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Archive for the ‘Healthcare’ Category

The GOP ignores its constituents and serves only its masters: Mitch McConnell flat out refuses to give Senate more than 10 hours to review healthcare bill

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Walter Einenkel writes at DailyKos:

As a small cabal of old impotent white men clandestinely put together an enormous tax break for the rich at the cost of millions of people’s lives, word has leaked that Senate Majority Leader Mitch McConnell plans on bringing his Trumpcare bill to the floor for a vote sometime next week. Senator Chuck Schumer (D-NY) questioned McConnell on the floor of the Senate Monday and tried to get something resembling “reason” out of a man and a political party that has long disappeared from democracy and into the funhouse of corruption. It led to this exchange:

Schumer: I’ll just renew my request for one more. Will we have time, more than ten hours since this is a complicated bill, to review the bill? Will it be available to us and the public more than ten hours before we have to vote for it? Since our leader has said—our Republican leader—that there will be plenty of time for a process where people can make amendments. You need time to prepare those amendments.

McConnell: I think we’ll have ample opportunity to read and amend the bill.

Schumer: Will it be more than ten hours?

McConnell: I think we’ll have ample opportunity to read and amend the bill.

Schumer: I rest my case.

There are not enough curses in the human family of languages to describe what I think of Mitch McConnell. You can watch the exchange here.

Written by LeisureGuy

20 June 2017 at 5:22 pm

How Two Common Medications Became One $455 Million Specialty Pill

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Marshall Allen reports for ProPublica:

Everything happened so fast as I walked out of the doctor’s exam room. I was tucking in my shirt and wondering if I’d asked all my questions about my injured shoulder when one of the doctor’s assistants handed me two small boxes of pills.

“These will hold you over until your prescription arrives in the mail,” she said, pointing to the drug samples.

Strange, I thought to myself, the doctor didn’t mention giving me any drugs.

I must have looked puzzled because she tried to reassure me.

“Don’t worry,” she said. “It won’t cost you any more than $10.”

I was glad whatever was coming wouldn’t break my budget, but I didn’t understand why I needed the drugs in the first place. And why wasn’t I picking them up at my local CVS?

At first I shrugged it off. This had been my first visit with an orthopedic specialist and he, Dr. Mohnish Ramani, hadn’t been the chatty type. He’d barely said a word as he examined me, tugging my arm this way and bending it that way before rotating it behind my back. The pain made me squirm and yelp, but he knew what he was doing. He promptly diagnosed me with frozen shoulder, a debilitating inflammation of the shoulder capsule.

But back to the drugs. As an investigative reporter who has covered health care for more than a decade, the interaction was just the sort of thing to pique my interest. One thing I’ve learned is that almost nothing in medicine — especially brand-name drugs — is ever really a deal. When I got home, I looked up the drug: Vimovo.

The drug has been controversial, to say the least. Vimovo was created using two readily and cheaply available generic, or over-the-counter, medicines: naproxen, also known by the brand Aleve, and esomeprazole magnesium, also known as Nexium. The Aleve handles your pain and the Nexium helps with the upset stomach that’s sometimes caused by the pain reliever. The key selling point of this new “convenience drug”? It’s easier to take one pill than two.

But only a minority of patients get an upset stomach, and there was no indication I’d be one of them. Did I even need the Nexium component?

Of course I also did the math. You can walk into your local drugstore and buy a month’s supply of Aleve and Nexium for about $40. For Vimovo, the pharmacy billed my insurance company $3,252. This doesn’t mean the drug company ultimately gets paid that much. The pharmaceutical world is rife with rebates and side deals — all designed to elbow ahead of the competition. But apparently the price of convenience comes at a steep mark-up.

Think about it another way. Let’s say you want to eat a peanut butter and jelly sandwich every day for a month. You could buy a big jar of peanut butter and a jar of grape jelly for less than 10 bucks. Or you could buy some of that stuff where they combine the peanut butter and grape jelly into the same jar. Smucker’s makes it. It’s called Goober. Except in this scenario, instead of its usual $3.50 price tag, Smucker’s is charging $565 for the jar of Goober.

So if Vimovo is the Goober of drugs, then why have Americans been spending so much on it? My insurance company, smartly, rejected the pharmacy’s claim. But I knew Vimovo’s makers weren’t wooing doctors like mine for nothing. So I looked up the annual reports for the Ireland-based company, Horizon Pharma, which makes Vimovo. Since 2014, Vimovo’s net sales have been more than $455 million. That means a lot of insurers are paying way more than they should for their Goober.

