Petition to expand Medicare to be the Single Payer Healthcare System for the USA

[alexstar]

I suspect he will be in a "federal, pound me in the ass prison" soon enough. Or, dead from suicide.

He's led a trite and meaningless life, and he's a very bad person.

[Sbti]

Related?

[monadnocky]

The man literally said the following (regarding buying the exlusive rights to the new Wu-Tang clan album.) Remember, he is a pharmaceutical company CEO:

"If anyone wants to hear his Wu-Tang Clan album, of which there is only one copy, he has a price for that, too. 'I’m not going to play it for no reason,' he said. 'If Taylor Swift wants to come over and s— my d— I’ll play it for her.'"

Class act. Have fun in prison, you freaking sociopath.

[Vancouverdave]

The man literally said the following (regarding buying the exlusive rights to the new Wu-Tang clan album.) Remember, he is a pharmaceutical company CEO:

"If anyone wants to hear his Wu-Tang Clan album, of which there is only one copy, he has a price for that, too. 'I’m not going to play it for no reason,' he said. 'If Taylor Swift wants to come over and s— my d— I’ll play it for her.'"

Class act. Have fun in prison, you freaking sociopath.

Oh, man, some stuff you just can't make up! I'm a complete believer in socialized medicine being the son of a man who went into serious debt for his wife's cancer care in the 1960's and also had to score street shit to keep her pain under control and also being the husband of an RN who hears tales of "inside" the system. I believe a great funding stream would be one new federal tax and one increase--add $1/gallon to our wussy little US gasoline tax and slap $5 per bullet on all firearm ammunition. I'm not meaning this in any ironic or humorous way whatsoever.

[vertical_doug]

Since this thread started, we had the Skreli and Valeant blowup. Highline on Huffington Post just ran this long form story on 'Sleep Drugs'. It is not as good as their previous one on JJ (America’s Most Admired Lawbreaker - The Huffington Post) and the boy with DD Breasts, but still a interesting read.

Drugs You Don't Need For Disorders You Don't Have - The Huffington Post

One evening in the late summer of 2015, Lisa Schwartz was watching television at her Vermont home when an ad for a sleeping pill called Belsomra appeared on the screen. Schwartz, a longtime professor at Dartmouth Medical College, usually muted commercials, but she watched this one closely: a 90-second spot featuring a young woman and two slightly cute, slightly creepy fuzzy animals in the shape of the words “sleep” and “wake.”

Schwartz had a reason to be curious about this particular ad. Two years earlier, she had been a member of the advisory panel that reviewed Belsomra for the U.S. Food and Drug Administration—and the process had not gone well for the manufacturer, Merck. The company saw its new drug as a major innovation, emphasizing that the medication acted on an entirely different mechanism within the brain than the previous generation of insomnia medicines like Ambien and Lunesta. During the drug’s development, Merck had suggested that it could treat insomnia more effectively and produce fewer side effects than existing medications. In 2012, one Merck scientist described the science underlying Belsomra as a “sea change.”

But when Schwartz and her colleagues scrutinized data from the company’s own large-scale clinical trials, what they found was a lot less impressive. People taking Belsomra fell asleep, on average, only six minutes sooner than people taking a placebo and stayed asleep for a mere 16 minutes longer. Some test subjects experienced worrying side effects, like next-day drowsiness and temporary paralysis upon waking. For a number of people, these effects were so severe that the researchers halted their driving tests, fearing someone would get into an accident. Because of these safety concerns, the FDA ended up approving the drug at a lower starting dosage than the company had requested—a dosage so low that a Merck scientist admitted it was “ineffective.”

So when Schwartz saw the Belsomra ad, she was struck by how smoothly it sidestepped the drug’s limitations. A soothing voiceover hypes the science, giving a sophisticated explanation of how Belsomra targets a neurotransmitter called orexin to turn down the brain’s “wake messages.” “Only Belsomra works this way,” the voice continues. The ad ends with the young woman curling up with the “sleep” animal and falling into a peaceful slumber. “You have no idea watching that ad that we’re talking about falling asleep 6 minutes faster and staying that way an extra 16 minutes—and that’s at higher doses,” Schwartz said. “We really don't have a great idea of how well it works at the lower dose FDA actually recommends for people starting the medication.”

