Health Care – Page 8 – The Wrongologist

Politics Is Usually Not The Answer

For the first time in his six SOTU speeches, the president’s economic message on Tuesday was not: “yes, the economy’s weak, but it’s getting stronger” or “we’re on the right path, but we’re not out of the woods.” Instead, he called 2014:

A breakthrough year for America, [as] our economy is growing and creating jobs at the fastest pace since 1999. Our unemployment rate is now lower than it was before the financial crisis. More of our kids are graduating than ever before; more of our people are insured than ever before; we are as free from the grip of foreign oil as we’ve been in almost 30 years.

He added: “this is good news, people!” What President Obama meant was, now that we’ve have sustained economic growth in place, we need to start talking about the policy agenda that will give all of us a chance to benefit from that growth.

But the spin afterwards spoke about things like “leadership”, “redistribution” and “class warfare” that the many, many GOP presidential candidates and their surrogates will parse incessantly, without offering any solutions for our economic future, or those domestic problems that continue to dog America.

Speaking of politics that have not led to solutions, Mr. Obama spoke of his opening with Cuba. Here is what he said:

In Cuba, we are ending a policy that was long past its expiration date. When what you’re doing doesn’t work for 50 years, it’s time to try something new. And our shift in Cuba policy has the potential to end a legacy of mistrust in our hemisphere. It removes a phony excuse for restrictions in Cuba. It stands up for democratic values, and extends the hand of friendship to the Cuban people. And this year, Congress should begin the work of ending the embargo.

But anti-Castro politics, mostly fostered by Republicans, have embargoed some things that have potentially really cost American citizens. No, it’s not Cuban Rum. The Cubans have developed a drug called Heberprot-P, that appears to be very effective in curing advanced foot ulcers in people with diabetes. It could have been licensed for US clinical trials since 2007. It is patented in over 30 nations, including here in the US, and in the European Union.

Most of us have never heard of Heberprot-P. The drug uses a form of epidermal growth factor (EGF) to help regrow cells lost to diabetic foot ulcers (DFU). According to the American Diabetes Association, DFU causes about 73,000 non-traumatic lower-limb amputations in US adults aged 20 years or older who were diagnosed with diabetes.

The idea behind Heberprot was developed in St. Louis years before the embargo by biochemist Stanley Cohen and neurophysiologist Rita Levi-Montalcini. They received the 1986 Nobel Prize in Medicine for their discoveries of epidermal and nerve growth factors. They discovered that protein recumbent epidermal growth factor stimulates cell growth. The Cubans applied that idea to foot ulcers.

Because of the embargo, we haven’t brought the drug to the US for clinical trials. But, Mr. Obama could immediately license the import of Heberprot-P without waiting for Congress to debate the end of the embargo.

In fact, US scientists heard first hand from Cuban scientists about the Heberprot-P at two forums held here in 2014. One of them was a meeting of the Conference on the Management of Diabetic Foot Ulcers (DFCON, 2014), the largest meeting of US professionals treating patients with this ailment.

So, despite the politics and the hurdles presented by Cuban-American politicians, the President could license the importation of the drug for study and use in clinical trials, followed by an application for approval of Heberprot-P by the Food and Drug Administration. It could then be researched further by American scientists that wish to test different cell growth rates using incubation equipment and see if this treatment could in fact be applied to helping the regrowth of lost cells in humans due to DFU.

In fact, there is a precedent. In July, 2004, the federal government permitted a California biotechnology company to license three experimental cancer drugs from Cuba. That required permission from the Treasury Department’s Office of Foreign Assets Control.

At the time, a State Department spokesperson said that an exception had been made because of the life-saving potential of the experimental Cuban drugs. A government condition of permitting the license required that payments to Cuba during the developmental phase were to be in goods like food or medical supplies, which are permitted under the embargo, while there are rules against providing the Cuban government with foreign currency. In 2004, the ruling was that after drugs reach the market, payments could be half in cash.

Many Americans are mutilated or die every year because of diabetic foot ulcers. First the toes go, then the feet, and later the legs. Death often follows.

And this drug could have been available for trials since 2007 and wasn’t, because of politics?

We should ask Republican politicians why. Maybe the Republican agenda has been helped by calling the Castro brothers sponsors of state terrorism, but it hasn’t done anything to help people with diabetes in the US keep their toes and feet.

Democrats Have Lost America

Members of Congress will formally take their oaths of office on their respective chamber floors when the 114th Congress convenes at noon today.

