Category: Public Health

God Bless the 2nd Amendment

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This year toddlers have shot at least 23 people:

This past week, a Milwaukee toddler fatally shot his mother after finding a handgun in the back seat of the car they were riding in. The case drew a lot of national attention given the unusual circumstances: Little kids rarely kill people, intentionally or not.

………

 Last year, a Washington Post analysis found that toddlers were finding guns and shooting people at a rate of about one a week. This year, that pace has accelerated. There have been at least 23 toddler-involved shootings since Jan. 1, compared with 18 over the same period last year.

 In the vast majority of cases, the children accidentally shoot themselves. That’s happened 18 times this year, and in nine of those cases the children died of their wounds.

America, F%$# Yeah!!

Obamacare in a Nutshell

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Marcy Wheeler sees the elephant in the room about Obamacare, and by elephant in the room, I mean Republican thinking:

Partly, though, Obamacare is designed to underinsure people, because there’s a belief that unless people feel the sting of obtaining care, they’ll get too much of it. “Bending the cost curve” under Obamacare is largely driven by increasing the costs of actually using insurance to the end user as opposed to, say, eliminating the many layers of private profit that doesn’t actually improve health care but makes it expensive.

This is the problem at the core of Obamacare, and it is why allowing a Medicare buy in or a public option would have been so helpful.

It would have created an alternative to the contemptible greedheads who Obama shovels money at, and an infrastructure to move onto real publicly funded healthcare.

It Would Be Nice if Enlightenment Did Not Require that their Children Spend Weeks Fighting to Breath

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It should not take you child being in agony for you to realize that vaccinations are a good thing:

A brave mother has spoken out about refusing the whooping cough vaccine during her pregnancy and the devastating impact it’s had on her life.

The first time mother later went on to catch the potentially deadly disease and eventually gave it to her newborn baby girl, Eva.

“Within two weeks the cough became pretty scary, horror movie, coughing to the point of going blue, flopping in my hands, can’t breathe, not breathing for three minutes,” the clearly distraught mother explains in the clip.

The emotional mea culpa has since gone viral with more than 90,000 views since it was posted earlier in the day.

“They go red and from red they go blue, sometimes they go a bit black,” the mother laments in the footage speaking about her daughters daily struggles with the illness.

“For a moment there you think they are dead in your hands.”

The stunning admission was posted onto the Gold Coast Health Facebook page issuing a warning to others against making the same mistake she did.

“I’ve been a very healthy pregnant woman, no problems, no complications, worked out, went to gym, ate very healthy, had a natural birth and somehow in the last two weeks of my pregnancy I managed to get whooping cough, I didn’t know,” she said.

The mother admits that after the birth of Eva she went to the doctor about a persistent cough and found out she had whooping cough.

“Unfortunately we have been in hospital for the last three weeks, um, yeah, Eva was diagnosed with whooping cough and yeah, it’s been a nightmare”.

Please, vaccinate your kids, and vaccinate yourselves.

H/t  CT at the Stellar Parthenon BBS.

Lawmakers in West Virginia Pass a Bill Legalizing Raw Milk, and Toast their Success With Raw Milk………

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Then they proceed to make the state house resemble the sets in The Wild Bunch if the film had been directed by John Waters instead of Sam Peckinpah:*

In West Virginia, farmers and fans of raw milk celebrated this week as the governor signed a bill that, among other things, legalizes the sale of raw milk to consumers. Some delegates celebrated by drinking cups of raw milk from a local farm, or at least tasting it. Some of them are now sick with a mysterious gastrointestinal illness. Is it a coincidence or deep irony?

 ………

 Cadle himself was out with a stomach bug on Monday, but he and others point out that a similar illness had been circulating around the state capitol building for weeks. “It ain’t because of the raw milk,” he told the Charleston Gazette-Mail. “With that many people around and that close quarters and in that air and environment, I just call it a big germ.” The illness includes diarrhea, vomiting, and a fever, and sounds like our old fast-spreading pal norovirus.

………

 Health officials are investigating the milk incident.

This is just too perfect.

*Not my bon mot. I adopted this from Paul T. Riddell essay, The Attack of the Mad Sh%$ter.

