Posts from the moral center of hell

Over the past few days a number of commentators have expressed awe at the indecency and depravity of the Republican party and its core constituents in applauding the notion that the state has no obligation to ensure the well being of it citizenry in the event of unforeseen medical catastrophe.

During a televised debate between candidates for the Republican Party presidential nominee, CNN host Wolf Blitzer asked Rep. Ron Paul (R-TX), given that he was a practicing medical doctor, as to what obligation does the state have to an individual who chooses not to pay for medical insurance but falls ill. Ron initially evaded the question and gave the standard "right to choose" and "liberty" blather that economic libertarians like to preach. When Blitzer pressed on and asked if the man should be left to die, the crowd erupted in "Yeah!"

This is the party that always calls itself moral and Christian. This the party that goes around the nation demanding an end to abortion. Ron Paul himself has claimed that abortion is nothing less than murder. This is the same party that rammed through congress a bill that would have stripped Terri Schiavo's husband from deciding on her welfare, given her vegetative and unconscious existence, and making her a ward of the state. This is the same party that was shrieking over the evils of Obamacare and the horrors of death panels and socialized medicine, in the run up to the 2010 congressional midterm elections. Yet when faced with the opportunity to show some decency and Christian charity, they reverted to their true character.

Republicans aren't just an amoral political force. They are a dangerous cancer on humanity. Their war-mongering, anti-intellectual, anti-environmental, and hyper-religiosity founded on evangelical bigotry of all persons who do not share their immediate goals, has been shown to be lethal to those of us not living in Dixie.

Percentage of Canadians using the US health care system

The objective of this chart is not to cheer-lead on how great the Canadian health care system is; relative to European systems it's mediocre.  Rather, the chart is meant to illustrate that most Canadians aren't willing to spend vast sums of money on American health care that is comparable to what they are already receiving through a publicly taxed system.  Although a substantial number of Canadians do annually make their way into American hospitals for health care, for the majority it is for services that are not obtainable or easily performed within Canada and which is paid for by the patent's provincial government.

The Commonwealth Fund conducted a study earlier this year on 19 industrialized nations; including Australia, Canada, several European nations, and the USA.  The results were:

the U.S. [ranked] 19th in infant mortality, 15th in preventable mortality and 14th in the use of electronic medical records, all despite spending far and away the greatest percentage of GDP on health care. Relative to other comparable countries surveyed, the U.S. has the greatest incidence of medical and prescription errors, highest emergency room waiting times and ranks near the bottom in duplicate medical tests. The U.S. spends 7.3% of its health dollars on administration and insurance, compared to just 1.9% in France, 2.6% in Canada, and 3.3% in the UK.

Furthermore, the study concluded that Canada spends slightly more than half of what America does per capita for health care, yet reaches similar if not better overall results in terms of quality, access, efficiency, equity, and overall citizen health.

NYT's Book Review of Matt Taibbi's "Griftopia"

The New York Times Sunday Book Review looks at Matt Taibbi's newest publication "Griftopia"

The reviewer summarizes the book with the following:

In “Griftopia,” a relentlessly disturbing, penetrating exploration of the root causes of the trauma that upended economic security in millions of American homes, Taibbi argues that what unfolded was far from accidental. Rather, the nation suffered the equivalent of a hostile takeover of key areas of its commercial life by investment banking houses, while regulators and members of Congress abdicated their responsibilities either because they were influenced by campaign cash or because they believed the fairy tale that unsupervised markets always work best. The result, Taibbi asserts, was a thieves’ paradise — Griftopia.

Taibbi takes on the zombie lie, pushed by right-wing hacks, that the banks were forced to sell subprime mortgages to poor people and that Fannie Mae and Fredie Mac were the root causes of the crisis.

Taibbi persuasively dismisses the argument that the financial crisis was caused by poor people with a taste for real estate, delineating how Wall Street eagerly handed out mortgages to anyone with a pulse, and then used the home loans as the material for a far more lucrative enterprise — the exotic investments known as derivatives. The derivatives market depended upon a steady supply of mortgages. But when too many of the bets went bad, Wall Street persuaded the Treasury to construct bailouts that Taibbi describes as a “labyrinthine financial sewage system designed to stick us all with the raw waste and pump clean water back to Wall Street.”

The book attacks the mindless Tea-Party movement, calls Alan Greenspan the biggest asshole in the universe, delves into America's bubble machine typified by the original vampire-squid, Goldman Sachs, and considers how Obama's health care initiative is nothing less than a boondoggle for the toxic-sludge dealers in big-Pharma and the nickle-and-dime kleptomaniacs in the so-called insurance business.  As emotionally cathartic as it is to find someone who will call the biggest thieves and crooks on the planet, what they truly are. It is Taibbi's constant attack on the enterprises of American capitalism, those revered and sacrosanct temples, in which he viciously and relentlessly dismantles and exposes as being little more than high-end criminal rings, that is most satisfying.

An excellent read.  I hope someone was generous enough to put it under your Christmas tree.

Arizona's indulgence with the banality of evil

I have been for some years awed by the grotesque indecency and outright evil that presents itself as the norm in the low-tax geezer-vista that is the state of Arizona.  Many will recognize the ongoing battle between locals and illegal immigrants.  My disgust does not entail this well discussed legal tussle and the underlying racial animus prevalent across the state.  Instead, I'd like to draw attention to the mindset and legislative behavior of the state's Republicans, who with their tax-free and minimalist government ideology have created a perfect example of the banality of evil.

