INTERVIEW TRANSCRIPT

C-SPAN’S “NEWSMAKERS”

Guest: Billy Tauzin, Pharmaceutical Research and Manufacturers Association

Reporters: Jeff Young, Drew Armstrong

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Moderator: C-SPAN

Tape Date: Friday, March 6, 2009

AIR DATE/TIME: Sunday, March 8, 2009 10a.m. and 6 p.m. on C-SPAN

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C-SPAN/NEWSMAKERS

Host: Peter Slen

Guest: Billy Tauzin, Pharmaceutical Research and Manufacturers Association

Reporters: Jeff Young, Drew Armstrong

PETER SLEN: One of the major events this week in Washington was the Healthcare Summit organized and hosted by President Obama. Billy Tauzin, president and CEO of the Pharmaceutical Research and Manufacturers Association of America, better known as PhRMA, was one of the attendees and he's our guest this week on ‘Newsmakers’. Congressman Tauzin will be questioned by Jeff Young of ‘The Hill Newspaper' and Drew Armstrong of ‘CQPolitics'.

Congressman Tauzin, when you served as chairman of the energy and commerce committee in the 1990s, did you support universal healthcare as it's stated now on your PhRMA Web site?

BILLY TAUZIN, PRESIDENT AND CEO, PHARMACEUTICAL RESEARCH AND MANUFACTURERS ASSOCIATION OF AMERICA: No, I did not support the bill that came to the committee in 1993 primarily because it was a bill focused on a centralized single peer government run system and we opposed it then and in my current profession, we still think that's a bad idea. We do, however, support the program this year. I think the President's right on track in terms of both improving the coverage for all Americans and secondly, making sure that both the public and the private sectors work much more efficiently than they currently do. I'm also now a cancer survivor and cancer patient having had to leave Congress to go fight a deadly cancer, so I've got patient perspectives that I didn't have back in 1993.

SLEN: Jeff Young at ‘The Hill'.

JEFFREY YOUNG, HEALTHCARE REPORTER, THE HILL: Thank you. If I could follow up, Mr. Tauzin, on the point about the 1990s. I understand where your opposition came from back then, my question though is looking at the intervening decade and a half, that program failed, nothing's happened in between. Of course, the President's working on it now, but do you think that this country and the companies that you represent are better off today because nothing happened in the 1990s?

TAUZIN: No. I don't. I really think we should have settled this back in the 1990s. I think it should have been settled years and years ago. You can't have a healthy society a long term when you have a healthcare system so fragmented and so focused on the wrong things. I mean the healthcare system we have today is focused primarily on the damage done by basically five chronic diseases. We spend 75/80 cents out of every dollar on amputations and surgeries and all of the hospitalizations for people who have never been cared for properly at the front end of disease and I've learned particularly in the last four years and having been a patient myself, how much prevention is missing in our system, how much early detection, early treatments could save both suffering and cost in our system if everybody had good insurance and insurance covered the right things.

YOUNG: Do you have any regrets, personally, about anything you – any part you might have played in the 1990s debate? Or your colleagues in Congress? Anything you would have done differently if you'd known what you know now?

TAUZIN: Well, yes, I wish we'd have had a chance to really have two competing plans or to have some opportunity to literally negotiate around the single plan that was offered back in ‘93. It was sort of a take or leave it. There was not a lot of what's going on today. A lot of effort to find consensus, a lot of effort to bridge gaps and differences and find compromises that would work. We were just given a plan and told to approve it. I was a democrat then on the energy and commerce committee and there were quite a few of us on the energy and commerce committee, democrats, who opposed a single peer system for America. The President said it best yesterday, we need a uniquely American plan.

We wouldn't put up with what happens in Europe where doctors cannot give the right medicine or the right therapy to their patients because government won't let them. We wouldn't put up with that. Here in America, the President is exactly right, we need a truly American solution to our American problem and it's got to respect the fact that doctors and patients make decisions about their care, not government.

DREW ARMSTRONG, HEALTHCARE REPORTER, CQPOLITICS.COM: Now, Congressman, you mentioned that in the 1990s, with the Clinton plan, part of the problem was that the President sort of dictated what was going to happen. I'm wondering now though we're still seeing congress, to some extent, especially in the house side, where you are a former member, asking the President to lead. What is the nuance between getting the President to lead and getting the President to provide those details, maybe more than he should?

