Tuesday, October 27, 2009

How Drug-Industry Lobbyists Won on Health-Care

How Drug-Industry Lobbyists Won on Health-Care

I just had a dumpster delivered to my house. I've found a buyer, and I feel blessed. Around here seemingly every second house is for sale. The buyer is a young fellow; a hunter who's already set up a deer stand high in a tree on what will soon be his land.

He'd worked over in Iraq as a contractor to earn his down payment, alongside devoted patriots. Though I have never hunted, we can agree that there is something wrong with the disparity in pay over there. We like each other pretty well, though we come from different backgrounds. Both of us would prefer our patriotic soldiers to be paid more, and for better jobs to be available here at home.

I'm happy that he could afford his nugget of cash to get past the borrowing hurdles which were never there for me. I bought this house for no cash down, way back when they were giving money away. Now, even with lots of money down, the bankers still want to be sure your house is worth at least half its asking price.

Around here in Western New York we never did experience any great bubble in real estate value, and so no real wealth evaporated when that bubble popped. I mean the wealth never was real, but the leveraged purchasing surely was, and we never experienced that either.

I think, but have not done the research to be certain, that there is less unemployment around here now also. Well, it's been so many decades of hemorrhaging jobs by the tens of thousands form Kodak, Xerox, Bausch and Lomb, never mind the old manufacturing industries like steel and automotive.

Housing prices aren't really down, but the number of qualified buyers surely is, which has approximately the same effect. Stimulus cash doesn't matter if you don't have the down payment nest egg. If you want to be the one to sell, you have to give the buyer his price. We are pricing now well below the replacement cost for similar housing. While there was no bubble, there was a drastic oversupply of sprawl-placed cardboard housing.

Now I face my impossible quarterly bill for health insurance, and life insurance, and disability insurance - shortly to be disburdened of the homeowners which has always been, strangely, the least expensive of the bunch.

There are lots of burned out houses around here, and you can only speculate as to the origins of those fires. Rebuilding a destroyed house would bizarrely leave the insured with a covered expense that much higher than the new house's market value.

I wonder what the insurance companies actually do? Do they pay you just to move?

So, according to the Time Magazine article quoted above, there are that many more drug industry lobbiests than members of Congress - 2.3 for every 1 - and one must assume that each of them is paid more highly than we pay our representatives, or at least that a large number of them are at $180K apiece from my back of the envelope calculations, as compared to $165K for our more patriotic, yeah, servants.

Or, who knows? Maybe these guys also work for peanuts and the bulk of the money goes to perks and parties and campaign or memorial contributions for their favored elected officials. People will do almost anything for money these days.

I've been a kind of Rip VanWinkle for some time now, living way out in the boonies, catching the news as catch can when I return after dark from my ever widening tech support rounds. I had no real clear idea that genetic engineering had already begun reaping multi-billion dollar rewards from actual medical products. I'd been waiting for announcements of gene therapy and brave new disease-free human forms.

And I had absolutely no idea that the cost to use these "biologic" drugs, "derived" from living matter, could exceed in one year the cost of an actual house around these parts. Surely they have perfected now a kind of perfect torture for those afflicted with whatever their drugs can cure.

If you are known to have the disease - let's say rheumatoid arthritis - then you won't be able to get new insurance and so you couldn't possibly afford the $50,000 annually which relief might cost. What then would you do. And which side are the genetic engineers on? Shouldn't they really want publicly funded health insurance. What else aren't we being told? Shouldn't they be arguing for no exclusions for pre-existing conditions? Wait . . . .!

They argue, and apparently win, to extend the period of their patent protection well beyond the 5 years which is customary for other drugs. Their outlays are so huge. And apparently these full outlays must get factored in to however the price gets set to alleviate the suffering for those afflicted.

It's supposed to be a real price, but how does it get measured then, against the massive profits. What is their calculus for returns from the government granted patent monopoly extended out now to perhaps 12 full years? They must know precisely how many of us have which diseases. They must understand the interval of pain against believability. They must have programs to suppress inconvenient truths about alternative methods. They must have budgets to fund the touting of the preferred routes toward solution.