But even as the new Congress gets sworn in, and Democrats dutifully take up their positions in the minority, It is important to realize that Democrats have taken their collective eye off the ball in the states for the past 6 years: Not only do Republicans control Congress, they control an overwhelming majority of state legislatures as well, including 100% control (legislative and executive) of 24 states.

Despite the Democrats’ obsessive focus on holding the Senate and winning the presidency, DC was not the only battlefield; there was a huge battle for control of the states. The WaPo reported this week that the battle is over. Republicans now control 31 governorships and 68 of 98 partisan legislative chambers.

Before Election Day 2014, the GOP controlled 59 partisan legislative chambers (most states have two chambers, some only one) across the country. The increase to 68 gives Republicans six more chambers than their previous record, set twice after special elections in 2011 and 2012.

Republicans also reduced the number of states where Democrats control both the governor’s office and the legislatures from 13 to 7.

While pundits everywhere are talking about what is going to happen in Washington in 2015, we should spend a little time preparing for a new wave of conservative state laws. Republicans plan to launch fresh assault on:

• Common Core education standards, the national standards adopted by 46 states and the District of Columbia. Opposition on the right has led three states — Indiana, Oklahoma and South Carolina — to drop out of the program. Some states will attempt to join those three in leaving the program altogether. Others will try to change testing requirements or prevent the sharing of education data with federal officials.
• Abortion regulations: Measures to ban abortions after 20 weeks of pregnancy will advance in Wisconsin, South Carolina, West Virginia and Missouri.
• Corporate and personal income taxes: Arkansas, Arizona, North Carolina, and North Dakota will prioritize cutting personal or corporate income tax rates.
• The power of labor unions: Republicans in nine states are planning to use their power to pass “right to work” legislation, which would allow employees to opt out of joining a labor union. 24 states already have such laws on the books, and new measures have been or will be proposed in Wisconsin, New Mexico, New Hampshire, Ohio, Colorado, Kentucky, Montana, Pennsylvania and Missouri.
• Environmental Protection Agency: A dozen states have challenged proposed EPA regulations on power plants in federal court.
• Challenges to State Pension Programs: Many states will try to deal with underfunded pension plans, which threaten to swamp state budgets over the long term. In Illinois, where the state pension is funded at less than 40%, Gov.-elect Bruce Rauner (R) made pension reform a cornerstone of his 2014 campaign, while fights are brewing in Kentucky and in New Jersey.

All of the above is partly the result of a sustained campaign by Republicans to reduce voting. It is also partly the result of Democrats deciding that Congressional and state political campaigns can be won even without addressing the real issues or the real record of the two parties.

Democrats are facing a long, brutal slog in the states and in the Congress. Mr. Obama gets elected twice, and by a greater margin the second time, yet his party loses control of almost everything else, now politically controlling just 7 states.

What does this say about 2016? Will Hillary have enough coattails to move some legislatures or Senate seats, or will she be the second coming (politically) of Mr. Obama?

Finally, the next time some moron tells you that both parties are the same, remind that person what is about to happen in the states, specifically, the undoing of the social contract that is about to take place. The next time somebody tells you one vote doesn’t count, tell them it doesn’t count unless you cast one.

Maybe Democrats need to get off their duffs and do something about this.

How Do You Honor The Troops?

Veteran’s Day came into being on June 1, 1954 as a date to honor all who served in the US Military. Memorial Day is a day for remembering those who died while serving in the Military. We celebrate Veteran’s Day on the date of the WWI armistice, the 11th day of the 11th month in 1918 that ended the fighting. That was exactly 96 years ago today.

Veteran’s Day brings the reflexive, “thank you for your service” from everyone in America. The two things the average person could do to honor the service of veterans are to vote, and to make sure that Vets get the health care they need when they come home. Sadly, we do neither:

People: If you say that veterans died to protect our freedoms, you dishonor them when you don’t vote!

The Census Bureau reports that in 2013, 3.6 million veterans had a service-connected disability, with 957,504 having a rating of 70% or higher. Severity of disability is scaled from 0 to 100%, and eligibility for compensation depends on the rating. Let’s also remember that Post Traumatic Stress Disorder (PTSD) is at epidemic levels among Vets, as is suicide. According to a study by the Department of Veterans Affairs, 22 Vets a day commit suicide. You all know we continue to do a terrible job taking care of returning veterans, and you should be finding out why, and pushing your congressperson to finally fix it!

