Sen. Orrin Hatch, a Utah Republican who retires in the Senate for 42 years as a new generation is sworn in, leaves behind a long list of achievements in health care. Some were less controversial than others.
Hatch played a pivotal role in the 1
"AIDS does not play favorites," Hatch told other senators. "It affects poor and rich, adults and children, men and women, rural communities and inner cities. We know a lot, but the fear remains."
Hatch, now 84, has over the years accompanied a number of bills with Democrats often with the late Senator Ted Kennedy of Massachusetts. The two men were sometimes referred to as "the odd couple" because of their politically mismatched friendship.
In 1997, the two proposed a broad new child health care network – the Child Health Insurance Program.
"This is an area of great progress and we should all be proud of it – and Senator Hatch should as well," says Joan Alker, executive director of the Georgetown University Center for Children and Families.
Before CHIP was passed, the number of uninsured children in America was around 10 million. Today it is less than half of it.
Hatch influenced American health care partly because of the sheer number of bills he had sponsored or sponsored – more than any other living senator – and because he was chairing several powerful senate committees.
"The story was on its side because the Republicans were responsible," Dr. David Sundwall, professor emeritus of public health at the University of Utah and Hatch's health director in the 1980s.
In the election of Ronald Reagan president in 1981, the Senate was controlled for the first time in decades by the Republicans. Hatch has been appointed Chairman of today's Health, Education, Labor and Pensions Committee, which oversees the Food and Drug Administration, Disease Control and Prevention Centers and the National Institutes of Health.
"He was virtually catapulted into this role of chairmanship," says Sundwall. "It is amazing that in his first term in the Senate he chaired a roof committee."
In 2011, Hatch was also appointed to the influential Senate Finance Committee, where he later assumed the chairmanship. There he helped monitor the Medicare, Medicaid and CHIP national health programs.
Hatch's growing influence in Congress has not gone unnoticed by healthcare lobbyists. According to the watchdog organization Center for Responsive Politics, Hatch has been in third place for contributions from the pharmaceutical and healthcare sectors over the last 25 years of funding political campaigns . (This is behind the Democratic Senators who ran for higher office – President Barack Obama and Presidential Candidate Hillary Clinton.)
"Obviously, he was the PhRMA man on the hill," Dr. Jeremy Greene, who refers to a trading group that represents the pharmaceutical industry companies. Green is Professor of History of Medicine at the Johns Hopkins University School of Medicine. Despite Hatch's commitment to lowering drug prices, Greene says the senator's report is mixed in the regulation of drug companies.
An important element of Hatch's legislative legacy, for example, is the 1984 Hatch-Waxman Act, co-authored with then-Rep. Henry Waxman, an influential Democrat from California. Although the bill promoted the development of cheaper generic drugs, it also rewarded brand companies with expanding their patents for valuable drugs.
The law has pushed the sale of cheaper generic drugs, according to Greene. However, the drug makers soon learned how to exploit the weaknesses of the law.
"Manufacturers of brand name drugs began to make ever larger networks with multiple patents for their drugs," says Greene, in order to obtain their monopolies after the expiration of the original patent
Other brand manufacturers have preserved their monopolies, by paying for generic manufacturers to not compete.
"These pay-for-delay deals are effectively dependent on part of the Hatch-Waxman Act," says Greene.
Hatch also worked closely with the nutritional supplement industry. The multi-billion dollar industry, which specializes in vitamins, minerals, herbs and other "natural" health products, is focused in its native state of Utah. In the early 1990s there was disagreement over whether dietary supplements such as foods or more strictly such as drugs should be regulated.
"There was really no room for these natural health products," says Loren Israelsen, president of the United Natural Products Alliance and a Hatch employee in the late 1970s.
In 1994, Hatch funded the DSHEA Supplementary Dietary Services Act (DSHEA).
"It was necessary to have someone who was a champion who would say," All right, if we need to change the law, what's the situation? and, let's go ", says Israelsen.
Some legislators and consumer representatives demanded that vitamins and other dietary supplements undergo a rigorous approval process, similar to food testing and drug administration requires drugs. However, DSHEA has established itself in the FDA and found that nutritional supplements do not have to meet the same safety and efficacy standards as prescription drugs.
This regulatory regulatory bottleneck has led to continuing questions as to whether dietary supplements actually work and concern about how they work together Patients may be taking other medicines.
DSHEA was co-sponsored by Democrat Tom Harkin, the then Senator from Iowa.
While this type of two-party career spanned much of Hatch's career, this has been less obvious in recent years. He strictly rejected the Affordable Care Act and in 2018 cited heathen lawmakers among the "stupidest fools" he'd ever met. (Hatch later described the remark as "a poorly worded joke.")
In his farewell address to the Senate in December, Hatch lamented the polarization that had overtaken Congress.
"Gridlock is the new norm," said. "Like humidity, partiality permeates everything we do."
This story is part of a report partnership to which KUER, NPR and belong to Kaiser Health News .