Open Letter to MMJ (Health Care Reform)

[camille]

I'll Pass on 'Opting Out'

The Democrats' all-new "opt out" idea for health care reform is the latest fig leaf for a total government takeover of the health care system.

Democrats tell us they've been trying to nationalize health care for 65 years, but the first anyone heard of the "opt out" provision was about a week ago. They keep changing the language so people can't figure out what's going on.

The most important fact about the "opt out" scheme allegedly allowing states to decline government health insurance is that a state can't "opt out" of paying for it. All 50 states will pay for it. A state legislature can only opt out of allowing its own citizens to receive the benefits of a federal program they're paying for.

It's like a movie theater offering a "money back guarantee" and then explaining, you don't get your money back, but you don't have to stay and watch the movie if you don't like it. That's not what most people are thinking when they hear the words "opt out." The term more likely to come to mind is "scam."

While congressional Democrats act indignant that Republicans would intransigently oppose a national health care plan that now magnanimously allows states to "opt out," other liberals are being cockily honest about the "opt out" scheme.


On The Huffington Post, the first sentence of the article on the opt-out plan is: "The public option lives."

Andrew Sullivan gloats on his blog, "Imagine Republicans in state legislatures having to argue and posture against an affordable health insurance plan for the folks, as O'Reilly calls them, while evil liberals provide it elsewhere."

But the only reason government health insurance will be more "affordable" than private health insurance is that taxpayers will be footing the bill. That's something that can't be opted out of under the "opt out" plan.

Which brings us right back to the question of whether the government or the free market provides better services at better prices. There are roughly 1 million examples of the free market doing a better job and the government doing a worse job. In fact, there is only one essential service the government does better: Keeping Dennis Kucinich off the streets.

So, naturally, liberals aren't sure. In Democratic circles, the jury's still out on free market economics. It's not settled science like global warming or Darwinian evolution. But in the meantime, they'd like to spend trillions of dollars to remake our entire health care system on a European socialist model.

Sometimes the evidence for the superiority of the free market is hidden in liberals' own obtuse reporting.

In the past few years, The New York Times has indignantly reported that doctors' appointments for Botox can be obtained much faster than appointments to check on possibly cancerous moles. The paper's entire editorial staff was enraged by this preferential treatment for Botox patients, with the exception of a strangely silent Maureen Dowd.

As the Times reported: "In some dermatologists' offices, freer-spending cosmetic patients are given appointments more quickly than medical patients for whom health insurance pays fixed reimbursement fees."

As the kids say: Duh.

This is the problem with all third-party payor systems -- which is already the main problem with health care in America and will become inescapable under universal health care.

Not only do the free-market segments of medicine produce faster appointments and shorter waiting lines, but they also produce more innovation and price drops. Blindly pursuing profits, other companies are working overtime to produce cheaper, better alternatives to Botox. The war on wrinkles is proceeding faster than the war on cancer, declared by President Nixon in 1971.

In 1960, 50 percent of all health care spending was paid out of pocket directly by the consumer. By 1999, only 15 percent of health care spending was paid for by the consumer. The government's share had gone from 24 percent to 46 percent. At the same time, IRS regulations made it a nightmare to obtain private health insurance.

The reason you can't buy health insurance as easily and cheaply as you can buy car insurance -- or a million other products and services available on the free market -- is that during World War II, FDR imposed wage and price controls. Employers couldn't bid for employees with higher wages, so they bid for them by adding health insurance to the overall compensation package.

Although employees were paying for their own health insurance in lower wages and salaries, their health insurance premiums never passed through their bank accounts, so it seemed like employer-provided health insurance was free.

Employers were writing off their employee insurance plans as a business expense, but when the IRS caught on to what employers were doing, they tried to tax employer-provided health insurance as wages. But, by then, workers liked their "free" health insurance, voters rebelled, and the IRS backed down.

So now, employer-provided health insurance is subsidized not only by the employees themselves through lower wages and salaries, but also by all taxpayers who have to make up the difference for this massive tax deduction.

