If I hear or read about another billionaire claiming that the current economic woes we are suffering as a nation is due to our “entitlement” programs, I am going to scream. The latest in the long line of billionaire apologist is Pete Peterson. Mr. Peterson, is a longtime opponent of Social Security, Medicaid, and any other government programs targeted to help the needy, who appeared on Charlie Rose. According to Mr. Peterson it is not greed and speculation that has reeked havoc on our economy for the past 30 years, it is the entitlement programs. All this time I have been thinking that not being able to know when you’ve had enough is the problem. Come to find out I am looking in the wrong direction. Greed has been around for a long time, entitlements have not. The Crash and the Depression occurred prior to entitlements; I wonder who Mr. Peterson blames those on.
I believe the Social Security Trust Fund belongs in the first tier of classic oxymorons. In the first place, the Social Security Trust Fund should not be trusted, and it is not funded. We anesthetize the public with highly reassuring long-term statements that the trust funds are solvent for decades. Yet, we do not tell the public that the payroll taxes of our children and grandchildren would have to double to cover the costs of Social Security and Medicare. That is an unthinkable burden. We do not tell the public that whether you have a trust fund or not, you still face the same three hard choices: increased taxes, cut benefits, or try to borrow unprecedented amounts.
Now how much would we have to borrow? I think it’s time we started thinking in cash flow terms, because these programs are obviously pay-as-you-go programs. The projected cash flow deficits for Social Security and Medicare go from a modest $25 billion in 2003, to a projected $783 billion in 2020, and trillions of dollars thereafter.[1]
These statements on the surface seem reasonable enough, we have not done a good job funding and fixing the entitlement programs. Instead of facing some tough realities and questions the politicians have continued to ignore them, afraid of providing the American public the ugly truth, ugly truths do not win elections. The problem I have with these guys is they present the picture as though the entitlements were the only item in the budget. So rather than saying it is a matter of priorities they present the picture as a zero-sum game. Nowhere do they mention the military budget, the tax-cuts, or the other government programs that make up the complete budget. We are left to believe that the entitlements exist on some island, isolated from the other expenditures.
Mr. Peterson discussed the Prescription Drug benefit that was added to Medicaid as an example of making a bad situation worse. I agree, but he doesn’t mention that he is a Republican and it was the Republicans who created the Bill that forbid the Government from negotiating prices for the prescriptions. I wish just once these guys would take responsibility for the messes they make. The Republicans built in astronomical profits for the benefit of the big pharmaceuticals, just as they did for big oil who is recording unprecedented profits. Nowhere does he mention the billions of dollars that were made during the mortgage meltdown by those same companies who are now crying bankruptcy. Is it me or did billions of dollars just disappear into thin air? Someone had to profit from all of those loans, why is this information never debated? Nor, did he mention that it is the Republicans who are trying to bankrupt the system to force its collapse.
Mr. Peterson stated that he supports John McCain and was asked about Senator McCain’s flop on the tax-cuts, he presented the standard line that what McCain was against was not tax-cuts per se but tax-cuts without spending cuts. McCain and his supporters are backpedaling so fast from statements like the following it blows the mind:
“Mr. President, the principle that guides my judgment of a tax reconciliation bill is tax relief for those who need it the most—lower- and middle-income working families. I am in favor of a tax cut, but a responsible one that provides significant tax relief for lower- and middle-income families. And I commend Sen. Grassley for moving in that direction. But I am concerned that debt will overwhelm many American households. That is why tax relief should be targeted to middle-income Americans. The more fortunate among us have less concern about debt. It is the parents struggling to make ends meet who are most in need of tax relief.
“I had expressed hope that when the reconciliation bill was reported out of the Senate Finance Committee, the tax cuts outlined would provide more tax relief to working, middle-income Americans. However, I am disappointed that the Senate Finance Committee preferred instead to cut the top tax rate of 39.6% to 36%, thereby granting generous tax relief to the wealthiest individuals of our country at the expense of lower- and middle-income American taxpayers.”[2]
Senator McCain and Mr. Peterson have no problem today with the Feds bailing out Bear Sterns and the Wall Streeters, it is the average American who Senator McCain was concerned about in 2001 who don’t deserve any relief. Mr. Peterson said that while it was a dangerous precedence, he supported the bail-out to stem broader market drops. You have to love this line of, “we hate to do it and we know its bad business, but we have to. He gave the same excuse for all of the liquidity funds they have received from China. He didn’t seem to have any problem with China owning large sections of our banking industry. I’m no Nobel economist but even I know that can’t be a good idea.
