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Wednesday, February 21, 2007
John Stossel :: Townhall.com Columnist
No Drug Price Controls
by John Stossel
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The Democrats who now control Congress want to change President Bush's Medicare drug benefit to require government officials to negotiate drug prices with the pharmaceutical companies. Under the current program, competing insurance companies cut the deals and offer coverage to the retired and disabled.

Yet another lesson in the well-established principle: Government intervention begets more government intervention.

When Bush signed this program into law, it was the biggest expansion of the welfare state since Lyndon Johnson's Great Society. As with all "entitlement" programs, the costs will explode. Tax-financed health programs are always more expensive than promised.

Rep. John Dingell, D-Mich., defends the drug-negotiation proposal, saying, "It will deliver lower prices to seniors, lower prices at the pharmacy and savings for all taxpayers."

At first glance the idea makes sense. Instead of multiple companies competing to negotiate drug prices, have one big powerful entity do the negotiating. Wouldn't that lead to lower prices?

It might -- and that's part of the problem. We should be suspicious when someone promises benefits from a government monopoly. Government doesn't produce things. It simply uses force to move things around. So why think that Medicare, hardly a paragon of efficiency, should be given the power to negotiate -- in reality, control -- prices?

Government's clout to negotiate lower drug prices supposedly comes from Medicare's 43 million beneficiaries. According to the theory, drug companies will have little choice but to submit to the government's demands because having their products excluded from the program would be self-destructive.

But there are problems with that theory. First, the government doesn't know what the "right" price is. In the real world, prices are set by supply and demand. Government is not part of the marketplace and would have no competitors. Its attitude would be "take it or leave it."

The story won't have a happy ending. A lot of money is needed to develop medicines. Getting a new drug through the FDA labyrinth to consumers takes $1 billion. Most drugs in the research pipeline never even get that far. It's a failure-intensive business.

The occasional success makes it all worthwhile.

So when the government uses its muscle to force prices to sub-market levels, the drug companies will develop fewer life-saving drugs. We will suffer more pain and live shorter lives.

Medicare participants probably won't even have access to some drugs that are already developed. To see this we need only look at the Department of Veterans Affairs. I happened to have lunch with Sen. Hillary Clinton recently. When I went into one of my usual libertarian rants about free markets, Ms. Clinton cited the VA as an example of government success. Indeed, under her husband's administration, the Veterans Health Administration came to provide the "best care anywhere," according to The Washington Monthly. Great.

But government monopolies like the VA never embrace innovation in the same way the private market does. And sure enough, the VA now rations drugs. If you are a VA patient and you need a new and expensive drug, you can't get it. Writes Sally Pipes, president of the Pacific Research Institute and author of "Miracle Cure: How to Solve America's Health-Care Crisis and Why Canada Isn't the Answer", "Only 19 percent of drugs approved by the FDA since 2000 are listed on the VA formulary, and only 38 percent of drugs approved in the 1990s are listed. ... ".

In other words, the department keeps a rein on costs by withholding drugs from veterans.

The giant Medicare drug program, which created the cost problem the Democrats say they will solve, shouldn't have been created. We ought to get our drugs through the private marketplace or from private charities. If government must be involved, at least let it be through the states so they can compete against each other.

The last thing we should do is give federal officials more power. When government controls prices, it must eventually ration supplies. Consumers suffer. When the product is medicine, the results could be catastrophic.

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John Stossel blogs at http://blogs.abcnews.com/johnstossel/ is an award-winning news correspondent and author of Myths, Lies, and Downright Stupidity: Get Out the Shovel--Why Everything You Know is Wrong.
 
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The Democrats complain about
the price of drugs but they are the ones mostly responsible for this artificial mess. The laws on drug patents were overhauled during the period when the Demos and Klinton controlled the government giving the drug companies the ability to maintain patents much longer and to renew patents with only minor changes to the drug. This allows the drug companies to keep out the lower price generic drugs for a much longer peiod of time. The actual cost of manufacturing a drug is miniscule compared to what is charged by the drug company.

The drug companies claim that they need this in order to offset the high cost of testing prior to release of a drug for use in the markets. No what we need is to go back to the old laws for a shorter patent period so that generics can come on the market more quickly and we need something else to get the price of testing and development down.

