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The bipartisanship test

As Tim Fernholz notes, Republicans have been arguing that the country needs a bipartisan health-care bill. Fair enough: Where's theirs?

[A]side from not doing much, this Republican bill isn't even remotely bipartisan. They don't even bother to include any Democratic ideas about health-care reform. Say what you will about the Democrats' process, they certainly included Republican ideas in a symbolic way, particularly on malpractice tort reform, and I would argue that they included conservative ideas because their plan is a compromise between the kind of government involvement favored by the Left (single-payer as a prime example) and the private model preferred on the Right.

More to the point, Senate Democrats actually included Republicans in the process. The legislation the Senate Finance Committee passed was substantially written in negotiations with Mike Enzi, Chuck Grassley, Olympia Snowe and, at one point, Orrin Hatch. Which Democrats have been in the room with Boehner?

By Ezra Klein  |  November 3, 2009; 4:39 PM ET
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Anna Eshoo, that's who. Her pro-PhRMA biosimilars amendment was adopted wholesale in the Republican bill.

-Unprecedented: 12 year data exclusivity for biologics (versus 5 for small molecule drugs, FTC recommended zero)
-Easy 2.5 year extension (total 14.5 years)
-Unprecedented: biosimilars can't have the same scientific name, confusing doctors and patients
-Unprecedented: additional clinical trials required for generics, a huge new barrier to entry

Because there are also patent and manufacturing hurdles, biologics have almost no generic competition even in countries where biosimilars are already approved. One drug (Avonex) which was initially patented in 1980--recently got a U.S. patent extension to 2026 and has no generic competition on the horizon. lists the price as $2385/month.

Generic maker Sandoz says the Eshoo amendment--which is in the House, Senate, and Republican bills--makes biosimilars "not a viable business" in the US. With biologics making up 25% of the drug pipeline and already the most profitable drugs for some manufacturers, the long-term cost to the public is incalculable. The last thing we should be doing is making it harder to bring generics to market.

Pharma is by far the top campaign contributor to Rep. Eshoo.

Posted by: bmull | November 3, 2009 5:18 PM | Report abuse

It's true that the Democrats consulted a handful of the most moderate Republicans; however none of Reps evidently feel enough of their ideas have made it into the final bill to sign on. In my book the emerging Democratic bill does not come close to warranting a "bipartisan" label. It's pretty much a Dem. power play.

Posted by: tbass1 | November 3, 2009 7:35 PM | Report abuse

Since the "Bill" is apparently a Readers Digest Condensed book adaption of numerous Republican bills that passed the republican Controlled House over the years and died in the republican controlled Senate, There weren't even all that many Republicans in the room when it was written. Six months late and totally clueless the Republicans cough up a hair ball and call it Health Care Reform.

More the point there is actually nothing in the bill that didn't get considerred in the mark up of the bills the House and Senate are moving to final votes.

Meanwhile George Voinovich wants Congress to stop considering the Carbon Control bill until Republicans should deign to read it. Since the deomcrats seem to have read it, what's the hold up? Can't any of you Republicans read without moving your lips?

Actually, can't any one on any of your STAFFS accomplish that feat of literacy?

Posted by: ceflynline | November 3, 2009 7:38 PM | Report abuse

Wyden/Bennett was as bipartisan as you could want and a better bill than any of those that have followed.

And the House bills have not the slightest evidence of Republican involvement.

Nothing like an invidious comparison.

Posted by: lfstevens | November 3, 2009 8:23 PM | Report abuse

To pull this point further, the current bills are all very similar to, and probably owe their existence to, Republican proposals from the 1994 era. The introduction of this legislation itself was a bipartisan compromise, although as you've stated many times before, because it happened so soon there's no credit given.

Posted by: etdean1 | November 4, 2009 10:47 AM | Report abuse

"Say what you will about the Democrats' process, they certainly included Republican ideas in a symbolic way, particularly on malpractice tort reform". Don't have a clue what you or Tim are talking about. "Included in a symbolic way" - i.e., not included. There is absolutely nothing in the Democratic bills that meets the conservative agenda. They are, however, not as much of what the liberals want - I guess that's why Tim means when he says the bill is a compromise.

Who in the world would imagine that a conservative counter-proposal ought to be "bipartisan"? The point of a counter-proposal is to show where we differ.

And why in the world

Posted by: MikeR4 | November 5, 2009 10:54 AM | Report abuse

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