
I'm Jane, and I'm a breast cancer survivor
There was much celebration on Capitol Hill today with the announcement of the new House health care bill. For myself, as a three time breast cancer survivor, there was tremendous sadness and disappointment in the Speaker.
Nancy Pelosi made a choice with regard to the lifesaving biologic drugs I took when I was in chemotherapy that will cost many of my fellow breast cancer survivors everything they own, and quite possibly their lives.
Jeanne Sather is another breast cancer survivor. In 2007, she wrote on her blog The Assertive Patient:
I love Herceptin, a drug I have been getting to treat my metastatic breast cancer for more than five years now….The main reason I love Herceptin is that it is a targeted antibody, without the side effects of traditional cancer drugs: hair loss, fatigue, nausea, vomiting—you know the list.
The cost of Jeanne’s miracle “biologic” cancer drugs, Herceptin and Avastin, was $300,000 a year in 2006. By the time she switched to another biologic drug, Tykerb, she was within a few months of hitting her lifetime cap of $1 million:
Even with the help of a special state health insurance plan, the 53-year-old freelance writer is struggling to afford the expensive new drugs that are helping her in her battle.
“I’ve been borrowing against my house to make ends meet, and that can’t go on,” Sather says. “I’m so afraid these drugs will cost me my home.”
Jeanne fought. She and others went to the state capital and lobbied to have the cap raised. “Now I am safe for another few years,” she said.
But she is not alone. Biologic drugs also treat rheumatoid arthritis:
Access was the issue for Theresa Manville, 61, of Bay Village, Ohio, who simply could not afford the rheumatoid arthritis drugs she needed. She was laid off from her job as a senior account manager at a public relations firm in 1992, and though she started her own company, she could not get private insurance because her arthritis was considered a preexisting condition.
“Today,” Manville says, “I’m on Medicare disability because I didn’t have these drugs and my RA progressed. My joints deteriorated. My hands are deformed. I used to be a runner, a softball player and scuba diver. Now I need special orthotics in my shoes just to walk. And I’m going to need replacement surgery in my right knee.
“Think of the pressure on the health care system, just from me,” Manville says. “If I’d had the drugs 10 years ago, I could be independent today. I might not even be on disability.”
Medical student Laura Musselwhite tells the story of a patient who was hospitalized with Crohn’s disease:
This patient required hospitalization for a flare that she attributed to not being able to afford the month’s Humira, a biologic medicine used to treat severe, active Crohn’s disease.
The drug is priced by Abbott Laboratories at a staggering $22,000 a year. This patient would clearly have benefited from the availability of an affordable, generic version.
But thanks to Representatives Anna Eshoo and Joe Barton, there will be no generic versions of these drugs. At least not for 12 years, if the House health care bill announced today passes. And because of an “evergreening” clause that grants drug companies a continued monopoly if they make slight changes to the drug (like creating a once-a-day dose where the original product was three times per day), they will never become generics. Instead of the Waxman-Deal amendment that granted much more reasonable terms to biologic patent holders, Speaker Pelosi chose the Eshoo-Barton amendment. And we could all be paying for that choice for the rest of our lives.
Breast cancer boards are filled with women who have been turned down by their insurance companies for Herceptin because they only cover generic drugs, or because they only pay a portion of the $48,000 a year (or more) that the drug costs.
Cheryl, a Stage IV breast cancer survivor, writes:
As my socialized plan has decided to stop paying for my herceptin, I’m now looking at paying “out of pocket”. My insurance won’t cover herceptin. Let’s see, $142K a year. I don’t think my house is worth that much. I was curious about this thread because I suspected herceptin cost about that much but wasn’t sure.
I’m trying not to freak out about this too much. My children need a home and that appears to be my next option.
I think it’s time for me to start sitting on the corner with a tin cup.
Another survivor writes:
Well, I just got my insurance explanation of benefits, and they are treating it as a pharm…which means I have to pay $553. I can’t afford this drug. I’ll try appealing to the ins. co (which means calling between working hours, and I can’t afford any more time off to deal with this.)
I’m not happy.
My mom is 2+ in ICH and now 3.89 ratio in FISH. The onc said she’ll have 6-8 sessions of chemo and she could take the herceptin while doing chemo or after chemo. Not sure what does 3.89 means or how does it affect the cancer. Another thing that we’re worried of is the price of Herceptin. The price is too high and we’re not sure if we can afford it :(
This is deeply, deeply wrong. It’s immoral for Congress to give endless monopolies to pharmaceutical companies on these cutting edge drugs in this bill. If an AIDS vaccine is found, it too will be a biologic.
These drug manufacturers argue that the cost of developing biologics is so expensive that they need the extra patent time to recoup their investment, or they won’t have any incentive to develop them. Hogwash. A study done by Drs. Joe DiMasi and Hank Grabowski, who are funded by PhRMA, concluded that the cost for developing biologics is $1.3 billion, as opposed to $1.2 billion for conventional drugs.
And as for incentive for development? As bleicher of Blue Mass Group notes, granting endless monopolies for slight changes encourages companies NOT to innovate:
[T]]hey will have far less reason or incentive to invest in patentable new cures, and will have every reason to invest in low risk, incremental development of existing products to reap (without taking risk) the same profitable rewards. In the short term, some of our local companies may like this protection of their products, but over the long term, as we fail to incent investment in new discovery research, our biotechnology edge will decline and the rest of the world will pass us by as they invent the next generation of products.
There is nothing good about this legislation, unless you’re Roche, Eli Lilly, Schering-Plough or any of the other giant pharmaceutical companies reaping huge profits off these blockbuster drugs of the future. About a quarter of new drugs, and half of important new drugs are biologics. This is nothing short of an attempt to sew up the future at the expense of you and your children.
So POP is joining to together with students like Laura Musselwhite and others in the AMSA for a Halloween “treat, not trick” demonstration this Friday at four locations around the country. I’ll be there with medical students in Washington DC at the Russell Senate office building as they arrive fully costumed in their white coats and give out “treats,” urging Senators not to “trick” the nation’s patients with a bad ‘biologic’ medicines proposal.
Please join us:
DATE: FRIDAY, OCT. 30
Washington, DC: Russell Senate Office Bldg, Constitution & Delaware at 3:00 pm
Baltimore, MD: Barbara Mikulski’s office, 1629 Thames St. at 2:30 pm
Raleigh, NC: Senator Kay Hagan’s office, 310 New Bern Ave @ 1:30 pm
Palo Alto, CA: Anna Eshoo’s office, 698 Emerson St, Palo Alto at 2:00 pm
These students are fighting for us, fighting for our future. Please join me in supporting them, and their commitment to being healers who want to give their patients the very best care that they can. They don’t want their hands tied by this bill. I have been helping them organize and they are just so wonderful.
