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Bush attacks Kerry on health proposals

by SteveGargini / September 17, 2004 8:15 PM PDT

Bush attacks Kerry on health proposals


By William Douglas

Knight Ridder

BLAINE, Minn. - President Bush stepped up his attack on Sen. John Kerry's health care proposals Thursday, accusing the Democratic presidential nominee of seeking to expand the federal government's power by controlling the country's health-care system -- something Kerry says he is not suggesting at all.

``The nationalization of health care would be wrong for the American people,'' Bush said during a campaign event in southeastern Minnesota.

He said Kerry's plan would cost too much and would drive many employers to drop health insurance for their employees, causing many to end up on Medicaid. His own approach, he said, would help people buy their own health insurance, would cost taxpayers far less and would reduce the ranks of the uninsured.

The Kerry camp, campaigning in Las Vegas, responded immediately, accusing the president of lying about the Massachusetts senator's plan in an effort to scare and mislead voters.

Kerry's health plan relies on tax incentives to businesses and individuals and would pay for most catastrophic costs in an effort to reduce insurance premiums. It would use the existing employer-based insurance system, and would cost taxpayers an estimated $650 billion over 10 years.

The Kerry campaign also launched a new TV ad on national cable and local stations in battleground states attacking Bush for mischaracterizing Kerry's health care plan. The ad is titled ``Not True.''

``We believe the Bush campaign's decision to attack John Kerry is a costly mistake,'' said Tad Devine, a Kerry campaign strategist. ``His effort to attack John Kerry is designed to mislead voters, not inform them.''

Bush described the difference between his own health proposals and Kerry's as a contrast between expanding opportunity for individuals and expanding the role of government.

``I have a common-sense, practical plan to make high-quality health care more affordable and more accessible,'' Bush said during a rally in St. Cloud, Minn. ``My opponent wants government to dictate; I want you to decide when it comes to health care.''

The president says he would expand health insurance coverage for more Americans by encouraging the use of health savings accounts -- tax-free savings that can be used for medical expenses -- and by allowing small businesses to pool resources to buy insurance at discount rates as large companies do. He also has proposed a tax credit to help poor people purchase health coverage.

Bush's plan would cost an estimated $156 billion over 10 years.

In addition, the president wants to overhaul the medical-liability system to limit jury awards for malpractice, which he says drive up insurance premiums for doctors and add to escalating health care costs.

Under Kerry's plan, the federal government would underwrite 75 percent of the cost of catastrophic health care coverage provided by employers. Kerry also has proposed a ``patients' bill of rights'' to empower people in their dealings with health-maintenance organizations and other managed-care programs.

Kerry campaign officials, citing an independent study, say his plan would cost about $650 billion over 10 years and would be funded by eliminating the 2001 tax cut for people with annual incomes of more than $200,000.

Bush, armed with a new study by the American Enterprise Institute, a center-right Washington-based research center, said Kerry's plan would cost $1.5 trillion over 10 years.

``See, I think the problem in this campaign that my opponent has is that it's a plan that is massive, and it's big, and it puts the government in control of health care,'' the president said in St. Cloud. ``And you can tell it's massive by the price tag.''

Bush said Kerry's plan would crowd out private health insurance and give businesses an excuse to drop employees from health care plans.

Bush attacks

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Remember, Steve...
by J. Vega / September 18, 2004 6:26 AM PDT

Steve, if the Government controls your health care, it can mean that they control life itself in some cases. The words "not authorized" can be as deadly as a bullet in a sense.

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Re: Remember, Steve...
by SteveGargini / September 18, 2004 7:03 AM PDT
In reply to: Remember, Steve...

I know exactly what you mean J.
Here in the UK we still have the National Health Service, which is in effect what Kerry is suggesting.
When there is a shortage of beds, or doctors, or both, it is a lottery who GETS the treatment.
Several factors are taken into consideration but at the end of the day, someone misses out.

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Re: Remember, Steve...
by Mark5019 / September 18, 2004 9:46 AM PDT
In reply to: Re: Remember, Steve...

its just as bad here with the friggan HMOs they say only generic drugs well my advair isnt generic 100 bucks or more

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100 bucks - wow
by SteveGargini / September 18, 2004 10:00 AM PDT
In reply to: Re: Remember, Steve...

That's expensive Mark. I guess they are fairly special drugs, but that is a lot of money to find on a regular basis. I don't know a lot about HMO, but is it a government department which helps you pay for your treatment.