And Vimovo wasn’t Horizon’s only such drug. . .

Continue reading.

And do read the whole thing. Later:

. . . With Vimovo, it seemed I stumbled on another waste stream: overpriced drugs whose actual costs are hidden from doctors and patients. In the case of Horizon, the brazenness of its approach was even more astounding because it had previously been called out in media reports and in a 2016 congressional hearing on out-of-control drug prices.

Health care economists also were wise to it.

“It’s a scam,” said Devon Herrick, a health care economist with the National Center for Policy Analysis. “It is just a way to gouge insurance companies or employer health care plans.” . . .

Written by LeisureGuy

20 June 2017 at 3:37 pm

How can a child die of toothache in the US?

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Mary Otto reports in the Guardian:

On 11 January 2007, about 30 miles from Baltimore, a boy named Deamonte Driver – a normally energetic child – came home from school not feeling well. “He kept complaining of a headache,” his mother, Alyce Driver, said. His grandmother took him to Southern Maryland Hospital Center, not far from semi-rural Brandywine, where his grandparents’ red-and-white trailer home stood in the patchy shade of a grove of trees. He was given medicines for headache, sinusitis and a dental abscess. The following day, a Thursday, Deamonte went back to school.

“That Friday he was worse,” his mother said. “He couldn’t talk.” She took him to Prince George’s County Hospital Center, where Deamonte received a spinal tap and a CT scan. “They said he had meningitis,” said Alyce. The child was rushed to the Children’s National Medical Center in Washington DC, where he underwent emergency brain surgery. “They said the infection was on the left side of his brain. They had to remove a bone.”

On Saturday, Deamonte started having seizures. “The infection came back,” Alyce said. “They had to go back in.”

Deamonte required brain surgery again, and this time the abscessed tooth was removed too. It was a molar on the upper-left side of his mouth: a so-called “six-year molar”, one of the first permanent teeth to erupt when baby teeth are shed, and particularly vulnerable to decay. This tooth was ruined, infected to the core. Bacteria from the abscess had spread to the boy’s brain. Alyce remembered a doctor telling her: “This kid is fighting for his life.” Her world, which was fraught with struggle on the best of days (she had been coping with homelessness since leaving a violent relationship), seemed to fall apart.

The extended family gathered around Deamonte’s bed and appealed to heaven. They called upon Jesus and asked him to save the boy. “He slept for two days straight. I said, is my baby ever going to wake up?”

Finally, Deamonte opened his eyes.

After more than two weeks at Children’s National, he was moved to the nearby Hospital for Sick Children, where he began an additional six weeks of medical treatment. He received physical and occupational therapy, did schoolwork, and enjoyed visits from his mother, his brothers and teachers from his school.

Yet Deamonte’s eyes seemed to be weak, his mother said, and his complexion got darker. On Saturday 24 February, he refused to eat – but still seemed happy. He and his mother played cards and watched a show on television, lying together on his hospital bed. After she left him that evening, he called her and said: “Make sure you pray before you go to sleep.”

Next morning she got another call. Deamonte was unresponsive. Alyce found a ride back to the hospital.

“When I got there,” she said, “my baby was gone.”


In the 21st century, thanks to professional care and advances in antibiotics and water fluoridation, reports of death by dental infection in the US are mercifully rare. But in Baltimore, experts at the University of Maryland School of Dentistry were not so surprised that a child had died, having regularly seen the grave consequences of rampant oral disease. They knew that people with good jobs and dental benefits had access to the American dental care system – but they also knew that people who were poor or working poor or underinsured, or who relied upon Medicaid, or who had no benefits of any kind, were often shut out.

Untreated cavities were common among the half a million poor, Medicaid-reliant children in Maryland, who included Alyce Driver’s boys. According to a study by the University of Maryland dental school, the pain of untreated cavities made 8% of these children cry – but Deamonte Driver did not complain about his teeth, his mother said. Maybe he felt that it was futile to complain. Or maybe he just took the pain for granted. . .

Continue reading.

