Posted on 09/30/2005 4:10:47 PM PDT by calcowgirl
It's not even October yet, and already the barrage of advertising for two competing drug discount measures on the Nov. 8 ballot has begun.
In a widely screened television commercial, a white-haired "Marcus Welby" hands out pieces of paper -- presumably prescriptions approved for a discount -- with a kindly smile. This is supposed to be life under Proposition 78, a drug discount plan backed by the pharmaceutical industry and endorsed Friday by Gov. Arnold Schwarzenegger.
Cut to: Snarling bureaucrat stamping REJECT on prescription-size pieces of paper. This, according to the same ad, would be life under Proposition 79, a competing drug discount plan backed by Alliance for a Better California, a coalition that leans heavily on teachers' and other public-sector unions.
Meanwhile, backers of Prop. 79, who are strongly opposed to 78, kicked off their campaign in Sacramento this week with speeches and accusations.
"Why do the drug companies need the voters' approval to voluntarily lower their prices?" said Consumers Union Western media director Michael McCauley in an interview this week, laying out one of the key themes of the anti-78 campaign. "The only reason this is on the ballot is to confuse voters."
The initiatives both propose creating programs to offer substantial discounts on medications to those who qualify. In both, manufacturers will cut their prices, but under Prop. 78, they participate voluntarily, while under 79, companies that don't participate will be excluded from Medi-Cal, which covers the very poor. The two propositions also differ in what it takes for a patient to qualify, so estimates of who would benefit range from 5 million to 10 million people.
Only one of the initiatives can win in November. Both could, of course, lose. But if both pass -- that is, get more than 50 percent "yes" votes -- the one with the most "yes" votes becomes law.
The battle comes at a confusing time for consumers, especially older ones. California recently sued 39 drug manufacturers over the prices they charge the Medi-Cal system. And starting in mid-November, Medicare recipients -- seniors 65 and older and the disabled -- can sign up for the complex federal drug-discount plan that takes effect Jan. 1.
The 78 vs. 79 race looks to be the most expensive in the history of ballot initiatives, with most of the money on the 78 side, where the campaign chest has already passed $70 million, compared to about $16 million for Prop. 79.
"Even if we had X million dollars in the bank right now," said Prop. 79 spokesman Anthony Wright, "we wouldn't be spending it ... for an election several months away. We know we will be outspent. We know we will be outspent exponentially."
Both proposals would establish discount programs overseen by the state Department of Health Services and whichever private vendor it chooses to run the program. Neither involves massive drug purchases by the state. The Legislative Analyst's Office estimates start-up and administrative costs in "low tens of millions of dollars annually" -- "chump change" in health care, according to one analyst. Both require an annual fee -- $15 for Prop. 78, $10 for Prop. 79.
There are significant differences, however.
Prop. 79 sets the coverage threshold at four times the federal poverty level, or about $77,000 in annual income for a family of four. It extends coverage to those with high medical expenses as well, and authorizes the state to get discounts for those who have some insurance at work or through a union.
The industry version, Prop. 78, puts the threshold at three times the federal poverty level, or about $58,000 for a family of four, and omits the other categories of possible users. Wright says it would cover only about half as many people.
"To the casual observer, it's hard to sort out who's on the consumer side," said Larry Levitt, a vice president of the Kaiser Family Foundation. "Because it sounds like everyone's on the consumer side."
The Prop. 78 forces say the Medi-Cal link in Prop. 79 won't work because it requires federal approval, and the feds "have never, ever, ever approved a program like Proposition 79," according to Jan Faiks, vice president for governmental affairs and law for the Pharmaceutical Research and Manufacturers of America.
Prop. 79 forces say flatly that without the Medi-Cal link, the drug companies won't participate. "And if they start to, the discounts will go down as soon as the political pressure does," said Wright, who is executive director of Health Access, an advocacy group.
"Proposition 78 ...has a poison pill clause that the program will end if the drug companies don't participate," said Wright. "And they won't."
To which Faiks replied, in essence: Trust us.
Drug makers have had "charitable programs" since the 1950s, she said. In several states, including California, those programs have been coordinated and put online. (See rxhelpforca.org.)
In California, Faiks said, the terms of Prop. 78 were worked out between the industry and the Department of Health Services, to obtain a discount rate of at least 25 percent ("but we're hoping for 40 percent"). And the state would be able to bring fraud charges if a company were to certify a price that was not its lowest. That's "a huge hammer," said Faiks.
The Kaiser Foundation's Levitt called the face-off "a fairly classic battle between using the power of government to help people with a problem vs. encouraging the marketplace. It's an ideological battle we see all the time in health care."
So who's right?
"We don't take a position on issues," said Levitt, but: "It's fair to say that Proposition 79 has a much higher chance of yielding discounts for consumers than Proposition 78 does. There's not a lot that Proposition 78 does that goes beyond what's happening now."
