After the rhetoric, US Democrats face questions over drug reforms

After the promises of reforming Medicare "in the first 100 hours" of taking control in the US Congress, Democrats are facing the realities of policy opportunity. Perhaps ominously for those with plans of wholesale reform, two of the three most influential US liberal-leaning newspapers have all published analyses of the Medicare Part D prescription drug benefit, concluding that leaving it substantially alone would make the most sense. Other reports suggest that more areas of the Democrats' drug agenda are being downplayed, which leaves congressional oversight and the prospect of hearings to cross-examine government health care agencies and drug industry executives on issues ranging from ensuring safety in the approval process to drug purchasing policies by federal government agencies.

The Washington Post, having previously suggested that the Medicare Part D program deserved a decent trial period before major changes were made (Marketletter November 13), describes the Democrats as "struggling" to keep their promises on drug price negotiation. Prior to winning control of both Houses of Congress, the then opposition said that it would overturn the ban on allowing the Department of Health and Human Services to negotiate, on behalf of the Medicare drug plans, prices directly with drugmakers. The proposal was condemned by the drug industry and supporters of free market pricing as "back-door price controls." The HHS Secretary, Michael Leavitt, even went so far as to declare himself opposed to being awarded additional powers.

"When you've got a law that is working well, why change it?"