Counterfeit Meds in America

While outrage over antibiotics in chicken or beef grab headlines, critical questions about antibiotics and other meds taken by us human folk here in America point to an even more grim reality.

2004 saw the closure of the last American plant making such vital medicine. Fearing FDA oversight, companies fled overseas, so that today most antibiotics and key ingredients in other medicines are made in India and China - not a bad thing in itself, but now we find the meds you take may be fake at best, deadly at worst.

In truth many big pharma makers in India do a fine job. We know little about China since they won't let FDA folks examine their facilities.

Recent reports ( here and here) highlight deeply troubling trends:

-- The World Health Organization estimated that one in five drugs made in India are fakes. A 2010 survey of New Delhi pharmacies found that 12 percent of sampled drugs were spurious.

-- One widely used antibiotic was found to contain no active ingredient after being randomly tested in a government lab. The test was kept secret for nearly a year while 100,000 useless pills continued to be dispensed.

More tests of hospital medicines found dozens more that were substandard, including a crucial intravenous antibiotic used in sick infants.

-- India’s pharmaceutical industry supplies 40 percent of over-the-counter and generic prescription drugs consumed in the United States.

-- One federal database lists nearly 3,000 overseas drug plants that export to the United States; the other lists 6,800 plants. Nobody knows which is right.

Drug labels often claim that the pills are manufactured in the United States, but the listed plants are often the sites where foreign-made drug powders are pounded into pills and packaged.

-- Imports rule in America as we receive  80 percent of the seafood consumed in the United States, 50 percent of the fresh fruit, 20 percent of the vegetables and the vast majority of drugs, all originate overseas.

Rep. Roe's Weak Alternative to Health Care Reform

With enrollment options for the Affordable Care Act set to start in just days, Congressman Phil Roe is pushing a very weak alternative idea from Republicans which fails to offer much reform at all. Where has Rep. Roe been for the last 4 years? 

He's been actively blocking most any idea Tea Party Republicans tell him to block. Crafting legislation to assist East Tennessee is not his priority. This last-minute bill he's touting is far too little and so very, very late.

As noted in this report, the alternative has major flaws:

"No overall cost estimates for the bill were available.

Officials said the legislation contains no provision to assure insurance coverage for millions of lower-income Americans who are scheduled under current law to be enrolled in Medicaid, a state-federal health care program for the poor.

Nor are there replacements for several of the requirements the current law imposes on insurance companies, including one that requires them to retain children up to the age of 26 on their parents’ coverage plan and another barring lifetime limits on coverage."

Go Hungry Says Sen. Campfield

Children in need are being threatened in legislation from Knoxville Senator Campfield. He wants to withhold food stamps from families if a child makes bad grades in school. Campfield wants kids in poverty to face more hardships, worse, face the prospect of going hungry, if they are also having problems with their studies.

Classy Campfield. Punishing kids is Ugly Government.

Another Tennessee government over-reach means lost jobs. The state wants to force private businesses to allow more weapons in the workplace. The massive investment and growth of the VW manufacturing complex in Chattanooga is in jeopardy thanks to this proposal.

More legislators, sadly including my new State Rep Tilman Goins, are refusing to allow funds for health care in the state from the Affordable Care Act go to those who might need it. Firstly, we've paid the taxes that create the funds and are obligated for the debt it creates too. The least we should expect in return is to receive the health care programs and expansions which would follow. Politics aside, even of the funds are turned away, other states will receive the funds, so why cut us out? The state's Federal representatives have made and are making calls for the repeal of the Act - but no go. Until or unless such a repeal takes place then don't let TN get less than their share. If the state refuses the money then residents will just have to find health insurance on their own.

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Today's Court Ruling on Heath Care and What It Means

UPDATE: Much surprise that the Supreme Court has upheld that the Affordable Care Act. Chief Justice Roberts and the majority of the court agrees that the law is indeed constitutional - much to the surprise of many court followers and those who have opposed President Obama, it's a clear win for his policies -- from the SCOTUS blog:
"In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding."
 
 original post follows below ...
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Today, some people are hoping the Supreme Court effectively ends the presidency of Barack Obama by ruling his health care law unconstitutional and thus rejecting a centerpiece of his first term in office. It's the culmination of a fierce and dedicated attempt to discredit and dismiss Obama from the political world, and this effort really has no concern about that status of health care in America.