Oh, by the way Mr. Peterson is making a donation of a billion dollars to help teach Americans how to save. First of all, how rich do you have to be to give away a billion dollars? Secondly, what he failed to mention is why the American family is in the situation it finds itself. Due to flat wage pressure being exerted by Mr. Peterson and his billionaire friends for the past 30 years, the wife has had to go to work to increase household buying power. After that money was spent, they began mortgaging their homes and running up credit card bills for expense money. Now that they have spent that money the well is now dry. And Mr. Peterson says if they had just saved money the economy wouldn’t be in this predicament. He wants consumers in a consumer economy to not consume or reduce consumption. That horse is already out of the barn, we have been bombarded since the age of television to buy. Where were the commercials for saving money?
[1] http://petersoninstitute.org/publications/papers/peterson0804.pdf
[2] —Senate floor statement during debate over President Bush’s tax relief package, May 21, 2001.
Thursday, April 3, 2008
Enough Is Enough
Tuesday, June 19, 2007
Drug War IV
In my continuing series on the “War on Drugs”, I want to turn our discussion to the doctors who are now under attack by the DEA as drug pushers. It appears that the trust relationship between doctor and patient is now under scrutiny. Are there doctors who prescribe too many and too much prescription medication? Of course there are, but one must be careful when confronting this issue. It is reckless prosecutions that can send chills throughout the medical community and cause needless suffering on the part of legitimate patients. We live in a drug seeking culture, if you are not completely happy then take one of these pills and you will be. The pharmaceutical industry is spending millions on trying to find the perfect feel good remedy for all of us depressed Americans.
It’s a false choice. Virtually everyone who takes opioids will become physically dependent on them, which means that withdrawal symptoms like nausea and sweats can occur if usage ends abruptly. But tapering off gradually allows most people to avoid those symptoms, and physical dependence is not the same thing as addiction. Addiction — which is defined by cravings, loss of control and a psychological compulsion to take a drug even when it is harmful — occurs in patients with a predisposition (biological or otherwise) to become addicted. At the very least, these include just below 10 percent of Americans, the number estimated by the United States Department of Health and Human Services to have active substance-abuse problems. Even a predisposition to addiction, however, doesn’t mean a patient will become addicted to opioids. Vast numbers do not. Pain patients without prior abuse problems most likely run little risk. “Someone who has never abused alcohol or other drugs would be extremely unlikely to become addicted to opioid pain medicines, particularly if he or she is older,” says Russell K. Portenoy, chairman of pain medicine and palliative care at Beth Israel Medical Center in New York and a leading authority on the treatment of pain.
According to the pharmaceutical research company IMS Health, prescriptions for opioids have risen over the past few years. They are used now more than ever before. Yet study after study has concluded that pain is still radically undertreated. The Stanford University Medical Center survey found that only 50 percent of chronic-pain sufferers who had spoken to a doctor about their pain got sufficient relief. According to the American Pain Society, an advocacy group, fewer than half of cancer patients in pain get adequate pain relief.
Several states are now preparing new opioid-dosing guidelines that may inadvertently worsen undertreatment. This year, the state of Washington advised nonspecialist doctors that daily opioid doses should not exceed the equivalent of 120 milligrams of oral morphine daily — for oxycodone or OxyContin, that’s just 80 milligrams per day — without the patient’s also consulting a pain specialist. Along with the guidelines, officials published a statewide directory of such specialists. It contains 12 names. “There are just not enough pain specialists,” says Scott M. Fishman, chief of pain medicine at the University of California at Davis and a past president of the American Academy of Pain Medicine. And the guidelines may keep nonspecialists from prescribing higher doses. “Many doctors will assume that if the state of Washington suggests this level of care, then it is unacceptable to proceed otherwise,” Fishman says.[1]
Despite popular belief, not everyone that takes drugs become addicts. I know from my own experiences that there are millions of people who take drugs and do not become addicts. The problem is no one can tell by looking who will and who won’t become addicted. But there is also the physiology of drugs and the human body. There are drugs that are physically addicting no matter who takes them (ie opiates such as heroin, morphine, etc.). It is these powerful drugs that are used to manage pain in most cases. Pain is not always a readily identifiable condition; there are sometimes no physical blueprints to follow. What degree of pain a person can tolerate varies greatly with each individual and also whether someone is actually in pain. There are no accurate tests for specific pain. I had a friend that suffered from migraines for years. He would go from doctor to doctor and no one could help him, sometimes they couldn’t even identify the pain that he was suffering. For many years in this country pain management was not part of most doctors practice's or part of any medical school courses. For that reason, many people suffered needlessly from under treatment of their pain symptoms.