Veterans rapidly are becoming a two-age group cohort. The Census Bureau report shows that most Vets are getting older, with 47% over the age of 65. Tom Dispatch reports that today’s military is made up largely of Millennials. In fact, with nearly 43% of the active duty force age 25 or younger, and roughly 66% of it 30 or under, it’s one of the most Millennial-centric organizations around.

How the “entitled” generation will perform as our protectors is still up in the air. An NIH study determined that people in their 20s have Narcissistic Personality Disorder at a rate three times that of people 65 or older and a recent survey by Reason and pollster Rupe found that 18-24 year olds are indeed in favor of participation trophies while older Americans overwhelmingly favor winners-only prizes.

Millennials may yet surprise even a cantankerous coot like the Wrongologist. Time will tell.

Here are two terrific, but very under-appreciated tunes for Veteran’s Day. We start with “1968” by Dave Alvin.

Sample lyric:
And tonight in this barroom he’s easin’ his pain
He’s thinkin’ of someone, but he won’t say the name
Folks say he’s a hero, but he’ll tell you he ain’t
He left a hero in the jungle, back in 1968.

Here is another almost unknown song “I’m Writing in the Margins” from the album of the same name by John Gorka about a soldier in Afghanistan:

Sample lyric:
I am writing in the margins
Notes to me and you
Cause the pages are all filled
With new orders coming through

There are not a lot of rich boys
Wearing DCUs and sand
But I’ll think about that later
When I make it home again

(DCUs are Desert Camouflage Uniforms)

There is a great story told about a T-Shirt worn long after the war by a Vietnam Vet. On it was the outline of a map of Vietnam, superimposed with:

Participant, Southeast Asia War Games, 1961-1975: Second Place.

Huge thanks to the guys/gals who follow orders, who do really hard and dangerous things and who too often pay a high price for doing so.

Sources:

Monday Wake Up Call –November 10, 2014

OK, we just had our bi-annual vote to rearrange the deck chairs, and boy, people were angry. But what good will come of it is difficult to guess. This we do know: According to a CNN exit poll, 8 in 10 Americans disapprove of how Congress has been handling its job, while almost 6 in 10 are displeased with President Obama; 44% have a positive view of Democrats; 40% have a positive view of Republicans.

So, Americans elected the party they like the least to run the part of the government they trust the least.

There’s a lot of discussion of how and why Democrats did so badly, and much of it focuses on messaging. The litany of excuses is long: Democratic candidates were arrogant. The White House failed to transfer money, or stump effectively. The GOP caught up in the technology race, or the GOP recruited excellent, disciplined candidates.

Democrats ran on everything but?policy. Did the Democrats run the government well? Are the lives of voters better? Are Democrats as a political party credible when they say they’ll do something?

Their message was based on a group of poll-tested ideas that they thought would appeal to mainstream voters. But, the message, “vote for us, we’re not right-wing fanatics” didn’t cause the majority of us to turn out for the election. In fact, turn out was the lowest it had been in 40 years.

Liberal ballot propositions won in various parts of the country last Tuesday, from marijuana products (like https://www.cheapbudcanada.com/marijuana-products/vape-pens/fatboyz-disposable-thc-vape-pen/, for instance) to the minimum wage. Democrats didn’t. That should tell the Democratic Party something. Liberal policies can resonate with the public. It would be nice if there was a party which could embody and fight for those ideas.

So what would be a winning message? The economy. There’s infrastructure work to be done. The private sector could hire people to do it with government money. There are hungry people who need to be fed, and homeless people to be housed. And, ending our adventures in the Middle East would improve our lives.

“Vote for us, we bring peace, prosperity, and weed” – that slogan just might get you somewhere.

Keeping with the spirit of a new politics, here is your wake-up tune of the day. It is “Uprising” by Muse, released in 2009. So get upright and rock out:

Sample lyrics:
Rise up and take the power back
It’s time the fat cats had a heart attack
You know that their time’s coming to an end
We have to unify and watch our flag ascend
(so come on)

They will not force us
They will stop degrading us
They will not control us
We will be victorious

Here is your breakfast buffet of linkage:
Connecticut’s Democratic Governor was reelected, running as a progressive: It was close, but Dan Molloy won bigger this time against the same conservative opponent.