Some have framed the entire discussion about reforming the way we pay for and receive health care as a debate over President Obama's worth as the nation's leader. They have worked so very, very hard to disguise the decades-old problems of affordable health care as some horrible governmental monster.

Court watchers all claim there are four key issues on which the court today will issue it's decision - the media meanwhile has bought into the narrative that this is a do-or-die game akin to a run for the final playoffs in the upcoming presidential election.

What I deeply dislike is the eagerness to ignore the realities of a for-profit health care system, a fatally flawed system where so many simply cannot afford basic medical care. There is little interest in providing such care to those who need it, even though we claim to have the finest medical care in the world ... if you can pay for it. Indeed, such folks who oppose reform laws embrace the notion that if you cannot afford it, that also proves something about your worth (or lack of it) as a citizen.

I don't expect the court will back the president today - Conservatives would knock anything and anyone down in their blind ambition to prevent any change to the status quo and to marginalize any idea from this president. In the eyes of some, the issue is not that our nation has citizens who can't receive medical care - and the cure for that delusion remains elusive.

Rotten Foot; or My Own Health Care Meltdown

I have a good excuse for not having created new posts at my normal rate.

I have what could best be termed a metabolic derangement.

I've altered and adjusted my dietary intake to affect some change - with little success. One doctor tells me I have a hereditary predisposition for the condition, so I'm stuck with the problem. The problem - a fiercely painful problem called gout - was long referred to as a "rich man's disease" or a "king's disease" or the product of "indolence" - none of which apply to me (okay, maybe I am a little bit indolent, as I most often spend my hours at a desk and keyboard). Historians tell me that such luminaries as Alexander the Great and Isaac Newton suffered this problem.

It first dug into my hide last February, I woke up thinking I had broken my ankle during my sleep or something. (A true sign of aging, indeed - waking up having injured myself in my sleep.) I actually had to get a dang cane and hobble into the doctor, who promptly said "Oh, it's gout" and gave me a few prescriptions, which did scale it back to a more normal Joe kind of day pretty quickly. But it keeps coming back. It sort of feels like someone is pounding on my feet with a ball-peen hammer repeatedly.

History, again, reveals that it was Ben Franklin who, suffering the condition, obtained a a medicine made from the autumn crocus, aka, meadow saffron, called Colchicine. The same medicine was prescribed for me. However, the medicine was banned last fall by the FDA, as it had never undergone the standard testing procedures modern medicines must undergo. It was also only 6 dollars a for a month's supply.

A new drug, Uloric, is being promoted instead, and it costs about 200 dollars for a month's supply.

Thanks. Like I can afford that.

Now let's get even more confused.

One doctor claims that the FDA only banned the sale of injectable Colchicine. An article in the Oak Ridger by Dr. William Culbert Jr says the drug has been approved by the FDA, but fails to note the massive change in prices, up to $5 per pill.

What I have learned is that since Colchicine was "grandfathered" by the FDA since it had been used for centuries before there was an FDA, that allowed for a company called URL Pharma to step up in 2009 and pay for the FDA testing and for a new patent on Colchicine, now called Colcrys. The result of their actions forced all other makers of generic Colchicine to halt all sales. It's buy their product or nothing. Their product also costs about $300 for a month's supply.

URL Pharma was quick to eliminate even a discussion by doctors about the change from generic to a very expensive medication. "Shake-down letters" - that's what some physicians called the communications from URL Pharma. "Liability" replied URL Pharma.

Which all leaves me without medicine, as that price tag is too large. I'll have to try and get on a "patient assistance program". Which I am loathe to do.

And, frustrated, in pain, and more than a little confused, it's been tough to sit down and write something for my blog. And so here I am, offering instead far more personal information than I really wanted to provide. Who wants to read about my health problems? (And I am most grateful this is the only medical woe I have, as millions of others have far more horrifying conditions and limited treatment tales.)

