Healthcare companies are also a political power to reckon with, having spent more than any other industry to lobby the U.S. government in 2002. The industry hired 625 different lobbyists to press lawmakers on such issues as pending legislation that would curb rising drug prices. According to Public Citizen, a health and safety nonprofit organization in the United States, U.S. pharmaceutical companies spent $262 million (U.S.) during the 1999-2000 election cycle.
High on pharmaceutical companies’ priority list is preserving differential pricing schemes. Medication costs are higher in the United States: For instance, a month’s supply of the antidepressant Zoloft costs $82 in the United States, $42 (U.S.) in Canada, and $29 (U.S.) in France. Prices are lower in Europe and Canada because their governments regulate the prices of drugs and use their immense bargaining power to dictate hefty discounts. As such, pharmaceutical companies are compelled to charge more to U.S. consumers to recoup their massive research-and-development expenses. (Thepharmaceutical industry is also coping with declining revenues as top-selling drugs go off patent, opening the door to competition from cheaper generics.) Lobbyists for the pharmaceutical industry argue the best solution is not lowering drug prices, but helping patients pay for drugs through expanded, government-subsidized Medicare benefits.
On the one side, governments are struggling to keep a lid on fiscal spending and out-of-pocket expenses for patients; on the other, the healthcare and pharmaceutical industries are seeking to maintain their bottom lines. Caught somewhere in between are physicians, who are increasingly discontented with cost pressures, excessive bureaucracy, and declining compensation. Growing frustration with the system is prompting an exodus from the medical profession. Applications to U.S. medical schools, following a 1996 peak, have since declined by 25.9 percent. More than 126,000 nursing positions currently remain unfilled, a shortage that has become so severe it is endangering the lives of patients. Foreign nationals already account for 11.5 percent of the registered nurses, 17 percent of the medical aides, and 25.2 percent of the physicians working in the United States.