No final de junho, a Gilead Science anunciou o preço do remdesivir, o primeiro tratamento aprovado nos EUA para a COVID-19. O medicamento não melhora as chances de sobrevivência do paciente – na melhor das hipóteses, acelera a recuperação e diminui a necessidade de hospitalização de quinze para onze dias, de acordo com um estudo do National Institute of Allergy and Infectious Diseases.
Embora não seja uma cura milagrosa, o preço definido pela Gilead pode te fazer acreditar que fosse. Para receber os seis comprimidos do medicamento necessários para o tratamento, as companhias de convênio serão cobradas em $3.120 – uma margem e tanto para um medicamento cujo custo total de produção é de $10. O argumento da Gilead é que a redução de gastos em cuidados hospitalares forneceria economias que justificam o preço.
Esse preço é reservado para os pacientes estadunidenses com planos de saúde. Em outros países desenvolvidos, seus sistemas de saúde pagarão 25% menos pelo remdesivir. (O mesmo preço com desconto também está sendo aplicado a agências governamentais dos EUA, especificamente hospitais voltados a veteranos e o Departamento de Defesa, que compram medicamentos prescritos sem intermediação).
Por que a discrepância, a despeito do fato de que os contribuintes estadunidenses gastaram $70 milhões para desenvolver o medicamento na forma de subsídios do Instituto Nacional de Saúde? É simples, praticamente qualquer outro país desenvolvido no planeta possui alguma forma de sistema universal governamental e regula o preço de medicamentos sob prescrição em seu sistema.
Esse não é o primeiro – e nem mesmo o mais escandaloso – exemplo da Gilead explorando os estadunidenses por um medicamento que o dinheiro dos seus impostos ajudou a desenvolver. A companhia vende remédios para Hepatite C como Sovaldi e Harvoni. Inicialmente, esses medicamentos custavam mais de $1.000 por pílula nos Estados unidos, mas eram encontrados a por volta de 60% desse preço na Europa.
O preço era tão excessivo que, mesmo quando foi reduzido a $500 por pílula nos EUA, médicos de Sloan Kettering e do Centro Para Inovações Biomédicas do MIT sugeriram que seria uma economia geral de custos se o governo federal simplesmente comprasse a Gilead, pagando aos seus acionistas um prêmio de 30%, e ao mesmo tempo pagasse o débito de $26 bilhões da companhia. À época, isso teria custado $156 bilhões aos contribuintes, mas teria reduzido o custo do tratamento por paciente de $42.000 para $15.700, ao mesmo tempo em que eliminaria inteiramente o custo para pacientes que estão cobertos pelos planos de saúde públicos, juntamente dos militares da ativa, funcionários dos governos estaduais e federal e veteranos.
Quando falam sobre os altos preços de medicamentos nos Estados Unidos, democratas têm apresentado uma miscelânea de soluções. A normalmente mais falada permite a importação de medicamentos mais baratos de outros países e que o plano de saúde público negocie preços com produtores de medicamentos sob prescrição. A verdade é que essas medidas seriam de grande serventia e economizariam muito dinheiro dos consumidores estadunidenses, mas a raiz do problema precisa ser atacada.
O que torna os EUA não competitivos em relação ao resto do mundo nesse aspecto é o fato de que seu sistema, que abrange milhares de planos de seguro, é simplesmente ineficiente e leva consumidores a pagar preços mais altos por medicamentos sob prescrição.
Essa ineficiência não é apenas um número na planilha de Excel de um contador. Esses custos serão pagos, em última instância, em sofrimento humano. Se um medicamento que nem ao menos cura o coronavírus custa às companhias de planos de saúde milhares de dólares, imagina qual será o custo de um medicamento que realmente funcione. As empresas dos planos de saúde não vão simplesmente engolir esses preços mais altos – vão passá-los adiante na forma de tarifas, cobranças de co-participação e franquias, aumentando os custos para os consumidores e empresas. Ao fim e ao cabo, esses custos significarão menos acesso à saúde.
Oponentes de sistemas públicos de saúde adoram nos lembrar de que nada é gratuito. Esse mesmo princípio deveria ser considerado para as milhões de pessoas que possuem um plano privado de saúde. Nos EUA o atual sistema de saúde os condena a pagar o que na prática representa um imposto de 33% sobre o remdesivir. Quando uma vacina for desenvolvida, os consumidores americanos dos planos de saúde podem esperar ter de pagar novamente essa taxa.
Repetidamente ao longo dos debates das primárias de 2020 do Partido Democrata, moderadores e democratas moderados defenderam os planos privados de saúde, se passando por defensores dos consumidores presos a eles. O preço do remdesivir é ainda outro exemplo de como esses políticos, junto dos interesses e lobbys corporativos que os apoiam, estão satisfeitos em tratar as pessoas que dependem de seguradoras privadas de saúde como os otários do sistema global de saúde.
A única maneira de acabar com esse tipo de vigarice é dar um fim ao sistema privado de seguradoras cuja ineficiência, fundamentalmente, está na raiz do problema.
Aqueles que continuam a argumentar contra um sistema público e universal de saúde precisam explicar porque estão defendendo um sistema privado de seguradoras que, por seu próprio projeto, esfola seus consumidores.
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