Just Say Eh?

Every now and then, a funny thing happens in American politics: An upsurge of populist demand for sensible public policy actually trumps the powerful business interests that oppose it. Sometimes this happens even after the big business has forked over millions of dollars to elected officials.

Take the national debate over how to best control the skyrocketing costs of prescription drugs. Until recently, the effort to create hassle-free access to cheaper drugs from other nations, especially Canada, had been a pet issue of just a few politicians. Two Minnesota legislators--Gil Gutknecht, a Republican congressman from Rochester, and Democratic Senator Mark Dayton--have trumpeted the issue of importing drugs.

In the last few weeks, the import bandwagon has become much more crowded, fueling optimism that long-stymied reform is on the horizon.

"We've got a collision of tectonic plates, the will of a great number of Americans versus the power of the Bush administration and the drug industry," observes Kip Sullivan, a Minnesota health care activist and expert on drug importation. "You can see the tension building. And I think we're moving rapidly towards making it easy to import."

Sullivan points to Governor Tim Pawlenty's surprise announcement two weeks ago that his administration is now seriously looking at developing a state-run drug import program. With that, Pawlenty--normally a cautious politician who seldom antagonizes his party fellows--broke ranks with the Bush administration, the national GOP, and that most powerful of lobbies, the pharmaceutical industry. If Pawlenty's plan goes forward, he will undoubtedly run afoul of the federal bureaucracy's most strident anti-import entity, the Food and Drug Administration.

But the logic behind the governor's gambit is plain to see. For starters, in a season of tight budgets and escalating health care costs, imported drugs could save the state government an estimated $20 million annually. Just as significantly, with a statewide drug-import program, the governor would earn the gratitude--and maybe the votes--of the growing legion of Minnesotans who now struggle to purchase their drugs.

Ironically, Pawlenty's agenda brings him into alignment with his chief political foe, Attorney General Mike Hatch. Last week, on the heels of the governor's announcement, Hatch fired his own salvo in the prescription drug war, releasing a 54-page report, "Follow the Money. The Pharmaceutical Industry: The Other Drug Cartel."

The details are damning. Leading drug companies enjoy profits that are five-and-a-half times those of the average Fortune 500 company. The industry routinely gouges American consumers on drugs that their tax dollars helped develop. (For instance, in 2000, American consumers paid $241 for a supply of the breast-cancer drug Tamoxifen; in Canada, the same supply cost just $34.) And of course the industry wields enormous political influence. As the Hatch report notes, it has spent an estimated $477 million lobbying the federal government since 1997.

Yet the political momentum for reform continues to build. In Washington, Congressman Gutknecht, a self-avowed conservative, has spearheaded the crusade for drug import legislation since 2000. Despite vigorous opposition from his party's leadership (and the outright refusal of committee chairs to grant him a hearing the last two years), Gutknecht succeeded in forcing a floor vote on his bill this summer. It passed 243 to 186.

But that doesn't mean others aren't fighting it. Consider Minnesota's junior senator, Norm Coleman. In the 2002 election cycle, Coleman was a notable recipient of pharmaceutical industry largesse. According to the Center for Responsive Politics, he ranked eighth of the 535 members of Congress in political donations from the industry, raking in $124,250.

Coleman communications director Tom Steward maintains that the senator favors permitting drug imports. But there is a caveat: Coleman--along with 52 of his Senate colleagues--has stipulated that he will only back importation if the Secretary of Health and Human Services certifies that the imported drugs are safe.

But, critics like Gutknecht and Kip Sullivan point out, the safety provision is really a poison pill because the regulatory actions necessary to demonstrate that imported drugs pose "no additional risk to consumers" would be prohibitively expensive.

Besides, there is scant evidence that drugs imported from other first-world countries actually pose a significant risk to consumers. In fact, says Bryan Anderson, Gutknecht's communications director, the FDA has been unable to produce a single instance of an American citizen whose death was caused by defective drugs imported from a first-world nation. Imported foods, Anderson further notes, are linked to thousands of illnesses per year, yet no one in Congress or the FDA suggests a similar standard for food importation.

Still, the FDA continues to do all it can to ratchet up public fears over the supposed dangers of imported drugs. Just last week, the agency announced the results of drug seizures at several mail facilities across the country this summer, in which they examined some 1,100 packages. The FDA declared that hundreds of these drugs were "potentially dangerous."

Sullivan is skeptical of such conclusions. "I find that extremely difficult to imagine," he says, adding that some drugs from third-world nations may be deemed unsafe. "If it was true, given the enormous flow of drugs from other countries, we should have heard about suffering and mortality caused by these drugs. We haven't heard a thing."

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