.......cont

[clunk]

This is why single-payer is unlikely in this country and another reason HRC is the establishment candidate on the Democratic side:

https://theintercept.com/2016/05/03/...yer-dems-colo/

"INFLUENTIAL DEMOCRATIC CONSULTANTS, some of whom work for the Super PACs backing Hillary Clinton, have signed up to fight a bold initiative to create a state-based single-payer system in Colorado, according to a state filing posted Monday. . . "

[jclay]

Just a "heads up" for like minded individuals: If you desire single payer health care (or anything else) then this is a real good time to tell the Democratic National Committee (like tonight, as they meet in Orlando tomorrow). The Party Platform Committee is meeting to negotiate what will be included in the platform. The link below is to a petition to the DNC in support of single payer.

Legislative Action Center | National Nurses United

Since I figure that the powerful don't relinquish power easily I sent the following message to the Florida DNC delegates, my Senator, Congresswomen and President Obama.

Dear Delegate,

Please support Medicare For All by incorporating it into the Party Platform. It's vital to the health of our population and economy.

I contributed to a series of private healthcare insurance policies for my entire working life. As I approached retirement age I realized that the instant I retired I'd lose the benefit of all of those contributions; my lifetime contributions to healthcare, well into six figures, would evaporate at retirement as indeed they did at each job change. That's a ludicrous way to fund a cradle to grave need, particularly one that doesn’t always align with periods of employment. It would be like losing the equity in a house every time you sold one. It's nuts and we can't afford it.

And as you're a Democratic Party Delegate let me share with you a more general message: I'm a professional 60ish YO lifelong Democrat who has been abandoned by the rightward shifting Democratic Party. This November it is I who will abandon the Democratic Party and vote for Jill Stein unless Bernie Sanders becomes the nominee. I am no longer going to be held hostage by the party of "fake left, go right". If a Trump presidency and right wing Supreme Court appointments are the price of wrecking the Democratic Party in order to enable a progressive alternative then I will pay it. Examine the 2016 presidential primary statistics. It took every device the Democratic Party had to keep Bernie from going from zero to victory in a little over a year. I'm not alone in my position and a storm is coming. I urge you to support Bernie Sanders while saving the Democratic Party and transforming it into the agent for progressive change it should be.

[vertical_doug]

http://well.blogs.nytimes.com/2016/0...=top-news&_r=0

Mylan also doing the Valeant. (Buy old drugs, hike the prices)

from 103 in 2009 to 608 in 2016.
or $264 July-13 hike $461 May-15, then hike $608 in May-16,


as per NYTIMES:
A steep increase in the price of the EpiPen, a lifesaving injection device for people with severe allergies, has sparked outrage among consumers and lawmakers who worry that parents won’t be able to afford the pens for children heading back to school.

With a quick stab to the thigh, the EpiPen dispenses epinephrine, a drug that reverses swelling, closing of the airways and other symptoms of a severe allergic reaction to bee stings, peanuts or other allergens.

Mylan, the pharmaceutical company, acquired the decades-old product in 2007, when pharmacies paid less than $100 for a two-pen set, and has since been steadily raising the wholesale price. In 2009, a pharmacy paid $103.50 for a set. By July 2013 the price was up to $264.50, and it rose 75 percent to $461 by last May. This May the price spiked again to $608.61, according to data provided by Elsevier Clinical Solutions’ Gold Standard Drug Database.

Doctors advise allergic patients to carry two EpiPens with them at all times in case an extra dose is needed to quell a severe reaction. Most parents buy multiple EpiPens for home, in the car and school and may replace them annually, depending on the expiration date.

Mylan has declined to comment on the price hike, issuing a statement pointing the finger at high-deductible health plans that require consumers to pay much more out of pocket for many drugs. The company said a $100 coupon they offer for the product means most people don’t pay anything for the pens.

But how the price hike affects consumers varies widely, depending on the prices charged by their local pharmacy and the details of their insurance plan. People without insurance or with high-deductible insurance plans can’t always use the coupon and are paying about $640 a set, said Michael Rea, the chief executive of Rx Savings Solutions in Overland Park, Kan. Other patients say that even with good insurance, their copayments are as much as four times higher than in the past.

