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Do Politicians Know Better Than Patients?

By Jon Kyl

Polls show that Americans want more affordable health care options. This week the Senate will debate health care legislation that provides an important window into how the two political parties believe we should address accessibility to health care.

Republicans support a consumer-driven health care system that harnesses the competitive market to lower costs, expand access to coverage, and maintain individual control over health care decisions. In fact, we proved that the competitive model works with the new prescription drug bill.

Republicans passed a prescription drug benefit that uses market competition to provide critical medications to seniors at much lower costs than were projected. This "Part D" benefit for the first time is providing seniors with affordable access to a broad range of prescription drugs. Due to robust competition among health plans, the average senior is saving more than $1,200, with many saving much more. Average monthly premiums for seniors are only $22 -- 40 percent less than expected. Over 90 percent of Medicare beneficiaries are now receiving comprehensive prescription drug coverage, and polls show that more than 80 percent of seniors are happy with their drug coverage.

The American taxpayer also benefits from these lower costs. The drug benefit is estimated to cost $265 billion less than projected over the next ten years. When is the last time a government program came in under budget with a greater than 80 percent approval rating? Yet, instead of supporting the principles that have made this program successful, Senate Democrats this week will try to undo them.

The debate focuses on something called the "non-interference clause" in the drug benefit law. This provision requires private competitors, rather than the government, to negotiate lower drug prices on seniors' behalf. It's a bipartisan idea, actually. The first legislation to include non-interference language was introduced by the late Democrat Sen. Patrick Moynihan, and President Clinton's health care proposal included language almost identical to what is being debated now.

Importantly, the non-interference language does not prohibit negotiations for lower drug prices. Drug price negotiation is at the heart of the Medicare prescription drug benefit. Rather, the non-interference language prevents the government from interfering in the private sector negotiations already happening.

But now Democrats say that they don't believe that competition is working, and they want the government bureaucracy to step in and fix prices, despite the fact that the nonpartisan Congressional Budget Office (CBO) has repeatedly stated that private sector negotiations are effectively working to lower prices. More importantly, the CBO has repeatedly said that the Democrat model will not lower prices unless it also restricts choice and access to important medications.

Rather than the competitive free market plans that allow seniors to choose an option that best meets their health care needs, the Democrats want a "one size fits all" approach that puts the government between seniors and their doctors.

Proponents of government intervention say they simply want to use the market power of the large number of Medicare beneficiaries to lower prices. But private pharmacy benefit managers (PBMs) already use this same market clout to negotiate lower prices. In fact, according to a report by the Congressional Research Service, the three largest PBMs already negotiate on behalf of four times as many beneficiaries (200 million) as the entire Medicare population (44 million).

The choice is clear: a government-run health care bureaucracy that restricts choice and rations care or a consumer-driven health care system that expands health care options while controlling costs. The prescription drug legislation has put this choice to the test, and seniors have proven that they prefer the Republican model. Seniors have independently chosen plans that provide more health care options at lower costs. For example, 88 percent of seniors who enrolled in a prescription drug plan in 2007 chose a plan that offered coverage other than the standard benefit, and this year seniors have chosen plans with 13 percent more available medications than last year.

The debate on "non-interference" is, therefore, a proxy for whether we should pursue health care reform with more or less health care options for consumers, more or less government control, and more or less interference between the government and patients. Seniors have made their choice clear by making the prescription drug benefit a resounding success. The question is whether politicians know better than the patients.

Sen. Kyl serves on the Senate Finance and Judiciary committees and chairs the Senate Republican Conference. Visit his website at

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