Clinton announced another Canada policy this week, could affect millions: Pharma

Lost in the noise of her headline-grabbing coming-out against the Keystone XL pipeline, Hillary Clinton announced another Canada-U.S. policy this week that could affect millions of people.

She called for legalizing prescription-pill imports from Canada, becoming the second Democratic presidential candidate to adopt the position and effectively making it party policy in the 2016 election.

Millions of Americans who struggle with high drug prices have purchased cheaper medicine abroad since online pharmacies first opened two decades ago, with Canada pioneering that grey-market industry.

The issue has resurfaced politically as U.S. drug prices experience their biggest jump in years. One company was forced to back down last week amid news that a life-saving medicine had increased overnight from $13.50 to $750 per pill.

The same pill is available from a Canadian online pharmacy for $5.28. It’s generally illegal for Americans to buy and import that medicine, but the law is rarely enforced.

Now Clinton wants to normalize the practice.

“If the medicine you need costs less in Canada, you should be able to buy it from Canada _ or any other country that meets our safety standards,” she told an Iowa audience the same day she announced her long-awaited pipeline position.

“When I was privileged to represent upstate New York (as a senator)… every week there would be buses of American seniors going over to Canada, to buy drugs that were American-manufactured, drugs that were invented by American companies, for a much cheaper price over the border.

“That makes no sense at all, folks … I don’t want you to have to drive to Canada. So you can order them online.”

She became the latest candidate to endorse that policy. As he presented a bill this month, socialist Sen. Bernie Sanders reminded people that he helped spread word of cheaper drugs in Canada, in 1999 when he took a busload of seniors on a cross-border trip to the pharmacy.

“I will never forget the tears in the eyes of women who were able to buy the breast cancer drug tamoxifen at one-10th of the price that they were paying in the U.S.,” Sanders said.

“If we can import lettuce and tomatoes from Mexico, there is absolutely no reason why we cannot import safe and affordable prescription drugs from Canada.”

The issue cuts across partisan lines. There’s a similar Senate bill from Republican John McCain. Republican Mike Huckabee is campaigning on the idea. A survey from the Kaiser foundation said 72 per cent of Americans support buying prescription drugs from Canada. The proportion was higher among Republicans.

Congress even passed a law allowing importation in 2000 _ but the president, Clinton’s husband, gutted it. George W. Bush and Barack Obama both campaigned on a policy change _ it never happened.

The pharmaceutical industry has considerable pull in Washington.

It spent US$229 million lobbying Congress last year, according to the transparency site Open Secrets, and it donated $50 million in the 2012 election. For the sake of comparison, that last sum is almost as much as all the national spending allowed for political parties in Canada’s current election.

As their shares dipped slightly this week, the industry blasted Clinton’s speech and argued her policies would hurt companies that create new drugs.

She laid out other proposals including ending certain tax breaks, creating spending targets for research, and a $250-a-month limit on out-of-pocket expenses under insurance plans.

She accused the industry of anti-competitive behaviour and price-gouging, citing the controversial 5,000-per-cent price increase in the drug Daraprim.

Her plan proposes a crackdown on one factor believed to be driving high prices: collusion.

Like Sanders, she wants to curb the practice dubbed “pay to delay” _ where drug makers pay off generic rivals to keep them from bringing cheaper alternatives to market. U.S. federal regulators have punished companies over that practice on different occasions this year alone, and Sanders proposes far more severe penalties, including stripping companies of exclusivity rights over a drug.

But how would that affect Canadians?

One health-policy researcher worries it could hurt them by causing supply shortages and driving up prices.

“The giant sucking sound that would empty our pharmacies into the U.S. would be heard across the country,” said Amir Attaran, a health-policy researcher at the University of Ottawa.

“The drug shortages … in Canada … would be massive.”

A prominent health economist is less worried. A supply crisis would be far likelier in a major outbreak or a terrorist attack, said Steve Morgan of the University of British Columbia.

But he agreed online pharmacies wouldn’t solve the price problem for Americans.

He proposes a single-payer pharmaceutical system for Canada _ and for the U.S., he says, greater government management would improve the system.

Right now, U.S. prices are mostly fictitious, he says. Patients with insurance providers get discounts negotiated in secret. Others use online coupons.

The net result is a system designed to make everyone pay the maximum they can afford. And those without access to insurance or discounts could be out of luck.

With a better-managed system, he said, “you would just eliminate all these games.”



Life and health insurance industry experiences strong growth in 2014

Life and health insurance industry experiences strong growth in 2014

TORONTO, Aug. 31, 2015 /CNW/ – Today, the Canadian Life and Health Insurance Association (CLHIA) released the 2015 edition of Canadian Life and Health Insurance Facts. During 2014, the industry continued its trajectory of strong growth, despite the climate of prolonged low interest rates and slower growth of the Canadian economy. “The strong performance of the Canadian life and health insurance industry highlights the trust Canadians have in our companies, and that we continue to offer products and services that our customers need and value,” notes CLHIA President and CEO Frank Swedlove.

