NYT is looking out for you.

"Experts say that most drugs, whatever the disease, work for only about half the people who take them. Not only is much of the nation's approximately $300 billion annual drug spending wasted, but countless patients are being exposed to unnecessary side effects."

How intriguing! A surprising quote from the NYT. They can't possibly be dissing the pharmaceutical industry, or leaning toward homeopathic/holistic care could they? ... Of course not.

Headline: Patient's DNA May Be Signal to Tailor Medication.

Oh, I get it. Sensationalist.

The first paragraph describes a woman who has been taking a drug for two years to prevent a recurrence of breast cancer. "Then a new test suggested that because of her genetic makeup, the drug was not doing her any good." She was "devastated" and stopped taking the drug while looking for alternative treatments. She is now in a "predicament" because newer alternatives are only available for post-menopausal women, and she is not one.

Woah. Okay, as you may have picked up from the opening of this post, I believe society is overmedicated. That said, this is craziness. This is a new (read: not that much reliable data) test, and it only suggested (read: could be right, could be wrong) that because of her "genetic makeup" (read: lots of societal and scientific misconceptions about what this really means) the drug wasn't doing her any good (read: not even psychosomatically, if you want to go there).

How did this woman get to this new test anyway? This information "devastated" her! It wasn't a necessary test, per se. Maybe some psychological screening, doc? She has survived breast cancer and was taking this drug. She didn't see signs of remission while taking it, but decided (on her own? help of her doc? help of her new doc with his new tests?) to stop taking the drug--she's not taking anything now since "newer" alternatives aren't available to her. (Did she look in to older alternatives?).

At this point you may be saying "wow, what a heartless bitch--criticizing a cancer survivor and her doctors!" I am not trying to do that. And I will admit that I do not have all the information (though I doubt the NYT does either). I'm not this woman's doctor and I didn't create this genetic test. Maybe it is a fantastic new tool, and maybe ceasing medication is the best course for this woman.

I was struck by (1) that NYT has written this article at all, and (2) the way it was written. .....

So the article goes on, discussing how inefficient "one-size-fits-all" medicine is, and how genetic testing paves the way for "personalized medicine," the wave of the future--20-30 years down the line. (And how different is the world going to be then?).

NYT tells us the villains of the story are pharmaceuticals, who don't want to see their drugs limited in use, and insurance companies who don't want to pay for these tests (read: this amazing new technology that will save your life!).

NYT then tells us about a "cautionary tale" of Herceptin, the "archetype of personalized medicine." Ten years after coming to market scientists are realizing "tests...could be inaccurate."
Oh.

However, this drug, and this woman's situation must be different:

If only women with [a certain gene] had been assessed, tamoxifen might have
worked as well or better than the newer drugs, according to researchers at the
Dana-Farber Cancer Institute in Boston.

Yep. The researchers further point out:

that 32 percent of the women with inactive 2D6 enzyme had relapsed or died
within two years.

Interesting--our patient that stopped taking the drug, presumably she does not have the active form of the gene that interacts with this drug.. Therefore, the drug wasn't working. The drug she was taking for 2 years without relapse.

The Times further admits there have been contradictory results in this type of test, and that there are variants of the gene, leading to even more complications.

Yes NYT, this untested, sensationalized, decades-down-the-line solution will solve the health care crisis and we will all live forever. Thanks for looking out for us.

Glaxo to stop political contributions

WSJ reports that Glaxo (a UK company) is to stop political contributions in an effort to achieve transparency and trustworthiness. In another article, CEO Andrew Whitty explains:

"We continue to believe that it is important for GSK to be engaged in policy debates and the political process," Witty said. "However, we need to ensure that there is no implication whatsoever that corporate political contributions provide us with any special privilege. We do not believe they have, and in the few countries we have given contributions we have done so in full compliance of the law."

Glaxo spent almost $600,000 in contributions this past year. The company stopped making political donations in the UK in 2001. Note that the voluntary employee-run PAC will still be functional. And of course individuals may still make donations. And lobbying efforts are still a go ($8.4M spent in 2007).

Glaxo has been on a buying spree in emerging markets.

The cynic in me asks: what's going on?

Romney in 2007 on Mass Health Care. Good glimpse at the free market mindset behind the "universal" plan in Mass.

Also, a nice Ah-Ha! moment--

Medicaid is a lousy insurance product. It's a product designed for the poor.

And this is why people are opposed to expanding medicare to universal coverage. Because what happens if we do? We get what the poor gets.

(And forget about those countries that have a mix of universal care and free market options--as far as we know that doesn't exist. How could it possibly?)

So we put in place free market products and help people buy 'em.

There you go.

Intelligence Squared....

NPR's Intelligence Squared debate asks "Should the Government be Responsible for Universal Care?"

Midway through listening right now... gra!

One excerpt: "The government can't even count votes!"
...wtf?
You're arguing for the free market using an example of what happens when government functions are privatized. And people laugh. This does not make sense.

Also, this debate is a good illustration of a problem with the health care debate: It's pitted as Socialized vs Free Market. It's a false dichotemy that keeps any real solution from occuring. Secondly, even the one guy that mentions the money lost due to administration and insurance companies doesn't say--hey, let's get rid of the insurance companies.

new hhs head.

Obama appointed another health care "expert" (this time on lobbying) to his staff. tom daschle.

