I was listening to the radio this very morning and suddenly felt very vindicated. Let me explain.
Beginning ten years ago, in 1997, I looked at the state of things in healthcare, particularly healthcare financing, and realized that the whole thing was a house of cards, and not a particularly well-built one at that. I've touched on this in previous posts, but in a nutshell, it goes like this:
Insurance premiums go up and up while covered services get fewer and those covered are restricted through "prior authorization" and the like. Meanwhile, patient copays climb higher and higher, while doctor and hospital payments slide lower and lower. Nobody knows the true cost of a service, not even the doctor providing it, because he's had to adjust his fee so much to make up for what the insurance companies aren't paying him that he no longer recalls what the real cost is anymore. Furthermore, government oversight and insurance company meddling increase the hassle factor of medical practice more and more each year, month, and day. Inflation chops away at doctor and hospital profit from the opposite end from the payors at an ever escalating rate. The liberal elite, controlling the media and thus controlling the argument, proclaims healthcare a "right" (which really it isn't) and leads society into believing more and more that they can have all the healthcare they want, the cost be damned. (Of course what is wanted is not counseling on lifestyle changes to prevent or control chronic disease, or medications to thwart the devastation of diabetes, high cholesterol, hypertension, and the like, but rather cosmetic surgery, Botox for everything, laser facial peels, and other crap that won't add a day to their lives.) Swimming over all of this are the sharks, the malpractice lawyer-jackals, who ravenously feed parasitically off of every part of the healthcare systemwithout any restraint . Looked at globally, the entire thing is unsustainable, and headed for collapse, primarily because the wrong component of the system is in control.
So, ten years ago, I began to predict that ten years hence, in 2007, an event would occur that would make it obvious that the wheels were coming off the cart, that the seams were coming apart, that the house of cards was coming down.
Six years ago I refined my prediction -- I named the event . I predicted that the event would be when a major national employer and its labor union would break off talks on renegotiation of the labor contract, and the union would go on strike, and the camel-back-breaking straw would be the health benefit part of the contract.
About two and a half years ago, I learned that there was a major national employer whose union labor contract would be up for renegotiation in 2007. Even better, this employer was in trouble and had already sought and obtained health-benefit-related concessions from the union. So I modified my prediction even more.
I predicted that the event would be when the union went on strike against General Motors because they could not come to terms on healthcare, the union wanting more, and the employer offering less.
So imagine my lack of surprise when I heard on the radio this morning that the contract between GM and its union had officially terminated last Friday at midnight (three days ago), and it was being continued hour by hour while negotiations continue. And the sticking point?
Healthcare benefits.
I feel vindicated. And a little scared.
Why scared? Because the house of cards is coming down, and with the way things are in this country right now, the obvious solution to the coming crisis will be thought to be the same one that was created for the Medicare drug problem -- let the government take over!
Only that will be the wrong solution. For that will take the control of the system out of the hands of the insurance companies, who have control now, and put it in the hands of the government. Control will go from one set of wrong hands to another set of wrong hands. And those who have the right hands will continue to suffer.
Whose hands are the right hands? My answer might surprise you. It's the patients.
Monday, September 17, 2007
Sunday, September 16, 2007
Why Medicines Cost Too Much -- The Government Is Not Here To Help You
I'm finally back to the series on why your medicines cost too much. This time around we're going to look at what many (and they control the news media) say is the solution to the problem -- the ye olde Federal Government. I maintain It is one of the problems, and in many ways.
First off, let's take the Food and Drug Administration (please!). This agency is tasked with protecting the American public from dangerous drugs, and despite recent events with various drugs (Rezulin, Vioxx, Zelnorm, Propulsid, Avandia), they actually are doing a fairly good job of this. After all, the American drug consumer never saw thalidomide (as a morning sickness agent), whereas in Europe many people were born with deformed limbs because of this. And even though thalidomide is now actually on the market (it does have a use for multiple myeloma and certain kinds of resistant leprosy), it is highly regulated and covered with warnings. I of course have no documentation of this, but I am sure there are other medications that we have been equally protected from. It's hard to prove a negative, after all.
