Healthcare has featured predominantly in President Obama’s $4 trillion budget submitted to the US Congress and observers have focused upon plans to let the government negotiate the price of drugs, his precision medicines initiative and a proposal to tax the foreign earnings of firms such as Pfizer and Merck & Co.

The president has proposed that the Department of Health and Human Services request proposes a budget authority of about $1.09 trillion for fiscal 2016, up from $1.04 trillion in fiscal 2015. Of that, $83.8 billion is discretionary funding, an increase of $4.8 billion from fiscal 2015.

One key proposal is that the HHS would be granted the power to negotiate with drugmakers over the price of specialty therapies under the US government's Medicare Part D programme, which offers private coverage for senior citizens and the disabled. HHS Secretary Sylvia  Burwell said the move will help with the sky-high cost of some treatments.

Industry against price negotiation

However, commentators across the pond believe the proposal is unlikely to come to fruition, predicting opposition from Congress and industry. The Pharmaceutical Research and Manufacturers of America’s president John Castellani said that “while we support collaborative public and private efforts to advance biomedical research, the president’s budget includes harmful and misguided proposals that could undermine seniors’ access to care in the successful Medicare Parts D and B programmes and would hinder the development of new, life-saving medicines for patients.

Pres Obama also proposed a $215 million investment for his Precision Medicine Initiative, including $130 million for “a voluntary national research cohort of a million or more volunteers to propel our understanding of health and disease and set the foundation for a new way of doing research through engaged participants and open, responsible data sharing”. Some $70 million would go to the National Cancer Institute to scale up efforts to identify genomic drivers.

Other highlights of the budget include a proposal targeting US companies' offshore profits with a one-time 14% tax to build a "21st century infrastructure,” to be used to repair roads, bridges and so on. Pres Obama also proposed setting up a separate agency to regulate food products, including possibly dietary supplements, which are currently covered by the US Food and Drug Administration. Meantime, the latter’s budget request is $4.9 billion, up 9% from 2015.