TAUZIN: Well, the nuances that this President remarkably – I was at the session yesterday, he is truly extraordinarily talented at bringing different voices into – around the same table. This President is not only invested heavily because he feels a passion about this, a deep passion that this is an imperative, not just financially, but morally, that we do something about making sure every person in this country have an equal access to the incredible new medicines and therapies that are available to some and not to others in our country. And because he feels that passion and he's giving so much of his personal effort to it and he has this extraordinary capability of bringing people from different – totally different perspectives into a common focus. I think we've got a real chance to get it done.

Secondly, this real urgency today. In 1990, you could argue whether it was an urgent problem then. It was a growing problem. Today, in this time, in this age, it's a part of economic recovery. It's critical to whether we're going to have a healthy economy. You can't have a healthy economy if you've got sick workers, if a population is too sick to show up on Monday morning to go to work or if when they show up, they can't do the job because they're suffering from a chronic disease or a combination of them that they didn't take care of when we could of. The imperative of doing it and doing it now is so real, he's so committed to it, that there is an obvious recognition that this is not going to happen unless we have that type of leadership.

ARMSTRONG: Congressman, I hear the case you are making you're talking about the moral imperative, the fiscal imperative for our country and when you were a law maker, obviously, those were the types of concerns as a public servant, you dealt with. Now, you are in the business of business. You represent the pharmaceutical industry. Make a business case to me as if I'm one of your member companies or if I'm a shareholder in your company for why healthcare reform is good for the pharmaceutical industry.

TAUZIN: Yes, because that's our business. I mean we are in the business, literally, of helping people live and helping them live good, productive lives. That's what we do. That's why we spend $70 billion every year – 70 percent of the research on new and innovative and discovery products is done in this country for the world. We are the leaders in the world in trying to find new ways to keep healthy or to protect them from disease and more and more now to prevent disease from ever happening. That's our business and it's what the 500,000 men and women of the pharmaceutical industry wake up every morning dreaming about, whether they can one day actually produce a product that saves lives.

I'm a beneficiary of that. I'm alive today because a great new discovery that was made just a few years ago, just in time to save my miserable life. I came within an inch and I know having come through that how critical that discovery process, that fact that we innovate everyday in healthcare. So that the business case is that if our country builds a good healthcare system, not a sick care system, but one that really focuses on prevention and early detection and early treatment, that we're going to be part of the solution, we're going to be making the products, discovering the innovations that are going to make that happen for our country. We have every business reason to want to see this happen and we have every moral reason to see it happen because our patients are our first concern.

SLEN: Billy Tauzin, given the current economic situation in the US today, do you think that congress has the will and the ability to pass major healthcare reform at this time?

TAUZIN: We don't know yet. I mean that's why I'm – in answer to your earlier question, why it's so important that the President lead the way he's leading, there are going to be people trying to block it, I'm sure. His great talent is somehow working through that. There are going to be people who disagree with different elements of it, how will we ever get past those disagreements if we first don't sit around the table and work out the things we agree with? But there's more commonality than I've ever seen before among disparate groups. We're working with groups we never worked with before. Families USA, The American Agenda, we're working with labor and we're working with healthcare providers that never stood together on the same platform together.

I was in a forum in Miami with Donna Shallaly (ph) just recently and you can see that on the Web, it's available if you want to see it, where there were so many commonalities around the table. So much agreement on what the problems were and what some of the great solutions could look like that my answer is I think it can happen now. It can happen for that reason. It can happen because of the urgency of it. It can happen because all of the predictions are that we're going to be a sicker, less productive country if we don't do this and it can happen because for the first time, I see republicans and democrats actually talking to each other for the first time about common solutions rather than party or political solutions.

YOUNG: Mr. Tauzin, I see the same thing at this early stage where particularly among healthcare interest groups and healthcare companies that an openness to reform that may not have been there in the 90s.

TAUZIN: Yes.

YOUNG: And of course, we saw at the summit yesterday, to a certain extent, the same spirit coming from republicans and democrats from the congress. However, while this is going on, there's also already starting the campaign to oppose what the President wants to do and in particular, I wanted to ask you about the strategy and the rhetoric coming from your former colleagues among house republicans. A number of people I'm getting statements, people are calling me saying these things to me, they're talking about socialized, government run healthcare and they're saying that that's what the President wants to do. Do you think that's what he wants to do? Do you see socialized medicine in what President Obama, Senator Baucus, Senator Kennedy are proposing so far? Do you think that's an accurate description?

