Legal But Immoral Medicare Ripoff?

According to a CNN report, By Wayne Drash, Sergio Hernandez and Aaron Kessler, CNN, published June 29, 2018, entitled,

"Medicare spent $2 billion for one drug as the manufacturer paid doctors millions"

 Ref. https://www.cnn.com/2018/06/29/health/acthar-mallinckrodt-medicare-claims-doctor-payments/index.html

Quotes shown below are from the above referenced article.

While the vast majority of doctors consider the needs of their patients first, and, in general, try to use generic drugs when writing their prescriptions, there are a significant number, who, apparently, consider their financial needs first.  I can attest to that because myself I have experienced where proprietary drugs were ordered, when compatible generic drugs were available, which were ultimately successfully used, upon my insistence.

"(CNN)More than 80% of doctors who filed Medicare claims in 2016 for H.P. Acthar Gel -- a drug best known for treating a rare infant seizure disorder -- received money or other perks from the drugmakers, according to a CNN analysis of publicly identified prescribers."

CNN shows the following quotes:

"The evidence that this drug is any better than synthetic steroids is either weak or does not exist. Daniel Hartung, Oregon State College of Pharmacy"

"We clearly found that as you ratchet up the payments to doctors, there were more prescriptions generated and more spending in the Medicare program on this drug," said Daniel Hartung, the study's lead author."

"Acthar is best known for treating babies with infantile spasms, a rare and catastrophic form of epilepsy. Hartung, an associate professor at Oregon State's College of Pharmacy, said he found it troubling the drug is being marketed in adult medicine, with taxpayers footing the bill for hundreds of millions of dollars." 

It appears, an infant drug is now prescribed for seniors, for a variety of reasons, at a staggering cost to Medicare.

"A steroid like prednisone can cost as little as $2.50 for a bottle of pills -- less than a venti coffee from Starbucks -- compared to Acthar at nearly $39,000 a vial of injectable liquid. Over a course of treatment, those figures get even more dramatic: $7.50 for three bottles of prednisone vs. $117,000 for three vials of Acthar."

Year	Claim Count	Total Spending
2011	1,471	$49,456,911
2012	3,387	$141,451,608
2013	6,752	$262,581,602
2014	9,611	$391,189,653
2015	11,209	$503,999,371
2016	12,867	$636,174,840
Total:	45,297	$1,984,853,985

The meteoric rise in claims is surely the result of massive payoffs to the doctors involved.  The CNN article, shows some amounts spent on doctors, and even names a few of them.

"Since Mallinckrodt purchased the drug from Questcor in 2014, the price of Acthar has gone from $32,000 a vial to nearly $39,000. In 2000, before Questcor purchased it, it was $40. Questcor shocked the medical community when, on August 27, 2007, it raised the price overnight from $1,600 to $23,000 a vial."

CNN shows this quote:

  

"Medicare having to spend almost $2 billion on a drug that is of questionable benefit is very disturbing.  Rita Redberg, cardiologist and professor at the University of California, San Francisco, School of Medicin" 

"Multiple doctors familiar with Acthar told CNN that the drug shows little benefit in adults over steroid treatments, which they said could range anywhere from $2.50 for prednisone to $5,000 for a high IV dose of methylprednisolone. Even at the high end, these doctors said, prescribing steroids over Acthar could have saved Medicare nearly $1.8 billion."

"Why would Medicare pay nearly $2 billion over five years when there was a far cheaper alternative?

Stephen Schondelmeyer says you can thank lawmakers for that: Medicare is not allowed to negotiate drug prices or tell doctors what drugs to prescribe.

"Our Congress has told the Medicare program, you cannot control drug prices," says Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota. He directs the College of Pharmacy's PRIME Institute, which studies economic and policy issues related to pharmaceuticals. "We don't have any government process for evaluating, regulating and managing drug prices." 

 

It is this pervasive behavior, bordering on fraud, by the Pharmaceutical industry, and by some doctors that add to the high cost of medicine in the US, when compared to other industrialized countries.

 

This $1.8 Billion fraud connected to this one drug, is surely just the tip of the iceberg.

 

For more details, I suggest one reads the article/report, referenced above.

 

Past and Present Wrongs Do Not Make a Right

The recent separation of families produced many self-righteous protests; over and over we hear the critiques shout, this is not what we are as a nation.  If we really want to know what we are as a nation, when it comes to separating families, then we owe it to ourselves to read the article by By Harmeet Kaur, CNN, published June 24, 2018.

https://www.cnn.com/2018/06/24/us/us-long-history-of-separating-families-trnd/index.html

Even history of not too long ago shows that children were taken from their families under other Presidents as well, in that regard President Trump is not unique.  Many of the little wars we partake, openly or covertly, around the world result also in family separations.  These latest family separations are as gruel as the rules of law facilitating them.  But, please let us not say, this is not what we are as a nation.

Fake News/Image At Its Best

The following was published, in part, by the BBC today.

