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By George Landrith
President of Frontiers of Freedom, a public think-tank
House Speaker Nancy Pelosi is considering a monumental change to Medicare—and believes that President Donald Trump might support her plan.
Her big idea? Binding arbitration—a method that empowers government appointed “arbitrators” to dictate the price of new medications and treatments. She hopes it’ll lower drug spending.
Arbitration is just a fig leaf for government price controls. And like all price controls, arbitration would discourage medical innovation.
Under Medicare, drug coverage is broken into two parts. Medicare Part B covers potent medicines, like chemo and immunotherapies that physicians administer in hospitals and doctor’s offices. Medicare Part D covers prescription drugs that patients can pick up at the pharmacy.
For both programs, drug prices are determined through negotiated prices between drug makers and private payers, like hospitals or insurers.
In a binding arbitration system, if Medicare officials aren’t satisfied with those negotiated prices, they could appoint an arbitrator to do their bidding. Medicare officials would explain to arbitrators why they feel a lower price is justified. Pharmaceutical companies would justify their own suggested price.
Arbitrators would then choose a legally binding price. And their decision wouldn’t be limited to the two proposals on offer.
Government officials would get to pick the arbitrators, and would almost certainly choose ideologues that agree with them. So the “negotiation” would function identically to price controls.
Price controls always stifle innovation and harm patients in the long run.
Drug development is a risky business. It takes about $2.6 billion and between 10 to 12 years, on average, to create just one new drug. Around 90 percent of medicines never make it past clinical trails.
Investors are willing to take such financial risks on the off chance their drug succeeds and is profitable. Price controls eliminate that potential by making it harder for companies to recoup their R&D expenses, No investor would risk her capital knowing the government could undervalue her discoveries.
Just look at what price controls did to Europe. In 1970s, European companies made more than half of the world’s new drugs. Then governments across Europe began to implement various price control schemes over the next ten years. European countries developed less than 33 percent of new drugs today.
The United States, on the other hand, is the global leader in drug development, and has done so for over three decades. Because our healthcare system values drugs fairly, drug innovators are eager to research and develop drugs stateside. In the United States, researchers are developing roughly 4,000 new medicines targeting a range of diseases, including potential cures to Alzheimer’s, cancer, and diabetes.
If binding arbitration takes off, Americans may never benefit from these potential treatments. Instead, patients would be left at the mercy of diseases for which here are currently no cures.
Binding arbitration doesn’t deserve President Trump’s support, or the support of Democrats.