DiscoverVox's The WeedsSneak peak: a new Vox podcast, about how policy effects real people

Sneak peak: a new Vox podcast, about how policy effects real people

Update: 2016-11-21
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This is a pilot episode of a new show Sarah has been working on, looking at the real-life stakes of policymaking. The show's name? That's for you to help us decide.

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the way we as listeners that this is Eric left but this is not the weeds this is a brand new podcast this is our pilot episode we're still figuring out if we're going to do a first season and it is so new that we do not even name for this podcast so i've to requests of you and they both involve sending an email to weeds at Foxconn first I want you to send us your suggested names we are desperate for some good name ideas because all of ours are terrible and second I want you to send us feedback on this episode which you liked about it what you did like topics you want us to cover if we do do a full season if you want to hear full season of this podcast please send us an e mail and let us know that so with that I will let you get to listening happy listening and Happy Thanksgiving Laura Mars since apartment is pretty average for thirty four year old living in DC the rooms are pretty small and she's got these two pet cats running around and at first glance or fridge it seems pretty normal to me there's bread there Zags there's like so a dozen protein shake then she opens up the vegetable crisper and it's got all these plastic bags full of white prescription boxes two four six eight and thirteen by laws and sciences sounds like it's three hrs like the that number isn't far off each bio holds less than a tablespoon of insulin but its retail price is around two hundred and fifty dollars which is obviously really really expensive especially given that it didn't used to be this bad of aisles just twenty dollars when Moore was first diagnosed in ninety six view the same drug same packaging but now it's ten times more expensive and more has no way of knowing if the price will keep climbing it says it's kind of a terrifying exists in the end it's not just Laura and her insulin this is a pattern we see over and over again back in August the cost of epi pens are on the rise in back in twenty fifteen there is at Burma Road Martin J Crowley who jacked up the price of a key malaria and HIV drug one tablet of their firm used to cost thirteen dollars fifty cents the drugmaker recently increased the price to seven hundred the it's all part of this really big and uniquely American story it's widely known that spending on prescription drugs continues to rise we can afford to drop wire the excess pounds consistently will take price increases sometimes every six months sometimes a recorder can anything be done to stem the tide to help those Americans struggling to pay for their prescription drug the Today we want to talk through some of those questions I'm Sir Cliff and I'm Lynn Shelton and in this episode we're going to tell you why the prices of prescription drugs are so incredibly high in the United States that will talk about our policies have led to the prices that we have and will walk through the impact of policies that good and the bat so poor she is an example of the negative side effects that high drug costs can have over the decades she's watched the price of a brand of insulin just go up and up and up and it's not just her brand the two other companies that make insulin have also bumped up their prices right and because Laura has Type one diabetes going with out since land is not an option without incident I would die quicker than most people would without water so it would be like the water was controlled by three companies and they could charge you whatever they wanted ever since she was diagnosed Laura has been making very careful choices about what to study and where to work also that she can be sure she has a job with insurance that will cover the ballooning price of her insulin with you into law school and part just so you could get health insurance in part everything in my life is just so I can get health insurer I mean everything is but even though Laura structured everything around making sure her insulin was paid for she couldn't plan for the recession and when the economy crashed Laura lost her job as a lawyer get a severance package but when that's up using insurance effective that day to afford her and slant Laura took on credit card debt she cashed out of four one K my parents let out of their retirement it was horrifying that's why Laura has this extra insulin stash in her fridge if she ever loses her job again if her insurance doesn't come through she never ever wants to worry about where her next a vial of insulin will come from I mean does he honestly believes the chances are that the if if tomorrow they decided insulin cost a million dollars of bio I'm using these you know and I mean okay so for Laura the rising cost of insulin is not just a theoretical thing it's an issue that she really worries about and has shaped her life and what's so crazy about this Liz is that it might not be an issue at all if Laura live somewhere else in the world like if she lived in Europe or if you lived in Australia rate that scene insulin vial that cause lor two hundred and fifty dollars in the state's cost sixteen pounds in the UK that's a little more than twenty bucks and it's not just insulin in general medications cost much less in other developed countries than they do here in the United States and that is because most developed countries have big government health systems that cover everyone socialized medicine in her in Britain they do have something called the National Health Service the day and age the this is an unjust USA from nineteen forty eight this new service will be organized on a national scale as a public responsibility everyone will pay for and everyone will the the the if you need treatment in Britain the NHS pays for it and because NHS covers everybody can have with pharmaceutical companies to get lower prices for prescription drugs so here's how that works there and I have never seen the movie You've Got Mail made the the streets of New York the the the from you I think I saw at some point in middle school maybe ok so here's what you need to know it's a romantic comedy of course starring Meg Ryan and Tom Hanks Meg Ryan owns this cute little children's bookstore and Tom Hanks is opening a soulless big box competitor just down the block Fox Books Superstore has nothing to do it as its big Overstock and full of ignorant salespeople but the discount but a discount you can think about the difference between the US and Britain sort of like the difference between Meg Ryan's small store and Tom Hanks is Fox Books and instead of drugs they're buying and selling books I sell books I do so sue me the key thing here is Howard