Two down and one to go! Though the one will only be with a Washington staffer of Senator Snow and that will be on the 18th. Meanwhile Gerda and I have met with Representative Michaud on Sunday, November 29th in his Lewiston office and Senator Collins through a video-link on Monday, December 7th. Both were very attentive though it was a relatively short meeting with Collins as she had other meetings scheduled. Let me detail the encounters individually.
Michaud: Very knowledgeable about the details of the bill and very sceptical about it and without much hope of meaningful change. He does want the government to negotiate with pharmaceutical and insurance companies over costs and does want a vigorous public option. Finally he was very upset about the Stulpak amendment and does not expect that it will stay in the final bill though there likely will some restriction on abortions.
Collins: We did agree on a number of points as cost containment and that the bills as now presented will do little to change that. She did seem surprised to learn about the waste of monies here in Lewiston-Auburn. There was little time for discussion. I have asked for clarification and explanation of one remark that was left dangling-that she was opposed totally to any government plan. So far, no reply.
And that's the update from here in L/A
where the women are strong
the men, good looking
and the children above average.
Stephen & Gerda
Saturday, December 12, 2009
Tuesday, December 8, 2009
Thursday, November 26, 2009
An Early Holiday Gift for the Big Pharma
Well it is now the holiday season and we all look forward with gratitude for what we have to a wonderful season with family and friends-the true gifts of this time.
Our friends at "Big Pharma" evidently have been so excited that they could not wait and decided to give themselves an early gift by raising prices this year so far a whopping 8.9% despite the fact that the Consumer Price Index (CPI) has fallen 1.3%.
It would seem that after careful reflection they were very uneasy about the 8 billion dollars that they promised President Obama in yearly price reductions over the next 10 years if the government would not start negotiating prices for medicare or other government programs. A bit like going into the local store when they have those end of year sales-10% off the 25% mark-up.
The usual argument is heard round the corporate tables. If we do not do this, why then research and development (R&D) of those vital lifesaving drugs will stop and we will all suffer unspeakable consequences. Let's take a closer look at this claim, as who would be so selfish and un-American as to want to be responsible for all that misery.
The ten biggest pharmaceutical companies had total sales of 269 billion dollars in 2008. Of this only 42 billion (15%) went for R&D. The vast majority of R&D money comes from the National Institutes of Health, our tax dollars at work. The other 30% comes from foreign laboratories. Additionally the vast majority of these drugs were "me too" products that added nothing to health care. Of the 667 new drugs approved from 2000-2007 only 75 (11%) were either new important additions or a significant improvement on an existing product. "Big Pharma" made 49 billion in profits (18%) in 2008. Now that's good business as the average for all Fortune 500 companies was a paltry 0.9%.
To ensure it's place "in the sun", "Big Pharma" spent 55 billion for lobbying, political contributions, front groups as "patient advocacy"and" independent" think tanks.
Education is a major part of this money. Hundreds of "detailers" scurry around the country to educate doctors that their drug is the best and has the least side effects. As part of this process free meals are given, meetings are sponsored and gifts with the drug name inscribed are distributed. For the consumer ads and free first prescription offers abound on television and on the Internet. While researching this Blog entry, I have bumped into Lipitor at least 5 times.
One of the most fascinating aspects of this (for me) is the creation of new disease entities to expand a particular drug's market. We now have "Social Phobia Disorder" and that can be treated. A few years back, those folks were just shy and considered normal. Up to 7% of American children now have Attention Deficit Hyperactivity Disorder and are medicated with who knows what long term effects. Years back they were considered variations of normal and sent out to the playground to "run of some steam". Interestingly in Great Britain, the estimate is only 1%. We now have children as young as 3-4 being labelled as Bipolar and treated again with unknown long term effects on the developing brain. Turns out that the physician that did the studies was funded by the very pharmaceutical firm that manufactures the medication.
And so in this season of joy and gratitude, we should all reflect on our health care chaos, realizing that all too many of our fellow citizens and other folks that we invited here have no regular means of getting help when they are ill. We must change this. Then this season will have a real meaning.
Stephen
For those who would like references, go to the website of Physicians for a National Health Program--- pnhp.org. There, look up work done by Dr. Marcia Angel, former editor of The New England Journal of Medicine.
