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Latest News!Written By Comment Count Comment Last Three August 31, 2009
Caroline Patton
One of the presumptions behind calls for wider access to health insurance is that over the last ten years more and more Americans have found themselves uninsured. But it turns out that this isn’t quite true. Sure, the number of uninsured Americans is higher now than it was a decade ago but the change has a lot to do with population growth. A far better measure is the percentage without insurance, which despite fluctuations, has not changed a lot since even the early 1990s. In fact, between 2006 and 2007, the last years for which there is good data, both the number and the percentage of Americans who are uninsured went down.
Uninsured Americans  And while obviously the recession that hit the US beginning last year has worsened the picture, a Gallup poll in June 2009 put the number currently uninsured at around 16 percent of adults. That is higher than in previous years, yes, but not shockingly or dangerously so. It also represents only those uninsured at one point in time and leaves out people under 18, who tend to have a higher rate of being insured, especially with the extension this year of programs like SCHIP. I’m hardly going to argue that “only” 14-16 percent uninsured is a reason to leave the US health care system as is. However, both honesty and well-researched information have been lacking, on all sides, of the health care debate. The myth of the rising uninsured is yet another example of this. -
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August 31, 2009
Peter Pitts
In Sunday's edition of the New York Times, Robert Pear reported that: “Medicare beneficiaries would often have to pay higher premiums for prescription drug coverage, but many would see their total drug spending decline, so they would save money as a result of health legislation moving through the House, the Congressional Budget Office said in a recent report.” The "but" is at the very end of the article: “But, Mr. Elmendorf said, the averages conceal the fact that beneficiaries would be affected in different ways.” (That’s Doug Elmendorf, director of the CBO.) And when you consider the, um, facts … “Those who use a relatively small amount of prescription drugs would pay more in additional premiums than they would save, he said, while those who use a large amount of drugs would gain more from lower cost-sharing than they would pay in higher premiums.” The CBO study was undertaken at the request of Representative Dave Camp (R, MI), the senior Republican on the Mr. Pear ends by reporting that, “The budget office did not estimate how many Medicare beneficiaries might see an increase in their spending for prescription drugs and drug coverage, and how many would see a reduction, under the House bill. Mr. Camp said “the vast majority of seniors” would pay more, and he said House Democrats should scrap their bill and “start over with open, bipartisan talks.” The complete New York Times article can be found here. What’s the problem with higher co-pays? They reduce usage and compliance. Great if you’re trying to save money in the short-term. Not so great if you’re trying to enhance patient outcomes over the long-term. Short-term-savings (a political objective) vs. long-term patient health (which is also much more cost-effective in the long-term). Short-term (political) thinking delivers long-term (public health) problems. According to a recent study by Wolters Kluwer Health, fewer Americans are filling their drug prescriptions. In the fourth quarter of 2008, Why? Drug prices. It's not that the cost of prescription drugs is rising - it's patients' out-of-pocket costs, or co-pays. One of the reasons for this is that insurance companies, reluctant to foot the bill for brand-name medications, have been refusing to cover more brand-name prescriptions. In the fourth quarter of 2008, in fact, health insurers denied coverage for 10.8 percent of brand-name drugs - a jump of 21 percent from the first quarter of 2007. When co-pays go up, more people see the need to abandon their prescription drug regimen. At least that's what a study from As health care costs continue to rise, it's understandable that insurance companies (including the nation’s biggest payer – Uncle Sam) are looking to save money wherever possible. Passing off the cost of prescription drugs to patients, however, will only drive up overall costs while resulting in dramatically poorer health for more Americans. -
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August 28, 2009
Mario Coluccio