"A little girl who became the public face of US migrant family separations was not taken away from her mother at the US border, says her father."
For the full story follow this link: https://www.bbc.com/news/world-us-canada-44578339

"A photograph of the Honduran toddler sobbing in a pink jacket was taken at the scene of a border detention."

"Time magazine has used the image for its latest cover, depicting President Donald Trump looming over the girl with the caption: "Welcome to America"".

"The image was taken by a photographer for the news agency Getty Images, John Moore, on 12 June at McAllen, Texas.
The Pulitzer prize-winner told the BBC that the mother had been breastfeeding her child after crossing the Rio Grande in a raft in the moments before they were detained."
"Mr Moore said they were taken away together by border patrol."
 

"Mr Valera said his daughter and her mother, Sandra Sanchez, have been detained together in the border town of McAllen as Ms Sanchez seeks asylum.
Honduran Deputy Foreign Minister Nelly Jerez verified Mr Valera's version of events to Reuters.
The Border Patrol agent who stopped Ms Sanchez and her daughter, Carlos Ruiz, said the mother was asked to set the child down so she could be searched.
"The kid immediately started crying as she set her down. I personally went up to the mother and asked her, 'Are you doing OK? Is the kid OK?'
"And she said, 'Yes. She's tired and thirsty. It's 11 o'clock at night.'"
The little girl is two-year-old Yanela Denise, according to the Daily Mail newspaper.
Mr Valera said Ms Sanchez and their daughter had left the Honduran city of Puerto Cortes without telling him or the couple's three other children."


 

Fabricating wrong impressions is the new media standard; I would expect this from Tabloids, but not from, so called, respected media outlets.  They should have selected an image that had an ounce of truth.

Apparently, lawmakers put gruel laws into the books in order to satisfy a current need, hoping it would not be enforced; when such laws are enforced these very same scoundrels cry out in protest, again satisfying another present need.

Small And Insecure Bullied Children Take Their Own Life - Older Bullied Children Take the Life Of Others

The BBC reported 6/20/2018 with photos included, on the unfortunate story about Mallory, a New Jersey girl.  For the sad details follow this link: https://www.bbc.com/news/world-us-canada-44552864.  As I stated in previous posts, as long as bullying is going on, suicides and mass-shooting will be here to stay.  Parents must seriously become involved in the prevention of these tragedies, to-date it appears they are not.  If anything, by providing these cell-phones and tablets to their children, they are actually facilitating the abuse of other children, by their own flesh and blood, unless they step in and put a stop to this.

Parents must regularly inspect these electronic devices of their children for tale tale signs of bullying, or messages showing them to be the Bully.  When your child is on the receiving end, report it to the school by all means, but don't stop there, file a police report, it can save the life of your child.  Equally, counsel your child, and boost their self-esteem in a big way, every chance you have!

Talk to your friends with children about this major problem, become involved, don't be a spectator, become an activist.

 Mallory

 I tried to make contact, by emails, with the leaders of the Parkland School Survivors, but was entirely ignored.  Apparently, while they are ready to lay blame on anybody-else, they themselves view themselves entirely blameless, and therein lies the problem.  In their defense, as long as their parents ignore the real problem, and thus fail to counsel their children, they will remain what they are, self-righteous spoiled brats, harassing others, just for the fun of it, even if it means driving them to suicide. 

BBC reported, "Speaking at a news conference on Tuesday, the Grossmans' attorney, Bruce Nagel, said complaints to the school had been "terribly ignored" and called smart phones "a lethal weapon in the hands of the wrong child."

I fully agree with the above quotation, these electronic devices can be as deadly as firearms, and worse; guns don't psychologically torture their victim to death.

How Much Worse Can It Get?

Dr. John D. sent me the following report, as part of his regular news digests, etc.

I must warn you the article, by Chris Hamilton, referenced in the link below is very disturbing, at least it should be.  Thankfully it includes a number of charts (pictures), which, as the saying goes, are more worth than a thousand words.  For myself, I was never in doubt that our economy is in serious trouble, I just did not know by how much.

Just follow this link for the full story and more charts.
https://econimica.blogspot.com/2018/06/americas-greatest-crisis-upon-usdebt-to.html

https://econimica.blogspot.com/2018/06/americas-greatest-crisis-upon-usdebt-to.html

The Forgotten Gentile Victims Of the Holocaust

The article, by Karen Silverstrim, MA Candidate, referenced below, makes some very important points regarding the Holocaust.  Indeed when anybody makes reference to the Holocaust, the masses immediately equate that to the Jewish dilemma during the Nazi period, and WW II.  Many more Gentiles were the victim of the Holocaust than were Jewish people.  This is why a careful reading and understanding of the referenced article is so important; all of the victims must be honored, and not be forgotten, just because the noise level of one people is drowning out the voices of the over 16 million forgotten Gentiles lost in the Holocaust.

Ref.  http://www.ukemonde.com/holocaust/victims.html
By Karen Silverstrim, MA candidate
University of Central Arkansas