A case for treating health care and hospitals as utilities: Conservatives have won the battle to eliminate much of the government control in quasi-monopolistic markets like telecom and electric power. You be the judge about whether you are better off with de-regulation of those industries. Health care is a de facto monopoly, should it be treated as a utility?

Wikipedia is the sixth most popular website in the world, with 22.5 million contributors and 736 million edits in English. It’s as if the entire population of Australia (23.6 million) each contributed 30 times. 36 people run Wikipedia. Who are they?

Transparent solar panels could make solar power more competitive. CSEM, a Swiss technology company, have developed solar panels that you can see through and have no visible connections, which gives architects a lot of room to incorporate solar power into the walls of buildings without having to give up any aesthetic goals.

How often should you get dental x-rays? Dentists differ.

Many people believe that medical malpractice reform is the key to cutting cost from the health care system. But evidence shows that belief could be mistaken. However, if you have been affected by medical negligence, you’ll want to consider your options. Some people contact the hospital directly to complain about the medical professional who failed to take suitable care of them. A better alternative to this idea is actually to contact a personal injury lincoln ne service, or a lawyer more local to you. Seeking legal assistance can help you to strengthen your claim against the staff member in question.

The US currently has 30 declared presidential states of emergency. The University of Michigan explains why this is a bad idea. The National Emergencies Act requires the Congress to vote every six months on whether a declared national emergency should continue, Congress has done this only once in the nearly 40-year history of the Act.

Protect us from the media: CNBC’s “Squawk Box” anchor (Joe Kernan) shows complete ignorance of Ireland while talking to Martin Shanahan, head of the Irish Industrial Development Authority. Then he insists he is correct:
CNBC: You have pounds anyway don’t you still?
Shanahan: We have Euros.
CNBC: You have Euros in Ireland?
Shanahan: Yes. We have euros, which is eh…
CNBC: Why do you have euros in Ireland?
Shanahan: A strong recovery….
CNBC: Why do you use euros in Ireland?
Shanahan: Why wouldn’t we have euros in Ireland?
CNBC: Huh. I’d use the pound.
Shanahan: We use euro.
CNBC: What about Scotland? I was using Scottish eh…
Shanahan: They use Sterling.
CNBC: They use Sterling?
Shanahan: They use Sterling. But we use euro.
CNBC: What? Why would you do that?

And some of you use CNBC for investment advice!

Here is your thought for the week. It is from George Orwell:

The great enemy of clear language is insincerity. When there is a gap between one’s real and one’s declared aims, one turns as it were instinctively to the long words and exhausted idioms, like a cuttlefish squirting out ink. In our time, political speech and writing are largely the defense of the indefensible.

Thus political language has to consist largely of euphemisms, question-begging and sheer cloudy vagueness. Political language is designed to make lies sound truthful and murder respectable…

Wednesday Linkage

What’s Wrong Today:

We have the methods, materials, and expertise to handle any of our major problems, be it with economic growth, war/peace, income inequality, social malaise or, outbreaks of serious infectious disease. Our problem is that in all of these areas, we have chosen not to use our abilities to solve any problems that involve use of the commons because the Congress won’t agree that the commons can be used for these things, except in an academic sense.

In America, when push comes to shove, it is you and the people you feel are part of your clan or tribe that count–never mind that we live on a finite planet with finite resources and carrying capacity–that is irrelevant to the vast majority of us.

Now, along comes Ebola, and, collectively, we have chosen to ignore the problem, to slow roll vaccines that could treat it, because, capitalism.

Are we going to realize that simply following our own self-interest may not be in our self-interest? That maybe the culture of narcissism may not be all it’s cracked up to be? The Ebola diversion from real election issues will not stop, however. If it does, the media will simply find a new shiny object.

Could our leadership class be motivated enough to actually be responsible, and not just to APPEAR to be responsible?

Here is some Wednesday linkage:

Music playlists for Euro soccer teams: a few surprising choices for 20 & 30-something profession athletes.

Tokyo has way fewer homeless than NYC. Why? The Japanese Constitution guarantees its citizens “the right to maintain the minimum standards of wholesome and cultured living.” That document was drawn up by Gen. MacArthur during our occupation after WW II. So, because of the US, the Japanese have a stronger safety net for their citizens than we do in our own country. Ironic, or what?

Palestinian women are protecting the Al-Aqsa Mosque compound from Israelis who want to take it over: There are attempts on most days by Israelis to enter this mosque and lay claim to it. Older Palestinian women work to keep control of it. This will not end well.