I came across this example in the NY Times of the lengths many of the well-heeled denizens of the state will go to, in order to protect their personal fortunes from the local taxman.  Consider the following:

“Arizona is seeing more of the traditional battle of the generations...between some retirees who want taxes — including school taxes — kept low, and most parents who want better support for the schools their kids attend.”

Patrick Flynn, the president of a homeowners group in Troon, AZ in 2007, states that he has no qualms about education, he "just does not like the idea of paying for it."  In this particular exhibition of generational greed and malice, the residents of the district created a bogus local school district with no schools, teachers, or students to prevent their property taxes from being raised.  Families with children must pay adjacent districts to have their children participate in schooling.  As a state senator explains, “The whole purpose of this was to avoid taxes on their million-dollar homes.”

In an earlier post titled "The young must die so Geezers can pay low taxes" I explained how the Governor of Arizona planned to eliminate health coverage for 47,000 low-income children.  In the name of fiscal austerity the legislators gladly abandoned their most vulnerable citizens so that these modern day Merchants of Venice wouldn't have to worry about wasting their well earned shekels on youthful vermin.  The fact that the elderly receive federally subsidized Medicare and have no worries about paying for health care costs is an irrelevance to these hypocrites.  Racial bigotry is used by the citizens of the state to claim that most of the children were the offspring of illegals, who shouldn't be receiving benefits regardless.

What has drawn my particular ire today though is another instance of greed masquerading as fiscal rectitude.  The NY Times has a horrible story of how Arizona legislators have stripped citizens belonging to the state Medicaid program from having life-saving transplants.  Persons who for whatever reason that were waiting for a liver, lung, or other tissue were told to drop dead by their own representatives.

When Alan Grayson, the former congressman for Florida, said in 2009 that the Republican plan for health care reform was, "Don't get sick. That's right, don't get sick."  The MSM and Republicans bemoaned his rhetoric and yet evidence is abundant that he was absolutely correct.  On the floor of the House of Representatives, Grayson offered this scathing critique of the Republican party's program for health care

According to this study, “Health Insurance and Mortality in U.S. Adults” which was published two weeks ago, 44,789 Americans die every year because they have no health insurance. That’s right, 44,789 Americans die every year, according to this Harvard study called “Health Insurance and Mortality in U.S. Adults.” You can see it by going to our website, grayson.house.gov. That is more than ten times the number of Americans who have died in the war in Iraq.

It’s more than ten times the number of Americans who died in 9/11. But that was just once: this is every single year. That’s right: every single year. Take a look at this. Read it and weep. And I mean that – read it and weep because of all these Americans who are dying because they don’t have health insurance.

The state of Arizona offered this pathetic rational for why the government was serving poor and sick citizens a death sentence:

State Medicaid officials said they recommended discontinuing some transplants only after assessing the success rates for previous patients. Among the discontinued procedures are lung transplants, liver transplants for hepatitis C patients and some bone marrow and pancreas transplants, which altogether would save the state about $4.5 million a year.

While many states in the union have reduced or eliminated aspects of health coverage during the Great Recession, Arizona once again goes the extra distance to condemn their citizens to the vagaries of market-based health care; i.e. pay or you fucking die!  The cruelty and lack of any resemblance of ethics of these people is mind-boggling.

The behavior of all levels of government in Arizona is one of maximizing short term financial gains for their most well off citizens, while brutally undermining the health, education, and well-being of large portions of their population.  How is it that the richest country in the world has a health care system that is on par with second-rate industrial nations?  The justifications of the proponents of this lot are always anchored to some bizarre notion of moral indignation that others are getting a free ride, while they -the greediest generation, who never sacrificed, never went to war in the name of democracy and freedom, and who had their entire lives subsidized from birth- continuously demand others do without, what they loudly proclaim is their deserved entitlement.

Glaxo Guilty of Selling Tainted and Defective Drugs

GlaxoSmithKline, a British pharmaceutical company, has been forced to pay $750 million (USD) "to settle criminal and civil complaints that the company for years knowingly sold contaminated baby ointment and an ineffective antidepressant."

The case was initiated by a former employee and whistle-blower who sought penalties against the company.  The NY Times elaborates on the nature of the crimes at their Puerto Rico facility:

This was GlaxoSmithKline’s premier manufacturing facility, producing $5.5 billion of product each year. But Ms. Eckard [the whistle-blower] soon discovered that quality control was a mess: the water system was contaminated; the air system allowed for cross-contamination between products; the warehouse was so overcrowded that rented vans were used for storage; the plant could not ensure the sterility of intravenous drugs for cancer; and pills of differing strengths were sometimes mixed in the same bottles.

Instead of heeding FDA warnings about QA/QC inadequacies of the facility and their own internal people's advice, GlaxoSmithKline either ignored and/or dismissed concerns.  Ms. Eckard, who was initially sent to lead "a team of 100 quality experts to fix problems," was stonewalled by management and then dismissed once she began to demand that products be recalled.  She will now earn for her part in the whistle-blower case, "$96 million from the federal government, and she will collect additional millions from states."

The circumstances surrounding this particular case are unlike previous situations. 

Nearly all previous cases against the industry involved illegal marketing. This is the first successful case ever to assert that a drug maker knowingly sold contaminated products.