Depraved Heart Murder

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The Governor of Michigan can now be shown to have studiously ignored the outbreak of Legionnaires Disease in Flint, Michigan:

It was the Fourth of July, a warm summer night in 2014, but Tim Monahan was shivering in a thick blanket as he watched fireworks from his front yard here. By the next afternoon his temperature had shot to 104.6, and doctors at the hospital he had checked into puzzled over what was wrong.

Two days later, they had an answer: Legionnaires’ disease, a virulent form of pneumonia caused by a type of bacteria that can multiply in water systems. Mr. Monahan, now 58, was given antibiotics and eventually recovered, but his case turned out to be at the leading edge of a Legionnaires’ outbreak that sickened at least 87 people in the Flint region, killing nine of them, from June 2014 through October 2015.

State officials still say they cannot conclusively link the outbreak to Flint’s contaminated water supply, partly because sputum cultures were not collected from patients. But the possibility of a link was raised in internal government emails as early as October 2014, and state officials did not inform the public of the outbreak until last month.

The Legionnaires’ cases started popping up as Flint residents were complaining about the foul-smelling, discolored water flowing into their homes after the city switched to a new water source, the Flint River, in April 2014. Soon they were reporting rashes and stomach ailments, and whistle-blowers eventually pointed to alarming levels of lead in the water supply and in children’s blood.

An examination of government emails, and interviews with people who survived Legionnaires’ and relatives of those who died, shows the government response to the Legionnaires’ outbreak followed the same pattern that prevailed throughout the Flint water crisis: a failure to act swiftly to address a dangerous problem or warn the public.

Even as more residents became critically ill with Legionnaires’ disease, and some died, the officials remained mired in jurisdictional battles, according to emails released by the Michigan Department of Health and Human Services and the health department in Genesee County, which includes Flint. Some at the state level seemed more concerned about following bureaucratic protocol, and not raising public alarm, than protecting residents.

People were dying, and they knew it, and they deliberately did nothing.
It’s depraved heart murder.

I Can Haz Prosecushuns?

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Michigan Governor Rick Snyder has released more of his emails, and it is pretty clear that he knew that he was poisoning the people of Flint, and he did not care:

Gov. Syder released 1.02 GB of emails in pdf form from various departments in his administration. However, none of them are pre-2014, a time period when many of the decisions regarding Flint’s move to the Flint River as its temporary source of drinking water were being made. Still, there is a LOT of new information in these emails and much of today’s news round-up comes from analysis of them by various news outlets. If you have a burning desire to plow through the gigabyte and change of files, here are the links to all of them:

………

In late March 2013, a full year before Flint switched to the Flint River as the source for its drinking water under the order of its Emergency Manager and with sign-off by their boss State Treasurer Andy Dillon, DEQ officials warned them about the potential for problems. In an email sent on March 26th, Stephen Busch, a staffer in the drinking water division of the Michigan Department of Environmental Quality (DEQ) informed his superiors about problems they could anticipate making the switch. That email was then forwarded up the food chain to Treasurer Dillon. Here’s are some of the warning flags he raised:

………

Mike Glasgow, Flint’s laboratory and water quality supervisor at the time of the switch to the Flint River made it very clear in an email to DEQ officials that the city’s water treatment plant was not going to be ready to treat river water in time for the conversion from water obtained from the Detroit Water and Sewerage (DWSD). However, his superiors were blowing him off:

………

On September 30th, Gov. Snyder finally acknowledged what nearly everyone else already knew: Flint had a problem with poisoned water and his administration had made mistakes, including not properly treating the water to prevent corrosion. However, it took until November 4th for his administration to finally authorize the installation of the corrosion control equipment:

………

Between Gov. Snyder’s admission and the approval of the corrosion control equipment, DEQ director Dan Wyant, a man with no background in water treatment or water regulations, assured the public that corrosion control had been in place the whole time. By the time he got around to approving the equipment, Flint had already switched back to DWSD water (that is already treated with phosphate for corrosion control.)

All of this happened, by the way, months after the EPA had been pushing them to begin phosphate treatment back in August:

The original docs are at the link along with some damning quote.

I want to see some prosecutions for depraved heart murder.

