Not so very long ago - in historical terms - the politics of Medicare were thought to be stable and well-established. Medicare’s 1965 enactment culminated an epochal political battle that spanned fifteen years and involved mass mobilization, millions of dollars in lobbying expenditures, and bitter partisan controversy. By the late 1980s those seemed to be distant birthing pains long since overshadowed by the program’s robust health and popularity. Medicare politics had devolved into a model of pluralist “normalcy” in which a (...) relatively specialized and autonomous group of subject-matter experts in the federal bureaucracy, the Congress, and affected interest groups largely made policy by negotiating among themselves, primarily on issues of provider reimbursement. Even the extraordinary events involving the 1988 enactment of the “Medicare Catastrophic Coverage Act” legislation, and the ensuing public firestorm that led to its partial repeal in 1989, could be seen as an aberrational deviation from a more placid pattern. (shrink)

This paper explores the ethical obligations of pharmaceutical companies to charge fair prices for essential medicines. The moral issue at stake here is distributive justice. Rawls'' framework is especially germane since it underlines the material benefits everyone deserves as Kantian persons and the need for an egalitarian approach for the distribution of society''s essential commodities such as health care. This concern for distributive justice should be a critical factor in the equation of variables used to set prices for pharmaceuticals.

This article examines the ethical issues raised by the pricing of priceless goods. Priceless goods are defined as ones that are widely held to have some special non-market value that makes them unsuited for buying and selling. One subset of priceless goods isprescription drugs—particularly life-saving and life-enhancing ones. Drug makers are under pressure to price their medicines responsibly, which means to restrain their prices (and profits). However, this article argues that it is precisely because life-saving and life-enhancing medicines are priceless (...) that it is especially urgent to leave companies free to charge market prices for them. (shrink)

This article examines the ethical issues raised by the pricing of priceless goods. Priceless goods are defined as ones that are widely held to have some special non-market value that makes them unsuited for buying and selling. One subset of priceless goods isprescription drugs—particularly life-saving and life-enhancing ones. Drug makers are under pressure to price their medicines responsibly, which means to restrain their prices (and profits). However, this article argues that it is precisely because life-saving and life-enhancing medicines are priceless (...) that it is especially urgent to leave companies free to charge market prices for them. (shrink)