Whereas in the past, big-pharma was tagged for deceptive marketing and off-label sales tactics, GSK engaged in the willful and knowing dissemination of tainted, ineffectual, and potentially dangerous drugs to the public. This failure of both GSK and the American government to regulate the company is another indictment of the laissez-faire deregulatory approach that highlighted the conservative dogma prevalent in the Bush years.  Furthermore, it decimates any specious arguments that importation of Canadian drugs are a threat to consumers.

Given that the profit sources for big-pharma are waning and that numerous lawsuits have been asserted against big-pharma for misleading patients and "defrauding federal and state governments" the entire health care bills pushed through by both the Bush and Obama administrations reeks of corruption.  These companies are clearly unable to actually provide quality drugs that benefit people. So instead of ramping up their R&D base to find new drugs, they fire scientists and engage in legislative trickery to extend the patent life of their already questionable drug performers and push onto the market products that are ineffective and potentially lethal.  These people are just evil.  Sick and dying people shouldn't have to worry about whether their doctor is in collusion with the drug company to push a useless product upon them.  Patients shouldn't have to worry if FDA "approved" medication is actually effective or instead going to make them more sick or even kill them.

Is this all America is about? Lying, cheating, and using the government to swindle dying people out of their life savings. While congress subsidizes big-pharma, agriculture corporations, the military-industrial state, and bails out the banking industry for the umpteenth time, what are you getting? Maybe you can find it in your bonus that comes in the form of less take home pay, less benefits, less social mobility, more hours working, or more of your taxes going to maintain the lifestyles of corporate lobbyists and the "masters of the universe"-crowd.

Wake up people!

Take the red pill people, and fucking wake up!

***

This blog has previously dissected and listed other areas of fraud and corruption by big-pharma:

• Novartis fined $422 Million
• Big-Pharma, perennial fraud-mongers
• Pfizer on eminant domain and corporate welfare (NY Times)
• The corruption of university bio-medical research (NY Times)

Another Poisoned Prescription: Novartis Fined $422 Million for Fraud

Another year and another multi-million dollar fine and settlement from another Big Pharma corporation.  Novartis, which is headquartered in Switzerland, has agreed to pay $422.5 million, in order to settle criminal and civil investigations arising from the marketing of the antiseizure medicine Trileptal and five other drugs. 

The NY Times summarizes the billion dollar payouts that Big Pharma has agreed to in regards to criminal investigations conducted over the past decade:

Novartis joins a growing list of pharmaceutical companies that have settled government investigations into health care fraud in the last few years, including Pfizer, which paid $2.3 billion; Eli Lilly, $1.4 billion; Allergan, $600 million; AstraZeneca, $520 million; Bristol-Myers Squibb, $515 million; and Forest Laboratories, $313 million. Pfizer, Lilly, Allergan and Forest pleaded guilty to crimes in the cases.

Earlier this year I outlined in a previous blog entry the business practices and criminal endeavours pursued by Big Pharma and the medical community on an annual basis against consumers.  The above settlement list validates the fact that when the world's largest corporations are found engaging in criminal activities, little more than nuisance fines are levied against these multi-national predators.  The profits elicited from pushing either unproven or detrimental pharmaceuticals, via morally compromised physicians, far outweighs any financial fine that the US government is prepared to impose.

Andy Wyss, president of Novartis Pharmaceuticals, said that Novaritis would “continue its commitment to high standards of ethical business conduct and regulatory compliance in the sale and marketing of our products.”  For industry watchers, the current press release is a familiar issuance from the fraud-mongers in the pharmaceutical industry.

Erik Gordon, an assistant professor at the University of Michigan school of business who follows the drug industry, said it was “easy to stifle a chuckle” when the company announced a guilty plea and, in the same news release, promised to continue ethical conduct.

Prosecutors said top management at Novartis had approved illegal marketing from July 2000 to June 2004. No individual, however, was named or charged.

Given the unscrupulous and illegal behavior of these companies, it is only further telling that both Republicans and Democrats fall over themselves to placate and support these corporate criminals.  Instead of allowing Americans to purchase drugs from Canadian manufacturers, the spineless Obama administration blocked Americans from cross-border shopping and individual state governments from engaging in bulk purchases to reduce costs.  If the US Department of Justice was sincerely interested in preventing these recalcitrant criminals, whether in Big Pharma or Wall St., from repeating their actions, hundreds of corporate managers and board members would be forced to defend their actions in court.  Once the cost-benefit equation is shifted, only then will these miserable crony-capitalists be effectively dealt with.

Fat and Lazy: It's Not Just for Americans Any More!

As everyone knows America is not a healthy country.  For example, French fries and ketchup are considered vegetables, and 68% of the population is overweight, with a scale tipping 34% of the overall population obese.  Yet because of America's infatuation with sports, athleticism, and that California "good-look" epitomized on television and the movies, exercise venues and sports clubs are an ubiquitous part of the cultural landscape.

In France, the idea of a thin European smoking cigarettes and sipping coffee or wine still impregnates the imagination.  In 2004, a book was written by Mireille Guiliano titled, French Women Don't Get Fat.  However, the idea of a svelte and upwardly mobile Frenchwomen appears to be more fiction than fact, if one considers what the LA Times had to say back in 2007:

Already, 42% of the French population is either overweight or obese, according to the National Institute for Health and Medical Research, known by its French initials, Inserm. The rate among children and adolescents has quadrupled in the last 25 years and has been growing almost as fast as in the United States.