Economist Thomas Sowell on life expectancy rates and the health care debate: “No small part of the current confusion between ‘health care’ and medical care comes from failing to recognize that Americans can have the best medical care in the world without having the best health or longevity because so many people choose to live in ways that shorten their lives.” Howard Dean on the reason tort reform is omitted from the current House proposals: “Here is why tort reform is not in the bill. When you go to pass a really enormous bill like that the more stuff you put in, the more enemies you make, right? And the reason why tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on, and that is the plain and simple truth. Now, that’s the truth.” Chairman of the House Energy and Commerce Committee Henry Waxman on Medicare Part D: “We want it back. We want to make sure the windfall for the drug companies does not continue, and we want to recover the money that has been a windfall.” Henry Waxman on the deal between PhRMA and the White House: “We don’t have any deal with them, and the whole enterprise of doing health insurance for all Americans isn’t to make the drug companies happy, or wealthier.” PhRMA CEO Bill Tauzin’s response to Waxman’s efforts to recover a so-called windfall for drug companies as a result of Medicare Part D: “You not only break the deal, but you break the bank for us.” Senator Joe Lieberman (I-CT) on the ambitious health care proposals currently under consideration: “We’ve got to think about putting a lot of that off until the economy’s out of recession. There’s no reason we have to do it all now, but we do have to get started. And I think the place to start is cost, health delivery reform and insurance market reforms.” Senator Mary Landrieu (D-LA) on how to proceed with health care reform: “I'd prefer a private market-based approach to any health care reform that would extend coverage. I'd like to cover everyone -- that would be the moral thing to do -- but it would be immoral to bankrupt the country while doing so.” -
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August 28, 2009
Mario Coluccio
Reading responses to a recent piece on ideas for increasing transparency in industry support for continuing medical education, this particular comment stuck out to me: All industries use corporate support to further continuing education. There should not be a ban on that. If we are going to cut the communication between the industry and professionals, then how on earth the new technologies can be introduced to professionals. The fight to prevent influencing the minds of physicians is going too far. Now we want the industry and physicians not to even see each other??? Does it not sound like the Taliban… too orthodox? I am a physician and I want to know what is going on in the healthcare industry. I want someone to tell me what new medicines are coming out of pipeline into the market. I do not have time to research it myself. Just because a physician saw it in a seminar does not mean they will not use it judiciously. Even ACP and other conferences have sections where they allow healthcare industry to show case what they got. Those who do not want to know the latest technology are actually doing a disservice to their patient. For example a recent drug was introduced in the market as an alternative to allopurinol for gout. I would not have known about it for many months, unless a drug rep had not come in and told me about it. I still write allopurinol, but in the back of my mind I know I have a second medicine to help my patients, if they need it. Industry and Professional communication is very important for overall development of technology. The users have to be told what tools they have. Once we are out of school those opportunities are limited. There is just too much to do than just browse every single medical journal to see what’s new out there. Every single day the fast food companies advertise on television and ask our children to eat cholesterol laden food which will make them obese. Every single day marketeers are ruthlessly selling a lot more harmful stuff to everyone including us. We should focus on that, rather than just be trapped in our own world of medicine and to cut communications inside it. Senator Grassley and gang; Read it, print it, frame it, and hang it up on your office walls. Bill Bartmann
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August 28, 2009
Peter Pitts
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August 27, 2009
Peter Pitts
According to a report in PharmaTimes: “A study has found that over 80% of on-line advertisements for Internet pharmacies accepted by the search engine Yahoo were in violation of US federal and state laws.The researchers were able to buy prescription drugs without a prescription from Yahoo Internet pharmacy advertisements, and in one case the drugs were imported from India, which is prohibited by US law, says the survey, which was conducted by research firms LegitScript.com and KnujOn.com.” The complete report can be found here. -
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August 26, 2009
Caroline Patton
Earlier this week I discussed why differences in definitions of live and still birth make comparisons of international statistics on infant mortality misleading. But these divergences in reporting requirements are not the only reason that international comparisons of morality rates are unreliable and inaccurate.