Even if you’re not in close to one of the events, you can help out by joining the POP Facebook Group, Tweeting about the events and donating to POP.
And please call your member of Congress and tell them that this is a terrible bill that will sentence breast cancer survivors and others to financial ruin and death. For the sake of everyone in need of health care in the future, please tell them to vote “no” on this cruel piece of legislation crafted to maximize drug company profits at the cost of human lives.




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I swear, congress is acting like a drunk frat boy who will do anything to screw us.
The Pyrrhic Option: you begged for nothing and you got it.
Stop being peasants and start demanding a specific solution to the country’s healthcare crisis…
Medicare For All / HR 676: Don’t accept any substitutes or legislative rebranding of the only real option for the American public
Jane, I’m not sure I understand you, are you just referring to the Eshoo Amendment or the whole thing? IOW, are you advocating that the CPC block passage entirely or do you think something worthwhile may yet be salvaged?
Medicare for all doesn’t do a damn thing for patent protection. Nor does it slice, dice, pickle or scramble inside the egg.
Come back and lecture us “peasants” when you’ve got a bit more information.
We have totally subverted the intent behind patent protection in this country. Patents are supposed to grant limited monopolies when doing so serves the public interest. Yet here we are granting effectively limitless monopolies that serve private interests in a way that harms the physical well-being of the public.
So even a landslide electoral victory and 75% public support for real healthcare reform cannot sway our elected officials to do anything but label on the gravy for the healthcare industry. If this is democracy, what is the point?
our ip laws are evil, have killed many and do not need to be made even worse. it’s an outrage and i will happily make calls on behalf of your efforts to have the laws changed. but i’m a little confused by your comment re hr 676 as it would, if enacted (*), cover the cost of prescription drugs.
* note: (which of course is why it’s important not to wait for comprehensive reform if lives can be saved now by blocking this bill)
How about not caring if we live or die ?
I’m on it. With a little luck, i’ll have statistics as they pertain to Philadelphia, and the makings of an article that will reach about 100,000 individuals in the metro area. (my paid work has to be pertinent to Philly, but this means i can call out fattah, brady, and schwartz by name)
jane, any state-by-state, city-by-city fact sheets you can send me about breast cancer rates?
I am sorry Jane and feel disappointed and sad too.
Jane,
if the Bill passes with this inhumane amendment in it, when do the patent extensions take place – 1/10 ?
jesus this is a truly ugly story – it appears both Ted Kennedy and Howard Dean have argued on behalf of the 12 year rule.
Eshoo deserves whatever heat comes her way on this – but she and Barton were joined by another 45 critters in their Yes votes – guess I have some googling to do.
I have a great deal in common with Theresa Manville. I’m 48 with RA, hands and feet are deformed, joint problems everywhere else, living on disability insurance, unable to afford the newer RA treatments my doctor and I would prefer because they would throw me into the Medicare Part D doughnut hole within a month.
When I read that the House bill will offer a 50 percent discount for name brand drugs to Medicare recipients in the doughnut hole I knew even half would be too much. My disability insurance is my sole source of income and my Medicare premium takes more than a tenth of that. Then I read that they intend to close the doughnut hole by 2019… thanks so much guys.
Jane,
Can you please explain how the ban on the “lifetime cap” I’ve heard about relates to this issue?
If my current insurance covers my Humira, won’t this bill prevent my insurer from cutting off my coverage at some point in the future on the grounds that I’ve exceeded some lifetime limit?
Thanks.
/jc
that was easy . . .
here be da ho’s
Edward J. Markey, MA Yeah
Rick Boucher, VA Yeah
Bart Gordon, TN Yeah
Bobby L. Rush, IL Yeah
Anna G. Eshoo, CA Yeah
Bart Stupak, MI Yeah
Eliot L. Engel, NY Yeah
Gene Green, TX Yeah
Diana DeGette, CO Yeah
Mike Doyle, PA Yeah
Jane Harman, CA Yeah
Charles A. Gonzalez, TX Yeah
Jay Inslee, WA Yeah
Tammy Baldwin, WI Yeah
Mike Ross, AR Yeah
Jim Matheson, UT Yeah
G.K. Butterfield, NC Yeah
Charlie Melancon, LA Yeah
John Barrow, GA Yeah
Baron P. Hill, IN Yeah
Doris O. Matsui, CA Yeah
Donna M. Christensen, VI Yeah
Christopher S. Murphy, CT Yeah
Zachary T. Space, OH Yeah
Jerry McNerney, CA Yeah
Bruce L. Braley, IA Yeah
link
I guess I’m a little confused by the idea that 676 is “free.” It’s my understanding that the costs are covered by a payroll tax, and if prescription drugs — a huge chunk of health care costs — never go into generic form, the payroll tax paid by individuals will have to pick up the cost of hugely inflated pharmaceutical prices. Which mean less subsidies available for low income people, etc. etc. Single payer isn’t the panacea that many acolytes seem to assume — it’s only as good as the amount of resources applied to it. And if they’re all going to PhRMA, they ain’t going to you.
John Conyers is a cosponsor of Eshoo-Barton, so it doesn’t appear that he thinks the two bills are inconsistent.
I agree, this is inhumane, will bankrupt people, and cause needless death. So will the rest of the Health Care bill, no matter whether it’s the SFC version, the Senate HELP committee version, or the newly unveiled House version.
Nobody has paid any attention to how this will affect people who are chronically ill. I’m talking about the people are not declared disabled but whose illnesses or conditions cannot be cured. These are the people who will pay not only a hefty percentage of their incomes for premiums (as almost all of us will), but who will pay the maximum out-of-pocket year after year after year. If you have an emergency – a heart attack, say – that causes you to hit the maximum out-of-pocket one year, that’s something you can recover from financially, but it’s going to take a while, most likely several years. If you have a condition that is expensive to treat and is ongoing, you are going to take that hit EVERY SINGLE YEAR. That is most likely not something you can recover from financially, and you’ll slip farther and farther towards bankruptcy, the loss of your home, and finally abject poverty.
Public option or no public option, this is what we are in for. I have a number of chronic conditions. The only reason I’m going to be OK is that I have Medicare at 49 due to being on dialysis. If I get a transplant, though, I’m going to wind up in this same boat until I’m 65 or broke enough for Medicaid, whichever comes first.