TAUZIN: Well, I take them at their word. I mean I listened to the President very carefully yesterday at the White House and he very clearly said and he put down the challenge, if you can work this out in the private sector, I'm willing to go there. If you can show me how we can build a healthcare system for America that provides good comprehensive coverage to everyone so that they can get preventative and healthcare when they need it instead of when it's a dire emergency in an emergency room somewhere, work it out. Show me you can do it. If you can't and the only way I can do it is with a government program, that's where I'm going to go. That's exactly what he said yesterday. So he's basically put out the welcome mat to the republicans and to conservatives who want a more private solution to come and show me how you can do it. So I think it's up to them now to take advantage of that invitation and accept the challenge.

I know that in the house, that John Bainer has set up a committee of members of his party to see what kind of healthcare reforms they could recommend. That's a very good step forward. Yesterday in the break out session I was in, I heard Congressman Joe Barton and Congressman Waxman agree to meet every week from now on, the way Mr. Grassley and Mr. Baucus are meeting in the senate on a weekly basis to actually cross party lines and talk about commonalities. I didn't hear that in 1990s. I mean it was take it or leave and the republican response was, ‘Well, our plan is to beat your plan and then beat you in the elections.' I don't hear any of that right now. I hear people talking about the fact that this is an American problem and that if republicans have a chance to dialogue and have a chance to compromise with democrats on it, if it's not just rammed through the way it was attempted to be done in the 90s, that at least I hear a willingness to try to do that and I would strongly recommend they take advantage of the invitation and the challenge that was laid down yesterday.

ARMSTRONG: Congressman, I want to mention Joe Barton, who you just brought up as the ranking republican on the energy and commerce committee being cooperative. I want to read you a comment he made yesterday at the Healthcare Summit, he said, ‘Not all of the democrats ideas are objectionable, just nearly all.' That doesn't sound like he's planning on doing any sort of cooperation that you're talking about now. That sounds a little bit more like the rhetoric from the 1990s. It's still in the process.

TAUZIN: Well, you've got to hear all of his statement. I was in the room with him when he said he agreed with the President's principals. He said he couldn't find anything in the President's principals not to agree with. That's pretty strong. He also said that he was willing on a regular basis to meet with Congressman Waxman and his chairman to talk about what differences do exist between republicans and democrats and they're primarily around that central issue, do you have a separate government plan that competes with the private plans? Or do you have a single peer system? That's a big area of disagreement. The other areas are going to be, do you have mandates? How do you pay for it? But those are going to be difficult areas for all of us to work through as a country, but I sensed from Joe, first of all, typically Joe speaks his mind very clearly. He said very clearly I don't think that things failed in 1990, I think we succeeded in killing a good plan. He said that very clearly, that the plan offered in the 90s was not, in his view, a good plan. He also said, I agree with the President's principals and if you're willing to talk with me, I'm ready. That's pretty encouraging.

SLEN: Congressman Tauzin, what do you see is PhRMA’s seat at the table and how it will develop?

TAUZIN: Well, first of all, we're very please that we did receive an invitation to be at the table. That's all we've ever asked for. I've got all of the furniture I can need, I don't need to own any tables or chairs or anything else, but we do believe that we should be part of the solution. We're about 10 percent of the healthcare costs in America and yet, the 10 percent we provide very often keeps people out of hospitals and keeps them out of doctor's offices. And we know that half of the prescriptions in America go unfilled because of the high co-pays and the high barriers that people have to cross to get to our medicines because insurance doesn't cover it very well. We, ourselves, provide free medicines to five and a half million people today because we know they can't get it.

We understand we make products that are not ice cream that you can take or leave. They are products that people have to live and we're doing our best to make sure people get to them. And part of our seat at the table is to make those – make the case for the patients who can't fill the prescriptions today because they're not covered. To make the case for the – those that live above 200 percent of poverty who can't get free medicine, on the one hand, and can't afford the high co-pays on the other. To make a care that if we have good insurance in America it ought to cover medicines, as well as it does doctors and hospitals, so people can stay out of hospitals and doctor offices and stay well. We're trying to literally be a part of the solution as to how this country could be healthier and wealthier long term, instead of poorer and less productive.