Naomi Shulman of Northampton, Mass., has a 12-year-old daughter who is allergic to cashews and keeps EpiPens at home and school. Last year, Ms. Schulman’s out-of-pocket copayment for an EpiPen two-pack was $100. But because EpiPens may expire after a year, Ms. Shulman had to buy another two-pack to send along to her daughter’s camp this summer. Her cost for the same two pens was $400.

“I called the insurance company and asked why it was so high and was told that, actually, it’s $700 total, and my co-pay is $400,” she said.

For the first time in 10 years, Ms. Shulman said she briefly considered forgoing the purchase, but didn’t want to risk it. “It’s very wrong,” she said. “It’s gouging parents about their children’s lives. It’s not like letting them sniffle. It’s life or death.”

Laurent Barr of Clark, N.J., said her copayment on EpiPens has risen from $141 to $245 in a year, and she will spend $735 this year for a supply of three EpiPen sets. Her 6-year-old daughter Leah is allergic to rice, tree nuts and mushrooms.

“The price of EpiPens has been getting progressively worse over the years, but now it is just obscene,” Ms. Barr said.

The price hike has caught the attention of Washington lawmakers. Senator Amy Klobuchar, Democrat of Minnesota, who has a daughter who carries an EpiPen, has called on the Senate Judiciary Committee and the Federal Trade Commission to review whether the price hikes violate any anti-competition rules. Last year, the drug maker Sanofi recalled a competing product, Auvi-Q, because it may not have been delivering the correct amount of epinephrine, leaving the EpiPen as the primary emergency treatment for severe allergic reactions.

“This is a mainstream product that people carry, and it’s getting harder and harder for people to afford it,” said Senator Klobuchar. “It’s just another example of what we keep seeing, outrageous price increases when a monopoly situation ends up in a company’s lap.”

Senator Chuck Grassley of Iowa called on Mylan to explain the price hikes, noting that they impose a burden on both parents and school districts, who often keep supplies of the pen at the ready.

A petition to Congress protesting the price increase, called “Stop the EpiPen Price Gouging,” has emerged on social media. It has collected more than 48,000 signatures.

Tonya Winders, president of the Allergy & Asthma Network, said her group is planning to work with other advocacy organizations to make the EpiPen a more universally-covered expense through a federal preventative services task force. She said most families are not feeling the impact of the EpiPen price hike because they have commercial insurance plans with lower copayments and deductibles. The families most affected by the price hike are those who don’t have insurance or those with high-deductible health plans, she said.

“A lot of the families that are being hit with sticker shock are the ones that opted into high-deductible health plans in 2016,” Ms. Winders said. “We believe that Mylan should design a program specifically for those in that high-deductible rate.”

In April, a pharmacist told Sarah Brown of Boulder, Colo., that her copayment on an EpiPen two-pack would be $585, even with a $100 coupon from Mylan. She said she had no choice but to take her chances and hold on to her expired EpiPens instead. “It was a gamble,” she said.

In August, Ms. Brown’s family switched insurance plans so they could afford three packs for home, school and a grandmother’s house. Now, with the new policy and the Mylan coupon, she gets her pens at no charge. “The difference in insurance coverage means being able to afford them or not,” Ms. Brown said.

[jclay]

If you think health care or pharmaceutical corporations, or any other other corporate structures care about your health and well being its time to revisit basic economics....or failing that simply believe the recent quotes of some healthcare insurance and pharma CEOs who have clearly stated "we're in business to increase shareholder value". Job one for any publicly traded corporation is to increase shareholder value, to increase wealth accumulation. Offering a service or product is simply e mechanism. A tax funded, national single payer HC system would cover everybody, is more cost efficient and is in your best interest.

[Saab2000]

If you think health care or pharmaceutical corporations, or any other other corporate structures care about your health and well being its time to revisit basic economics....or failing that simply believe the recent quotes of some healthcare insurance and pharma CEOs who have clearly stated "we're in business to increase shareholder value". Job one for any publicly traded corporation is to increase shareholder value, to increase wealth accumulation. Offering a service or product is simply e mechanism. A tax funded, national single payer HC system would cover everybody, is more cost efficient and is in your best interest.