Really? Did you even think about that before you posted?
“The program established by H.R. 676 will cover all medically-necessary services without charging co-pays or deductibles. The services covered will include: primary care; inpatient, outpatient and emergency hospital care; PRESCRIPTION DRUGS; durable medical equipment; hearing, dental and vision care; chiropratic treatment; mental health services; and long-term care.”
And further, because you don’t know what you’re cheerleading and the effects of your misdirected actions:
Why do you care about patents here? Because of prices.
How are prices set? By markets.
What does a single payer system, a la MFA, create? A 300M strong market that not only will be able to pick up the tab for all prescriptions, but will also SET prices –and not just for drugs, but all health related services.
Medicare For All / HR 676: The ONLY solution for containing ALL healthcare costs in America
Jane,
do we (FDL Action) have material that can be used for local press releases? Your post has a lot of good information and I’d like to see some of it in the Mercury News on Friday or Saturday (or better yet Sunday).
Hmm. I foresee a post to the suggestion box.
You are correct dump this pice of crap demand Single payer nancy and the Dem’s let us down
Rat! That sucks! Oh, with a loved-one’s face on the outcome of this just makes it almost to much to bear.
Lifetime cap would keep Sather’s “lifetime cap” situation from occurring, but it doesn’t do anything to require insurance companies to pay for drugs.
HHS gets the ability to negotiate for Medicare drug prices, but if you’re not on Medicare, that doesn’t help.
“our ip laws are evil, have killed many and do not need to be made even worse” ; so true but they are integral in ALL trade ‘treaties’ now; what is tragically ironic is that if such existed during the 1800′s and early 1900′s, the U.S. would not be the nation it now is as the U.S. used whatever invention it could without paying exorbitant IP fees for such inventions.
And it’s not just breast cancer drugs but any drugs dealing with cancer period.
Will call but with “John Conyers is a cosponsor of Eshoo-Barton, so it doesn’t appear that he thinks the two bills are inconsistent.” this being the case, odds are long against us.
This is appalling. I heard an interview with Eshoo on my local public radio station recently. She seems to think her amendment would not allow for the evergreening, so she was either lying or she doesn’t understand her own bill.
Companies that market drugs shouldn’t be allowed to develop them, anyway. Seems like a trust violation of some kind.
The government labs and university medical research centers should do the developing, with the patents belonging to The American People, and then let pharmaceutical companies sell and market the drugs. Then they won’t have to worry about the “staggering” costs of development.
Plus, R&D can be directed to what is needed (disease cure/prevention) as opposed to what is most profitable (more and better erections).
howdy – sent it along to Mercury News Assignment Editor this morning
Bert Robinson
jhrobinson at mercurynews dot com
Fired off an email to Jane Harman promising to help organize her defeat to Marcy Winograd.
Fuck’em all!
I am 55 years old, always in good health….
Last spring I had a series of seizures or strokes depending on the doctor you ask. I have Blue Cross Blue Shield for medical insurance. Unfortunately in Michigan where I reside, the economy is in tatters. My sales job income has been totally blown up, and as a result I had to cut back on my insurance (not so good). After over $7000 out of pocket, plus my premiums, I have been told I have MS. The treatment is shots weekly to keep that bad boy in remission. The cost is literally thousands a month. I have no prescription drug coverage as an individual subscriber, and to buy it would cost my wife and I over $2300 a month. That amounts to more than half of my take home pay in a month. Additionally I would still have a pretty large deductible and co-pay. Hence no help from insurance, and we just can’t even begin to afford treatment.
So it is sort of a bummer. I have two kids in college, a big ass house payment, and did I mention sales have sucked in Michigan for a couple years?
So I went and obtained a recommendation for medical marijuana. I was not even thinking that way previously. I can say for sure it helps mute the burning in my legs, arms, etal. But is that what it really has come to in our country?
Twenty years of schoolin and they put you on the day shift… as bob dylan said….
So 30 plus years of working to help people, and now I am left to fend for myself in a substandard manner, with virtually no alternatives than to take the ride.
This whole shit sandwich has a bad taste of class warfare, where the rich get richer and healthier, and the rest of us better take some warning from the late Warren Zevon…. Don’t Let Us Get Sick….
My wife and I love you and your spirit, Jane, we never miss your appearances on Rachael Maddow’s show. All our thoughts and best wishes to you and Christy….
“fear is like dragons, guarding our most precious treasures”… Rilke
If this were France, Italy, Germany, Spain or any number of European countries the streets would be jammed with people building baracades and threatening the stability of the sitting governments. In the U.S. silence from the masses.
This is another crime against the people. Madame Speaker, you are pushing us to far, HR676.
Thanks. I’m grateful to be able to cope as well as I do. There are so many facing much more dire circumstances. I wish real help would come to them sooner than later.
Have to run some errands, see you later.
as a long time denizen of Silicon Valley she knows what’s up and is lying.
she actually rolled Chairman Waxman to get this monstrosity passed
PHRma has spent $110 million on lobbying since January
they have provided $2.6 million in the past 3 years to members of Waxman’s committee
You know, it’s a good thing that I believe in single payer philosophically, because the arrogance and the stupidity of those who believe it will cure everything is enough to make you question anything they would support.
The insurance plans of almost all these people cover PRESCRIPTION DRUGS, too. And yet, even in ALL CAPS, these patients can’t get what they need.
John Conyers, author of 676, let’s say it again, is also a cosponsor of Eshoo-Barton. Which keeps drugs from becoming generic, which affects the MARKET. It’s called a MONOPOLY.
We’re working on some 676 stuff, but I never actually release it because I don’t want to have to apologize for the kind of embarrassing absolutism it attracts. It’s just not worth it.
http://www.spockosbrain.com/BrianSussmanKSFOscreamingatdoctorabouthealthcareAugust72009643PM.wma
in san franciso Brian Sussman, evening radio host on KSFO believes that there ARE programs that pay for these treatments. Listen to the clip above where he tells a doctor that a woman the insurance companies were trying to cut off because of crohns disease should be able to find coverage.
Kaiser advertises on his show. The drug companies can’t lie in their ads but the talk radio hosts can lie with impunity. If you think he is wrong about programs for these drug call in tonight. Ksfo.com 6-8pm pacific time
listen on line first.
They are funnels for willful misinformation.