They knew that they were putting people’s lives at risk, and they did not care.

The Snake Had Chronic Traumatic Encephalopathy

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Another victim of repeated head trauma in the NFL, only this time it is a quarterback, Ken Stabler of the Oakland Raiders:

Former Oakland Raiders quarterback Ken Stabler, who died in July at the age of 69 of colon cancer, was found to have suffered from chronic traumatic encephalopathy, the degenerative brain disease found in people who have had repeated blows to the head, according to a researchers at Boston University.

Stabler’s diagnosis is the latest in a line of former NFL players who have been found to have the disease. Scientists in Boston said that on a scale of one to four, Stabler had high stage three CTE.

“He had moderately severe disease,” Ann McKee, the chief of neuropathology at the VA Boston healthcare system and a professor of neurology and pathology at Boston University school of medicine, told the New York Times.

………

After his death, Stabler’s brain was removed and donated to researchers at the NFL’s “brain bank” at Boston University, who spent months dissecting it for clues as to why the quarterback’s mind declined in his final years. During the last few years of his life, Stabler rapidly slowed down in his cognitive functions. He began complaining of a high-pitched ringing in his head, couldn’t handle bright lights or loud noises, and began repeating himself.

McKee, who conducted the examination, called Stabler’s case “pretty classic”.

“It may be surprising since he was a quarterback, but certainly the lesions were widespread, and they were quite severe, affecting many regions of the brain,” McKee, who conducted the examination, said. “There was no question about the diagnosis.”

If this happens to a quarter back, it happens to everyone on the field.

Mothers, do not let your kids play football.

If So, I Approve this Camel’s Nose………

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Matt Bruenig has a very interesting perspective on Bernie Sanders’ single payer program, specifically, he believes that it provide the fiscal basis for a massive expansion of social welfare programs:

Currently, total health expenditures in the US make up around 17% of GDP. The average for the OECD is 9.3%. Around half of our healthcare spending is public while the other half is private. Thus, very roughly speaking, to shift all of the current healthcare expenditures onto the public health insurance, you’d need initially to raise the tax level by 8.5 points of GDP (half of 17%).

 If you believe, as I do, that switching to a single-payer healthcare system would allow us to better curb healthcare inflation and thus to control costs much more effectively than we currently do, then that means that the 17% of GDP we currently pay towards healthcare could be pushed down over time. Let’s assume that, by keeping healthcare inflation in check through single-payer, we could eventually bring health expenditures down to around 10% of GDP (slightly above the OECD average).

 Under this scenario, we would initially raise the tax level by 8.5 points in order to cover the half of health expenditures that are currently paid out privately. Then, over time, we would cut healthcare expenditures by 7 points (from 17% to 10% of GDP). Assuming we didn’t lower the tax level over the expenditure-slimming period, we would be able to use those 7 points of savings towards other welfare programs (child care, child allowance, paid leave, etc.). And there is a lot of stuff you can get with 7 points of GDP.

He’s an optimist.

My guess is that these savings, will go to bombs and bullets, because  ……… America!!!!

We have still not accepted the wisdom of Eisenhower’s Chance for Peace speech, while we bankrupt ourselves through military procurement and military adventurism.

Can We Give Florida Back to Spain?

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In response to donations from sub-par hospitals to the state Republican Party, Florida has abandoned surgical standards for hospitals:

Children’s heart doctors in Florida are reeling from a recent decision by the state to drop surgical standards for pediatric open heart surgery, CNN reports. To add insult to injury, doctors and medical experts suspect that the decision was purely political.

The decision follows a 2014 medical review and a June 2015 report by CNN, which found that one particular medical facility, St. Mary’s Medical Center and Palm Beach Children’s Hospital, had an abysmal track record for pediatric open-heart surgery—a death rate more than three times the national average. And the two reports found that the facility was failing to meet the now-repealed standards, which include proficiency in performing the surgeries themselves.

The St. Mary’s facility is run by Tenet Healthcare, which coincidentally donated $200,000 to the state’s republicans between 2013 and 2014, including $100,000 to Republican Governor Rick Scott’s political action committee. Those donations were the highest of any Tenet gave to political groups in other states.