Our friends at "Big Pharma" evidently have been so excited that they could not wait and decided to give themselves an early gift by raising prices this year so far a whopping 8.9% despite the fact that the Consumer Price Index (CPI) has fallen 1.3%.
It would seem that after careful reflection they were very uneasy about the 8 billion dollars that they promised President Obama in yearly price reductions over the next 10 years if the government would not start negotiating prices for medicare or other government programs. A bit like going into the local store when they have those end of year sales-10% off the 25% mark-up.
The usual argument is heard round the corporate tables. If we do not do this, why then research and development (R&D) of those vital lifesaving drugs will stop and we will all suffer unspeakable consequences. Let's take a closer look at this claim, as who would be so selfish and un-American as to want to be responsible for all that misery.
The ten biggest pharmaceutical companies had total sales of 269 billion dollars in 2008. Of this only 42 billion (15%) went for R&D. The vast majority of R&D money comes from the National Institutes of Health, our tax dollars at work. The other 30% comes from foreign laboratories. Additionally the vast majority of these drugs were "me too" products that added nothing to health care. Of the 667 new drugs approved from 2000-2007 only 75 (11%) were either new important additions or a significant improvement on an existing product. "Big Pharma" made 49 billion in profits (18%) in 2008. Now that's good business as the average for all Fortune 500 companies was a paltry 0.9%.
To ensure it's place "in the sun", "Big Pharma" spent 55 billion for lobbying, political contributions, front groups as "patient advocacy"and" independent" think tanks.
Education is a major part of this money. Hundreds of "detailers" scurry around the country to educate doctors that their drug is the best and has the least side effects. As part of this process free meals are given, meetings are sponsored and gifts with the drug name inscribed are distributed. For the consumer ads and free first prescription offers abound on television and on the Internet. While researching this Blog entry, I have bumped into Lipitor at least 5 times.
One of the most fascinating aspects of this (for me) is the creation of new disease entities to expand a particular drug's market. We now have "Social Phobia Disorder" and that can be treated. A few years back, those folks were just shy and considered normal. Up to 7% of American children now have Attention Deficit Hyperactivity Disorder and are medicated with who knows what long term effects. Years back they were considered variations of normal and sent out to the playground to "run of some steam". Interestingly in Great Britain, the estimate is only 1%. We now have children as young as 3-4 being labelled as Bipolar and treated again with unknown long term effects on the developing brain. Turns out that the physician that did the studies was funded by the very pharmaceutical firm that manufactures the medication.
And so in this season of joy and gratitude, we should all reflect on our health care chaos, realizing that all too many of our fellow citizens and other folks that we invited here have no regular means of getting help when they are ill. We must change this. Then this season will have a real meaning.
Stephen
For those who would like references, go to the website of Physicians for a National Health Program--- pnhp.org. There, look up work done by Dr. Marcia Angel, former editor of The New England Journal of Medicine.
Wednesday, November 18, 2009
THE REPLY
Dear Senator Collins,
Thank you for your recent response to my concerns about health insurance, the reform process and its impact on health care here in America.I am deeply disappointed by your reply and I do hope that it was written by one of your staff as it shows a complete lack of understanding about this most important issue. Additionally the "non-partisan" Lewin Group that you cite is a subsidiary of United Health Care, a large corporation that sells (would you believe) health insurance. To use them as a resource is disingenuous and only obfuscates discussion on this issue. Obviously you have little knowledge of how the rest of the developed world functions and functions well as opposed to our totally inadequate and grossly unfair system that seems only to penalize the ill and helpless. Are you aware of the number of Americans that die yearly because of a lack of health insurance and thereby a lack of adequate health care, approximately 45,000 and of those close to 3,000 are veterans who served their country. Are you aware that the majority of bankruptcies in America are due to medical bills and the majority (75%) of these folks are working. I have two children with pre-existing conditions who cannot afford insurance. You ignore the fact that a public option does not obligate anyone to give up their present plan if they are content. I do believe that, as drug companies are now rapidly increasing their prices, the insurance industry will simply raise premiums to ensure that their obscene profits continue.
With respect I urge you to examine this with greater care. It is one of the most important issues today. Our system is in great danger of collapse and nothing in the Congressional bills seems to want to recognize that. You are all too beholden to the insurance industry.
