How an obscure drug’s 4,000% price increase might finally spur action on soaring health-care costs

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By Carolyn Johnson

Spectacularly high drug prices have become a political punching bag, especially since Turing Pharmaceuticals struck a nerve by increasing the price of a 62-year-old drug by more than 4,000 percent — a mind-boggling increase similar to waking up one day and finding out a gallon of gas costs nearly $100.

Hillary Rodham Clinton announced on Twitter that she’d lay out a plan to help control the “price gouging” in the pharmaceutical industry, which she called “outrageous.” Meanwhile, Sen. Bernie Sanders (I-Vt.) and Rep. Elijah E. Cummings (D-Md.) this summer launched an investigation into exorbitant drug prices and began sending letters to drug companies requesting information about their prices.

The details do indeed turn out to be as insane as they sound. But behind them lurks a real lesson about the way drugs are priced in the United States and what role they actually play in the trillion-dollar fight over controlling health-care costs.

New York-based Turing bought the drug called Daraprim for $55 million this summer. It is used to treat toxoplasmosis, a parasitic infection that can be severe in patients with compromised immune systems, such as HIV, and for pregnant women. Earlier this month, the head of the Infectious Diseases Society of America and the HIV Medicine Association condemned the price increase from $13.50 a pill to $750, noting that the average cost per year for a patient weighing more than 132 pounds would be $634,500

Read more at The Washington Post

Hospitals Are Robbing Us Blind

Forget Obamacare. The real villains in the American health care system are greedy hospitals and the politicians who protect them.

Hospitals that don’t face competition from other nearby hospitals have huge power in their local markets.
Hospitals that don’t face competition from other nearby hospitals have huge power in their local markets.

By Reihan Salam

Five years ago this week, Barack Obama signed the Affordable Care Act into law, and we’ve been debating it ever since. Like many Americans, I oppose Obamacare, and I think we ought to repeal it and replace it. Over the past few months, however, I’ve come to the conclusion that the fight over Obamacare is a distraction from a much deeper problem, which is that America’s hospitals are robbing us blind.

I realize that this is an impolitic thing to say. What kind of lousy ingrate doesn’t love hospitals? Go to any big American city, including cities like Cleveland and Pittsburgh that have been devastated by deindustrialization and joblessness, and you’ll find a mammoth hospital complex in the center of town, buzzing with activity. Forget about big cities—there is a hospital in every congressional district in America, and local hospitals are often among the largest employers in the district. One of the reasons President Clinton’s 1993 health reform effort failed is that he never won over the hospital lobby. President Obama learned from the Clinton debacle; hospitals were among his most important allies. Republicans get in on the act too. Right now, for example, a number of GOP lawmakers are pushing a Medicare “reform” that guarantees higher payments to doctors and hospitals today in exchange for the promise of spending reductions a decade or two from now. Good luck with that.

You can hardly blame them though. The health sector employs more than a tenth of all U.S. workers, most of whom are working- and middle-class people who serve as human shields for those who profit most from America’s obscenely high medical prices and an epidemic of overtreatment. If you aim for the crooks responsible for bleeding us dry, you risk hitting the nurses, technicians, and orderlies they employ. This is why politicians are so quick to bash insurers while catering to the powerful hospital systems, which dictate terms to insurers and have mastered the art of gaming Medicare and Medicaid to their advantage. Whether you’re for Obamacare or against it, you can’t afford to ignore the fact that America’s hospitals have become predatory monopolies. We have to break them before they break us.

Read more at Salon.com

You Can’t Quarantine Stupid: Ebola & Unconstitutional Health Policy

WWI propaganda poster warning soldiers against catching venereal diseases
WWI propaganda poster warning soldiers against catching venereal diseases

The year was 1918. After two and a half years of uneasy neutrality, America had finally entered The Great War and had committed over 4 million men to the war effort. As one would expect—or at least hope—the United States government took great care to prepare newly enlisted men for military service, making sure that those who had no prior military experience would be adequately trained and ready to fight when they reached Europe. However, the United States government understood that their soldiers would not only face dangers abroad, but at home as well, and worked tirelessly to keep them safe from that most dreaded of all military foes: syphilis.

