On Monday, Elizabeth Warren delivered a fiery floor speech in opposition to the 21st Century Cures Act:
Mr. President, three weeks ago, Americans went to the polls. Voters were deeply divided on whether Democrats or Republicans should be in charge. Donald Trump is the President-elect despite losing the popular vote by more than two million people.
But there is one thing that Americans were not divided on. On one issue, their message was loud and clear. According to exit polls, 70% of voters said they think the American economy and the lawmakers who oversee it are owned - owned - by big companies and special interests. That's 70% of everybody-Democrats, Republicans, Independents.
In the closing days of this Congress, Big Pharma has its hand out for a bunch of special giveaways and favors that are packed together in something called the 21st Century Cures bill. It's on track to get a vote in the House this week and then get rammed through the Senate. I've been looking at the details.
And when American voters say Congress is owned by big companies, this bill is exactly what they are talking about. Now, we face a choice. Will this Congress say that yes, we're bought and paid for, or will we stand up and work for the American people?
For more than two years, Congress has been working on legislation to help advance medical innovation in the United States. Medical innovation is powerfully important, and I have spent as much time working it as any other issue during my time in the Senate.
From the beginning, I have emphasized one obvious fact. Medical breakthroughs come from increasing investments in basic research. Right now, Congress is choking off investments in the NIH. Adjusted for inflation, federal spending on medical research over the past dozen years has been cut by 20%. Those cuts take the legs out from under future medical innovation in America. We can name a piece of legislation the "cures" bill, but if it doesn't include meaningful funding for the National Institutes of Health and the Food and Drug Administration, it won't cure anything.
That's why months ago Senate Democrats said any so-called "cures" legislation must have a significant investment in medical research. And that's why Senate Republicans publicly committed to doing exactly that. But now they have reneged on that promise and let Big Pharma hijack the Cures bill. This final deal has only a tiny fig leaf of funding, for NIH and for the opioid crisis.
And most of that fig leaf isn't even real. Most of the money won't really be there unless future Congresses pass future bills in future years to spend those dollars.
Why bother with a fig leaf in the Cures bill? Why pretend to give any money to NIH or opioids? Because this funding is political cover for huge giveaways to giant drug companies.
One of the sharpest parts of her speech was where she highlighted the difference between “compromise” and “extortion”:
But I cannot vote for this bill. I will fight it because I know the difference between compromise and extortion.
Compromise is putting together common-sense health proposals supported by Democrats, by Republicans, and by most of the American people, and passing them into law. Extortion is holding those exact same proposals hostage unless everyone agrees to special favors for campaign donors and giveaways to the richest drug companies in the world.
Compromise is when Senators - Democrats and Republicans - find the way forward on issues that matter to their constituents. Extortion is telling those same senators to forget what your constituents want - nothing to deal with the skyrocketing cost of prescription drugs and nothing to increase medical research. Instead, every important, common-sense, bipartisan bill on mental health, genetic privacy, opioid addiction, foster care, and anything else will die today - unless Democrats agree to make it easier for giant drug companies to commit fraud, give out kickbacks, and put patients' lives at risk. This demand is enough to make me gag.
As David Dayen explains in the American Prospect, the main purpose of the bill, as it has ended up, is to weaken the FDA:
The Cures Act would severely undermine the FDA by altering its drug and medical device approval process to value speed over accuracy and profits over health and safety. In response to corporate complaints that FDA approvals are costly and time-consuming, the bill would reduce standards, streamline reviews, secure automatic approval for certain devices and drug therapies without rigorous screening, and allow the use of “real world” evidence of drug effectiveness rather than more credible randomized clinical trials. Third parties could certify certain medical devices, avoiding the FDA entirely. Even articles from medical journals could be used as evidence, despite an uptick in retractions in these publications in recent years.
….
The proposals could lead to ineffective and even hazardous treatments and a return to the old days of quack cures and snake oil. Harvard’s Daniel Carpenter calls it the “19th Century Fraud Act.” Moreover, rather than intervening to make drugs affordable, the bill saves drug companies from compliance costs.
The dangerous Sunshine Act revisions in the bill, which would have exempted doctors from requirements to disclose speaking fees and other payments for “medical education” (effectively, a legalization of bribery), seem to have been dropped. But Mitch McConnell’s provision to accelerate approval of untested regenerative therapies as long as they are labeled a “moderate risk”—a sop to Republican donor and regenerative medicine investor—appears to still be in there.
The bill, as Dayen explains, is also a perfect example of robbing Peter to pay Paul:
First off, $3.5 billion of the $6.3 billion price tag is paid for through a raid on the Affordable Care Act’s prevention fund, part of which was supposed to go to preventing diseases like Alzheimer’s and cancer. So the money earmarked for prevention goes to fund research into cures of the same maladies. Another $1 billion comes from selling off oil from the Strategic Petroleum Reserve. Still more comes from reducing certain Medicare and Medicaid payments. Section 5011 rescinds $464 million in health-care funding that would have gone to cash-strapped Puerto Rico to subsidize Obamacare exchange purchases.
So how did House Democrats respond to Elizabeth Warren’s challenge?
The wrong way.
The Cures Act passed easily, 392 to 26—with most of the opposition coming from the right-wing of the Republican Party.
But six progressives voted against it, and deserve to be commended for doing so:
Rosa DeLauro (CT-03)
Lloyd Doggett (TX-35)
Raul Grijalva (AZ-03)
Barbara Lee (CA-13)
Jim McDermott (WA-07)
Jan Schakowsky (IL-09)
The bill now moves on to the Senate, where senators like Bernie Sanders (I-VT) and Jeff Merkley (D-OR) join Warren in opposition.