We need to start bringing drugs across the border anyway. In a very visible way. Let them arrest us. Make sure it gets on the news. I would be a mule for Herceptin. We could do it in a very Quaker kind of way.
Why aren’t the unions, consumer groups, moveon, and other progressive organizations calling for mass rallies and demonstrations. The only thing corrupt governments understand is the anger and outrage of the people. A general strike is what is needed but the so called “movement” is anemic at best.
Edit is my friend.
“The Pyrrhic Option: you begged for nothing and you got it.”
What a great line. Yep, y’all converted me. Time to drop the depth charges on this submarine PO.
That’s what you get from a culture weened on easy credit and deficit spending. But, that, I believe, is about to change. Americans will have a hell of a time adjusting to permanent joblessness, falling wages, and in due time, perhaps even hyper inflation.
The American version of capitalism is immoral, and the backlash, when it finally arrives, will be severe.
There are programs that pay for treatments — they have to or the horror stories would be so acute there would be marching in the streets. But the cancer boards are filled with people who say they don’t qualify, they make too much money, or that is isn’t available to those with the kind/stage of cancer that they have even though an oncologist recommends it.
They’re not lying — it’s just not comprehensive by any means.
Exactly; a nation of sheep.
YUP !!!!
Sorry about the long link if it doesn’t play as wma turn the last three letters (wma) to mp3
for macs. Brian Sussman calls himself a theocon neocon and talks about Jesus a lot. FWIW.
Cross post from Health Care 101
This is turning into such a train wreck one hopes it never leaves the station. If so a lot of people are going to die before a rational solution is developed. Small favors. It is so bad that hopefully it won’t run long before change can be made.
I not trying to be an ass or make an assinine remark, , I guess that I’m posing a question, Can a group bring corruption charges “RICO” against our elected officials ( bhye, liberman etc) for collusion conflict of interest. Seems to me that if I as a citizen were to do the same things to a client of mine , I could be charge with fraud at the least.
Am I out to lunch here?
In all fairness, most people pay little attention to the “workings” of government. To most, democracy is barely a spectator sport let alone one that actually demands participation. Too busy trying to put food on their family and such. The Dems will sell this health care garbage through the corporate media as a great victory for the American public. Not having a legitimate 4th Estate (with the exception of the internet) the masses won’t know any different until they actually need real healthcare.
We need to hammer on Eshoo for this.
jesus – another one. *s*
P.S. And I’m probably *way* over the limit for getting modded today.
Carry on.
P.S. {{{{ratfood}}}}
Would the Holder Justice Department bring RICO charges against his President and members of his corrupt party? When pigs fly and Hell freezes over.
Thanks Jane.
I just got off the phone with Gwen Moore’s DC office. I referenced your post and told them this is bad for the taxpayers, but good for big pharma and the health insurance oligopoly. I told them I expected the Congresswoman to vote against this travesty.
Much appreciated.
To vote against the Eshoo amendment?
$300,000 a YEAR?!?!?! But these drugs help and are so…wow i had no idea breast cancer survivors had to put up with this kind of shit, as i’m a guy and none of the women in my family or circle of friends have had this curse. Jesus, how do these executives sleep @ night. Oh, yeah, “On top of a pile of money with many beautiful ladies.”
Lots of big-pharma mergers that need their steady cash-inflow injections. Merck increased it debt significantly to effect its merger with Scheirng-Plough. So what if some folks die before the next wonder drug is developed –that is probably their attitude.
http://online.wsj.com/article/SB123659326420569463.html
of course it’s not free (don’t think i ever said that), but the medications would be available without charge to those who need them and we would all contribute a little bit via taxes to make that happen. it’s still an unjust bailout for big PhRMA (one of many that now do great harm to individuals and distort r&d priorities), but all your friends would be taken care of because we’d pay the price together. not my first choice, but the cost of all prescription drugs (the drugs you’re post is about are only a portion of that total) is about $250 billion or 10% of total national healthcare expenditures (cms data) — a figure that is well below the savings that should be realized from administrative costs alone by hr 676, estimated to be at least $350 billion.
by restructuring the financing, massive amounts of money could be saved on administrative costs and redirected towards healthcare. last analysis i saw, for about the same total national health expenditures, we could have comprehensive, universal healthcare. we’re already paying for it, we’re just not getting it.
finally, hr 676 is not designed with subsidies for low income people (whoever told you that has grossly misinformed you) all people are treated the same and it’s first dollar coverage. hence the description: everyone contributes via taxes and
everybody in, nobody out.
no premiums, no deductibles, no copays, no coinsurance.
doctors and hospitals compete for your business.
This is what I’ve been saying for years. But yesterday I spent hrs arguing with a poster who says the only way to effect change is to play it cool, “chill the fuck out” and let the “vagueries” of the political process work themselves out. Doesn’t it crack you up how Americans strut around w/ their chests out and fancy themselves tough guys who don’t take any crap but are in fact easily herded sheep. Compared to the French, who throw a raging fit at the least little infringement of their rights, we are abject wussies.
“Why do I always sit where the irony is thickest?”
This all just makes me very sad.
There are too many SELFISH ass_ _ _ _ _ out there that hate the thought THEY might have to SHARE their blessings with anyone. They got where they are by themselves and pulled themselves out of the mud (Primordial) by their own hard work. Share? Forfend:0!
Ms. Hamsher knows of what she speaks…..
In fact, I would go so far as to suggest that a patent extension deal that we agreed to sometime ago up here in Canuckistan, for which we got very little in promised investment in R&D return, has hamstrung us considerably in terms of being able to use our collective/universal buying power to drive down the cost of biologics like Herceptin.
This, of course, as Jane points out leads to a viscious cycle as the inflated costs do lead to rationalization (eg. Herceptin is an antibody – it costs nothing to make – the ‘cost’ is all based on the ability to maintain the patent protection on the ‘blockbuster’)
____
On the flip-side, when we told companies with patents on gene-based diagnostics (eg. BRCA1 testing) to go to hell when they threatened legal action for our clinics doing tests off-patent, our collective/universal power did shut them up (but that was because we didn’t enter into silly hamstringing agreements like you all are about to enter into if this bill goes through)….
.
I know this posting is about the House, but Democrats.Senate.gov have a YouTube up with Sen. Majority Leader Reid saying
the horror stories you’ve told were caused by 1) insurance lifetime cap, 2) exclusion for pre-existing conditions and 3) i couldn’t tell, maybe lack of insurance?
hr 676 doesn’t have lifetimes caps or exclusions for pre-existing conditions. is there some other reason i missed that they couldn’t get what they need?
again, in no way am i suggesting we should not all be 110% behind the effort to kill this bill. absolutely. i only think your comment re hr 676 was mistaken, and wanted to clear that up (or alternatively, if i’m the one who is mistaken, have my understanding corrected).
