Wednesday, June 17, 2009
Financing Reform: Limiting Malpractice Liability?
"In closed-door talks, Mr. Obama has been making the case that reducing malpractice lawsuits — a goal of many doctors and Republicans — can help drive down health care costs, and should be considered as part of any health care overhaul, according to lawmakers of both parties, as well as A.M.A. officials."
Funding Reform: Drug Ads Deductions No More?
Ways and Means Cmte. Chair Charles Rangel has announced that the House is considering eliminating the advertisement tax break that Pharma gets, in order to pay for health reform. This idea has been around since before BO took office, when Rahm Emmanuel warned industry leaders.
It never occurred to me that there is a tax break for advertising. It's a a business deduction as it is an "ordinary and necessary expense paid or incurred during the taxable year in carrying on any trade or business." Huh. Makes me wish I had taken more tax classes.
Now, while I'm certainly no advocate for BigPharma, I will say the Representative's argument has me thinking about a variety of issues:
Almost all ads are for things we don't need. The others are for things we need that we can get from a variety of sources in various permutations (that are probably unnecessary or undesirable alterations anyway). In this sense it's not a very strong argument.
What pharmaceutical drugs are needed anyway? What OTC drugs are needed? What drugs of any kind are needed?
Who should decide what's needed?
The Rep's problem isn't with consumerism, i'm sure. In fact, that is supposed to be ENCOURAGED in our society (hence a crux of the health care "debate"). The problem is who pays for this consumerism. Unless, of course, the Representative is concerned with the large amounts of side effects & subsequent treatments or deaths associated with prescription drugs. While this is a more humanitarian perspective, it is still a monetary problem as well. I wonder if Rangel was concerned about the taxpayer subsidization of these ads before he started pondering the costs of health care reform? He could have been. I don't know. I'll get back to you on that one.
Also, the Representative says ads encourage patients to ASK for drugs they may not need. What's the problem with that, Mr. Thought Police? People ask for things they don't need all the time. In fairness, it could be a problem if not only are the drugs not needed, but they're dangerous, or the ads are misleading or straight up lying (which does happen). That kind of speech is not protected. Otherwise, if the ads pass First Amendment commercial speech regulation tests, the problem would lie in the granting of an unreasonable request, which really would fall to the doctors, wouldn't it. Is this a veiled jab at health care providers, and by extension, the AMA, who vehemently deny their prescribing habits are tainted by the ad efforts of BigPharma? (BTW, BigPharma spends 3-4 times as much on ads & swag for drs than it does on direct to consumer ads. i'm sure that's because they find advertising to consumers more profitable & therefore a less worthy investment.)
Rep. Rangel's argument that ads make people want to buy things they don't need could just as easily be applied to a commercial for Taco Bell. ...except his argument points to a key issue (IMO) that doesn't get as much attention as I think it should--Health issues are not standard free market issues. Rangel says people purchase DRUGS they do not need. What makes Rx drugs different from a Fiesta Burrito? I'll leave that one to you.
So there's a little rant on tax breaks for drug ads. Take it all with a grain of salt, or whatever your drug of choosing, while you still can make the choice. Believe it or not after reading this post, I'd be in favor of such a measure, if it could be implemented in a logical & justified way, rather than simply a lame attack on a very profitable industry.
"Rangel said he and other lawmakers believe it is wrong to let drug companies
deduct their advertising costs for prescription drugs. ... Rangel said it’s
inappropriate for taxpayers to subsidize ads for pharmaceuticals because they
encourage viewers to ask for drugs they may not need."
It never occurred to me that there is a tax break for advertising. It's a a business deduction as it is an "ordinary and necessary expense paid or incurred during the taxable year in carrying on any trade or business." Huh. Makes me wish I had taken more tax classes.
Now, while I'm certainly no advocate for BigPharma, I will say the Representative's argument has me thinking about a variety of issues:
Almost all ads are for things we don't need. The others are for things we need that we can get from a variety of sources in various permutations (that are probably unnecessary or undesirable alterations anyway). In this sense it's not a very strong argument.
What pharmaceutical drugs are needed anyway? What OTC drugs are needed? What drugs of any kind are needed?
Who should decide what's needed?
