America's Political Prescription: A Historical Analysis of Medicare Part D’s Prescription Coverage and the Role of the Pharmaceutical Industry

Abstract

This thesis examines the role of the pharmaceutical industry in the establishment of Medicare Part D, the prescription coverage for the senior citizen population. It attempts to answer the following research questions: Why did it take approximately forty years after the passage of Medicare for a prescription drug coverage to be included? How did the pharmaceutical industry acquire so much political power that forever changed the course of prescription coverage and drug cost control in the United States? These questions are relevant for domestic health policy issues today because it demonstrates how an industry can influence policy decision-making. Using a historical approach, the thesis tracks the creation and evolution of Medicare Part D with respect to the growth of the pharmaceutical industry’s political power. Pharma acquired this power by weakening the American Medical Association’s community of physicians then corrupting the U.S. Food and Drug Administration. The final consolidation of power came through the united stance against Clinton’s national health insurance plan. The turn of the century marked the creation of a political pharma, one that was responsible for significant coverage gaps, federal budget deficits, and uncontrollable drug costs. The effects of pharma’s strategically crafted provisions for Part D continue to impact senior citizens.