Recent rumblings in the Senate regarding drug pricing “transparency” have many Americans puzzled. On one hand, who could possibly oppose transparency? Surely we all support efforts to promote candor and accountability in our health-care system. And yet, knowing as we do the tendency of bureaucrats and politicians to use euphemisms to mask more sinister motives, we owe it to ourselves to dig deeper.
At issue is a proposed law, S.127, the “PBM Transparency Act.” On the face of it, this bill purports to impose greater oversight and stricter reporting requirements on obscure entities in our medical system known as “pharmacy benefit managers,” or PBMs for short. PBMs offer their services to Medicare, health insurance companies, unions, and businesses big and small, negotiating with the wholesalers of prescription drugs in order to lower prices. By one estimate, PBMs save the average American around $1,000 per year.
Outrageous, right? Downright scandalous! You can see why lobbyists working for pharmaceutical companies and drug wholesalers would want to nip those PBMs in the bud. They’re cutting into their precious profits. Joe Biden’s activist Federal Trade Commission is pitching in too, not surprisingly. In a “coincidence” that will shock no one, pharmaceutical makers were by far the biggest spenders on lobbying last year, reportedly shelling out a whopping $284 million to influence our policymakers. That’s over 70 percent more than the second-leading industry.
Like most bills circulating in Congress, this one has been written off by and for special interests — in this case, the fat cats who make billions by overcharging Americans for drugs that people in other countries get for much, much less. If that were all that was at issue in this political battle, though, you and I might roll our eyes and forget about it. After all, wasting money and making the rich richer is what our federal government does best.
It turns out, however, that the stakes might be a lot higher. That’s because provisions in the bill seem to authorize the Federal Trade Commission, the Government Accountability Office, and potentially state attorneys general to access medical records and information in unprecedented ways.
For instance, Sec. 6(b)(1) states, “If the attorney general of a State has reason to believe that an interest of the residents of the State has been or is being threatened or adversely affected by a practice that violates this Act, [he/she] may bring a civil action on behalf of the residents of the State in an appropriate district court of the United States to obtain appropriate relief,” which could involve, as per Sec. 6(b)(3), “documentary or other evidence.” What’s more, according to Sec. 6(c), in such a case, a PBM would bear the burden of “affirmative defense,” meaning that it, as the “defendant,” would effectively have to prove its own innocence.
The real danger here is that federal or state officials could decide that, to enforce the PBM Transparency Act properly, they need patient-level data about pharmaceutical prescriptions — data that includes which patients are on which drugs. There is nothing currently in the legislation to prevent this. Naturally, among the drugs at issue would be Covid vaccines. And that simple fact should set off alarm bells galore, especially considering that, as the Covid-19 “health emergency” expires in May, more and more Americans will be using their health insurance to pay for Covid vaccinations.
Let us not forget that, until very recently, the Biden administration, and its willing accomplices in the health-care industry, were attempting to coerce Americans into “getting the jab,” and they were even ordering that stubborn, selfish “anti-vaxxers” should be hounded out of their jobs, denied access to schooling, and in general should be treated like second-class citizens (or, to put it another way, worse than non-citizen illegal immigrants, to whom these mandates did not apply). Only when slapped down by the Supreme Court did the Covid tyrants relent in pursuing (most of) these pernicious and deeply un-American policies.
And that’s why now, as the PBM Transparency Act percolates in the Senate, it behooves us to ask whether something much more important than padding the profits of drugmakers is taking place. Americans should keep a close eye on this bill, and they should demand of their senators: 1) that they explain why a crackdown on PBMs is necessary in the first place, 2) that they undertake to protect patient privacy and never to impose a Covid vaccine mandate on anyone, and 3) that they clarify how much money they have received from the pharmaceutical industry, and to what degree they coordinate their agenda with that of Big Pharma.
In other words, instead of putting PBMs and ordinary Americans on the hot seat, let’s demand that our senators, and their lobbyist friends, practice some “transparency” for a change. Wouldn’t that be nice?
Dr. Nicholas L. Waddy is an Associate Professor of History at SUNY Alfred and blogs at: www.waddyisright.com. He appears on the Newsmaker Show on WLEA 1480/106.9.
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