The question:
Q Good afternoon, Mr. President. Bill Anderson from New Hampshire. In reference to what you just said -- I'm presently under the New Hampshire Medicaid system and I have to take a drug called Lipitor. When I got onto this program they said, no, we're not going to cover Lipitor -- even though I'd been on that pill for probably 10 years, based on the information my doctor feels is right for me.
And I had to go through two different trials of other kinds of drugs before it was finally deemed that I was able to go back on the Lipitor through the New Hampshire Medicaid system. So here it is, the Medicaid that you guys are administering and you're telling me that it's good -- but in essence, I'm dealing with the same thing, and you're telling me the insurance companies are doing. Thank you.
THE PRESIDENT: Well, I think that's a legitimate point. I don't know all the details, but it sounds to me like they were probably trying to have you take a generic as opposed to a brand name. Is that right? And it turned out that you did not have as good of a reaction under the generic as the brand name, and then they put you back on the brand name. Is that what happened?
Q Correct, to save money.
THE PRESIDENT: Well -- right. Look, there may be -- in nine out of 10 cases, the generic might work as well or better than the brand name. And we don't want to just subsidize the drug companies if you've got one that works just as well as another.
The important thing about the story that you just told me was -- is that once it was determined that, in fact, you needed the brand name, you were able to get the brand name. Now, I want to be absolutely clear here: There are going to be instances where if there is really strong scientific evidence that the generic and the brand name work just as well, and the brand name costs twice as much, that the taxpayer should try to get the best deal possible, as long as if it turns out that the generic doesn't work as well, you're able to get the brand name.
So the basic principle that we want to set up here is that -- if you're in private insurance, first of all, your private insurance can do whatever you want. If you're under a government program, then it makes sense for us to make sure that we're getting the best deal possible and not just giving drug makers or insurers more money than they should be getting. But ultimately, you've got to be able to get the best care based on what the doctor says.
And it sounds like that is eventually what happened. It may be that it wasn't as efficient -- it wasn't as smooth as it should have been, but that result is actually a good one. And you think about all the situations where a generic actually would have worked -- in fact, one of the things I want to do is to speed up generics getting introduced to the marketplace, because right now drug companies -- (applause) -- right now drug companies are fighting so that they can keep essentially their patents on their brand-name drugs a lot longer. And if we can make those patents a little bit shorter, generics get on the market sooner, ultimately you as consumers will save money. All right? But it was an excellent question, so thank you.
http://latimesblogs.latimes.com/washington/2009/08/obama-healthcare-transcript-new-hampshire.htmlNow, I'm not sure if this guy is on Medicare or Medicaid, but let's set that aside. His problem was that he was required by his insurance to try out two cheaper medications before going back on his Lipitor.
Here's what impressed me: instead of fudging an answer, Obama stood up and said that that's the procedure he expected to see after health reform. If there is a cheaper generic out there, you'll go on the generic unless there is a good reason to switch to the more expensive name brand.
No hemming and hawing, just a straight answer.
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