But what are we to do with those who are addicted? They appear the same initially as the real pain patient, if anything they may appear more normal. Is the doctor responsible for what a patient does with his medication? Can a doctor accurately monitor a patient’s behavior that he may see once a month? Is it fair to expect that type of scrutiny from our doctors with our 15 minute HMO visits? It is questions like these that will cause many to suffer from pain or lack of treatment for other ailments due to the fear on the part of doctors to be arrested, sued, or even investigated. An investigation can cause a doctor to lose his livelihood.
Will another casualty of the “War on Drugs” be that patients suffer due to fear on the part of their doctors to do their job? There will always be people who abuse the system for their own personal gain, which goes for patients as well as doctors, but we must not allow the government in their zeal to fight this war to intimidate those trained to alleviate pain and suffering. As anyone who has read my writings know, I am not a fan of big pharma, but I am also not a fan of an intrusive government that under the guise of fighting a losing war is causing needless suffering. It is up to the doctors to decide the plan of treatment for their patients, after all that is what they get paid the “big bucks” to do. Let’s keep the government out of the examination rooms and peeking over the doctor’s shoulder. Should we monitor the performance of doctors? Of course we should, but their treatment should not be micro-managed by bureaucrats and drug agents.
[1] http://www.nytimes.com/2007/06/17/magazine/17pain-t.html?ref=health
Thursday, May 17, 2007
Imported Drugs
"There is a pricing problem with prescription drugs," said Sen. Byron L. Dorgan (D-N.D.), who co-sponsored the amendment with Sen. Olympia J. Snowe (R-Maine). "The identical drug, FDA-approved, the same pill, put in the same bottle, made by the same company, is set virtually every other place in the world at a lower price. And the American consumer is told, 'You know what, we have a special deal for you: You get to pay the highest price in the world.' "
I beg to disagree with the Senator, we don’t have a pricing problem; we have an ethics problem. We have an industry that is too embedded with our legislators and elected officials. The senate voted to add an amendment to an FDA bill to allow for the importation of prescription drugs from Canada. The cost savings to consumers is estimated to be around 50 billion dollars over 10 years. One of the major instruments driving seniors and the poor deeper into poverty is the high cost of health care, particularly prescription drugs. I applaud the senate for pursuing this issue even in the face of a veto from the President.
There has been talk about the safety of imported drugs for years, but as the Senator stated these are the same drugs made by the same manufacturers. This fear concerning the safety of these drugs is a smoke screen being concocted by the pharmaceutical industry to keep Americans paying the highest cost for drugs in the world. It is a sad commentary when those who we have elected and sent to Washington to represent us must be coerced into doing what we pay them to do. We should not have to justify saving money to these people, they should be looking for ways for us to save money in every area of our economy. Unfortunately those elected officials and their aides have decided that the large corporations need protection more than the consumers. Of course, it doesn’t hurt that the pharmaceutical companies have spent in excess of 100 million dollars annually to pay for lobbyist to press their agenda. I can see where they need all the help they can get to protect them from us ungrateful consumers.
Public Citizen has done a report of the unethical goings on between Washington and the big pharmaceutical companies.[1] I would recommend everyone to read this report and see just how much money and influence peddling these companies are doing. It’s no wonder we are paying the highest prescription drug costs in the world.
To show you how we must be living in bizarro land, the war on drugs was supposed to increase the cost of illegal drugs, unfortunately it has had the opposite effect. It has however had the unintended effect of increasing the cost of prescription drugs; can anyone explain this to me?
