At this point, it's the drug industry versus democracy, a fed-up sounding Sen. Bernie Sanders (I-Vt.) told reporters as he left Capitol Hill Thursday.
Sanders, the chairman of the Senate Budget Committee, was being peppered with questions about concessions that might have to be made to more conservative Democrats in order to get President Biden's whittled-down Build Back Better legislation passed.
What stopped him as he was about to get into his waiting car was whether he could accept a bill that didn't include the measures to lower prescription drug costs, with the main proposal being to let Medicare negotiate prices with drug companies.
"I think in terms of the pharmaceutical industry, when you've got 80 or 85% of the American people who want Medicare to negotiate prescription drug prices, want to drive prices down, it is beyond comprehension that there's any member of the United States Congress who is not prepared to vote to make sure that we lower prescription drug costs," Sanders began, before using that point to make a larger one.
"I'm going to say this, and you're not going to write it, and that worries me. We've got 1,500 paid lobbyists here from Pharma -- 1,500," Sanders said. "They are spending hundreds of millions of dollars, trying to make sure that they continue to make outrageous profits, charge us by far the highest prices in the world for prescription drugs," Sanders said.
His point wasn't just that Americans get screwed on drug prices, but the fact that they do is evidence of a much bigger problem.
"This is not just an issue of the pharmaceutical industry. This is an issue of American democracy, and whether or not the United States Congress has the ability to stand up to incredibly powerful special interests, like the pharmaceutical industry," Sanders said. "Does that interest anybody? Is that an issue?"
(A handful of reporters in the scrum around him said yes.)
"OK, I would hope you give some thought about it, guys, because this is -- lowering the cost of prescription drugs -- very popular, obviously. It's what the American people want," he said.
"They say lower the cost, have Medicare negotiate. The [Veterans Administration] has been doing this for I don't know how many years, but for many, many years. The VA is paying one half of what Medicare pays for prescription drugs. Make sense to anybody in America? It doesn't," Sanders said.
And here's the rub.
"Why are we not succeeding? Because you have an incredibly powerful special interest, who is incredibly greedy," Sanders said. "This is an issue not just of lowering prescription drugs -- it's whether or not democracy can work. And if democracy cannot work, if we cannot take on the pharmaceutical industry, why do you go out and ask people to vote? Why do you ask them to participate in the political process? We don't have the power to take on a powerful special interest. So that's why this to me is so very important."
He went on to say it wasn't just the drug industry's lobbying that's trumping the popular will.
"It's campaign contributions. It is TV advertising. It is -- I my guess is that as of now, I'm guessing -- it's that the pharmaceutical industry has probably spent a half a billion dollars trying to defeat this," Sanders said.
His guess is probably not far off. In 2020, the pharmaceutical industry spent more than $300 million just on lobbying. And in just the first half of this year, shelled out more than $170 million.
That leaves out campaign spending and television adds, which has been substantial over the years. One recent study found that from 1998 to 2018, pharmaceutical firms spent $4.7 billion on influence operations.
He was also asked specifically about Sen. Kyrsten Sinema, the Arizona Democrat who has lately opposed much of Biden's agenda, and was instrumental with Sen. Joe Manchin (D-W.Va.) in getting the White House to cut the size of Build Back Better from $3.5 trillion to under $2 trillion. (Manchin strongly supports Medicare negotiations, however.)
"I would say that Sen. Sinema, every Republican and every person in the House, do what the American people want," Sanders said. "And they want us now to lower the outrageous cost of prescription drugs. Thousands of people die each year because they cannot afford the medicine that doctors prescribe. One out of four people go to the doctor's office and they can't fill the prescription. That makes sense to anybody? It doesn't. So I would hope that Sen. Sinema does what the people in Arizona want and what the people in America want."
A number of Democrats in the House also oppose drug price negotiation. Among them are Reps. Scott Peters (Calif.), Kathleen Rice (N.Y.) and Kurt Schrader (Ore.), who all voted against that provision in the Energy and Commerce Committee's portion of Build Back Better.