Reuters reports that the US Army is quarantining soldiers who provided Ebola support in West Africa for 21 days: Despite the fact that current Defense Department policy allows troops with no known exposure to the virus to return to work and interact with their families after coming home, as long as they have their temperature checked twice daily for 21 days.

Baby Boomers are seeing a tsunami of products aimed at “helping” with problems of aging: Check out Depends in designer colors and the cane made from bull penis. Corporations are bringing sexy back to the 60-somethings.

Health Watch:

Corporate Wellness programs are ineffective: The Kaiser Family Foundation (KFF) survey found that 36% of firms with more than 200 workers, and 18% of firms overall, have wellness programs. The Upshot says they rarely work. Quelle surprise!

States that have expanded Medicaid as part of health reform expect their share of Medicaid spending to grow more slowly than states that have not expanded, a new KFF report finds.

Hospitals are now taking their cues from the airlines and the auto industry. Now your healthcare price comes unbundled, with additional fees and options. At least auto salesmen negotiate with you while you are conscious and not impacted by meds and pain.

Your Business Trip:

Legal marijuana is a growth industry, with annual revenues forecasted to be $35 billion by 2020.

Business Insider says maximizing shareholder value is bad. OMG, what would Mitt say? James Montier, a behavioral finance writer, believes that companies should be required to focus on running their businesses, producing quality goods and services, treating customers and workers fairly, and creating shareholder value as a by-product, not as an objective.

Blinded by Science:

Genome study shows humans bred with Neanderthals. And not just on Saturday night in college!

The new Afghanistan President gets violent reception from the Taliban. According to an AP tally, there have been at least 10 incidents in Kabul (including inside the Green Zone) since Ghani Ahmadzai’s inauguration on Sept. 29th, killing 27 people.

Your music moment:

The Rolling Stones were filmed by Martin Scorsese at NY’s Beacon Theater in 2006. The entire documentary was released in 2008. The film’s title, “Shine a Light” is from a Stones song by the same name. Here are a few minutes behind the scenes with Scorsese, the Stones and Bill Clinton:

https://www.youtube.com/watch?v=QO9fXphmuGk

Monday Wake Up Call – October 27, 2014

Welcome to the working week. This week brings Halloween and the end of daylight savings time. Next Sunday, time “falls back”, and sadly, so will Democrats on the 4th of November.

But right now, it is time to get up and get going. Remember Disco? Get down with “Stomp” by the Brothers Johnson from their 1980 Platinum album, “Light up the Night”:

Quincy Jones worked with the Brothers Johnson on several of their albums for A&M. Michael Jackson does background vocals on another song on this album, “This Had to Be”. “Stomp” went to #1 on the R&B charts, #1 on the Dance singles chart and #7 on Billboard in 1980.

Here are a few hot links for your Monday breakfast buffet:

The Federal government’s 2014 fiscal year ended on September 30th. Here are 10 facts you may not know about the federal budget.

The Sunshine Act, a provision of the Affordable Care Act, requires doctors, hospitals, pharmaceutical companies, and medical device manufacturers to disclose their financial relationships. The Centers for Medicare and Medicaid Services (CMS) has released the first set of data. It includes $3.5 billion paid by Big Pharma to over half a million doctors and teaching hospitals in the last five months of 2013.

For 18 years, thousands of students at the University of North Carolina – Chapel Hill had “no show” classes with no assigned readings, and no responsible faculty member. These classes had just one requirement: a final paper that no one ever read. In the most crucial finding, no player was paid for an autograph, so it’s just a minor scandal.

More about the Dallas Ebola screening fail and likely cover up. It appears that the hospital and the software firm retrofitted the data to the story. Once again, we may never know the truth about what happened in Dallas.

My Terrifying Night with Afghanistan’s Only Female Warlord. Commander Pigeon is a woman who kills men, and is known to everyone in Kabul, but we are just hearing about her.

Al-Qaeda has a new English magazine called “Resurgence.” It is 117 pages of glossy graphics and articles about jihad and the war against America, all in understandable English.

The Social Security office that hears appeals for disability benefits is 990,399 cases behind. This Washington backlog is bigger even than the backups at Veterans Affairs, where 526,000 people are waiting in line, and the patent office, where 606,000 applications are pending.

Politics never change. Here is a 1796 editorial by Alexander Hamilton that accuses Thomas Jefferson of an affair with a slave.

