European Stars and Stripes (Newspaper) - November 10, 1992, Darmstadt, Hesse                                Tuesday november 10, 1992 commentary the stars and stripes Page 13drug report raises serious questions on pricing James j. Kilpatrick Mark Twain once wrote of three forms of the lie. There Are lies he said damned lies and statistics. Twain a cynical observation applies with full Force to last months report from the general accounting of fice on drug prices Here and a in  the report Isnit a lie and surely not a damned lie but the Gao put its statistics together so cannily that a false picture emerges. Drug prices in the United states Are indeed higher than drug prices in Canada but american Consumers Are not being ripped off quite As wickedly As Henry Waxman would have us believe. Waxman a Liberal Democrat from California is now serving his ninth term in the House where he sits on the key subcommittee on health. He has Long been an advocate of some form of National health insurance. To quote another cynical fellow Waxman wanted statistics As a drunk wants a Lamppost More for support than illumination. The Gao came through handsomely. The report compares . Factory prices with those a in Canada Quot and therein lies the first deception. The Canadian figures do not come from a in  they come Only from Ontario and Ontario vends prescription drugs under a Price control system unknown in the United states. Moreover the Ontario program pays Only for drugs used by the elderly and by Low income families. The effect of these limitations is further to lower the reimbursement prices paid to Consumers. By comparing Ontario a controlled prices to a sticker prices Quot in the United states which apply before medicaid rebates and discounts the Gao was Able to produce data that greatly pleased Henry Waxman. As a consequence the press last month uncritically proclaimed that drug prices a in Canada Quot Are 32 percent lower than comparable drug prices in the United states. The new York times obligingly ran horrid examples to demonstrate How sick people in America Are gouged robbed cheated swindled and otherwise abused by the greedy grasping Money hungry monarchs of the drug Industry Etc. The pharmaceutical manufacturers association responded to the Gao report with a press release of its own. The pm regarded the Overall findings As a quite misleading Quot a fair characterization but the pm had no ready answer for some of the comparative figures. When full account is Given to the apples to oranges comparison american Consumers Stul have some Good questions to ask. An elderly person in Toronto gets 100 tablets of tylenol with codeine for $3.32. His american counterpart pays $19.38, almost six times As much. Why the Upjohn company Sells Wanax a drug widely it  cd am used for treating anxiety for $47.81. The same package Sells in Ontario for $16.92. How come Roche biomedical labs makes the Antibiotic Bac Trine and the tranquil Izer valium. The Batrine is $22.62 there $77.36 nere. A Hundred 5-Milligram tablets of valium Cost $7.57 there and $40.41 Here. What explains this differential another leading drug manufacturer is the american Home products corp. The Gao study concentrated on the 121 drugs most widely prescribed Here and there. American Home manufactures nine of the 121, including pre Marin used for treatment of postmenopausal syndrome. It is the fourth most commonly prescribed drug in the United states. An american woman pays $26.47 for 100 tablets of pre Marin her counterpart in Ontario pays $10.10. These Are other startling comparisons on drugs produced by american Home trip Hasil an Oral contraceptive $15.60 Here $9.46 there Micro a a potassium supplement $9.49 and $6.35 at Ivan a tranquil Izer $49.43 and $6.16 Isordia a heart Medicine $17.41 and $1.63 Raglan a stomach Medicine $34.46 and $5.34 Trudis an arthritis Medicine $69.99 and $28.14 and phen Ergan an anti nausea drug $18.43 and $9.14. But consider this american Home also markets Wysox an Antibiotic. The Gao says it Sells for $16.84 Here $16.46 there an almost identical Price. What gives yes the . Drug Industry invests $10.9 billion a year in research and development and yes its products save lives and immensely Benefit Mankind. True it takes forever to get a new drag approved and yes patents expire before we know it. Everybody knows that. The Gao a statistics May be misleading but even misleading statistics have value. They Lead to legitimate questions. C Universal press Syndicate Linton must hurl hardball Back at gop sneaks republicans Are already undermining Bill Clinton with foreign diplomats and business people a just As they did to Jimmy Carter with crippling effect after the Nixon Ford administration. The hits come from former officials who have worked intimately with foreigners in 20 of the last 24 years and have gained their Trust. The undermines include the likes of Henry Kissinger former top Reagan Bush National Security aides and conservative legislators. Their message is the same everywhere this governor of a Small Southern state is dangerously inexperienced in world politics As was Carter. Clinton is being surrounded by naive carte rite liberals and democratic Neo isolationists. And with Only 43 percent of the popular vote he has no mandate. If the president elect is to avoid being weakened even before he Steps into the Oval office he had better Cut off the prisoners at the Knees now. He must Send out the word that he knows who they Are a and that he will Settle accounts soon. Republicans have played the game just that hard in past transitions. Democrats should do no less. It is the Only Way to survive and govern in Washington. It is also the Best Way to let foreigners know that they too will pay for m gratuitous opposition and personal attacks. Washington has become almost totally unruly. The town is saturated with left and right Wing ideologues officials and lobbyists with Independent Power bases. They do not respond Well to persuasion. But they do appreciate fear and Power. The question is whether Clinton has the stomach for such combat. Conservatives Are unashamed by self interest and feel comfortable exercising Power on their own behalf. But because moderates and Lockean liberals tend toward tolerance by philosophy and temperament they want to understand other Points of View and find it natural to live with differences. Thus they feel awkward wielding raw Power. They prefer using it Only to Foster High principles such As human rights. Clinton is a moderate and a politician to his soul. He does not incline toward skin pinching horse trading or threats. He seeks to conciliate make eve Leslie h. Gelb Tryone feel Good convince through reason and balance conflicting interests. Typical of the Clinton style is the Way he handled the North american free Trade agreement. From the beginning he clearly favored the treaty As a net plus. But he insisted on knowing the minuses a particularly the difficulty of enforcing environmental Laws and retraining workers Likely to lose jobs a and pinpointing them in his endorsing statement. He Fine tuned the whole operation personally. His Naftal position has rigor and reason a which wont take him very far in getting the treaty approved. He will not be Able to please everyone. He will need to put a harder Edge and thrust on his advocacy a Ana break some Knuckles. No one Ever talks of Clinton As a knuckle breaker As ruthless or Tough in dealing with others. He evinced no such traits As governor of Arkansas or As a presidential candidate. This does not mean he lacks personal toughness. On the contrary he demonstrated an incredible ability to absorb hard blows in running the presidential Gauntlet. He can also show anger but showers it mostly on his own staffers. He generates affection loyalty and respect. But he inspires no fear among supporters let alone among adversaries. Clinton bridles when his toughness in exercising Power is questioned. But he knows people think he Isnit Tough. In no Small measure that awareness accounts for his hard nosed and Correct staff decisions Friday he made Warren Christopher the Day to Day transition chief thus virtually removing him from the Secretary of state sweepstakes. Christopher though especially Able is perceived As too Liberal for that Post. And Clinton also displaced Mickey ran Tor an old and close Friend As Overall transition chairman. Getting Tough with friends and liberals is one thing. Putting butterflies in hostile Republican bellies is another. But Clinton had better show he can play Lyndon Johnson style hardball before he even takes the oath of office. Otherwise he will face More trials at Home and abroad than he or any other Leader can survive. C the new York times the opinions expressed in the columns and cartoons on this Page represent those of the authors and Are in no Way to be considered As representing the views of the stars and stripes or the United states government