What the Dems are also not telling you is that their other major constituency, the trial lawyers, are also partially responsible for the high cost of marketing these drugs. Like AGW, the difference between coincidence and causation is a hard point to get across. It is hard to convince a lay jury that just because 3 or 4 people develop a problem while taking some drug, that that doesn’t necessarily mean the drug caused the problem. That makes little difference when the laws are rigged to give the trial lawyers the ability to achieve jackpots from the drug companies and insurance companies.

Yes, there are a lot of things that could be done to reduce the price of drugs, but having the government dictate the price is the typical socialist response favored by the Dems.

Drug Companies
Like all companies, they are entitled to an "honest" profit, but who determines that figure?

My rhetorical question is: "Could the greater majority of mainly older Americans afford to pay for all of their health expenses?" Unlikely, for sure, and that's where health insurance jumps in...to which we pay premiums.

Prescripion drugs are included in this health care and I tend to think the companies have no justification for the astronomical price tags they put on some of these drugs.

Some health insurance companies refuse to cover some of these drugs, no matter that they worked very well for the patient. They insist on a lower priced medication.

Yet, U.S. pharmaceutical companies do not want Americans to purchase drugs from Canada, where they actually can save some money.

As to how long a drug company should be entitled to hold a patent on a drug they developed, I don't know the answer to that. But I completely disagree that they, and the Federal and State goverments of the U.S. should have the power to prevent U.S. citizens from purchasing needed drugs from Canada, for instance.

If they can't afford the prices here, why shouldn't they? It's their lives!

Last comment: How many advertisements have we all witnessed on TV in the last few years for SOME drug? "If you have this or that, you may not be able to take this drug." And, "Ask your doctor about this drug".

My opinion: Stop advertising prescripion drugs. The media is hardly the place for it. Lower your prices instead. We'll all be better off!

For those...
...who think that drug companies are making excessive profits off their drugs,please tell us how much stock you own in those companies.If you believe what you are saying,I would think that you would want to get in on the action.After all,the drug companies are for sale Monday through Friday on the New York Stock Exchange.So take out a second mortgage on your house,borrow from banks and your family and friends as much as you can,and call a stock Broker the first thing in the morning.

Just think,you can be one of those fatcat exploiters making obscene profits off the little guy! Just like those other fatcats in the oil business!

Of course,if you are wrong,you are going to lose your shirt.But to prove you believe what you are saying,please tell us upfront how much stock you own in those companies.

Solution is simple...
The problem with the drug companies, and almost every other sort of intellectual property debates is that fact the the first copy of something costs a fortune, and the second and subsequent copies are almost free.

This is why the drug companies can sell drugs in Canada cheaper... Canada caps the price they can sell the drug, and the drug companies largely don't care as long as those cheap drugs don't find their way back to the unregulated US market.

This is particularly irksome given the fact that the drug was developed by Americans, tested on Americans, and eventually sold to Americans at the highest prices.

So the solution is this: Simply make a law that the drug companies cannot sell a drug in the US for MORE than the lowest price sold to any other G8 country. This would put the US into the same "boat" as the Canadians and the Europeans. Drug companies would play hardball with these countries, and since those countries can't afford NOT to have the drugs, they will end up paying more and we will end up paying less. We all then can defray the cost of the development of these drugs, drug companies can still make a lot of money on them, and thus the incentive to make new drugs goes on unabated.

US citizens are winners in this scenario, and the G8 countries are the losers since they will pay more, but no one has to pay the outlandish prices these drugs are sold at in the US.

A fairy tale
Pretend that I'm a drug(or any other) company. It costs me $2 a pill to put a medicine on the market which breaks down thus: $.25 for production costs, $.25 for administrative costs, $.25 for taxes, and $1.25 for R&D costs required for FDA approval. A foreign govt (look up North) passes a law that only allows me to charge for direct production costs. How many pills do you think I'm gonna offer for sale at a $1.75 loss on each? Hmmm.

We have previous experience with this
Does anyone remember the SHORTAGE of flu vaccine from a couple of years ago?

That was a Hillary Clinton government negotiation boondoggle come home to roost.

While the Clintons were in the White House they "negotiated" with the drug companies (extorted them actually) and got the exact same kind of cap put on the price of kids flu shots that were administered at public schools that the Dems are now proposing for all Medicare and Medicaid prescriptions.

