During this presidential year the battle to obtain affordable drug prices raises questions about the positions among the current candidates on that issue. A good place to start is a candidate who's been closely involved with health care for more than 20 years – Hillary Clinton.

Clinton's history on domestic issues, particularly those affecting middle class jobs, wages and living costs, has been at best mediocre. In the past she supported the job-destroying NAFTA treaty and the World Trade Organization. Consumer advocate Ralph Nader calls Hillary Clinton the leader of "corporatist, militaristic, Wall Street-funded Democrats." His opinion is that with Hillary in office, "the plutocracy and the oligarchy running this country...have no worries" because their campaign contributions to her guarantee business as usual.

With Hillary Clinton and every other candidate, an assessment must start with money, the lifeblood of politics. Nader's view is buttressed by Peter Schweizer's book, Clinton Cash, which documents the maneuvering of donors to the Clinton Foundation, including shady deals and huge speaking fees involving global corporations and foreign dictators.

A study published more recently by CNN found that between February 2001 and May 2015, Hillary and Bill Clinton raked in $153 million in speaking fees that amounted to an average of $210,795 for each of 729 talks the Clintons gave during that time.

Last week the Washington Post reported that the "full tally of the money...[Clinton's] campaign is receiving from Wall Street" is "a sign of her deep and lasting relationships with banking and investment titans."

Through last December, the Post found that donors from "hedge funds, banks, insurance companies and other financial-services firms had given at least $21.4 million to support Clinton's 2016 presidential run." In addition to campaign donations, Hillary "personally earned more than $3.7 million for delivering paid speeches to banks and other financial-services firms since leaving the State Department in 2013."

But that's Wall Street and assorted financial service firms. What about drug companies and health insurers?

In a recent debate Hillary Clinton referred to pharma and health insurers as her "enemies." That claim, however, hasn't stopped Clinton from taking millions of dollars in donations from companies in those sectors.

Pharma companies and insurers have divided their largesse between the Clinton campaigns and the Clinton Foundation. Some of the companies that donated between $1 million and $5 million each to the Clinton Foundation include Pfizer, the OTC maker Procter & Gamble Co., Blue Cross Blue Shield of North Carolina, and Humana.

When it comes specifically to pharma donations, Clinton tops the 2016 campaign field in drug industry donations.  According to The Hill, she has received "more campaign cash from drug companies than any candidate in either party, even as she proudly declares the industry is one of her biggest enemies." The Washington Examiner, using Federal Election Commission records, found that Pfizer, for example, recently gave at least $1 million to the Clinton Foundation, even as executives at the company donated nearly $40,000 to Clinton's campaign.

Stat News in Boston, citing data from the Center for Responsive Politics, reported last week that Clinton's campaign received $332,016 in contributions from the pharmaceutical and health product makers in 2015. Since the beginning of the campaign Clinton has received more than other candidates from health product manufacturers and most of that has come from "individual donors affiliated with the pharmaceutical industry."

Donations reported by the Clinton Foundation, according to US News, likely represent just the "Tip of the iceberg, as Clinton enjoys the support of numerous Super PACs whose finances are notoriously obscure."

In addition to contributions made directly by pharma companies, The Daily Caller reports, "Hillary's Best Bundlers Lobby For Big Pharma." In this manner some of the donations to Clinton came from sources connected to Pfizer Inc., Johnson & Johnson and Bristol-Myers Squibb Co.

According to Columbia University economist Jeffrey Sachs, the claim that Hillary is bad on the corporate issues but good on national security is a myth. His observation has ramifications for high drug prices.

On foreign policy, Sachs believes the conventional wisdom extolling Clinton's experience is nonsense. He sees her as "a staunch neocon whose record of favoring American war adventures" accounts for much of the nation's security danger. "Her so-called foreign policy 'experience' has been to support every war demanded by the US deep security state run by the military and the CIA." Moreover, "the list of her incompetence and warmongering," involves supporting NATO expansion into Ukraine and Georgia, meaning that she "presided over the restart of the Cold War with Russia."

Sachs finds the record of both Clintons on corporate issues even more damning. Their close ties to Wall Street, he argues, "helped to stoke two financial bubbles (1999-2000 and 2005-8) and the Great Recession...In the 1990s they pushed financial deregulation for their campaign backers that in turn let loose the worst demons of financial manipulation, toxic assets, financial fraud, and eventually collapse. In the process they won elections and got mighty rich."

So what does this suggest about Hillary Clinton's effect on drug prices? The answer is that in a global economy, neocon foreign policies are part and parcel of deference to corporate interests. So even though Clinton belatedly accepted the advice of her campaign handlers to oppose the Trans Pacific Partnership (TPP) – which she helped develop while Secretary of State – it seems likely that as president she will accept some minor modifications to the treaty and push for its passage.

The TPP, as noted last June in this space, will escalate drug prices throughout the world. Among its malevolent features, the treaty gives pharma companies longer and stronger patent protection for its prescription drugs. The TPP will clearly make other countries pay more for their drugs, but more insidiously, it will also lead to higher drug prices in the U.S.

One of the ways TPP will raise drug prices is by means of its Investor State Dispute Settlement (ISDS) tribunals. These are extra-judicial panels empowered by the treaty to override U.S. law with rulings that are not subject to appeal. In fact, the ISDSs would function as secret courts because their rulings wouldn't even have to be publicly disclosed. That means even if Medicare did receive authority to negotiate prices and used its purchasing power to secure an affordable deal on a particular drug, the pharma company could challenge any agreement in an ISDS. The tribunal wouldn't even have to divulge a reason for granting a higher price.

Hillary Clinton has adopted as her campaign theme the promise to continue the "progress" of Obama's eight years as president. Yet Obama's two terms, as well as those of George W. Bush and Bill Clinton, have shown several clear trends such as the stagnation of middle-class incomes, a transfer of wealth and income to the top one-hundreth of one percent, and an exorbitant rise of drug prices.

On the issue of drug prices, any more such "progress" under Hillary Clinton will put medication beyond the reach of everyone except the wealthy.


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