Sincerely
Thank you for your recent response to my concerns about health insurance, the reform process and its impact on health care here in America.I am deeply disappointed by your reply and I do hope that it was written by one of your staff as it shows a complete lack of understanding about this most important issue. Additionally the "non-partisan" Lewin Group that you cite is a subsidiary of United Health Care, a large corporation that sells (would you believe) health insurance. To use them as a resource is disingenuous and only obfuscates discussion on this issue. Obviously you have little knowledge of how the rest of the developed world functions and functions well as opposed to our totally inadequate and grossly unfair system that seems only to penalize the ill and helpless. Are you aware of the number of Americans that die yearly because of a lack of health insurance and thereby a lack of adequate health care, approximately 45,000 and of those close to 3,000 are veterans who served their country. Are you aware that the majority of bankruptcies in America are due to medical bills and the majority (75%) of these folks are working. I have two children with pre-existing conditions who cannot afford insurance. You ignore the fact that a public option does not obligate anyone to give up their present plan if they are content. I do believe that, as drug companies are now rapidly increasing their prices, the insurance industry will simply raise premiums to ensure that their obscene profits continue.
With respect I urge you to examine this with greater care. It is one of the most important issues today. Our system is in great danger of collapse and nothing in the Congressional bills seems to want to recognize that. You are all too beholden to the insurance industry.
Sincerely
Saturday, November 7, 2009
The Forces of Darkness and Evil
"Of all the forms of inequality, injustice in health care is the most shocking and most inhumane"
Rev. Martin Luther King Jr.
This was recognized by Dr. King almost 50 years ago as he engaged in the Civil Rights struggle. Yet we today have been unable to address and correct this glaring inequity.
I spent with Gerda a fascinating day making the rounds of our congressional delegation to try and foster a meaningful dialogue. We was most politely received in all three offices. we spent the most time at Senator Snowe's office where we discussed health care and a range of different but related social issues. I found Mrs. Diane Jackson most attentive and interested and I do thank her for her time. Less time was spent at Senator Collins office but we were shown the same courtesy and interest by David Heidrich Jr. Sadly at Representative Michaud's, it was very different. We were told by the staffer that he could spare us five minutes and, although notes were taken, I felt that there was little interest in what we were saying. We will remember that. Whether the afternoon will make an iota of difference.............. well I do doubt it. Nevertheless it is critical for each of us to continually register our concerns.
I thought that it would also be reasonable in each of these blogs to focus on one particular problem among the myriad in our rapidly crumbling all-American system. Today's will be bankruptcy caused by medical bills. A Harvard study recently published in the prestigious American Journal of Medicine ( August, 2009 ) found that 62.1% of bankruptcies in 2007 ( before the recession ) were significantly contributed to by medical problems. The majority ( 77.9% ) had health insurance at the start of the illness. Of these 60.3% had private coverage. These folks were solidly middle class and were working at the time of their illness. Many lost their jobs and their insurance as a result of the illness. In no other developed nation does this occur. Their medical bills ranged from $17,749-$34,167 depending on the type and chronicity of the illness. As we can learn even the well insured can be devastated by high out-of-pocket costs incurred by co-payments, deductibles and non-covered services. Having two children with pre-existing conditions, we know both how hard it is to find reasonable coverage ( there is none ) and the fear engendered by going without.
And that's the news from Lake Auburn,
where the women are good-looking,
the children above average
and you had better pray that your
insurance is adequate.
Stephen & Gerda
Rev. Martin Luther King Jr.
This was recognized by Dr. King almost 50 years ago as he engaged in the Civil Rights struggle. Yet we today have been unable to address and correct this glaring inequity.
I spent with Gerda a fascinating day making the rounds of our congressional delegation to try and foster a meaningful dialogue. We was most politely received in all three offices. we spent the most time at Senator Snowe's office where we discussed health care and a range of different but related social issues. I found Mrs. Diane Jackson most attentive and interested and I do thank her for her time. Less time was spent at Senator Collins office but we were shown the same courtesy and interest by David Heidrich Jr. Sadly at Representative Michaud's, it was very different. We were told by the staffer that he could spare us five minutes and, although notes were taken, I felt that there was little interest in what we were saying. We will remember that. Whether the afternoon will make an iota of difference.............. well I do doubt it. Nevertheless it is critical for each of us to continually register our concerns.
