Clinton lambasts greedy drug firms

PRESIDENT Clinton yesterday fired the first heavy salvo in his battle to reform America's health- care system, lambasting drug companies for their 'shockingly' high prices, and announcing an extra dollars 300m ( pounds 215m) of government money to help the vaccination of children.

Speaking at an Arlington public clinic, and accompanied by his wife Hillary, who heads a task force plotting health-care reform, the President demanded that the drug industry change its ways. 'They must not profit at the expense of our children. These practices must stop.' Mr Clinton produced statistics to make his case. Over the past 10 years, vaccine costs had risen at six times the rate of inflation. Polio shots, which cost dollars 1.80 in Britain and 77 cents in Belgium, cost dollars 10 in America - 'compared to other countries, our prices are shocking'.

Drug company profits had risen four times more than inflation, yet in the Western hemisphere only Bolivia and Haiti had lower vaccination rates. It was unacceptable, said the President, that 'alone of industrialised countries, the US did not have a guaranteed public programme of vaccination for all its children.'

Automatic immunisation for common childhood diseases is a key goal of the new administration, as it seeks to wean the country from its addiction to hugely costly treatment to cheaper preventive medicine. But Mr Clinton yesterday accused the drug companies of refusing even to start talks on negotiated discount rates for vaccination programmes with at least three individual states.

The dollars 300m of new federal money is one part of a three- pronged programme to make vaccination available for all. The Health Secretary, Donna Shalala, is to open talks with the companies to ensure that states 'get the vaccines they need at affordable prices', while the White House will start work with Congress on a guaranteed immunisation programme for all.

In rounding on the industry yesterday, in the bluntest language of his presidency thus far, Mr Clinton has picked a popular - and probably the easiest - target as indignation rises at the cost of health care, which now accounts for 14 per cent, or dollars 939bn, of total gross domestic product.

Hitherto, the drug companies have insisted that smaller profits would force them to cut back research. But, the President retorted yesterday, the industry was spending dollars 1bn more every year on advertising and lobbying than on developing new or better drugs. 'The public outpouring on this is so strong, they'll come round and do it,' he said.

The extra dollars 300m is for clinics in poor rural and inner-city areas. White House officials reckon it will enable 1 million more children a year to be immunised. At present, around half of all children in poor urban areas are not vaccinated against such common diseases as measles, mumps and German measles. 'Why,' Mr Clinton asked, 'must we run the risk of new epidemics?'

The industry's answer is that vaccine is available but clinics are so understaffed that it cannot be used. The drug companies will without doubt mount a fierce campaign to show that they are not the villains of the piece. But neither the government nor the public are much disposed to listen.

Speaking at a health-care forum in Middletown, Pennsylvania on Thursday, Mrs Clinton argued that the vaccination problem was just another facet of the crisis of America's 'patch-work, broken- down' system of health care. She pledged anew to have a first blueprint for reform ready by mid- May, despite the opposition and obstructionism to be expected from many quarters.

The Pentagon is recommending a substantial streamlining of the air arms of the army, navy and marines as well as the US air force itself, as part of efforts to cut defence spending, writes David Usborne.

'All are going to get smaller and we've found other ways to mix the capabilities and make them more complementary,' the Chairman of the Joint Chiefs of Staff, General Colin Powell, said. The plan will entail merging some maintenance and training operations, withdrawing some aircraft and personnel from service and reducing the military's VIP aircraft fleet. The Pentagon says closing 30 maintenance centres could save dollars 600m a year.