You've been in a position that gives you a unique view of how pharma handles itself, both from a public relations perspective
and from a political perspective. What has the industry done wrong and right over the past few years?
They will be the first to tell you they have made mistakes. They have earned some of their black eyes. But from all my discussions
with the leaders of this industry, they want to do better. They understand that access and affordability are not just ideals.
If Americans are going to appreciate the work companies do, they can't just find and manufacture and market these medicines—they
have to make sure they reach patients. So insurance coverage, or healthcare coverage, is very important.
It is not all the industry's fault. I don't know of anybody who gets on a bus to drive to Canada to go to a hospital or see
a doctor. We don't do that, because we have healthcare coverage in America for those kinds of healthcare events. The reason
people go to Canada and the reason people are upset about the prices of drugs in America is there are too many uninsured.
Medicines are not covered under Medicare until 2006. There are people slipping in between the cracks of Medicaid and Medicare
who receive no help at all. We have to find ways to solve that basic problem.
The advocacy side of pharma has been extremely successful. But I think the members of the industry collectively agree that
there have been some expensive victories. There have been ugly victories. You can't keep doing that and expect to have an
environment in which you can succeed.
What would be an example of an ugly victory?
I don't know that I want to pin it on any one of them. There's sort of a perception that pharma wins because it's big, it's
powerful, the companies are strong and financially able, and they go out and fight hard and win.
Let's take Medicare.
That was clearly less than beautiful. There was more partisan politics played around that fight than it deserved. Patients
don't sign in as Democrats or Republicans when they go to the hospital or to fill a prescription, and yet this became a big
partisan fight. The bottom line is you just can't keep having those kinds of fights without suffering in the long haul.
Speaking of Medicare, you had a front-row seat for what the industry was attempting to do and how it performed. If you had
been at PhRMA instead of in the House during the battle over Medicare, what would you have done differently?
Medicare became a partisan issue from day one. It is easy to understand why. Here were Republicans telling seniors, "We're
on your side, and we are going to try to create a Medicare benefit for you." I have been both a Democrat and a Republican,
so I can speak with some authority here. Democrats had to be terribly offended by that. They considered seniors as part of
the Democratic base. Here are Republicans saying, "We are going to create an entitlement for seniors." And it was a challenge
that the other side felt it had to answer.
It was also all about elections. There was a feeling that people were voting against the Medicare Bill in order not to give
the other side a win before the election. There was a sense that if you could just keep the issue alive, you could keep beating
up on each other, and somehow somebody would gain an advantage. It became the battle for the majority. It became the battle
for the White House. We as Republicans were either going to take that issue away by successfully passing the Medicare bill
or lose it and perhaps lose the majority. It was that critical at points.
When these issues become so political, so heavily burdened with success or failure of a thinly held majority, they are going
to stay ugly. I wish I could promise you differently. I wish I could tell you I could have done a better job on it from this
position. But I don't know that I could have.