In some states, the vote counting went on well past George W. Bush's acceptance speech. And it still hadn't been completed in the few short days it took vanquished Democratic contender John Kerry to pick up right where he left off: challenging the administration to do better on providing healthcare coverage to children.
"It is a disgrace that in the wealthiest nation on earth, 8 million children go without health insurance," Kerry wrote in an e-mail message to some 3 million of the party faithful just days after his concession speech.
The underlying message was clear: The election is over, but the long-fought war between the political left and right over healthcare in America appears far from over.
Even if the timing of Kerry's missive took Capitol Hill observers by surprise, there was no great shock that the Democrat would seize on healthcare as the first issue of a new shadow campaign for the 2008 election. But Bush and the Republican Party leadership also wasted no time in using expanded majorities in the House and Senate to ram through the first healthcare issue of their own: swiftly approving a measure that would allow more insurers and public health groups to stop funding abortions. Pasted into the $388 billion domestic spending bill was another provision to spend $100 million to start to rectify an embarrassing embroglio that popped up as an issue in the waning days of the campaign: making sure that the country never again would face a flu season without the needed vaccines.
"Good for biotechnology"
From Wall Street's perspective, Bush's election was a major boon to publicly traded healthcare companies. And one of the biggest winners in Bush's reelection was the biopharma industry. Drug stocks - threatened by Kerry's promise to permit reimporting drugs from Canada - were among the first to take off on the morning of November 3 in a market rally that cheered the election results. All the big pharma companies had drugs that would have had to compete with cheaper imports. And under Bush, the Food and Drug Administration has been an avowed opponent to reimporting drugs, claiming it would threaten the United States with an unsafe supply of drugs.
"I think in general Bush's election is probably good for biotechnology," says SG Cowen biotech analyst Philip Nadeau. "All of biotech takes leadership from the large cap space, and the large caps would probably have been under pressure from a Democratic administration that was focused on pricing and the negotiation of pricing by the government. With Bush in there, it probably is going to be a little easier for big pharma and to a lesser extent biotech. When large cap biotech stocks are working, then money flows up the risk curve and also allows them to work."
But other analysts have also been quick to offer their opinion that even with Bush renewing his lease on the White House, the growing grassroots support for reimportation would likely keep the issue on the front burner.
"We believe enthusiasm could be short-lived given that fundamental pharmaceutical industry issues, including pricing pressures, remain unchanged," Merrill Lynch analyst David Risinger summed up as he reviewed the numbers from election night. "Political pressures on the drug industry are unlikely to ease in 2005."
Political pressures on the FDA, meanwhile, have not only failed to ease in the post-election period, they are growing at a fierce rate.
FDA in the spotlight
In the latest attack on the FDA's role in regulating the nation's drug supply, a new study published in the Journal of the American Medical Association concluded that Bayer AG was too slow in pulling its anti-cholesterol drug in 2001. Where were the regulators, critics asked.
For the agency, it was just the latest in a string of headlines that have questioned the FDA's willingness to protect consumers over drug interests. The agency is already embroiled in a dispute over the way safety experts inside the FDA are treated. Dr. David Graham, one of its top safety researchers, claimed the spotlight in testimony to Congress that the agency had left the U.S. defenseless against another drug like Vioxx, which was pulled years after Merck's own studies had highlighted a link between Vioxx and elevated risks of heart attacks and strokes.
To make his point, Dr. Graham pointed to five drugs on the market that needed serious study to determine if they were actually safe as prescribed. And his comments followed earlier missteps on the use of antidepressants among teens and the sudden loss of half of the nation's supply of flu vaccine.
And to add insult to internal injury, the Journal of the American Medical Association has recently slammed the FDA in an editorial calling on the federal government to create a new safety review board - independent of the FDA.
Stem cell research
One group of stocks that didn't respond well to the Bush victory celebration were those from stem cell companies. Early in his first term President Bush moved to limit research into embryonic stem cells to a few dozen existing lines on moral grounds - satisfying religious conservatives who were opposed to destroying embryos for scientific research.
California voters, though, OK'd a provision that would provide $3 billion in public funds to support stem cell research activities. And within days there were signs that at least a few stem cell companies would relocate to California as a result of the initiative - which was backed by popular Republican governor Arnold Schwarzenneger
Whatever the issue of the day, though, the underlying reason why healthcare issues will stay on the front burner of American politics has more to do with rising costs than any other factor. As states all over the country - including Tennessee, Mississippi and Texas - do more to restrict access to state programs for low-income residents, the trend will continue to push up the number of uninsured in the U.S. Overall employer-provided insurance coverage, meanwhile, has plunged from 67 percent to 63 percent between 2001 and 2003, according to a report out from the Center for Studying Health System Change, a figure that leaves nine million more people exposed.
And as long as costs are rising for both providers and patients, there's no end in sight for the debate over who in the United States will pick up the tab - whether its an election year or not.