Unlike others, who because of the need to withdraw a small number of medicines from the market feel that the FDA allows medications onto the market too quickly, I hold the opposing view. I think they don't approve medications quickly enough. Most of this is because the FDA will not accept foreign (mostly European) safety data for medications and insists that the drug companies do specific studies in the U.S. for them to review. This adds to the already high cost of bringing a drug to market, which must then be recouped. And since a company's patent (and exclusive right to market a new drug) starts when they first invent the molecule and not when they get it on the market, this delay in getting to market shortens the time the company has to recoup the cost. Higher costs, less exclusivity, up goes the price! Meanwhile, some of these drugs have already been on the market in European nations for up to 10 or 15 years! The post-marketing safety data in these countries (or at least those countries we scientifically trust, like England, France, Germany, Spain....) could be used to show that the drug is safe for America, but to my knowledge, the FDA will not accept this data for review.
Another way the Federal government causes escalating drug prices is through its protection of the managed care system. I strongly feel that managed care has never brought down any costs in the medical field, but it sure has saved a lot of money for the insurance companies! In the 1970s, the Congress passed a law commonly called ERISA -- the Employee Retirement Security Income Act of 1974. Though its name does not immediately suggest this has anything to do with healthcare, the law provides certain regulation of employer-provided health insurance programs. Despite the fact that the law does not explicitly provide for this, the health insurance industry has successfully and repeatedly used ERISA as a shield, arguing in court that the federal regulation preempts any state law to otherwise regulate health insurance, thereby preventing state courts (where most malpractice and liability cases are brought) from using state laws to penalize the insurance companies when they deny payment for obviously needed medical care.
The health insurance companies thus literally get away with murder, with their great lie that they only pay for medical care, they don't decide whether care is or is not provided, and that's because of ERISA. As far as I know, ERISA says nothing of the sort, but legal precedent has interpreted it to provide this shield. And of course, legal precedent by a judge is so much more important than what a law actually says. Or a Constitution for that matter. Meanwhile, the cries of many to amend ERISA to explicitly say what is and is not protected go unheeded. The only instances when the insurance companies have not been able to use ERISA as their shield is when their denial of (payment for) care involves a government employee. You see, like most onerous legislation (the ADA, HIPAA, et cetera), the government exempted itself from ERISA.
The Federal government does not just protect managed care, however. Oh no, It expands it. Just what do you think Medicare and Medicaid are? Let's see, both are programs that contract with "providers" to provide care at a dictated discounted price. Why, that's a PPO! And Medicare Part D? Just another pharmacy benefit management system; just more managed care. It doesn't matter whether the Part D benefit is run by the real managed care industry or the faux one called the government. Managed care is managed care. And it will, it can do nothing but drive up the cost to the consumer. The only other choice for managed care is rationing.
But that's another rant for another time.
First off, let's take the Food and Drug Administration (please!). This agency is tasked with protecting the American public from dangerous drugs, and despite recent events with various drugs (Rezulin, Vioxx, Zelnorm, Propulsid, Avandia), they actually are doing a fairly good job of this. After all, the American drug consumer never saw thalidomide (as a morning sickness agent), whereas in Europe many people were born with deformed limbs because of this. And even though thalidomide is now actually on the market (it does have a use for multiple myeloma and certain kinds of resistant leprosy), it is highly regulated and covered with warnings. I of course have no documentation of this, but I am sure there are other medications that we have been equally protected from. It's hard to prove a negative, after all.