Well the day will come when American’s will not have a choice because it’s going to be taken from them. Rome fell from a thousand cuts and the U.S. will likely suffer the same fate. With it’s corruption, inherent poltical, social and economic contradictions and various global threats it will most likely happen mush faster than the fall of Rome. More like the collapse of the Soviet Union that caught “everyone” by “surprise.” On second thought, the U.S. may already have collapsed or at the least morphed into something unrecognizable from 60 years ago. The Corporate States of America. Why not just say the Honorable Senator from “Genral Electric”, the Honorable Congressperson from “United Health Care” etc. etc.
don’t know about canuckistan, but last estimate i saw for your south of the border neighbors was that big pharma here was spending about 2x on marketing, etc as on r&d. if i believed in hell, i’d be wanting to send some of the people responsible there right now.
selise @60–
Yes – that’s true generally (ie. all the junk adds to the pharmacosts significantly), but these ‘blockbuster biologics’ are way, way off scale. The levels of profit that are being grabbed are truly egregious – just look at the costs in Jane’s stories for these things – it’s ludicrous that people should be losing their houses to survive.
.
amen.
edit to add: that much of the r&d is done via public funding for these kind of drugs makes it even more outrageous if that is possible.
Eureka, I was able to get back on! Jane Hamsher, I support you and all women with breast cancer and other diseases with all my heart and soul. I was going to make a joke (humor is the last thing to go): you look really good in the photo. As someone with severe CFS/ME, who has heard that a lot, I can say it and wryly.
My mother-in-law had breast cancer on top of her diabetes. Died after initial treatment and I’m not sure why. (I’m escalated after navigating my way back on site…older woman only online just under 2 years and CFS/ME makes learning a wee bit difficult. I’m master of understatement.)
Breast cancer, Crohn’s Disease, all autoimmune diseases, CFS/ME and all diseases that hit more women than men make this issue a feminist/woman’s issue. There’s discrimination. I’m old enough to have watched it for a long time. (See the Op Ed piece by Hillary Johnson “A Case of Denial” in the NYTimes, Oct. 21, 2009 – the newspaper that has helped “diss” and deny CFS/ME for the past two decades. I did the arithmetic on how long I have it…finally, scary. I remember the day I got sick in Dec.1981.)
I will fight as can, for women who have real treatments for their illneses. There’s treatment for breast cancer. Some treatment for MS, another illness that hits more women than men. Other illnesses have been mentioned.
I have heard about Jane Hamsher via Glenn Greenwald, and that’s how I got here. I’m old enough to remember the 1970s phrase, “The personal is the political.”. Some of us combine, as can, political analysis, as does Jane H. (my skills and stamina are so rotten I dare not check the spelling and come back down to finish this…). It’s amazing to me how women fight for our individual survival and fight for others at the same time. Fight for the whole society’s survival. Brava.
Regarding my #61…..
Ludicrous in the sense that there is plenty of reasonable profit to be made with biologic blockbusters that people have to take longterm without gouging anybody.
And make no mistake, that’s what this is – gouging.
A National Health Care System also requires a National Medicine and Pharmaeutical system not controlled by Goldman Sachs. If we cannot replace the privatized Pharma’s, then compete with them, with a people’s Pharma that researches and manufactures medicines as a nonprofit venture.
This would also provide jobs in the US of A. Alternative teatments and medications would probably quickly drive the privatized companies out of business.
Frank33 @65–
I work with a non-profit policy group up here in Canuckistan that is grappling with the very issue that you just raised.
You are quite correct, despite our Universal ‘care’ it is the cost of ‘pharma’ that is the major driver of increasing costs (which, is of course, why BigPharma wants this so much – in the end they don’t care who pays for their gouging as long as whoever pays pays them).
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Jane, I know it’s never smart to insert oneself into an another’s argument, but I think your post is focused understandably on patent drugs and all the crimes connected to that, and slowereastside’s initial comments express distaste with the WHOLE watered down negotiated rate PO that came from Pelosi today WITH all its crappy amendments. Friends should’nt be called peasants but Slow has trouble resisting a good line. There. Now I’m sure I’ll get lambasted by both of you. What follows is something I wrote earlier today at another post concerning the continued eviscerating of the PO.
OK. What so many of us suspected would happen has come to pass. We demanded something concrete and got window dressing. I like Ekunin’s idea of a large and accessible database to graphically depict how the nation will be taking it in the wallet at all levels. Perhaps this could be attached as a part of FDL? No? Yes?
But I also think that an important move RIGHT NOW and going forward is to pound home to the population over and over why this will fail. We need to lodge the idea of “BIG FUCK UP” in the minds of the people SO that a bell will ring in their Pavlovian heads at that point when this roadkill PO starts to disintegrate operationally. We also need to stick to a consistent theme and catch-term, RIGHT NOW, so that down the road, when it is obvious to everyone that the FUCK- UP is unsustainable, the remedy of MEDICARE FOR ALL is the next bell that rings in their heads.
So 1. This plan will not contain costs. Expect premiums to you, your employer, and everyone will continue to skyrocket.
2. millions will still be uncovered by insurance
3. The cartel will continue to steal hundreds of billions from healthcare and the wider economy and use it to buy YOUR politician.
4. Let’s call it MEDICARE FOR ALL and hammer away
Finally, show our support, mightily for those pols who speak the truth and attack with a holy vengeance, relentlessly, those who are puppets of the cartel.
Perversely, the good news is that this PO thing isn’t going to work and THE PROBLEM IS NOT GOING AWAY. We will gain strength from the stubborness of facts. As my pop used to say, “stick around for the next act.”
(((ratfood)))
The idea of allowing R&D to be done by universities at fractional (and accountable) costs and then allowing the marketing to be done by Pharma, with profits going back to the university system makes sense. Ms. Eshoo and Mr. Barton are clearly happy as hell to be corporate whores, money like crack… etc.
I have a similar issue with prescription drugs, but nothing so life threatening… and it amazes me that every year for the last five years my ability to get my scrips filled has resulted in smaller quantities, with correspondingly larger premiums, deductibles and co-pays. Now how does all that happen if our “elected representatives” are not either just turning a blind eye or just don’t give a flying fuck?
re your first paragraph. just my opinion, but this is an issue that is so personal and so painful to so many of us that it’s easy for tempers to flare. it means we care.
personally, i didn’t see slow’s comment to be that much different from jane’s previous “don’t be chumps” — but that doesn’t mean others won’t see it differently. ymmv.