Levitt noted that public opinion about the drug companies could provide a counterweight to their advertising money. Although drugs represent only about one health care dollar in 10, the pharmaceutical industry is "everybody's favorite bogeyman when it comes to health care costs," said Levitt.
"Drugs are much more of a retail transaction than other parts of the health care system," he said. "So it's a very visible target."
You can read it in Post #2--the Duf left it on my voicemail ;-)
They both represent handouts, IMO.
The (R) party I once joined would have vigorously opposed both Prop 78 and Prop 79.
ROFL. Miracles do happen! I even agreed with FairOpinion--once. ;-)
Party for sale? Get your pork here!
Last time I went lobbying I did eat pork bellies. No joke.
"Can someone tell me why the Republican Party is actively promoting Prop 78? "
======
Because Prop 79 is going to pass. Prop. 79 was put on the ballot first and it was going to pass. THEN, to try to twarth Prop. 79, Prop 78 was put on the ballot. Whichever proposition gets the most votes, if both pass, it will become law.
If Republicans vote no on both, Prop 79 will pass,it is being pushed by the Democrats. The only hope is that by having Prop 78 on the ballot, it will split the Dem vote, or even if Dems vote yes on both 78 and 79, but Republicans vote yes on 78 and no on 79, 78 would receive more votes.
Again, we do not live in a fairly land, we live in reality. Our choice is NOT "neither 78 or 79", 78, 79.
Our choice is ONLY between 78 and 79. If you vote no on both, that will result in 79 passing.
I am amazed at the naivity and lack of any "strategery" thinking on the part of some conservatives.
Wouldn't everybody who's voting for 79 vote against 78? Why would they vote for both?
Can you please provide support for this comment?
I have seen nothing that shows this will get more than 50% in the election.
In fact, the most recent polls (as heleny posted above) indicate it will not pass.
Governor backs parent notice on abortion
San Francisco Chronicle, September 24, 2005
(snip)Evaluating the Administration's California Rx ProposalSchwarzenegger also said he supports Prop. 78 and opposes Prop. 79, which are two competing prescription drug discount measures. Prop. 78, which is backed by the pharmaceutical industry, is mirrored on a legislative initiative proposed by the governor that failed to win support in the Legislature.
(snip)Governor's Proposal. The Governor's 2005–06 budget plan for the Department of Health Services (DHS) proposes to establish a California Rx program aimed at reducing the costs certain California consumers would have to pay for drugs purchased at pharmacies. The California Rx plan was initially offered in a modified form as amendments to several legislative measures last year, but was not adopted. Since that time, the Governor has revised his legislative proposal in some significant respects (now contained in SB 19 [Ortiz]), and incorporated a request for 18.5 staff positions and about $3.9 million from the General Fund into the 2005–06 spending plan for DHS.
Bottom line: Do you prefer 79?
As I said repeatedly, 79 will pass. If 78 won't get more votes, 79 will become law.
Voting no on both propositions will result in 79 becoming law.
>>As I said repeatedly, 79 will pass.
I asked for some support for that comment--can you provide any?
AARP Urges Californians to Vote No on Proposition 78 (and yes on 79, as well as no on 76)
http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/09-28-2005/0004133772&EDATE=
Dems are most likely to vote yes on 79 and no on 78, but may vote yes on both, because they want the subsidy, so that if 79 won't pass, they will at least have 78.
So Republicans will be able to be a deciding vote, in giving 78 more votes.
I have seen some early polls, which said 79 had a lot of support.
BUT, as I was doing further research, I found an article, which said that 79 may be defeated. If I knew for sure, that 79 WILL be defeated, I would agree, that we should vote no on both. But I think the reason 79 MAY be defeated is exactly that people may vote for 78 instead.
It's a very tricky situation. 79 is so bad, that we can't afford to have it pass.
Here is the article I am talking about:
Voters unhappy with governor, his initiatives -- poll
55% disapprove of job he is doing, none of his measures in survey top 43% approval
http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2005/09/29/BAGK2EVFKK1.DTL
You said: "As I said repeatedly, 79 will pass."
I said: "I asked for some support for that comment--can you provide any?"
You gave me this link, which says nothing about the liklihood of Prop 79 passing.
http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/09-28-2005/0004133772&EDATE=
I ask again: What support do you have for your contention that "Prop 79 will pass"?
http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2005/09/29/BAGK2EVFKK1.DTL
Prop. 79 would require drug companies to provide a discount or be shut out of the state Medi-Cal program. Just 34 percent of likely voters support this measure, with 40 percent opposed and 26 percent undecided.
I just explained it in my previous post.
Do you actually read my posts?
Prop. 79 would require drug companies to provide a discount or be shut out of the state Medi-Cal program. Just 34 percent of likely voters support this measure, with 40 percent opposed and 26 percent undecided.
So even if 60% of the undecideds voted in favor of the initiative (pretty unlikely given that it only has the support 45% of the 74% who are decided), it still wouldn't pass. You realize that this strategy you're advocating carries a very high risk of needlessly enacting Prop. 78 against the will of the majority of voters?
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