Bonus Monday Music: You probably have heard that Jack Bruce died on the 25th. As Bob Lefsetz says:

Clapton might be God, but there was no Cream without Jack Bruce. He was the one who sang most of the songs.

He wrote the riff that we all know from “Sunshine of Your Love”. Here is Cream doing “I Feel Free”. That’s Jack Bruce on the left, Ginger Baker on drums and Eric Clapton on the right:

Feel free all week, my friends.

Monday Wake-Up Call – October 20, 2014

Happy Monday! Here is your thought for the week:

“People react to fear, not love. They don’t teach that in Sunday school, but it’s true” − Richard M. Nixon

Not a complete surprise that Nixon was wrong. They DO teach fear in Sunday school:

In Liberia, only 43% of the adult population are literate, so radio, not the written word, is the best way to inform people about the disease. There are 16 local languages in Liberia, in addition to English. People rarely have access to the Internet or television.

Songs about Ebola are popular in West Africa. One of the most popular is “Ebola in Town” by Samuel “Shadow” Morgan and Edwin “D-12” Tweh, along with Kuzzy, of 2Kings. The song sounds like American hip-hop, but the style is called “Hip Co”, a form of colloquial English that appeals to young Liberians (about 50% of the population is under 18).

Here is an audio file of the song. There are YouTube videos out there, but they have extremely graphic depictions of Ebola victims, and may not be suitable for viewing at work or at home, if kids are in the room:

https://soundcloud.com/shadowmrgn/ebola-in-town-d-12-shadow-kuzzy-of-2kings

A sample of the lyrics:
Something happen
Something in town 
Oh yeah the news 
I said something in town
Ebola
Ebola in town

[Snip]

If you like the monkey 
Don’t eat the meat
If you like the baboon
I said don’t eat the meat
If you like the bat-o
Don’t eat the meat
Ebola in town.

Songs can’t do all that much in a nation with the second-fewest doctors per person in the world.

Here are today’s hot links for your breakfast buffet:

Ebola got you stressed? Try textual healing. A new breed of online-therapy services offers flat-rate plans that allow you to text-chat with a licensed, accredited therapist as much as you like (need).

At least 30 states are still providing less funding per student for the 2014-15 school year than they did before the recession hit.

Researchers have created what they call Alzheimer’s in a Dish — a petri dish with human brain cells that develop the telltale structures of Alzheimer’s disease.

And we were doing so well in Pakistan: Six senior members of the Pakistani Taliban vowed allegiance to the Islamic State.

Go ahead, take your time getting to the party: Study shows that the median arrival time of 803 guests was 58 minutes after the party’s start time.

Of course we love our allies: Saudis to behead, then crucify a cleric who spoke out against the King. Did you know that Saudi Arabia doesn’t have a constitution?

We will never learn: John Allen, the general in charge of the US-led coalition’s response to ISIS says the US will create “a home-grown, moderate counterweight to the Islamic State”. Didn’t work in Vietnam, Afghanistan, or Iraq. Why would it work this time?

Sunday Cartoon Blogging – October 19, 2014

Your thought for the weekend is from the movie, The Birdcage:

Senator Kevin Keeley: Louise, people in this country aren’t interested in details. They don’t even trust details. The only thing they trust is headlines.

Well, CNN headline writing is as bad as their broadcast. Is that Helvetica?

Since it is Nobel Prize time, here is an anecdote by Walter Gilbert (1980 winner in Chemistry) about what happens when you travel with your medal:

When I won this, my grandma, who lives in Fargo, North Dakota, wanted to see it. I…decided I’d bring my Nobel Prize. It was uneventful, until I tried to leave Fargo, and went through the X-ray machine. I could see they were puzzled. It was in my laptop bag. It’s made of gold, so it absorbs all the X-rays—it’s completely black. And they had never seen anything completely black.

“They’re like, ‘Sir, there’s something in your bag.’
I said, ‘Yes, I think it’s this box.’
They said, ‘What’s in the box?’
I said, ‘a large gold medal,’ as one does.
So they opened it up and they said, ‘What’s it made out of?’
I said, ‘gold.’
And they’re like, ‘Who gave this to you?’
‘The King of Sweden.’
‘Why did he give this to you?’
‘Because I helped discover the expansion rate that the universe was accelerating at.’
At which point, they were beginning to lose their sense of humor. I explained to them it was a Nobel Prize, and then their question was: ‘Why were you in Fargo?’”

