Al Gore told George W. Bush in 2000 that he was backing the drug companies’ bill, and pointed to his own 24 years of fighting them.
“Alright, here we go again,” Gore started, and went straight at Bush.
If you want someone who uses a lot of words on a convoluted process and ends up backing a bill the big drug companies support, Gore said, “this is your man.”
For 24 years, he said, he had never been afraid to take on the big drug companies.
He gave them credit first. They discover great new cures, and he wanted that to continue.
Then came the charge. They were spending more on advertising and promotion than on research and development, and they were trying to extend their patent monopolies to keep prices high.
His plan was a Medicare drug benefit for all seniors:
You pick your own doctor.
Your doctor picks the prescription, and nobody overrules it.
You go to your own pharmacy, and Medicare pays half.
If you’re poor, Medicare pays all of it.
Medicare pays everything over $4,000 out of pocket.
He also wanted faster approval of competing generics to bring prices down for everyone.
Bush’s plan leaned more on private insurance and targeted help for low-income seniors.
Bush won. In 2003 he signed Medicare Part D, a drug benefit run through private plans. The law also barred Medicare from negotiating drug prices directly. Supporters said competition between the plans would keep prices down. Critics said Medicare’s buying power was being left on the table.
That ban held until 2022, when Congress gave Medicare the power to negotiate prices on some drugs.
Both men promised lower prices. Medicare waited 22 years for the power to bargain.
25% up doubles the money and 25% down wipes it out, and that's the private equity model Stephen Schwarzman described in 2005.
Charlie Rose asked the Blackstone CEO what private equity actually is.
"Well, what we do is pretty simple."
Raise large amounts of money, mostly from pension funds and endowments.
Buy companies with it.
Borrow about $3 for every $1 of equity in the deal.
Control the company, improve it and own it for a while.
Then sell it, "and hopefully make a lot of money for our investors."
The $3 is where the 25% comes in.
Put in $1 and borrow $3, and you control a $4 company. Grow its value 25% to $5. The debt is still $3, so your $1 is now $2.
Now run it backwards. A 25% drop takes the company to $3. The debt is still $3, and your $1 is gone.
Same company. Same 25%. 1 side doubles, the other goes to 0.
That's why he said "hopefully"