Unlike others, who because of the need to withdraw a small number of medicines from the market feel that the FDA allows medications onto the market too quickly, I hold the opposing view. I think they don't approve medications quickly enough. Most of this is because the FDA will not accept foreign (mostly European) safety data for medications and insists that the drug companies do specific studies in the U.S. for them to review. This adds to the already high cost of bringing a drug to market, which must then be recouped. And since a company's patent (and exclusive right to market a new drug) starts when they first invent the molecule and not when they get it on the market, this delay in getting to market shortens the time the company has to recoup the cost. Higher costs, less exclusivity, up goes the price! Meanwhile, some of these drugs have already been on the market in European nations for up to 10 or 15 years! The post-marketing safety data in these countries (or at least those countries we scientifically trust, like England, France, Germany, Spain....) could be used to show that the drug is safe for America, but to my knowledge, the FDA will not accept this data for review.
Another way the Federal government causes escalating drug prices is through its protection of the managed care system. I strongly feel that managed care has never brought down any costs in the medical field, but it sure has saved a lot of money for the insurance companies! In the 1970s, the Congress passed a law commonly called ERISA -- the Employee Retirement Security Income Act of 1974. Though its name does not immediately suggest this has anything to do with healthcare, the law provides certain regulation of employer-provided health insurance programs. Despite the fact that the law does not explicitly provide for this, the health insurance industry has successfully and repeatedly used ERISA as a shield, arguing in court that the federal regulation preempts any state law to otherwise regulate health insurance, thereby preventing state courts (where most malpractice and liability cases are brought) from using state laws to penalize the insurance companies when they deny payment for obviously needed medical care.
The health insurance companies thus literally get away with murder, with their great lie that they only pay for medical care, they don't decide whether care is or is not provided, and that's because of ERISA. As far as I know, ERISA says nothing of the sort, but legal precedent has interpreted it to provide this shield. And of course, legal precedent by a judge is so much more important than what a law actually says. Or a Constitution for that matter. Meanwhile, the cries of many to amend ERISA to explicitly say what is and is not protected go unheeded. The only instances when the insurance companies have not been able to use ERISA as their shield is when their denial of (payment for) care involves a government employee. You see, like most onerous legislation (the ADA, HIPAA, et cetera), the government exempted itself from ERISA.
The Federal government does not just protect managed care, however. Oh no, It expands it. Just what do you think Medicare and Medicaid are? Let's see, both are programs that contract with "providers" to provide care at a dictated discounted price. Why, that's a PPO! And Medicare Part D? Just another pharmacy benefit management system; just more managed care. It doesn't matter whether the Part D benefit is run by the real managed care industry or the faux one called the government. Managed care is managed care. And it will, it can do nothing but drive up the cost to the consumer. The only other choice for managed care is rationing.
But that's another rant for another time.
Friday, September 14, 2007
Aliens Cause Global Warming and Other Wisdom from Michael Crichton
I had found this speech in PDF format several months ago, and after my last posting decided to look it up and link to it. And I found a couple of other gems to go along with it. All of these are a little long, but they are well worth reading.
The first is entitled "Aliens Cause Global Warming" and discusses the underpinnings of the pseudoscience of anthropogenic global warming.
The second is called "The Case for Skepticism on Global Warming". This goes into a little more detail about some of the problems with the so-called data on which the whole idea of global warming is based. His discussion of the statistical tweaking needed to create the 'hockey stick' graph that we've all grown to hate from Al Gore's "An Inconvenient Truth" is not (as far as I can tell) original to Mr. Crichton, as I have previous seen this same criticism made elsewhere by the head of the American Statistical Association.
The last speech is "Complexity Theory and Environmental Management", which isn't about global warming per se, but does reference it obliquely. It raises some interesting concepts to consider if mankind is going to wade into trying to "manage" the climate of this world when we only have the glimmer of an inkling of a grasp of the edges of what actually drives the climate. (This is beside the point that all 7 billion of us together are too puny to really affect the climate.)
And speaking of Al Gore's ridiculous movie, if you haven't watched it, then don't! Or at least try to do it in a way that keeps money from going to this poor deluded soul. I saw it on Showtime, and I must admit that I was surprised to see certain scenes included in this serious tome on how we are ruining the planet. You know the scenes -- the ones with Al Gore campaigning for president, talking about the death of his sister and the accident that occurred to his son, and finally culminating in the scenes of him losing the election (and yes, the news media's recount of every vote in Florida still showed he lost). I wasn't initially sure what all these scenes had to do with global warming, but then it finally dawned on me -- the inconvenient truth isn't that we're melting the icecaps; it's that Al Gore really did lose in 2000.