YOUNG: The argument that you make, of course, about prevention and about treatment of chronic disease and using medicines to keep people healthy or to heal them faster, avoid surgery, those different things, of course, that makes intuitive sense from a medical standpoint. Can you quantify that in some way for the President or for congress to say, ‘This is the amount of dollars that can be saved if we put the following policies in place'?

TAUZIN: Yes. We've already done that. I – we're part of a coalition led by Doctor Ken Thorpe, who is an advisor, by the way, to Hillary Clinton back in the 1990s. Doctor Thorpe of Emory University is leading a group called ‘The Partnership to Fight Chronic Disease' and that partnership has done a study, it's asked the Milken Foundation to actually quantify that effect. Here are the numbers for you; if you look at the five big chronic diseases where we spend nearly 75/80 percent of every dollar in healthcare, those five chronic diseases account for about a $1.3 trillion cost for the American economy, most of it in lost productivity. So people who can't come to work, people who can't work when they come to work because they're sick and they're not getting treatment. When you quantify that $1.3 trillion, you find out that about $1 trillion of it is lost productivity. The rest of it is medical expense. If you project that 20 years, it's going to be $6.7 trillion every year. We'll be a sicker, less productive, less competitive country in the world economy.

What the Milken study says and what Doctor Thorpe and his organization has produced is a fact that if we do change our system to one that focuses on covering prevention, early detection, early disease management, rather than sick care, then we can save $1.1 trillion every year. We'll be richer, we'll be healthier more productive if we take that course. Now, I've been through one of those ‘duh' moments in my cancer treatments where the doctors told me that they had a brand new experimental medicine that could kill me, but might save my life, but I was going to die other wise. Might die is a lot better than die. In my view, healthier, richer is a lot better than poorer and sicker and less productive. So there's an economic imperative for us to make this change. There's a moral imperative, as the President said, because we're talking about people living sick for the rest of their lives or somehow managing a disease earlier, preventing it in the first place.

Governor Huckabee of Arkansas is a great example. He was given a good/bad news; the good news was that he had 10 years to live, because he had such a bad case of diabetes and the bad news was they would be the worst 10 years of his life. How many people are living the worst 10/20 years of their lives in America because they didn't know they had a bad disease like that or hadn't dealt with it? You see Governor Huckabee today, he's on television, has got his own show, he ran for President. He's a picture of health because he took real serious the fact that he diabetes, that he had to get on a healthy course of living and he had to take his medicine regularly and the result is he's living a healthy more productive life. That's a story for America. We can live the (thin year) bad news story that the Governor had or we can live a life of health and productivity if we change our healthcare structure.

SLEN: This is CSPAN's Newsmakers program. Our guest is Billy Tauzin who is president and CEO of the Pharmaceutical Research and Manufacturers of America, also known as PhRMA. Questioning him, Jeff Young of ‘The Hill' newspaper and Drew Armstrong of ‘CQPolitics.com'. Mr. Armstrong?

ARMSTRONG: Mr. Tauzin, a lot of the word we have coming out of Congress that they tell that they are saying to industry is that this is going to be a legislation – a period of legislation that's going to require shared sacrifice from everybody and when they say that, it's something that we all understand to mean that there will be shared monetary sacrifice. There's a limited amount of money in the healthcare system and there will be losers or at least disruptions in the amount of money being made by hospitals, doctors, insurance companies, drug makers. There is going to be some reshuffling of how money gets paid and there is a limited amount of it. Do you think we're in an environment – and I ask you this as someone who I believe is part of the Kennedy workhorse group, the private group of about 20 that Senator Kennedy's staff has been pulling together to try to get everybody on the same page and try to get that shared sacrifice. Are in an environment where share sacrifice and not just about policy priorities, but real dollar disruptions and dollar sacrifices can have – can happen in order to improve the nation's healthcare efficiency and the system overall?