"If you look at the statistical curve, we're now where the U.S. was in the 1970s," said Olivier Andrault, a food expert with the French Union of Consumers. "It means if we do nothing, in a few years the French will be as fat as Americans."

Like every other Western society, France is seeing an unprecedented acceleration in its health care costs.  The increased girth of the population has put pressure not just on waistbands, but also on the finances of the country.  An obvious solution to the health of its citizenry is for the French to migrate towards the workout routines or fitness lifestyle as seen in America.  However, for both cultural and economic reasons, this solution do not appear likely.

"It appears to me that more people are sitting in cafes smoking cigarettes and drinking coffee than working out ... the French don't see fitness as a lifestyle," says American-born fitness consultant Fred Hoffman, who has lived in Paris for 21 years.

Only 5.4 percent of French people belonged to a health club in 2008, according to the International Health, Racquet and Sportsclub Association, compared with 9.5 percent for Italy, 11.9 percent for the United Kingdom and 16.6 percent for Spain.

For a society that invented the French kiss and a noon time excursions between the sheets, it strikes me as odd that the French don't like to sweat.  I've had others too, exclaim that they didn't like sweating.  Obviously no likes perspiring in public and looking like a big fatty, but the excuse seems terribly lame given the upside.

A Reuters article describes the economic and additional societal reasons why fitness clubs don't appear to taking hold.  Vive la Fatties!

Employee Health Insurance Changes

Kevin Drum at his blog over at MotherJones.com unloads the statistics related to the unsustainable increases in worker health insurance, for both the employer and employee over the past decade in America.  With individual increases in deductions, co-payments, and other ancillary charges, coupled with the fact that the average person's income has flat-lined or worst decreased during the past decade, America's middle class and low wage earners are seeing more of their income shunted towards paying for health care.

The problem with this arrangement, which I've discussed to some depth in a previous blog entry, is that the system is broken and without meaningful cost controls, strict penalties on those who engage in slothful and/or unhealthy lifestyles, and a shift towards re-aligning the American market to one that which exists in other Western nations, costs will continue to increase, the quality of service and the level of coverage will decrease, and the insurance companies in collusion with big-Pharma will reap the excessive profits.

Like everything in America these days, little attention is made towards reasonable and intelligent discourse.  Instead the dunces prattle on about imaginary enemies, irrelevant conflicts, and absurd realities in their Quixotic journey through life.  Attention to meaningful policies that affect all Americans, is jettisoned to make way for everyone's two-minutes of hate.  The right attacks liberal institutions, environmentalists, and all the secular evils for depriving them of their non-regulated Christian Eden.  The left bickers amongst themselves about gay-politics, token policy gestures made by the Obama White House, and the deceit of Democratic Party, while rarely challenging or stopping the crony-capitalists.

Pancreatic cancers use fructose, common in the Western diet, to fuel their growth

Pancreatic cancers use fructose, common in the Western diet, to fuel their growth

According to UCLA researchers everything gives you cancer can now be officially extended to fructose. The research examined the metabolic differences of pancreatic cancer cells when given glucose or fructose as monomeric carbohydrate sources. Conventional biochemistry would imply that there should not be a significant difference between the isomers. However, upon analysis it was found "that cancer cells can readily metabolize fructose to increase proliferation. They have major significance for cancer patients, given dietary refined fructose consumption."

Pancreatic cancers use the sugar fructose, very common in the Western diet, to activate a key cellular pathway that drives cell division, helping the cancer to grow more quickly, a study by researchers at UCLA's Jonsson Comprehensive Cancer Center has found.

Although it's widely known that cancers use glucose, a simple sugar, to fuel their growth, this is the first time a link has been shown between fructose and cancer proliferation, said Dr. Anthony Heaney, an associate professor of medicine and neurosurgery, a Jonsson Cancer Center researcher and senior author of the study.

"The bottom line is the modern diet contains a lot of refined sugar including fructose and it's a hidden danger implicated in a lot of modern diseases, such as obesity, diabetes and fatty liver," said Heaney, who also serves as director of the Pituitary Tumor and Neuroendocrine Program at UCLA. "In this study, we show that cancers can use fructose just as readily as glucose to fuel their growth."

The study appeared in the Aug. 1 issue of the peer-reviewed journal Cancer Research.

The source of fructose in the Western diet is high fructose corn syrup (HFCS), a corn-based sweetener that has been on the market since about 1970. HFCS accounts for more than 40 percent of the caloric sweeteners added to foods and beverages, and it is the sole sweetener used in American soft drinks.

Between 1970 and 1990, the consumption of HFCS in the U.S. has increased over 1,000 percent, according to an article in the April 2004 issue of the American Journal of Clinical Nutrition. Food companies use HFCS - a mixture of fructose and glucose - because it's inexpensive, easy to transport and keeps foods moist. And because it is so sweet, it's cost effective for companies to use small quantities of HCFS in place of more expensive sweeteners or flavorings.

In his study, Heaney and his team took pancreatic tumors from patients and cultured and grew the malignant cells in Petri dishes. They then added glucose to one set of cells and fructose to another. Using mass spectrometry, they were able to follow the carbon-labeled sugars in the cells to determine what exactly they were being used for and how.