Yes, at the beginning of the 20th century, venereal diseases were a massive problem for the US military, with 13% of all Americans drafted by Uncle Sam for WWI testing positive for syphilis or gonorrhea. At the time, there was a more intensely moral stigma around venereal diseases than there is today, and the primary mode of transmission for such diseases was widely thought to reside solely in sex acts that occurred outside of traditional marriage, the most pernicious of these sex acts being prostitution. In response to this, US, state and local governments eschewed the simple solution of providing their soldiers-in-training with prophylactics should they purchase a few moments of a woman’s time and tried to take away the opportunity for soldiers to contract the diseases by dismantling the prostitution trade.

In the summer of 1918, US Congress took matters into its own hands and passed the highly unconstitutional Chamberlain-Kahn Act, which granted the military $1 million to be used in a “civilian quarantine and isolation fund” that could be used to indefinitely detain prostitutes and “promiscuous women and girls.” The exact number of women who were unjustly detained as the result of this program is unknown, but estimates generally suggest a number somewhere around 30,000. The women were held in quarantine for an average of 70 days in federal detention centers and 1 year in reformatories near Army and Navy training camps.

Only 1/3 of the women that were held in these detention centers and reformatories were ever charged with prostitution. The other 2/3 were simply detained for having a venereal disease or for a host of arbitrary reasons ranging from how they dressed to the way they danced. In no way were any of the decisions on who to quarantine based on the most recent scientific findings or public health concerns. Rather, these decisions revolved around the personal moral judgements of men in power concerning women who had little or no rights. As a member of the military’s newly formed Commission on Training Camp Activities from New Jersey described after “investigating” the behavior of local women, “the manner of dancing by certain of these girls was so suggestive as to constitute almost positive proof of their indulging in sexual intercourse.” In other words, they’re whores because we say they’re whores.

The most egregious example of this pseudo-scientific posturing is from the bipartisan duo of New York and New Jersey Governors Andrew Cuomo and Chris Christie, who apparently obtained masters degrees in Public Health overnight and have enacted strict quarantine policies for people returning from West Africa who have had contact with Ebola patients. Governor Christie echoed the inane violations of civil rights perpetrated nearly a century ago on prostitutes and “impure” women by quarantining Kaci Hickox, a nurse who had been working with Médecins Sans Frontières (Doctors Without Borders) to help people in Sierra Leone who were enduring the ravages of Ebola. Upon landing in New Jersey, Hickox, who was asymptomatic for Ebola or any other disease for that matter, was promptly detained and quarantined in a tent equipped with the luxury of a portable toilet, but without a shower or television.

Read more at the Daily Kos

Out of control: How the world’s health organizations failed to stop the Ebola disaster

 Two people lay dead on the floor Sept. 20 inside a ward at the Redemption Hospital, which has become a transfer and holding center for Ebola patients in the New Kru Town slum of Monrovia, Liberia.

Two people lay dead on the floor Sept. 20 inside a ward at the Redemption Hospital, which has become a transfer and holding center for Ebola patients in the New Kru Town slum of Monrovia, Liberia.

Tom Frieden remembers the young woman with the beautiful hair, dyed a rusty gold and braided meticulously, elaborately, perhaps by someone who loved her very much. She was lying facedown, half off the mattress. She had been dead for hours, and flies had found the bare flesh of her legs.

Two other bodies lay nearby. Bedridden patients who had not yet succumbed said of the dead, “Please, get them out of here.”

Frieden, the director of the U.S. Centers for Disease Control and Prevention (CDC), knew it was no simple matter to properly carry away a body loaded with Ebola virus. It takes four people wearing protective suits, one at each corner of the body bag. On that grim day near the end of August, in a makeshift Ebola ward in Monrovia, Liberia, burial teams already had lugged 60 victims to a truck for the trip to the crematorium.

Frieden had seen plenty of death over the years, but this was far worse than he expected, a plague on a medieval scale. “A scene out of Dante,” he called it.

