Voters said a big no to Big Soda, yes to pot and Big Pharma. And Obamacare?

Although many Americans remain saddened or exultant  by the results of the  presidential vote, the November ballot produced key health-related results worth a quick post-mortem:

• Big Soda lost big after spending big to defeat new taxes aimed a cutting consumption of sugary, fizzy drinks.
• Big Pharma, which also dropped a lot of money, successfully beat back an effort to contain its products’ prices.
• Marijuana advocates advanced legalization across the country, with California, Massachusetts, and Nevada voters approving ballot measures allowing recreational use. Florida, North Dakota, and Arkansas voters OKd medical marijuana ballot measures, and Montanans eased their state’s pot laws.
• The fate of the Affordable Care Act, aka Obamacare, grew even more unsettled with victories giving the GOP control of the presidency, as well as the U.S. House and Senate. But ….

Big Soda: Voters in the northern California cities of San Francisco, Oakland, and Albany joined residents of Boulder, Colo., in approving new soda taxes in what analysts are calling a “devastating” defeat for soft drink advocates. The campaign in the Bay Area alone became costly, with the two sides spending an estimated $50 million. Big Sugar and Big Soda found themselves battling health-minded billionaires and public health experts in decrying the harms, particularly in kids, caused by excess sugar consumption, especially through soda drinking. Voters in Philadelphia earlier this year rejected Big Soda-financed campaigns to enact soda taxes, which also are in place in Mexico. Even as soft drink consumption continues to decline, the industry also soon may see new beverage taxes enacted in Cook County, Ill. (the Chicago area) and perhaps at the federal level, says the Wall Street Journal. I’ve written about the sugary beverage taxes, and the unsavory roles that Big Soda and its cousin Big Sugar have played in trying to sway research on their products’ health harms.

Big Pharma: California voters, barraged by almost $130 million in campaign spending, defeated by a 54-46 margin a proposal to curb skyrocketing prescription drug prices. The state’s Proposition 61 sought to lower those prices by requiring that state agencies pay no more for medicines than the federal Department of Veterans Affairs. The measure was supported by U.S. Sen. Bernie Sanders of Vermont and others who wanted the nation’s largest state to try to hold the line against Big Pharma and its skyrocketing prices. The industry and its supporters said the ballot measure wouldn’t work and it might cut off some Californians from medicines they desperately need. This ballot measure became one of the most expensive in the state’s history, the Los Angeles Times says.

Marijuana: America’s not just a red-versus-blue nation. It also split on Election Day into a green and not so country, as more states approved recreational or medicinal use of marijuana. Ballot measures from coast to coast, especially with sprawling California joining the recreational use states, create a challenge for federal officials, who must enforce drug laws restricting pot use, President Obama has said. Republicans have taken a tougher stance against legalized pot, whether for recreational or medicinal use. I’ve written on how pot legalization creates growing concerns about road safety. Colorado and Oregon pioneered recreational use, and serious public policy research is under way on the issue.

Obamacare: The day after Donald J. Trump was elected president, more than 100,000 Americans raced to sign up for Obamacare health insurance during what some analysts saw as an already “doomed” annual open-enrollment period. What’s clear about Obamacare, however, is what isn’t: Although the GOP made it a signature element of the 2016 election campaign that the party would “repeal and replace” the ACA, a lot can and will happen before that pledge may be fulfilled. The president-elect may not agree with his allies on the Hill, as he already has suggested he will keep parts of Obamacare, which won’t be easy to wipe away after it has been in place for years now. The health care industry is powerful and deeply invested in many aspects of the ACA, and though caught short by the GOP sweep, its political force has yet to be felt on Obamacare’s future. Although there are direct presidential steps that could be taken to gut the ACA, the governor of Kentucky, for one, has found how politically parlous it can be to cut big chunks of the population off from health coverage. If the politicians truly want to show that a new day has dawned, they could stop the bitterly partisan nonsense about so crucial an issue as Americans’ health care—especially its access, quality, safety, and affordability. I’ve said before that it’s insufficient to keep repeating that Obamacare must be repealed and replaced. With what? How will our health care be better with an alternative?