The result was that all but one manufacturer eventually bowed out of the flu vaccine business because they COULDN'T MAKE A PROFIT! (Harmony please note)

When the lone remaining manufacturer had a problem with one season's batch guess what. We got a shortage.

When Nixon imposed "price-wage freezes" in the early seventies it resulted in guess what. A gasoline shortage (and yes I know there was an oil embargo, but that too was government intervention).

Today we are still paying higher prices for auto fuel, electricity, and natural gas because the federal government has interfered with the free enterprise in the energy industry.

Anytime the government meddles with the free market the results are either higher prices or shortages. The one significant exception to this concept is the Sherman Anti-Trust Act, which actually contributes to a free market by preserving competition.

The notion that 'capping' prescription drug prices will somehow escape the same natural economic forces the befell energy and flu vaccine is not only an example of hopelessly naive do-gooderism, but also an example that theleft is incapable of learning from previous experience.

U.S. citizens are stuck with the bill
Coolmoose hits the nail on the head. Why should U.S. citizens pay the entire development costs of these drugs and let the rest of the G8 countries have a free ride? Obviously, the drug companies must make a profit and recoup their development costs. Nothing says that they must make all of their profit here in the U.S. The free market argument falls apart. There is no free market on drugs between the U.S. and the rest of the first world countries. I find it ironic that the U.S. government and drug companies act concerned about possible counterfeit drugs crossing the border. Without the laws restricting international drugs sales, we could buy from reputable suppliers and pharmacies in Canada and elsewhere.

Coolmoose and Frank
The drug companies aren't making a huge profit in the US, they are making up for losses they suffer in other countries which impose price caps. Put those price caps in the US too and you will not see cheap drugs, you will see, first, no NEW drugs, as research funds dry up, then, no drugs at all, as the companies go bankrupt, when they have virtually no profits but are still subject to absurd US liability laws and the massive cost of FDA approval.

So, go ahead, try to cap drug prices in the US. Enjoy going back to a lifespan of 40 or 50 in the US... Great plan.

NOTHING the gov't does is "cheaper".
The best comparison I can think of is the US Postal Service. A little known fact is that the USPS was made a government-authorized monopoly (nobody else is allowed to deliver First Class mail...the Boy Scouts of America, in fact, were once fined $50,000 for putting Christmas cards in people's mailboxes because they "violated" this monopoly) in the 1870s. According to the congressional record, the reasoning for this is that if competition were allowed, the USPS wouldn't be able to compete. Congress openly admitted that the private market could deliver mail more efficiently for a lower price than the government could ever dream of.

The Democrats' support for government control isn't about lowering any prices. It is about the control, plain and simple.

Medicare
Ok, is anybody here a physician? Do you know that the physicians are forced by the government to accept medicare patients as a condition of accepting any private insurance? Do you know how poorly medicare pays? Pennies on the dollar. On top of that, they frequently put unreasonable preconditions on the care requirements that make it impossible to turn a profit if one plays by the rules. Case in point- a physical therapist can generally work with four patients at a time (ongoing care, using a PTA) when they are private insurance pts. No decrease in the level of care each receives. Medicare, while paying only a fraction that the private insurers do, demands that their pts are scheduled completely by themselves and seen by the therapist only for the entire time. On top of this, Medicare has been scheduled for directed compensation cuts totalling 20-30% over the next several years. I am not talking about a "cut" in politicalese where a reduced increase is called a cut, either. They plan to pay less and less to private physicians and facilities, in today's dollar, as time goes on. Do the docs' prices for everything not increase yearly? Why will they accept this? Oh, yeah- the govt. has legislated that they can force them to. It gets worse as the private insurers are moving away from "usual, customary and reasonable" fees to paying 108% of the medicare fee schedule. Do you all think that the gov't. will not use their heavy hand to force big pharma to operate at a loss? What will be the influx of new drugs on the market as companies fight to just stay afloat? Zero! Thanks Pres Bush and the Republicrats, the blame rest with you.

Important economic reality
Come to grips with this FAST because it won't ever change:

You can change the price of anything but the cost of nothing.

Once you accept this, price meddling in any industry by the 'all knowing' guys with guns(Feds) is idiotic.


All potentially effective proposals...
...to reduce spending on pharmaceuticals have one thing in common. They only work if pharmaceutical companies reduce the new medicines they bring to market.