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(NT) (NT) zocor, crestor, provachol, etc. run close to $200
by TONI H / September 18, 2004 10:08 AM PDT
In reply to: 100 bucks - wow
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crickey! and if you have any money for old age left
by SteveGargini / September 18, 2004 10:17 AM PDT

you would be lucky.
It must be a right old monopoly with the drug companies charging such high prices. I realize they have to recoup the development costs, but do they have to charge so much. Sad

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Re: crickey! and if you have any money for old age left
by Dave Konkel [Moderator] / September 18, 2004 1:29 PM PDT

Hi, Steve.

>>I realize they have to recoup the development costs, but do they have to charge so much. <<
The answer is no -- they spend more on advertising (both public and to doctors) than they do on development. And the Bush drug bill had specific language to forbid the government from using it's buying power to drive down prices for covered Rx drugs -- the only explanation for that is the huge drug industry contributions to the Republican/Bush political war chest. it's also that one of the "features" of Bush's plans (allowing pools of small business employees to get better rates) was in fact a key element of the Clinton health plan that the Republicans' trashed -- except that plan made even more sense, not limiting the pools to business employees, but to anyone in a given geographic region not covered in a large employer pool. The insurance industry hates this idea, because it would give affordable rates to those now forced to pay exorbitant rates or do without.

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Re: crickey! and if you have any money for old age left
by Evie / September 18, 2004 2:20 PM PDT
the only explanation for that is the huge drug industry contributions to the Republican/Bush political war chest. it's also that one of the "features" of Bush's plans

No Dave, the explanation for this is so that we don't do to the entire pharmaceutical industry what we did to the vaccine portion of it. It's time to push for fair trade policies so that the US doesn't subsidize the R&D for the entire world.

I'm not thrilled with all aspects of the new plan either, but I'm not ready to hand over more control to the government.

Evie Happy
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Patent loophole allows
by TONI H / September 18, 2004 9:07 PM PDT

for not only the first 20 years of the drug being on the market disallowing generics to be manufactured in order for the pharmaceutical company to recoup their 'development' money, but near the end of the 20 years, the pharmaceutical company can pull the med off the market, revamp and rename it very slightly, and bring it right back with a new patent for the next 20 years again charging the high price once more with an exclusive right to disallowing generics once more.


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Re: Patent loophole allows
by Evie / September 19, 2004 1:16 AM PDT
In reply to: Patent loophole allows

Hi Toni,

There are a number of factual and/or practical errors in your post.

1. Yes, the original patent is for 20 years, but that 20 year period begins at the time of filing. With the backlog in the US, the lengthy approval process cuts into that by about 6 years on average meaning that for some drugs, the effective patent period is 14 years. Taking Zocor as an example, it was first approved in 1992 and it's patent goes off in 2006. In terms of its usage for heart disease, that was approved by the FDA in 1995 but doesn't extend the patent AFAIK.

2. Yes, drug companies do "retool" their patented drugs to get new patents on ostensibly very similar products. But this does NOT prevent the production of a generic version of the original drug. It seems that Zocor was available in Canada before the US, and thus a generic form was approved in that country in 2003**. I am not sure what the process is for generics here in the US, but the structure and production methods for a drug are readily available (hence the need for the patent to protect intellectual property), so it would seem that generics can get a jump start on the approval process so that they are ready to go from "day 1" that the patent goes off. On the one hand, I can understand the frustration when a "time release" or slightly changed formulation gets a new patent, but many of these improvements in formulation do offer the consumer a better product. Again using Zocor as an example, who is going to fund the research into forms/delivery methods that may reduce negative liver effects if they cannot recoup that investment?

** Aside: I note that the generic Apotex is being made available at only a 30% price reduction over Zocor. Yes, that is substantial, but it does put into perspective the reality of what constitutes the price. What I'm getting at is that while we sometimes think the costs are unconscionable, the generic alternatives are STILL priced pretty high, and a 30% "price hike" to recoup R&D and marketing (it is a necessary evil folks) costs for a new drug for a finite time window, hardly seems as large in this context.

Let's also consider a couple of things the pharmaceutical industry is vulnerable too:

1. Domestic and/or foreign patent infringments should a compelling public interest be declared: e.g. Cipro during the anthrax scare. Some people were frothing at the mouth to throw all patents out the window to make the drugs available. While we can ALL see the need for life-saving drugs to be available in emergency situations, there simply aren't the pre-existing safeguards in place to protect the company's investment in the development of these drugs.