How corporatists fight Ebola in Texas:

The truth is, everyone is infected by the headlines:

And the headlines gripped Wall Street:

Ebola: Oh My God, We’re All Gonna Die!

Why is it that so many pundits feel the need to tweet/talk/bloviate in a way that sounds like they’re proven right when there is a new case of Ebola? Why did Bill O’Reilly feel the need to say that he knows better than the head of the Centers for Disease Control and Prevention about how to keep Americans safe from the Ebola virus? The greatest cost of our rampant corporatism may be the continued chipping away at our trust in public institutions.

Even though spreading panic is great politics, if we need to reevaluate our protocols for healthcare workers caring for patients with Ebola, fine, but if you live in another state from the person infected in Dallas, you’re gonna be ok.

Let’s remember that Thomas Duncan, the sole Ebola fatality in the US, spent 3 days at home with a fever of 103. He was infectious for the 3 days he was at home with the illness, and he could have infected someone else in the household, but he did not. Apparently, his family took great care not to be exposed, and they seem to be on the verge of succeeding, since the incubation period is up to 21 days. Duncan showed symptoms on Sept. 24th. If we count from then, the family still have a day or two before they are out of the woods. If we count from Sept. 28th, when he was vomiting and went to the hospital for the 2nd time, they would be safe on Saturday.

Most of the Americans flown to the US with Ebola were healthcare workers. The person who died from the disease in Spain was a healthcare worker. Many who get it in Africa are caregivers or healthcare workers. So, again, this indicates an ongoing risk for those who care for patients with Ebola, but the average American’s risk for catching the disease is still near zero.

That said, this report in Scientific American by Judy Stone, MD and infectious disease specialist, speaks to the problems with both process and culture in hospitals:

One hospital I am familiar with has Powered Air Purifying respirators (PAPRs), purchased with bioterrorism preparedness grants, but neither stethoscopes nor other dedicated equipment for isolation rooms. So nurses and docs gown up to go in the room of a patient with a “superbug” but take their stethoscopes into the room and then on to other patients, perhaps remembering to wipe it down first.

This New York Times blog post & graphic on the procedures for healthcare workers caring for people with Ebola echoes Dr. Stone’s discussion and shows how hard it is to be careful.

Here is a chart by Dr. Stone on of our expense for Public Health Preparedness spending since 2001:

This shows that funding for preparedness efforts have fallen by a cumulative total of $2.4 billion since the high point in 2006. The chart shows that the deepest cuts came in GW Bush’s second term. Since then, substantially more has been cut from the programs. Starve a program designed to educate and isolate a deadly outbreak among public health professionals and then blame the government when something goes wrong. Thanks Mr. O’Reilly.

Politics, as usual, is the fly in our soup. Unfortunately, next month Americans again go to the polls and at least half of them will vote for the very people who are doing everything in their power to eliminate public health care.

Isn’t it strange that public health policy is being decided based on economic beliefs about free trade and travel rather than mathematics and science? We in the West offered no assistance to immediately help control the initial Ebola outbreak in Africa. We said, let it burn itself out, like it has done before.

But, the New York Times reports that the new head of the World Bank, Dr. Jim Yong Kim, was among the first to see the need to move quickly against the Ebola threat. He committed $400 million to fight Ebola, and $105 million has already been disbursed. In September, he said to Dr. Margaret Chan, the head of the World Health Organization:

You have the authority to act in this emergency…so why aren’t you doing it?

Now, in October, she seems to be finally on the case.

Here at home, Republicans are vying with each other to shame the Obama administration into implementing a travel ban against Ebola-affected countries. That wouldn’t be an unreasonable suggestion if it could stop the spread of the disease. But it won’t. Here’s why:
• There is a de facto private ban already in place, since US-based airlines stopped flying to Ebola-afflicted countries two months ago (to protect their crew and passengers from exposure — and themselves from lawsuits).
• Delta and United offer direct, nonstop service between the US and West Africa—Delta to Lagos, Accra, and Dakar, and United only to Lagos.
• No travel ban or quarantine will seal a country completely. Models predict that even if travel could be reduced by 80%, new transmissions would be delayed only by a few weeks.

And health-care workers who become ill would not be able to get out for treatment, and the international health personnel needed to quell the outbreak would no longer be able to get in.

