We’ve heard a good deal of discussion about a public option in the healthcare system – the option that was too politically hard to wedge into the Affordable Care Act (Obamacare).

Here’s a proposed public option for production and sale of prescription drugs – one that could very well ratchet down the prices of drugs from the grasping, pill-pushing Big Pharma, star attraction in the Wall Street Casino.

A new report published this week by The Democracy Collaborative proposes the creation of a public pharmaceutical industry as an alternative to privately owned drug companies, which are focused on the pursuit of profit at the expense of the needs of patients and communities.

We’ve heard a good deal of discussion about a public option in the healthcare system – the option that was too politically hard to wedge into the Affordable Care Act (Obamacare). Here’s a proposed public option for production and sale of prescription drugs – one that could very well ratchet down the prices of drugs from the grasping, pill-pushing Big Pharma, star attraction in the Wall Street Casino.

A new report published this week by The Democracy Collaborative proposes the creation of a public pharmaceutical industry as an alternative to privately owned drug companies, which are focused on the pursuit of profit at the expense of the needs of patients and communities.

Exorbitant drug prices have prompted millions of patients to engage in sometimes deadly rationing of their medications and acts as a form of double taxation since the public has already paid for the basic research on which private drug manufacturers then capitalize. Drug industry profit extraction has also given it tremendous resources with which to distort our democracy.

"The only option for comprehensive reform is a transformational alternative that would fundamentally shift the balance of power in the sector and provide mechanisms for true transparency and accountability," writes report author Dana Brown. "Public ownership can be the vehicle for the designs we need to ensure that public health needs are prioritized by our pharmaceutical industry."

Critical needs like addressing the high cost of insulin—which affects more than 7.5 million people—are ideally suited for a public option in pharmaceuticals. Without waiting for the federal government to act, states and municipalities can take the lead in setting up a system that addresses the health needs of their populations, using lessons drawn from successful public pharmaceutical operations in several other countries. (A brief on how this would work in California has been published by the Sustainable Economies Law Center.)

A resilient ecosystem of publicly owned companies across the healthcare supply chain can offer improved outcomes for our health, economy, and democracy.

Here is the full report.

Check out these highlights, adapted from the report’s summary section:

The pharmaceutical industry, unaccountable corporations for whom the pursuit of profit trumps the needs of patients and communities, should have to compete with a democratic, publicly-owned pharmaceutical sector, designed to respond to public health needs and deliver better health outcomes at lower costs.

Democratic, public ownership of pharmaceutical development, production, and distribution in the U.S. is necessary to combat the increasingly harmful impacts of Big Pharma. The industry’s focus on profits, stock prices and stockholder benefits puts patients last. Inflated prices that cause dangerous, and sometimes deadly, medication-rationing; mislabeling and deceptive advertising as well as well-financed influence of doctors (see: opioid epidemic) are the result.  

Big Pharma distorts our democracy with the largest lobby in the US, illustrating “regulatory capture” with well paid ex-regulators and elected officials that allow the drug industry to mask its oligopolistic, anti-competitive nature and behavior.

Democratic, public ownership of pharmaceutical development, production, and distribution in the U.S. is necessary to combat the increasingly harmful impacts of Big Pharma which decades of regulation have failed to counteract.

Existing public resources like the Veterans Health Administration and the US Postal Service could be leveraged to help deliver medications, and public, unitary pricing on medications and their distribution would create transparency in the pharmaceutical supply chain that could inform further policy efforts.

Ensuring that new drug development is done in the public interest assures that not only do we get the medications that we need for the most pressing public health concerns (rather than the most profitable health issues), but also that those medications come at an accessible price.

A clear role for public pharmaceuticals would be to assure the adequate supply of generics, especially for essential medicines—many of which are currently in short supply in the United States.

Pharmaceutical spending is now the fastest growing portion of a healthcare sector that is already approaching a fifth of the US economy—while life expectancy declines. No reform currently under serious consideration would challenge the underlying profit-driven structure of the industry, which allows it to function outside democratic, public control and contrary to vital public needs.

Publicly-owned pharmaceuticals, free of the structural need to appease profit-hungry shareholders, would be able to focus first and foremost on public health priorities. Public pharmaceuticals can play an important role in constructing that future we so desperately need.

The original report was published Sept. 10 by the Democracy Collaborative and on Sept. 16 by Portside.