Drugs, Votes, or Cash, It’s the Same Mistress by Pat Conrad MD

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Years ago in a residency ethics seminar, a classmate was arguing for government production and distribution of common, generic drugs. I pointed out that doing so was not only an improper role of government, but that it would lead to scarcities and higher prices for newer, potentially better drugs for non-government patients. The leftist classmate reiterated that most people didn’t need the most advanced or newest therapeutics, whereupon an ally quipped, “Oh, so you want second-class drugs for second class patients.” The leftist called us both Nazis, which is what lefties do when people are too slow to open their wallets.

Years after that, I was in D.C. (fighting my urge to go all Jubal Early on that swamp) lobbying with the AAPS against the enactment of Medicare Part-D, aka W’s “Free Drugs for Old Peoples’ Votes” program. We argued to now-Georgia governor/then-Rep. Nathan Deal (Ga.-R) that it was not only inappropriate to use taxpayer money for meds, but that it would lead to significant price increases, and blow holes in a budget that now seems laughably benign. Rep. Deal told us that we were wrong, that we could not expect to provide deserving seniors Medicare without ensuring they could pay for the meds prescribed them by their kindly government-funded doctors.

So after being called names by a moonbeam and schooled on healthcare economics by a politician, what have we? The AP is wondering aloud if government involvement has allowed, and even encouraged drug makers to jack up their prices. The latest straw dog to beat is Mylan CEO Heather Bresch who okayed the gouging of EpiPen prices because, well, she could. For those of you who think I’m saying anything nice about this utterly corrupt woman, you can read my previous criticisms HERE. But when Congress gets into the market and Obama signs a bill providing “free” EpiPens to schools, then the daughter of one of his political allies is bound to see an opportunity for some PR cover. Hey, she’s a scorpion, and scorpions only do one thing.

Medicare Part-D has invited more drug sales, and the new taxpayer money flooding the industry led to price increases, and the development of newer, pricier drugs that Fred and Ethel just gotta have. Sen. Chuck Grassley of (R-Ia) said, “When companies are allowed to manipulate public programs, consumers and taxpayers lose out,” and he ought to know. In 2003, Uncle Sugar ladled out $1.2 billion for powered wheelchairs and scooters, and was shown to have been fraudulently billed in the hundreds of millions. Finance Committee Chairman Grassley responded to this fiscal gaffe by requesting that CMS “Provide a crosswalk from the 49 codes released on February 2005 to the 63 codes released on September 14, 2005.”

From the article: “Fundamentally, we disagree that there is not adequate cost containment for medicines built into Part D, or the ACA,” said Lisa Joldersma, vice president of policy and research with the Pharmaceutical Research and Manufacturers of America. We think the market is best able to manage the holistic picture and to strike the right balance across cost containment, access and continuous innovation,” she added.

Then why do you need government cash and tax shelters Ms. Joldersma? Her answer of course is that without those taxpayer supports, prices would be that much higher. We U.S. voters have created an amazing vortex of crony corporatism whereupon, by the government providing things as rights, those things only get more expensive, with worse price flights and shortages guaranteed if that which increases prices is withdrawn. Give that equation to your local college administrator or teacher union boss, and watch them wink and smile.

The article includes that Rep. Xavier Becerra (D-Ca) doesn’t blame either Bush or Obama for their big government expansions, but still thinks Congress should act. And do what, but make things worse still? The article notes that Obama extended protections of certain drugs from generic competition to 12 years. Cal me a hard-ass, but I still don’t get why drug patents ever expire. Why should a Beatles song still retain its copyright, but not Augmentin? And if drugs kept their patents intact, wouldn’t their profits extend longer, making government subsidies harder to justify? Of course the government would have less influence on drug-makers and drug-takers, so …