Shaken, he flew back to the United States on Aug. 31 and immediately briefed President Obama by phone. The window to act was closing, he told the president in the 15-minute call.

That conversation, nearly six months after the World Health Organization (WHO) learned of an Ebola outbreak in West Africa, was part of a mounting realization among world leaders that the battle against the virus was being lost. As of early September, with more than 1,800 confirmed Ebola deaths in Guinea, Liberia and Sierra Leone, there was still no coordinated global response. Alarmed U.S. officials realized they would need to call in the military.

Obama eventually ordered 3,000 military personnel to West Africa; about 200 had arrived by the beginning of this month. They will be joined by health workers from countries such as Britain, China and Cuba. Canada and Japan are sending protective gear and mobile laboratories. Nonprofit organizations such as the Gates Foundation also are contributing. But it’s not at all clear that this belated muscular response will be enough to quell the epidemic before it takes tens of thousands of lives.

This is an open-ended crisis involving a microscopic threat on the move. This week came the unsettling news that the Ebola epidemic has now reached across the Atlantic Ocean to a hospital in Texas, where a Liberian man has tested positive for the virus.

So how did the situation get so horribly out of control?

Read more at The Washington Post

World News Forum Commentary

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© 2010 by Paul Kennedy

Hello, Jewel. I vaguely remember this last CPAC convention. Basically, a bunch of rich donors to the Republican Party gathered to go over their talking points and write big checks.

This is sad stuff. This is the best they can do. Red state-blue state? Really, Rick? Texas ranks 21st among states in per capita income in the United States–New York ranks fourth, and most of the rest of the top twenty are blue states, according to the U.S. Census Bureau. And Texas has more citizens without health insurance than any other state, according to a Gallup poll taken in 2011:

Texas continues to be the state with the highest percentage of residents without health insurance. At 27.6%, its rate is more than four percentage points higher than the next highest state, Mississippi. This is the largest gap Gallup has measured between the first and second state since it began tracking health insurance in 2008.

During the last presidential election campaign, as I’m sure you’ll remember, Rick Perry’s Texas was lauded by Republicans as a model of sensible Republican fiscal management. Never mind that he used billions in Federal bailout funds to balance his state budgets, even while bashing Obama over federal stimulus spending:

But the reality of Perry’s relationship with fed-stim is complicated. Through the second quarter of this year, Texas has used $17.4 billion in federal stimulus money — including $8 billion of the one-time dollars to fund state expenses that recur over and over. In fact, Texas used the federal stimulus to balance its last two budgets.

Source: The Texas Tribune.

Because Republicans have no earthly idea how to grow an economy, they are desperate to slash spending whenever and wherever they can, except for rich people, because the very, very wealthy are, after all, the minority interest they represent.

America incarcerates a larger percentage of its population than Putin’s Russia or Communist China, and those countries put people in prison just for making the government mad by saying unpopular things. And Texas, by the way, executes more people than Saudi Arabia.

Republican governors have discovered that, in the long run, it might actually be cheaper to spend money on things like education than on incarcerating people. Republicans have had a sudden revelation: after decades of pushing for harder and stiffer sentencing laws, that maybe it doesn’t really make all that much sense to put every kid convicted of a minor drug offense into prison for decades.

Republicans are the party of bold new thinking. Trouble is that it’s progressive thinking from the 1930s.

Senate Republicans Turn Their Backs on Veterans

Senator Bernie Sanders (AP Photo/Rich Pedroncelli)

It’s hard to pinpoint the pinnacle of Republican depravity, but GOP senators came close Thursday afternoon when they blocked a bill extending healthcare, education and job training to hundreds of thousands of veterans, largely because they were unable to use the bill as a vehicle for new sanctions on Iran.

“Today, the Senate had a chance to put aside partisan politics and do what was right for the men and women who have sacrificed so much while wearing our nation’s uniform,” said Daniel Dellinger, commander of the National Legion, a prominent veterans organization with a conservative reputation. “I don’t know how anyone who voted ‘no’ today can look a veteran in the eye and justify that vote.”

