Dear Mr President
We are writing as members of the Democratic
leadership of the House of Representatives and senior Democratic Members of the Committee
on Ways and Means to express serious concerns about the Administration's effort to modify
Australia's national pharmaceutical reimbursement program as part of the negotiations for
a free trade agreement (FTA) with Australia. Key elements of the proposal appear designed
to increase drug prices in Australia at a time when the Bush Administration has
failed to reduce drug costs for Americans.
We recognise and support the right of the U.S.
pharmaceutical industry to protect its intellectual property rights in foreign markets,
including markets such as Japan, Korea and France that have applied discriminatory pricing
schemes to benefit domestic industries to the disadvantage of our innovative industry. We
also support efforts to improve transparency in foreign markets, including Australia's, so
that our businesses have a fair chance to compete and make the case for selling their
products.
Unfortunately, the proposal tabled by U.S.
Trade Representative Robert Zoellick goes much farther. Since the proposal has not been
shared with the public in either the United States or Australia, we cannot reference its
specific language. However, there are at least four major problems with the proposal.
First, we are deeply concerned about the
proposal's implications for the United States. A number of elements of the proposal, if
applied to public and private programs in the United States, could harm American veterans
and others by raising drug prices and restricting choice or access, among other potential
consequences. Individuals potentially affected by the proposal include the elderly who
receive Medicare, working people on Medicaid, veterans who receive health benefits through
the Veterans Administration, and active military men and women who participate in the
Department of Defence TRICARE program, as well as other people who participate in programs
administered by the Indian Health Service, the Public Health Service, and a myriad of
state and local governments throughout the United States. this impact comes at a time when
the Bush Administration has done little if anything to address the serious need to broaden
access here at home.
In this regard, some have suggested that the
United States would be exempt from application of this proposal. We do not know whether
the Government of Australia would be willing to accept such a one-way mandate in the FTA;
however, regardless of what its position might be, we believe it is inappropriate to seek
changes in other countries' policies or programs that we would not be willing to accept
here at home.
Second, U.S. Trade Representative Zoellick has
stated that proposals made in FTA negotiations should become models for all future FTAs.
We have been concerned with the attempt of USTR to utilise provisions of one FTA as a
"model" for others, even where circumstances are very different. Given this
serious problem, it is essential that this proposal be more carefully considered - with
respect to both its ramifications on current U.S. programs as well as how it may constrain
Congress' ability to expand access to medicines in the future - before we lock ourselves
into a web of international commitments. Moreover, given that far too many Americans
cannot afford access to life-saving or life-prolonging medicines, it is astounding that
the United States may seek to impose those shortcomings not only on Australia today but on
the rest of the world tomorrow.
Third, the proposal's potentially wide-ranging
mandates and constraints are likely to raise costs both for the Australian government and
its citizens. Regardless of whether one supports Australia's universal health care system,
it is indisputable that Australians on the whole have far better access to affordable
prescription drugs than do many Americans either on their own or through various public
and private insurance programs. The broad access that Australians currently enjoy would be
undoubtedly threatened if prices increased.
That said, given that the recently enacted
Medicare law failed to take steps to reduce, in any meaningful way, the cost of
prescription drugs for the elderly in the United States, perhaps it is understandable that
the Administration would seek to raise prices in other countries as well. However, if the
Administration proceeds along this track in the name of preventing "free
ridership" by countries and their citizens, we respectfully request to see the
Adminstration's plan to lower prices correspondingly for American purchasers.
Fourth, it is not clear that this proposal
comports with, let alone is called for by, the principal trade negotiating objectives of
the Trade Act of 2002. The Act states clearly that the objective of eliminating price
controls and other practices applies when those measures "provide a competitive
advantage to [the foreign country's] domestic producers
and thereby reduce market
access for United States goods." It is far from clear that the Australian system
as currently structured provides any net advantages to Australian producers in competition
with U.S. pharmaceutical companies - and to date, this reason has been offered as the
basis for the proposal.
Given these concerns, we urge you to direct
USTR Zoellick to withdraw the proposal and replace it with one that is derived after a
meaningful dialogue with Congress and reflects the views of a broad, bipartisan
cross-section of Congress. This is the traditional basis on which trade agreements have
been negotiated and implemented throughout the postwar era by Republican and Democrat
Presidents alike, particularly from the time of President Ford through to President
Clinton. We also urge you to immediately release the proposal so that a full public debate
of its merits can occur.
Signed by Nancy Pelosi, Democratic Leader,
Steny Hoyer, Democratic Whip, Charles B. Rangel, , Committee on Ways and Means, Pete
Stark, Subcommittee on Health, Robert T. Matsui, Subcommittee on Social Security, Sander
M. Levin, Subcommittee on Trade, George Miller, Committee on Education and the Workforce,
John Budget Committee, Jim Clyburn, Vice Chairman, House Democratic Caucus