Tom Hanks is character can sell those books for so cheap his giant chain Fox Books buys millions and millions of books from a published the so if Tom Hanks character decides the price is too high and he's just not going to buy the books the publisher is going to lose millions of dollars so they have to negotiate to bring their price down and because Tom Hanks gets his books for cheap he can pass that low price down to consumers as discounts may grain store on the other hand is the it charming little book store was sold when three hundred fifty thousand dollars with the books of the Year Tom Hanks is oh so romantically telling Meg Ryan that that's nothing compared to his millions in sales for if the publishers can afford to lose makes business so she can really negotiate for lower prices she has to take whatever price the publishers give her and that's why her books are more expensive the back the all these American insurance companies are like Meg Ryan stores none of them have enough patience to really go toe to toe with Big Pharma companies like Eli Lilly which makes doors in the NHS they are like the Fox Books of health care they can go to Eli Lilly and say look here's the deal you are selling as insulin for sixteen pounds now shilling more we are walking away and you lose sixty million British customers in the That is how the NHS its lower prices for the British people the land because we don't do this there are thousands of Americans like for the They worry about the pace of the rack up debts to afford their medications and some people skip doses to make their medications last month are the the the ICS so this means if we want lower prescription drug prices in the US we need a fox books write something like Britain's NHS or we can get socialized medicine the wealth was no we actually already have an insurer that could be like Fox Books is it Medicare is Medicare you are raids so Medicare covers all Americans sixty five and older and they're about fifty million people in it which is only slightly smaller than the entire population of Britain and some people think if we let Medicare negotiate it becomes like Fox Books it could force prices down and those lower prices they would ripple out to the rest of the healthcare system this sounds like a great idea I'm all for more Tom Hanks in my life let's do it yes I'm sorry to burst the bubble but we can't seriously yet seriously and you're going to tell me why rate I am but I am going to need some help to duets I'm Julie rather I have now been covering health policy in Washington for thirty years I was five when I started um and I think what I started covering health care they were talking about prescription drugs now thirty years later they're still talking about prescription drugs they were even talking about prescription drugs before Julie Robin or was covering health care I was there when Lyndon Johnson signed the Medicare bill into law in nineteen sixty five that's the late Senator Ted Kennedy speaking on C span back in two thousand and three he was telling the audience that the very first version of Medicare covered a lot of things doctors visits are in there so our trips to the hospital the one aspect that wasn't there was the prescription drugs and that was something the Kennedys constituents kept telling him they wanted him to change its ace ace Senator when you going to put in that prescription drug program so he along with a lot of other politicians were trying to do just that proposals came up in the nineteen eighties under Reagan and again in the nineties under Clinton and didn't go anywhere every time this came up the pharmaceutical industry pushed back they did not want Medicare to cover prescription drugs because they were afraid of exactly the thing we've been talking about this actually seems kind of weird like if Medicare covered prescription drugs that would mean a lot more business for pharmaceutical companies but they were so worried about price controls they said no to the whole thing the theory was if the government starts paying for something in Medicare eventually will want to set the price that was what the drug industry feared most that they would just be another regulated provider of health care under Medicare ok so something changed rate because Medicare does cover prescription drugs now they pay for my grandmother's heart medication when I go to the pharmacy with her yes fast forward to two thousand and three in two thousand and three when George W Bush got a Republican Congress for the first time he thought well it still is issued from the Democrats and do it ourselves good morning this week I was on a design the Medicare Act of two thousand and three this new law would give seniors better choices and more control over their health care and provide a prescription drug benefit so Kennedy finally got what it is not exactly the bill did pass but Kennedy he was not happy about it and that's why he was on C span on that day in two thousand and three it's a raw deal for the seniors in this country and Kennedy was not alone Senator John McCain from Arizona was really mad to owe this package explicitly prohibits Medicare from using purchasing power to negotiate lower prices would manufacture how is that possible in two thousand three Pharma was very clearly in bed with the Republicans so the drug industry was very adamant and they went in saying that their price for supporting this and its port it was that the government not set prices the drug industry basically said your Medicare coverage for prescriptions you need to promise us they will never ever be able to negotiate prices Senator McCain he had a really choice analogy for the whole thing this legislation reminds me of the Asian medieval practice of leaching every special interest in Washington is attaching itself to this legislation and sucking Medicare dry this was not the end of a fight for years after that huge coverage battles so this is a two thousand and seven then Senator Barack Obama took up the issue on the presidential campaign trail the cause thanks but no thanks for overpriced drugs drugs that cost twice as much here as they do in Europe and Canada Mexico will let Medicare negotiate for lower prices so young so idealistic I'm against it didn't work out that way it did not Obama won in his health care law to go through go but in order to that yet to get every single Democrats support it so he needed to get farm on board if Pharma had been working against it not a chance Obama compromised Obamacare passed the Medicare still couldn't negotiate drug prices and that is where we are today the drug companies set their prices and Medicare pays them so that's where things stand now but we still hear politicians talking about Medicare negotiation we heard Hillary Clinton and Donald Trump both on the campaign trail and twenty sixteen saying that they thought it was a good idea and the American people agree with them a Kaiser Family Foundation poll