Bernie Sanders has some explaining to do
by Doyle McManus
Bernie Sanders, the insurgent candidate for president, says he plans to give "a major speech" soon explaining what he means when he calls himself a democratic socialist.
"I think there are a lot of people who, when they hear the word 'socialist,' get very, very nervous," Sanders told reporters in Iowa this week. He's right; a recent Gallup Poll found that 50% of voters aren't willing to vote for a socialist.
But it's a little puzzling why Sanders thinks he needs to give a stemwinder on the subject. He's been explaining his definition of socialism almost nonstop since he declared his candidacy in April.
"To me, democratic socialism means democracy," he said in Iowa. "It means creating a government that represents all of us, not just the wealthiest people in the country." (That's the Ben & Jerry's version.)
"There are socialist programs out there that are some of the most popular programs in America," he said, citing Social Security and Medicare. "When you go to your public library, when you call your fire department or the police department, what do you think you're calling?" (The New Deal version.)
"What democratic socialism is about is saying that it is immoral and wrong that the top one-tenth of 1% in this country … own almost as much wealth as the bottom 90%," he said at the Democrats' debate last week. (The Occupy Wall Street version.)
Actually, none of those captures what "democratic socialism" means — at least, what it meant half a century ago, when Sanders joined a socialist youth group at the University of Chicago. Back then, socialism was a muscular creed that sought to put workers in control of the economy, often by nationalizing major industries like energy, automobiles and steel.
But Sanders is running for the presidential nomination of the Democratic Party, not the Socialist Party. He's watered down the faith of his youth to make it more palatable to most Americans — and that's fine.
He's turned into a "social democrat" much like the technocrats he praises in Denmark and Sweden. To purists on the left, that makes Sanders a SINO — a socialist in name only. But he's winning millions of converts and widening the Democrats' window of debate toward the left, which is more than old-school socialists have accomplished since about 1972.
But giving explanatory speeches will only take Sanders so far. What he needs to do now is describe how his ambitious, big-government proposals would work, whether you choose to call them progressive, socialist or anything else. He hasn't done much of that, even though he's been running for six months.
Take his biggest, boldest idea: Medicare for all. Sanders says he wants everyone enrolled in one big government-run health insurance system. No more private insurance plans, no more Obamacare, no more Medicaid. At least, that's what I think he means; he hasn't provided any details.
"I wish I had more answers for you," his policy director, Warren Gunnels, told me this week. "He hasn't decided on the exact form it should take — other than being universal, single-payer, Medicare for all."
That also means it's impossible to estimate how much the plan would cost. One expert outside Sanders' campaign calculated $9.6 trillion over 10 years; another, $17.6 trillion — a big range. Either way, Gunnels said, the plan would end up saving Americans money because they wouldn't have to pay for private insurance, and because it would be more efficient than our current profit-based crazy quilt.
I happen to think he's right because most advanced European countries (not just Denmark) have single-payer systems that work as well as ours, at much lower cost. But without more details, no one can really say.
Will Colorado Become the First State to Implement Single-Payer Health Care?
Tuesday, 20 October 2015 00:00 By Michael Corcoran, Truthout | Report
The fight for a statewide single-payer health-care system has shifted from the Green Mountains to the Rocky Mountains: Colorado citizens are about to put single-payer up for a statewide ballot referendum in the 2016 election. If voters approve, the state constitution will be amended to create a statewide, publicly financed, universal system for the first time in US history.
After a long struggle, Vermont's proposal for a similar plan died in January 2015, after a decision by the governor to abandon the plan. Green Mountain Care, as it was known, is the closest any state has come to implementing a public health-care system that covers everyone. So the failure was a major disappointment for advocates for social justice everywhere. But the setback didn't stop activists in states across the country from pursuing similar reforms. Many in these states watched events in Vermont closely - to see what worked and what didn't and to avoid the pitfalls that proved fatal.
