Image Source: Huffington Post

If there is one thing that some of the extreme left and standard Democrats share, it’s their ability to attack and rip apart any of their own based on bare bones information. It typically has to only include some meme posted on social media and, without fact checking or being aware of the real contents of an amendment or bill as well as lack of knowledge of the industry that it will affect, liberals make the decision that a candidate is “unworthy” of their support.

This is what happened in January, 2017, when thirteen Democrat leaders voted against an “amendment” that was added to a bill that supposedly lowered prescription drug costs for those imported from Canada. This situation was immediately snagged by extreme liberal groups as they ran down the streets ripping their hair out and posting some rather misleading information on the Dem Senators as well as not having any idea of the “amendment” (note — not a bill) itself or what it really meant. While thirteen Democrats were involved in the vote, Sen. Cory Booker (D-NJ) was singled out for most of the attack.

I have worked in the pharmacy industry for many years and after reading the amendment information and following the bad info that was being posted, I spent a lot of time making an attempt to “explain” what was going on. Some receive the explanation well, while others were too busy throwing Booker and the other twelve Senators under the bus; refusing to even accept the data, the experience or the knowledge.

To begin with, you have to understand that this was an amendment only and it was deliberately added by Sen. Bernie Sanders (I-VT) with the understanding and belief that the other Senators would see through the ruse, vote against it, and then allow his radical groups to hold these Dem Senators up and burn them in effigy.

The action worked, as the liberal cult groups flooded social media with bogus data and Booker, as well as his associates were crucified.

Way to go guys. Sanders accomplished what he wanted so that his cult and others would refuse to endorse Booker and others as part of his “purity test”.

The Meme is Misleading and WRONG

Before I talk about the actual amendment and the bill, I will address the meme that was circulating that led so many liberals to the point of no return.

A Politifact article addresses this misleading meme by stating:

“The viral image was created by a group called The Other 98, which says it fights “economic injustice, undue corporate influence and threats to democracy.” We were unable to reach a representative of the group. However, we were able to make pretty solid guesses about the underlying reference.”

(Note: The first hint should be that they misspelled Booker’s first name)

The group that reported these numbers lumped ALL of the donations from healthcare sources under the heading of “Big Pharma”. This is not only misleading, but wrong. The article continues to detail:

“However, the ‘pharmaceuticals/health products’ category as defined by the Center for Responsive Politics is actually broader than what most reasonable people would consider “big pharma.”

For this purpose, a more accurate subcategory for “big pharma” would be the Center for Responsive Politics category “pharmaceutical manufacturing.” Several of the senators listed on the post rank in the group’s top 20 recipients of ‘pharmaceutical manufacturing money’ during recent election cycles, but not all of them do — and the amounts for each are smaller than what the meme reflects.”

Considering that the correct header for the donations should be “healthcare”, it should also be noted that the one name that is conveniently omitted from this list is Bernie Sanders himself. In an OpenSecrets.org article, they list the single year of 2016 that shows Sanders received $119,535 from a “healthcare organization”. (Kaiser Permanente). While the donations from these sources for Sanders are a bit below the others, clarity is required when you make an accusation.

The most IMPORTANT factor of the donations themselves exists in the area of “who” donated. This is a critical piece of data. The Politifact article states:

“Then there’s another caveat we always mention in articles like this one. The industry donation breakdowns tallied by the Center for Responsive Politics doesn’t just include donations by fat-cat executives and company political action committees. It also includes donations made by any individual employed by a company in a given industry sector. This can include rank-and-file employees — and in states with a heavy pharmaceutical presence in the workforce, this can be a significant factor. These states include Delaware, represented by Carper and Coons, and New Jersey, represented by Booker and Menendez.”

This means that any doctor, nurse, medical technician or anyone “employed” in the healthcare vertical that made a donation to these candidates are included in the dollar figures that they lumped into “Big Pharma”.

Image Source: Politico

One Bad Amendment Replaced and Then Supported By the 13

The FDA has historically used reasoning for not approving the import of drugs from other countries. Those that have no idea how the industry works have railed against them as a way to show that they are simply encouraging a profit machine for pharmaceuticals. But there is a reason for the stand by the FDA:

Not all countries have the same guidelines as the United States for drug manufacturing. While we are far from perfect, these rules assist in protecting Americans against getting medications that are made in less than sterile or monitored conditions as well as ensuring that the formulations are correct. Those that scream about cheaper drugs have no clue that medications from other countries could include things such as rat feces or even lesser quantities of the main ingredient. While it is well-known that both Canada and Japan exceed the guidelines of even the United States, not all of the medications that would be imported from Canada would fall under their guidelines.