Heaney found that the pancreatic cancer cells could easily distinguish between glucose and fructose even though they are very similar structurally, and contrary to conventional wisdom, the cancer cells metabolized the sugars in very different ways. In the case of fructose, the pancreatic cancer cells used the sugar in the transketolase-driven non-oxidative pentose phosphate pathway to generate nucleic acids, the building blocks of RNA and DNA, which the cancer cells need to divide and proliferate.

"Traditionally, glucose and fructose have been considered as interchangeable monosaccharide substrates that are similarly metabolized, and little attention has been given to sugars other than glucose," the study states. "However, fructose intake has increased dramatically in recent decades and cellular uptake of glucose and fructose uses distinct transporters … These findings show that cancer cells can readily metabolize fructose to increase proliferation. They have major significance for cancer patients, given dietary refined fructose consumption."

As in anti-smoking campaigns, a federal effort should be launched to reduce refined fructose intake, Heaney said.

"I think this paper has a lot of public health implications," Heaney said. "Hopefully, at the federal level there will be some effort to step back on the amount of HFCS in our diets."  Heaney said that while this study was done in pancreatic cancer, these finding may not be unique to that cancer type.

Going forward, Heaney and his team are exploring whether it's possible to block the uptake of fructose in the cancer cells with a small molecule, taking away one of the fuels they need to grow. The work is being done in cell lines and in mice, Heaney said.

Torture me Slowly: Bush's Medical Experimentation Program

With each turn and further examination of the Bush Administration's institutional program of torture, the history becomes more surreal and terrifying.  According to a report issued by Physicians for Human Rights, the Bush Administration engaged in human experimentation with detainees across the globe in order to empirically assess the degree to which they could inflict pain on their prisoners without killing them.

Health professionals engaged in research on detainees, in violation of the Geneva Conventions and other international and domestic prohibitions against human subject research and experimentation. This research included monitoring the effects of abusive treatment, including waterboarding and sleep deprivation, in order to assess how far "enhanced interrogation techniques" could go and still be within the legal parameters and to guide the future application of the techniques.

James Risen, who exposed the existence of the National Security Agency’s warrantless surveillance program in 2006, has written another article in the NY Times outlining the findings of the PHR report.

The data collected by medical professionals from the interrogations of detainees allowed the C.I.A. to judge the emotional and physical impact of the techniques, helping the agency to “calibrate the level of pain experienced by detainees during interrogation, ostensibly to keep it from crossing the administration’s legal threshold of what it claimed constituted torture,” the report said. That meant that the medical professionals crossed the line from treating the detainees as patients to treating them as research subjects, the report asserted.

This is not a triviality.  Medical physicians and psychologists, as the report, the Times article, and numerous others have pointed out, are prohibited by national and international codes in conducting human experimentation without informed consent.  There are no persons undecided as to if the Nazi's, the Imperial Japanese, or the Khmer Rouge were not criminal when they engaged in these heinous actions.  However, these practices also remind us of America's own dark history of eugenics, experimentation on black citizens and prisoners throughout the 20th century, and military/CIA studies on large scale groups, which has all been well chronicled.  It is therefore no surprise when these sadists rear their ugly heads and perversely claim that torture (or "wink" something like it) is a necessity required to protect Americans from foreign enemies.  What has been done is inexcusible; it is a war crime.

The authors provide evidence about the government's meticulous studies:

The report cites agency guidelines for health professionals involved in interrogations requiring that they document each time a detainee was waterboarded, how long each waterboarding session lasted, how much water was applied, exactly how the water was applied and expelled, whether the detainees’ breathing passages were filled, and how each detainee looked between treatments.

Andrew Sullivan asks, "where was the experimentation taking place? How many doctors and psychologists were involved? Was there a separate facility, as at Bagram, for experimenting with torture? Did these experiments ever go wrong?"

Whereas, Glenn Greenwald asks what is President Obama doing to investigate, prosecute, and prevent this from occurring again?  The horrible answer is obvious; nothing.  Obama has decided that the country and more importantly the American Empire cannot afford to be hijacked by squabbles over petty matters like constitutional law or war crimes committed by the executive.  Rather, the nation must boldly ignore the slight inconveniences of the previous Bush administration and get on with the business of voting for the next American Idol.

You may Not Patent my Genes!

In a decisive blow to the fraud-mongers in the biotech industry and US Patent office, U.S. District Court Judge Robert Sweet in New York State invalidated part of seven patents granted to Myriad on the BRCA1 and BRCA2 genes. BRCA1 and BRCA2 are two alleles or variants of a tumour suppressor gene that is found in all humans and responsible, under normal situations, in removing malignancies that may arise. The BRCA1/2 mutational variants substantially increase the risk of a carrier developing breast, ovarian, prostate, pancreatic, colon, and other cancers. Based on current data, females carrying either of these two mutations, will encounter lifetime risks above normal for developing ovarian cancer at 10-20% for BRCA-2 mutations and 40-60% for BRCA-1 mutations.

USA Today outlines the discovery process of BRCA1/2:

The genes for both BRCA1 and BRCA2 were first patented by geneticist and Myriad founder Mark Skolnick, who in the 1990s began looking at detailed family histories to zero in on the genetic basis for breast cancer. Family histories helped him figure out which genes probably carried the mutations. Using gene sequencing, he found exactly where on the genes the mutations occur.

