Pills and the Public Purse: The Routes to National Drug Insurance
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If national health insurance becomes a reality, what options should be considered for the coverage of prescription drugs? The authors--whose Pills, Profits, and Politics has had a dramatic effect on physicians, pharmacists, patients, and the drug industry as well as on federal and state legislators--insist that the major objective must be the best possible health care. But holding down costs to patients and taxpayers must also be a goal.
To complicate matters further, the advantage of each likely option--including price controls, the use of formularies, drug utilization review, patient cost-sharing, and the use of low-cost, generic-name products--is offset by a disadvantage, even a danger. If drug prices are slashed too much, the industry will lose many of its incentives to develop better drugs for the future. Particular attention is focused on the so-called drug lag--the lengthy delays in licensing of new drugs, even after they have been used with apparently good results in other countries. Pills and the Public Purse also addresses the seldom-appreciated fact that investing tax dollars in needed drugs may save taxpayers in the long run by minimizing unnecessary physician visits and hospitalization. Pills and the Public Purse challenges Congress and such agencies as the Food and Drug Administration and the Health Care Financing Administration to enact policies that put the interests of the public before those of government, industry, physicians, and pharmacists.Milton Silverman was Senior Lecturer and Research Pharmacologist; Philip R. Lee is the former Director of the Institute for Health Policy Studies; and Mia Lydecker, at the time of original publication, was Principal Editor and Research Associate--all in the School of Medicine at the University of California, San Francisco.
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