You’ve heard all the good news coming out of Washington.
al-PhARMA has generously offered to cut their theft by $80 billion over the next 10 years.
The health insurance industry is promising to reduce their greed by 1.5% for the next 10 years.
HCA and other the poor hospital corporations (ignore all of those construction cranes) are offering to forgo a fraction of their annual increases.
What more could we possibly ask for? How about a bit of honesty and some serious savings?
We should note that with universal healthcare, or something approaching it, there will be more patients for the hospitals and more customers for drugs. The insurance companies are expecting more clients as well. The pie will be bigger and they all want a private system to ensure they can continue to leech off of the misery and misfortune of their fellow Americans.
The insurance companies have signed up one-fourth of those eligible for Medicare for a scam. The companies get the Medicare monies plus an additional $11 billion a year subsidy. They promised it would result in better outcomes. It hasn’t. There’s an attractive saving.
If I say let’s rid ourselves of the prime culprits who created the current mess, some will scream that all of those poor, unnecessary insurance company employees will be out of work. Actually, a single-payer system will create far more jobs than it eliminates. It also gives these people something to do which will benefit rather than harm the rest of us. Savings and more jobs.
The savings would even pay for their retraining. The executives would have to adjust to a significant pay cut. I recommend they begin a savings account now. They might even consider selling 3 or 4 of their mansions and trading down a couple of their private jets.
Hospitals may complain about the government requiring them to behave in a socially responsible manner but most are adequately subsidized. There are numerous areas of possible savings for the government vis-a-vis hospitals. Some are obvious, some not.
Without an autopsy many fatalities are ascribed to auto accidents. Was the driver made drowsy by medication? Did a mixture of drugs prove toxic? Hospitals were required to autopsy 20% of the deaths they handled. They failed to do so. So, once again the government relented to the lawbreakers. We are left with less information about causes of death than we could use. This costs lives and wastes money.
Medicare pays for an autopsy when anyone over 65 dies. They pay for it. The hospitals take the payment. They don’t perform the autopsies. The hospitals don’t want their mistakes known. The same with physicians.
The White House is giving major play today to an announcement that the hospitals are offering a savings of $155 billion over the years. That seems too specific a number when one sees the how vague and lacking in detail the “deal” actually is. Don’t get too excited about it yet.
The drug companies don’t want you to be reminded that prescription drugs, taken as prescribed, are the 4th leading cause of death. The information gained from knowing the real cause of death in many cases contributes to the saving of lives and money.
Prescribing a drug for something not approved by the FDA is known as prescribing off-label. It is against the law for drug companies to even suggest it. Surprise, they do it anyway. One drug, Neurontin, earned over $9 billion from off-label uses. That is over 90% of its total earnings. Not a single scientific study showed it to be efficacious for any of these off-label problems.
Neurontin was approved for epileptic seizures. It was almost useless, even for that. It was to be used as a second drug to aid a primary drug if it wasn’t doing the job. The company trained their sales force to break the law by recommending it for essentially everything: ADD, manic-depression, sexual dysfunction, hiccups, any neurological disorders they could think of, tremors, Lou Gehrig’s disease, peripheral neuropathy, migraines and a host of other maladies.
John Ford, a senior marketing executive, told a meeting of salespeople, “That’s where we need to be, holding their hand and whispering in their ear. Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything.” He also stated, “I don’t want to hear that safety crap either. Have you tried Neurontin? Everyone of you should take one just to see there is nothing. It’s a great drug.” This was in response to a question of tripling the approved dosage.
At least $9 billion was wasted on off-label and the remaining billion dollars was spent on something that barely worked in the studies the company itself conducted. Those studies, by the way, were definitely not scientific. They ignored such niceties as randomization, double blinds and placebo-controlled protocols.
Such cavalier behavior, in defiance of the law, is not limited to one drug, or one company. It is rampant. It is costly. There needs to be penalties for physicians prescribing off-label. The government could save billions by refusing to pay for such prescriptions.
They will claim that it is sometimes advantageous. Create a waiver office. Require a waiver in advance if it is to be covered. Records could be kept to see which drugs and which prescribers show up too frequently, prompting an audit. Major savings and fewer lives lost to untested medications.
Presently, the overwhelming majority of research and advertising money spent by the drug companies is aimed at “me-to” drugs. When a competitor has a major success they copy the drug but slightly modify a molecule for the purpose of obtaining a patent. Patents should be given out only one to a class of drugs. Coverage should be for generics only, once they are available. This would provide enormous savings.
The government has no interest in promoting or paying for lifestyle drugs. Yeah, you know what I’m referring to: Viagra, et al. Here is a bit more of a savings.
The members of al-PhARMA are subsidized by the government in many ways. This come through tax advantages that other industries don’t enjoy. It comes through both direct and indirect subsidies.
Some of the biggest breakthroughs in the field came from government labs or academic labs supported by tax monies. The drug lords get to claim credit and profits for these. Why should we taxpayers pay the drug companies to advertise, market and profit from these drugs? Once again, significant savings.
There is no earthly reason for advertising drugs to the public. Only the US and New Zealand permit it. Does the patient know about a drug that was advertised on TV while his physician is unaware of a treatment for the patient’s problem?
Which drugs receive the most airtime and ink? The ones that are the most expensive, the least effective and share the market with the most “me-to” competitors. The savings to the drug companies from not advertising could be passed along. Although probably not, if properly monitored it could be a sizable savings.
Drug companies do not violate the law. The executives do. All legal judgments should be borne by the people who perpetrate the violations. At least tens of thousands of people have died in this country from the illegal actions of pharmaceutical executives. Why have none been imprisoned? Why have none been fined? Why have none been charged?
Eliminate all payments and other considerations of value to physicians from the drug companies. This costs the drug companies and, in turn, the government, insurance companies and you and me. Any physician working for or receiving remuneration from a drug company should be barred from academia and clinical practice for 5 years.
Physicians average an income level that puts them in the upper percentiles financially. If they need free dinners at expensive diners and frequent trips to exclusive resorts in order to read medical studies or listen to paid hawkers of snake oil, they might hold on to their Lexus SUVs an extra year or two. If passed along, the drug companies’ savings would be of considerable help to patients and taxpayers.
Give us real science. We don’t automatically accept the defendant’s account in a courtroom. Why do we accept a drug pusher’s claims for his products? Time after time we see violations of accepted scientific protocols. This isn’t an occasional gotcha. This is de rigueur for the entire industry.
Destroy the FDA and start from scratch. Why are drug companies allowed to pay the FDA to divert their resources? The drug company will only pay for what it thinks is a profitable product. That translates to “me-to” and lifestyle drugs. The FDA’s priority focus of resources should be to needed drugs. The revolving door between the FDA and PhARMA should be boarded up. FDA personnel should not be allowed to work for the drug companies on the side.
When you add up the number of people covered by Medicare, Medicaid, SCHIP, the military, the VA and civilian employees of the government it turns out that the government is already paying 45% of the entire healthcare bill.
Simply extending Medicare to everyone would give us a single-payer system. That would be far more practical and far less expensive than putting the entire population on the Congressional payroll. We would get a better plan though.
The potential savings I have covered are not exhaustive. They are, however, sufficient to pay for a single-payer system without taxing health benefits or being burdened by any of the other straw men the industry is using to scare you.
{ 1 comment }
Awesome post, will be a daily visitor from now on!
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