Colorado has been especially active, and activists are set to turn in more than 150,000 signatures (about 99,000 are required) to put health reform on the 2016 ballot, said Lyn Gullette, campaign director for ColoradoCareYES. Organizers say they are optimistic that their strategy will succeed where Vermont's failed - and that when ballots are cast in 2016, public, universal health care may become a reality in Colorado.
"We are really excited about this. We have been so heavily invested in the campaign," Gullette told Truthout. "Of course, we watched events in Vermont closely. There were some things they did that we want to emulate and things we want to do differently."
Vermont, however, is probably the most progressive state in the union. Its legislature is dominated by Democrats, and its citizens have elected a self-identified socialist as a mayor, a congressman and a senator, repeatedly for decades. How can Colorado - a purple state with a divided legislature - expect to make such a landmark advancement in health-care reform and social democracy?
It is a fair question. The strategy for reform in Colorado, however, is dramatically different from the one used in Vermont. Colorado Care has a chance to succeed for several important reasons: 1) Colorado law allows for citizen's ballot initiatives, which limits the ability for politicians to intervene; 2) local politicians say the Affordable Care Act's "state innovation" language is more favorable to Colorado in terms of financing a plan; and 3) organizers have been much more specific in how the plan will be funded, after watching how the ambiguities of Vermont's plan contributed to its demise.
If all the signatures are validated by the Colorado secretary of state's office (which could take several months), the question will be decided by Colorado voters, whose judgment on Initiative 20 will have an impact all across the country. It is important for advocates of health-care justice everywhere in the United States to become invested in this campaign.
New Screening Guidelines Won’t Assure Fewer Mammograms
by Aaron Carroll
In 1985, about three-quarters of women age 40 to 79 had never been screened for breast cancer with mammography. By 2010, things had changed enormously. More than 70 percent of women of similar age had been screened in the previous two years. Many people attribute the large improvements we’ve seen in breast cancermortality over that period to early detection through ambitious screening programs.
In recent years, though, many researchers have concluded that annual screening mammograms for a wide range of women may be doing more harm than good. Because of this, the American Cancer Society has updated its recommendations on how often women should be screened. But after years of public awareness campaigns, getting physicians, and the public, to accept the new guidelines will probably be very hard.
This is a big change. For years, many organizations, including the cancer society, recommended annual mammograms beginning at age 40 and clinical breast exams every few years starting as early as age 20. After 2003, the society changed its guideline development procedures to be more transparent and evidence-based; these new recommendations are a result.
For instance, a new study examined whether annual or biennial screening is superior for women of different ages. The researchers used data from the Breast Cancer Surveillance Consortium to look at more than 15,400 women 40 to 85 who were found to have breast cancer within a year of an annual screen or within two years of a biennial screen. They wanted to determine if the screening interval affected prognosis.
This is important because many believe that stretching out the time between mammograms means that when tumors are diagnosed, they will be more advanced, and therefore more dangerous. The researchers found that in premenopausal women, women who had screens every other year were more likely to have a higher proportion of cancers diagnosed at stage IIB or higher, or to have a tumor greater than 15 mm. After menopause, however, these differences were no longer found. This is why annual screens are recommended from age 45 to 55, and biennially after that.
But it’s important to talk about the benefits of screening not just in relative risk reductions. The overall impact, or absolute rate reduction, of screening is often small. Systematic reviews of randomized controlled trials estimate that almost 2,500 women age 40 to 49 need to be screened to prevent one death from breast cancer in 15 years. More than 1,600 women over age 50 need to be screened to achieve the same result. Cohort studies and case-control studies are more supportive of screening, but still find that many hundreds of women need to be screened to prevent one death from breast cancer over 15 years.
