John McCain – Where the Candidates Stand – Part 8

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  1. The focus of the McCain position on health care is not on universal coverage, but on the control of costs through a number of mechanisms.  In a speech in October, 2007 in Iowa, he stated that "[t]he state of our medical science is the envy of the world. The problem is not that most Americans lack adequate health insurance. The vast majority of Americans have private insurance and our government spends billions each year to provide even more. The biggest problem with the American health care system is that it costs too much, and the way inflationary pressures are actually built into it. Businesses and families pay more and more every year to get what they often consider to be inadequate attention or poor care. And those who want to buy insurance are often unable to because of the high cost."   

With regard specifically to pharmaceutical companies, in that same Iowa speech, he did not sound like a fan – "Pharmaceutical companies must worry less about squeezing additional profits from old medicines by copying the last successful drug and insisting on additional patent protections and focus more on new and innovative medicine."

Looking at our five domains:

  1. Importation of Drugs – Recently, Senator McCain stated that he favored the reimportation of prescription drugs.  He has also expressed this position through his voting record – in favor of the importation of drugs as provided under S. 812 – during the 107th Congress.
  2. Medicare Part D Reform – The Senator favors reforming Part D to allow the government to negotiate prices with the pharmaceutical industry, according to the WebMD profile of the candidate. 
  3. Pharmaceutical Marketing Restrictions - Nothing found, but if they could be tied to lowering costs, it might be attractive to him. 
  4. Follow-on-Biologic Regulation – Nothing specific found, but any promise of cost reduction would appear to appeal to the candidate.
  5. Generic Promotion – Also according to this WebMD profile, the Senator favors wider access to generics, but it is unclear what form that would take.  Also – from the speech in Iowa – "if there are ways to bring greater competition to our drug markets by safe re-importation of drugs, by faster introduction of generic drugs, or by any other means we should do so…"

Analysis:  His position offers a stark contrast to many others in that he does not believe that the lack of insurance for over 40 million Americans is the major problem but that if insurance is made cheaper the uninsured will all buy it.  On the Republican side, he breaks away from the pack a bit in terms of his stands, particularly on favoring Part D reform and the issue of importation.  He offers more specifics than many of his Republican colleagues, but still falls very short of many on the other side of the aisle in terms of providing specifics on how he intends for goals to become realities.  It sounds like the candidate does favor universal coverage when stating "we can and must provide access to health care for all our citizens – whether temporarily or chronically uninsured, whether living in rural areas with limited services, or whether residing in inner cities where access to physicians is often limited."  But the emphasis on the plan is on providing access, not ensuring access.  And while relying on controlled costs to reform healthcare, there is no clear plan laid out for controlling costs other than to provide for greater national competition and offer insurance more broadly than with employer based systems. 

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