If anyone still questions the economic importance of controlling drug costs and overall health care spending, the following simple facts about the current presidential campaign should resolve all doubt.

Hillary Clinton and her supporters claim that the costs of Bernie Sanders' programs (Medicare for all, free college tuition) aren't covered by the combination of savings from single-payer health care and tax increases on Wall Street and the wealthy.

The Sanders camp responds by claiming the numbers do add up, "if you assume a 3.8 percent rate of unemployment and a 5.3 percent rate of growth." Unemployment stood at that level in the late '90s and the country enjoyed a 5.3 percent growth rate in the early '80s.

So what would bring back those levels of growth and low unemployment?

Sanders' surrogates claim his "proposal for a single-payer healthcare system" would do it.

In their opinion the fact that health care spending now consumes almost 18 percent of America's GDP means the cost savings from single-payer would free resources for other uses. By investing those savings in areas such as infrastructure and apprenticeship programs, the nation's economy would receive a permanent boost.

That makes it instructive to examine some of the things pharma is doing to maintain its swindle of Americans which, in turn, harms America's economic as well as physical health.

Some activists around the country understand that the gerrymandered Congress, together with a timid, ineffective president, make it necessary to pursue an alternative course for containing unaffordable drug prices. Former Alaska Senator Mike Gravel, for example, has written that state-by-state initiatives represent the most practical way around an intransigent Congress.

With that in mind, several consumer groups pushed legislation in at least nine states – including Pennsylvania – that would bring some transparency to pharma's bogus claims about high R&D costs justifying exorbitant prices.

Recently a group in Ohio has taken this approach beyond a mere call for transparency. The AIDS Healthcare Foundation and other groups recently collected more than 170,000 signatures to place a referendum on that state's fall ballot to limit the prices Ohio pays for drugs. Under the proposal, state agencies there would pay the same prices for drugs as the Veterans Administration. Currently that amounts to a 24 percent discount below average manufacturer prices.

The pharmaceutical industry's lobby, PhRMA, together with like-minded business lobbies, sued Ohio's Secretary of State, alleging that the activists failed to obtain enough authentic signatures to get on the November ballot. The Secretary of State directed state election officials to review the signatures and they found the activists had obtained more than enough to qualify for the ballot. The PhRMA and its Rightwing Mini-Me's have now filed new suits to keep voters from ever seeing the measure.

A similar initiative in California did qualify for their ballot, but 20+ pharma companies have so far poured almost $50 million into a promotional campaign to defeat it.

Another part of pharma's campaign to continue plundering the American public is represented by its effort to gain control over the FDA, the agency charged with regulating the nation's drugs.

Pharma has now been successful in that endeavor, largely because of a flimsy and conservative president who feels beholden to the drug makers for not opposing his Affordable Care Act. At the end of February the Senate confirmed President Obama's choice, Dr. Robert Califf, as commissioner of the FDA. Califf had been chancellor of clinical and translational research at Duke University until January 2015 when Obama appointed him Deputy Commissioner of the FDA's Office of Medical Products and Tobacco.

Health care journalist Martha Rosenberg points out that Duke, where Califf directed clinical research, was a poor place from which to select an FDA commissioner. The clinical research operation there, according to Rosenberg, "is still recovering from a major research fraud scandal that resulted in terminated grants, retracted papers and a 60 Minutes special."

As a medical researcher in academia, Califf was certainly smart enough to know where his bread was buttered. He received funding from twenty-three drug companies and served as a senior company officer ("director, partner, employee, advisor, consultant or trustee") at Roche/Genentech.  Portola Pharmaceuticals acknowledged that Califf was on the company's board of directors until he left for the FDA last year. In disclosures for publication, Califf also disclosed financial ties to Gilead, Regeneron, and AstraZeneca, as well as equity holdings in four medical device companies.

Califf is a cardiologist and among his forays into public issues concerning cardiovascular products, he defended Merck's recalled anti-inflammatory, Vioxx, which the FDA's Dr. David Graham reported as having caused 50,000 deaths and at least 120,000 heart attacks.  More recently Califf was a major advisor to Bayer and Johnson & Johnson on the development of their anticoagulent, Xarelto, which has been linked to serious injuries and more than 300 deaths.

So pharma's schemes to keep cost control measures off state ballots and its success in getting a known henchman appointed to head the FDA demonstrate its top priorities: avarice and short-term profit making.

The nation's economic prosperity and physical health, on the other hand, require preventing pharma from achieving these goals.

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