The beginning of the doughnut hole has been noticed at a new blog (to me) called On the Pharm. I suspect we’ll hear lots more about this by November.

The Industry Veteran is back. He notes a piece I’d missed in which the oh-so-rational editorial board of the Wall Street Journal declared Part D to be a future political liability for their desire to drown the government in a bath-tub. And it’s all or mostly the fault of poor Hank McKinnell. The Veteran’s not too impressed with their analysis:

In its May 19 editorial, the Wall Street Journal bitch slapped Pfizer’s CEO, Hank McKinnell, for strongly advocating the 2003 Medicare Modernization Act (i.e., Part D) before the legislation passed and since.  In the week preceding the May 19 cuffing, McKinnell apparently did a panegyric for Medicare Part D in front of the Journal’s editorial board that the Goebbels Gang considered less than persuasive.  Before writing their Night of the Long Knives editorial, the Journal’s editors knew that McKinnell’s partisanship for Part D was more than mere flack work, sycophancy or a simple affirmation of sound, eighteenth century economics.  In his role as president of Big Pharma’s trade group, the Pharmaceutical Research and Manufacturers Association (PhRMA), McKinnell was a driving force behind the Medicare Modernization Act.  Never more than six months behind the news, the Journal is finally reflecting some of the sotto voce criticism that McKinnell is receiving from within Pfizer itself.The Journal’s criticism of Medicare Part D and its advocates combines boilerplate, right wing economics with Monday morning political quarterbacking and crypto-fascist scare threats about single-payer health systems.  The patellar reflex economics faults Part D for contributing to the federal deficit.  In this respect the Journal aligns with Reaganite and other conservatives who label Bush a fraud for posing as a conservative when he is actually a big deficit spender who obtains Congressional acquiescence for his military Keynesianism by declining to veto porkbarrel legislation.  The Wall Street Journal’s reproval of Bush’s spending, however, is less credible than Claude Rains’s declaration of shock at learning that there is gambling at Rick’s Cafe.  Bush is only opposed to federal spending if it benefits the middle class and the poor.  He doesn’t have the slightest problem with a fiscal deficit policy as long as the spending benefits his cronies and benefactors who run multi-billion dollar corporations.  It is for this reason, rather than some fixation on 1960’s vocabulary, that I call George Bush a fascist.  In siding with the stopped-clock conservatives who favor a balanced budget, the Wall Street Journal’s editors merely seek a cloak of principle for their Hjalmar Schacht economics.The Journal’s Monday morning quarterbacking faults Republicans for thinking that the Medicare Modernization Act would turn Medicare from a Democratic into a Republican issue.  Instead the MMA gives Democrats a reason to call for constant improvements to the program that will require more federal spending.  In the Journal’s horror scenario, the out of control spending will lead to calls for Medicare to act as a single purchaser that can constrain costs.  The Journal holds some smelly socks and underwear between its thumb and forefinger to admonish thoughts of price constraint by claiming that the pharmaceutical industry will fail to discover new remedies if it can no longer gouge a cancer patient $300,000 a year for his medication.  (I mean, is this a great country or what?)  If a rejoinder to the Journal’s herring-stained fright-wig is necessary, it is the fact that the development of new molecular entities constitutes the sole reason for the existence and capital investment of branded pharma companies and biotechs.  The aging demographics of the developed world, and our commitment to health and longevity, virtually guarantee a fair return on this investment for a biopharmaceutical industry.  Not content with a fair rate of return, the Wall Street Journal, Hank McKinnell and George Bush take a unconscionable rate as their entitlement and that is where I want to see them bent, broken and humiliated.  Is Medicare Part D turning out badly?  If so, that’s good.  When it comes to George Bush and all his constituencies, worse is better.