Obamacare one step forward, one step back
Posted July 19, 2012, at 3:41 p.m.
The affirmation of the constitutionality of the Patient Protection and Affordable Care Act, or Obamacare, on June 28 by the U.S. Supreme Court was a big step forward for our country. But parts of the act itself are a step in the wrong direction.
First, the steps forward. For the first time since the enactment of Medicare in 1965 the federal government has taken the position that health care is a right of the U.S. public — a heroic political achievement.
Obamacare accomplishes this by expanding public programs such as Medicaid and Community Health Centers, and requiring most Americans to buy private insurance or pay a tax penalty. These requirements are enabled by a variety of tax-funded subsidies to employers, employees and individuals.
To its credit, Obamacare also outlaws the most antisocial practices of private insurers — excluding people with a history of illness from coverage, charging outrageously high premiums if they’re sick or retroactively canceling coverage if a health insurance subscriber has the temerity to become ill and actually submit a claim.
But there was one especially troubling step backward that is the source of the unease felt by many health policy experts about the law. Prior to Obamacare, our private for-profit insurance industry’s future was bleak. Facing the choice of satisfying Wall Street’s incessant demands for profitability or face declining stock prices, they were being forced into a death spiral of ever increasing premiums and ever harsher attempts to limit claims payments by denying services and otherwise restricting coverage to only those with the least probability of becoming ill. Those most vulnerable to illness were being left to fend for themselves.
By requiring tens of millions of healthy Americans to buy private health insurance with the help of federal subsidies, Obamacare has come to the rescue of corporate America once again. This insurance mandate gives the term “corporate welfare” a new and more robust meaning.
Anemia drugs made billions, but at what cost?
By Peter Whoriskey,
On the day Jim Lenox got his last injection, the frail 54-year-old cancer patient was waiting to be discharged from the Baltimore Washington Medical Center. He’d put on his black leather coat. Then a nurse said he needed another dose of anemia drugs.
His wife, Sherry, thought that seemed odd, because his blood readings had been close to normal, but Lenox trusted the doctors. After the nurse pumped the drug into his left shoulder, the former repairman for Washington Gas said he felt good enough to play basketball.
The shots, which his cancer clinic had been billing at $2,500 a pop, were expensive.
Hours later, Lenox was dead.
For years, a trio of anemia drugs known as Epogen, Procrit and Aranesp ranked among the best-selling prescription drugs in the United States, generating more than $8 billion a year for two companies, Amgen and Johnson & Johnson. Even compared with other pharmaceutical successes, they were superstars. For several years, Epogen ranked as the single costliest medicine under Medicare: U.S. taxpayers put up as much as $3 billion a year for the drugs.
The trouble, as a growing body of research has shown, is that for about two decades, the benefits of the drug — including “life satisfaction and happiness” according to the FDA-approved label — were wildly overstated, and potentially lethal side effects, such as cancer and strokes, were overlooked.
Last year, Medicare researchers issued an 84-page study declaring that among most kidney patients, the original and largest market for the drugs, there was no solid evidence that they made people feel better, improved their survival or had any “clinical benefit” besides elevating a statistic for red blood cell count.
It was a remarkable finding of futility: While drugmakers had seen billions in profits over 22 years, much of it from taxpayers, millions of patients had been subjected to dangerous doses that might have had little advantage.
How did this happen?
The rise and fall of a billion-dollar drug
Amgen and Johnson & Johnson earned billions on the trio of anemia drugs Epogen, Procrit and Aranesp since their introduction in 1989. But over time, an understanding of their risks has grown, as have doubts about their effectiveness. Amgen says it acted quickly and responsibly as its understanding of the drugs evolved.
One comment on the above story: westernstates
9:36 AM EDT
I do think the doctors are the primarily culpable parties here. They should know that they do not know. Instead, they put on this big show spouting lines from the drug companies' promotional literature. My late husband's doctor would actually become irate if anyone questioned the wisdom of his stupid, lethal, and unnecessary statin therapies. When I questioned him, he volunteered that he was not getting kickbacks from the drug companies without my ever asking or accusing him of doing so, which about says it all. Sometimes you have to go to a doctor. Sometimes (but very rarely) there is a useful medicine. But be very skeptical. The doctor is not really a scientist; s/he is a salesman. Eat mindfully, do yoga, and stay away from doctors.
Liberals Go Dizzy Spinning ObamaCare
Targeting Single-Payer Advocates
President Obama’s Patient Protection and Affordable Care Act sucks. It isn’t change in the dysfunctional American health care system that any one should believe in or defend. And yet that is exactly what liberals and progressives are doing. Led by spin doctors at The Nation, they’re spinning ObamaRomneyCare (ORC), and that’s what it should be called, as if it were a step in the right direction. As if it were the only outcome of the national health care reform debate in 2009.
The individual mandate that compels millions of people to purchase unaffordable underinsurance and then punishes them with a fine if they don’t, and the transfer of $447 billion in tax payer money to the health insurers were deal breakers for advocates of a single-payer, national health care system. It doesn’t make sense to give the corporations that cause the health care crisis more profits and power in exchange for a modest expansion of Medicaid and a series of mostly rhetorical reforms that the insurance industry and employers are already undermining. It’s no different than giving the bankers responsible for crashing the world financial system billions of dollars in bail out money. How’s that working for Americans?
A word of caution on Massachusetts health cost reform
I feel like I’m watching one of those basketball games that drags on forever before all the important action takes place in the last few seconds.
The governor and legislators have been working for more than 17 months on bills to control health care costs in Massachusetts. Now a legislative conference committee is running out of time to reconcile competing versions passed by the House and the Senate.
The idea of legislators attempting to fix any kind of market should come with caution flags. A government plan to influence one of the biggest segments of the state’s economy — a last-minute compromise hatched behind closed doors — makes me very nervous.
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