Saturday, August 19, 2006

The Lie of Drug Company Profits -- What's the Reason?

Last time I informed you that the complaint that drug company greed was driving up the costs of drugs was actually untrue, and that it was actually part of a coordinated campaign of lies and manipulations by certain individuals. I then specifically identified this group as being the Democratic Party. Now I will explain the reason for all of this.

The purpose of the manipulation is, of course, to serve as a means to a particular end, in this case more power. Power over other people's lives. The only kind of power that means anything in the political world. Many people think that the end is money, but to these people, money is just another way of wielding power.

This is how the manipulation works: If I can get you upset enough about the "fact" that somebody (else) is taking advantage of you, I can get you angry enough to demand change. If I can get enough people angry enough, then I can create a force for change. And if I have been the one creating the upset, anger and now the force for change, I can suggest the alternative improvement that will fix the problem. And naturally, that solution will ultimately leave me and those like me in charge of ever increasing portions of your life, giving me more and more power over you. Yes, the power that these people want is not the power to change things, it is the power to control you.

In this case, the lie is that the drug companies make too much money, and they make it at your expense. This leads to the upset, and makes you angry. When enough people are angry enough, then they propose the solution -- price controls, managed care, a government controlled Medicare Part D, et cetera. Once they control these things, they can tell you which drugs you can and cannot take (via formularies), thus controlling another little part of your life.

When did this begin? And why do I blame only the Democrats? The seeds were likely planted long ago, but this particular manipulation became blatantly apparent during the Presidential campaign of 1992. During this campaign, Bill Clinton strapped a saddle onto the backs of the drug companies, hounding them (and of all of healthcare only the drug companies) about their prices and their "obscene" profits. He rode the drug companies into the White House. But then he made a big mistake.

Instead of trying to bend to his will the force he had created against only the drug companies, he tried to use it to control all of healthcare by proposing the Clinton Healthcare Plan (aka "Hillary Care"). This plan was a none-too-thinly veiled attempt at a government takeover of the insurance industry. But the American people had not been made angry at the insurance companies, so they wisely stopped this plan in its tracks.

Today, the public at large are finally (and more appropriately) being made angry at the insurance companies, who actually are making obscene profits, enough to make the oil companies jealous. And there are those in the political world ready to offer their radical solution.

A single-payer government healthcare system. Government control over every aspect of your healthcare.

Keep in mind that the only healthcare system that the government knows how to run is the VA Medical System. (Medicare is actually an insurance plan, not a medical system.) The VA system is for all intents and purposes a staff model HMO. Managed care. And managed care saves money in only two ways: rationing and cost shifting.

Why blame only the Democrats? It was they that rode the pharmaceutical industry into office. It was they who tried to take over the health insurance industry. And it is only among the Democrats (and a few fringe liberal groups) that one hears the call for a single payer system.

Hopefully the American people will keep their wisdom and kill this idea also. But I'm afraid, very afraid, that the manipulation this time will succeed.

Wednesday, August 16, 2006

Think The Drug Companies Are The Problem? Think Again

Once again it's time to get back to the task of discussing why medicines cost so much. Or in this particular case, why they don't, though you think this is a reason that they do.

If you were to go out on the street and ask people why they think their medicines are so expensive, I suspect the most common response would be something like "Because the drug companies are too greedy!" And it's not surprising that they would blame the drug companies. After all, that's what they've been told is the main problem for years. Unfortunately, what they've been told for all these years is a fabrication. A fabrication constructed for one and only one ultimate purpose -- manipulation to an end.

Now, regular readers here (I am egotistically assuming that there are some regular readers despite the lack of evidence to support this) have already learned about my belief that some things in medicine are done for non-altruistic, power-seeking purposes (see "Medicare Part D Delenda Est!"). This is another one of these purposes.

We have all been led to believe that the drug companies greedily seek exorbitant profits, and that this is what is the major force behind the escalating cost of prescription medicines. This is not really the case. The corporate profits of the drug companies, after expenses including R&D, is no higher and really no lower than that of your average large corporation. (I will fault the drug companies, however, for trying to hide behind the argument 'we need these profits to fund R&D'. R&D is a business expense, everybody else considers it a business expense, you guys consider it a business expense, no one else is ashamed of it and you shouldn't be either.)

