BUSH DOWNPLAYS LIABILITY ISSUES IN STATE OF UNION SPEECH.

In his Jan. 20 State of the Union message, President Bush shifted his focus and barely mentioned the liability issues at the forefront of his agenda since taking office three years ago.

Instead, he defended the war in Iraq and emphasized his record on the economy and on making health care more affordable and accessible for the elderly and uninsured.

His shift came after the surprisingly strong win in the Iowa Democratic caucuses by Sen. John Kerry (D-MA) and the last-minute surge of voters in favor of Sen. John Edwards (D-NC), which catapulted the former plaintiffs' attorney into second place.

The president's shift also came after a new Washington Post-ABC poll showed only 43 percent of Americans would trust him to do a better job than Democrats in Congress on taxes and the economy, 35 percent on prescription drug care benefits for the elderly and 33 percent on health care cost and availability issues.

On taxes, Bush credited the tax cuts passed since he took office three years ago for "driving this economy forward" and urged Congress to act to make the cuts permanent before they expired "for the sake of job growth."

He then made this brief mention of his priority issue of lawsuit protection: "Our agenda for jobs and growth must help small business owners and employees with relief from needless federal regulation, and protect them from frivolous lawsuits."

He also called for computerized medical records to "avoid dangerous medical mistakes, reduce costs and improve care."

He continued: "To protect the doctor-patient relationship, and keep good doctors doing good work, we must eliminate wasteful and frivolous medical lawsuits."

On health care, he praised the recently-passed Medicare prescription drug bill because it allows seniors to choose "to keep their Medicare just as it is" or choose a private insurance plan that better meets their needs and allows tax-free savings for medical expenses in health savings accounts.

He said it was "critical" that Americans are able to choose and afford private health care coverage.

"A government-run health care system is the wrong prescription," he added.

Bush also proposed allowing small businesses to group together and negotiate with insurance companies to cover workers under association health plans and allowing those who buy catastrophic health coverage to be allowed to deduct their premium cost on their income tax return.

Senate Majority Leader Bill Frist (D-TN) predicted Jan. 21 on NBC's "Today" show that the health care coverage promises by the "Democrat presidential wannabees" are "the same old rhetoric from a long time ago. People are too smart for that today. They want specific solutions. And this president gave specific solutions."

A Jan. 25 editorial in The Washington Post, however, took the opposite view. If the president wishes to avoid a government-run health insurance system, it said, he "needs to think more creatively about how he is going to keep the nation's private health care system viable. A peculiar jumble of old ideas, long discussed but never acted upon, isn't going to do it."

All the Democratic presidential candidates have endorsed more ambitious health coverage plans than Bush. Dean, a physician, came out first with a plan similar to what Vermont has. That plan would cost $88 billion annually and would widen current Medicaid coverage for low-income children and young adults up to age 25.

The Democratic winner in Iowa, Kerry, would spend $72 billion annually to expand health coverage, covering all children from households earning up to three times the poverty level.

Entrance poll results in the Iowa race, conducted by Edison/Mitofsky, showed the voters trusted Kerry the most on health care/Medicare issues, with Edwards being the second most trusted on these issues.

Kerry benefited on health issues in the Iowa race by the aggressive campaign help he received from Sen. Edward Kennedy (D-MA), the Democratic spokesman on health issues who is leading the fight to repeal portions of the recently passed Medicare law.

Kennedy, however, gave Edwards an active role in sponsoring the Patients' Bill of Rights and Edwards was instrumental in working out key compromises on the legislation with Republicans from both chambers.

Although that bill passed both chambers, it died after Rep. Charles Norwood (R-GA), one of the bill's sponsors and chief conferees, agreed to a compromise with the president on non-economic damage caps and the Democratic sponsors found the caps unacceptable.

Democrats increased pressure on Republicans on health issues Jan. 22 with Kennedy telling the consumer advocacy group, Families USA, how to fix the Medicare law.

"The most important single step we can take to strengthen the program is to privatize George Bush, not privatize Medicare," he said.

Among the changes he advocated were: repealing the provision barring the federal government from negotiating directly with drug companies for lower prices; legalizing "the safe re-importation of prescription drugs from Canada and the European Union; setting federal limits on the drug industry's promotional practices, and repealing the "so-called premium support program that supports insurance industry profits and severely undermines Medicare."

Bush threatened to veto any such changes to the bill in his State of the Union speech.

The Congressional Budget Office gave the Republicans some support Jan. 22 on the provision barring negotiations, concluding it would have no effect on the Medicare program because private insurance companies and health plans that offer drug benefits to Medicare patients would have strong incentives to negotiate discounts.

Meanwhile, Dave Mackay, executive director of the Canadian International Pharmaceutical Association, reported five major U.S. pharmaceutical manufacturers are attempting to cut the supply of cheaper Canadian prescription drugs by cutting off or reducing the volume sold to wholesalers there.

He said the five companies were AstraZeneca, Eli Lilly, Glaxo-SmithKline, Pfizer and Wyeth.

Sen. John Rockefeller IV (D-WV), who opposed the Senate bill when it passed the Senate Finance Committee and when it passed the Senate, said he expects the actions of the pharmaceutical companies to anger seniors and "come election time, everything's going to come home to roost."

Food and Drug Administration Commissioner Mark B. McClellan also took steps Jan. 22 to stop three Texas-based companies from importing drugs from Canada or face possible prosecution.

"We cannot tolerate shady operations that enrich a few while exposing many patients to the risks of dubious imports," he said.

The three companies, all located in Temple, TX, are Expedite-Rx, SPC Global Technologies Inc. and Employer Health Options Inc.

Tom Curb, a pharmacist who helped start Expedite-Rx and SPC Global Technologies, said he expected the companies to avoid prosecution once they corrected some of the misconceptions the FDA expressed in its warning letters to the companies.