2. There is more to the re-importation laws than expediency (political and otherwise) would lead one to believe. This article about patents and availability is a good assessment of the problems involved. If the pharmaceutical companies are to be expected to make life-saving drugs available at reduced prices (and in large quantities given the populations involved) to Third World, they need First Worlders to not exploit this by re-importation. Otherwise, there is little doubt that absent incentive, the companies are no longer going to invest capital in developing new drugs. To a lesser extent this needs to extend to true "fair trade" policies with other First World countries so that the US consumer is not footing the entire bill for innovation.

The FDA approval process was "reformed" a few years back. This article gives a nice overview of what's involved. Essentially the financial burden of funding the FDA has shifted substantially to the drug company themselves. While this may extend their effective profit window, it still costs them money in "user fees" for the extension. My guess is that these fees are passed along to the customer just like any "cost of production" for any product.

On a final note, the liability issues need to be addressed. If an FDA approval does not offer a company some sort of protection against law suits, then it is merely a matter of good business to build "insurance" into the price of drugs under patent. I'm not talking about a company that would intentially fail to divulge (or worse) negative effects during the approval process, but a company that has in good faith brought a product to market where a side effect is disovered only after years of use in the general population. The class action suits over "elective drugs" really get my goat. There is a high demand for "miracle pills" for all sorts of maladies ... consumers must be willing to accept that there is going to be risk associated with those "miracles". The risk of jail time for executives I think is far more likely to induce compliance and care in evaluation than lawsuits after the fact -- at least from the perspective of the consumer's pocketbook.

Back to the Zocor (and other statins), many doctors seem to have developed an almost knee-jerk attitude towards prescribing these. The goal of lowering cholesterol seems dangerously single-minded in that other factors are overlooked. If and when the relatively small percentage of millions on statin drugs have the inevitable damaging side effects, it won't be the CDC or whatever other national physicians organization promoting their use that shoulders the accompanying law suits. It will be the pharmaceutical companies that are NOW being pressured to make their products available to everyone. Anyone that believes this liability concern is not incorporated into the current cost of these products is fooling themselves.

Evie Happy

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What dose are you on?
by Evie / September 19, 2004 1:57 AM PDT
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Re: What dose are you on?
by TONI H / September 19, 2004 2:25 AM PDT
In reply to: What dose are you on?

This is what I take monthly (doesn't count the extras like aspirin, niacin, fish oil, etc) and just called the CVS Pharmacy here to get pricing:

Zocor 80MG - $148.99
Toprol XL 50MG - $32.19
Isosorb DIN 20MG - $9.99
Lisinopril 5MG - $21.39
Plavix 75MG - $139.99

Grand Total per month = $352.55

That's nearly half of my monthly income........


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Let's be fair though Toni ...
by Evie / September 19, 2004 3:18 AM PDT

... you are enrolled in non-government programs to the extent that you are NOT paying for all of these medications -- at least that is the impression I am left with following previous discussions. I think it would also be fair to say that you are the exception -- income vs. needwise -- rather than the rule in terms of the types and dosages of drugs you require and your personal life story.

When I hear DK, for example, complain about his out of pocket costs, it makes my blood boil. He clearly CAN afford it. Having his costs subsidized in any manner by "insurance" is -- no two ways about it -- deferring/distributing that cost to others that may or may not be capable of affording it, and that includes every taxpayer in TX that funds his State bennie package. I use my own parents as an example as well. Through hard work and a little luck, they are well situated into retirement and then some. It makes no sense, then, for the taxpayer to foot the bill for their medications they can clearly afford.

While not all cholesterol levels can be managed with diet and lifestyle changes, many can be. I last had lipids tested 2-1/2 years ago. Since then I have lost some weight and changed my diet to a low carb one and committed to exercising more regularly. My triglycerides are now down from 180's (the only real "alarm" back then) to 105, and my total cholesterol is down 12 points while the HDL portion of that is up 13 points. My blood pressure is down from "borderline high" to a healthy normal. Mine is probably a "high cholesterol" diet by any standards, yet these are my results much as they fly in the face of the medical establishment that still seems to doggedly advocate the low fat diet as sole solution. I am encouraged to think of how much more improvement lies ahead if and when I decide to be more diligent in my efforts -- suffice it to say that I "cheat" quite often, still drink socially, and don't always exercise as regularly as I could.

