"I hope this isn't just political theater, where we're just playing to the cameras," President Barack Obama said in his opening remarks at his health care summit Thursday.
But of course that's all it was. When he said it was "full of sound and fury, signifying nothing," Shakespeare's Macbeth might have been anticipating this event.
President Obama performed well, as he is wont to do at these staged events, though he got testy when Republicans called him on playing fast and loose with the facts.
The fury came mostly from House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid, who seemed peevish and angry, as much at each other as at the Republicans, who were to be cast as the villains in this bit of political theater.
The purpose of this exercise was to portray President Obama as a reasonable man open to compromise, and the Republicans as abominable "no" men. But that purpose was undermined by the leaks beforehand that the Democrats plan to try to ram through Obamacare 2.0 (which combines the worst features of the House and Senate bills) through the budget reconciliation process.
It is disingenuous to pretend to be open to compromise when you've already prepared a bill which addresses none of the Republicans' concerns, and a plan to ram it through without any Republican votes. And it's downright stupid to reveal that plan before your dog and pony show takes place.
If Ms. Pelosi and Mr. Reid seemed peevish and angry, it's because nobody thinks she's got the votes to pass Obamacare 2.0, and many suspect he doesn't, either. And that's not because of Republican "obstructionism." It's because polls indicate a large majority of Americans really hate this bill, and hate using parliamentary tricks to try to pass it.
If — as I hope and expect — Obamacare 2.0 meets the fate of its predecessor, the way to proceed is with smaller bills which people can digest and understand, and which can attract genuine bipartisan support.
The purpose of these bills should be to lower health care costs, but to do it in ways that do not diminish the quality and availability of care, or increase taxes or the deficit.
There are three things we could do to reduce the cost of medicines.
First, remove legal restrictions on the importation of foreign drugs. Most medications sold in the U.S. are sold abroad for a small fraction of what they cost here, usually by foreign subsidiaries of U.S. manufacturers. Essentially, we Americans are paying the research and development costs for medicines for the entire world.
This is a step many liberals have long advocated, and it is consistent with freemarket principles. The pharmaceutical companies would squawk, but since they're big supporters of Obamacare, Republicans don't owe them anything.
Second, Europeans can buy over the counter in their pharmacies a plethora of medications Americans can obtain only with a prescription. They sell for much less than they do in the U.S. (though this is due in large part to our subsidy of drug development costs). And the Europeans don't have to pay for a doctor visit to get a prescription.
Incidences of adverse drug reactions and drug abuse are no greater in Europe than they are here. If we allowed the purchase of non-controlled medications without prescriptions, as the Europeans do, we could save a lot of money.
The most important step we could take is to repeal the Kefauver Amendment of 1962, which requires the Food and Drug Administration to certify that a new medicine is both safe and effective, instead of just safe, as was the case before.
The effect of the Kefauver Amendment is to lengthen greatly the time it takes to get new medications to consumers, and to increase substantially their cost. Between 1948 and 1961, it took an average of 4.5 years for a drug to go from the laboratory to market. Now it takes nearly 15 years. The lengthier procedure boosts the costs of drugs about 40 percent, according to Gary Becker, a Nobel prize winner in economics.
The Kefauver Amendment does nothing to promote drug safety, which the FDA was already charged with. But the delays Kefauver imposes have cost thousands of people timely access to new medications. Repealing Kefauver would save both money and lives.
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