Unless we begin to take control of our government soon I am afraid democracy will be a concept talked about in history classes. It will no longer be practiced here. This President has already begun to plant the seeds of the “Imperial President” due to 9/11. A President that is no longer accountable to anyone, but his own way of thinking and those of like mind. We must never tire of doing the right thing or be swayed by the propaganda of the wealthy and their apologist.
Our seniors have given a lot to this nation and they deserve our thanks and our support. We must not let them be gouged by the big pharmacy companies, because in the end it is us who will have to pay the bill. They should never have to choose between medicine and food; no American should. If the drug companies don’t want to lower prices, then it is only fair to let our seniors and poor get the medicines they need at the lowest and safest possible cost. This unsafe argument is a red herring; I have yet to hear of any mass deaths in Canada from their prescription drugs. Do they care about their citizens any less than we do? When you live on a fixed income the money saved from the imports can go a long way to allowing you some of the comforts that we take for granted.
Read more!Friday, May 11, 2007
Drug Wars III
In my ongoing discussions of the drug policy in America, I have come across some very disturbing information concerning our children, doctors, and pharmaceutical companies. I briefly talked about the relationship in Drug Wars II, but there are reports that doctors on the pharmaceutical payroll are now prescribing drugs for our children that were not tested or designed for the purposes they are being prescribed.
The information is from Minnesota, the only state by the way that forces doctors to disclose where their income is coming from, and shows a correlation between the amounts of money doctors are receiving from the pharmaceutical companies and the number of prescriptions being written by the doctors. The pharmaceutical companies pay doctors to hold “educational” meetings to discuss their products and how to prescribe them, which seems harmless enough. However, the fees charged for these meetings may actually be concealed payments to the doctors from the pharmaceutical companies, which is in violation of the law. It is illegal for pharmaceutical companies to directly pay doctors for prescribing specific products and against Federal rules for the companies to promote unapproved uses for the products.
“From 2000 to 2005, drug maker payments to Minnesota psychiatrists rose more than sixfold, to $1.6 million. During those same years, prescriptions of antipsychotics for children in Minnesota’s Medicaid program rose more than ninefold.
Those who took the most money from makers of atypicals tended to prescribe the drugs to children the most often, the data suggest. On average, Minnesota psychiatrists who received at least $5,000 from atypical makers from 2000 to 2005 appear to have written three times as many atypical prescriptions for children as psychiatrists who received less or no money.
But studies present strong evidence that financial interests can affect decisions, often without people knowing it.
In Minnesota, psychiatrists collected more money from drug makers from 2000 to 2005 than doctors in any other specialty. Total payments to individual psychiatrists ranged from $51 to more than $689,000, with a median of $1,750. Since the records are incomplete, these figures probably underestimate doctors’ actual incomes.
Such payments could encourage psychiatrists to use drugs in ways that endanger patients’ physical health, said Dr. Steven E. Hyman, the provost of Harvard University and former director of the National Institute of Mental Health. The growing use of atypicals in children is the most troubling example of this, Dr. Hyman said.
“There’s an irony that psychiatrists ask patients to have insights into themselves, but we don’t connect the wires in our own lives about how money is affecting our profession and putting our patients at risk,” he said.”[1]
It is apparent that money and medicine are creating an atmosphere that is endangering the health and welfare of many of our children. Many times these drugs have not been tested on children in clinical trials so no one really knows what the side-effects or outcomes will be with long term usage. Because so much of medicine is trial and error we are putting these children at grave risk by allowing them to be human guinea pigs for the pharmaceutical companies and unscrupulous doctors. Many of these drugs are being prescribed with little or no empirical or historical data that they even work for symptoms or illnesses they are being prescribed for. So often today people are looking for the magic pill or quick fix for an unruly or aggressive child and these doctors are promising the parents quick answers to what usually are very complex issues.
As a parent, I understand the desire to want your children to be healthy and happy. I couldn’t imagine the pain and suffering that some parents endure with children that have emotional issues, but there is a growing body of evidence that many of our children are being misdiagnosed and drugs are being improperly prescribed. Doctors are free to prescribe medication as they see fit and the majority of doctors do an excellent job, but just as there are those in my field that are looking for easy answers I am sure there are doctors doing the same. Of course it doesn’t hurt to make a little cash on the side either.