A month after CNN’s report, the state announced that it would repeal the standards for children’s heart surgery. Florida’s health department explained the move by saying that the standards were never properly approved by the legislature, but it failed to explain to reporters why legislative approval was not sought upon realizing the lapse.

It appears that Florida is in a competition with Texas for most repulsively corrupt politics in the United States.

Not a Good Sign

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One of the features of Obamacare is the not for profit co-ops that are supposed to find an alternative to for profit insurers.

Many of them have failed, and now what is arguably the most successful co-op, Maine’s Community Health Options, has shut down individual enrollment:

Community Health Options, a not-for-profit co-op insurance company based in Maine that also sells health plans in New Hampshire, will limit individual enrollments later this month because of “higher-than-expected claims costs.”

It’s an inauspicious sign for the company, which was one of the few successful co-ops created by the Affordable Care Act. Twelve of the ACA’s 23 co-ops have folded or are in the process of closing down, all of which occurred this year.

Community Health Options is one of three insurers selling individual plans in Maine and one of five insurers in New Hampshire. Both states use the federal HealthCare.gov website for enrollment. The co-op will stop directly enrolling people in individual coverage on Dec. 15, and people who are signing up for its plans through HealthCare.gov will only have until Dec. 26, the co-op said on its website Wednesday.

The decision to halt enrollment early will not affect current members, and Community Health Options still plans on pursuing small employers into next year. “We aim to resume individual enrollment as soon as possible, but in the meantime continue to focus on group business,” CEO Kevin Lewis said in an e-mail Wednesday.

Community Health Options, which has 76,000 members, was one of the only ACA co-ops that didn’t lose money out of the gate. Several of the failed co-ops—written into the ACA as an alternative to the so-called public option—lost millions of dollars due to costly claims. Many older and sicker members chose the co-ops during the first two open enrollments due to their low premiums, but they also used a lot of healthcare services, which crushed the co-ops and their limited financial reserves.

The co-ops were supposed to be two things, a weak tea alternative to a public option, and to provide some cost competition with the for profit insurers who dominate their respective markets.

They are failing, and the largest insurer in the US,  UnitedHealth is threatening to leave the exchanges completely.

We are not yet in an adverse selection death spiral, but this is troubling.

Schadenfreude Alert

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The Kaiser Family Foundation has just released a study on public health costs, and they found that both state spending has mushroomed in states that have refused to adopt Medicaid expansion:

Beginning in FY 2014, policy changes introduced by the Affordable Care Act (ACA) have been driving Medicaid enrollment and spending growth. This report provides an overview of Medicaid enrollment and spending growth with a focus on state Fiscal Year (FY) 2015 and state Fiscal Year 2016. Findings are based on interviews and data provided by state Medicaid directors as part of the 15th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) and Health Management Associates (HMA). Information collected in the survey on policy actions taken during FY 2015 and FY 2016 can be found in the companion report. Key findings related to Medicaid enrollment and spending growth are described below.

Medicaid enrollment and spending increased substantially in FY 2015, the first full year of implementation of the major ACA coverage expansions. Across all 50 states and DC, Medicaid enrollment increased on average by 13.8 percent in FY 2015, largely due to the ACA coverage expansions. Driven by growth in enrollment, total Medicaid spending increased by 13.9 percent on average in FY 2015. (ES – 1)  Beyond enrollment, states reported that the other drivers of increases in spending were provider rate increases and the higher cost of health care, including prescription drugs. Improvements in the economy were a downward pressure on enrollment which affected spending, but downward pressure in enrollment and spending as a result of the improving economy were outweighed by the ACA coverage policy changes.

………

In FY 2015, Medicaid enrollment and total Medicaid spending growth in expansion states far exceeded growth in non-expansion states. Expansion states reported Medicaid enrollment and total spending growth nearly three times the rate of non-expansion states. (Figure 2) A total of 29 states were implementing the ACA Medicaid expansion in FY 2015, up from 26 states in the previous year (FY 2015 additions include: New Hampshire, Pennsylvania and Indiana).