For the past twenty years, due to legal gimmickry, the biotech industry has been able to wage a concerted racket against patients and scientific advancement.

A case was filed against Myriad Genetics by the ACLU and the New York-based Public Patent Foundation on behalf of doctors, patients and several medical groups, including the Association for Molecular Pathology and the American College of Medical Genetics. To the surprise of both legal analysts and the biotech industry, Judge Sweet effectively told Myriad as described by Stanford Law Professor Hank Greely, “You didn't invent this, you didn't make it, and you shouldn't get a patent on it!"

The Judge overturned all the patent claims held by the defendant, based on the fact that they cover products of nature and abstract ideas. In his decision, Judge Sweet wrote:

The resolution of these motions is based upon long recognized principles of molecular biology and genetics: DNA represents the physical embodiment of biological information, distinct in its essential characteristics from any other chemical found in nature. It is concluded that DNA’s existence in an “isolated” form alters neither this fundamental quality of DNA as it exists in the body nor the information it encodes. Therefore, the patents at issue directed to “isolated DNA” containing sequences found in nature are unsustainable as a matter of law and are deemed unpatentable subject matter under 35 U.S.C. § 101.

Beyond the legal arguments, there exists the practical dimension that these patents impinge on necessary scientific research, inhibit patients from effectively ascertaining their genetic profiles and evaluating treatment options, and gouge consumers with excessive charges. In the latter case, Myriad Genetics charged patients $3,000 to assess whether they were carriers of the BRCA1 or 2 alleles. Patients like Lisbeth Ceriani, who was diagnosed with an aggressive form of cancer in both of her breasts, had to wait a year and a half to find out if she needed to have her ovaries also removed, because Myriad Genetics refused to deal with her insurance company (Massachusetts MediAid), due to the low reimbursement rate provided.

The Economist magazine discussess a report published by Duke University researchers, which concludes that gene patenting and its monopoly granting status prevents access to these critical tests for many poor Americans, prevents diagnostic accountability from the monopoly providers, and hampers business innovation in the field of medical diagnostics.

Again and again, the typical business model in America is to put the profits of individual corporations over the collective needs and in this case the lives of ordinary people. My genes, your genes, or that of any organism on this planet are not for sale, nor is it the ownership of crooked scientists who have sold their souls to profit on the exploitation of the genetic commons.

Capital G Award: Big Pharma, Agents for Fraud

Fraud is one of big-Pharma’s most profitable endeavours. Just consider Pfizer Inc., which is the world’s largest pharmaceutical company with approximately $50 Billion in annual revenue. This past September (2009), BusinessWeek reported that Pfizer, “plead guilty to one felony count to settle federal criminal and civil charges that it illegally promoted its Bextra painkiller and other drugs.” The admission of guilt comes with the largest criminal fine ever imposed in US history; $2.3 Billion. Pfizer will pay a criminal fine of $1.195 Billion, $1 Billion to resolve civil claims, and will enter a corporate integrity agreement with US HHS, which will monitor the company’s future marketing activities.

The same BusinessWeek article summarizes the underlying rational for the 2009 fines:

The settlement stems from a four-year investigation instigated by six whistleblowers, who between them will receive $102 million from the federal fines. The complaint charged that Pfizer sent doctors on all-expense-paid trips to resorts, gave out free massages, and paid kickbacks to doctors, all to get them to prescribe its drugs for off-label uses. Although it is legal for physicians to write such prescriptions, and a common practice, companies are barred from actually promoting their drugs for purposes other than those that have won Food & Drug Administration approval.

Pfizer however, has proven itself to be a recalcitrant corporate criminal, with no less than four additional settlements since 2002 resulting in $513 million in fines.

This past March, Pfizer was found guilty by an eight person jury for “engaged in a racketeering conspiracy over a 10-year period” Evidence provided during the trial found that Pfizer’s own studies showed that the drug in question, Neurontin, was completely ineffective and had no more effect than a placebo; a fact which Pfizer never disclosed to either doctors or patients. The jury described the activities conducted by Pfizer as pure fraud, a violation of RICO statutes, and California’s Unfair Competition Law. Under RICO, the initial damages found by the jury -$47.36 million- were tripled; i.e. $142.1 million in total.

Lawyers for the plaintiff, Kaiser-Permanente of California, described the verdict as a “triumph for evidence-based medicine over marketing-based medicine.”

Pfizer isn’t alone it is morbid fascination with bilking the sick and pushing useless products onto desperate people. Since May 2004, Pfizer, Eli Lilly & Co., Bristol-Myers Squibb Co. and four other drug companies have paid a total of $7 Billion in fines and penalties. Six of the companies admitted in court that they marketed medicines for unapproved uses.

Eli Lilly, an American based pharmaceutical company with annual revenue of $20 Billion was charged and fined by the US government $1.42 Billion, for bribing doctors to prescribe a schizophrenia drug, Zyprexa, to elderly patients suffering from dementia, despite clinical trial data, which indicating a death rate of 31 people out of 1,184 participants (double the placebo rate). Bloomberg News describes that, “Lilly already had a criminal conviction for misbranding a drug when it broke the law again in promoting schizophrenia drug Zyprexa for off-label uses starting in 1999.”

In September 2007, New York-based Bristol-Myers paid $515 million -without admitting or denying wrongdoing- to federal and state governments in a civil lawsuit brought by the Justice Department.