I agree on the first part of your statement. But just to play devil's advocate here, how to products like the EpiPen get developed in the absence of a profit incentive?

I am no expert on economic matters or health care policy but it seems to me that there must be profit somewhere in the system or innovation stops.

[EightySixer]

Nothing like an idiopathic, chronic, progressive and incurable disease followed by low dose chemotherapies, Anti TNF-Alpha blockers at $2k a week and $12k a month among a dozen other failed treatments before the trips to the surgical table started..

It really sucked to experience the business end of the "Healthcare Business." People tend to drop that second word there or just forget to include that when talking healthcare.

I feel for these people, bigtime.

[bigbill]

If you think health care or pharmaceutical corporations, or any other other corporate structures care about your health and well being its time to revisit basic economics....or failing that simply believe the recent quotes of some healthcare insurance and pharma CEOs who have clearly stated "we're in business to increase shareholder value". Job one for any publicly traded corporation is to increase shareholder value, to increase wealth accumulation. Offering a service or product is simply e mechanism. A tax funded, national single payer HC system would cover everybody, is more cost efficient and is in your best interest.

A single payer national HC system would still prescribe meds made by private company and that company will set the market price. All of the ideas put forth for health care including ACA fail to address the root cause, the cost. A single payer would just be another way to pay the high cost by sharing it among taxpayers. The US health insurance point of view is based on "getting it all covered" and that can't happen under our current system. Proponents of universal care believe that everything will be covered for all people. The reality of universal healthcare is very basic care, annual wellness checks, vaccinations, emergency medicine, hospitalization, and co-pays for everything. Elective surgery will still be elective, and the benefits of medical care will be weighed with the cost. Our system is not set up for that. The first thing we'd have to do is lay out all the reasons for the high costs. Meds are expensive, but for example I had back surgery last November. I had one visit with the surgeon, one morning spent at the hospital doing all my pre-op stuff (EKG, bloodwork, chest X-ray), and then 6 hours at the hospital having 45 minutes worth of surgery. $30,000. My insurance ended up paying $15,000 to settle it all. Very few meds were involved and all my follow up meds were covered by my drug plan from work. Why does everything leading up to and including 45 minutes of surgery cost $30K?

[jclay]

I agree on the first part of your statement. But just to play devil's advocate here, how to products like the EpiPen get developed in the absence of a profit incentive?

I am no expert on economic matters or health care policy but it seems to me that there must be profit somewhere in the system or innovation stops.

Single payer is the financing system for medical care; it isn't hospitals, pharma or medical appliances which would still remain much as they are (via for profit entities....except for the government sponsored research and development which is responsible for much of the basic and applied science and devices) but with a single purchaser for the ~300 million of us the purchaser would have unmatched negotiating power, particularly if some of the rules governing price negotiating were adjusted a bit more in favor of patients as opposed to outsized profits. This is common in other western countries.

What our system would cover would, ultimately, be up to our society. Similarly, rules allowing corporations to price gouge are also up to society. If we think it's OK to allow a product like the Epipen, largely developed in the public (as in govt) sphere and which has been around for a long time, to be co-opted by a corporation then we get to suffer the consequences. Alternatively we could regulate that sort of thing in the public interest, much as we do with regulated industries (typically natural monopolies/ologolopolies) like power companies. Private industry would still be a vital part of the system but would be prevented from the excesses that are, or should be, apparent to even moderately well informed folks.

[roseyscot]

A single payer national HC system would still prescribe meds made by private company and that company will set the market price. All of the ideas put forth for health care including ACA fail to address the root cause, the cost. A single payer would just be another way to pay the high cost by sharing it among taxpayers. The US health insurance point of view is based on "getting it all covered" and that can't happen under our current system. Proponents of universal care believe that everything will be covered for all people. The reality of universal healthcare is very basic care, annual wellness checks, vaccinations, emergency medicine, hospitalization, and co-pays for everything. Elective surgery will still be elective, and the benefits of medical care will be weighed with the cost. Our system is not set up for that. The first thing we'd have to do is lay out all the reasons for the high costs. Meds are expensive, but for example I had back surgery last November. I had one visit with the surgeon, one morning spent at the hospital doing all my pre-op stuff (EKG, bloodwork, chest X-ray), and then 6 hours at the hospital having 45 minutes worth of surgery. $30,000. My insurance ended up paying $15,000 to settle it all. Very few meds were involved and all my follow up meds were covered by my drug plan from work. Why does everything leading up to and including 45 minutes of surgery cost $30K?