This entire perversion under the false flag of “market forces” is so bad, so pervasive, so emotionally guarded, that I’m reduced to agreeing with and Urban Institute economist in the article’s final quote, by Eugene Steuerle: “Government simply cannot provide monopoly power and at the same time say that it will pay a price set in the private market by those companies. Turning the power of the purse over to monopolists is absurd.” He’s got that right.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Drugs, Votes, or Cash, It’s the Same Mistress by Pat Conrad MD

  1. Ben Van Raalte
    October 8, 2016 at 4:11 pm

    To pass ObamaCare the Democratic Party cut a deal with the drug companies, who responded with very generous campaign contributions.
    Those working for the government, those getting ObamaCare, those on Medicaid, and those on Medicare dont care that prices increase, they have their costs paid for by the taxpayers and those who dont have unlimited health care.
    Thus you get middlemen taking a cut with no ultimate savings in the bait and switch game.
    You have a CEO of a small Drug company that makes EpiPen raise the price 800% and her pay for a small company higher than major drug companies. In addition her resume supposedly false, and her dad a Democratic Senator from WV who stifled generic competition, and her mother the head of the education association that mandated EpiPens at schools. That is crony capitalism and is a specialty of the Democratic Party.
    Thus you have $80,000 pill treatments for hepatitis. All the government had to do was say no, and either the company would be out of business or lower the price.

    But I have to learn Epic and Cerner and get 40 hours of training for FREE. I doubt any other group would have worked for free. It should not have taken 40 hours. I have to take ER call for FREE, and do a 2 hour surgery after waiting 3 hours for a $300 payment with a $200 an hour overhead

    It is totally corrupt. But communism is just as corrupt and more so with loss of freedom. In addition it ultimately collapses because the harder workers refuse to work harder when they are not rewarded.

  2. HJR
    October 8, 2016 at 11:30 am

    F-ing A. ????????????

  3. Bill Ameen MD
    October 8, 2016 at 11:22 am

    Well, we all know that the main reason drugs cost so much in the U.S. is that insurance companies will mostly pay for them, and to a lesser extent Medicaid and Medicare. And of course to pay for their legions of cheerleader reps, advertising, and food for doctors. Capitalism taken over by greed isn’t a lot better than Communism.

    • Pat
      October 8, 2016 at 11:40 am

      This isn’t capitalism, it’s crony corporatism. Completely opposite.

  4. October 8, 2016 at 9:07 am

    “If there is no price, there is no value.” When Eastern Europe turned away from an abysmal bureaucratic government control of all things, this dilemma made things very difficult.
    Is it worth, for instance, getting cheap but low-grade coal from nearby, or better but more expensive coal from afar? Is this power plant worth operating at all? The only sane way to make these judgments is with the real input of price. Otherwise, as the old Red governments did, the bureaucrats shrug and put their hands under the table for “advice.”
    I embrace liberalism to the degree that injustice should be remedied. I dislike current American liberalism, which is utterly careless about accomplishing these remedies, instead merely gesticulating at them in a threatening manner. I dislike a general habit of American society, which begins with the premise, “There are a*holes; but then there is me, the glorious ME, who is virtuous and pure.”
    These corrosive effects are evident in the degradation of medicine. Once, when you diagnosed a heart attack, you were reasonably expected to provide such care as to ameliorate its damage, to a degree within your skill and resources. But now, when you practice the New Bad Medicine, you give the complainant a nitroglycerin, a GI cocktail and hydrocodone, and send them home with “chest pain, resolved.” Who can blame you? “What are we supposed to do, be some wizard that knows EVERYTHING? We diagnosed it – chest pain – and said it should be fixed. What else do you expect from us, magic?”
    We are satisfied that liberalism – or at least a sense of empathy and kindness to others – can be paid off under the table by meaningless gestures. If there is no value to reform, it will not be done. If we devolve all our responsibilities off to “the government,” and then roundly damn those Democrat/Republicans in Congress for not achieving the solution, that President for not making magic happen – isn’t that enough of our citizens’ duty? No. That’s how societies fail. The Trumpian nostalgia is not for the country which we used to have, but rather for the people we used to be.

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