trump echoes the deep frustration with this country’s profound inequality and the rigged economic system that perpetuates it.
Polls show large majorities of Republicans and Democrats alike are furious about drug companies using government-granted monopolies on government-discovered medicines as a launching pad for price-gouging. And those same majorities want government to do something about it. Trump taps into that frustration with his rhetoric, saying the drug companies are “getting away with murder,” and pledging big changes.
Of course, we know better than to believe that Trump will actually pursue meaningful action to back up his screeds. In fact, he has stocked his staff with pharma industry veterans who are working to create an executive order on drug pricing that would do far more harm than good.
But there is hope in the fact that he feels the need to repeatedly claim he is addressing the imbalance between corporate power and individual needs. For us human rights activists, the growing popular recognition of this raw deal is fodder for something more meaningful than a presidential tweet—something like the long-overdue U.S. recognition of health as a human right, not a commodity to be auctioned off for the few who can afford it.
A second reason for hope in the access to medicines world is the seizing of reform initiative at the states level. While multiple drug pricing proposals go nowhere in Congress, states are feeling the budget pinch from skyrocketing costs to their Medicaid programs, and hearing up-close from struggling constituents. So the laboratories of democracy have fired up their bunsen burners hot enough to singe Justice Brandeis’ eyebrows.
Just this year, Nevada enacted a new insulin pricing transparency law, Maryland empowered its attorney general to sue generic drug manufacturers if their prices rise more than 50% in a year, California passed a requirement for pharmaceutical companies to give notice and justify large price increases, and New York created a de facto cap on the prices it will pay for drugs under its Medicaid program. These are just a few of more than 100 pieces of legislation on prescription drug pricing introduced in state legislatures in 2017 alone.
And guess what? Most of the state-level action on drug pricing is a bipartisan effort. An increasing number of free market Republicans are growing weary of defending a pharma industry dependent on government-imposed patent monopolies and no-negotiation bulk purchases from the U.S. government.
So there you have it. There is optimism to be found in the Trump administration, state government actions, and the stances of political conservatives. Just think of the inspiration we can derive from the growing grassroots activism for access to medicines by patients themselves, healthcare providers and labor unions.
Even in these dark days, we are still able to fill our prescription for hope.
[Eds: Want more? The second post in the series is here!]