Drug costs under scrutiny
By Lynda Arakawa
Advertiser Capitol Bureau
The rising cost of prescription drugs is emerging as a key issue that Hawai'i politicians are testing to measure public interest as they build the foundations of their campaigns for 2002.
Advertiser library photo • Jan. 25, 1999
Lt. Gov. Mazie Hirono, a Democrat who is running for governor, has said she plans to lead efforts to reduce prescription drug costs for Hawai'i residents.
Lt. Gov. Mazie Hirono said she is looking for ways to cut drug costs.
State Sen. Ron Menor, a Democrat who is considering a run for lieutenant governor, last week used his position as chairman of the Senate Commerce, Consumer Protection and Housing Committee to launch a series of statewide public hearings on the cost of prescription drugs. And state House leaders, who lost seven Democratic seats to Republicans in last year's election, say the issue is a priority in the coming legislative session.
"Prescription drugs could be one of the defining issues of the next session and of next year's political season," said Joe DeMattos, associate state director of the Hawai'i office of AARP.
"The rising cost of prescription drugs is one of those instances where genuine and identifiable community need converges with good government and smart politics," said DeMattos, whose organization represents retired people.
Rising prescription drug costs have been targeted by candidates on the national level since the early 1990s. The issue was prominent during last year's presidential campaign, with both George W. Bush and Al Gore promising to work to make medicine more accessible to the elderly and the poor.
In Hawai'i, the issue has recently gained new urgency. Various surveys indicate 10 to 20 percent of Hawai'i's residents lack insurance coverage for drugs, DeMattos said. And rapidly rising drug costs are cited by insurers as one of the primary justifications for raising premiums and co-payments.
Advertiser library photo • January 2000
What makes the prescription drug cost battle appealing for candidates is that it is no longer seen exclusively as an issue for the elderly. An AARP public opinion survey indicated the issue is as significant a concern for baby boomers in their late 40s and 50s as it is for senior citizens.
State Sen. Ron Menor is holding hearings on the issue.
"More people are affected by the rising costs of prescription drugs and ... I think it will continue to be discussed because of the impact it will have on the public," said University of Hawai'i political science professor Yas Kuroda.
"At this time it's potentially a good campaign issue for many candidates, particularly Democratic candidates," he said, since Democratic voters tend to be less affluent.
UH political science professor and interim UH chancellor Deane Neubauer said the emergence of drug prices as a national issue makes it easier for local candidates to propose state initiatives.
"Anytime a candidate can identify with an important public policy issue it has to be useful to them in a campaign," Neubauer said. "I just happen to believe that this is an important and authentic issue."
Rosemary On, a Nu'uanu resident in her 30s, said prescription drug costs are a top concern for her family. Both her father, who had a stroke, and her mother, who has diabetes and Parkinson's disease, have no drug coverage and pay up to $300 a month for their medication, she said. She said her vote would likely be influenced in the next election by a candidate or party who did something to ease the pressure.
"My parents are not poverty level, but they have a lot of debts," she said. "They're retired already, so that makes it harder for them. They have to decide whether to pay the bills or refill the medication. It's a hardship for the children, too. If the state did something, that would help a lot. They should have something in place as soon as possible. I'm sure this is a main concern for everybody."
Roma Johnson, a 59-year-old Kona resident, has drug coverage through her state job as a speech pathologist and audiologist. But she said the rise in her monthly drug co-payment — from $10 to $27 in the past two to three years — makes her reconsider whether she wants to continue taking the extra medication that helps maintain her health.
She said the issue would be a significant factor in how she votes: "The people who don't have drug coverage and have four or five medications wouldn't have a choice (of discontinuing drugs). I would certainly look at it."
Hirono last week began a series of discussions with organizations such as the AARP and the AFL-CIO to explore how to reduce prescription drug costs. She acknowledged the effort could help her gubernatorial campaign, but pointed to her background in consumer issues.
"As we say, good policy is good politics, and I've been known as a consumer advocate for the whole time that I've been in political office," she said. "I think any good thing that anybody does, it will boost their profile. But like I said, I've been working on these kinds of issues for a good many years."
Menor, D-18th (Waipi'o Gentry, Wahiawa), who said he is "seriously moving in the direction" of running for lieutenant governor, also acknowledged that playing a role in the issue "might" help a statewide campaign. But he added: "This is really a part of my responsibility as the chair and given the fact that I plan to continue serving as chair for at least one more year I want to make sure that I do an effective job."
A bill authorizing the state to create a buying pool to negotiate prescription drug discounts for people with no drug coverage passed the House last session but failed in the Senate after Menor said he wanted to study the issue.
House Minority Leader Galen Fox, R-21st (Waikiki, Ala Wai), said state efforts are futile on an issue of such national significance and are an obvious example of politicking.
"I think it's pretty hopeless that at the state level we can make any progress on an issue like this," he said. "There might be something that the state government might want to do to supplement what the federal government does. It's high on the agenda of both parties in Washington. Why don't we wait and see what Washington comes up with."
Twenty-nine states have started or are developing programs to address the issue, including subsidizing prescriptions for low-income people, providing tax credits to consumers, and establishing buying pools to leverage discounts with pharmaceutical companies.
John Rother, AARP national director of legislation and public policy, said states can make an impact on drug prices. Some state have developed programs to get a 10 percent discount on prescription drugs. However, Rother acknowledged that many such programs are new and have yet to build a track record.
Some Hawai'i politicians are particularly interested in a Maine program in which the state negotiates prices directly with pharmaceutical companies. If the state isn't satisfied with the prices by 2003, the state can set a ceiling on retail prices.
A federal appeals court recently upheld the Maine law, clearing the way for the state to operate the program. But its effectiveness has yet to be determined.
Reach Lynda Arakawa at larakawa@honoluluadvertiser.com or 525-8070.