Republicans used a procedural move to kill the legislation, which was the largest veterans bill in decades and had the support of all of the major veterans groups. The bill would have funded twenty-seven new clinics and medical centers, and made VA healthcare more accessible for veterans without service-related injuries. It would have strengthened dental, chiropractic, fertility and sexual trauma care. It would have extended a job training program and given veterans better access to higher education by making more of them eligible for in-state tuition. Spouses of deceased service members and families caring for wounded veterans would have received better support.

Unsurprisingly, Republicans said the $21 billion package was too expensive. “This bill creates new veterans’ programs and it’s not paid for—it’s all borrowed money,” Senator Jeff Sessions said before raising a budget point of order that effectively killed the legislation by requiring sixty votes to proceed. Only two Republicans, Dean Heller of Nevada and Jerry Moran of Kansas, voted with the Democrats, leaving the motion to waive the point of order a few votes shy of passage.

“If you can’t afford to take care of your veterans, then don’t go to war,” Senator Bernie Sanders, the chairman of the Committee on Veterans Affairs, said on CNN shortly before the vote. Sanders proposed paying for the bill with savings from the drawdown in Iraq and Afghanistan; the expenditures amounted to less than 2 percent of those savings, and would have directly benefitted the soldiers who fought those wars. (Which, incidentally, themselves added $2 trillion to the debt.) Furthermore, according to an updated score from the Congressional Budget Office, the bill would actually have decreased the deficit by $1.34 billion over the next decade.

Read more at The Nation

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The GOP’s health crisis – Eugene Robinson, The Washington Post

Oh dear. The Republican Party’s worst nightmare is coming true. Obamacare is working.

The news that nearly 1.2 million people signed up last month for insurance through the Affordable Care Act exchanges is highly inconvenient for GOP candidates nationwide. It looks as if the party’s two-word strategy for the fall election — bash Obamacare — will need to be revised.

Wednesday’s status report on the health-insurance reforms was by far the best news for Democrats and the Obama administration since the program’s incompetent launch. January was the first month when new enrollments surpassed expectations, as the balky HealthCare.gov Web site began functioning more or less as intended.

Cumulatively, 3.3 million people had chosen insurance plans through the state and federal exchanges by the end of January. That is fewer than the administration had originally hoped but well above the predictions of critics who believed — or hoped — that the program would never succeed. The Congressional Budget Office projects that 6 million people will have chosen plans through Obamacare when the initial enrollment period ends March 31, down from a pre-launch estimate of 7 million. Not bad at all.

The numbers are even more encouraging when you look more closely. The proportion of young people — from 18 and 34 — who chose insurance plans through the exchanges increased slightly to 27 percent, compared with an average of 24 percent in previous months. This is important because premiums would have to rise if not enough young, healthy people enrolled.

Read more at The Washington Post

Eugene Robinson won the Pulitzer Prize in 2009 for Distinguished Commentary.

Why Republicans Keep Calling Women Sluts

They just can’t help themselves, and here’s why.

As you’ve heard, yesterday Mike Huckabee stepped up to the plate and smacked a stand-up double in the GOP’s ongoing effort to alienate every woman in America, when he said, “If the Democrats want to insult the women of America by making them believe that they are helpless without Uncle Sugar coming in and providing for them a prescription each month for birth control because they cannot control their libido or their reproductive system without the help of government then so be it! Let us take that discussion all across America because women are far more than the Democrats have played them to be.”

As expected, Huckabee quickly explained to his supporters who the real victim is here (“I am apparently the worst conservative ever or at least the most annoying one according to the left wingers in Washington today”), but the question is, why do they keep doing this? After all, every Republican knows by now that their party has a problem with women; Mitt Romney lost their votes by 11 points. The simple answer is that they can’t help themselves, but more specifically, it’s a combination of ignorance, contempt, and Puritan morality that inevitably leads to these eruptions. And it’s going to keep happening. Let’s look at the particulars:

Read more at The American Prospect

Law’s Expanded Medicaid Coverage Brings a Surge in Sign-Ups

Sharon Mills, of Welch, W.Va., has a list of ailments that require treatment that she cannot afford. She has been eagerly waiting on the benefits of the Affordable Care Act. Sam Dean for The New York Times

WELCH, W.Va. — Sharon Mills, a disabled nurse, long depended on other people’s kindness to manage her diabetes. She scrounged free samples from doctors’ offices, signed up for drug company discounts and asked for money from her parents and friends. Her church often helped, but last month used its charitable funds to help repair other members’ furnaces.