In other cases, bureaucracy intrudes so that even those who meet the definition of live birth may not end up in statistics. In France, in order for the baby to be given a birth certificate as a live birth, one must have “a medical certificate [that] attests that the child was born ‘alive and viable’.” On the other hand, “[i]n the absence of a medical certificate attesting that the child was born ‘alive and viable,’ the civil service officer only establishes a certificate of a child without life,” in lieu of a birth certificate. Overall, “this procedure applies, on one hand, to children born alive but not viable, and on the other, to children stillborn after a term of 22 weeks…or with a weight of at least 500 grams.” Thus, there is ample opportunity for babies to not be counted either because they are considered nonviable or because a certificate that they were born alive and viable could not be obtained. The scale of the resulting impact on mortality rates is implied by statistics that show that under a sixth of recorded infant deaths in France take place in the initial twenty-four hours after birth, versus one-third in both the US and Canada. Another such case is Canada. Like that US, Canada uses the WHO definition of live birth but bureaucratic complexities may mean that not every baby born alive makes it into the register of live births. One such baby is Sonja Stefnovic, born January 6, 2006 in Ontario and who, though she lived a mere 35 minutes, more than met the criteria for a live birth. Yet, when her parents asked for a birth certificate they were told none existed. The paperwork had been filed to register her death but not her birth, which, unbeknownst to her parents, had to been registered separately. As far as Ontario was concerned, Sonja had never been alive at all. While such cases are unusual in most of Canada, they are endemic in Ontario where in the last ten years there have been over 30,000 cases of unreported births due to bureaucratic delays, confusing procedures, and a substantial fee for registering births. That adds up to thousands of missing birth records each year and constitutes 30 percent of records of babies who lived less than a year. And Ontario makes up 40 percent of births in Canada. Ontario has also consistently been late in reporting births to federal statisticians. Arne Ohlsson, director of evidence-based neonatal care and outcomes research at the University of Toronto has said that, "[b]ecause such a large proportion of the population is born in Ontario and those vital statistics are not accurate, the country's statistics are not accurate and comparisons with other countries will be inaccurate." Whether the flawed records are used in calculating national statistics or whether Ontario is omitted, the result is nonetheless a number that does not cover all the babies born in the country. Even if you can overcome the statistical problems, there are other factors that make infant mortality rates an inaccurate tool for comparing the quality of care in different health systems. Access to and quality of care are certainly influential in determining death rates but elements related only partially, tangentially, or not at all to the medical system are critical as well. Many are cultural, like delayed childbearing, use of fertility treatment, multiple births, or a high percentage of teen births, since these trends come with higher prematurity rates. Further, mortality rates are affected by ethnic factors that differ widely –and cannot be dismissed merely as reflections of access or socio-economics. Culture may also trickle into medical care in another realm, in influencing the willingness of doctors and hospitals to pull out all the stops to try to save even the smallest and most premature babies. In the US, the expectation is that doctors will do everything possible to keep preemies alive unless the parents object. But in the Netherlands, premature babies below 25 weeks gestation are no longer to be resuscitated because the chance of survival without serious disabilities is considered low and they are instead given palliative treatment. Other nations fall somewhere in between and in countries like the UK and Canada, the enormous cost of intensive intervention and shortages of pediatric nurses and spaces in NICUs have played a significant role in the debate over when and how to intervene. What the ‘correct’ policy may be is beyond the scope of my present post –and the answer is probably neither singular nor fixed. But it is something that needs to be taken into account when comparing statistics. All of these issue show why international statistics should be interpreted with extreme caution, at least until we know where the number come from, how they are derived, and what other factors are simultaneously in play. And although it may be frustrating to know that, as in this case, the answer may be that the statistics cannot tell us much about the strengths and weaknesses of health care systems and their relation to one another, it is better to know we are in the dark than to clutch at false illumination. Kelsey Smith
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August 26, 2009
Peter Pitts
With all the talk about healthcare reform going around Washington, one thing that has been overlooked is an industry in which tens of billions of dollars is spent annually with relatively limited federal oversight—namely dietary supplements, or "complimentary medicine." The passage of the Dietary Supplement Health and Education Act (DSHEA), in 1994, represented an attempt by Congress to regulate the burgeoning marketplace in "natural" health remedies. The intent was to protect consumers from snake-oil salesman while allowing access to a large and legitimate category of health options. The most important reform in DSHEA established that dietary supplements would be regulated as foods rather than medicines. For that reason alone, it's time to review the shortcomings of DSHEA.
