Tommy Denton

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"We all," according to Health and Human Services Secretary Michael Leavitt, "want people with Medicare to get the prescription drugs they need at the lowest possible prices."

Well, no, not really.

Not that Leavitt, who wrote those words in an essay last week for The Washington Post, is inclined toward naked prevarication. Of the members of the current administration, he demonstrates a greater spirit of service to the common welfare than most of the apologists for corporate oligarchy with whom he serves in President Bush's Cabinet.

Leavitt merely overstated the case. For starters, a troubling proportion, perhaps even a majority, of Congress has demonstrated that far from everyone wants to impede the U.S. pharmaceutical industry from amassing whatever profits its executives can extract, however unrelated to efficiency and equity.

As a case in point, the new majority of Democrats in the U.S. House proposed a bill to require Medicare, on behalf of all American taxpayers, to negotiate prices of drugs for its beneficiaries.

To those who still harbor more than a sentimental attachment to democratic values, such intrusions on the dictatorial discretion of the pharmaceutical executives should be self-evidently agreeable.

Unfortunately, the legislation would not allow the government to drop from its approved list those drugs on which manufacturers refuse to offer acceptable deals. In other words, Medicare could bring no real leverage to the bargaining.

Congress, in effect, would preserve the status quo by hoisting a fig leaf that allows another of its K Street benefactors to keep having its way under bipartisan crony capitalism that has run rampant in Washington in recent years.

The Democrats would get to tell seniors they're sternly forcing the drug firms into negotiations, but at the same time, behind the backs of their hands, they would assure Big Pharma's lobbyists that they could continue business as usual -- including their campaign contributions -- because the law's "required" negotiations really don't have any teeth to make it happen.

That's what happens when too many members of Congress forget whom they're supposed to represent, and when political leverage falls into the hands of those who demand that societies be arranged by private interests to serve the economy, rather than establishing an economy that serves the purposes of a just society.

A preferable bill the Democrats should introduce would give Medicare the same leverage as employed by the Department of Veterans Affairs. Because its bulk purchases allow economies of scale favorable to the care of the infirm, the agency realizes discounts of between 25 percent and 40 percent for veterans' medications. If drug companies decline to negotiate, their products don't make the approved list.

Industry lobbyists will spend lavishly to plead against government interference in the divinely ordained free market. Never mind the precedent at Veterans Affairs, Canada, Australia and all other vibrant, capitalist countries that operate health care systems.

Big Pharma's hired guns will argue that dampened profits will hamper their ability to continue research into new miracle drugs.

Never mind that much of the cutting edge science leading to truly breakthrough medicines has come from methodical, painstaking, expensive research in university laboratories and medical schools through public investments by the American taxpayer and then exploited by the drug companies.

Never mind, too, that two-thirds of the industry's research budgets goes to create copycat drugs that essentially duplicate existing ones but extend patent protection against generic drug competition.

Robert Reich, a professor of public policy at the University of California at Berkeley and former labor secretary under President Clinton, has proposed the creation of a Medicare drug plan to compete against those of private insurers.

"Medicare would subsidize any plan," Reich wrote in an essay for tompaine.com, "so seniors wanting drugs not on the approved list would still have access to them. But seniors wanting the lowest drug prices would join Medicare's own plan. It would have the cheapest drugs because the plan's size would give it the most bargaining power and because it would only include drugs that manufacturers offered at a steep discount."

No one should expect a zero-defect system. But the American people should expect their elected representatives to protect their bests interests in a marketplace that -- theoretically, anyway -- exists to serve them.

Denton's column appears in the Sunday and Tuesday editions of The Roanoke Times.