The purpose of this fabrication takes a little explanation. In the current twisted field of medical reimbursement, the vast majority of people have no idea what their medical care costs. Medicare or Medicaid or managed care or an insurance company foots the bill, and all most people ever see is the co-pay, if that much. Those few who look at their bills think they are getting a great benefit from how much their doctor charged and got paid by the payor, never realizing that the doctor really only got paid some small percentage of his charges and the rest went away as a "contractual write-off". (This issue itself is another reason I'm nigh on to postal, but that's a different rant.)

Medicine costs are a different matter. Most people either pay for their own medicines or pay a much higher percentage of the costs of their medicines, so they are much more sensitive to this cost. This makes it an excellent target for manipulation. And there is one group that excels at manipulating it.

Some would call this group "liberals". I think this actually maligns some liberals, as little as that is possible. I am more willing to focus down to who it really is that is doing the manipulating with this fabrication, and I am willing to name names.

It is the Democratic Party.

But what is the purpose of this kind of manipulation? What is the goal? What power am I talking about?

More in my next post.

Saturday, August 12, 2006

God Sent Me A Kittycat and His Name Was Toby


Toby was born sometime in 2003; the exact date is known only to his littermates. He died on July 23, 2006 after a lengthy illness. He is survived by his owner, PostalMed, and his constant companion, Tyler. Services were held at a private cemetery belonging to the family.

I lost my friend on July 23 of this year. Already you are probably wondering what this has to do with anything medical, but I'll come to that. But you need a little backstory first.

I have had a few dogs in my life before, but never a cat. I was a dog person; cats were inferior creatures. And all three of my previous dogs had had good, full, long lives. In October 2003 I had been without a pet for some period of time. And then a cat found me. Or rather, God sent me a cat.

One morning I awoke to find a half-grown scrawny cat clinging to the window screen of the breakfast nook like one of those Garfield dolls you've seen stuck to the inside of car windshields. The breakfast nook window faced out onto the covered back porch. Nothing I could do over the next few days could persuade this cat to leave. I swung a broom at him (no, I did not hit him with the broom; I reserve that to those of the human persuasion); I tossed him out into the rain; I tried yelling and other loud noises. He would occasionally wander off but every morning there he'd be, either clinging to the screen or sleeping in an empty flowerpot on the porch. "Well," I figured, "he'll leave when he gets hungry enough." One morning he wasn't there. But wait, there he was, crawling headfirst down a tree in the backyard!

After almost two weeks of this, I couldn't take it anymore. I tossed him a slice of ham (which he promptly dashed off with). Okay, he could be the porch cat. That lasted for about a week, till the first time it got cold. Then in he came. He got a bath and a trip to the vet to check him for disease, but except for some intestinal parasites, he checked out clean from all the usual cat ailments. After about another month I figured it out; his name was Toby. (I have always believed that you don't name a pet; you wait till it tells you (by its personality) what its name is.)

For the first year or so, everything was grand. He played, he ate, he pooped (always in the litterbox; he took to it instinctively), he slept and he slept some more. He grew and became a sleek, sophisticated, elegant, almost professorial cat. He almost never made noise and his meows were quite soft. He tossed his own featherball and then chased it down. He made sure my alarm clock woke me up by crawling under the covers and attacking my feet. He occasionally decided to give my hair an impromptu grooming. (He had a thing about hair, the longer the more fascinating.) He chased the laser pointer to the point of exhaustion. He hid in the laundry sink when my great niece came to visit. And he finally learned to purr, although so quietly you had to almost have your ear in front of his mouth to hear it.

In late 2004 things began to change. He slept more and more. He didn't eat as much. Ultimately he stopped eating altogether. He lost weight -- lots of it. After exhaustive testing (if you knew how much that all cost you'd realize just how postal-crazy I am!) we had an answer. Toby had feline leukemia virus (FLV for short). On his initial vet visit he had tested negative for this and he had been vaccinated, so this wasn't the first thing we checked. And he had never been exposed to any other cats since he had acquired me. FLV has a window period (like another virus we all know and fear), and we had missed it the first time around.

By this time Toby had lost about one-third of his body weight, so nutrition was paramount. Have you ever force-fed a cat? It's an interesting process. Through perseverance and with time Toby regained his weight. And after almost seven months of force-feeding, he began to eat on his own again. We had turned the corner -- Toby would live! But some of his blood counts remained low and his FLV test remained positive. The vet was somewhat less than cautiously optimistic.

