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Roger Hickey is co-director of the Campaign for America’s  Future. He is co-editor, with Robert L. Borosage, of The Next Agenda: Blueprint for a New Progressive Movement.
Some political advertising campaigns hit their targets, but sometimes they backfire. This election year the drug industry, intending to help their friends in Congress, have been spending millions on advertising that gives unexpected help to their critics.
Over the last few weeks the pharmaceutical industry, through the U.S. Chamber of Commerce, has been spending millions of dollars on an ad campaign in 10 districts or states praising incumbents who voted for the controversial Part D prescription drug plan. “Big pharma” is publicly embracing their champions in the Congress just as millions of seniors are getting the unexpected shock of falling into the infamous “doughnut hole” gap in the new program’s coverage. After their first $2,250 in drug expenditures are covered, seniors must pay all their drug costs completely out of pocket for the next $2,850, even while still paying a monthly premium for a program that gives them no benefit at all.
September 22 was “doughnut hole day”—the day the average senior who endured the aggravation of enrolling in the program fell into the coverage gap. But seniors with higher drug bills have been experiencing this rude awakening for months now—and millions more will get there before the election. When they recover from the shock of being charged hundreds of dollars for the same prescription that cost them only dollars on their last trip to the pharmacy, seniors (and their younger family members) want to know why this happened. Why would politicians design a program with this kind of potentially life-threatening gap in coverage?
Here’s the answer that most seniors are starting to understand: The Republican majority wanted to win support from older Americans, but they also wanted to do something for their very powerful political donors in the drug and insurance companies. Seniors got some subsidy, but they also got a confusing array of plans run by private insurance companies. And the pharmaceutical industry got the biggest gift of all: the law creating the Part D program prohibited the government from requiring the drug companies to compete to offer the lowest price on drugs. This provision in the Bush program said to the drug companies: “Charge whatever you want, and we’ll make sure you get paid.”
The doughnut-hole gap in coverage results from the bill’s authors’ desire to cap the overall price of the program. After they made it way too expensive by allowing their drug company friends to charge high prices, they had to cut a gaping hole in the seniors’ coverage in order to save money. Economist Dean Baker has calculated that if the Part D program had been structured to get the best, lowest prices from the drug companies—as the Veterans Administration does today—we could have saved enough money to eliminate the donut hole without raising the cost of the Part D program.
So, as seniors fall into the doughnut hole—and as they and their families get wise as to why this happened to them—the drug industry-Chamber of Commerce TV spots are a great guide to who they should hold accountable. And all over country, activist citizen groups, led by the Americans United coalition, are publicly pointing to drug company contributions to specific incumbent senators and representatives as an explanation for why seniors are falling into the doughnut hole— with potentially life-threatening consequences. And they point to the TV spots as just another way the industry helps their servants in Congress.
On Sept. 26, 74-year old Fort Lauderdale native Betty Priscak helped deliver a box of doughnut holes to Congressman Clay Shaw, R-Fla., in West Palm Beach, Fla. Ms. Priscak explained to Shaw’s staff: “The Part D ‘doughnut hole’ has almost killed me. I cannot afford to pay for my medicines, which have already cost me $3,600 out of my own savings this year.”
Similar highly publicized protests have been held at district congressional offices and campaign headquarters in every state in the union. Others take place in senior centers, union halls, or radio and TV studios. The idea is to publicize not only the human costs of the coverage gap but to publicize the way drug industry campaign contributions led directly to legislation that gave a windfall to that powerful industry—while leaving seniors dealing with dangerous shortfalls in coverage.
Some incumbents may protest. “Yes, I took their money and their TV spots, but I’m not in the pocket of the drug industry.” And for that, seniors and citizen groups have a simple test that will be the focus of their local actions from now until the election. “Will you promise to get rid of the doughnut hole? Will you promise to fix Part D by giving Medicare the power to get the lowest prices from the drug industry?” The answers, all to be highly publicized, will be the best guide yet as to who stands with seniors and who stands with the big drug companies. And if we don’t get an answer to that question, we know that the drug industry only spends advertising money on its very best friends.