The problem has been so bad for various areas of chemical monitoring, that the FDA began working with China to try to oversee the issue.

As indicated, Sanders was fully aware of how useless the amendment was that he introduced.

The Politifact article included exactly what the amendment wouldn’t do:

“The vote was more symbolic than substantive. It was an amendment to a Senate budget resolution, which is a non-binding measure that doesn’t get signed by the president or become law. Rather, they set a framework for committee chairs to work within when deciding how to spend money.

So the measures shouldn’t be oversold as direct action.

‘Simply put, if adopted by the Senate, the amendment would not have required the United States to begin importing drugs from Canada — period, full stop,’ said Jeff Giertz, communications director for Booker. ‘It would have added language into the budget resolution that would have advised the Senate to spend money in a way that would result in this.’ ‘Giertz said that Booker supported the same goals, but wanted to see a framework for ensuring the safety of imported drugs included in the amendment.’ “

Here’s the real low-down that the extremists DIDN’T include:

“It’s important to know that every one of the 13 senators listed in the meme voted in favor of a separate amendment that did urge lower drug prices.

This other amendment effectively prevented the Senate from considering legislation that did not ‘as promised by (President-elect Donald Trump), lower drug prices, as certified by the Congressional Budget Office.’

Like the other amendment, this did not pass — it won only 47 votes in favor, with 51 against. But the fact that all 13 senators listed on the meme voted to support this amendment muddies the conclusion of the meme that they all ‘voted against cheaper medicines.’”

While everyone seems to think that the Senators involved in the vote were simply abiding by the hidden money of the drug companies, many of them recognized that the “amendment” was not only useless, but deliberately inserted to fail.

It was the wording of the original amendment that the Senators took offense to, NOT the ability to offer lesser cost medications for Americans.

Image Source: Slide Share

A Lesson On WHO Controls the Drug Costs

One of the benefits of working in the pharmacy industry is in knowing the details. A majority of the American public points the finger of blame to the pharmaceutical companies for the high costs. Granted, they are the first line in establishing pricing for their brands, and they have to not only earn back the investment made for the long process of development, testing and rigorous FDA approval, but show a profit for those brands within the seven year timeline before they can be launched as generics.

However, when it comes to going to the pharmacy and picking up a prescription, there is a little-known group that is actually controlling the prices. These are the pharmacy benefit managers or PBM’s and they are the dark side of the high drug costs.

A simple explanation of who this group is can be found via Wikipedia:

“In the United States, a pharmacy benefit manager (PBM) is a third-party administrator (TPA) of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.[1][2][3]

According to the American Pharmacists Association (APhA), “PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims. For the most part, they work with self-insured companies and government programs striving to maintain or reduce the pharmacy expenditures of the plan while concurrently trying to improve health care outcomes.”[4][5]

As of 2016, PBMs manage pharmacy benefits for 266 million Americans.[2] They operate inside of integrated healthcare systems (e.g., Kaiser or VA), as part of retail pharmacies (e.g., CVS Pharmacy or Rite-Aid), and as part of insurance companies (e.g., UnitedHealth Group).[1][5] There are fewer than 30 major PBM companies in this category in the US,[1]and three major PBMs comprise 78% of the market and cover 180 million enrollees.[1][6]

A PBM has the power to negotiate with large groups, including insurance companies, to coordinate which medications will be allowed as part of a program, the requirement of a brand over generics to participate, and the pricing itself. They align themselves with the largest healthcare providers and the bigger the group, the better the discounts. While you might think this is a “good thing”, they are also in the back pocket of the pharmaceutical companies and it is this end that causes some of the higher prices. They are influenced by the big money that they are collecting to negotiate deals that only support brand drugs and can limit what a health insurance company can offer.

Drug companies play both sides and one of their major goals has been to appeal to the patients directly via direct-to-consumer advertising. We have all seen them, the commercials showing happy health people taking an array of medications that somehow now have names that are less “medicinal” and a lot more friendly sounding. But then, as the commercial wanes, we hear a litany of side-effects that are often more disastrous than the original disorder that you are taking the medication for!

Only two countries in the world allow direct-to-consumer advertising for pharmaceutical drugs: The United States and New Zealand. The rest of the world knows that this is a bad idea.

There are many elements to the high costs of medications and before you do a knee-jerk reaction in throwing some of our best representatives away:

Read the actual documents to understand why they may have voted in a specific direction.

Fact check before believing any organization’s accusations and claims.

Learn from those in the specific industry — so you know the details.