The first is entitled "Aliens Cause Global Warming" and discusses the underpinnings of the pseudoscience of anthropogenic global warming.
The second is called "The Case for Skepticism on Global Warming". This goes into a little more detail about some of the problems with the so-called data on which the whole idea of global warming is based. His discussion of the statistical tweaking needed to create the 'hockey stick' graph that we've all grown to hate from Al Gore's "An Inconvenient Truth" is not (as far as I can tell) original to Mr. Crichton, as I have previous seen this same criticism made elsewhere by the head of the American Statistical Association.
The last speech is "Complexity Theory and Environmental Management", which isn't about global warming per se, but does reference it obliquely. It raises some interesting concepts to consider if mankind is going to wade into trying to "manage" the climate of this world when we only have the glimmer of an inkling of a grasp of the edges of what actually drives the climate. (This is beside the point that all 7 billion of us together are too puny to really affect the climate.)
And speaking of Al Gore's ridiculous movie, if you haven't watched it, then don't! Or at least try to do it in a way that keeps money from going to this poor deluded soul. I saw it on Showtime, and I must admit that I was surprised to see certain scenes included in this serious tome on how we are ruining the planet. You know the scenes -- the ones with Al Gore campaigning for president, talking about the death of his sister and the accident that occurred to his son, and finally culminating in the scenes of him losing the election (and yes, the news media's recount of every vote in Florida still showed he lost). I wasn't initially sure what all these scenes had to do with global warming, but then it finally dawned on me -- the inconvenient truth isn't that we're melting the icecaps; it's that Al Gore really did lose in 2000.
Tuesday, September 04, 2007
I Am Not Postalmed.com!!!
Just got through Googling myself to see if I was having an impact on society yet. It was an ill-conceived notion, and I am now considering prescribing myself antidepressants. But I did find that I am being poached upon.
Many of the links on the Google results page referenced an organization calling itself postalmed.com. ( I left off the www. to keep from creating a hyperlink.) This seems to be some sort of an Internet-based pharmaceutical ordering company that, as best as I could tell from the two or three minutes I spent looking at it, is based somewhere in India.
I am not, and have absolutely no association with, "postalmed.com". Furthermore I discourage all of my readers (yes, all three of you!) from ordering anything from this company. If this company is based in India, then the quality of anything from there is highly suspect. Additionally, India allows its pharmaceutical companies to flaunt international law and copyright/patent law and produce medicines in violation of US and other national patents. Such action contributes to the higher prices we pay for medicines in the USA and should not be rewarded. If it is not in India, it is still not headquartered in the United States and utilizing such a service is a violation of Federal law.
Many of the links on the Google results page referenced an organization calling itself postalmed.com. ( I left off the www. to keep from creating a hyperlink.) This seems to be some sort of an Internet-based pharmaceutical ordering company that, as best as I could tell from the two or three minutes I spent looking at it, is based somewhere in India.
I am not, and have absolutely no association with, "postalmed.com". Furthermore I discourage all of my readers (yes, all three of you!) from ordering anything from this company. If this company is based in India, then the quality of anything from there is highly suspect. Additionally, India allows its pharmaceutical companies to flaunt international law and copyright/patent law and produce medicines in violation of US and other national patents. Such action contributes to the higher prices we pay for medicines in the USA and should not be rewarded. If it is not in India, it is still not headquartered in the United States and utilizing such a service is a violation of Federal law.
Update on Global Warming
The Canadian National Post continues to expound on the widespread scientific opposition to the idea of anthropogenic global warming. When I first linked to this series of articles, it contained ten articles. The list has now been expanded to 33 articles, with the suggestion that more are to come. Find the current list (and hopefully the ongoing index) here.
