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Public Opinion on Negotiating the Price of Rx Drugs

By Douglas Schoen

When the issue of having the federal government negotiate drug prices directly with pharmaceutical companies for the Medicare Part D program comes up later this week in Congress, it will be another example of an idea that seems to poll well and appears to enjoy a great deal of public support.

However an in depth look at public opinion shows that once the American people understand the possible implications of negotiating the cost of prescription drug prices, public opinion changes significantly and voters become very skeptical of the idea and the implications for public health.

Penn, Schoen, and Berland, a firm where I am a former and founding partner has recently completed a fairly comprehensive public opinion poll on the subject with the Tarrance Group, among 1,098 voters nationally who participated in the 2006 midterm November elections.

While voters offer initial support for the current proposal before Congress, which would require the federal government to negotiate Medicare prescription drug prices with pharmaceutical companies, once voters are educated about the possible downsides of the proposal and the implications for public health, the public overwhelmingly opposes negotiations.

Here is the precise data that was collected by these two firms.

* Initially, 76% of voters support government negotiation and 24% oppose it. However, the way the question is posed, there is no reason to oppose the proposal. After all who is really against negotiations? When I initially reviewed the results, I was actually surprised that the number supporting the proposal wasn't even higher.

* However, after we told survey respondents about some of the potential negative implications of the negotiation proposal, opinion flipped - only 35% supported government negotiations, while 65% opposed it:

Question Text: Do you favor or oppose the current proposal in Congress requiring the government to negotiate Medicare prescription drug prices with pharmaceutical companies?

medicare.gif

* In our detailed data analysis, we found significant opposition among Democrats, Republicans and Independents.

Additional data that we collected on this point was even more stark.

When voters learn that the proposal could limit access to prescription drugs, it further eroded support for government negotiations.

* 89% opposed the negotiation proposal when they learned it could limit access to new Rx Drugs.

* 87% opposed the negotiation proposal when they learned it could restrict choice of Rx Drugs.

* 86% opposed the negotiation proposal when they learned similar negotiation proposals in other countries like England and Australia have restricted access to Rx Drugs.

* 77% opposed the negotiation proposal when they learned that it gave the government the right to create a single list of government-approved Rx Drugs.

On a similar point, 80% of voters judged the negotiation proposal to be "not worth it" after learning that the Congressional Budget Office has reported that granting the federal government the power to negotiate drug prices will not save enough money to fill gaps in coverage.

All in all, when we present voters with the context and the possible implications of allowing government negotiations, public opinion turns very much against the negotiation of drug prices.

All that being said, tracking data from a survey conducted nationally on Election Day shows that voters continue to have a favorable impression of the Part D Prescription Drug benefit.

Question Text: How favorable would you say your impressions are of the Medicare Part D Prescription Drug Benefit Program? Would you say your impressions are very favorable, somewhat favorable, somewhat unfavorable, or very unfavorable?  
 
Overall
 
Nov. 7
Dec. 19-21
Favorable
56%
55%
Unfavorable
44%
45%

Moreover, the number saying they believe those enrolled in the Medicare Part D Plan who are saving money is increasing.

Question Text: Do you believe that people who are enrolled in the Medicare Part D Prescription Drug Plan are saving money?
 
Overall
 
Nov. 7
Dec. 19-21
Yes
53%
61%
No
46%
39%

Congress should instead focus on other healthcare issues that enjoy a far greater level of public support such as; insuring uninsured children, using technology like bar coding to prevent medical errors, ensuring that all parts of the country, particularly rural ones have access to good doctors, preparing government for a response to public health emergencies and increasing federal funding to cure debilitating diseases like Alzheimer's and Parkinson's.

 
Very Strongly Agree
Somewhat Agree
Don't Agree At All
Provide health insurance for all children
75%
19%
6%
Require bar coding in hospitals to prevent patients from receiving the wrong medication
73%
24%
3%
Reduce the number of medical errors through health care information technology
65%
33%
1%
Ensure there are adequate numbers of trained doctors in all rural parts of America in every state so that nobody is penalized for where they choose to live.
62%
34%
4%
Prepare the federal government to respond to possible public health emergencies like an avian flu outbreak or a bioterrorist attack
62%
34%
4%
Increase federal funding for conducting research to cure debilitating diseases like Alzheimer's and Parkinson's disease
61%
33%
6%

That agenda offers a much higher level of support and will allow Congress to begin to rebuild its support in the eyes of the public and position itself as advocates of the health and well being of the American Middle Class.

**********

NOTE: Dr. Schoen's article references the following polls:

Dec. 19-21, 2006 Poll

A national poll of 1,098 voters was conducted among those who participated in the November 2006 midterm elections.

The overall margin of sampling error is +/-2.96% and larger among subgroups.

Interviewing took place December 19 - 22, 2006 and was done in conjunction with The Tarrance Group, a Republican polling firm.

Nov. 7, 2006 Poll

Penn, Schoen & Berland Associates (PSB) conducted 2,097 nationwide interviews among Americans who voted on in the 2006 midterm elections.

All interviews were done on November 7th, 2006

The margin of error is +/-1.8% among the total sample and larger among subgroups

A memo and presentation reviewing the results described above, may be accessed through Penn, Schoen, and Berland's website:

Memo:
http://www.psbresearch.com/docs/MemoGovtNegotiationSurvey.doc

Powerpoint:
http://www.psbresearch.com/docs/PSB_GovtNegotiationSurvey.PPT

Douglas E. Schoen is the author of the recently published book, The Power of the Vote: Electing Presidents, Overthrowing Dicators, and Promoting Democracy Around the World (Morrow, 2007).

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