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The October issue of the Medical Society's publication, St. Louis Metropolitan Medicine, sought responses on several major health care questions from candidates for the U.S. Senate from Missouri and two St. Louis-area U.S. House seats. Thanks to all the candidates who took time in their busy schedules to respond to our questions. Multiple attempts were made to contact all candidates.

Following are the candidates for the U.S. House of Representatives from the metropolitan area and their responses:

U.S. House, First District

William (Lacy) Clay, Democrat (Incumbent)
www.lacyclay.org

Robert Vroman, Republican
www.facebook.com/VoteVroman

Robb Cunningham, Libertarian
www.facebook.com/RobbLibertarian

Robert Vroman and Robb Cunningham did not provide responses.

1. What are your priorities for enabling our health care system to provide the most affordability, accessibility and quality?

Clay: I am very proud to cosponsor Medicare for All as a public option under the Affordable Care Act. The profound difference between my opponents and I is that I have always believed that access to quality health care is a basic human right ... not a commodity.

2. Recent surveys show that an increasing number of physicians support a single-payer health system. What considerations do you think are important in determining whether a Medicare for All system should be adopted?

Clay: The Medicare for All legislation that I am proud to cosponsor would generate billions of dollars in health care savings by streamlining paperwork and introducing efficiencies of scale that will save money and save lives.

3. What actions would you take to control the rise in drug prices and end shortages of needed drugs? Do you support removing the “safe harbor” provision of the 1987 Medicare Act that exempts hospital group purchasing organizations (GPOs) and pharmacy benefit managers (PBMs) from anti-kickback provisions?

Clay: My top priority in lowering the costs of Rx drugs is lifting the ban on importation of most prescriptions and allowing Medicare to negotiate bulk drug pricing as is currently done by the VA and the Department of Defense medical service.


U.S. House, Second District

Cort VanOstran, Democrat
www.cortforcongress.com

Ann Wagner, Republican (Incumbent)
www.annwagner.com

Larry Kirk, Libertarian
www.facebook.com/KirkforLiberty/

David Arnold, Green Party
https://electdavidarnold.weebly.com/

Rep. Wagner, Larry Kirk and David Arnold did not provide responses.


1. What are your priorities for enabling our health care system to provide the most affordability, accessibility and quality?

VanOstran: In America every person should have access to quality, affordable health care. Allowing private insurers to hold the reins on the market has put their profits ahead of people and their doctors for far too long. The Affordable Care Act was never perfect. Now we need to commit to strengthening and improving it and expanding Medicare and Medicaid. By doing so, we will see greater market participation and lower premiums for everyone.

2. Recent surveys show that an increasing number of physicians support a single-payer health system. What considerations do you think are important in determining whether a Medicare for All system should be adopted?

VanOstran: A Medicare-for-All program should be the long-term goal for our nation’s health care. Multiple bipartisan studies show up to $2 trillion in national health care expenditure savings with the adoption of a single-payer plan. But we won’t be able to shift trillions into the public sphere overnight; the move will have to be incremental. That is why I support allowing younger people like myself to buy into Medicare to both drive down premiums and protect its solvency. The bottom line is that every dollar we spend on premiums could go toward improving America’s health care, rather than insurance companies who profit.

3. What actions would you take to control the rise in drug prices and end shortages of needed drugs? Do you support removing the “safe harbor” provision of the 1987 Medicare Act that exempts hospital group purchasing organizations (GPOs) and pharmacy benefit managers (PBMs) from anti-kickback provisions?

VanOstran: The rebate retention process for PBMs is opaque, and has resulted in massive profits to a few big companies—without an increase in quality of care. I support the elimination of the safe harbor provisions that allow companies like this to take advantage of sick people. Everyone deserves access to the drugs they need to lead a healthy, happy life. To tackle this problem, we need to address the monopolies created by the patent abuse of pharmaceutical companies. Encouraging the production of generic and biosimilar drugs will not only lower costs and increase competition, it will help to avoid shortages.




 

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