To help rural America, policymakers must first understand it
Poll: Voters are angry about prescription drug costs
For over 30 years we have been conducting health-care surveys from separate national polling firms associated with different political parties. In all those years, our surveys have never found the intensity of frustration with health-care costs higher, particularly on prescription drug prices. Most recently, a new poll we conducted together on a bipartisan basis re-affirms overwhelming voter anger about prescription drug costs, with over 9 in 10 voters saying it is important that Congress take action to reduce prescription drug prices in this session of Congress.
Most notably, our poll documents broad demand across the political spectrum for aggressive policy interventions, even when pressure-tested against the most likely counter-arguments that will be made by opponents.
Our survey finds that 84 percent believe the prices drug companies charge for prescription medicines are unreasonable, and voters tell us reducing the cost of prescription drugs needs to be a top priority for Congress. Policies such as Medicare price negotiation for drugs with no competition in the marketplace are strongly supported by more than 90 percent of the voting public. But poll findings on this general issue and approach do not measure how the public responds to the strongest arguments against specific prescription drug cost policy reforms.
Failure to pressure-test such issues can and often does result in surprising and unsuccessful outcomes. President Clinton's Health Security Act polled quite high - in excess of 70 percent. There was even initial openness to repeal and replace the Affordable Care Act. But when tested against the likely pro/con arguments about the policies contained in the proposal, popularity declined to levels that ensured eventual failure.
With this history in mind, Arnold Ventures asked us to construct a comprehensive polling survey that provided very specific information about policy options and tested them against the strongest and most likely arguments opponents would make.
We tested for policies that took different approaches to using Medicare's purchasing leverage to secure more affordable prices for drugs that face little or no competition in the marketplace, including reference pricing to other Western industrialized nations' prices, binding arbitration (such as what Major League Baseball uses), and compulsory licensing to contract out the production of the medication from another manufacturer.
We tested predictable arguments against Medicare negotiation, including (1) if Medicare demanded too low a price, some manufacturers would "stop selling essential prescription drugs to seniors, denying millions the drugs they need to treat their disease...;" (2) the notion that "government price controls will significantly reduce research and innovation that create life-saving medicines; " and (3) the idea that we "should leave negotiation to business people in the private sector...to negotiate good drug prices for seniors," not "government bureaucrats (who) don't have the skills, experience or time" to do this well.
We also gave the likely counter-arguments to these criticisms, namely that drug manufacturers cannot afford to lose the Medicare market, that they spend more money on advertising and marketing than they do R&D, and that leaving price negotiation to the private sector has not solved the problem of unaffordable prices for some drugs. These arguments and counter-arguments reflect the likely debate around policies aimed to limit pricing excesses of prescription drugs that face no competition.
Remarkably, even after the strongest opposing arguments were made, support for aggressive policy options held up across party affiliation - with large majorities of voters continuing to support them. For example, even after hearing the argument that R&D investments would fall if price limits were introduced and drug companies might withhold certain drugs from Medicare, 87 percent of all voters, including a supermajority of Republicans (67 percent), still support Medicare negotiating for more affordable drug prices for sole source drugs.
The frustration with prescription drug costs and the lack of ability to relieve the cost pressure with voters has significant political consequences. Well over 7 in 10 voters indicated that they would think less favorably toward their Member of Congress if they did not support legislation to provide prescription drug cost relief.
In our experience, the voter intensity and anger about prescription drug pricing is at a record level. We believe it reflects the trends for higher deductibles and cost-sharing over time, high launch prices, price increases, reported profits of the pharmaceutical industry and years of unrealized policymaker pledges. Regardless, the implications from our data are clear: Failure to address the cost of prescriptions for patients and taxpayers alike has great potential to be a prescription for political pain for unresponsive politicians.
Geoff Garin is the president of Hart Research Associates, where he conducts opinion research for the nation's leading foundations, progressive advocacy organizations, and Democratic candidates. In addition to Arnold Ventures, he has conducted research on health care issues for such clients as Protect Our Care, Planned Parenthood Federation of America, SEIU, and the Center for American Progress.
Whit Ayres is the president of North Star Opinion Research. He has years of experience performing research on health care and other topics for clients including the U.S. Chamber of Commerce, Pharmaceutical Care Management Association, American Medical Association, American Action Forum and the Federalist Society.
The poll was conducted by Geoff Garin of Hart Research Associates and Whit Ayres of North Star Opinion Research. It was funded by Arnold Ventures.