Ms. Mills, 54, who suffered renal failure last year after having irregular access to medication, said her dependence on others left her feeling helpless and depressed. “I got to the point when I decided I just didn’t want to be here anymore,” she said.

So when a blue slip of paper arrived in the mail this month with a new Medicaid number on it — part of the expanded coverage offered under the Affordable Care Act — Ms. Mills said she felt as if she could breathe again for the first time in years. “The heavy thing that was pressing on me is gone,” she said.

As health care coverage under the new law sputters to life, it is already having a profound effect on the lives of poor Americans. Enrollment in private insurance plans has been sluggish, but sign-ups for Medicaid, the federal insurance program for the poor, have surged in many states. Here in West Virginia, which has some of the shortest life spans and highest poverty rates in the country, the strength of the demand has surprised officials, with more than 75,000 people enrolling in Medicaid.

While many people who have signed up so far for private insurance through the new insurance exchanges had some kind of health care coverage before, recent studies have found, most of the people getting coverage under the Medicaid expansion were previously uninsured. In West Virginia, where the Democratic governor agreed to expand Medicaid eligibility, the number of uninsured people in the state has been reduced by about a third.

America ranks near the bottom of developed countries in health and longevity, and many public health experts believe that improving that ranking will be impossible without paying more attention to poor Americans. It is still an open question whether access to health insurance will improve the health of the disadvantaged in the long run, experts say, but the men and women getting the coverage here say the mere fact of having it has drastically improved their mental health.

Waitresses, fast food workers, security guards and cleaners described feeling intense relief that they are now protected from the punishing medical bills that have punched holes in their family budgets. They spoke in interviews of reclaiming the dignity they had lost over years of being turned away from doctors’ offices because they did not have insurance.

Read more at The New York Times

Kentucky governor sees health law as chance to heal an ailing state

Kentucky Gov. Steve Beshear is overseeing a promising rollout of the healthcare law. Defying bitter GOP opposition, he says it’s medicine the state needs.

FRANKFORT, Ky. — Relations between President Obama and Kentucky Gov. Steve Beshear have not always been friendly. When Obama paid his first presidential visit in May 2011, his fellow Democrat was somewhere else. Later, Beshear lashed out at the administration’s environmental regulators, telling them to “get off our backs.”

But leading one of the nation’s poorest, sickest states, Beshear has improbably overseen one of the most successful rollouts of Obama’s troubled healthcare overhaul and become, deep in his long public career, a hero to Democrats grasping to find a redeeming figure amid the political wreckage.

He’s an unlikely champion, not least because Kentucky’s two U.S. senators are both implacable opponents of the program.

“I knew if I was going to make a huge difference in the health status of Kentucky, it was going to take some kind of transformational tool to do that, and that’s what the Affordable Care Act is for me,” Beshear, white-haired and greyhound-lean, said as he sat behind a big maple desk in his office. “I think we’ve started something here,” he later added, “that a generation from now you’ll see a very different Kentucky than what you see today.”

For now, Kentuckians may feel understandably whiplashed.

While Beshear, serving his second and final term, has become one of the foremost proponents of Obamacare, the state’s senior senator, Republican leader Mitch McConnell, has been an even more visible foe. Facing a tough 2014 reelection fight, he calls the law “a disaster,” “a huge mistake” and “a monstrosity” that “needs to be pulled out root and branch.” The sentiment is seconded by Kentucky’s junior senator, Republican Rand Paul, who was elected in 2010 in a tea party fever born of seething opposition to the president and his healthcare plan.

Read more at the Los Angeles Times