How many people are stuck in jobs they hate and aren't good at, rather than going out and doing something useful, because they need the health insurance from their employers? I'm not just talking about MSNBC anchors -- I mean throughout the entire economy.

Almost everything wrong with our health care system comes from government interference with the free market. If the health care system is broken, then fix it. Don't try to invent a new one premised on all the bad ideas that are causing problems in the first place.

We could talk about this MMJ Fanatic, but my problem is that you didn't actually write a single word of it.  Ann Coulter did.

This is an incredibly complicated subject, and as pennylane just demonstrated, it's as personal, as gut-wrenching as it gets. It's heated, understandably. And everyone gets to have an opinion, but for the purposes of this discussion it would be helpful if you had an opinion of your own, because from where I sit, I honestly don't think you understand a word of the legislation you seem so hell bent on denigrating.

[bear sin rug]

In 8 years, Bush did absolutely nothing to reform (our even consider reforming) our screwed up health care system; I find that un-American.

[camille]

Just in case you think I think the bill is perfect, MMJ Fan...

The House version of the bill that Pelosi released today does not have the Waxman amendment that would've but the hammer down on big pharma to speed the production of generic alternatives to meds such as Herceptin, which millions of breast cancer patients the world over use every day, yet somehow still costs around $200K a year for most Americans. Pelosi instead adopted the Joe f*cking Barton Amendment, which - as it's currently written - does everything legislatively possible to allow big Pharma to screw Americans for years to come.

I'm hoping hoping hoping some of these things get cleaned up in the Amendments process.

'Cause here's the thing, government can in fact be a force for good.  Rep. Waxman (D-CA) has been around a while. In the 80s he got a letter from one of his constituents - the mom of a kid who had Tourette's. She was beside herself because the drug that had done great things for her kid was about to be axed from production because there just wasn't a big enough market for it.

So Waxman authored, fought for, and passed the Orphan Drug Act in 1983. Thousands of rare diseases ("orphan" diseases = too small to attract big research $$) - everything from Tourette's to sickle cell anemia to several childhood cancers now have medications (and few of those childhood cancers even have cures) because of that legislation. It provided longer periods of patent protection and strong tax incentives for long-odds, specialized research. And research in those areas bloomed. Spectacularly.

Just one shining example - AZT was pulled out of mothballs and further studied as a possible rare cancer treatment under the auspices of an Orphan Grant. The research took a left turn and didn't pan out for cancer, but became the #1 treatment for AIDS the world over. Spectacularly.

And the frustrating part is, the patent extensions big Pharma lobbies so vehemently for today (which the Barton amendment gives away) are born of the precedent the Orphan Drug Act set - it set up the Herceptin fight we have today.  

So. No question - a lot of this legislative work is sloppy and imperfect and so very 1 step forward, 2 steps back, and yet Waxman's still in there fighting.  He's still writing amendments, he's still working. The Orphan Drug Act has been worth BILLIONS of dollars to big pharma. He's saying fair is fair and you deserve to profit from your work, but - a the very least - why are Americans singled out to be screwed worse than the citizens of every other country on the planet? Why don't we get to negotiate like everybody else?

A valid question. I don't understand what Pelosi's doing. I hope more people notice. I hope she's flamed for it and eventually backs down. We'll see. And I say "We'll see" because it could happen. Government can, in fact, be a force for good.

If the free market ruled all - set aside the 200K people in this country that suffer from rare diseases that now have treatments - many many millions of people with AIDS would have died decades ago. It's a big freakin' deal.

Know hope.

[el_chode]

Camille:

Based on your statement of the Orphan Drug act, is that a problem of patent legislation? I'm doing a lot of reading on the strangulation of creativity by big copyright, so I was wondering if big pharma is pulling similar strings in the patent world.

I remember being appalled a year or so ago when a company received a patent on a gene. You know, those things that occur naturally within all of us. In a strange, technical way, you don't own it.