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It is very hard to get doctors to do less. I have discussed this before in the context of the placebo effect in operations. Once physicians believe they are doing good, it is hard to get them to change their minds. Others think that doing more protects them from lawsuits, although that’s most likely untrue. Some have seen screening pick up diseases, leading to treatment and positive outcomes, and have assumed that it was the screening that made the difference (although evidence refutes this). And, yes, some are probably influenced, overtly or subtly, by financial incentives that still lean toward everyone being more invasive.
But in this case, it will most likely be even harder to change the public’s expectations. For decades, we’ve been told, over and over, that more screening is better, that early detection is the key to a cure. That’s true, up to a point. We seem to have passed that point, though, and more and more experts are trying to reverse course.
HEDGE FUNDS ATTACK AMERICAN HEALTH CARE
A NEW ANALYSIS SHOWS RAMPANT SPECULATION BY HEDGE FUND AND PRIVATE EQUITY IN THE BRANDED DRUGS THAT ARE RISING FASTEST IN PRICE
It’s not just one highly unethical man: dozens of high-flying financial speculators at hedge funds and private equity firms are driving up the price of pharmaceuticals across the country.
The now-infamous Martin Shkreli recently became the target of extremely well deserved worldwide scorn.[1]
Shkreli, a 32-year old hedge-fund-manager-turned-pharmaceutical-executive, bought the rights to Daraprim, a toxoplasmosis drug often required by women, men and children with immune systems weakened by diseases like HIV/AIDS. After acquiring the drug rights, Shkreli increased the price by 5,000% to $750 per pill.[2]
The ensuing backlash against Shkreli has brought much needed attention to the problem of price gouging in the pharmaceutical industry.
Given the increased scrutiny, we think that it is only appropriate to point out that this problem extends far beyond the actions of just one disgraced hedge fund manager/pharmaceutical executive:
The table below shows the branded pharmaceuticals that have increased the most in the Medicaid National Average Drug Acquisition Cost (NADAC) survey over the previous two years.
Among the top twenty-five drugs, twenty of them have seen significant activity from hedge funds, private equity, and other deep-pocketed speculators.[3]
Yes, you read that right: 80% of the drugs with the fastest-rising prices were involved in hedge fund, private equity or similar speculative attacks in the past two years.
The exact circumstances of each deal varies, but the outcome is always the same: branded pharmaceuticals — drugs for which no lower-cost generic alternative drug exists — see their prices increase many times over to satisfy the greed of speculative investors.
Often, the catalyst for price increase isn’t related to medical or productions costs. Drugs like Sprix nasal spray or Vimovo have rocketed in price after an ownership change made possible by private investment.
One company that stands out in all this is Valeant, a drug manufacturer that partnered in 2014 with a hedge fund called Pershing Square Capital Management to attempt the takeover of Allergan, another pharmaceutical company.
While Valeant and Pershing Square kept increasing their bids for Allergan, the price of Valeant’s branded drugs increased in near lockstep.
Billionaire hedge fund manager William “Bill” Ackman runs Pershing Square, and his manipulative moves exploded prices for medications needed by ordinary Americans – Americans who aren’t billionaires, and who can’t afford to pay billionaire prices for their medications.
Valeant produces twelve of the twenty-five branded drugs that have increase most in price over the past two years. Among the top fifty, Valeant produces twenty-seven.
Given that branded drugs are essentially a license to print money, it appears that Valeant was pumping up the prices of these medications to finance the Allergan takeover attempt – and/or to ensure big profits for billionaire hedge fund manager Ackman.
Looking back at the data on the pharmaceuticals with the largest price increases in the past two years, Horizon Pharma’s Vimovo is at the very top of the list.
Horizon Pharma acquired the arthritis drug from AstraZeneca in November 2013 – just after Horizon partnered with a wrecking crew of voracious venture capitalists.[4]
Prior to the purchase, Horizon Pharma had done a series of venture capital raisings, beginning in 2005. By November 2013, the company had raised $204 million from FirstMark Capital, Scale Venture Partners, Sutter Hill Ventures, Essex Woodlands, TVM Capital, Kreos Capital, Oxford Finance Corporation, and Silicon Valley Bank.[5]
The Vimovo acquisition follows a pattern similar to other pharmaceutical purchases made by companies with hedge fund, private equity, or venture backing.