TAUZIN: Yes. We're hearing that and I think everybody understands that. It needs to be reasonable. It needs to be correctly apportioned. It needs to reflect the realities of the marketplace. It shouldn't be cost controlled. It should be the fact that everyone is willing to, literally, to help make this happen in a way that not only brings down the cost of healthcare in America, more specifically targets healthcare the right way for the right patient at the right time. And we're all willing to be part of that discussion. Obviously, there is some recommendations in the current plan that we would take quarrel with. We don't like the fact that there's some cost control in this plan being applied to the private sectors. That's a no-no with us. We think the private sector ought to be reinforced not diminished. We're very concerned that you never discouraged the investment in innovation. Anybody who thinks we found all the medicines we could find to cure disease, they're living in a dream world. We've got 2,700 new medicines in the pipeline right now being tested. Seven hundred and fifty new cancer drugs alone that are being tested and there's great new war the President has declared against cancer.

So we would balance it. Make sure you don't kill the goose that laid the golden egg, but we're all willing to be part of the effort to make this thing work.

SLEN: Is there a role for generics in healthcare reform?

TAUZIN: My God, generics are 72 percent of the marketplace already, Drew. They're a huge part of the solution. The inflation rate of medicines last year, including generics and patent drugs, was one percent. Generics have already played a huge role of holding down the increasing cost in medicines in America and will continue to do so. Many of the companies in PhRMA make generic products. One of our companies, Novartis, is as big a generic company as it is a new patent discovery company. So it – generics have and will continue to play a big role. We, obviously, have a concern always that we have an incentive still in place as the last great marketplace for invention and for new discoveries. As I told you, 70 percent of the new discoveries happen in America because 70 percent of the research is done here. We don't want to stop that either. You can't have a generic until you have a discovery. So you've got to have a place for both.

YOUNG: From the standpoint of your member companies and what they need to thrive, when you look at the plan and you see things like some of the things you've already mentioned, the creation of the new public insurance plan or government negotiations of Medicare drug prices which I don't think have talked about today ...

TAUZIN: Wasn't in the plan.

YOUNG: Well, I suppose that's true. It's on the congressional agenda, I think, it's fair to say. Well, they haven't backed away from it any how, but it's something on their mind and the house, I believe, already passed once and then the increased rebates the drug companies would pay to Medicaid programs. You see all of that there, how do you reconcile knowing that that's part of what the President and/or congressional democrats might have in mind with the fact that you say you feel so optimistic about something positive coming out of this process for your industry?

TAUZIN: Well, first of all, the first thing we have noticed is that at least in the plan there isn't an attempt to fight these old wars. The old wars in importation. The old wars on government intervention into Part D where there's such great private competition going on that the senior approval rate is sky high. Seniors love the program, it's working great for them and we continue to point out that you shouldn't mess with something that's working. But it's the first thing we ever created in Washington, that I'm aware, that's coming in under budget and over performing for heaven sakes. So we at least see a reasonable approach that doesn't include those old wars. We hope it stays that way because if we don't go to battling and separate corners over these old wars, we have a chance to sit down at the same table and work out good programs.

When it comes to what's in the plan, as I said, we have some real concerns about the rebate is structured and in particular, then way it's applied to private operating market plans. We don't think that should be the case, but we also understand, obviously, that this is going to be a total package and we have to be part of it and we're going to have to discuss that and we're all going to be part of a solution that hopefully yields a better result, not only for us, but for our patients and for the country. This needs to be a win/win/win. This needs to be something that all of the healthcare providing community participates in and is better off for. It needs to be a win for the patients of our country who I think are the big losers today when they don't have access to the great medicines that saved my life, for example. And it needs to be a win for those who are out there working every day to try to discover those new medicines.

I don't know if you know this, but when I came out of my cancer treatments a year later, the first thing I did was to go visit that discovery team in California who discovered the medicine that saved my life. It took them 15 years. It took them $1.2 billion to get through the clinical trials and they finally produced a drug that within six months, if it hadn't been produced, I wouldn't be alive. I don't want to see that process stop, not for me, not for anyone in this country. So somehow we have to balance what is being asked of us, but what we need and what all of us need in the healthcare community to keep improving innovating and discovering those great new products and therapies that continue to save people's lives. A little device, a little (INAUDIBLE), saved me again. I was bleeding to death from complications of the big surgery I went through five years ago. Cancer is gone, but I had a side effect. They figured it out, saved my life again last year. Every American ought to have that chance, ought to have the insurance coverage to be able to say one day that someone they loved is alive because of that good insurance coverage.