When one does pay for their meds, they are more likely to seek out the most econimical source/course. That may be more incentive to try less costly lifestyle changes first. It may also be shopping around for meds and/or tablet splitting. Just one example of what I'm talking about is that 40mg Zocor costs the same as the 80mg tablet. It is perfectly acceptable to split those tablets (my hubby is prescribed 1-1/2 tablets of one of his meds as a matter of routine, and that's a relatively cheap one) if one falls among the ranks of those that take 40 mg dose -- that cuts the cost in half right there. Doesn't work for the needed dose for every drug, but something the savvy consumer can certainly look into -- and something far more likely to happen if one pays out of pocket vs. a fixed co-pay.

Evie Happy

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Re: Let's be fair though Toni ...let's be then
by TONI H / September 19, 2004 3:51 AM PDT

Those are the same meds that were prescribed for me 8 years ago after my bypass surgery.......and I couldn't afford them then any more than I can afford them now. However, I wasn't told by my cardiologist team that I could get them through the indigent programs that the pharmaceutical companies provide, and had to make life threatening decisions every month about whether I could buy them or not. It wasn't until years later that a hospital told me I qualified for those programs and my cardiologist team office were supposed to be filling out the paperwork.......which I waited another two years to have happen. By the time they finally got around to me, I was told they were too busy now to bother with it and sent me to social services to fill out the paperwork. Go to social services and although the pharmaceutical companies only require my social security documentation as proof for qualifying, social services demanded copies of all of my bank statements AND my life insurance policies. I refused to furnish it so went a couple of more years without the meds before another hospital told me I could download the forms from the net or call the pharmaceutical companies directly to get the forms mailed to me. I then could fill them out myself, take them to my doctor's office and just get a signature and the prescription area filled out and mail them myself. THAT has only happened in the last six months after eight years and three more heart attacks later because I put myself at risk by not taking the meds all along.........the same way Bill Clinton did and HE could afford to buy the stuff all along.

If the doctors prescribe it, they should also be compassionate enough to ask a patient or LISTEN to one when they tell said doctor they can't afford to buy what he/she wants us to take, and INFORM the patient of options available, and have somebody on staff to help that patient get what they need.

For eight years I struggled to try to pay for those meds.....and it's only been in the last six months that I got the help I and many others need. BUT, if the pharmaceutical companies, in their brochures that are all over the doctor's office, would put contact information in there for their indigent programs, and how to go about applying if you are qualified for them, more people wouldn't have to make life-threatening decisions each month.

I have an appointment at my local doctor's office in two days.....part of that appointment is to volunteer my services twice each week to come to her office and help people fill out the forms I have and can make copies of for most of those pharmaceutical companies so that her patients will have an opportunity to get their meds that they need......and without the indignity of having to go to social services and spill their financial guts to the little town we live in to do so.


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Fair enough!
by Evie / September 19, 2004 4:30 AM PDT

I heard just the other day on the radio that doctors need to establish better communication with their patients as to whether or not they can afford the prescriptions they write. It makes no sense to prescribe something if the patient isn't going to fill that prescription as ordered. I know that back when the hubby was self employed (and not working for quite a stretch due to multiple bouts with pneumonia), his doc did ask him about insurance for meds (we had none) and outfitted him with free samples when he could.

It's not fair to blame the pharmaceutical companies for other failings of the healthcare system in general. I think if many were made more aware of existing options re: prescriptions, there would have been less of a clamor for the all-encompassing new drug benefit that was passed.

I guess my point was that it is a bit unfair to argue the "advertised cost" when many don't pay that. The same way it has been shown that what students ACTUALLY pay for an education -- after all the loans/grants -- is a fraction of the advertised tuition.

Again, it would seem the government would do better to provide drugs directly rather than the various confusing "insurance" plans -- I just REALLY don't want to see the essential controlling of the market by the behemoth that would be the Federal Government. But, while I can understand privacy concerns, etc., when government provides a benefit, any benefit -- funded by the public -- I don't see any "fair" way around full documentation of need. Still, if the state purchased meds in bulk (and thus at some discount), they could sell some at cost (or even a profit to them but discount to consumer) to higher income/uninsureds, and directly subsidize the cost to others on a sliding scale to where it would be free or very low cost to those at the low end.

Toni, you have been honest in sharing with us that you still smoke. I won't judge you on that, I have never been a smoker but know enough to understand why so many continue the habit no matter what the indications are not to. But let's all be wary of giving over control of our health to the government. Not all that long ago I read where Great Britain would be denying surgery/care to cardio patients that didn't meet lifestyle changes such as quitting smoking, losing weight, etc. I'll have to look up the link. I prefer to keep the decisions, no matter how difficult, no matter the sacrifices, in my own hands.