Across the 29 expansion states in FY 2015, enrollment increased on average by 18.0 percent and total spending increased by 17.7 percent; both enrollment and spending growth were driven by increases in enrollment among adults qualifying under the new expansion group. Of the 29 states expanding Medicaid in FY 2015, more than half (17 states) noted that enrollment initially increased faster than expected. Over two-thirds of expansion states reported that per member per month costs for the expansion population were at or below projections.1 Across the 22 states not implementing the Medicaid expansion in FY 2015,2 enrollment and total spending growth was 5.1 percent and 6.1 percent (respectively), much slower growth compared to the expansion states. Increased enrollment among previously eligible parents and children was the primary reason cited for enrollment growth in non-expansion states. (ES – 2)

This could not happen to a more deserving bunch of narcissistic nihilists.

H/t Talking Points Memo.

He Has to Be the Most Evil Ratf%$# in Business Today

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Remember Martin Shkreli?

He’s the contemptible greedhead who raised the price of Daraprim by 5500% when he got the rights to it.

After a storm of public outrage, he agreed to roll back the price to an unspecified degree.

Guess which drug has not come down a penny in price:

It’s been two weeks since Turing CEO Martin Shkreli announced he would scale back the price of his drug, and so far nothing has really changed.

The biotech leader came under fire last month for his 5,000% price hike of Daraprim, a drug that fights parasitic infections.

The drug, which rose from $13.50 to $750 seemingly overnight, left the biotech and pharmaceutical industries reeling, with corporations such as Valeant facing a lot of criticism for their similar price-hike moves.

In September, he told ABC News, “We’ve agreed to lower the price of Daraprim to a point that is more affordable and is able to allow the company to make a profit, but a very small profit.”

That hasn’t happened yet. A 30-day, 30-pill supply of Daraprim would cost me $27,006 at my local pharmacy.

That boils down to about $900 a pill, which includes the wholesale cost, along with specific pharmacy fees based on the zip code I gave the pharmacy.

So while the price of the drug hasn’t gotten any higher since Shkreli hiked it 5,000%, it hasn’t gotten any lower since he promised to reduce it either. Turing did not respond to Business Insider’s request for clarification about this price.

(emphasis original)

This ain’t business, this is terrorism.

Perhaps the President should consider a drone strike.

Yeah, It Doesn’t Work in Education Either

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A study has shown that payments for quality of outcomes in hospitals do not actually improve those outcomes:

Medicare’s quality incentive program for hospitals, which provides bonuses and penalties based on performance, has not led to demonstrated improvements in its first three years, according to a federal report released Thursday.

The Government Accountability Office examined the Hospital Value-Based Purchasing Program, one of the federal health law’s initiatives to tie payment to quality of care. Earlier this year Medicare gave bonuses to 1,700 hospitals and reduced payments to 1,360 hospitals based on their mortality rates, patient reviews, degree of improvement and other measurements.

While the payments to a majority of the nation’s hospitals have been affected each year, the audit found the financial effect has been minimal. Most hospitals saw their Medicare payments increase or drop by less than half a percentage point. In the fiscal year that ended Sept. 30, 74 percent of hospitals fell within that range, with a median bonus of $39,000 and a median penalty of $56,000, according to the analysis.

………

The report said that even before the program began in October 2012, hospitals had been improving in how consistently they followed basic clinical guidelines, such as performing blood cultures before giving patients antibiotics. That improvement continued but did not increase with the advent of the financial incentives. The same was true for patient ratings, on such items as the quality of communication from doctors and nurses, and for mortality rates for heart attack patients. Heart failure and pneumonia death rates stayed roughly the same.

“Our analysis found no apparent shift in … quality measure trends during the initial years of the program, but such shifts could emerge over time as the program implements planned changes,” the GAO wrote.

This is unsurprising.

As these payments become more significant, I expect to see hospitals use the same tactics as the charter schools: Find a way to encourage hard cases to go elsewhere.

These sorts of pay for performance schemes tend to generate efforts to game the metrics, not to improve performance.

This is a Feature, Not a Bug

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The fact that the nominee for head of the FDA has extensive financial ties to the pharmaceutical industry should come as no surprise.

