Thursday, August 31, 2017

Betraying an Electorate: On President Obama's Deal with Drug Companies

While campaigning for the U.S. presidency in 2008, Barak Obama decried the greedy Republican lawmakers acting at the behest of the drug companies to keep drug prices artificially high. A year later, those same drug companies wanted Obama to oppose a Democratic proposal that was intended to bring down the prices of medicine. Beyond betraying those voters who voted for him based on his campaign rhetoric on drug prices, Obama belied the trust that is necessary for a viable republic to function democratically.

 “On June 3, 2009,” according to the New York Times, “one of the lobbyists e-mailed Nancy-Ann DeParle, the president’s top health care adviser. Ms. DeParle sent a message back reassuring the lobbyist. Although Mr. Obama was overseas, she wrote, she and other top officials had ‘made decision, based on how constructive you guys have been, to oppose importation on the bill.’ Just like that, Mr. Obama’s staff abandoned his support for the reimportation of prescription medicines at lower prices and with it solidified a growing compact with an industry he had vilified on the campaign trail the year before.” 

As per the quid pro quo, the industry sponsored its own advertising campaign in favor of Obama’s health-insurance proposal. It was not just the guys’ constructiveness that had convinced Obama’s staff to “make the deal.” To be sure, the staff could have been supposing that the subsidies enabling middle-income Americans to afford health insurance and the expansion of Medicaid to cover 30 million uninsured Americans would relieve people from having to pay high prices for medicine (though everyone, even if only as payers of higher taxes, would be paying the price in the form of higher insurance premiums). However, there would be no guarantee that the government would pick up the tab when needed. Furthermore, the higher prices could widen government deficits.

Beyond health-care and budget policy, moreover, is the contradiction between Obama’s campaign speeches and his staff’s decision to oppose the bill. The implication is that Obama went back on his word, essentially betraying anyone who voted for him because he promised to support lower drug prices. Beyond Obama’s public credibility lies the mechanism of democracy wherein voters trust that a candidate’s campaign bears some relation to the candidate’s governance. Otherwise, the “will of the people” breaks down and mistrust sets in on a societal basis. In other words, when representatives say one thing on the trail and quietly do the opposite behind their desks, democracy itself suffers.

In the wake of the financial crisis of 2008, it was said that trust is vital to the financial system. The same can be said of a viable republic. The question, therefore, is how candidates can be held accountable for the assumed congruence when so much of governance is done behind closed doors. In an electoral system where not voting for one candidate benefits the candidate even further from the voter’s preferences, it can be difficult indeed to hold an office-holder accountable at the ballot box. 


Peter Baker, “LobbyE-Mails Show Depth of Obama Ties to Drug Industry,” The New York Times, June 8, 2012.