Jane, thanks again for your tireless efforts. As a strong supporter of 676 myself, I would like to say that one of the things that may occur if we had 676 would be, with the government footing the bill and the always constant pressure on legislators to keep taxes as low as possible, then IMO more pressure would be brought on the Congress to change the patent laws back to a more reasonable definition. I just really think the budgetary pressures would be so great that eventually they’d have no choice but to do something about these blackmailers. And that’s what it is, make no mistake about it. It’s blackmail. Pay me what I want, or you die. Motherfuckers.
(Sorry, really bad mood today).
Hope everyone else is better. Peace.
What Bluetoe2 said. Anna Eschoo, Congresslady from Pharma. How appropriate.
yes. but that’s not us. common people for the common good.
Jo Fish said:
I agree.
And in a nutshell that is what BigP promised us in Canada….Unfortunately (surprise!) it never happened in any meaningful way.
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“Rome fell from a thousand cuts and the U.S. will likely suffer the same fate.” Man, I like that line. Bluetoe, you see it. Yesterday I was told to “get a little perspective” when I said we are approaching the precipice from a cascade of compounding problems. People just think it can’t happen here.
– just a few ruminations from Fort Sumter
Most of the basic biomedical research in this country (the research that is turned into biologics like Herceptin) is funded by the National Institutes of Health, specifically the National Cancer Institute and the National Institute for Allergy and Infectious Disease.
That is to say, the basic research is paid for by our taxes. What Burroughs, Schering and the rest do is to take that research and convert it into useful treatments.
Folks, we don’t need them. We already have NIH, we can allow NIH to develop effective treatments and license production. What, this is impossible, you say? I say, not so. It’s what was done with the Salk polio vaccine. It has been done with other vaccines, too.
Vaccines were the original biologics. The new generation should be treated in the same way: we’ve already paid for most of the research, let’s get the for-profit parasites out of it.
I wonder if we could persuade Cuba to take on America’s sick people somehow? Like they had that free heating oil thing going on when gas hit the sky-high Goldman Sachs induced high?
OldFatGuy–
In a perfect world, maybe.
In Canada it has led, unfortunately to rationalization for drugs like those described by Jane in her post.
Maybe I have to explain this another way….
Classical slash and burn chemotherapy (ie. doxyrubicin/taxol – the kind of stuff that makes your hair fall out and your guts go green) is essentially a one shot deal (or a few quick shots).
But these new, targetted biologics (which very often have many fewer extreme side-effects) are used over and over and over again, long term… And that is where the Pharmapalooza comes in (it screams big profit/blockbuster/protect at any cost to them).
OK?
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I can’t speak for Jane, but wouldn’t you rather see no bill than a bad one? I know I would, and have called my two Senators (no need to call my Rep, he’s an R and voting no anyway) to urge them to just kill it.
If we let a bad bill pass, then not only are more folks going to continue to die and go bankrupt unnecessarily, it will delay real reform for another generation as the pols will say “Hey, we just did reform. Let’s give that a chance.”
Another generation lost to unneccessary deaths and financial ruin due to health is unacceptable, IMO. YMMV.
bingo. no way should patents be permitted for any research funded by the public.
DavidByron–
This is not as far-fetched as you might think – It was the threat, for example, of African States going ‘roque’ on anti-retrovirals that ‘helped’ BigPharma see the light on doing (at least partially) the right thing…..
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Yeah, I get that.
But the same “rationing” is going to occur either way. I just believe, if the government is footing the entire bill, as under 676, there would be a better chance of them doing something to change the underlying cost structure than if it’s private insurers and the people themselves footing the bill. I didn’t fall off the turnip wagon yesterday and understand that in either case the paid lobbyists of PHRMA are going to be difficult to overcome. I just think there would be a better chance of them overcoming that if it were coming directly out of the treasury. IMO.
i’ll just quote southerndragon before taking off…..
Never. Give. Up.
New acronym: iwgf = It Will Get Filibustered
I’m right beside you.
Fight these motherfuckers.
Never. Give. Up.
Absolutely goddamn right.
New acronym: iwgf= It Will Get Filbustered
You and Conyers’ office seem to have different understandings of what his bill says.
Drugs would be subject to acceptance into a “national formulary” and have “medically necessary” limitations. So 676 is not just going to “pay for anything,” nor should it.
HHS would regulate what gets accepted, and yes, the higher the cost of a drug, the higher the bar for “effectiveness” it must clear for approval, just as they do now. Marcy and I both got sick from chemo; one drug worked for me, another worked for her. A drug may be 75% more effective than another at treating something, and 90% cheaper. But if you’re the 1 in 4 who is better treated by a drug that doesn’t get approved because it costs 90% more, you’d be out of luck. Right now you have to jump through all kinds of hoops to get Biotech drugs approved by Medicare for just this reason (their high cost). So I’d be inclined to go with Conyers’ understanding of “Medicare for all,” in which Medicare rules would still apply.
I’m also curious about how people who don’t have any money are going to pay taxes. Since I’m “seriously misinformed” about “subsidies,” does this mean they won’t be covered?
oh, fer gawdssake. Please don’t consider
lowestlowereastside to be any part of y’all.At least none of the y’all you wanna be associated with.
(It may take a while, but pretty soon you’ll be able to spot ‘em.)
On the Ed show, he just called Pelosi’s bill “a watered-down piece of garbage written of republican toilet paper”.
works for me.
So what? A monopoly simply means a single source or supplier.
FACT: Single payer countries pay less for on patent drugs than the US
FACT: Single payer countries that pay less for on patent drugs use less generic drugs / more brand name drugs
These single payer countries are buying from monopolies. In your view, this should lead to higher prices. But back in the real world, these single payer countries are paying less than the US for on patent drugs from monopolies and buying more brand name drugs.
In other words: Big pharma is willing to trade margins for volume with their on patent drugs in these countries, while still capturing higher margins on their brand name off patent drugs. .
You haven’t done your homework.
Medicare For All / HR 676: The smart solution for America’s healthcare madness
This is flat out NOT true. Although by far the greatest proportion of the “staggering development costs” of any pharmaceutical is in Sales and Marketing, they are NOT free to manufacture and distribute. Biologics like antibodies are actually MORE expensive in this respect than traditional small-molecule drugs (like viagra and most other things in tablet form). Compliance with regulatory safeguards alone takes many skilled, educated individuals–all of whom need to make a living.
