government officials, including senator mark warner, senator tim kaine, governor ralph northam, and lieutenant governor justin fairfax. the history of africans in america from fort monroe live saturday at 8:30 a.m. on c-span's washington journal and american history tv on c-span3. our conversation on prescription drug prices, we are joined by the president and ceo of the biotechnology innovation organization. on that organization, who do you represent? >> we represent about 1000 biotechnology companies, most of them are startup companies on the cutting edge of science. meetings and conferences all over the world. we bring investors together with small companies, sometimes large

companies and they make deals and decide whether they will invest. the second thing, we do public policy advocacy. at the state level, federal level before congress. >> how much time do you spend on capitol hill and how was your organization funded? >> we are funded by dues of our members. i spend maybe 10% of my time. i try to meet all the freshman members of congress. there are hundreds of them in this congress and then introduce them to what is biotechnology, what we are trying to accomplish and the policy issues that are conducive to the success of innovation. >> how many of those conversations have you met with the freshman income it's our focus on the cost of restriction drugs? >> most of them, if not all of them. >> do you think prescription drugs cost too much? >> i want to set forth two moral imperatives. there is a group of

patients who have diseases for which we have already developed cures. there might not one of them should never be a -- without the medicine they need. we believe in that imperative and makes her that does not happen. the second group of patients is a larger group and that is the patience for which we have not yet developed. hope, wents that have have to make sure the scientists working day and night around the country have been -- the resources necessary to develop treatments. i start there. to answer question -- do i think docs are too expensive? on the main, no. let's talk about why. some of them are. they are only expensive until they become generic. might start out appear and

in its patent expires. basicrives the price is economics. 90% of everything we do, all of the trials we get involved in, fail. most companies fail. the biggest economics a high risk, high reward. we have investors in our companies and those capitalists listen the companies and to the data. they might treat this in -- disease or other. the capitalist says i am going to lose my shirt nine times out of 10. if i can make my money back on works.h, this system i will continue to invest. high risk, high reward. host: why did the drugs american

spy cost two to six times as much as docs cost overseas? caller: we are dust guest: -- guest: your the only market-based left in the world. in every other country -- canada, new york another -- elsewhere. --r someone said you are in the u.k.. we have a six -- fixed budget. he had this much money to spend on drugs so i will give you $300. the company will take that because it is better than nothing. are sufficientns at driving into the sector. if we go down to their levels come up as investors will say i cannot get my money back so i will invest in the new app or other places they can invest their mind.

host: prescription drug prices is the top of our conversation. james greenwood with us, a republican from pennsylvania served from 1993 2005. (202) 748-8001. immigrants (202) 748-8000 -- democrats (202) 748-8001. independents (202) 748-8002. can you explain how the price of a drug is set? the nih, thank god is well-funded by the congress. basiconey goes to research. not trying to create a drug but find out why a seal works in this way. or how the genetics of this system worked. a startup company might lease

or intellectual property and the mr. to develop and process. it could take 12 years. .bout $2 billion they take the data to the clinical trials. it, theya approves said price. whether it is in medicare, they negotiate the prices. what happens is the negotiating with a pharmaceutical benefits -- the idea of a pbm was a good initially. there are three companies that make this duck. i represent 50 million people. from insurance companies or employers. whoever gives me the best price, we are going to take that drug and give to those patients. now they say three companies, i am going to buy one of your drugs. who will give me the biggest rebate to put in my pocket?

coachesult of that, the have to raise their list places to give the pbm. the patient does not get the business. the patient and the paying on the list price. is time to do away with pdfs? host: it is time to radically change that symbol. middlemen are extracting 106,000 dollars a year. caller: what is a better system look like? (202) 748-8000 if there is going to be a rebate given. patient does not have to pay a high price. thatould not be the case countries are forced to raise the list prices. the country has many cases, including insulin or they receive less than before.

at of illinois, a democrat. caller: i am at -- $1600 at my excellent. i could not pay for it. i had to call the manufacturer and ask if they with throw a hardship in front of me directly. they said they would send maybe my doctor and call -- and go past. insulin hasg on is been around. what this guy does is the given those back rooms and changes that patent a little bit. .nd it becomes the new pet it -- $1600. six host: thank you both.