Are these products foods or medicines? Well, to quote the great Hoosier poet James Whitcomb Riley, "If it walks like a duck and swims like a duck and quacks like a duck, I call that bird a duck." To those who would peddle dietary supplements as medicine, the message must be that FDA has the authority to stop you if and when you cross the line. And to Congress, the message is that if FDA is to embrace a "safety first" philosophy, then DSHEA needs to be reformed—because the line has been crossed too many times. This oversight must be corrected immediately. For the rest of the story, check out this piece from Pharmaceutical Executive Magazine. -
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August 26, 2009
Dr. Robert Goldberg
Senator Kennedy passed away a bit after midnight today. He lived 15 months after being treated for an advanced form of brain cancer. To the end he fought for what he believed in and was warmly regarded by everyone he dealt with of both parties -- staff included -- for his kindness, trustworthiness and comraderie. He was instrumental in reshaping FDA reform bills to refocus them on modernization not mindless retribution and it is unfortunate that illness left him unable to be fully engaged in the current health care debate. I will let others reflect on the other apsects of his life and legacy. As for me, I remember his moment of grace when delivering the eulogy for his brother Robert Kennedy:
"My brother need not be idealized, or enlarged in death beyond what he was in life; to be remembered simply as a good and decent man, who saw wrong and tried to right it, saw suffering and tried to heal it, saw war and tried to stop it. Those of us who loved him and who take him to his rest today, pray that what he was to us and what he wished for others will some day come to pass for all the world." As he said many times, in many parts of this nation, to those he touched and who sought to touch him: "Some men see things as they are and say why. I dream things that never were and say why not."
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August 25, 2009
Dr. Robert Goldberg
There are few people who purport to be academics with a more apt name than Donald Light... The man who invents statistics about international drug pricing and the cost of drugs and has no economics background is at it again and this time his ideologically driven and sloppy research finds a welcome home at Health Affairs.
Light has a personal vendetta against Joe DiMasi of the Tufts University Center for the Study of Drug Development. Light believes there is an international conspiracy to protect the validity of DiMasi's scholarly work on the cost of drug development. Light thinks that because the data on actual costs for each drug studied is not publicly available it can't be verified which is like you can't trust audited financial statements unless you have all the taxi receipts publicly available. The fact is, DiMasi's estimate of the capitalized costs of bring a new molecular entity to market, as opposed to just adding a liquid form of the same drug, has been verified time and again by analysis of private, public and public-private drug development activities where both opportunity costs and clinical trial complexity can be measured. But Light has his followers who are innovation haters and who believe that the true measure of drug costs are what it costs to bring a generic drug to market. Which begs the question that his Lightness never answers: if it costs so little to bring a new drug to market, why aren't generic companies innovators... In his lightweight Health Affairs piece, Light only avoids the issue further by claiming that producing more pill forms in response to price controls is a true measure of innovation. But he does a service by showing us the sort of dumbed-down health care we would receive under price controls of any form...and demonstrates again why Joe DiMasi is a class act and a real economist and some people just aren't either... Oh, and Light has NO degree in psychiatry or medicine ...
Bethesda, MD -- It is widely believed that the United States has eclipsed Europe in pharmaceutical research productivity. However, a comprehensive data set of all new chemical entities approved between 1982 and 2003 shows that the U.S. never overtook Europe in research productivity, and in fact Europe is pulling further ahead, according to a study published today on the Health Affairs Web site. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.5.w969 The study is one of three released by Health Affairs dealing with prescription drugs and intellectual property. The U.S. share of approved new drugs did increase in the decade from 1993 to 2003, as compared to the previous decade from 1982 to 1992, but that simply reflected the fact that the pharmaceutical industry poured more of its research dollars into American labs, says study author Donald Light, a professor of psychiatry at the University of Medicine and Dentistry of New Jersey and the Lokey visiting professor at Stanford. Over both decades, the U.S. share of approved new drugs lagged behind its share of research funding. On a dollar-for-dollar basis, Europe was more productive in discovering new drugs than the U.S. was, and the European productivity advantage was greater in the period from 1993 to 2003 than it had been in the period from 1982 to 1992. Japan outstripped both Europe and the United States in pharmaceutical research productivity over these twenty years. “Congressional leaders and others concerned about high prices of new patented drugs will be heartened by this analysis, because lower European prices seem to be no deterrent to strong research productivity,” writes Light. He cites previous research showing that pharmaceutical companies are able to recover research costs and make a “good profit” at European prices, and he rejects the notion that Europeans are “free-riding” on American pharmaceutical research investments. Donald Light
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August 25, 2009
Peter Pitts
A new report out of the University of Chicago (a national random sample mail survey of 599 primary care physicians and 600 psychiatrists from November 2007 to August 2008) indicates there is confusion among physicans about what is or is not “on-label.”