The Rep's problem isn't with consumerism, i'm sure. In fact, that is supposed to be ENCOURAGED in our society (hence a crux of the health care "debate"). The problem is who pays for this consumerism. Unless, of course, the Representative is concerned with the large amounts of side effects & subsequent treatments or deaths associated with prescription drugs. While this is a more humanitarian perspective, it is still a monetary problem as well. I wonder if Rangel was concerned about the taxpayer subsidization of these ads before he started pondering the costs of health care reform? He could have been. I don't know. I'll get back to you on that one.
Also, the Representative says ads encourage patients to ASK for drugs they may not need. What's the problem with that, Mr. Thought Police? People ask for things they don't need all the time. In fairness, it could be a problem if not only are the drugs not needed, but they're dangerous, or the ads are misleading or straight up lying (which does happen). That kind of speech is not protected. Otherwise, if the ads pass First Amendment commercial speech regulation tests, the problem would lie in the granting of an unreasonable request, which really would fall to the doctors, wouldn't it. Is this a veiled jab at health care providers, and by extension, the AMA, who vehemently deny their prescribing habits are tainted by the ad efforts of BigPharma? (BTW, BigPharma spends 3-4 times as much on ads & swag for drs than it does on direct to consumer ads. i'm sure that's because they find advertising to consumers more profitable & therefore a less worthy investment.)
Rep. Rangel's argument that ads make people want to buy things they don't need could just as easily be applied to a commercial for Taco Bell. ...except his argument points to a key issue (IMO) that doesn't get as much attention as I think it should--Health issues are not standard free market issues. Rangel says people purchase DRUGS they do not need. What makes Rx drugs different from a Fiesta Burrito? I'll leave that one to you.
So there's a little rant on tax breaks for drug ads. Take it all with a grain of salt, or whatever your drug of choosing, while you still can make the choice. Believe it or not after reading this post, I'd be in favor of such a measure, if it could be implemented in a logical & justified way, rather than simply a lame attack on a very profitable industry.
Friday, June 5, 2009
don't trust the insurance companies
I had been avoiding simply posting links with little commentary here, but in the interest of posting more, here goes.....
Op Ed from Paul Krugman in NYT on the need for a public option. It's refreshing that skepticism of the motives of the insurance industry in getting on board with reform is starting to get some public attention.
Op Ed from Paul Krugman in NYT on the need for a public option. It's refreshing that skepticism of the motives of the insurance industry in getting on board with reform is starting to get some public attention.
Thursday, June 4, 2009
Common Sense
Check out Dan Carlin's podcast, Common Sense on "Sick Politics." An excellent and spirited commentary on health care today. Thanks to B at Is it Luck for the heads up.
And think about this quote when you listen to the podcast:
And think about this quote when you listen to the podcast:
"Dismantling the private market ... is not something the president
supports. He supports moving forward and filling the gap, not disrupting the
entire market," Sebelius told the House Ways and Means Committee.
BO on reform
Tuesday the President sat in on a Senate Finance Committee meeting on health reform, and afterward released a letter addressed to Baucus and Kennedy summing up his support.
Here's the gist: BO supports reduced costs, keeping the health insurance you have if you want to. These things are neither new nor surprising. The letter continues, "I agree that we should create a health insurance exchange." Saw that one coming. And BO strongly supports a public health insurance option to compete with private plans. Yep. Further the President is "open to [some Senator's] ideas on shared responsibility." What does this mean, you ask? Insurance mandates. BO was not open to such an idea for anyone other than children during the presidential primaries. I will admit I'm slightly surprised this one is coming up so soon, though i note the noncommittal "openness" which shows a flexibility to jump on board or off whenever the jumping is good. I do believe that the President supports a mandate but will bide his time until a politically safe moment.
...
I've now been sitting here staring at this screen trying to figure out the best way to analyze and sum up my feelings about the president's letter. All I can say right now is: Get ready America.
Here's the gist: BO supports reduced costs, keeping the health insurance you have if you want to. These things are neither new nor surprising. The letter continues, "I agree that we should create a health insurance exchange." Saw that one coming. And BO strongly supports a public health insurance option to compete with private plans. Yep. Further the President is "open to [some Senator's] ideas on shared responsibility." What does this mean, you ask? Insurance mandates. BO was not open to such an idea for anyone other than children during the presidential primaries. I will admit I'm slightly surprised this one is coming up so soon, though i note the noncommittal "openness" which shows a flexibility to jump on board or off whenever the jumping is good. I do believe that the President supports a mandate but will bide his time until a politically safe moment.
...
I've now been sitting here staring at this screen trying to figure out the best way to analyze and sum up my feelings about the president's letter. All I can say right now is: Get ready America.
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