i should not happen to you. that goes to the first moral imperative i mentioned. no one in this country should ever do without a drug that they need because they cannot afford what is required to come from their pocket. there are 45 million people like you on medicare part d. and part b. and one million a year pay more $10,000 ournd some organization went to congress copiers ago and sent, you need to put an out-of-pocket cap -- on medicare part d. know what to be more than $200 a month for the drugs that they need. it is not expensive to do that. it is $1.2 billion year. like millions of people like you. and i said we will help you for it. we will come to the table and

the money up to pay for it. no one should be in the position you are now, mike. host: what happened? thankfully, senator grassley and the ranking member senator wyden included that in their package. . went it is in there. we do not think that the weight it should be. the total cap is a hit in a situation like mike's. would rather the see that stretched out so the patient does not have to pay more than $200 per year. month, excuse me. we are committed to that. know if that is scheduled for a floor vote or where that is in the process? guest: i think it will end up in the end of the year on this package. everything gets props to the ends.

and clearly, the congress, the president wants to do something to protect patients. i am hoping at the end of the year, we will get that done. host:? at the end of the fiscal year guest: minimum would probably be saturday. this will be a endless present. rocco, maryland, independent, good morning. caller: thanks for c-span. i want to make a comment about the guest. the demo comment is our health care system is a wreck. worsepublicans to make it . that is the general comments. he talksfic comment is about why it was change so much more. .he answer was

we have a market economy and health care and nobody is does. subsidizing metal and the rest of the world but also all the profits of drug makers. that was my point. host: let me agree with your first point -- guest: let me agree with your first point that the health system is in tatters. no one in this country should be without health care. i agree the congress has failed. i will even agree the who have said they are going to repeal and replace have-nots and that. i want a republican. i am still a registered republican. to your other point, i will agree with you there. we are subsidizing much of the rest of the world. true, and iwere not suggested to this administration that they take this up as a matter of trade issues rather

than making deals strong. they elevate the prices. we are not shouldering all of the burden. -- if they come down to our levels, the problem is there were not enough revenues coming into the small bites. the middle sized bites. was we haveentioned to develop. the alzheimer's parking signs -- many people waiting for those, we have to have the resources to do that we do not benefit in the past that we pay more. we meets the world in this. we have one million jobs come out of this industry so a lot of people are working. our patience have access to more drugs and clinical trials.

there is the benefit. i won't tonight the rest of the world is getting a benefit we are paying for. the solution is to make them pay more, not to bring the levels down so we can no longer afford innovation. host: the president's proposed place -- what is that? caller: one of the president's themes is we are getting taken advantage of by the rest of the world. he looks at this issue and says i do not think we should pay more than the rest of the world. you take the average price of drugs. isn't injectable drugs. look at the average price over 16 nations. canada, japan. countries like greece which are very low. thane will pay nowhere 126% of what they're paying. it is an african good idea,

except those companies look at our prices and that is how they said there's. we was set are slower and there was that there's lower and as a result of that, the investors will look at that and say i cannot get my money back. to invest ing medical innovation because the reimbursements are too low. host: is that the same as controls? guest: it is the government setting the prices. we negotiate our prices. you will hear people say all the rest of the world may negotiate prices but in medicare, the government says you cannot negotiate. the meta-fish -- medicare benefits is ministered by insurance companies. those companies negotiate. the solution to this problem is largely fixing the out-of-pocket cost.

if we can lower the out-of-pocket cost, it does not matter what they are paying canada and england. what matters is -- what are the american people paying? caller: we want to take you to a on the issue of drug prices. this is senator john kennedy, republican of louisiana talking. do not want to go to price controls. i do not believe him. the american people are being played for chumps. just chumps. forng four times the cost the same drug in another country? and it has got to stop. i do not mean to be overly critical. i am a member. i am criticizing myself. some people say we were born