From wiki: he has signed on as a Senior Policy Advisor with the K Street law firm Alston & Bird.[9][10] Health care interests, including CVS Caremark, the National Association for Home Care and Hospice, Abbott Laboratories and HealthSouth, are among the firm's lobbying clients.[4] The firm was paid $5.8 million between January and September 2008 to represent companies and associations before Congress and the executive branch, with 60 percent of that money coming from the health industry.[5]

more later....

Is there a Medical Expert in the White House?

Valerie Jarrett, a Chicago insider and former deputy to Daley, has officially been named a senior advisor for Obama, and will head the Office of Public Liason. She met the Obamas when she got a job for Michelle in the Mayor's office.

NYT says she is an "expert" on health care. Can anyone tell me how?

All I've found is that she's served on the board at Chicago Hospital and her dad was a doctor.

Currently Reading: The Social Transformation of American Medince

Just started reading. looks promising.

"To most of us, this power seems legitimate: When professionals claim to be authoritative about the nature of reality, whether it is the structure of the atom, the ego, or the universe, we genrerally defer to their judgment."

Do Something

Contact Congresspeople. Email, call, snail-mail, whatever...

If things are really going to CHANGE, let's try to make it for the better.

Per Health Care NOW: Contact Sen. Kennedy, who is really pushing to get health care legislation to BO's desk when "he hits the ground running."

Seniors aren't paying enough for drugs

USA Today article about how Medicare drug prices are going up up up.

Elderly and disabled people in Medicare prescription drug plans with the largest enrollments will pay 43% more on average in monthly premiums next year than when the drug program began in 2006, and some enrollees will see increases of as much as 329%, two analyses show.

[Even though]....Overall, the Medicare drug program is costing taxpayers less than originally estimated. The government's drug spending on the program fell by 12% to $44 billion in the fiscal year that ended Sept. 30, largely from the widespread use of low-cost generic drugs.

Someone want to argue with me about why having insurance companies involved in health care is a good idea?

AARP tells us to cut back on health care to cut back on costs.

"Of our total $2.3 trillion health care bill last year, a whopping $500 billion to $700 billion was spent on treatments, tests, and hospitalizations that did nothing to improve our health."

So many ways to react to this claim.

1. Who is choosing this treatment?

a. The patient. The double edged sword of information in a capitalist system:Patients are more able to take initiative when it comes to health care, and at the same time can fall prey to influence that is more prevalent with more information. And given how overworked doctors are nowadays, especially those that would give referrals, who can blame a patient for insisting on a test? It's a technological second opinion. And if the patient can pay, no problem. Its when the patient can't pay that the issues begin.

b. The doctor. To avoid malpractice, or to avoid a lengthy conversation with the patient or patient's parent as to why the treatment is not necessary. It's easier to just do it, if it's wanted.

c. Managed Care/Insurance??? Just a thought, though counterintuitive. The way doctors get paid is the biggest mess in the health care industry. This is not a sweeping statement that doctors' judgement is categorically influenced by payment, but I would imagine it's impossible not to think about it. Do I spend 30 minutes with this patient explaining the pros/cons of this MRI or CT scan, etc, or do i just send them to get it if they want it. As the article points out, they may not like the doctor's decision to decline to test and therefore find another doctor. So there's double financial incentive to give a more expensive test and to keep a patient.

2. A large portion of health care costs come from emergency and catastrophic treatment. Because people use the ER as primary care, and because people cannot afford regular checkups (among other preventative care options) and as such end up needing more care when they finally are forced to seek it out. I would assume this statement does not apply to this group of people because that would be absurd.

3. One thing that was not discussed is the high cost of technology and scientific advances in America. This comes through in so many ways. Not only are there more tests and more fancy expensive machines out there that do wonderful things, there are also more drugs being developed and at a high cost to Americans. Other countries cap payments for drugs. We don't. Why? Because we want to keep incentive$ for pharma to develop those drugs. The world benefits, we benefit. We're footing the bill. Not saying we shouldn't. Just saying we should recognize what's going on and decide if that's the best way to go about things.

I think the AARP is on to something here. But I don't think they know it. Western medicine--the American "system" specifically, is reactionary, not preventative. Think about it this way: Allopathic medicine, what is traditionally known as "western," was originally a derogatory term for a new kind of "heroic"medicine that was not evidence based. (Including bloodletting.) Allo means different. Compare with homeo (same) pathy. The whole point is to work against, rather than with, what is happening in the body--to react rather than nurture and sustain. This is going on a different tangent now, so I'll come back to the article, which does point out that much of the medicine practiced now is not "evidence based." (political buzz word, anyone?). Maybe in addition to rethinking the way health care delivery is structured in this country we should also rethink the care that is being delivered. That's a horse of a different color, to be addressed in another post.

All that said, worth reading, including a nice table of proposed changes to our current system with pros and cons. Enjoy!

The HCAN Con

IN PLACE of single-payer, HCAN claims to offer a "bold new solution" to the health care crisis--a hybrid system of three options: keep your private insurance plan, pick a new private insurance plan, or join a government-financed public plan. HCAN further calls for tougher regulation of health insurance companies to "quash greed once and for all." In fact, there's nothing bold or new about HCAN's plan. David Himmelstein, cofounder of Physicians for a National Health Plan (PNHP), calls the HCAN proposal "a superficially attractive health reform that has a long record of failure--akin to prescribing a placebo for a serious illness when effective treatment is available."

How the AMA shot itself in the foot and screwed the american people

Intro

I plan on using this blog to rant on health care issues of any kind. I think I'm boring my family and friends, so I need a different outlet!