Where does the drive to innovate then come from if the holding pattern to keep the old, and to water-drop-tortuously stage the rollout of the new, can be so unimaginably lucrative?

This is really no different from the torture apologies deployed over in Iraq. What limits can there be when lives are at stake?

I guess there's word that big pharma Rummie might be behind the scares for H1N1 vaccine production, because there is so much money in that too. He chairs big pharmas boards. Cheney won't shut up about why he'd had to torture. And Congress now makes little compromises to get the vote of those others on the take who want re-election that badly. What's matters a few years' patent protection among friends?

I think it might be critically important to whittle away around the edges of our assumptions. There are arguments that all cancer treatment, say, is motivated. That costly to life and wealth amputations and radiations and chemo-therapies are not so drastically better than strict dietary and lifestyle changes would be if they were tried. Certainly from the prevention side, there is much to be said in favor of not holding out medical remedies as a kind of nostrum to allow us to keep living as we have been.

But even from the side of treatment, there is much new to be said about less drastic interventions. That too early treatment might make that mountain of what could have been a disappearing mole-hill.

Science could be brought to bear on differing interpretations, but there would be that much less money in them for sure. And to the desperately afflicted, any margin of better must be priceless. Any statistical assurance of right direction.

But I do think that the margin of pain reflected by the price for relief is an almost perfect measure of the greed which must be deployed to find our cures. Isn't that what price means? These are our fundamentalist foundational Democratic Capitalist assumptions.

Surely, it is impossible to imagine that these cures could be found by the power of a kind of love, as they were so recently by Jonas Salk with his polio vaccine. Surely University researchers, tenured and motivated only by a search for truth, could never develop the wonder drugs so magically revealed by billions in venture capital deployed by motivated researchers?!

Masters of outsourcing are always mesmerized by a kind of perfected efficiency, as though this will magically release the human potential now locked away behind plodding work by ordinary people. Plausible deniability is an outsourced set of instructions to those who understand how to read the secret codes of implication.  Extraordinary rendition is an outsourced set of dirty deeds, no different in essence from the export of toxic wastes that we have accomplished now so perfectly in our tango with China.

The masters of these processes must be that drunk on their powers. There must be something intoxicating to be at that pinnacle of wealth and power and influence. Something nearly equal to the promise of eternal life their championed Jesus grants by proxy to such evidence of grace here on earth.

And what would it be worth to you, to alleviate the chronic pain of your afflictions? I sit now in the ever so mild pain an aging body feels after raking leaves by hand. I still perversely refuse the bottled analgesics, and don't have them available if I'd wanted them: a family member recently and so helpfully tossed the huge bottle of aspirin I've nursed for as old as my adult children now are. It had long expired.

So, I may be that willing to ignore life's small indignities. I still find hand tools near enough as quick, and far more satisfying than the powered variety. My mind is quiet enough to endure the repetitions. My body allows for pain.

But if I were in acute and chronic pain, there might be no limit to what I would pay or do to alleviate it. I think that must be what those people around here start from when they do crystal meth.

I find it unspeakably cruel that we would levy such a fee. No matter the costs, I think these should be born by the same agency which sends our rockets into space. I think our wars should be fought by patriots or not at all. And I think both Rumsfeld and Cheney belong in jail with their compatriot Bernie Madoff.

But that's just me. I'm about to dispose of my spent dreams in a very conveniently deposited dumpster. I'll pay my insurance premiums, up against the pain I would save those who love me. My life, my health, my abilty to continue to rake leaves measured with excruciating precision against my willingness to pay that price.

My true foundational and fundamentalist belief is that ordinary people liberated from the bonds that corporate and financial giants would precisely engineer for them would accomplish that much more and faster than can any of these out-sized quasi humans motivated only, apparently, by greed.

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