In 2014, Canadians’ purchases of insurance products were robust and the industry experienced year-over-year growth in premium revenues not seen since 2007, up 7.7% to $99.4 billion. Industry assets in Canada also rose 11.5% to $721 billion of which almost 90% were held in long-term investments, funding longer-term capital and infrastructure investments, critical to economic growth. Further, the industry paid out $83.5 billion to Canadian policyholders and annuitants in 2014, or more than $1.6 billionevery week. More details and statistics can be found in the CLHIA’s industry Factbook which is available on line

About the CLHIA

Established in 1894, the CLHIA is a voluntary association whose member companies account for 99 per cent of Canada’s life and health insurance business. The industry provides a wide range of financial security products such as life insurance, annuities (including RRSPs, RRIFs and pensions) and supplementary health insurance to 28 million Canadians. It also employs 155,000 Canadians as full-time employees and agents as well as independent advisors across the country.

SOURCE Canadian Life and Health Insurance Association Inc.

Shannen Doherty Reveals Breast Cancer Diagnosis in Insurance Lawsuit Against Ex-Manager

LOS ANGELES _ Shannen Doherty is battling breast cancer that worsened during a lapse in her health insurance caused by her former business managers, the actress claimed in a lawsuit filed Wednesday.

The former “Beverly Hills, 90210” star claims that her former business managers and accountants mismanaged her money and allowed her health insurance to lapse last year.

Because of that, she said she didn’t go to the doctor until she had insurance and there was a delay in diagnosing her cancer, which will likely require more drastic treatments, including a possible mastectomy and chemotherapy.

Doherty, 44, received the diagnosis in March and her doctors have said earlier treatment might have stopped its spread, the lawsuit states.

An attorney for the accounting firm Tanner Mainstain Glynn & Johnson denied the company caused Doherty’s health insurance to lapse.

“Tanner Mainstain is saddened to learn that Ms. Doherty is suffering from cancer and wishes her a full recovery,” the company’s attorney, Randall J. Dean, wrote in a statement. “However, the claim that Tanner Mainstain caused her to be uninsured, prevented her from seeking medical care, or somehow contributed to her cancer is patently false. Tanner Mainstain will aggressively defend all of Ms. Doherty’s claims in court.”

Doherty’s husband, photographer Kurt Iswarienko, also is suing the firm and its former partner, Steven D. Blatt, accusing them of mismanaging the couple’s money and leading to other financial troubles, including tax audits and liens.

A phone message for Blatt was not immediately returned.

The lawsuits do not specify how much damages Doherty and Iswarienko are seeking. Doherty has been unable to work since the diagnosis.

“The spread of the cancer has caused (Doherty) severe emotional distress,” the lawsuit states.

“The relationship between a business manager and its client is based on trust, in honesty and competence,” Doherty’s attorney, Devin McRae, wrote in a statement. “That trust was violated here, and we hope that the defendants will correct it in a responsible manner.”


Are 3 big insurers a flashing light for regulators?

WASHINGTON – Would a reduction from five health insurance giants to three trigger a flashing light for regulators concerned about industry competition?

That’s how many big companies could remain after the proposed combinations of Anthem with Cigna and Aetna with Humana, and experts say it would at a minimum bring scrutiny of the deals.

 At only three companies, “The agencies’ ears tend to perk up,” said Allen Grunes, who led merger investigations at the Justice Department as an antitrust attorney. “The underlying economic concerns start to really kick in,” said Grunes, a co-founder and attorney at the Konkurrenz Group in Washington.

In this case, the Justice Department will have to pass judgment on Anthem’s planned $48 billion acquisition of rival Cigna, a deal that would create the nation’s largest health insurer by enrolment with about 53 million U.S. patients. The antitrust attorneys and economists at Justice will also be examining Aetna’s $35 billion deal for Humana.

The question is whether the mergers would hurt competition and consumers, making the companies so dominant that they could push already high health-care costs even higher.

“This will be a very lengthy and complicated process,” said Robert Bell, an antitrust attorney at Hughes Hubbard.

Health care is one of three major industries — along with food and energy — that are especially important to the economy and consumers, and so they receive a careful review from regulators, he said.

“I think the government’s going to be extremely cautious about reducing the number of primary health care carriers down to three,” Bell suggested. “I would be very surprised if both mergers were permitted to go through.”

The proposed deals also are likely to draw the attention of state attorneys general, he said.

Among the factors the government likely will examine:

—What does competition look like in the markets — in states and for different insurance products — where the companies now operate, and how might that change after the mergers?

—How easy is it for new competitors to enter those markets? If the number of big companies is reduced, would new ones come in to fill the gap?

— What is the impact of the health-care overhaul law on competition in the industry?

But health-care policy consultant Dan Mendelson said that when the Justice Department monitors review the mergers, they’ll look at them on a local, not national, level. Health care is local, and the two proposed mergers don’t involve much geographic overlap, he said. That means they wouldn’t create the sort of consolidation involved in other industries such as telecommunications, in his view.

“I think by historical standards these mergers go through,” said Mendelson, who is CEO of Washington-based consulting firm Avalere Health. “They go through because there is not a lot of overlap, and they create efficiencies and allow companies to spread (costs) across a lot more people.”

Mendelson acknowledges that the question here will be whether the historical standards hold.

The picture is complicated by the fact that the insurance industry is regulated by states, not the federal government. States decide how insurers can conduct business and what new companies can enter the market.

Some states have a very competitive environment for health insurance while in others a few companies dominate the market, said Jesse O’Brien, a health-care advocate with the U.S. Public Interest Research Group. He puts Oregon, California and New York among those in the competitive category, and West Virginia, Illinois and Michigan in the category with a few dominant companies.

For the government regulators, “There’s kind of a balancing act that needs to be struck,” O’Brien said.

AP Health Writer Matthew Perrone contributed to this report.


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