tired and raised lazy. we never compass anything. we have not on this issue. just yada.s, the american people are going to demand it. if you did not make concrete suggestions that are helpful so we can both prosper, the american consumer and your clients? we end up with price controls. that is a fact. host: what would your response have been? senator kenny does not want the american people to be chumps and pay more than they can afford, senator kennedy should get behind a bill that cap's out-of-pocket in a medicare program. that is the solution. meet both moral imperatives. they make sure that they can afford the mental to make sure they have the resources we can

at best -- invest. the science is galloping now. we have immunotherapy. the hope that patients have has never been marked today. if we neglect dime this system, all of the science will go down the chain as with the hoax of all of those patients. guest: james green -- host: james greenwood with us for about another 20 minutes. wisconsin, independence, good morning. caller: yes. know what is going on, but they are not replacing any pain medication whatsoever. nobodye is making sure is on any kind of narcotic pain medication and i am sorry. if you are in a program, and you have been -- i worked for 37

years after the same company i got hurt there. i had to retire early. have been on payment occasion for so many years, now they have company completely off and i am right back to where i cannot do things anymore. what they are cutting off, is it opioid pain medication? caller: yes. i do not understand. it's a gephardt where people could get high on it. they did that over three years ago. they did that part of her three years ago. i do not know what the problem is. why they are making it where you cannot have any pain medication. host: congressman? guest: your story is like that of many americans who face

injuries at workplace recreation and whatever. and as a result, surgeries need pain medication. opioid is a very effective medicine to block pain. as you know, we have suffered and are continuing to suffer from an epidemic that began with opioids being overly prescribed with corrupt pharmacists who were prescribing, selling, making ridiculous amounts of opioid drugs and that led to her when crisis, a fence no crisis. we have thousands of deaths in the country as a result of that. the response should be to fix what is wrong with the system and model limit your opportunity to take the medicine that your doctor prescribes, to treat the pain you're suffering from. i would suggest and i'm sure

you're talking to your doctor but talked your member of congress to see what it is that is having an effect. one thing i can tell the companies are acutely aware of this phenomenon. we took a trip to ohio just to look at addicts, treatment officials, judges, to get a sense of the opioid crisis. and 13 of our studios went up to do that. we are trying to innovate solutions to this problem. innovate new treatments to people who are addicted so they can get off of the jugs they're taking illicitly. and also innovating new drugs that are pain relievers that are not addictive. there is a company called era. a nonaddictive drug used for surgeries. that is the kind of innovation we need to help people who need pain relief but do not want become addicted. guest: the biotechnology --

the biotechnology information's bio.org. jesse is a republican out of florida. good morning. caller: good morning. host: jesse, you are on. caller: i heard your speaker talk about innovation in medicine. the reason we need to have fireplaces is so that we can have innovation in medicine. the problem is innovation in medicine, they go on a formula that has a level five. even with medicare, we do not get any reimbursement. we are praying for innovation that is using the money that we paid to support people overseas and get that innovation supported by us. we do not get to benefit from the innovation. this innovation is to be

controlled by the government. companies that develop new products should be getting grants from government and those should be passed directly to the american people, not to foreigners. jesse come away you said about medicare and a high tier -- the solution to your problem pass aress needs to limit, a cap on how to -- on out-of-pocket so you were not strapped with payments you cannot afford. as far as the government taking over the whole process, trust me if you can. you tell me that will be the end of innovation. have bureaucrats deciding what we are going to invest in. we will invest number of dollars into this product -- why don't

we do -- if the first trial fails, we go back to the drawing boards. professions, ceos who have a lot of experience losing money and starting again -- these are the decisions that have to be made by those folks. if you look at how we have succeeded, leading the world in biotech innovations, you understand why that is the system that works. they are not innovating drugs and other systems around the world. most of the drugs -- many of the to go.re innovated this is the only place to get a return on investment. if we dumbed down our system and make it a government run system, you will never get the innovation we are producing now. nor the kind of innovation we are poised in the near future.

host: coming up, about 10 more minutes if you want to join the conversation. republicans,1 four (202) 748-8000 for democrats, (202) 748-8002 for independence. elias is on in maryland. independence. caller: quick comment. behind the market, it is a little long. companies pass without any kind bribe. the only solution would be keeping the free market the way it is now. not know why it doesn't make sense.

