Mt. Vernon Register-News

February 25, 2013

Learn something daily


CNHI

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I have been writing about the problem of health care becoming affordable for years and almost every day I learn something new. I have learned that allegedly drug makers pay other drug makers to delay entry of less expensive generic drugs into the market. This means that rather than you getting a break on price that they can keep charging the higher price for the drug by paying to delay the entry. Somehow, I have a problem with this practice when you consider that almost every day we hear about the necessity of reducing the cost of health care and improving the quality.

Although the article written by James Kanter and Katie Thomas about this practice started with a case of drug for severe cancer pain in Belgium, this problem exists on both sides of the Atlantic.

"Agreements to delay the introduction of generic drugs have come under heightened scrutiny in both Europe and the United States in recent years, with regulators on both sides of the Atlantic concluding that such deals are anticompetitive," the article states. "In the United States, the Supreme Court is scheduled to take up the issue in March. Patent expirations also open opportunities for generic competitors, which is why in some cases drug makers have been accused of paying generic competitors to delay bringing their products to market."

We are told daily that something must be done about the cost of health care and that the first choice of our politicians is to reduce; I hate to use the word "entitlements" with a lot of emphasis on reducing the costs of Medicare, which affects our seniors. Wouldn't you think that the focus should be to scrutinize every known practice to see if opportunities exist for savings to our citizens without affecting the quality of care? An interesting study would be to compare money spent marketing/advertising along with money spent lobbying Congress and money spent delaying entry of generic drugs with money spent on research.

This reminds me of how this industry was able to stop the negotiation of price when Medicare D became law and made drugs in Mexico and Canada so much cheaper than the United States, sometimes reportedly manufactured in the same factory. Something is wrong when this happens. I am told that even the Veterans Administration can negotiate price?

The very next item that catches my eye is a story by Raymond Hernandez and Frances Robles about one of our Senators allegedly bending the rules to help a doctor who was a major contributor to his campaign.

Two years ago, the doctor, despite an apparent lack of experience in border security issues, allegedly bought an ownership interest in a company that had a long-dormant contract with the Dominican Republic to provide port security. The senator, who is chairman of the Senate subcommittee that holds sway over the Dominican Republic, subsequently urged officials in the State and Commerce Departments to intervene to the contract would be enforced, at an estimated value of $500 million. You can draw your own conclusions.

"Aides to the senator said, however, that the senator had accepted two round-trip flights aboard the doctor's jet for personal vacations in the Dominican Republic in 2010," the article states. "He failed to report them as gifts or reimburse the doctor at the time, as required, and this month he sent the doctor a check to cover the cost of the flights."

"Aides said it was simply because of sloppy paperwork that the senator did not repay the doctor at the time," the article continued. "After reports surfaced late last year on The Daily Caller, a conservative web site, about his travels with the doctor, the senator recently sent the doctor's company a check for $58,500."

Just a couple of reasons why we should realize that there are not many problems we face that cannot be traced to special interest groups buying our politicians and the shrinking of our middle class to a smaller group daily. It has been reported that the middle class measured by income has declined from 61 percent to 47 percent and is still slipping.

Let me finish with one that I think will startle you. It's a story by Ben Goldacre who happens to be a doctor. He reports we now have a reported $10,000 lawsuits over a hip replacement that has experienced a 40 percent failure rate within five years. Some would say that mistakes happen, but it is reported that internal documents indicated that the flaws were known, but never made public. A failure to report after doctors and internal analyses were alerted to the problem is one thing, but, "Goldacre states these problems would be bad enough on their own, but they are compounded by a generation of 'fake fixes' that have delivered fake reassurance and so prevent realistic public discussion."

He discusses the many so-called fixes in the system to bring more transparency to clinical trial results and prevent drugs and medical items from reaching the market that are not safe nor do what they are advertised to do. I am quoting Dr. Goldacre, "This cannot be acceptable. Withholding data not only misleads doctors and patients; it's an insult to the patients who have participated in clinical trials, believing that they were helping to improve medical knowledge."

The thought of putting something in our bodies whether it is a pacemaker, artificial hip or anything else that was not properly tested with clinical trials and full transparency of results should make all of us mature folks not only nervous, but very scared. Please note that I said "mature" and not "old." I did not want to offend my playmates and friends. If you dig deep enough and really root cause the problems we face as a nation or state in unaffordable health care, education, debt and many others, you will eventually find a corrupt political system at the bottom.