SLEN: Final question,

ARMSTRONG: Congressman, the republican brain trust on healthcare in the house, as a former member of the chamber, I'm sure you've been watching it with interest and over the last several years we've seen republican ideas on health savings accounts, transparency, tax treatment of health care premiums, generally rejected by voters at the poll and also not see full implementation anywhere or really catch on with consumers at any point. Where is the house republican brain trust on healthcare? We have this healthcare task force, not necessarily a bunch of new minds on there, but again, where is – where are the new ideas going to come from from republicans for them to be a legitimate part of this debate, especially on the house side?

TAUZIN: Well, the good thing for republicans is that the business community is now engaging in the conversation, traditional supporters of republican causes are now saying, ‘Look, we need an affordable insurance plan for our workers. We need to focus on healthy workers instead of having to treat so many sick people and having to lose productivity as a result.' At the very support base of the republican part is asking them to be part of this solution and if they're hearing them and I hope they are and they're in the room talking with democrats, I think they're going to find a lot of commonalities this year. So my strong advice to them is as you build your own plans, as you think through your own solutions, recognize that there a lot of your own constituencies, traditional constituencies who really want to see this thing worked out and don't want battle lines drawn and mine fields set up so that it can't happen this year.

I think they understand that. I've had some conversations with the republicans of both the house and the senate side who tell me they believe it's going to happen and because they believe it' going to happen, they're more interested now in making sure that some of their principals and some of their concerns are addressed properly. You saw the President make that commitment yesterday to the crowd when he spoke, particularly to the question of whether he would have a public plan or not, that he wants to make sure that all those – if you will, all of those arguments are properly addressed and that we don't do something that's going to turn so many people off in this country that you can't get the job done.

SLEN: Billy Tauzin is president and CEO of the Pharmaceutical Research and Manufacturers of America and he has been our guest on ‘Newsmakers'. Jeff Young and Drew Armstrong, a lot of talk about bipartisanship from former Congressman Tauzin.

ARMSTRONG: That has been the watch word over and over and over and over again as we begin this process. It's a lot of good feelings out there right now. I was a bit young when the Clinton debates were going on, but from reading my history, I know that that was the – one of the watch words back then, as well. We have yet to see a lot of details and that tends to be where things begin to get ugly. Everybody agrees with these principals Obama is putting out, but those are a lot of feel good in a lot of ways.

SLEN: So what's the next step?

YOUNG: Well, practically or politically?

SLEN: Yes.

YOUNG: Well, I mean the first thing is that the coming week congress starts getting involved in a public way. There are number of hearings scheduled. The other day the middle of this past week, I guess, Senator Baucus, who chairs the finance committee, said – laid out a timeline and what did he say? He wants to do a ...

ARMSTRONG: He said ...

YOUNG: ... maybe by June.

ARMSTRONG: He laid out a timeline saying he wants the bill out of committee by June, the house and the senate have both said that they want to see it on the floor before the August recess and Baucus has also set up a process to do a – basically a dress rehearsal of the legislation with these stakeholder groups like PhRMA and he's going to start holding sets of informal hearings in April and then he is going to do what he calls a walk through where basically, he takes them through the components of the bill that are relevant to them and tries to take care of some of those objections before everybody starts running ads, Harry and Louise (ph) ads trying to bring this thing down.

YOUNG: Right. And that's really not that much time. I mean Senator Baucus, for example, has been building towards this for over a year. So it shouldn't come as any surprise to anybody who cares about it where he's generally heading with it and the fact that it tracks very closely with what the President campaigned on and the principals that he's laid out and the things he wrote into the budget. But so when you talk about bipartisanship, we're talking about a couple of months now where republicans may be invited in to buy into what democrats in the senate have been talking about and meanwhile when you look over the house, they're nowhere near as far along in the process as Senator Baucus and also Senator Kennedy and his staff and other democratic senators are. So if you combine that with the fact that historically speaking for a lot of reasons, the house tends to be a much more partisan body. If I were – I can understand republican skepticism about whether they're really going to be included in this process.

SLEN: Jeff Young of ‘The Hill' and Drew Armstrong of ‘CQPolitics', thank you for being on ‘Newsmakers'.

ARMSTRONG: Thank you.

YOUNG: Thank you for having me.

END