Impact of Fines

The deterrence factor of imposing these fines, even those in the Billon dollar range, is in question. For example, Zyprexa provided Lilly with $36 Billion in revenue from 2000 to 2008. A fine of a Billion dollars does not offset the profits to be made from off-label marketing. Bloomberg further elaborates:

The $2.3 Billion in fines and penalties Pfizer paid for marketing Bextra and three other drugs cited in the Sept. 2 plea agreement for off-label uses amount to just 14 percent of its $16.8 Billion in revenue from selling those medicines from 2001 to 2008.

The total of $2.75 Billion Pfizer has paid in off-label penalties since 2004 is a little more than 1 percent of the company’s revenue of $245 Billion from 2004 to 2008.

Lon Schneider, a professor at the University of Southern California’s Keck School of Medicine, states that Big-Pharma won’t stop pursuing this strategy of fraud and deceit. He argues that, “They’re drivers that knowingly speed. If stopped, they pay the fine, and then they do it again.”

The young must die so Geezers can pay low taxes!

It never ceases to amaze me at how greedy and un-Christian Southerners are. The latest volley of cruelty originates in the state of Arizona, where the possibility of raising taxes and forcing the wretched Geezer-polis of this desert wasteland to invest in their fellow Americans, communities, and infrastructure not linked to killing foreigners is verboten.

Gov. Jan Brewer signed an austere budget that will eliminate health coverage for 47,000 low-income children by eliminating the state's Children’s Health Insurance Program.   The only state in the union willing to do so.  The NY Times states that Arizona, not content to bulldozer over its future citizens, will "roll back Medicaid coverage for childless adults in a move that is expected to eventually drop 310,000 people from the rolls."

The Republican-controlled Legislature furthermore passed a budget that includes deep cuts to both health care and education.

The Medicaid reduction for childless adults rolls back an expansion approved by voters in 2000 and cuts enrollment about 25 percent. The expansion was to be paid for with tobacco settlement dollars, a revenue source that quickly proved inadequate.

No doubt the anti-tax armada of self-made Geezers will relish the thought that their precious money won't go to the superfluous requirement of having decent health care coverage or education for children.  After all, these people are clearly either just freeloading Mexicans or un-Godly creatures that the Lord himself is endeavouring to punish.

At what point do we stop calling America a civilized country and call it out as an intemperate international hooligan and wastrel. This recession was made, sealed, and delivered by the very people who are now lying in the Arizona sun, casually dispensing with their retirement days. These nabobs of consumerism, who to this day remain contemptuous of anyone who dares to challenge their pseudo-religious doctrine of low-taxes, unregulated capital, and maximum warfare, are to blame for this economic disaster.  The children of Saint Ronnie and his revolution of personal irresponsibility have had their gluttonous feast and are now more than happy to have someone else's children pay the bill.

Bend Over: This Will Hurt

"To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them."
- Hippocratic Oath.

Would you go to a car repair shop which was evasive and opaque with its pricing; persistently overcharged you for simple services and applied usurious costs for necessary repairs; had a history of neglect or incompetence; acted in collusion with regional shops to eliminate competition; and in some instances, were forced to call other shops to repair your vehicle when they further damaged it instead of repairing it?

Well this is the current scenario with the American health care system.

Consider the anecdotal story of Steve Spivey, a 44 year old Texan, who developed breathing problems after spine surgery at physician-owned and for-profit speciality hospital. As a result of there being no physicians on hand (at this physician owned and operated facility), the administrators were forced to call 911 and have him taken to a nearby and regular full-service hospital. He was unfortunately pronounced dead a short time afterwards. What makes this case so galling, is that according to state Medicare records, the same West Texas Hospital, which failed to adequately prepare for the post-surgery complications that Mr. Spivey encountered, called 911 for an ambulance 15 times to transfer patients during medical emergencies since it opened in May 2005. This wasn't an accident; this was a cost-benefit analysis, where a patient's life was jeopardized because the doctors didn't want to invest their time and money in making sure Mr. Spivey would survive their butcher knives.

As an American citizen, Mr. Spivey was not alone in his abandonment by those he ensured with his life and well being. According to studies completed over the past decade, as many as 200,000 people a year could be dying in U.S. hospitals and patient care facilities because of easily prevented errors. For example, 20-30% of patients in American hospitals or long-term care receive incorrect medical care; including incorrect medicine, wrong dosages, lethal infections arising from hospitalization, incorrect surgical operations, and general patient neglect. If listed along with other CDC morbidity indexes, medical errors would rank as the sixth leading cause of death, ahead of diabetes, pneumonia, Alzheimer's disease, and renal disease. In comparison with all other industrialized nations the United States stands out for inefficient care and errors and is an outlier on access/cost barriers.

Public Health

Fifty years ago, Americans used to be amongst the healthiest people anywhere. Today, the nation ranks dead last amongst Western industrialized nations and has been overtaken by some less than prosperous ones. With respect to the general population, life expectancy in America continues to slip, descending to 77.3 at birth, compared to Canada at 79.8 years and the Japanese reigning at 81.9. America is unique among Western nations in that 63% of its population are overweight, with an unprecedented 34% of the general population being obese and as many as six million being morbidly (or super) obese. Additional factors unique to America include that it has the highest homicide rate of all industrialized countries and given its size, is the largest consumer of illegal drugs in the world.

