Dear Editor,

Dr. Miller-Meeks, my representative in Congress, uses Republican talking points to justify an utterly untenable position against allowing Medicare to negotiate prices with pharmaceutical companies. I am also a physician (retired) and I have to call out Dr. Miller-Meeks for hurting Iowans for strictly political purposes.

If we live in a capitalist economy, then we have to respect the dynamic between those who buy and those who sell. Unfortunately, pharmaceutical companies have rigged that dynamic in their favor by getting Congress to pass legislation that prevents Medicare of negotiating drug prices. How could any elected representative do that to their constituents in good conscience?

Let's see what Miller-Meeks said.

She said that "prescription drug cost controls would interfere with the doctor-patient relationship" limiting access. Let's look at a couple of issues regarding access to healthcare under the current system.

Medicare has a formulary that does not include all medications. What drugs are included is determined in part by the price Medicare has to pay. Medicare also generally requires using less expensive drugs as first-line care and higher-priced drugs when first-line drugs aren't sufficient. Many insurance companies use similar policies to control what they payout for drugs. The notion that doctors give you the best treatment they know simply isn't true. They give you the best treatment they are allowed to give you.

Miller-Meeks also said: “We’ve had governors make decisions over what drugs doctors can prescribe their patients under the penalty of doctors losing their license. We’ve seen government bureaucracy interfere with the doctor-patient relationship, whether it’s prescribing treatments, what they can get through hospitalization.” She said this in the context of prescribing for treatment of COVID-19, but if it applies there, it applies everywhere. Government agencies and laws passed by our elected representatives have often restricted the use of medically indicated treatments, particularly in the areas of reproductive care (remember the battles over access to the "morning-after" pill?) and cannabis care (access to medical marijuana is still very restricted). Miller-Meeks, like most Republicans, is perfectly willing to let governments interfere in healthcare when it suits her/them.

Finally, though Miller-Meeks invokes fear of a "slippery slope," we can only hope that our elected representatives would work in the future to expand Medicare's ability to negotiate prices. We need to allow Medicare to negotiate drug prices and we need to replace representatives who oppose this commonsense measure.

David Sands, MD, Fairfield

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