“The drug industry and many doctors say that these promotional lectures provide the field with invaluable education. Critics say the payments and lectures, often at expensive restaurants, are disguised kickbacks that encourage potentially dangerous drug uses. The issue is particularly important in psychiatry, because mental problems are not well understood, treatment often involves trial and error, and off-label prescribing is common.
Dr. Steven S. Sharfstein, immediate past president of the American Psychiatric Association, said psychiatrists have become too cozy with drug makers. One example of this, he said, involves Lexapro, made by Forest Laboratories, which is now the most widely used antidepressant in the country even though there are cheaper alternatives, including generic versions of Prozac.
“Prozac is just as good if not better, and yet we are migrating to the expensive drug instead of the generics,” Dr. Sharfstein said. “I think it’s the marketing.”
Some psychiatrists who advocate use of atypicals in children acknowledge that the evidence supporting this use is thin. But they say children should not go untreated simply because scientists have failed to confirm what clinicians already know.
“We don’t have time to wait for them to prove us right,” said Dr. Kent G. Brockmann, a psychiatrist from the Twin Cities who made more than $16,000 from 2003 to 2005 doing drug talks and one-on-one sales meetings, and last year was a leading prescriber of atypicals to Medicaid children.”[2]
It is a frightening thing that some doctors feel that it is ok to prescribe these drugs even without scientific evidence of their effectiveness. There have been too many cases and lawsuits where doctors have prescribed medication that had not been thoroughly tested or had been marketed with false test data and promises. We as parents must be vigilant in safeguarding our children’s health. It is ok to question the doctors and do research on the diagnosis they give. It is especially important to find out all the information you can on the drugs being prescribed for your children, being careful to investigate the side-effects and any clinical trial data that you can find. It is a lot of work, but it is becoming evident that if you don’t do it, no one else will.
Read more!Thursday, May 10, 2007
Drug Wars II
Last week, I wrote about how illegal drug usage has skyrocketed. There is another phenomenon taking place simultaneously. We are taking more prescription drugs than ever before. Some would have us believe that it is due to our being better able to diagnose and treat diseases. I am not so sure.
One in ten of our children are taking prescription drugs. Not just for treating diseases, the majority of them are taking a potent cocktail of psychiatric drugs for behavioral problems. For the first time ever spending for behavioral problems outpaced spending for antibiotics and asthma among children. One in twenty of our kids are taking more than three prescription drugs per day. There has been a 369% increase in spending on ADHD (Attention Deficit/Hyper Disorder) drugs for kids under five. That’s right, kids under 5! We are setting them up for a lifetime of drug dependency and we do not even know what the long term effects of these drugs are. We are already seeing an increase in suicides and violence in our young people. Not to mention the costs they will incur for a lifetime of drug therapy.
Are there children who have legitimate medical reasons for taking prescription medication? Of course there are, but from the numbers there appears to be a large number of doctors and parents that are using these medications for quick fixes. There are some doctors over prescribing these dangerous drugs and misdiagnosing these children. We are not even letting these children develop personalities before we begin to try to alter them with these psycho drugs, many of which were not even developed for or tested on children. We must be careful and more diligent in this area; the stakes are too high to just casually prescribe these medications.
American consumers spent nearly $100 billion on prescription drugs last year, more than double what the nation spent on drugs in 1990. That number seems astronomical to me, so I have to break it down in a form that I can understand. That would put us number 48 on the worldwide country GNP list. We spent more money on prescription drugs than three-fourths of the world made in GNP. Why do we need to take so many drugs? Are our lives any better with all these drugs? Has our medical care gotten better because of taking all these prescription drugs?
There are a few things that are crystal clear concerning prescription medication in recent years:
1) Most seniors are taking more than one prescription drug, with almost half taking three or more.
2) Children are becoming major consumers of prescription drugs, in some cases on par with their parents, depending on their age.
3) The policy of prescribing multiple drugs simultaneously has become standard practice for most medical doctors and hospitals.
On the one hand we condemn the use of recreational drugs in our society and criminalize it, however we have no problem with drug usage as long as it prescribed and distributed by “Big Pharma”. We go into the schools proclaiming the dangers of drugs at the same time every morning these same kids are standing in line to get their morning dose of “Ritalin” to make them feel better. So, it is okay to use drugs to feel better so long as they are the drugs we give you. Am I the only one who sees the inconsistency here?
Stumble It!