Despite the fear-mongering, we know what needs to be done. We have organized the deployment of 3,000 troops and have begun marshaling a wider international response that is tragically slow. With the announcement of the Dallas case, hospitals across the country are now scrambling to get their procedures up to snuff.

We need to have the boots in Africa to help manage the probable local panic as well. It is a linear investment by the US that could have an exponential payback.

Meds Are Too Damn High

On Sunday, 60 Minutes ran a segment about the high cost of drug therapies. They exposed the rip-off prices Big Pharma charges for certain Cancer drugs. Moreover, the clear message was that if you have a life-threatening disease, it is likely that some drug company has come up with a treatment that may extend your life, at a price. How much would you pay for another year of life? In 2012, of the 12 cancer drugs approved by the FDA, 11 cost over $100,000 per year.

Who wouldn’t pay that (if they could) in order to stay alive? 60 Minutes quoted Dr. Leonard Saltz, chief of gastrointestinal oncology at Memorial Sloan Kettering:

And remember that many of these drugs, most of them, don’t replace everything else. They get added to it. And if you figure one drug costs $120,000 and the next drug’s not going to cost less, you’re at a quarter-million dollars in drug costs just to get started.

The big lie told to the American people is that these high prices are necessary for innovation. 60 Minutes asked John Castellani, the CEO of the industry’s lobbying group, PhRMA, to explain why drug prices have to be so high:

The drug companies have to put a price on a medicine that reflects the cost of developing them, which is very expensive and takes a long period of time, and the value that it can provide.

This is, of course, BS. You never buy anything because it costs more to develop. You wouldn’t pay more for a car because GM wasted extra money in R&D without results. You buy the car because the car is safer in a collision.

The same with drugs: we should pay what they’re worth, not what it cost to develop them, particularly if you knew about your options, or were able to negotiate, like you can at the car dealership. The neoliberal meme at work is that profits motivate someone to invent. Perhaps Big Pharma just forgets about Dr. Jonas Salk, who gave his polio vaccine to the public free of charge, demonstrating the big lie spoken by the Big Pharma lobbyist.

Of course sociopathic entities, (that would be our beloved Corporations, who are people now) do not grasp altruism and empathy.

The Food and Drug Administration (FDA) approves drugs if they are shown to be “safe and effective”, but does not consider what the relative costs might be once the new medicine is marketed. From Bloomberg:

By law, Medicare must cover every cancer drug the FDA approves. (A 2003 law, moreover, mandates payment at the price the manufacturers charge, plus a 6% cushion) In most states private insurers are held to this same standard. Physician guideline-setting organizations likewise focus on whether or not a treatment is effective, and rarely factor in cost in their determinations.

The reality is that the drug companies are taking advantage of the current US law (that they lobbied for) to price their Cancer drugs.

Are these prices a rip-off? Prices for some of these drugs have increased the longer they are available, even though there is no increased research, no additional expenses in order to produce the drug. For example, Bloomberg notes that Gleevec, from Novartis, possibly the greatest cancer drug ever invented, cost $24,000 a year when it was introduced in 2001; now it costs $90,000 per year, nearly quadrupling in price. The typical new Cancer drug coming on the market a decade ago cost about $4,500 per month (in 2012 dollars); since 2010, the median price has been around $10,000. Two of the newest Cancer drugs cost more than $35,000 each per month of treatment.

A final quote from Bloomberg: (Emphasis by the Wrongologist)

While generic drugs… now make up 86% of all medicines used in the US, that hasn’t reduced total spending on prescription drugs. In 2012, Americans spent $263 billion, or 11% more than the $236 billion in 2007, according to government data.

Fifty million people went without needed prescriptions in 2012 because they couldn’t afford them. It’s high time something is done about this.

A possible solution is to change the law so that Medicare negotiates volume discounts with the pharmaceutical companies, adding a fixed markup over costs, including R&D, plus the cost to produce and market the drug, and then adding a “fair profit” say, 20%.

By multiplying the number of probable drug users, the dose frequency, term of the prescription and the length of an exclusivity period, we could determine the cost/dose required to achieve that return. Parenthetically, the government should directly fund antibiotic research and also control the price of those drugs to give the company a fair fixed profit (at a lower return than if the R&D had been paid by the companies).

The drug industry needs to think about how it can limit Cancer and other drug costs, and how to price affordably — before someone decides to do the thinking for them.

The Wrongologist

Geopolitics, Power and Political Economy

Category: Health Care