But nobody is stupid enough to propose limiting pharma companies spending on new drugs, or to propose a limit on the number of new drugs a company can bring to market. But if Plan X is going to reduce spending on pharmaceutical products, you can bet it will have the same effect.

But what's coming is coming. You won't see as much fanfare as when an automaker closes a manufacturing plant, but research centers will be quietly closing over the next 15 years.

It is true that other countries are getting a free ride on the backs of American consumers. If that's what's bothering politicians then they can enact pricing-parity laws.

Harmony,
Since your misconceptions are some of the most common ones about the pharma industry, I’ll try to answer all your questions.

“Like all companies, they are entitled to an "honest" profit, but who determines that figure?”

-- The market, of which you are a part.

”My rhetorical question is: "Could the greater majority of mainly older Americans afford to pay for all of their health expenses?" Unlikely, for sure, and that's where health insurance jumps in...to which we pay premiums.”

-- Let’s say, you can invent a treatment that will extend my life by 1 year. If I cannot afford to pay you what it costs to invent and produce the treatment, what do you think should happen? Insurance premiums are just a way to smooth out health care costs equally among a group of individuals. Do you think the government should force you to produce the treatment for my benefit? Do you think it’s a solution to force everyone else to share in the cost? Should the government take my neighbor’s money and subsidize us?

”Prescription drugs are included in this health care and I tend to think the companies have no justification for the astronomical price tags they put on some of these drugs.”

-- It costs an astronomical amount of money to bring a product to market. Then companies make money for a little while. Then it goes generic and anyone can make the product, offering it for a markup over manufacturing cost. Without that small part in the middle there would be no new treatments. Ever.

”Some health insurance companies refuse to cover some of these drugs, no matter that they worked very well for the patient. They insist on a lower priced medication.”

-- Sometimes a much less expensive treatment is almost as good, or is just as good for an individual. But I thought what you WANTED was the lower priced medication.

”Yet, U.S. pharmaceutical companies do not want Americans to purchase drugs from Canada, where they actually can save some money.”

-- You cannot “save” money this way. If re-importation were to become common, pharma companies would either raise their prices to Canadians, or they would simply stop shipping their products into Canada. And as for those internet pharmacies of “Canadian” drugs, it is more likely that the company is a post-office box in Miami, with a computer server in Belize, buying dosage form products from India made from chemical that came from a non-registered, non-monitored plant in India or China.

”As to how long a drug company should be entitled to hold a patent on a drug they developed, I don't know the answer to that. But I completely disagree that they, and the Federal and State goverments of the U.S. should have the power to prevent U.S. citizens from purchasing needed drugs from Canada, for instance. “

-- This is matter of law established by Congress.

”If they can't afford the prices here, why shouldn't they? It's their lives!”

-- See my comment above.

Last comment: How many advertisements have we all witnessed on TV in the last few years for SOME drug? "If you have this or that, you may not be able to take this drug." And, "Ask your doctor about this drug".

My opinion: Stop advertising prescription drugs. The media is hardly the place for it. Lower your prices instead. We'll all be better off!

-- Companies discovered that advertising works. Where it doesn’t work, they stop doing it. How else would you let people know that there is now a new treatment for their old ailment? In general, advertising is good for consumers, but that’s an advertising industry question.

Big Pharma is already cutting back substantially not only in this area but in direct personal marketing to doctors as well. As I mentioned previously, they are also closing manufacturing facilities and cutting back on R&D.

coolmoose
Placing a uniform international price on drugs should have been done long ago.

As to fixing price on anything;
No one but the seller knows the fair price.
Any price fixing should be to maintain any increased price for an arbitrary period of months.
Like;
Joe and Bill both own gas stations.
Whatever price they set must be maintained for 4 months.
Will either of them set a price high enough to drive customers to the other for 4 months?

About "low cost" drugs from Canada
Those are not "low cost" drugs, those are govt. subsidised drugs. That is why the Canadian gov. had a problem with Americans buying those drugs just as much as the pharm companies did. From my understanding, the Canadian govt. subsidises all drugs and the consumers pay the difference.