that took a lot of time to review this kind of drug. that is ok. it is third world countries. case, we can preserve the free market. [indiscernible] guest: so, the reality is that -- you mentioned the companies set prices however they want. they cannot. they negotiate prices. when a company is fortunate enough to have a new drug approved that patients are waiting for, they go to the insurers and say we have a new drug. this is what it does. where are you willing to pay? a negotiation occurs.

if that was the case, we would be paying $1 million for every prescription. there are negotiations and the price can be high for a while and it belongs to society for a long time at a low price. that is not the answer. it is not also the answer that it will impact drugs from playing countries. .hat is not safe it toseen jugs and put this country from around the world. i was in an airport one-time and the folks at the airport, the customs people opened the package and it looked like the x-ray machine indicated drugs. there is poison. there are people around the world to make fake stocks. they are very good at making labels look exactly like the

real thing. what i found that that would .edicine that can be poisonous in reporting products from around the world is not safe. what you're doing when you do that is undercutting our system that drives investment into an novation and produces new treatments and yours. .e cannot have it both ways we cannot say we want all the drugs at rock bottom cost and asked the judge industry to make magnificent products. to do is makeve sure the patient does not pay or shepocket what he said should. insurance should become a weather medicare or private insurance -- insurance should be like this. we pay when we are of -- well. and when we are sick, we are

covered. it should not be that when we are sick, we get hit with medical bills we cannot afford. that is morally wrong. with you are familiar different mitchell. he was on this program last week. here is what what -- what he had to say. >> there is no correlation -- many's that he's between the cost of research and development . done companies have monopoly pricing power in our country and so they set the prices as high as they can. the fact is that all 210 drugs approved by the da from 2010 to 2016 are based on science, paid .or by taxpayers to the nih the national institutes of health of the single largest funder of biomedical research in the world. we are paying for that. with thedoes the dust

wonderful drugs is use them for drug that connect any price. we believe we need to restore balance. let's get that innovation but make sure especially with taxpayer drugs that we are getting the prices. i might add one more thing. that is that drug companies do not spend as much as i want you to believe. advertising and marketing been research and development. and: start at the end concerns about advertising and marketing. guest: it is a fallacy that drug companies spend more time on marketing than they do in r&d. all of the expenses that has to do with sales forces, it is not advertising. their sales forces distribute over.products the biopharmaceutical industry

invests or my back in the r&d than any other sector in the country. more than high-tech, more than anything we put back. the first thing he said was absurd. what he said was nih develop stocks and gives them the companies and the company -- companies charge whatever they want. that is a silly thing to say. what the nih does is it gives money to university researchers. they develop new knowledge and then how biology works. producessometimes information. and sometimes they are encouraged by federal law to license those. that is not the only place where companies get their ideas. that is the first mile. run by the miles is

companies. we fundnd way more then the nih. it can take 12 years to get a product to market. and more times, they fail. saying that is not how to we reimburse the companies brought the money they have spent? look at alzheimer's. alzheimer's is costing $250 billion a year now. our failure in finding a treatment for alzheimer's is 100%. our companies have spent billions of dollars to find a treatment for this terribly punishing, brutal disease that might only punishes the patients but their entire family. we failed every time. we suck it up, absorb losses and back at it trying to find new treatments for all slammers. if we kill that process, look at

what we have lost in terms of reduce suffering. will chat with a few more colors before you go. woody, michigan, democrat. caller: i agree with david. i keep hearing james talk about investors. a lot of the investors are the american taxpayers. we are not getting a return on our investments. if -- cannot make it 10 of money on something, they will just not bring it to market. host: that is jesse? caller: woody. -- guest: that is jesse? host: woody. guest: the nih is good. it is important. of thehe smaller part

investment. the investment is made by people . i wouldave a 401(k), imagine some of your dollars are invested in pharmaceutical companies. investments are made by venture capitalists who take high risks in some had of her ward of the end of the process. what -- would up -- without investors, they have no way to take scientists to develop docs. in system is working well terms of our ability to lead the world in innovative products, or atece that is broken least one is people like you are paying out-of-pocket more than they should and that is the moral imperative we have. we have to make sure no one is paying more from their pockets for the drugs that they need.

denver from colorado, republican, good morning. caller: good morning c-span2 mr. greenwich. i have a question. i am coming from a different slant on the job problem, which i am paying enough. i pay for a request. my aetna helps with that. then i was hit with a doughnut hole yesterday. i pay 129 dollars to get that prescription and ida would -- i would like to ask, when is the donut hole going to phase out? when is this penalty? i am stuck with a penalty that medicare has stuck me with. they said i did not have a valid .nsurance coverage i was covered with that for a few years.

