With Democrats like these…

Prices for prescription drugs in the United States are out of control and multiple times higher than they are in other countries around the world:

U.S. prices for the world’s 20 top-selling medicines are, on average, three times higher than in Britain, according to an analysis carried out for Reuters.

The finding underscores a transatlantic gulf between the price of treatments for a range of diseases and follows demands for lower drug costs in America from industry critics such as Democratic presidential candidate Hillary Clinton.

The 20 medicines, which together accounted for 15 percent of global pharmaceuticals spending in 2014, are a major source of profits for companies including AbbVie, AstraZeneca, Merck, Pfizer and Roche.

Researchers from Britain’s University of Liverpool also found U.S. prices were consistently higher than in other European markets. Elsewhere, U.S. prices were six times higher than in Brazil and 16 times higher than the average in the lowest-price country, which was usually India.

The United States, which leaves pricing to market competition, has higher drug prices than other countries where governments directly or indirectly control medicine costs.

Big pharmaceutical companies have lots of answers when they’re questioned about this. These prices don’t include insurance company discounts! Which aren’t large enough to make up the disparity. Health care in the US is more expensive in general? Well, sure, and medicine costs are a big part of the reason why. The high prices are necessary to fund research! OK, but then why is all that research being funded entirely on the backs of American patients? Why not spread that burden out to other countries?

The answer is pretty simple: every other industrialized country negotiates drug prices with pharmaceutical companies directly, instead of letting “market forces” determine them. This is because there is no “market” here–patients go to their doctors, are prescribed medicine, and take it, or they get sicker. Very few people shop around for the most efficient treatment option because they have absolutely no basis for comparing those options. This isn’t like buying a loaf of bread; the idea of an “informed consumer” in a field like medicine, where people study and train for years in order to gain some level of expertise is fanciful in all but a few cases. Other countries have governments that understand this. We have a government that likes to take a lot of campaign money from pharmaceutical companies.

The optimal solution to the problem of high drug prices in the US would be to reform the fucking health care system for reals, root and branch, as opposed to the overly complicated grab bag of privatized sludge that is the (still better than the old way) Affordable Care Act. That’s a tough political slog (made tougher because of the ACA’s flaws, it should be noted), so I realize it’s not going to happen any time soon, but for a center-left to left political party that takes policy seriously it should be a defining principle. One quicker, sub-optimal fix is to let pharmacies import drugs from overseas at lower costs. Bernie Sanders and Amy Klobuchar sponsored a measure that would allow them to do this, and it was defeated in the Senate last night. That prompted this tweet from Democratic Senate Leader Chuck Schumer:

Yes, most of the Senate GOP opposed it…along with 13 Senate Democrats, which suggests that maybe Schumer should police his own caucus before he criticizes anybody else. Many of those Democrats are major recipients of Pharma industry contributions. The 13 are:

Michael Bennet (D-CO)
Cory Booker (D-NJ)
Maria Cantwell (D-WA)
Tom Carper (D-DE)
Bob Casey (D-PA)
Chris Coons (D-DE)
Joe Donnelly (D-IN)
Martin Heinrich (D-NM)
Heidi Heitkamp (D-ND)
Robert Menendez (D-NJ)
Patty Murray (D-WA)
Jon Tester (D-MT)
Mark Warner (D-VA)

To me, this makes a handy list of Democrats who should be considered for primary challenges. Most of them are up for reelection in 2018–some, like Cantwell, from reliably Democratic states. But even the ones from purple or red states ought to face some kind of response for a vote like this. I get that those Democrats are constantly trying to walk a tightrope, but if walking that tightrope means you never take a stand and try to argue your case to your constituents, then what are you even doing in politics? If being a Democrat doesn’t mean fighting for the principle that all Americans should be able to get decent, affordable health care, then what the hell does it mean? Is it just a label you can throw on a campaign sign? Hell, Robert Menendez, also up in 2018, is so mired in corruption scandals that he’s a good bet to lose in November to a Republican, so why wouldn’t you want somebody to challenge him?

To be clear, this pharma measure likely wouldn’t have become law. It almost certainly would’ve been defeated in the House, or failing that vetoed (despite his empty rhetoric on the issue) by incoming President Trump. But these 13 Democrats unambiguously said that they value campaign checks from pharmaceutical companies over affordable medicine for their constituents, or that they fear Republican voters so much that they’ll vote like Republicans any time they’re presented with controversial legislation. Primarying these people would send a signal that the days of standing for nothing much more than your own political future have to end, that Democrats, while embracing a “big tent” kind of politics, still have to have some basic principles that define their party.

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