If only there were an American media outlet that had the courage to print such a series of articles. But no, like the recent Aug. 13 Newsweek front-cover article (sorry, can't access it online without coughing up money) on the topic, entitled "Global Warming is a Hoax* (with the asterisk leading to a line at the bottom of the cover indicating that the statement was supposed to be a joke), almost all of the coverage in the American media is so pro-global warming it makes me sick. To the writers at Newsweek, let me reiterate: I am a scientist who does not believe in the hypothesis of anthropogenic global warming and I am NOT on the oil industry's payroll.
At least in other countries (which we are being told [erroneously] are more accepting of this fairy tale than we are) the press still sees fit to pursue both sides of an issue to get to the truth. In America, it seems all the so-called journalists have partaken of Al Gore's Kool-Aid.
Is it any wonder that more and more people are getting their news from the Net?
If only there were an American media outlet that had the courage to print such a series of articles. But no, like the recent Aug. 13 Newsweek front-cover article (sorry, can't access it online without coughing up money) on the topic, entitled "Global Warming is a Hoax* (with the asterisk leading to a line at the bottom of the cover indicating that the statement was supposed to be a joke), almost all of the coverage in the American media is so pro-global warming it makes me sick. To the writers at Newsweek, let me reiterate: I am a scientist who does not believe in the hypothesis of anthropogenic global warming and I am NOT on the oil industry's payroll.
At least in other countries (which we are being told [erroneously] are more accepting of this fairy tale than we are) the press still sees fit to pursue both sides of an issue to get to the truth. In America, it seems all the so-called journalists have partaken of Al Gore's Kool-Aid.
Is it any wonder that more and more people are getting their news from the Net?
Sunday, February 04, 2007
Getting Overheated Over Global Warming
Not everything here is going to be medical, as I stated in my mission statement. Today we take a detour into another area of science. Though in this case, the more appropriate word is pseudoscience. The area of which I speak is the idea of global warming, or more accurately, the idea of anthropogenic global warming.
I do not intend to debate or deny the issue that our little planet has been getting a little warmer over the past few years. The data collected so far tells us this is true. But let's be truly accurate about this: Earth has been warming up over the past few thousand years (probably the last 14-18 thousand), since the last Ice Age.
What I will take issue with is that our puny little efforts are what's causing all this. When the warming started (14-18 thousand years ago), I doubt there were too many SUVs pouring CO2 into the atmosphere. Yet the glaciers receded. And when scientific estimates reveal that even a Mount Pinatubo size volcanic eruption spews out more "greenhouse gases" in a day than mankind does in a year, and there are volcanoes erupting somewhere on Earth almost every day, then it doesn't take much incredulity to dismiss the anthropogenic part of global warming. In my opinion, it takes a lot more incredulity (or is it gullibility?) to accept it.
Have you noticed, like I have, that every time one of these Global Warming Doomsayers tells us how warm it's going to get, they include a reference to the last time it was that warm on Earth, and that time is always tens, hundreds, or thousands of thousands of years before the first Homo species gave up knuckle walking? To quote John Stossel, "Give me a break!"
Want some more specific criticisms? Want evidence that the anthropogenic global warming critics (who in the typical liberal ad hominem way are derisively referred to as Deniers, thus creating an unjustified reference to Holocaust deniers) are not a bunch of nutjobs but are actually respected, well-credentialed scientists?
Go here to see the first of series of articles in the online Canadian National Post; links to the rest of the series are in the first article. This series introduces us to some of the Deniers, and why they are such. It punches huge, gaping, SUV-sized holes in the idea of anthropogenic global warming (I say idea since I don't feel it even warrants the term hypothesis, much less theory).
As an aside, I have to note that it is of great interest (to me) that I found this wonderful series of articles in a Canadian media outlet. Why hasn't the American news media done this type of investigation instead of swallowing "Global Warming" hook, line and sinker? Oh, yeah, that's right, this is a liberal issue, and the American media is dominated by liberals.