Like millions and millions of Americans, I am left with a simple conclusion - doctors don't operate our health care system, but pharmaceutical companies and insurance companies run it instead.

I suppose I should be happy I don't need a prescription to use a cane ..... yet.

Are We Further Away or Getting Closer to Figuring Out Health Care in America?

It appears that after many decades debating health care, insurance, and all the costs involved with medicine and doctoring and all the legislation to subsidize drug-making and drug-dispensing, we are inching closer and closer to the basics behind all these issues. Or are we?

Getting medical care when needed and paying for insurance, in America, can be a mammoth undertaking.

And it's pretty sad and utterly short-sighted to hear Tennessee's new governor, Bill Haslam, offer this comment regarding the current health care law approved by Congress:

"Our goal should be advocating for an approach that embraces healthy choices and personal responsibility and accountability for a healthy lifestyle."

So ... if he is right, then why do we even allow doctors and hospitals to operate?

We're all on our own, and if we make a decision or take an action, or by inaction allow for some illness or sickness to take hold of us, then each of us should just find some way to cope with it. After all, being in a human and an inherently decaying and injury-prone body, we must expect it to fall apart eventually. So, don't expect me to help you out since I'm planning on being self-sufficient.

If you seek zero government involvement in health care, then eliminate medical licenses and prescriptions and drug-testing, and we'll each just do our best, on our own to figure out why we are ill and how we can get better.

That's certainly an option and a direction our society could take.

Or maybe, using the idea of group involvement through insurance to help cover the costs, one could find a group to be a part of which will provide medical insurance at a lower cost. How about a group made of people who are your age, weight, height and eye color who also work at the same type of job? Or why not make the group really, really large - say, everyone who has a birth certificate in America?

Regardless of age or job or any "lifestyle choice", everyone would be in one group - would that make insurance premiums available at a low cost? Or will insurance companies and health care providers raise their prices so they don't have to alter their income levels?

It appears there are some mighty complex basic issues left to resolve. And we, in America, still have a long way to go before such resolution is to be found.

SEE ALSO:
A discussion of Governor Haslam's ideas at KnoxViews.

Some ideas from Dr. Paul Hochfield

If Chickens Were Money: A GOP Health Care Reform Idea

Sue Lowden, former chair of the Republican Party in Nevada, and seeking to replace Sen. Harry Reid if she wins her primary, has been getting grilled and ridiculed for comments she has made that a barter system is the way to cut down costs for medical care -- notoriously quoted as saying that in "olden times our grandparents, they would bring a chicken to the doctor, they would say I’ll paint your house, they would do... that’s the old days of what people would do to get health care with their doctors. Doctors are very sympathetic people. I’m not backing down from that system."

Wow, our economy must really be tanking beyond the levels of the Depression from the 1930s if trading livestock or labor for medical care is seen as a viable and desirable plan.

The jokes are flying fast and furious, and there's a Facebook page wanting to provide Lowden with "one million virtual chickens". Or I suppose one could donate chickens rather than cash contributions to her campaign and she can convert those cluckers to dollars.

If you want to calculate your chicken-to-dollars abilities, a nifty calculator has been created.

Still, such weighty thinkers as those at the Wall Street Journal thinks she has a great idea which should not be dismissed:

"No less an authority than the American Medical Association’s own newspaper, American Medical News, wrote about it just last year, calling it a “creative way to collect from patients during difficult economic times.”

Kaiser Health News also tipped a hat to bartering last year, reporting that “health care is surpassing auto repair and advertising as the service in most demand, say people who run local barter exchanges.” One doctor in Vermont “swapped Viagra samples for maple syrup.”

Even Lowden’s reference to livestock may not be so far off the mark. As American Medical News reported, an office manager for an orthopedics practice in Wisconsin said one doc bartered surgery for “a full cow’s worth of beef.”

All of which leads me to ask ...
Q: Why did the chicken cross the road?

A: To avoid being used to cover a pre-existing condition.

