When President Obama dismissed his Progressive critics by asserting that the public option was of little significance in the larger scheme of health insurance reform, and when the backroom deal was struck with the pharmaceutical industry that in return for their domestic support healthcare reform would prohibit purchase of less expensive drugs from Canada, it was clear that in his mind availability of health services trumped accessibility of health services. Such a view is entirely consistent with the principles of capitalism: you can have the best health care in the world as long as you can afford to pay for it.
This week's news is filled with hope that a recent study published by the New England Journal of Medicine will be a significant step in the fight against AIDS. A key drug in this effort is a product produced by Gilead with the trade name Truvada. The drug itself is not new, but its application as an AIDS preventative is. The catch is that it's expensive. Business Week puts the cost of Truvada between "$5,000 and $7,000 a year in the U.S. when bought through the health-care system, and more if bought privately." The New York Times puts the cost at "$12,000 to $14,000 a year."
In 2005, Gilead announced Truvada would be made available to developing third world countries at a before profit cost of $.87 per day. The New York Times, in its article, observes that "[i]n very poor countries, generic versions cost as little as 40 cents a pill." Thus, taking the most conservative numbers, the annual before profit cost of Truvana would be less than $500 a year, and the after profit cost would be at least $5000 a year for American buyers, an overhead spread of 1000 per cent.
It would seem that Progressives have a point. If the moral imperative to provide needed medication to third world countries is so obvious that the profit motive is cast aside in the interest of human need, what is the domestic justification for denying that medication to Americans who can't afford it? Is this not in fact a demonstration that in matters of public health, the application of capitalistic principles is inappropriate? Public health should be decoupled from private profit.