Before I get accused of being a pawn of Big Oil (a classic technique used to ostracize the Deniers), let me issue a disclaimer: I have received no funds, grants, or payments from any manufacturer of fossil fuel energy. I don't even own oil company stock (though I could kick myself repeatedly for not buying some a good many years ago). The closest I ever come to a connection to an oil company is when I have a gasoline nozzle stuck into my SUV.
I am not opposed to reducing our country's dependence on oil. However, I see this as a crucial national security issue, not an environmental one. And let's face it, the dilithium-regulated matter-antimatter generator (or even a workable fusion reactor) is not right around the corner, or even on the horizon. For the foreseeable future, we're going to have to burn oil (and coal, etc.)
By the way, has anyone ever calculated how much CO2 we humans collectively pump into the atmosphere just by breathing? Might make the cars seem insignificant.
ADDENDUM 2-6-07: Orrin Johnson also noted the series of articles in the Canadian National Post and has a very interesting opinion as to why Global Warming is being pushed so hard. Naturally, the reason is political, not scientific. Take a look at it here.
I do not intend to debate or deny the issue that our little planet has been getting a little warmer over the past few years. The data collected so far tells us this is true. But let's be truly accurate about this: Earth has been warming up over the past few thousand years (probably the last 14-18 thousand), since the last Ice Age.
What I will take issue with is that our puny little efforts are what's causing all this. When the warming started (14-18 thousand years ago), I doubt there were too many SUVs pouring CO2 into the atmosphere. Yet the glaciers receded. And when scientific estimates reveal that even a Mount Pinatubo size volcanic eruption spews out more "greenhouse gases" in a day than mankind does in a year, and there are volcanoes erupting somewhere on Earth almost every day, then it doesn't take much incredulity to dismiss the anthropogenic part of global warming. In my opinion, it takes a lot more incredulity (or is it gullibility?) to accept it.
Have you noticed, like I have, that every time one of these Global Warming Doomsayers tells us how warm it's going to get, they include a reference to the last time it was that warm on Earth, and that time is always tens, hundreds, or thousands of thousands of years before the first Homo species gave up knuckle walking? To quote John Stossel, "Give me a break!"
Want some more specific criticisms? Want evidence that the anthropogenic global warming critics (who in the typical liberal ad hominem way are derisively referred to as Deniers, thus creating an unjustified reference to Holocaust deniers) are not a bunch of nutjobs but are actually respected, well-credentialed scientists?
Go here to see the first of series of articles in the online Canadian National Post; links to the rest of the series are in the first article. This series introduces us to some of the Deniers, and why they are such. It punches huge, gaping, SUV-sized holes in the idea of anthropogenic global warming (I say idea since I don't feel it even warrants the term hypothesis, much less theory).
As an aside, I have to note that it is of great interest (to me) that I found this wonderful series of articles in a Canadian media outlet. Why hasn't the American news media done this type of investigation instead of swallowing "Global Warming" hook, line and sinker? Oh, yeah, that's right, this is a liberal issue, and the American media is dominated by liberals.
Before I get accused of being a pawn of Big Oil (a classic technique used to ostracize the Deniers), let me issue a disclaimer: I have received no funds, grants, or payments from any manufacturer of fossil fuel energy. I don't even own oil company stock (though I could kick myself repeatedly for not buying some a good many years ago). The closest I ever come to a connection to an oil company is when I have a gasoline nozzle stuck into my SUV.
I am not opposed to reducing our country's dependence on oil. However, I see this as a crucial national security issue, not an environmental one. And let's face it, the dilithium-regulated matter-antimatter generator (or even a workable fusion reactor) is not right around the corner, or even on the horizon. For the foreseeable future, we're going to have to burn oil (and coal, etc.)
By the way, has anyone ever calculated how much CO2 we humans collectively pump into the atmosphere just by breathing? Might make the cars seem insignificant.
ADDENDUM 2-6-07: Orrin Johnson also noted the series of articles in the Canadian National Post and has a very interesting opinion as to why Global Warming is being pushed so hard. Naturally, the reason is political, not scientific. Take a look at it here.
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