Is $300K a year per patient for herceptin immorally inflated? Yes. Are pharma execs immorally over-compensated. Yes. Are anti-cancer antibody treatments inexpensive to produce. ARE YOU FUCKING KIDDING ME?!!!
A glimmer of good news is that this type of antibody treatment is well into development for prostate cancer, too. So, pretty soon there are going to be a bunch of men in the same boat, vis a vis having to mortgage their entire lives to get life-saving treatment.
FunnyWheelieDiva
Damn, I had to work and you get to have all the fun. *g*
Nice guess. You sure about that? Most people who thought their lives depended on it might inquire a bit more deeply.
If you haven’t had cancer, here’s a preview of Stage IV, where they don’t really think anything will help you and statistically you’re out the door. But the oncologist says that MAYBE if you got Tykerb you would get another year. You decide you want to do it because to you, a year’s a year, right?
Only maybe not to the director of HHS, who has been charged under 676 with deciding what drugs go on the “national formulary” and are “medically necessary.”
Come on, come on, let’s have it — SINGLE PAYER IS THE MOST PERFECT AWSOMEMEST THING IN THE WORLD, IT WILL SOLVE EVERYTHING — and yet:
And so, because GlaxoSmithKline has a monopoly on Tykerb, you just get to die. In pain. Unless you can cough up the money.
But that’s the UK right? Can’t happen here. Well, let’s go back to Jeanne Sather, whose problems you say will disappear with 676:
I’ve had adriamycin and Taxol. You simply could not handle it for 11 years with any kind of quality of life. It’s a rugged grind for even 4 months. But that’s the approved treatment.
Availabililty of Tykerb wouldn’t be an issue with a program that was like “Medicare for All,” right?
Well, as long as a program like “Medicare for All” isn’t Medicare, you’d be fine.
don’t think i ever wrote “pay for anything” so you’re not quoting me there.
and absolutely limited to “medically necessary” that’s exactly what slow quoted above @16.
in the examples you gave above, none of the insurance companies had claimed these drugs were not medically necessary, so i didn’t think that was the issue (from my comment @56: lifetime cap, pre-existing condition and no insurance?). am i wrong on that? is there some controversy about these drugs being medically necessary? are these drugs (herceptin, avastin, tykerb) not considered medically necessary by medicare now?
people pay the tax they owe. even if their tax bill is zero, they are still covered. in full. this is a really important feature of the program because 1) everyone is in the same program and 2) everyone is covered (universality).
BargainCountertenor did a lovely oxdown diary about 7 months ago comparing the single payer bills, Single Payer Bills in Congress: First Impressions (highly recommended to anyone looking for an intro into these bills, i know it helped me a lot – thanks again BC!). i’ll first quote BC from that discussion:
from conyer’s faq:
the bill isn’t that long, for anyone who wants to give it a read, here’s the link:
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:h.r.00676:
FunnyDiva–
Initially, of course, in terms of the R&D to find develop the antibody that will bind to and downregulate Her-2 from the surface of basal-like tumors (ie. the rational/targetted part).
(and that is why plowing back profits into true R&D counts)
Please do not misunderstand me….What I’m talking about is the blockbuster effect here.
The actual cost of producing the humanized antibody is NOT egregious… if it came off-patent the cost would fall precipitously.
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i have had cancer. i also watched 3 of the five women in my family die of cancer within a 15 month period. that was also when i had cancer (i was number 4). i lived. they didn’t.
i also have a chronic illness which is occasionally life threatening.
you wrote:
that’s why i asked you if there was anything i was missing. here’s what i wrote:
and this:
i’d like to be better informed if you think any of my questions are relevant are are willing to let me know the answers.
……
i wrote nothing of the kind. your words. not mine.
……
do i understand you correctly, that Jeanne Sather’s private insurance pays for her meds, including tykerb, but that medicare does not cover tykerb?
Let’s face it. “Biologics” is not a household word yet. And until it is a household word, public opinion won’t start ebbing towards outrage the cost of biologics, will lawmakers do something.
It’s another “Till the shit hits the fan, the public won’t know something stinks” sort of deal.
If it wasn’t clear before, after yesterday, it’s clear now, Pelosi isn’t for us. God help us.
I’m hoping this is “the thin edge of the wedge”. I think it is.
I get treatment with an “orphan drug” too. When it was in the testing phase, it was $300 for the maximum treatment. Once it got FDA approval, the doctors couldn’t believe it, it suddenly was $3000.00 for the maximum treatment!
It will probably never be cheaper as so few people need it.
I guess my drug is a biologic too.
I sure could never afford it and with Medicaid reimbursement rates so low now, I’m kinda surprised my neurologist even will see me anymore.
I sure hope, if they are going to expand Medicaid, they don’t expect to not fund it or keep the funding the same. Doctors won’t see anyone with Medicaid if they do.
Gov. Richardson says budget bill would force him to cut Medicaid
i checked Jeanne Sather’s blog, and there’s a post from last year saying that medicare D did cover tykerb (horrible copay), but not xanax (??!!??).
if we have to depend on private insurance companies for better coverage than public insurance gives, then we are in way more trouble than i thought. a major point of the public option was provide the coverage that private insurance refused to.
…. got to go, but will try to come back to this thread in case anyone has any info, corrections, etc to share.
It is truly appalling that anyone in a civilized society (are we civilized yet?)has to endure this kind of situation.
But as a short-term solution (and I’m not sure of that), I’ve seen ads on tv for some medications that, after the long list of side-effects that in themselves sound life-threatening (‘some possibility of lymphoma, blindness, heart-attack or stroke’)end with “if you cannot afford your medications, we can help”. Possibly just a fake pr attempt, but does anyone take them up on that?
It might be worth a try, for the people outlined in this post and others in their situations, to contact the pharma companies directly to see if they have options for people who cannot afford their medications at retail prices. Which is for the most part what insurers are willing to pay. I can see no reason why it would not be in a pharma company’s interest to provide some medications pro bona or at substantial discount to some patients, if only for the pr benefit and the ability to discount it as a loss on their corporate taxes. We all know they can afford it, especially if they are able to continue to ding health insurance policies for payment-in-full or even at discount rates.
