In countries with social health care systems, including most European countries and Canada, we understand the pressures on governments to improve public health while effectively managing limited health care resources. In these countries, we advocate for health care policies that address the interdependent goals of:

Merck advocates for these goals through public policy forums and publications. Examples include:

• During the past decade, Merck has supported and actively advocated for the World Health Organization (WHO) Health for All (health targets) initiative, encouraging a "management by objectives" approach to health policy decision making and the efficient use of resources, which would also make "headroom" for greater access to innovative medicines. In 2008 we partnered with the European Observatory on Health Systems and Policies, an affiliate of the WHO Regional Office for Europe, to support their continued research on health targets and their new book, Health Targets in Europe: Learning from Experience. Merck also provides support to EuroObserver, the quarterly newsletter of the European Observatory.
• Merck has sponsored the European Health Forum Gastein, a congress of stakeholders from government, academe, industry, patients and the nongovernmental organization community, for over 10 years, collaborating with public health stakeholders to stimulate public discourse on issues related to health systems performance.
• Merck provides support to the London School of Economics' Eurohealth, an independent quarterly publication of current health policy issues. In 2008, Eurohealth published a special issue on the effects of cost containment policies on innovation and access to medicines.
• Starting in 2007, to celebrate the opening of our new regional office in Munich, Merck initiated a series of annual symposia on Access, Innovation and Affordability of Medicines (http://www.msd-forum.com/). The symposia seek to create a platform for policymakers, academics, patient groups and the media to discuss the most important issues facing the future of pharmaceuticals. The second symposium took place in Istanbul in October 2008.
• Merck also has been involved in the Bremen Process, which began in March 2007 when the German Presidency of the European Union held a conference in Bremen, Germany, on "Partnership & Responsibility - Together against HIV/AIDS." Merck supported the Declaration that arose from the meeting, which called on all public health stakeholders to join together and take action to support HIV and AIDS-related activities for poorer populations of Central and Eastern Europe. Merck has subsequently initiated discussions with Bulgaria to assess and address their HIV and AIDS challenges.

In the United States - Covering the Uninsured

"I told President Obama today that Merck will continue working with his administration and Congress to achieve real health reform this year and to resolve the affordability and access barriers that deny too many people medical care. We believe health reform, if done properly, will be good for patients and align perfectly with our mission."
— Richard T. Clark, Chairman, President and CEO, Merck & Co., Inc., May 13, 2009

In the United States, more than 45 million people —  eleven percent of which are children under the age of 18 — do not have health insurance and are at risk of missed health care, premature death and medical debt.¹ Merck believes that all Americans regardless of age or income should have access to quality, affordable health insurance coverage. Without coverage, our health care system will not deliver its full value to all. Merck advocates for health system reform and coverage for the uninsured that supports the following broad principles:

• Reforms should rely on market-based competition to improve quality, control costs and continue to encourage the innovation that has made the U.S. system deliver some of the best and most effective health advances and care in the world.
• Reforms should build upon the existing public/private health care system. There are important roles for both government and the private sector in providing and financing coverage.
• Reforms should reflect shared responsibility among all, including individuals, government, and employers. This responsibility should include fiscal responsibility to ensure that change is affordable and sustainable. We believe all individuals should be required to purchase health insurance, every employer should provide insurance or pay into a fund, and the government should provide subsidies or insurance for those who cannot afford it.
• Reforms should address not only the issue of coverage but also the need for broad reforms in our health care system to improve value, promote efficiency and enhance the quality of care.  Such improvements should include increasing research and public dissemination of cost and quality information, including increased price transparency at the point of service, as well as enhanced use of health information technology such as electronic personal health records.

While there are a variety of paths to achieving universal coverage that would be consistent with the Company's principles, Merck has identified specific policies that we believe would make universal coverage possible. To learn more, please click here.

Merck advocated strongly in the United States for reforms that enabled the inclusion of medicines in the Medicare program that provides health care to seniors. In 2003, the U.S. government enacted the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). The most significant of these changes was the establishment of a new Medicare drug benefit (Medicare Part D), which gave all Medicare beneficiaries, regardless of income, access to comprehensive, federally subsidized, outpatient prescription drug coverage. Merck strongly supports the competitive, private-sector design of this Medicare prescription drug benefit and is encouraged by analyses that show that the new benefit is delivering real value to people with Medicare. For example, the Centers for Medicare and Medicaid Services (CMS), credits competition among private plans for helping to lower the average monthly premium for a Medicare drug plan to just $25—one-third lower than the 2005 government estimate.

Key policy issues we advocated for in the United States at the state and Federal level in 2007- 2008 included:

• Support for improving access to Medicare prescription drug coverage for low income beneficiaries.
• Support for modifications to Medicare that would improve beneficiary access to preventive vaccines.
• Support for state-sponsored drug discount programs for the uninsured.
• Support for state-sponsored prescription clearinghouse organizations that assist patients in getting coverage or, if necessary, easier access to multiple manufacturer patient assistance programs.
• Improved federal funding for public health vaccine programs, including support for increased federal Section 317 funds and state general funds to strengthen state immunization programs; support for coverage of adult vaccines by state Medicaid programs; and support for expansion of federal Vaccines for Children Program to include coverage for under-insured children at public health clinics.

Click here to review Merck's public policy position statement on the uninsured/health care reform in the United States.

The content on this page was last modified on September 15, 2009.

Merck & Co., Inc., Whitehouse Station, NJ, USA, and Schering-Plough Corporation, Kenilworth, NJ, USA, are now one company. We have combined our global operations under the name Merck & Co., Inc. We are working to update our corporate responsibility Web site to reflect our new, combined, global organization.

¹ DeNavas Walt C, Proctor BD, Smith J. Income, Poverty and Health Insurance Coverage in the United States: 2007. U.S. Census Bureau, Current Populations Reports, Washington, D.C., 2008.