For Senator David H. Pryor, the fight against soaring drug prices is a crusade for compassion that started five years ago. In every other letter of the tons of mail he received from constituents "was a P.S. saying 'we can't afford drugs anymore,'" he recalls. When Pryor looked into the issue, "I found it worse than I had imagined. The majority of elderly were sacrificing food and shelter to pay for medicines."
Pryor sprang into action, only to end up tilting at windmills. Fellow Democratic legislators wondered why he bothered with a politically dead issue, and drug execs didn't come to his hearings. "I've been very discouraged," he says.
'GOOD POLITICS.' No longer. In fact, the gentlemanly senator from Arkansas is the man of the moment in Washington. Drug-company lobbyists suddenly want to plead their case to him. TV crews jostle for space in his packed hearing room. The difference, of course, is the new guy in the White House. President Bill Clinton, who succeeded Pryor as Arkansas governor, is a longtime friend, and Clinton has embraced the senator's pet issue with a vengeance. "High drug prices and other health-care outrages are the '90s equivalent of the Pentagon's $600 screwdriver," fumes one top White House official.
To pharmaceutical executives, Clinton's rush to help Pryor bash their industry smacks of cynical political maneuvering. "Beating on people is good politics from time to time," concedes one top White House official. Even though drug prices represent only 7% to 10% of the nation's health bill, quick action to limit prices would be a coup for an Administration intent on proving that it's serious about tackling runaway health-care prices. Success on the drug front would also help pave the way for an overall health-care plan. And with Pryor doing much of the work, the White House isn't wasting much of its own political capital. "It's an advantage for Clinton that Pryor is out there taking the heat," says Democratic consultant Victor Kamber.
Pryor laughs at such a Machiavellian interpretation. "This is a day-to-day, seat-of-the-pants operation," he shrugs. But for the first time, he is smelling victory. "The political Establishment senses a greater vulnerability of the pharmaceutical industry," he says. "Its excuses aren't selling anymore."
FIRST SALVO. The crucial question, of course, is where all this will lead. Pryor and the Administration haven't decided. A sufficiently abject agreement to voluntarily restrain prices might save the industry from stronger action. But Pryor isn't counting on this. One option he may propose is a government commission, similar to Canada's, that would limit price rises on existing drugs and set prices for new ones. Another is making government a drug wholesaler--with lots of buying leverage. "This scares companies to death," he grins.
For now, Pryor favors making government the buyer. "It's better than price controls," he says. Clinton is unlikely to go for such a drastic solution. But the President wants to begin reimbursing medicare patients for drug purchases, which would give Washington more clout in negotiating drug prices. Either way, the drug debate is the first salvo against health-care costs. And it improves the odds that Pryor may yet help all the people who wrote such heartrending letters.