[camille]

Camille:

Based on your statement of the Orphan Drug act, is that a problem of patent legislation? I'm doing a lot of reading on the strangulation of creativity by big copyright, so I was wondering if big pharma is pulling similar strings in the patent world.

I remember being appalled a year or so ago when a company received a patent on a gene. You know, those things that occur naturally within all of us. In a strange, technical way, you don't own it.

It is a problem with patent legislation, but much like the whole "patenting of a gene" thing, it's crazy complicated. It's always been a trade off.

Patent law says that the government will secure a little monopoly for you for 20 years in exchange for you revealing all of your work secrets. And the government will then unleash your secrets into the public domain after you've had a chance to profit. All the way back to the Founding Fathers they were worried that we should get scientific findings out into the public as soon as possible to encourage further work - patent protection was the compromise they struck.

And by the way - there's no law saying you have to patent anything. You could go "Bush's Baked Beans" style and just guard your work like a trade secret and hope no one else comes up with the same formula. There's no law saying you have to hand over your secrets, it's just saying if you want legal exclusivity, you can have it and make a lot of money off of it, and in exchange for that you have to share your work with everyone else, hopefully spurring further innovation.

When it all started it was pretty clear-cut. But then in the 30s the courts ruled that you could patent custom breeds of plants, and then in the 80s a scientist from GE created a new bacteria that could eat petroleum - ostensibly you could dump a ton of that bacteria in San Francisco Bay and the little guys would help clean up what the Exxon Valdez left behind. It was a 5-4 decision to award the patent and the dissenting opinion said "we are under the impression that life isn't patentable." But they were in the minority, and now life is in fact, patentable. It just can't be patented in its natural state - that bacteria didn't exist before that guy hybridized it.  That's the argument with patenting a gene - they say it's been extracted, purified, and re-engineered in a Petri dish (which no one was able to do before they did it) - thus making it novel and medically useful and not found - as it exists in that Petri dish - in nature. Who the hell knows anymore.

Anyways. The thing with the current big pharma strong-arming that's rooted in the Orphan Drug Act is that Congress bent over backwards to spur research that wasn't getting done and to spur production of drugs that were leaving the market because there was no profit motive in it. Now the drug companies are saying all drugs should enjoy those same "bend over backwards" tax-incentives and extended patent periods because all research is risky and you all should be thankful we do this at all. Waxman is saying - all the way back to the Constitution - patents exist to spur innovation. All you guys  (big pharma) are doing now is putting the vast majority of your money into tv ads "ask your doctor..." and lawyers who fight for years to stave off losing patent protection( of say, Lipitor.) Rather than spurring further innovation, you're hunkering down to hang on to what you have - a sure payday  - for as long as you can possibly ride it.  He's saying you clearly don't want patent protection to have more money for research, you want patent protection so you never have to do research again.

Incidentally, Pfizer spent twice as much on advertising as they did on research last year.

But the every day pocketbook problem for US citizens is the fact that patent protection periods differ from country to country, so Pfizer struck a deal with generic drug makers in Australia, Canada, Belgium, Germany, Italy, Sweden and said - sure, we'll allow you produce generic Lipitor soon in those countries, no problem, and in return for our not holding that up, you agree not to produce any generics for the US for a very long time. If you come anywhere near the US, we will essentially bankrupt you by tying you up in court for years. And, seeing as how the US is the only country on the planet whose government says its not allowed to negotiate drug prices, that leaves Americans paying huge $$$$$ for meds that the rest of the world pays pennies for.

Such is life. Anyways, Waxman's trying to push back. Pelosi, as usual, is doing a less stellar job. We'll see...

[el_chode]

That sounds like it is mirroring the copyright fights, where they take their royalties and put them into trusts that pay for lobbyists and lawyers to extend the term of the copyright to put more money into trusts and lawyers, etc.

Anyway, to your, or my previous point about the gene patenting, this was in Wired yesterday

http://www.wired.com/threatlevel/2009/11/genes/

[Nikkogino]

Whatever, I don't need fucking healthcare.  My immune system is impenetrable and my bones are made of steel.  Sucks for the rest of you...