I thought that it would also be reasonable in each of these blogs to focus on one particular problem among the myriad in our rapidly crumbling all-American system. Today's will be bankruptcy caused by medical bills. A Harvard study recently published in the prestigious American Journal of Medicine ( August, 2009 ) found that 62.1% of bankruptcies in 2007 ( before the recession ) were significantly contributed to by medical problems. The majority ( 77.9% ) had health insurance at the start of the illness. Of these 60.3% had private coverage. These folks were solidly middle class and were working at the time of their illness. Many lost their jobs and their insurance as a result of the illness. In no other developed nation does this occur. Their medical bills ranged from $17,749-$34,167 depending on the type and chronicity of the illness. As we can learn even the well insured can be devastated by high out-of-pocket costs incurred by co-payments, deductibles and non-covered services. Having two children with pre-existing conditions, we know both how hard it is to find reasonable coverage ( there is none ) and the fear engendered by going without.
And that's the news from Lake Auburn,
where the women are good-looking,
the children above average
and you had better pray that your
insurance is adequate.
Stephen & Gerda
Sunday, July 26, 2009
Health Care
I thought you all might like to see this as it was just published in the Lewiston Sun Journal on Sunday, July26th, 2009.
Inconvenient Truths about Health Care in America
Health care in America is a shambles and will, like a critically ill patient, likely collapse if it is not properly and promptly attended to.
We are told that we have the best health care system in the world, yet when we are ranked by the World Health Organization, we are 37th out of 137 just above Cuba and well below the United Kingdom and Canada both of whom have single payer systems. In the same ranking, we are 32nd in infant mortality, 24th in life expectancy and 54th in fairness.
Almost fifty million Americans are uninsured and a similar number are under-insured, 75% of whom are employed. Thirteen percent of Mainers live below the poverty level and over 9% are without health insurance. A similar number are under-insured. The Institute of Medicine of the National Academy of Sciences has shown that 50 Americans die daily because of lack of health insurance. Imagine if that figure were the casualties of our troops in Iraq and Afghanistan. Yet we expended 17% of our gross national product, 2.4 trillion dollars on health care in 2007, twice as much as any other industrialized nation and achieved significantly lower quality. We are now in the throes of a severe recession and more Americans, as they lose their jobs, lose their health insurance. Medical bills cause sixty percent of bankruptcies and 75% of these folks are insured.
Why? Private insurance companies are driven by profit and expend 16% of their income on overhead and therefore are very stringent about what they will and won’t cover. Most people with underlying common chronic problems as hypertension and diabetes are excluded. In contrast Medicare spends 2.1% and Canada, 1.2% on overhead and there are no exclusions. We spend over $7,000 per person per year while Canada spends $2,500 and achieves better results.
We have been told that free market forces and competition will correct these problems yet, since the inception of the private health insurance sector during WW2, costs have only accelerated. When you have a heart attack or appendicitis, it is very hard to shop around for the best price. These companies are not market driven. They are for profit. Keeping the present system of a myriad of private insurance companies only guarantees the status quo. Remember that the health sector spent in 2007 $450.7 million on lobbying alone and that was not to insure equal access for all. Pharmaceutical companies spent over 14 billion on advertising, not only to doctors but to all of us. Remember the slogan on those TV ads, “Ask your doctor if………” Some of these very drugs are quite hazardous. Hospitals, purporting to exist only for the best care of us, expend enormous amounts in competition for their “market share”. Just check the ads on TV and in the newspapers. Sadly doctors have also joined in.
A single payer system would eliminate many of these inequities by significantly reducing overhead, regulating costs and eliminating much of this frivolous waste. Good examples of excess here at home are the presence of three CT scanners, 2 MRI scanners and a part-time PET scanner, more than in any developing country. We also now have a cardiac surgical unit, which cost millions; while there is one of the best in the country forty miles down the road. A criticism has been long waiting times in such a system. Having had personal experience in Canada and Germany, I can state that no critically ill or urgent patient has been refuse excellent care. Unlike here where over 300,000 yearly are denied access no one is turned away from emergency rooms because of inability to pay.