According to the abstract, the average respondent accurately identified the FDA-approval status of just over half of the drug-indication pairs queried (mean 55%; median 57%). Accuracy increased modestly (mean 60%, median 63%) when limited to drugs the respondent reported having prescribed during the previous 12 months. There was a strong association between physicians' belief that an indication was FDA-approved and greater evidence supporting efficacy for that use. The study’s senior author, Dr. G. Caleb Alexander (assistant professor of medicine at the University of Chicago) said a concern was that off-label uses often did not have the same level of scientific scrutiny as FDA-approved uses. All the more reason for the FDA and the pharmaceutical industry to jointly develop (as part of the agency's Safe Use initiative) better ways to make the PI more user-friendly – specifically the physician-user. Here’s an idea – how about FDA-approved PI detailing guides? A good discussion topic for the Risk Communications Advisory Committee. -
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August 24, 2009
Caroline Patton
All too often people on all sides of the health care debate, to quote 19th century Scottish writer Andrew Lang, “use statistics as a drunken man uses lampposts – for support rather than for illumination.” So, I will attempt to shed some illumination on one of the reoccurring statistics of the American health care debate: infant mortality rates –and on why, in general, we must interpret statistics with care. Today I want to talk about how differing definitions have made infant mortality statistics incomparable across countries. Later this week I will address the role played by other factors.
As most have heard by now, the US has a significantly higher infant mortality rate than its peers, which is presented as a sign that its health care system is lacking. The first problem with international comparison of infant mortality rates is that definitions of live birth and stillbirth are not fixed and may be ambiguous or subjective. The US simply uses the World Health Organization definition, which classifies as a live birth any case in which there is “complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life - e.g. beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles - whether or not the umbilical cord has been cut or the placenta is attached.” But in the UK, while live birth goes essentially undefined, the legal definition of a still birth is “a child which has issued forth from its mother after the twenty-fourth week of pregnancy and which did not at any time after being completely expelled from its mother breathe or show any other signs of life.” The question of what constitutes a sign of life is left open, subject to the interpretation of medical personnel. Second, the fate of babies born earlier is left in a gray area. Again the judgment of doctors is crucial in determining which preemies are counted as still births and which are considered live births. Similarly, in Germany, the definition of a live birth follows closely, but not exactly, the WHO criteria. Under German law, “[a] live birth…exists when in a child after the separation from the mother’s body either the heart beats or the umbilical cord pulses or the natural breathing of the lungs begins.” This omits, however, voluntary movement. Like in the US, weight is not a criterion for live birth, although a threshold of 500g birth weight is used to differentiate a stillbirth or death during birth from a miscarriage in cases where the child shows none of the three above signs of life. Switzerland only uses two of the four WHO criteria, the two most obvious signs of life, respiration and heart beat. The oft cited figure of 30 cm as the required length for registering a live birth is not universal in Switzerland but is present in some cantons. Studies have found significant underreporting of premature births in Switzerland, including babies included in either local or national listings but not both, which can alter the overall mortality rate by more than a percentage point. Need more proof? Check out the following chart of restrictions on the gestation at which births must be reported as still or live:  Selected statistics from EURO-PERISTAT Project, with SCPE, EUROCAT, EURONEOSTAT, “European Perinatal Health Report,” 2008. These variations in definition are important because they mean that some babies are not counted in the statistics or are counted differently depending on the country. The broader the criteria for live birth, the higher the infant mortality rate will be because you will be including more babies who ultimately do not survive. Restrictions based on gestation or birth weight, which are present in some countries, exclude precisely the babies that are most likely to die and artificially bringing down the mortality rate. The fact that criteria for registering stillbirths also vary means that some babies are not counted at all and also makes it impossible to correct the statistics or to use alternative statistics, like fetal or perinatal mortality, to produce a numbers that are more representative and comparable across countries. -
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August 24, 2009
Peter Pitts