The revolving door has been spinning just as fast during the Obama administration as it ever has been:

It seems to be the season of the revolving door

in health care. The latest version got some media attention, because it involves one of the most important health care leadership positions in the US government, the Director of the Food and Drug Administration (FDA). However, the case actually seems much more serious than what the media has recently reported.

………

The only fly in the ointment was the matter of Dr Califf’s ties to industry. The WSJ article included,

Diana Zuckerman, president of the National Center for Health Research, a Washington-based group focusing on medical-product safety, questioned his ties to the drug industry.

‘Dr. Califf’s expertise and his close ties to the pharmaceutical industry are both well-known,’ she said. ‘His ties to industry have been a source of great concern to public-health experts when he was previously considered for FDA commissioner, and those ties raise important questions about this nomination.’


The MedPage Today article noted that Public Citizen’s Health Research Group stated,

‘During his tenure at Duke University, Califf racked up a long history of extensive financial ties to multiple drug and device companies, including Amgen, Astra-Zeneca, Eli Lilly, Johnson & Johnson, Merck Sharpe & Dohme and Sanofi-Aventis, to name a few,’ Michael Carome, MD, the group’s director, said in a statement. ‘Strikingly, no FDA commissioner has had such close financial relationships with industries regulated by the agency prior to being appointed.’

………

‘There are some who believe his relationship with [the drug industry] may be a problem, but most see it as a value-added factor in building a functional, more streamlined relationship with the industry in order to improve the speed with which truly effective and quality drugs and devices are made available, mitigate the excessive costs associated with pharmaceuticals, and influence policies and practices intended to improve health status.’

If that doesn’t scare the hell out of you, it should.

What that nameless source just said is that this is the sort of guy who could make the approval of a drug like Thalidomide go through more smoothly.

What Happens When This Doesn’t Generate a Media Sh%$ Storm?

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Martin Shkreli, the hedge fund pharma executive who generated outrage when he bought a drug for rare diseases and boosted its price by over 5555%, has backed down after he got called out by the New York Times:

“Yes it is absolutely a reaction — there were mistakes made with respect to helping people understand why we took this action, I think that it makes sense to lower the price in response to the anger that was felt by people,” Shkreli, 32, said.

Turing Pharmaceuticals of New York bought the drug from Impax Laboratories in August for $55 million and raised the price. Shkreli said Tuesday the price would be lowered to allow the company to break even or make a smaller profit.

Daraprim fights toxoplasmosis. The infection is particularly dangerous for people who have weakened immune systems, like AIDS patients, as well as for pregnant women, according to the Centers for Disease Control and Prevention.

………

Democratic presidential candidate Hillary Clinton was among those who expressed outrage over the price increase. On Tuesday she outlined a plan she said would limit how much patients have to pay out of pocket for medications each month.

As I noted last night, after Glaxo Smith Kline sold the drug market rights and before Shkreli bought the drug, the price was raised by 1350%, from $1.00 to $13.50 a pill, but since it wasn’t going from $13.50 to $750.00 a pill, nobody batted an eyelash.

Notwithstanding the protestations of contemptible greedheads like Martin Shkreli, generating unearned profits through financial engineering and exploitation of monopoly power benefits no one but contemptible greedheads like Martin Shkreli.

This Is a Clear Case of Immoral Parasitism, and It’s Pharma, so Not the Surprise

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You know the story, hedge fund puke buys a pharmaceutical firm, takes an out of patent drug that costs a few bucks, changes the distribution method to make analysis by potential competitors more difficult, and then raise the price by 5555%: (No, this is not a decimal place error)

Specialists in infectious disease are protesting a gigantic overnight increase in the price of a 62-year-old drug that is the standard of care for treating a life-threatening parasitic infection.

 The drug, called Daraprim, was acquired in August by Turing Pharmaceuticals, a start-up run by a former hedge fund manager. Turing immediately raised the price to $750 a tablet from $13.50, bringing the annual cost of treatment for some patients to hundreds of thousands of dollars.

 “What is it that they are doing differently that has led to this dramatic increase?” said Dr. Judith Aberg, the chief of the division of infectious diseases at the Icahn School of Medicine at Mount Sinai. She said the price increase could force hospitals to use “alternative therapies that may not have the same efficacy.”

