Going about one’s day becomes more challenging when one is confronted with articles such as this, describing a situation that is shameful for society and tragic for individuals and families. In our war on drugs, zealotry, government bullying, and perhaps no small component of self-interest and greed have combined to place the US as number one in incarceration rates among all nations.
Who is served by this situation and why is it tolerated at all? The manifest injustice of indeterminate sentencing for non-violent crimes that are clearly disproportionate to sentences for assaults, serious theft, and other matters where there is serious victimization and deprivation of the rights of others is compelling. Read the comments by readers for more insight.
As the parent of two small children, this is the kind of article that haunts me—a child with an incurable disease, a photo of that child, hopeful, bald due to medical treatment. Now deceased. I’m tempted to skip stories like this, but then again if nobody had the stomach to hear about the situations which are hard to face, solutions to problems would never be reached.
The gist of the situation is that thirty years ago, Congress passed the Orphan Drug Act as a way to lure pharmaceutical companies to develop drugs for rare diseases that had been “orphaned” — abandoned or ignored because they were unprofitable. The hope was that drugmakers would break even or post modest profits.
The act paid off, with hundreds of new drugs. But over the years, its good intentions have been subverted by the pharmaceutical industry, which has increasingly found ways to exploit this once-obscure health-care niche, transforming it into a multibillion-dollar enterprise. Read more…
That products (in this case herbal supplements, as discussed in this article) are not as they seem is only a problem if one takes seriously the value of and need for such products. Evidence supported by quality peer-reviewed science as to the value of such supplements is sorely lacking.
A decent balanced diet emphasizing variety of food and moderate quantities is more than sufficient to meet nutritional needs. To avoid adulterated supplements, it is most effective to avoid supplements, and be healthier and a bit wealthier in the process. The money saved can be put to much better use.
No, this is not a story about recreational drug use and the US-Mexican border. As this article in The New York Times highlights, moving pharmaceutical across the US-Canadian — and many other — border(s) is big business. The Canadian International Pharmacy Association, a 10-year-old group, said its members fill prescriptions for one million Americans each year.
Per the Centers for Disease Control, about 2% of adults — about 5% of the uninsured —said they had bought prescription drugs from other countries. The Food and Drug Administration says on its Web site that “in most circumstances it is illegal to import drugs into the U.S. for personal use” because the agency cannot guarantee they are safe and effective. The government also prohibits “reimportation” of drugs made in the United States because it cannot guarantee the medications were not tampered with or stored improperly.
The agency said it does not track the volume of such imports. However, it “typically does not object” to people buying imported medicine for personal use “under certain circumstances,” the agency said. Often the medications are available in other countries at a fraction of the cost here in the United States, even for those with health care insurance.
Personally, I’ve purchased prescription medications — with no prescription — in Spain, France, and Hungary. (I drew the line at Niger though it would have been interesting to see what the pills actually were. In 1999 in Niamey it was not uncommon in public places to be approached by a man with a foot-tall spinning rack of colorful pills in home packaging balanced on his head that he was eager to sell. None was in any sort of original packaging or had any directions included, much less was the name of the drug stated anywhere. Given the 20% literacy rate and the fact that cheap pink toilet paper for foreigners imported from China was about the only paper available in the country, this was probably reasonable in its way. There were of course dispensairs where you could be treated by a nurse if necessary, and given the country’s 47-year life expectancy at the time finding humor in the system is hardly the point. In Hungary in 2003 I paid $20 cash for a house call and some quite effective anti-nausea pills that lasted me a couple of years; in France in 1985 it was $5 and a couple of jokes at my father’s expense for the blood pressure medication he had forgotten to packet. He was traveling around Europe before settling into Spain for an extended stay and we left the pharmacy with enough medication to last a year.) Aside from the quirky cultural interactions, the situation itself is again a reminder of the ineffectiveness of how health care availability and costs are managed in the United States. The Times article is full of examples of purchasing medications on a regular basis from overseas as the only affordable way for many, including the insured, to manage their health. The title sums it up well: “As Drug Costs Rise, Bending the Law Is One Remedy.”
What consumer items in the US are priced at such a massive differential to Europe and elsewhere besides medications? Lobbying pays nicely it would appear. This is not just a problem for those with asthma or other illnesses requiring increasingly costly drugs. This is a problem for every patient, every insured, every taxpayer, and every employer who pays for insurance. This is of course due to the risk sharing inherent in any insurance system, where the healthier pay for the sicker. This means higher premiums, copays, deductibles, lower business profits, and lower pay due to business costs being shifted to higher benefits.
It is also a problem for caring physicians who are faced with the dilemma of helping their patients who may have to pay all or some medication costs out of pocket due to no, or limited, insurance coverage.
We are currently in a government shut-down, in part due to a small number of politicians who want to preserve this status quo – or at least it appears they do. The rhetoric attacks reform and change. The corollary of these attacks is that we leave things largely alone, including these windfall abuses of regulation.
In the free market that most believe in theoretically, safe drugs like those sold in Europe would be available in the US, unimpeded by protective and restrictive regulations that protect certain companies and products from competition. We currently have a system that is a far cry from free, rational, or equitable.
Innovation is not always comfortable. Change when it takes place will be disruptive, and it will be resisted. But it is necessary.
Senator Tom Coburn of Oklahoma chaired a hearing of the Homeland Security & Governmental Affairs Committee on the topic of Disability Fraud. The hearing was revealing, as are these articles (CBS News/60 Minutes, ABAJournal, C-Span). Coburn, a physician himself, detailed one fraud scheme.
As he details the boilerplate employed by those named in the current scheme, including attorneys and physicians, one can’t help but wonder if those involved in the system were not aware of the abuse as it took place, only to ignore the sham claims that were being approved by the thousands.
Perhaps the tide is shifting against the tolerance for misuse of the system. Unclear in this matter is what will take place with the claimants who have received millions if not billions of dollars as a result of fraud.
As noted in The New York Times and elsewhere, the panel in Texas responsible for reviewing biology textbook submissions from publishers has stirred controversy because a number of its members do not accept evolution and climate change as scientific truth. Publishers have submitted 14 biology textbooks for consideration this year.
The situation is troublesome for several key reasons. Some parents in Texas worry that if the teaching of basic scientific theories — that have now been internally accepted for decades—is eroded, their children will not be able to compete for jobs that require a rigorous scientific background, or will be disadvantaged in college science courses. Another concern is the introduction of beliefs based upon religious views — such as “creation science” — into public school classrooms. As noted, in a recent survey by Penn State political scientists, one in eight high school biology teachers have taught creationism or intelligent design as valid scientific alternatives to the theory of evolution.
Historically, give the state’s size, decisions made on textbooks for Texas strongly influences what textbooks are published and available in other states as well. However, given the availability of on-line editions, Texas’s impact has been somewhat diminished. Also, asThe New York Times notes, publishers are also likely to be influenced by the scientific standards developed by representatives of twenty-six state governments and groups of scientists and teachers, already officially adopted by seven states. The Texas state board will vote on a final approved list of textbooks in November. Read more…