Evie Happy

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I have no strong feelings about
by TONI H / September 19, 2004 4:51 AM PDT
In reply to: Fair enough!

government controlled health care other than I oppose it for now, just as I oppose HMO's because of the restrictions they have put on that care. I'm a recipient of Medicare and pay for that; however, I don't understand why company hospitalization programs have had in the past great group policies at low cost to the employees, and yet the rest of us normally pay outrageous hospitalization rates as individuals or families with far less coverage.

Why can't there be group rates with better coverage be offered to any of us who don't have employee/employer type programs available? I remember when Derek was born......

I already had employer Blue Cross group rates just before I got pregnant and it covered everything you could imagine......when I left their employ while pregnant, Blue Cross 'allowed' me to keep the coverage but at a family rate of quadruple the pay rate (jumped it to over $400 per month in 1980) and I was forced to pay that each month until Derek was born so I would have the coverage. Then I had to drop it.

However, even then, I got a bill from the hospital for Derek's circumcision (wasn't covered anymore in the family policy) and also for two of his three days in the hospital because as it was explained to me....Derek was only there because my doctor never released ME for three days after birth and because he was healthy enough to go home after the first day, they charged for the 'room' per day for him while he waited for ME to go home.

I would gladly pay double or even triple what Medicare charges per month if I could get complete health coverage like employer groups get, but even supplemental insurance is over $250 per month for an individual and doesn't cover glasses, hearing aids, or prescriptions. Each one is a separate supplemental plan and costs additional....I've checked into a number of plans and some won't even accept me as I'm under 60 years old....such as AARP.


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Re: Remember, Steve...
by Dave Konkel [Moderator] / September 18, 2004 1:23 PM PDT
In reply to: Re: Remember, Steve...

Steve, Kerry is NOT suggesting a National Health Plan on the British/Canadian model -- I wish he were.

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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The National Health Service
by SteveGargini / September 19, 2004 6:28 AM PDT
In reply to: Re: Remember, Steve...

was at one time second to none, and it was really good, but then it was abused by foreigners from everywhere under the rainbow who came here, and took advantage of the free treatment, paid for by the british workforce with National Insurance payments.
The same may well happen in the US by people from South America if you had the same system.
Just something I thought you ought to know about what can/does happen with a 'FREE' service.

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Re: Remember, Steve...
by Dave Konkel [Moderator] / September 18, 2004 1:22 PM PDT
In reply to: Remember, Steve...

Hi, J.

The Bush Medicare Bill includes more control than Kerry has ever suggested -- it essentially outlaws Medigap insurance once the woefully inadequate Medicare prescription "benefit" kicks in. Here's an editorial about it from the Houston Chronicle:
Bitter pill -- No wonder Republicans in Congress were happy to pass their drug plan in the middle of the night. It eats up Social Security benefits.
(Chronicle login: semods4@yahoo.com; pw = speakeasy)

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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He better put that right A.S.A.P Dave
by SteveGargini / September 19, 2004 6:40 AM PDT
In reply to: Re: Remember, Steve...

otherwise he may well see a lot of voters over the age of 65 years voting for someone else.
Now, that ain't smart in my book. Sad

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Re: Bush attacks Kerry on health proposals
by Evie / September 18, 2004 8:52 AM PDT

Hi Steve,

This isn't directed at you so much as at the press and the way in which this campaign has been characterized. I don't see Bush "attacking", I see him actually SPEAKING to an issue "of the day", with SPECIFICS and comparing and contrasting those with his opponent's. I wish the so-called mainstream would view Kerry's proposals with 1% of the skepticism due as to the enormous cost and dubious benefit of his plan. OTOH, Kerry offers few specifics and heaps on the blame for every hangnail created during his presidency.

Nonetheless, thank you for posting this! It is about time perhaps we can discuss issues that really matter instead of a decades old war!

Evie Happy

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I was just following the headlines
by SteveGargini / September 18, 2004 10:09 AM PDT

I agree Evie, he certainly didn't appear to attack anybody, but just pointed out the set backs to Kerry's plan.
I also agree about talking about matters which affect the american people NOW, not decades ago.
It's my guess that Kerry has so little to offer the american people as of NOW, that he has to rant on about what happened 30+ years ago.

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