 ………

 The Infectious Diseases Society of America and the HIV Medicine Association sent a joint letter to Turing earlier this month calling the price increase for Daraprim “unjustifiable for the medically vulnerable patient population” and “unsustainable for the health care system.” An organization representing the directors of state AIDS programs has also been looking into the price increase, according to doctors and patient advocates.

 Daraprim, known generically as pyrimethamine, is used mainly to treat toxoplasmosis, a parasite infection that can cause serious or even life-threatening problems for babies born to women who become infected during pregnancy, and also for people with compromised immune systems, like AIDS patients and certain cancer patients.

 ………

 This is not the first time the 32-year-old Mr. Shkreli, who has a reputation for both brilliance and brashness, has been the center of controversy. He started MSMB Capital, a hedge fund company, in his 20s and drew attention for urging the Food and Drug Administration not to approve certain drugs made by companies whose stock he was shorting.

 In 2011, Mr. Shkreli started Retrophin, which also acquired old neglected drugs and sharply raised their prices. Retrophin’s board fired Mr. Shkreli a year ago. Last month, it filed a complaint in Federal District Court in Manhattan, accusing him of using Retrophin as a personal piggy bank to pay back angry investors in his hedge fund.

 ………

 With the price now high, other companies could conceivably make generic copies, since patents have long expired. One factor that could discourage that option is that Daraprim’s distribution is now tightly controlled, making it harder for generic companies to get the samples they need for the required testing.

 The switch from drugstores to controlled distribution was made in June by Impax, not by Turing. Still, controlled distribution was a strategy Mr. Shkreli talked about at his previous company as a way to thwart generics.

 ………

 Dr. Aberg of Mount Sinai said some hospitals will now find Daraprim too expensive to keep in stock, possibly resulting in treatment delays. She said that Mount Sinai was continuing to use the drug, but each use now required a special review.

 “This seems to be all profit-driven for somebody,” Dr. Aberg said, “and I just think it’s a very dangerous process.”

You can read the details of his looting the last firm he ran here.

I would note that Mr Shkreli is not alone in this behavior: When Glaxo Smith Kline sold the marketing rights to the drug to CorePharma, the price of the drug was $1 a pill,

Is there anything that big finance can’t make destructive and evil?

A Very Good Point on Obamacare

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The folks at Naked Capitalism have never been big fans of the PPACA, because they feel that it has far too many sops to the evildoers in the US healthcare system, in particular the insurance companies. (I agree)

Now Lambert Strether makes what is an obvious point, that the “Cadillac Tax” on high value healthcare plans are pretty clearly a tactic developed to union bust:


I haven’t written about much about ObamaCare’s “Cadillac Tax” mostly because it seemed (as we shall see) such an obvious union-busting measure that there wouldn’t be much of interest to say. However, a recent Kaiser briefing on how many employers will be affected by it has generated a lot of coverage, and, as it turns out, the Cadillac tax — not that anybody could have predicted this — turns out to be insanely complex, based on a crazypants neo-liberal economic assumption, and will screw over a lot more working people than originally thought. (There’s actually some pressure on the Hill for reform or repeal, and not just by the usual suspects, but I won’t cover the politics of it here).

………

And if the unions can’t deliver wages, and now they can’t deliver benefits — or prevent existing benefits from being taken away — what exactly do they deliver? So who is to determine what is “generous”? Workers, or pencil-necked< neo-liberal economists? Who never mention whether CEO health insurance — or top 20% health insurance, for that matter — is “too generous”? That said, let’s turn to the crapification. From the Kaiser briefing:

The potential of facing an HCPT assessment as soon as 2018 is encouraging employers to assess their current health benefits and consider cost reductions to avoid triggering the tax. Some employers announced that they made changes in 2014 in anticipation of the HCPT, and more are likely to do so as the implementation date gets closer. By making modifications now, employers can phase-in changes to avoid a bigger disruption later on.

………

So, a race to the bottom that starts out affecting “overly generous” health insurance, and ends up affecting more and more of the rest of us. Typical. I doubt this can be fixed by Congress this year or next, since the Democrats will not be able to admit that Obama has ever made a mistake in any aspect of his sorry administration, and Republicans have no choice but to throw red meat to their base by trying to repeal it all together. Pass the popcorn.