For about 9 months Toby did fine. Then he started losing weight again, and quit eating. But this time it was different. The weight loss was rapid, and he actually felt thinner and more fragile than the measured amount of weight loss would indicate. Over the July 4th holiday, he started getting short of breath. So back to the vet he went.

It took the vet only a couple of minutes to discover that Toby had a pleural effusion, fluid trapped between his lung and chest wall, and it was smothering him. The vet removed 250 mLs of fluid (for a cat this is enormous), and then he could breathe better. Analysis of the fluid suggested the cause was heart failure. So we put Toby on Lasix and started to force-feed him again and hoped for the best.

Two weeks later, Toby was short of breath again. The fluid had returned. Only this time the fluid didn't look like heart failure. It was the kind of fluid that is usually caused by cancer. The rapid weight loss finally made some sort of horrible sense. My cat was a candidate for hospice care.

I took Toby home. I decided that if he began to suffer I would take him back to the vet for the final time, but I didn't really want to have to do this. But he didn't suffer. He never looked like he was struggling to breathe, though right at the end he did get cyanotic. Two days later, in the early morning hours of that Sunday, God took back the kittycat he had sent me only three years before.

That cat's death after only three years bothered me more than losing three dogs after 14-15 years each. Maybe it was because we fought so hard together to try to beat that virus. Toby died on July 23, 2006. But really I "lost" my cat in late 2004, when he first got sick. Even after his nutritional rescue, when we thought we had turned the corner, he was never the same cat as he was before. He didn't chase the laser pointer anymore; he didn't play with his featherball; he no longer crawled under the covers to attack my feet. And the quiet purr was no more.

Now comes the medical aspect of all this. Feline leukemia virus is a retrovirus similar to another feline virus, FIV--feline immunodeficiency virus, which is a close cousin to that dreaded human virus, HIV. Of these three, FLV was actually discovered first, in the 1960's, and it was the knowledge of its existence and what it does that led researchers to consider that AIDS might be caused by a virus (which we now know as HIV). Despite its name, the vast majority of infected cats do not get leukemia as was thought in the 1960's and 1970's, hence the name. However, FLV primarily causes immunodeficiency and it is this that occasionally leads to leukemia. FIV, which is even closer genetically to HIV, was actually discovered slightly after HIV. But they are all retroviruses, and they all have somewhat similar effects on the immune system.

Supposedly some researchers believe that FLV/FIV could be used as an animal model for HIV, and that discovering how FLV works and how to treat it would benefit human AIDS patients. A Google search for FLV and FLV+ research does not seem to indicate that this is happening to any great extent. One would think that using cats in research would be cheaper than using chimpanzees (which get SIV); however, it does not look like there is a lot of research going on into looking for treatments for FLV.

If FLV/FIV can serve as models for HIV, then it stands to reason that the biggest bang for the buck in research would be by looking for treatments for FLV/FIV and then trying them on humans, but as far as I can tell, it seems that the exact opposite is occurring. Human AIDS drugs are being tried on cats! Unfortunately, the HIV drugs either do not work or are too toxic to be used in cats. (Cats have very sensitive systems; vets have their work cut out for them taking care of cats.)

So far, there has yet to be discovered any effective treatment for FLV. The Internet is full of websites promoting the use of interferon (human and feline), aloe vera, vitamin C, and other so-called immunomodulator drugs (most of which are either herbal or bacterial extracts) but there is precious little evidence that any of this works. Meanwhile cats continue to die, and even the endangered Florida panther is now threatened by this virus.

Our four-footed companions deserve better than this. My Toby deserved better than this. And many humans in the past, present, and future may have benefited had this avenue of research been pursued more aggressively earlier.

Thank you, Toby, for opening my eyes. Cats are not inferior creatures. They are warm, sweet, cute and cuddly, funny and lovable. They are just as important as dogs and sheep and pigs and cows and horses and little white mice. And if we can learn to heal those animals entrusted to us by God, we might just learn how to heal ourselves.

I miss you, Toby. But I know you're waiting for me at the Rainbow Bridge, along with Duchess, Shaggy, and Scooby Doo. It's going to be quite a reunion someday.