No doubt that there is some trimming needed to the cost. Your insurance company paid $15k on the $30k bill which means their actuaries have calculated the real cost closer to $15k than $30k. But, the bills totaled $30k because of the following (and many other things that I am surely missing)

• making up for the losses in reimbursement in other areas that the hospital provides service (walk in clinics, primary care services, etc)
• covering the surgeon's costly malpractice insurance
• expensive equipment (probably overpriced by the suppliers in a similar manner to the epi pen issue)
• covering the cost of the dozens of other people associated with your visit - nurses, PA's, admins, billers who have to collect that $15k, etc
• making up for the unpaid ER services and unpaid bills from under insured or uninsured patients
• covering the largely unbillable (global period) follow up service you need in conjunction with such a procedure

[jclay]

Single payer is the financing system for medical care; it isn't hospitals, pharma or medical appliances which would still remain much as they are (via for profit entities....except for the government sponsored research and development which is responsible for much of the basic and applied science and devices) but with a single purchaser for the ~300 million of us the purchaser would have unmatched negotiating power, particularly if some of the rules governing price negotiating were adjusted a bit more in favor of patients as opposed to outsized profits. This is common in other western countries.

What our system would cover would, ultimately, be up to our society. Similarly, rules allowing corporations to price gouge are also up to society. If we think it's OK to allow a product like the Epipen, largely developed in the public (as in govt) sphere and which has been around for a long time, to be co-opted by a corporation then we get to suffer the consequences. Alternatively we could regulate that sort of thing in the public interest, much as we do with regulated industries (typically natural monopolies/ologolopolies) like power companies. Private industry would still be a vital part of the system but would be prevented from the excesses that are, or should be, apparent to even moderately well informed folks.

BTW: No snark or condescension was intended with the "even moderately well informed folks" comment (or anything else). What with the egregious episodes in recent news (Aetna CEO's threat if Humana merger is rejected, the Epipen thing and a half dozen others) folks should be detecting the dark side of of unfettered capitalism. We've had these lessons before; one would hope folks would start wondering if there might be better ways or adjustments to existing mechanisms that might yield better results. Physicians for a National Health Plan and "Healthcare Now!" are organizations who's websites are worth a read.

As to Big Bill's 15k surgery (which I hope came out swimmingly well) another question is why do we have to dicker down from 30k and what does that mean for the rest of society? Poor folks or those with less effective insurance companies get to "take it in the shorts"....is that really the world you want?

[jclay]

No doubt that there is some trimming needed to the cost. Your insurance company paid $15k on the $30k bill which means their actuaries have calculated the real cost closer to $15k than $30k. But, the bills totaled $30k because of the following (and many other things that I am surely missing)

• making up for the losses in reimbursement in other areas that the hospital provides service (walk in clinics, primary care services, etc)
• covering the surgeon's costly malpractice insurance
• expensive equipment (probably overpriced by the suppliers in a similar manner to the epi pen issue)
• covering the cost of the dozens of other people associated with your visit - nurses, PA's, admins, billers who have to collect that $15k, etc
• making up for the unpaid ER services and unpaid bills from under insured or uninsured patients
• covering the largely unbillable (global period) follow up service you need in conjunction with such a procedure

A big one is "because they can" but others exist, like those addressed by single payer.

They are, first and foremost, in the biz of maximizing return on investment. Period. Now that works well for the consumer when it involves commodity and consumer goods. You can compare Nabisco's Triscuits to the knock offs that your supermarket offers (Publix in my case) on price and quality, easily and without any life changing blowback in the event of getting it wrong. Tires, underwear, ice cream, et al.; the market works well for society while providing worthwhile returns to corporations and investors. Natural monopolies and ologolopolies, particularly when it comes to healthcare, don't work out as well for the consumer. You can't compare or try a heart transplant with the knowledge that you can toss it and get another if you don't like it or if it goes on sale elsewhere. And the oft trotted out bromide that "if each person is in charge of his/her healthcare account then they will shop wisely, compare prices, etc., etc., etc." is so obviously flawed as to not merit comment.....except you have to because some actually subscribe to it!