In 1995 Taiwan changed from a U.S. type system in which only 60% of the people were covered to a single payer system. By 2001 97% were covered will only a minimal increase in cost.
I agree with the “founding fathers” who believed “that all men were created equal” and that we all had “certain unalienable Rights, that among these are Life, Liberty and the Pursuit of Happiness.” Now I wonder how any of these rights are possible to those of us who are sick and cannot get proper care. A single payer system similar to Medicare, which has made a huge impact on the health of the elderly, can achieve these ends and is in keeping with the values that America and Americans espouse. Health care is a right for all and not a commodity for the privileged.
Inconvenient Truths about Health Care in America
Health care in America is a shambles and will, like a critically ill patient, likely collapse if it is not properly and promptly attended to.
We are told that we have the best health care system in the world, yet when we are ranked by the World Health Organization, we are 37th out of 137 just above Cuba and well below the United Kingdom and Canada both of whom have single payer systems. In the same ranking, we are 32nd in infant mortality, 24th in life expectancy and 54th in fairness.
Almost fifty million Americans are uninsured and a similar number are under-insured, 75% of whom are employed. Thirteen percent of Mainers live below the poverty level and over 9% are without health insurance. A similar number are under-insured. The Institute of Medicine of the National Academy of Sciences has shown that 50 Americans die daily because of lack of health insurance. Imagine if that figure were the casualties of our troops in Iraq and Afghanistan. Yet we expended 17% of our gross national product, 2.4 trillion dollars on health care in 2007, twice as much as any other industrialized nation and achieved significantly lower quality. We are now in the throes of a severe recession and more Americans, as they lose their jobs, lose their health insurance. Medical bills cause sixty percent of bankruptcies and 75% of these folks are insured.
Why? Private insurance companies are driven by profit and expend 16% of their income on overhead and therefore are very stringent about what they will and won’t cover. Most people with underlying common chronic problems as hypertension and diabetes are excluded. In contrast Medicare spends 2.1% and Canada, 1.2% on overhead and there are no exclusions. We spend over $7,000 per person per year while Canada spends $2,500 and achieves better results.
We have been told that free market forces and competition will correct these problems yet, since the inception of the private health insurance sector during WW2, costs have only accelerated. When you have a heart attack or appendicitis, it is very hard to shop around for the best price. These companies are not market driven. They are for profit. Keeping the present system of a myriad of private insurance companies only guarantees the status quo. Remember that the health sector spent in 2007 $450.7 million on lobbying alone and that was not to insure equal access for all. Pharmaceutical companies spent over 14 billion on advertising, not only to doctors but to all of us. Remember the slogan on those TV ads, “Ask your doctor if………” Some of these very drugs are quite hazardous. Hospitals, purporting to exist only for the best care of us, expend enormous amounts in competition for their “market share”. Just check the ads on TV and in the newspapers. Sadly doctors have also joined in.
A single payer system would eliminate many of these inequities by significantly reducing overhead, regulating costs and eliminating much of this frivolous waste. Good examples of excess here at home are the presence of three CT scanners, 2 MRI scanners and a part-time PET scanner, more than in any developing country. We also now have a cardiac surgical unit, which cost millions; while there is one of the best in the country forty miles down the road. A criticism has been long waiting times in such a system. Having had personal experience in Canada and Germany, I can state that no critically ill or urgent patient has been refuse excellent care. Unlike here where over 300,000 yearly are denied access no one is turned away from emergency rooms because of inability to pay.
In 1995 Taiwan changed from a U.S. type system in which only 60% of the people were covered to a single payer system. By 2001 97% were covered will only a minimal increase in cost.
I agree with the “founding fathers” who believed “that all men were created equal” and that we all had “certain unalienable Rights, that among these are Life, Liberty and the Pursuit of Happiness.” Now I wonder how any of these rights are possible to those of us who are sick and cannot get proper care. A single payer system similar to Medicare, which has made a huge impact on the health of the elderly, can achieve these ends and is in keeping with the values that America and Americans espouse. Health care is a right for all and not a commodity for the privileged.
Saturday, July 11, 2009
Friday, March 6, 2009
waiting
Well I am right now in a waiting mode. Waiting to see where I go next. Please stay tuned.
Stephen
Stephen
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