shows that eighty three percent of Americans think that is a good idea but it sounds really logical I mean that's why the public supports it will curse if they can negotiate couldn't they get lower prices of course they could get lower prices is if they were to cover fewer drugs this is the part that really doesn't come up much in arguments about letting Medicare be like a big box bookstore but it's a really big trade off and we need to talk about its Medicare in order to negotiate house to be willing to say this drug is too expensive and we're not going to cover its late Tom Hanks is Fox Books can only get lower prices because it's willing to walk away from the negotiating table and it's pretty much the same with these big government health care systems like the NHS in Britain they're not just negotiating on drug prices are also making some really tough choices about which drugs are going to cover its a sensitive debate which new drugs can the NHS in England before the storm is the breast cancer drug counseling the the That's from a BBC report in two thousand and fourteen this new breast cancer drug could just come out and the NHS was negotiating with the manufacturer to get a good price and or Jillian was there he was one of the negotiators for the NHS and this is what he told the BBC the price that the manufacturer wants to charge the NHS puts it well beyond anything we can dispose of the the this is a drug that gave patients around six more months of life but it would have cost the NHS equivalent of a hundred and seventeen thousand dollars for patients the soap instead of asking Hey do you think Medicare should be able to negotiate lower price as Julie Roberts thinks we should ask a different question well which is still sport make your negotiation if it meant there was a smaller choice of drugs people don't really like trade on the the the OK that's the short term trade off worth making if Medicare is going to negotiate prices it can't cover every single track and even if we're okay with that we also have to consider a second longer term trade off let's say Medicare does manage to bring prices down if we do pay last for medications we may get last new drug research but the true death the conversation we should be having is what the appropriate innovation a price trade off we can except we can't just ignore the fact that we're going to get less innovation sticker had the stands and think that if we if we cut prices there are no negative effects this is Craig Garth week he's an associate professor at the Kellogg School of Management so let's be really clear about what Craig is not St it is not that the money you make in profits today is then reinvested or research in developing the future we hear this kind of argument from pharmaceutical companies all the time like Oh any charge lots of money for this drug so that I can take that money and put into making new drugs Craig says that is not how it works right he said it's more about people trying to decide whether they're going to invest in the first place so imagine that Craig is a venture capitalist who's sitting down at his desk with his giant pile of money I've got ten million dollars to invest in any number of products are one of which might be the next you know great social media app that generates no value but people still pay for and one of which is a potential cure for pancreatic cancer so if venture capitalists craggy sees that Medicare is driving down the price of prescription drugs he might say you know what there isn't a high enough chance to profit from this I'm going to go invest in that social media app or cell phone games which could potentially leave us with a bunch of new cell phone games instead of new innovative products except it's okay we need to make a really important distinction here not all expensive new drugs are actually all that innovative there's a huge difference between breakthrough drives these new pills that cure a disease and tweaks where you just kind of up to drugs that already exists small changes in the expected value of life from a drug are getting pretty outsized rewards which brings us back to Laura and her insulin there are some diabetes technologies that are really new floor showed us this great gadget that feeds data about her blood sugar into her smirk watch a cute boy you can see Nick Jonas where the switch is like way appetizing Hampshire it's the latest greatest in soil with the isolated back in the nineteen twenties and yes there have been tweaks and improvements over time but the World Health Organization says that those tweaks don't really make enough of a difference in patients' lives to justify the ballooning costs so for Laura the OK I'll pay more for her for the fancy thing that transmits to my watch when it comes to end soon I'm just trying to live so this you are there with Myanmar's apartments it's just such a hard situation she's dealing with and being married singer insulin the cost so much money and how she's organizing your life around the edges of the symbols were I want to fix the only tool and the whole time thinking there has to be an easy way to do this there has to be an easy fix but it's harder than it seems they're always going to be trade offs like consider Laura's situation on the one hand we get sick with the system we have now where Gore chooses are in slanted stooge and fifty dollars It's so expensive to afford on the other hand we could switch to a system that negotiates but that's risky for Laura to she could end up with a lower price with her truck or maybe a situation where the government says they're going to cover different evidence and all the sudden nobody is willing to pay for the insulin she's been taking for twenty years if we do decide to go that route we might have to accept that we'll get less innovation in the drug for the the we want to lower drug prices if we want to help people explore how the mind that is a totally appropriate policy priority we just have to realize that in order to do that we have to mix the raisins the rates of VAT was our podcast we had so much fun making it a lot of think use for the work into this on first and foremost our producer the amazing bright pink or ten we had engineering help from Peter Leonard in a C Valdez and thank you so much to the spawn has applied for some of their feedback along the way and now we have just a little bit of work for you as you are traveling home for Thanksgiving are making a turkey whatever you're doing don't forget to send us an e mail that needs a boxed up home with two things ideas for what we should name this podcast and any feedback you have on this episode whether you want to hear fall season please please please send all of that's two weeds at Foxconn and we are so eager and excited to read all of your house thank you so much in advance the the
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Sneak peak: a new Vox podcast, about how policy effects real people