Tea Party Protesters Depend on Government-Run Healthcare

As a few thousand folks lined up to hear the Republican congressmen (most of whom were absent from actual committee votes on public policy) last week, some of those anti-healthcare bill protesters needed some emergency medical help from - gasp!! - government operated medicine providers.

One person suffered a heart attack and several others also needed medical care -- all of it provided by government medical personnel. Other protesters denouncing government-run healthcare likewise benefited from a service they despise, though none refused medical assistance from the Office of Attending Physicians who are always on hand to treat elected officials.

As for the work of the OAP:


"Services offered by the Office of the Attending Physician include physicals and routine examinations, on-site X-rays and lab work, physical therapy and referrals to medical specialists from military hospitals and private medical practices. According to congressional budget records, the office is staffed by at least four Navy doctors as well as at least a dozen medical and X-ray technicians, nurses and a pharmacist.

Sources said when specialists are needed, they are brought to the Capitol, often at no charge to members of Congress.

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"Members of Congress do not pay for the individual services they receive at the OAP, nor do they submit claims through their federal employee health insurance policies. Instead, members pay a flat, annual fee of $503 for all the care they receive. The rest of the cost of their care, sources said, is subsidized by taxpayers.

Last year, Congress appropriated more than $3 million to reimburse the Navy for staff salaries at the office. Next year's budget allocates $3.8 million for the office, including more than half a million dollars to upgrade the Office's radiology suite. Sources said additional money to operate the office is included in the Navy's annual budget.

In 2008, 240 members paid the annual fee, though some sources say congressmen who didn't pay the fee were rarely prevented from using OAP services"

Funny, but even elected officials who attended the rally say they love the medical care they receive while on Captiol Hill:

"On a related note, I can't help but wonder how many of the lawmakers who spoke at yesterday's rally also like to stop by the Office of the Attending Physician -- the elaborate, government-run health care office conveniently located between the House and Senate chambers, staffed with a team of medical professionals who are "standing by, on-call and ready to provide Congress with some of the country's best and most efficient government-run health care."

Rep. Mike Pence (R-Ind.), for example, hates government-run, taxpayer-subsidized health care, but he just loves the Office of the Attending Physician on the Hill.

I don't imagine this came up during yesterday's speeches. I wonder why."

My Turn At Sickness, No Options Available

It was inevitable, I suppose, given the time of year and the large number of un-well folks I have been around lately that I would contract my own version of a cold or flu or something. Seems like everyone has been exposed to colds and wheezing and breathing woes.

Great - I've got no time to be wasting on being sick.

Likewise, I will not be wasting time or money on visiting a doctor since I do not have health insurance, it costs far too much. And since I already have some sniffles and coughs, all I might be told is to do what I already know to do - drink fluids, rest, wash hands and face often, maybe take some vitamins and wait for 5 to 7 days to feel better. Should I become really, really sick -- I still lack the insurance most doctors would require to see me. Unless maybe I attend a RAM event, which is still the best treatment I know for those who need medical attention: it is free.

I was also reading some today from R. Neal at KnoxViews about the multitude of conditions which insurance providers regard as "pre-existing conditions" which would prevent health care coverage: things like being a victim of domestic violence, having a toe fungus, or pretty much any minor or major medical problems. The list is mind-boggling. Makes me think either a lot of folks are forced to lie to get coverage, or more likely, get an illness and find their insurance abandons them completely.

More than once in recent months, I have been to a few Knoxville area hospitals, amazed at the marble floors, the espresso stands, the vaulted ceilings, the pianist playing a grand piano in some semi-waiting area, the endless hallways and endless referrals and delays in getting an appointment, the voluminous paperwork needed to receive treatment, and on and on it goes.

At this point, it seems reforming health care and health insurance into an affordable system is about as likely to occur as a cure for the common cold. There is very little reason to reform anything on the provider end - it's a way to make billions and billions of dollars and no matter what happens, people will always need medical care. They can only lose and they know it, so the endless howls of fear and anger clog the halls of political change will insure nothing changes for them.