I guess what I am suggesting that one of the arrows of political unrest get directed at the pharma companies directly, not instead of but in addition to the long slog thru the usual political processes. And that people whose lives are threatened by the lack of meds these meds are supposed to help appeal directly to the pharma companies for assistance. Use the google to find out how Gleevac patients found relief.
Worth a try, maybe?
I’m not sure what your point is here, but I don’t think anyone has ever claimed that single payer solves all problems. It also requires realistic patent protections, it requires strong regulation, and it requires an involved public demanding it’s always funded properly.
But all of those are issues with our current system. And I can say this about single payer, insofar as all the issues mentioned above and many not, it is still WAY BETTER than having an unecessary, for profit, middleman. No matter the issue, drug availability, cost, whatever, single payer is better than the current, corrupt, system with a totally unecessary layer of profit as well as another totally unecessary layer of waste.
Thanks RossK. Good information to have.
What I don’t understand is why a state or local government can exercise its eminent domain privileges to take real property to build baseball stadiums or shopping centers, but our federal government can’t find a way to acquire intellectual property to save lives.
Another thing I don’t understand is why we need a for-profit pharmeceuticals industry. The scientists I’ve known aren’t in it for the money. The executives and marketeers and sales-bots don’t discover or invent anything useful. Science and engineering move most swiftly when information is shared freely … which doesn’t happen when companies are out for an intellectual property land-grab.
Some people can get drugs at reduced prices, but it’s difficult to sign up and generally requires knowing someone who knows it exists – and good luck finding one with the drug you need.
I think that drugs that are developed with federal funds or by people from public universities and colleges should not be patentable by corporations, for any length of time.
If Big Pharma wants extended patents for their products, they can use only their own money, and that of the insurance companies they’re in bed with, and see how far they get.
I see lots of conservadem names there. Some of them are people who damned well ought to know better, too.
There was a gene discovered last week in Vancouver BC that seems to point toward the potential for a vaccine for breast cancer.
When Big Pharma lobbied the Canadian federal government for longer patents to keep generic drugs off the market for longer, the federal government gave them their longer patents…..in exchange for price controls.
That is why precription drugs in Canada cost about 40% of what exactly the same drugs cost in the US. Our government acts for the good of Canadians, whereas your government apparently does not act for the good of Americans.
Canada has had a universal single payer health care system for 47 years which is far superior for the average Canadian than the US insurance-run health care system is for Americans. It is beyond me that Americans would stand for insurance company bureaucrats standing between them and their physicians, rationing their health care for profit. In Canada, government pays for our health care at arm’s length, leaving only us and our physicians to make our medical decisions. It is in the US that you have a bureaucrat, an insurance company bureaucrat making your medical decisions for you. Canadians would never tolerate having any inteference with our medical decisions by anyone other than our physicians and us.
It is clear that the US “for profit” insurance-run health care system and the US “for profit” pharmaceutical-run drug system are both killers and not made to be beneficial for the American people.
There is no rationing in Canada. There IS rationing for profit of both health care and pharmacuticals in the US. Both are rationed by profit margins in the US. Money and affordablilty are the rationing factors in the American profit driven system. Canadians have better access to both health care and pharmaceuticals than most Americans have.
Incidentally, Americans diagnosed and treated in the US are 40.8% more likely to die of that cancer than Canadians diagnosed and treated for cancer in Canada, according to the American Cancer Society and the Canadian Cancer Society. Rationing of drugs and medical care in the US is responsible for that. Since so many Americans can’t afford to see a physicians often as they should, and Canadians have universal access to a physician, Canadians are diagnosed far earlier and can be treated while cancers are much smaller and easier and cheaper to treat. Health care and drug rationing in the US kills.
It was Mr. “Peasants” above who said it would solve them all. It doesn’t.
Apologies, I did not read the second part. But yes, I think you did say that people wouldn’t have problems getting drugs with single payer, and my point is that if they are too expensive their use would be limited, even under single payer. Just as they are in Medicare.
I believe her point is that she couldn’t get approval on Medicare for Tykerb as an outpatient drug. If it was in the same price range of Avastin etc., there wouldn’t be a problem.
No, you’re right, it doesn’t. Whatever method we have of paying for it, the “it” still needs strong regulation and cost controls too. Sorry I missed that comment.
No argument there murphyj about the superiority of the system, including some of our provincial (read State’s) programs where there is directed drug use to ensure that the most appropriate and cost-effective ones are being doled-out and paid-for.
The point I was making is that our Canuckistanian Universal system would be even better if we had controlled costs by not WILFULLY entering into a stupid extended patent protection program.
Why?
Because, now we have no leverage to bring down the costs of the blockbusters to reduce rationing (and make no mistake about it, we do have rationing on biologics because of the costs – which leads, for example, to women looking for a sympathetic oncologist who will go back to the pathologist in attempt to get that Her-2-stained section re-scored) and make the entire system more sustainable.
Which is why, in my opinion, Jane’s point is such an important one.
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no problem. hopefully the thread will still be open later when i have a chance to comment at more length (i’ll try to do some back ground reading too), but for now a just a quick comment on one small point.
from reading just a bit of Jeanne Sather’s blog, i don’t think that’s right. here’s what i mean: from Jeanne Sather’s blog showing, if i understand correctly, that medicare did cover her tykerb (via part D, not part B) — her problem was not that medicare deemed it medically unnecessary, rather her problem was with the cost of the copays and donut hole.
more later…..
Three points:
1) Please stop hating the drug companies and start thinking of ways for liberty to provide the solutions. Herceptin exists. Why? Because some wonderful people figured out how to pay for the research and manufacturing and other wonderful people figured out how to make it. Intellectual property rights, the protections for you to profit on your years of risk and effort, need protection. If you don’t protect the rights then those wonderful people won’t be able to get an effort for a new drug project approved. While one company may have IP rights on one solution to a problem another company has an incentive for the next generation instead of just being an IP predator and making copies as quickly as they can. Government coming in and taking their IP at a price the government sets is not only tyrannical but has a negative effect on the calculus for investing in innovation.
2) Leaving decisions to government will be a death sentence to many of the most expensive patients. What was Tom Daschle’s point, that people need to start taking hard diagnoses better–to be more accepting of their fate? That is not the way we want to reduce costs of medical care.
3) It is hard for an individual shopping for health insurance. It is also hard for an employee in a company. One doesn’t necessarily understand things like a lifetime cap, either because you have to many complex choices and decisions or because your employer doesn’t even give you the options–and you have no clue about costs over time. Standardizing formats and options may help. Education may help. Adding bureaucrats doesn’t help.