This is not a bug.  It’s a feature.

If you were come up with a way to get the truth for any people behind Obamacare, whether Obama, Gruber, or whoever, they all would say that they want to eliminate employer sponsored health insurance by making various claims about how having open insurance markets and “skin in the game” will make healthcare more efficient.  (All the available evidence shows otherwise)

Obama has been (at best) lukewarm on unions, with no effort to push card-check, his hiring of union-busting heiress Penny Pritzker, his aggressive support of union-busting mayor Rahm Emanuel, his tepid opposition to “Right to Work” legislation proposals put forward in many states, etc.

There are way too many people among Obama’s “Chicago School” policy advisers who see an Ayn Rand inspired dystopia as a model for a good society.  (As an aside, it turned out that even Ayn Rand could not live in the world which she hoped to create.)

Our country is looking more and more like the USSR circa 1987.

This Guy Deserves to be Horsewhipped

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It’s such a joy having Governor Ratf%$# running Maryland.

Case in point, Kenneth Holt, Governor Hogan’s secretary of Housing, Community and Development is claiming that black mothers are feeding their children lead to get free housing:

Gov. Larry Hogan’s top housing official said Friday that he wants to look at loosening state lead paint poisoning laws, saying they could motivate a mother to deliberately poison her child to obtain free housing.

 Kenneth C. Holt, secretary of Housing, Community and Development, told an audience at the Maryland Association of Counties summer convention here that a mother could just put a lead fishing weight in her child’s mouth, then take the child in for testing and a landlord would be liable for providing the child with housing until the age of 18.

 Pressed afterward, Holt said he had no evidence of this happening but said a developer had told him it was possible. “This is an anecdotal story that was described to me as something that could possibly happen,” Holt said.

 He offered no specific proposals, but said he hoped to limit the liability of landlords in lead paint cases. He said his department is working with the Maryland Department of the Environment to draft legislation for the 2016 General Assembly session.

 Health advocates reacted by saying they would fight any effort to weaken lead paint protections — and Holt’s suggestion that parents might poison their children to gain housing benefits provoked outrage.

 “To me it’s beneath contempt,” said Ellen Silbergeld, a professor of environmental health science at the Johns Hopkins Bloomberg School of Health.

Of course it’s beneath contempt.

Just when I think that Republicans cannot get any more evil, they outdo themselves.

This guy so needs to get fired ……… Out of a cannon, into the sun.

Anti-Vaxxers Can Go Cheney Themselves

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We just had the first measles death in the U.S. in a dozen years:

Well, anti-vaxxers Jenny McCarthy and Jim Carrey should really feel like sh%$ right now.

For 12 years, not a single American has died because of the measles virus. But because of the anti-vaxxer movement, death by measles is once again a stark reality in the United States.

On Thursday, the Washington State Department of Health confirmed that a woman succumbed to the disease after discovering the cause of death via an autopsy.

In a statement released by the agency, the woman apparently contracted the disease unknowingly while at a hospital during a measles outbreak in the spring. And she was even more vulnerable to the disease because the medication she had been taking weakened her immune system.

………

The woman who died caught a disease that should have remained wiped out within our shores and it would have remained that way had it not been for anti-vaccination nut jobs who refuse to vaccinate their kids out of some ridiculous notion that the MMR vaccine causes autism. This death was preventable and shows why it is time to require vaccinations by law and eliminate the exemptions that allowed the measles to have a comeback in the first place.

It gets even worse, because this woman had been vaccinated for the disease:

A woman who became the first person to die of the measles in the U.S. in 12 years had been vaccinated against the disease, it has been revealed.

Health officials said she had the injection as a child but succumbed because she had a compromised immune system.

Dr. Jeanette Stehr-Green, the Clallam County health officer, told KOMO-TV the woman had been vaccinated as a child, but because she had other health problems and was taking medications that interfered with her response to an infection ‘she was not protected.’

The anti-vaxxers are morally responsible for the death of this woman.

Their actions are unsupported by the facts, selfish, and evil, and I am pleased as punch that California has tightened up its vaccination criteria.