, they slappedrred me with a penalty for life so i am paying $50 plus premium on my aetna job -- drug coverage and already pay enough for medicare. if i should have another , i couldy come along not afford another medication. host: let me adjust the donut hole problem. what does that mean? when we created medicare part b program. i worked very hard to make that possible so seniors would have access. before that, there was no payment system, for the elderly and disabled. the patient has to have skin in the game. 25% in theve to pay initial period.

then you hit the donut hole. the beneficiary pays 30%. in payingt results thousands of dollars out of pocket. the bill we supported does away with the donut hole. it changes the structure of the benefit and puts a heart cap on what people like you will have to pay in the course of the year. ,e think it should be something like $200 a month so you do not get hit with all of your months and we are going to work now through the end of the year but we want to make sure every single person who was on medicare is not strapped with unaffordable costs. they paid into the system other lives. they live on fixed incomes, average income of a medicare beneficiary households $29,000. for the government to touch them thousands of dollars, it did --

the stores appearance. people cannot take their jugs because they do not. host: the group is the biotechnology innovation organization. it is bio.org on the internet. mugs aregton journal available at c-span store.org. check out the washington journal mugs, and see all of the c-span products. tonight, a congressional hearing looking at efforts to combat homelessness in the u.s. committeeservices chair maxine waters chaired the hearing in los angeles last week. here is a preview. we cannot ignore that our homelessness crisis is

a link to the affordable housing crisis. too many people cannot afford to keep a roof over their heads. as wages have not kept pace with rising rents. los angeles has one of the least affordable housing markets in the united states. county, a rent earning the minimum wage of $13 -- $13.25 an hour would need to work 79 hours a week in order to afford a two point -- two bedroom apartment. as a result, 721,000 households in the county are civilian -- severely rent burden. meaning they pay more than 50% of their income on rent. a bold and comprehensive response at the federal, state and local level to address the homelessness crisis. that is why i have introduced this bill, the ending homelessness act. legislation that would provide over $13 billion in funding to

ensure every person experiencing homelessness in america has a .lace to call home the financial services committee passed this legislation earlier this year. i am committed to doing everything i can to get this bill passed into law. can watch this entire house financial services committee hearing on homelessness tonight at 8:00 eastern on c-span. and a reminder you can follow our programs online at c-span.org, and listen with the free c-span radio app. saturday on book tv at 7:00 p.m. eastern. in her latest book, author zara looks at the challenges female arab and middle eastern journalists face. authors were pursed through whatever barriers they had and write openly and honestly about their deepest struggles. one of the things that comes to such an account

of grief and loss. it also reflects the state of the arab world today. this is not an uplifting book. at 7:45 p.m. eastern, princeton university professor on race, gender and class in america. her most recent book is "breathe: a letter to my sons." >> the reality is, i have to arm them, not simply with a set of skills and intellectual tools that allow them to flourish in school, and ethics and values, but also ways to make sense of the hostility they encounter every day. from people, at times, lose responsibility is to treat them as community members. media9:00 p.m. eastern, research center and founder on his book "unmasked: big media's

war against trump." >> all decency has been cast aside. not only from donald trump to his opponents, but from his opponents to him. him far worse things. there are attempting to do far worse than him the way he can do to them. they have no right, none. >> watch book tv every weekend on c-span2. joining us from new york is staff writer for the christian science monitor harry bruinius, joining us to talk about socialism in campaign 2020. he took a trip through a county north of out what people think about the issue. among his pieces he has written in this pennsylvania swing county, socialism is a hot topic. thank you for being with us.