Also, drug cost might be a bit lower if so many people weren't convinced they needed a drug to do any and every thing in life. My mom thought she "needed" her reflux drugs because her reflux flared up when she ate pizza. My solution was "just don't eat pizza". Why would you pop a pill everyday just so you can "enjoy" pizza.
Many drugs seniors and others use control things that we as a society refuse to control with proper diet and exercise. Vanity drugs also make a lot of money because it is easy to "create" problems that don't really exist, but people "think" exist. Maybe you can't sleep at night because you are too much in debt, having a tough time a work, etc. But no, it is because you have "insomnia" and you Need the new drug.
Maybe you have the blues after a baby because your body is going through an extreme hormone adjustment, your have this "new life" to be responsible for, you are getting very little sleep, and it will take a while for you to get everything in balance. No, you have "PPD" and you Need to take a drug everyday until little Johnny is 19 just so you can cope.
We diagnose kids with ADD/ADHD because they won't sit down and be quiet in school. Heck, I don't have to "sit down and be quiet" at my job for 6 - 8 hours at a time. Maybe little Johnny is bored, or tired, or really just wants to run a couple of laps around the school. No, little Johnny needs a pill every day for the rest of his life.
No longer do we just want "life sustaining" medications, we now want "life enhancing" medications. That is what drives up drug cost as well. Not the only reason, but definitely one. Find a person over 70 years of age and ask them how many pills they take. Then, ask them what all those pills are for. You will find less than 30% of those pills are life sustaining. I honestly haven't met anyone over 65 that wasn't take a pill for acid reflux.

An intellectual excercise.
Consider the extreme examples.

Imagine that Congress voted to strip all patent protection away from all existing and future pharma products. Immediately everything becomes much, much less expensive. Then what happens? Now imagine companies being granted 100 year patents.

Good policy has to start with an understanding of the trade-offs.

Maybe it would be good public policy to make the pharma industry less profitable. Maybe it would be good public policy to make them more profitable. Maybe we have a pretty good balance and shouldn't mess with it too much. Who can tell? Most of the debate is driven by politicians pandering for votes to the uninformed.

informed
messing around with the drug program will probably not improve it at all. It is working just fine for me. My heart meds etc. were taking nearly 1/3 of my monthly income then dropped to an affordable price that I am quite pleased with. This noise by some politicos is nothing but some one trying to make political hay out of something that does not exist.

Time for an EXPORT tax...
Yep, any drug that is based on ANY research that is in any way supported by US taxpayers must be sold in the US for a price no higher than it is sold anywhere else worldwide. If it is, the company will be liable for treble the difference to the US treasury as an "IP Export Duty."

If you wish to pay for your own research, pay for your own testing, develop your own drug with your own money then you can charge whomever whatever you please.

But if you use US taxpayer-supported universities or professors (even if you are hiring them as 'consultants'), if you are using a US non-profit hospital, if you are using research that initially was funded by NIH or another government agency, then the US Government holds a claim on your IP.

And the treble damages will be tied to the IP licensing.

Why wouldn't it work?

Why doesn't the GOVENRNMENT do drugs?
Seriously, with all the money that is funneled toward drug research today, why not just channel it towards actual drugs that the govt can hold a partial patent on?

Then the deal is simple: US Govt gets the drug for "free" (all US sales are at production cost only) and drug company can sell product overseas for whatever they want to.

And the drug companies unhappy with this can create their own drugs but without US taxpayer help.

Pirate
Government is forbidden to compete with private enterprize.
Now think Government Printing Office!

Government is part of the problem.
Government allows Drug companies to extort old sick people by charging every penny they can scrape up. Some of the sick old retirees can't pay so Government pays part of the cost with tax money and the Drug companies raise prices so it still costs every penny old retirees can scrape up.
This is the same as allowing Drug companies to tax the American people.
If Government is going to protect a monopoly then Government should regulate that monopoly.

This business of turning the American Dollar into monopoly money steals buying power from any money you save and makes it worth less than it was worth at the time you earned it.
This discourages saving for the future because you have no idea what the future holds for your savings.
Investments are risky and often do not even keep up with loss from inflation.

Neogtiating drug prices
Just to introduce some facts into the discussion:

For starters, compamies retrain their patents on drugs for 17 years. After that, they become "generic".

The U.S. government already does make deals in drug prices with big Pharma--the VA does it regularly, at
great help to veterans.

The reason drug prices are less in Canada is that the Canadian government negotiates drug prices with American pharmaceutical companies. Durg prices there are generally about 50% less than in the U.S.

Drugs from Canada are the real thing--not cheap Indian knock-offs, as one writer suggested. I know--I got some of my drugs from Canada, via mail. I save about $400 a month.