- Speculative private capital is used is used to acquire an existing branded drug from an established pharmaceutical company.
- Because the drug is branded, no generic exists, and the producer is granted a monopoly on the sale of the drug.
- Once the acquisition is completed, the company drastically increases the price of the pharmaceutical.
- Because no generic exists, customers who need the drug are forced to accept any price dictated by the companies.
The only winners in this game are the pharmaceutical companies and their financiers: the hedge funds, private equity firms, and the venture capitalists. These speculators stand to make fortunes.
Following the acquisition of Vimovo from AstraZeneca, the Horizon Pharma didn’t immediately begin marketing the drug. The Medicaid National Average Drug Acquisition Cost survey shows that the national average per-unit price of Vimovo stayed relatively flat, before spiking in early March 2014.
One possible reason for the delay: Horizon Pharma didn’t actually begin selling Vimovo until the first quarter of 2014.[6]
harmaceutical companies like to justify the existence of the twenty year monopolies granted to branded drugs like Vimovo, by pointing out that they spend “vast sums of money on research and development… and that monopolies and high prices are a ‘necessary evil’ needed to finance innovation of new medicines.”[8]
But the Vimovo case, like the other examples outlined in this paper, show that these monopolies are being exploited by financiers who see them merely as a license to print money and add to their billions in wealth — at the expense of the public, and at the expense of public health.
Soaring EpiPen Prices Raise Questions About Pharmaceutical Industry
By Dr. Mallika Marshall
October 21, 2015
BOSTON (CBS) – For someone with an allergy, an EpiPen can mean the difference between life and death. The price of this indispensable injectable drug has soared in recent years. Dr. Mark DeMatteo, an emergency room doctor at Beth Israel Deaconess in Plymouth, said the cost was around $60 ten years ago. The price now is about $400.
Every bite Dylan Frazier takes needs to be watched closely because the 9-year-old from Duxbury has severe food allergies.
“If we don’t have an EpiPen and he has a reaction, it could be deathly for him,” explained his mother Kristen Frazier.
Frazier makes sure there are EpiPens near Dylan at all times. “One in his backpack to and from school in case anything happens on the school bus. In his classroom. In the cafeteria. I carry one at all times. My husband caries one and we have one in the sports bag.”
An EpiPen is an injectable form of epinephrine which can quickly reverse an allergic reaction. Frazier has noticed the spike in price.
“It has gone up significantly,” she said.
Professor Todd Brown, who teaches at Northeastern University’s School of Pharmacy, said the increase in prices is, “a bigger issue across most medications in general now.”
Brown added, “Pharmaceutical companies have really changed the way they price medications. It used to be related to the impact of the medication. And now it has really changed essentially to how much they can get for a medication.”
This is a real problem in the United States. For example, those same EpiPens which cost about $400 here can be purchased for about $85 in France.
Massachusetts Congressman Michael Capuano believes the system to procure drugs doesn’t make any sense here. He said there is no federal regulation on how high drug prices can go. “We have prohibited the government from negotiating prices with drug producers by law, which is crazy thing to have done.”
Dr. DeMatteo reiterated how critical this medication is for allergy patients, and is concerned some families might be forced to cut back. “These events can progress at a very rapid pace, sometimes as quickly as 20 minutes. Under those circumstances, having an EpiPen will be absolutely lifesaving.”
Frazier knows she’s lucky her insurance covers a majority of her costs, but her co-pays still add up. She worries about the future. “I have a friend who recently had to pay a $1,000 for the EpiPens she wanted.”
In a statement, the Mylan Corporation, which manufactures EpiPens, said they offer financial help to families who quality. They have also provided free devices to more than 60,000 schools.
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