THE THREAT OF HEALTH CARE RATIONING & THE DENIAL OF LIFESAVING DRUGS - Part 2.

Last month we considered the demographic, political, and cultural trends that threaten our own right to lifeespecially as we approach old age. Now we need to look in more detail at the political trends.

The threat here is two-fold: (1) a movement to repeal current provisions in the law that allow Medicare recipients to add their own funds to a government contribution in order to purchase private, un-rationed, and unmanaged health insurance, (a topic for another column); and (2) attempts to have the governmentnot your insurance company"negotiate" the price of the drugs purchased from the pharmaceutical industry.

As to the latter, Congress already has already taken the first steps. On January 12, 2007, the House of Representatives passed H.R. 4 by a vote of 255 to 170. (Twenty-nine votes short of a veto-proof majority.) H.R. 4 would make government the sole agent "negotiating" with the pharmaceutical industry about drug prices for Medicare's Part D.

This may sound good but is, in fact, a very dangerous de-velopment, because your access to newer drug treatments would be severely limited.

The false argument is made that the government as the largest "customer" has the most clout in negotiating prices for prescription drugs, hence patients will be better off. Yet you will not be better off. Let us consider the details.

* When the government is the sole negotiator it does not really negotiate: it sets prices. The pharmaceutical industry can then "take it or leave it." And when it comes to the newest and most effective drugs, the industry typically "leaves it"and you the patient must do without such medications. In a free country, the government can't, in effect, confiscate the drug industry's products at prices that make their production unprofitable. Under such a regimen, the government "negotiates" you right out of access to lifesaving medications.

* We actually know from experience what happens when the government is the sole negotiator for drug prices (for the drug formulary of the Veterans Administration) and when it is not (for the drugs available under Medicare's Part D).