Written by LeisureGuy

17 June 2017 at 2:05 pm

If Obamacare Dies, National Health Care Will Take Its Place

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Kevin Drum has an excellent post, and points out an excellent report from Ezra Klein at Vox:

Ezra Klein makes an argument about Obamacare that I’ve heard a lot of lately:

If Republicans wipe out the Affordable Care Act and de-insure tens of millions of people, they will prove a few things to Democrats. First, including private insurers and conservative ideas in a health reform plan doesn’t offer a scintilla of political protection, much less Republican support. Second, sweeping health reform can be passed quickly, with only 51 votes in the Senate, and with no support from major industry actors. Third, it’s easier to defend popular government programs that people already understand and appreciate, like Medicaid and Medicare, than to defend complex public-private partnerships, like Obamacare’s exchanges

This sounds pretty plausible to me. If passing a cautious, incrementalist program like Obamacare doesn’t provide any protection against Republicans destroying it, Democrats have no motivation to bother with cautious, incrementalist programs. They might as well just bend the rules, pass national health care, and be done with it. If insurance companies don’t like it, tough. Democrats contorted themselves into pretzels to design a program acceptable to insurers, and were rewarded with disaster. Insurers screwed up both their pricing and participation so epically that they brought Obamacare to its knees, and when Republicans proposed ditching the whole thing they just sat on their hands. It’s obvious now that the support of the insurance industry provides zero—or maybe negative—benefit. So the hell with them.

And that’s all in addition to the fact that the Bernie movement has made single-payer health care a live possibility in a way it’s never been before.

Republicans are basically hellbent not on any positive agenda, but on repealing everything Obama did in his eight years. Dodd-Frank. Obamacare. Paris. Higher taxes on the rich. A less interventionist approach to the Middle East. Immigration. Cuba. Net neutrality. Almost literally, they have nothing left of their own that they’re interested in doing. . .

Continue reading.

Written by LeisureGuy

15 June 2017 at 11:50 am

Read Kevin Drum’s post on the GOP’s healthcare bill

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From his column:

The Senate health care bill will take away insurance from millions. It will slash Medicaid. It will wipe out Obamacare’s promise of coverage for essential benefits. It will gut protections for pre-existing conditions. It will reduce subsidies for the poor and working class. And it will give millionaires a big tax break.

Read the whole thing.

Written by LeisureGuy

13 June 2017 at 5:10 pm

They in fact have no shame: How the Republican Coward Caucus is about to sell out its own constituents — in secret

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Paul Waldman writes in the Washington Post:

The fate of the American health-care system now rests with a group of allegedly “moderate” senators, who are getting ready to approve a bill to repeal the Affordable Care Act, a repeal bill so monumental in its cruelty that they feel they have no choice but to draft it in secret, not let the public know what it does, hold not a single hearing or committee markup, slip it in a brown paper package to the Congressional Budget Office, then push it through to a vote before the July 4th recess before the inevitable backlash gets too loud.

“We aren’t stupid,” one GOP Senate aide told Caitlin Owens — they know what would happen if they made their bill public. Even Republican senators who aren’t part of the 13-member working group crafting the bill haven’t been told exactly what’s in it.

Today, we learned that in a break with long-standing precedent, “Senate officials are cracking down on media access, informing reporters on Tuesday that they will no longer be allowed to film or record audio of interviews in the Senate side hallways of the Capitol without special permission.” Everyone assumes that it’s so those senators can avoid having to appear on camera being asked uncomfortable questions about a bill that is as likely to be as popular as Ebola. As Julie Rovner of Kaiser Health News tweeted about the secrecy with which this bill is being advanced, “I have covered every major health bill in Congress since 1986. Have NEVER seen anything like this.”

This is how a party acts when it is ashamed of what it is about to do to the American people. Yet all it would take to stop this abomination is for three Republicans to stand up to their party’s leaders and say, “No — I won’t do this to my constituents.” With only a 52-48 majority in the Senate, that would kill the bill. But right now, it’s looking as though this Coward Caucus is going to be unable to muster the necessary courage.

To understand the magnitude of what they’re doing, let’s focus on Medicaid, because it was supposed to be a sticking point on which some senators wouldn’t budge, particularly those whose states accepted the ACA’s expansion of the program. But according to various reports, the moderates have already caved.

Take Sen. Shelley Moore Capito of West Virginia, a state where more than 175,000 people have gotten insurance thanks to the Medicaid expansion. For a while, Capito made noises about she wanted to preserve the expansion to protect her constituents. “I mean, we can’t just drop them off and wish them good luck,” she said. But no more.

Last week The Hill reported that Capito now supports eliminating the expansion after all — just doing it over seven years instead of the three years that the House bill required. The Charleston Gazette-Mail in Capito’s home state noted that Capito had said she didn’t want to drop all those West Virginians off a cliff, but “Instead, she would drop them off a cliff on the installment plan — around 25,000 per year for seven years.”