The Teva (Hebrew for "Nature") press release begins as follows: “Teva Pharmaceuticals USA, the world's leading generic pharmaceutical company, today announced the start of its "Patient First" project as part of the Year of Affordable Healthcare campaign. The initiative, available at: www.yearofaffordablehealth.com/patients, features a first-hand perspective of everyday Americans as they struggle with the enormous and sometimes insurmountable expense of paying for their prescription medicines.” And ends: But – just how much will FOB legislation really change the cost equation? Well, for starters, that’s the wrong question. The right question is (not surprisingly) more complicated. And it’s a two-parter: How much will FOB legislation change the cost/quality equation? If we can stipulate that quality (aka: safety) cannot be sacrificed for cost (Can we, in fact, stipulate that? Hope so.) – then the answer to cost reduction is maybe 20% or so. Significant, yes? Game changing from a spend perspective? Well – it ain’t chicken feed, but neither is it manna from heaven. The first point to consider is that FOBs aren’t generics in the Hatch-Waxman sense. (Note: Always take a corrective 2X4 to anyone who utters “generic biologics.”) FOBs will require robust (aka: expensive) clinical trials and complicated (aka: expensive) GMPs. That’s just the nature of the beast. The next point is that the above will restrict the number of classic “generics” companies who can play in the FOB space (and Teva is at the top of that short list). The ramp-up is too expensive and the risk is too high. And there are three kinds of risk. The first is failure in either the clinical trial or the GMP aspects of the proposition. The second is that the profit margins are radically different from small molecule generics. And the third is that innovator companies are likely to stay in the game post patent-expiry. It’s that third issue that’s the biggest as well as the least discussed. So, let’s talk about it. Will costs come down? They will. But don’t look for the same precipitous decline in prices that we’re used to seeing from Hatch-Waxman generics. As far as Teva’s “Patient First” program is concerned – kudos. But safety first trumps all. -
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August 21, 2009
Peter Pitts
From the Lou Dobbs program, Thursday, August 20th, 2009: The complete Lou Dobb segment can be found here. -
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August 21, 2009
Peter Pitts
The 8th U.S. Circuit Court of Appeals has rejected That’s unfortunate since it will lead to So there is preemptive authority when it comes to pricing – but their isn’t preemptive authority when it comes to safety? An unfortunate allegory akin to health reform really being abot cost containment rather than patient care. -
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August 20, 2009
Mario Coluccio
Politico is reporting that “House Democrats are probing the nation’s largest insurance companies for lavish spending, demanding reams of compensation data and schedules of retreats and conferences.” Who is one of the major players driving this investigation? None other than Henry Waxman, Chairman of the House Energy and Commerce Committee. Surprise, surprise. Given the economic make-up of Congressman Waxman’s congressional district, you’d think he would have more than enough “lavish spending” and “schedules of retreats” of which to investigate. Nope. Politico continues its report: Letters sent to 52 insurance companies by Democratic leaders demand extensive documents for an examination of ‘extensive compensation and other business practices in the health insurance industry.” The letters set a deadline of Sept. 14 for the documents. Oddly enough, there’s plenty of work for Mr. Waxman without probing insurance companies or his district. It’s called Medicare. Over his career, Waxman has never missed an opportunity to cut funds for anti-fraud efforts at the Department of Health and Human Services. He has consistently opposed introducing market-oriented competitive bidding in Medicare, which would greatly reduce massive fraud, particularly in the durable medical equipment space. He also opposes efforts to promote transparency for providers of healthcare services, despite the fact that 98 percent of Americans believe they have the right to know cost and quality information. One would think that making it easier to know which hospital is more likely to kill you would be pretty non-controversial. So why is Mr. Waxman so interested in how private companies spend their money and apathetic to the significant fraud inherent in Medicare – a program that falls well within his Committee’s oversight role? This nonsensical probe only serves to reinforce the public’s perception of Congress as being out of touch. Pay attention, Detective Waxman. -
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August 20, 2009
Mario Coluccio
