The Milwaukee Post

March 24, 2017 • Milwaukee County Post • 9 MPS teacher running on Black Lives Matter platform To the editor: Years ago, Mark Belling stated as long as there is Milwaukee Public Schools he'll always have material to talk about. March 17, 2017: Aisha Carr, an MPS teacher, is running for School Board. She is teaching a new class, "Black Lives Matter." Who dreams these up? I was hoping people would know without having to go to class. Richard McKowen West Allis Cure for Obamacare would make things worse To the editor: I can tell you from both person- al and professional experience that the American Health Care Act would create a health care crisis now that would hurt Wisconsin for decades to come. This Republican-led effort to repeal the Affordable Care Act would pay for it on the backs of the disability community, low- income families and children, and poor seniors. These politicians don't realize Medicaid is more than just health insurance. For people like my son, it has paid for therapies at school and children's supports that have helped him gain inde- pendence, participate more fully in school, and is ultimately lead- ing him to an adulthood where he will be an employed, tax-paying citizen. Where I work, Medicaid sup- ports older adults who have expended their life savings and adults with disabilities who need support to work in the communi- ty and stay in their homes instead of costly institutions. All that is at stake with this proposal to cut 25 percent and $880 billion out of Medicaid in the next decade. Harming our most in-need com- munity members will only lead to higher costs later: more hospital- izations, more nursing homes, more preventable illnesses and injuries. And that doesn't even look at the human toll. Why is this being rushed through Congress without hearings, with- out careful analysis, without even the opportunity for us to weigh in with our congressional reps at town halls? Wisconsin voters deserve answers now, not after the harm has been done. Tracy Hedman Glendale OPINION LETTERS TO THE EDITOR By JOHN TORINUS Despite the best efforts of all kinds of smart people to put a brake on health cost inflation, the pharmaceutical industry keeps putting its heavy foot on the gas pedal. Take Serigraph, Inc., my organization, as an example. The managers and co-workers collaborated to drive costs down by $259,000 in 2016. That's a nice reduction in a $6 mil- lion total bill for care. But that saving for the company and its people (we share the health care bill) was mostly wiped out by a $228,000 increase in drug costs. Ten years ago, we spent 10 percent of our health bill on pharmaceuticals. In the fourth quarter of 2016, drugs cost us 22.5 percent. With about the same number of employ- ees and family members, our bill for phar- maceuticals has doubled from $613,000 in 2006 to $1.25 million in 2016. It's killing our bottom line. I'm not buying that the underlying costs of new drugs have doubled over that time period. As one egregious example of gouging, there are some rogue owners of "orphan" drugs that have set outlandish prices. One for muscular dystrophy, primarily for boys, was being imported for about $1,200 per treatment. Its new owner has pegged its future price at a net of $54,000. Congress is investigating, and it should. But many of the major pharmaceutical companies are also charging astronomical prices for their branded specialty drugs. They set the prices sky high because they know that people in the hurt locker have nowhere else to go. They know that insurers will submit and pass through the outrageous charges. The pharmaceutical companies put on the angel wings and say they need the elevated prices to pay for research and develop- ment. The reality is that they spend as heavily on lobbying and advertis- ing as they do on R&D. If President Trump wants to reform health care, here is one place for his imme- diate attention. How about an executive order to put in price controls? The public should pay no more for a drug regimen than Medicaid pays. Go for it, Mr. President. Drain that swamp. Let's take rheumatoid arthritis drugs as a point in case. Serigraph has six people using two drugs. The annual cost for a regi- men of Remicade infusions is running $42,000, while Humira is at $33,000. The total for the six patients was $222,000 in 2016. Our total bill for just 15 our people on spe- cialty drugs was about $600,000, half of our total pharmaceutical bill for about 1,000 members on our health plan. The cruel reality is that those specialty drugs really work. They vastly improve the quality of life for the people who are suffer- ing from arthritis. Congratulations to the drug researchers. But, at what price? Health care economics are a national dis- aster. We spend 18 percent of GDP on health care. The Defense Department spends more on health costs than on weapons. They are the No. 1 cause of personal bankruptcy in the U.S. Family health costs are now $26,500 per the Kaiser Foundation. Small compa- nies can no longer find affordable coverage. Obamacare exchanges sell policies with killer deductibles of $6,000 for its most affordable plan. This is an unsustainable economic model for the country. And drug hyperinflation is at the core of the problem. The good news on this front is that inno- vative private companies have learned how to deflate most medical costs. The bad news is that they have only a few tools to get a col- lar on drug costs. The market, such as it is or isn't in health care, simply doesn't work for drugs. Nor are pharmaceutical prices regulated — the antidote to a lack of market disci- plines. The drug companies operate in no man's land. They price whatever they want to. I am not a big fan of price controls. Remember when President Nixon's attempt at price controls failed miserably? But, in the case of Big Pharma, there may be no other answer. One possibility is a real dialogue between the industry leaders and the Trump admin- istration. No fingerpointing, but a real dia- logue to figure out how to cut down on the long development cycle for new drugs. There must be a better path forward than spending $1 billion for a new drug approval. Let's talk about a hepatitis C treatment for insights. In the states, the bill for a 12- week treatment runs more than $100,000. That is not a typo with an extra zero. The drugs alone cost $90,000. That same treatment on Grand Cayman Island (not a bad place for a 12-week regi- men) runs $25,000. The hospital that delivers that price is the top-notch Health City on Grand Cayman Islands, a 70 percent-30 percent joint ven- ture of Ascension Health and the Narayana Group of India. The low price is attained because the same drugs used in the U.S. are brought in from India. In short, the U.S. patients pay awful prices to cover pharma overheads, and the rest of the world gets a cheap ride. Those bloated prices make U.S. compa- nies, the real payers for the whole $3.2 tril- lion U.S. health care bill, less competitive. High benefit costs also come at the expense of wages. Hence, some of the country's wage stagnation. This idea may confound our president. He wants to raise prices on imports. But in the case of drugs, he should do the opposite — open the doors to lower-priced imports. The drug regulators will scream about offshore drug quality. He should tell them to figure out import quality controls — forthwith. If he can't pull that off, then it may be time for Congress to slap price controls on Big Pharma. I'm not a fan of price controls, but unsolvable problems call for desperate solutions. Private payers should pay no more than foreigners pay or what Medicaid pays for Remicaid or Humira. Fix it, Mr. President. Put America first. (John Torinus is chairman of the board of Serigraph Inc. in West Bend and blogs regularly at www.johntorinus.com. His col- umn runs occasionally in the Post.) Controlling drug prices key for health care reform Torinus

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