Or how about Ohio Sen. Rob Portman? In his state, 700,000 people gained insurance as a result of the Medicaid expansion. He drafted a letter to Majority Leader Mitch McConnell (R-Ky.) stating his opposition to the House bill because it didn’t protect those who gained insurance from the expansion. Now Portman also wants to phase outthe expansion over seven years.

What about Sen. Susan Collins, supposedly the most moderate Republican in the Senate? While Maine hasn’t accepted the expansion due to the resistance of America’s Worst Governor™, Paul LePage, Collins has said that she would like to see her state accept the expansion (with some provisions that make it more uncomfortable for recipients, just so those poors don’t get the idea that they should accept it without shame). But we’ve been through this dance with Collins before — Democrats hope she’ll be a vote for moderation; she talks about how she wants to find a compromise; and in the end she votes with the GOP on every important bill.

It’s important to know that the Medicaid question isn’t just about the millions who would lose coverage if the expansion is eliminated. Paige Winfield Cunningham reports today that Senate Republicans are considering even deeper cuts to Medicaid than the $880 billion the House bill slashed out of the program. They’d pay for the slower elimination of the expansion by cutting money out of the existing program, so they could get rid of all of the ACA’s tax increases — which mostly affected the wealthy. In other words, they want to cut Medicaid to give a tax break to rich people.

Just as critical, they want to end Medicaid’s status as an entitlement, meaning that the program wouldn’t cover everyone who’s eligible. States would get a chunk of money to spend, and if more people turned out to need coverage, tough luck for them. . .

Continue reading.

I hope this is a wake-up call for Trump supporters, but I imagine they’ll blame libtards and minorities.

Written by LeisureGuy

13 June 2017 at 4:48 pm

An example of why it’s difficult to respect the GOP: Their attack on the Affordable Care Act

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Krugman has a good column in the NY Times:

I’m as riveted by Trump/Russia as everyone else. But meanwhile Trumpcare — which really has very little to do with Trump, except that he’ll sign it — appears to be marching on despite the terrible CBO score on the House version and the near-certainty that if the Senate passes anything it will be barely if at all better.

This tells you a lot about the values of the modern GOP, which will happily trade off health care for ~20 million people for tax cuts that deliver almost half their benefits to people with incomes over $1 million — fewer than 800,000 tax units.

But aside from the priorities, think about the process. The AHCA was deliberately rushed through before CBO could weigh in; the Senate GOP is working completely in secret, with no hearings, and anything it passes will surely also try to preempt the CBO.

You might think that this in part reflects conservative analyses that reach a different conclusion. But there aren’t any such analyses. Remember, OMB works for Trump; it has offered nothing. Even the Heritage Foundation, which used to be the go-to source for conservative creative accounting, hasn’t produced some implausible account of how the magic of markets will make it all work.

This is new. You might say that just as the GOP has decided to shrug off conventional concerns about ethics, it has also decided to shrug off conventional concerns about whether policies actually, you know, work.

To be sure, Republicans gave up evidence-based policymaking a long time ago. Back when Paul Ryan was pretending to be a serious policy wonk, he always started from the answer, then invented some assumptions and magic asterisks to justify that answer. Heritage has been a hack operation for many years.

But they used to at least pretend; people like Ryan weren’t actual policy experts, but they played them on TV, and gullible centrists were happy to help them maintain that pretense. Now they’re not even bothering to fake it.

And it’s hard to say with any assurance that they’ll pay a political price. . .

Continue reading.

And Kevin Drum observes at Mother Jones:

Sarah Kliff:

The possibility that Republicans will repeal Obamacare or drive it into collapse is an increasingly real one. That’s a reality where millions fewer have health insurance coverage and lower-income Americans struggle to afford coverage.

….Behind closed doors, Senate Republicans have worked out a path toward Obamacare repeal. The plans under discussion would end Medicaid expansion,causing millions of low-income Americans to lose health coverage. They may allow health insurance plans to charge higher premiums to people with preexisting conditions, too.

The Republican plan is coming together because moderate senators are beginning to drop some of their initial repeal objections. Sens. Rob Portman (R-OH) and Shelley Moore Capito (R-WV), for example, now back a plan to end the Medicaid expansion.

Ah, the fabled moderate Republicans. They hated the old repeal plan, which phased out Medicaid expansion in three years. But they love the new plan, which phases out Medicaid expansion in seven years. It turns out that taking health coverage away from millions of people was never really their problem. They just didn’t want it to happen so quickly that anyone would blame them for it. They’re real profiles in courage.

Written by LeisureGuy

12 June 2017 at 9:37 am

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