Enough. Those who are curious and open to better ways will do some homework. Ain't nothing I can say will change the minds of the others.

[roseyscot]

A big one is "because they can" but others exist, like those addressed by single payer.

They are, first and foremost, in the biz of maximizing return on investment. Period. Now that works well for the consumer when it involves commodity and consumer goods. You can compare Nabisco's Triscuits to the knock offs that your supermarket offers (Publix in my case) on price and quality, easily and without any life changing blowback in the event of getting it wrong. Tires, underwear, ice cream, et al.; the market works well for society while providing worthwhile returns to corporations and investors. Natural monopolies and ologolopolies, particularly when it comes to healthcare, don't work out as well for the consumer. You can't compare or try a heart transplant with the knowledge that you can toss it and get another if you don't like it or if it goes on sale elsewhere. And the oft trotted out bromide that "if each person is in charge of his/her healthcare account then they will shop wisely, compare prices, etc., etc., etc." is so obviously flawed as to not merit comment.....except you have to because some actually subscribe to it!

Enough. Those who are curious and open to better ways will do some homework. Ain't nothing I can say will change the minds of the others.

Who is the "They" that you refer to? The non-profit hospital (most are non-profit) or the private companies supplying the (malpractice) insurance, equipment and research that enables these procedures? My point was trying to highlight a few of the reasons why a 45 minute back surgery can be a $30k bill. I believe our whole healthcare system is severely broken, and like much of this nation (roads, schools, gov't), it will continue to be inadequately patched until it comes crashing down.

As an interesting comparison/side note, I came across some of our bills for the delivery of kid #2 back in 2012. Having a "normal" birth in the hospital was billed at around $4k total.

[Rich Beaudoin]

Who is the "They" that you refer to? The non-profit hospital (most are non-profit)...

I feel the need to point out that 'non-profit' and 'not for profit' hospitals are in fact extremely profitable.
As someone intimately involved in this field, I know that the board members of those institutions are likely the highest paid members of your community. Keep in mind that the NBA is also in this category

[vertical_doug]

I agree on the first part of your statement. But just to play devil's advocate here, how to products like the EpiPen get developed in the absence of a profit incentive?

I am no expert on economic matters or health care policy but it seems to me that there must be profit somewhere in the system or innovation stops.

As a generalization, true, but in healthcare, not necessarily the case.

Mylan was never an innovator but a generics manufacturer. They have gradually shift from offer cheap products, to trying to acquire older medicines through acquisitions and then systematically raise prices while aggressively lobbying to keep competitors out. The extra sales revenue is not going into research as much as going into expanding the lobbying/marketing presence. Mylan is closer to a Valeant (serial acquirer, research budget slasher, price hiker model). If you look at the balance sheet, you will see Mylan spends 3x as much on sales and general admin, vs research. (Biogen, Amgen and others spend closer to equal amounts). Where Mylan has invested is in scaring schools and parents into thinking a epipen needs to be everywhere to double sales volume. (See the hiring of Sarah Jessica Parker to make a short film and be a spokesman, although in lieu of the recent backlash, she has just quit)

Most of the recent price controversy has not been in innovative drugs, but in old line medicine, where an acquirer through M&A tries to milk the product before competition arrives. (Turing, Valeant, Mylan)

[ldamelio]

know that the board members of those institutions are likely the highest paid members of your community.

Where did you get this? I don't know a single board member at a non-profit hospital who is compensated. Most are chosen because they are successful in their primary profession (often finance or law) to lend their expertise to the hospital as a community service. Physicians who serve on boards to lend insight to clinical matters do so on their own time on top of their practices, teaching and research. This is done gratis - maybe a nice pen for the holidays, but it's understood and expected that the board members also contribute their own $$$ to the cause. Although it's hard for the snarks and conspiracy theorists to understand, sometimes talented, successful people really do give back to their communities with no expectation of return.