American children like their adult counterparts are also experiencing higher levels of obesity, hypertension, diabetes, and heart disease than previous generations and are likely to impose a severe cost upon any future social security and health care systems. Other less than stellar achievements in the areas of childhood care include the fact that the country has the highest infant-mortality rate, the highest child-poverty rate, the highest teen-pregnancy rate, and the highest child-abuse death rate in relation to its peers.

Dr. Stephen Bezruchka, a senior lecturer in the School of Public Health at the University of Washington in Seattle states, "There isn't a single measure in which the U.S. excels in the health arena…We spend half of the world's health care bill and we are less healthy than all the other rich countries."

Economics

The American health care system as a whole is a behemoth that only as recently as 2004 was spending $1.9 trillion dollars per annum, or 16% of GDP; nearly twice the OECD average. Despite years of bipartisan posturing about reform (including the infamous Bush Medicare donut) this year alone health-care expenditures are expected to account for about 18% of US GDP. President Obama’s Commerce Secretary, Gary Locke, recently opined in the Wall Street Journal that without reform, health care costs will increase to 28% in 2030 and to 34% in 2040 of GDP.

The number of persons sequestered to administer and manage the system has increased between the years 1969 and 1999, from 18.2 percent to 27.3 percent. Compared to Canada, which has a universal health care system, its percentage of the labour force dedicated to health care only grew from 16.0 percent in 1971 to 19.1 percent in 1996. With medical inflation outpacing inflation, American companies continue to reduce the health coverage they offer to employees. The percentage of workers who receive health insurance from their own employer has fallen from almost 70% in the late 1970s to around 50% today. So what we have today is a system that continues to grow without constraint, while providing fewer services and most certainly value to a smaller proportion of the working force.

With decades of growth across a patch-work of state health systems, the Byzantine network of American health care has created opportunities ripe for fraud and corruption. FBI data indicates that between 3-10% of health care funding is lost to fraud. There maybe as much as $75-250 billion dollars being squeezed out of the current Medicare system every year by crooked pharmacies, doctors, HMO’s, and equipment providers. Pfizer Inc, one of the world’s largest pharmaceutical companies, recently agreed to pay $2.3 billion, the largest health care fraud settlement in the history of the Department of Justice, to resolve criminal and civil liability arising from the illegal promotion of certain pharmaceutical products. UnitedHealth Group at the beginning of 2009 was forced to pay a record $350 million to defrauded customers to resolve allegations of price fixing. Similarly, Aetna, the United States’ third-largest health insurance company, agreed to pay $20 million to a non-profit body that would fairly determine rates for patients who use doctors outside the network.

The American Medical Council, a professional group which certifies internists, makes the statement that, "Primary care is on the verge of collapse." They explain that, "Very few young physicians are going into primary care and those already in practice are under such stress that they are looking for an exit strategy."

So unless wholesale and systemic changes are made to the way health care is paid for, delivered, and managed, the entire system is posed to collapse.

Alternatives

What is not in dispute is that America has some of the greatest public health centers in the world. The Mayo Clinic, the Cleveland Clinic, the Johns Hopkins Hospital System, Massachusetts General…etc are world renown institutions that service countless Americans and people from across the world. If you have the finances, the ability, and/or status to pay top dollar for your health concerns, then you will be more than adequately serviced by these hospitals. Although there may be some physicians and hospitals that offer similar treatments elsewhere, the collection of these centers of health excellence are what Americans think about when they say their country offers the best in health care.

The Bush administration deduced that the reason health costs were too high was because people had too much insurance and purchased too much medical care. Their solution was what the population needed were “tax-advantaged health savings accounts tied to plans with high deductibles that induce people to pay more of their medical expenses out of pocket.” Of course as with all things Dubya, this would (again) favour his true base; the rich and the very-rich. The standard Republican line is deference to big-pharma, increase the monopoly power of the insurance companies, and shriek about states rights when it comes to regulation. Yes the public continues to suffer and get taken to the bank (which curiously enough they now perversely own), but I'm sure that's what the founding fathers would have wanted.

Many Democrats, especially economists like Paul Krugman and public health practitioners advocate either a Canadian or European style system. Given that 40% of Americans already receive health care through Medicare, state plans (Medicaid), children health insurance plans (CHIP), Native American health care systems, and/or military/veterans’ affairs, a large minority already have that system in place. From 2000 to 2005, per capita health-care spending in Canada grew by 33 percent, in France by 37 percent, in the U.K. by 47 percent—all comparable to the 40 percent growth experienced by the U.S. in that period. So regardless of the nation or model being used, health care cost everywhere continue to rise at an unstable level and consume larger-and-larger portions of government spending. Furthermore, the United States has a number of cultural and societal attributes, as discussed above, that impose significant limitations towards the successful adoption of any foreign system in the long-term.

The Brookings Institute summarizes the attributes that meaningful reform will need to entail in America:

Reforming our health care delivery system to improve the quality and value of care is essential to address escalating costs, poor quality, and increasing numbers of Americans without health insurance coverage. Reforms should improve access to the right care at the right time in the right setting. They should keep people healthy and prevent common, avoidable complications of illnesses to the greatest extent possible. Thoughtfully constructed reforms would support greater access to health-improving care — in contrast to the current system, which encourages more tests, procedures, and treatments that are at best unnecessary and at worst harmful.