Drugs from Canada are drugs from Canada
If you're dealing with a pharmacy that has a physical presence in Saskatchewan, and the package originates from Canada, and if the prices aren't lower than the trade price into Canada, then you're probably ok.

But not all those drugs "from Canada" are actually from Canada. Indian and Chinese companies DO make knock-off compounds in non-FDA regulated facilities, and they ARE marketed in the US as being from Canada. That's a fact.

Pirate,
Many universities do hold patents on compounds, and pharma companies often enter into licensing agreements with them.

The NIH sponsors research for some compounds to treat ailments that would be unprofitable to bring to market. For example, if you need to bring all known patients into your Phase III trial, you're not going to make any money on that product.

Believe me, you don't want the government replacing private research. Sometimes it's tough enough to kill a bad research project as it is.

Coolmoose is right.
Coolmoose nailed it. We are subsidizing ineffective socialist health care plans.

John Stossel, Coolmoose and Pirate

Interesting and informed comments, all. And I apologize for the length of my comments here, but I believe them to be necessary.

I fought tooth and nail to keep the Medicare Modernization Act, with its Prescription Drug Plan, from becoming law.

My thinking was that there was no reasonable way to "lower" the prices of drugs when there are so many middlemen to consider. Not only must middlemen be considered, but simply try to imagine the increased numbers of insurance company employees, increased numbers of Medicare employees, increased space needed for these personnel, and increased numbers of computers, increased health care and prescription drug coverage for all these additional personnel. It boggles the mind to consider it. To believe this will help "lower" drug prices is madness.

Adding insult to injury, I have no idea of the current number of billions of dollars of taxpayer funds are provided to the National Institutes of Health -- but it is a huge number. These billions of dollars are used for, among other things, drug and pharmaceutical research and development. Who benefits from this? Well, first of all, of course, drug companies do.

Therefore, I do not need to drag out two or three hankies for all the tears shed for the horrendous costs that must be borne by the poor drug companies in their research and development. Those companies are getting a lot of help from Uncle Sam. The result: taxpayers pay three or four times, counting Prescription Drug Plan assistance for seniors utilizing it.

And let us not forget that much of drug companies' "research and development" pertains directly to market research and development, not drug research and development. Please let us also not forget the millions of dollars spent on drug company advertising. While we are on the subject, let us also not forget the tax write-offs drug manufacturers receive from the government for research and development, and, of course, advertising. And don't forget manufacturing, either. Tax write-offs for companies using knowledge created by government-paid personnel do make me somewhat irritable.

Let us also not forget that there are many occasions where drug companies pay off generic manufacturers not to manufacture generics. That way, the original patent holder can extend the time frame during which it may continue charging the highest prices. Sometimes the companies get caught at this game, but not always.

It probably is not nice to instill fear, but it is nice to instill information. Attempt to learn how many foreign manufacturing facilities are utilized by American drug manufacturers. The numbers are unknown, but perhaps they can be rooted out by a good TV journalist/writer. John Stossel, maybe?

After discovering how many foreign manufacturing facilities are in use by American drug companies, then attempt to learn how often the FDA inspects these facilities. Attempt to learn how diligent these inspections are. If you happen to be taking a medication in its original bottle that was purchased here in the U.S., try to find the country of manufacture. If you are able to find this on these bottles, it will truly mess with your mind.

In the event anyone noticed, I do not weep for drug companies.

As for Medicare, or, in this case, the Department of Health & Human Services, "negotiating" lower drug prices on behalf of the Medicare Prescription Drug Plans, please, Democrats, just think about this before voting for it. That goes for a few Republicans and perhaps Independents, too. There is the same problem here as with the Medicare Modernization Act: too many middlemen.

And here is a little-known fact: some of Wal-Mart's (and perhaps others') generic drug prices are lower than those of the VA. There is absolute proof of that. All one needs to have are copies of the formularies used by both entities.

Competition, free enterprise, plain old capitalism, along with supply and demand, will lower drug prices. Remember Milton Friedman's "Free to Choose."

We are not now free to choose.

drug intervention
The government should educate people on how to use drugs and use minimum daily dosages. There should be divided interventions and thus competition can control the prices.

Raj
http://www.drug-intervention.com/kansas-drug-intervention.h tml
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