With their dream of socialized medicine fading before their very eyes, the smear merchants at Media Matters are in propaganda overdrive. Media Matters is falsely claiming that a recent Atlanta rally in defense of health care freedom fell far short of expectations: Right-wing organizers hoped 15,000 people would attend a Centennial Olympic Park rally this weekend to yell and scream about health care reform. In the end, just one-fifth of that showed up. Not true. More than 12,000 Americans showed up at the rally. A 90 degree weather, raging humidity, scorching sun, and a security team greeted all attendants of the Healthcare rally at the Centennial Olympic Park downtown Atlanta this Saturday. Upon entering the area, after having their bags and backpacks searched, everyone received a paper hand "bracelet" that read "americastownhall.us". The bracelet helped organizers keep track of how many people attended. The event started at 1 p.m. and ended shortly before 4 p.m. At around 3 p.m. it was announced there were at least 12,000 in attendance. Not only that, the rally was competing with a Paul McCartney concert in the area, the extremely hot weather, and an Atlanta Braves game. 12,000 people still showed up to make their voices heard on this issue. At the end of the day, Media Matters’ continued diminution of the majority of Americans who stand opposed to a government takeover of health care only deepens that outfit’s lack of credibility with the public. In that regard, more power to them. By the way, CMPI’s Vice-President Robert Goldberg participated in the Atlanta rally. Video of the entire rally can be viewed here. -
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August 20, 2009
Peter Pitts
Is a public health insurance option essential? Only if we want healthcare reform to fail in Congress and flounder in practice. Rather than turning Uncle Sam into Uncle Sam, MD, we should learn from history and build on the success of Medicare Part D - the prescription drug benefit for senior citizens. Part D is the largest health entitlement program since Medicare was signed into law in 1965. It has a 90% + approval ratings among its users and the projected cost for the program is $117 billion lower over the next decade than experts estimated. When it comes to the federal government providing healthcare to millions of Americans- it can be done with satisfaction and budgetary prowess.
How? By adhering to free market principles. The success of Part D is due to its uniquely American hybrid nature. The federal government partnered with the pharmaceutical and insurance industries to offer senior citizens healthcare choice via free market competition. Rather than a one-size-fits-all government plan, Part D offers dozens of private sector plans offering Medicare-eligible Americans various options that best suit their personal healthcare situations. Uncle Sam doesn't design the programs or process the claims or dictate the formularies. Uncle Sam writes the check and sets the ground rules so that everyone has access to the medicines they need. And the same can happen for access to health insurance - but only when we purge ourselves of the notion of the "essential nature" of a "public" plan. -
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August 19, 2009
Mario Coluccio
Yesterday, Congressman Anthony Weiner (D-NY) appeared on MSNBC to promote the “public option” and maintained that would continue to push for a public plan in any House bill once he returns to Capitol Hill after recess. Congressman Weiner, obviously no Economic Scholar, repeatedly declared that health care is not a commodity throughout the interview. Ed Morrissey happily offers the Congressman an Economics 101 lesson free of charge: Of course health care is a commodity. Weiner wants to use this populist pet phrase, which goes along with the notion of a “right” to health care, but it’s absurd. Food is a commodity, water is a commodity, clothing and shelter are commodities. Until cap-and-trade came up in the House, air was not a commodity, but carbon dioxide will shortly become one, even though life itself cannot exist without it. People have to produce the goods and services that comprise the health-care industry, which means that the supplies are finite and they expect to get compensated for their work. That makes it a commodity, regardless of Weiner’s socialist rhetoric. Anything with a cost is a commodity, by definition. Morrissey points out that, “Anyone who doesn’t understand that much about economics has no business creating policy.” Hear, hear! Words do have meaning, after all. -
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August 19, 2009
Peter Pitts
In April 2004 (when I was an associate commissioner at the FDA), I met with representatives of the major credit card companies. The focus of these meetings was on how their transactional services were being used to facilitate illegal internet prescription drug deals. I was roundly denounced by, among others, Wisconsin Governor Jim Doyle, as using “hardball tactics" to stop traffic in low-cost prescription drugs from Canada.” Political rhetoric aside, it was all about safety.
As it is today. According to a story in today’s Financial Times, Search engines pressed over drug ads policy, “Pressure is building on the major US search engines to stop showing advertising from overseas drug sellers that deliver potentially counterfeit and dangerous products to consumers in violation of federal laws. The US Drug Enforcement Administration and the Food and Drug Administration are concerned that the practice is continuing despite the deaths of consumers who ordered drugs without examination by a doctor.” It was the right thing to do in 2004 and it’s the right thing to do now. -
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