Posts tagged with: Health/Medical/Pharmaceuticals

Blog author: ehilton
posted by on Monday, September 9, 2013

Crowded emergency room waiting area.The Obama Administration is counting down the days and rounding up “navigators” to get Obamacare off the ground. (Those navigators, by the way, will get $58 for each person they sign up, on top of their hourly pay.) The big question: Is Obamacare going to work? Will it deliver better health to Americans? There are a lot of skeptics, including Forbes’ Paul Howard. Howard’s concern is that Obamacare is using mid-20th century assumptions about health and insurance in a 21st century world.

Washington’s view of health care remains deeply entrenched in mid-century assumptions about health and illness.  Health care via industrial policy makes sense if illness is an Act of God to which all are equally vulnerable and a known quantity of health care can be delivered to everyone at a fixed price.   If these assumptions are true, the largest payer – the government – can set the rules of the road, from which all (or almost all) benefit.

That was a reasonable picture of medicine well into the 20th century…when infectious diseases dominated U.S. deaths.  But by 1950, heart disease and cancer had displaced infections as the nation’s most potent killers.  (“Diseases of early infancy” was still the fourth-leading cause of death in 1950. By 2010, they had dropped off the table entirely.)

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Ever since the Department of Health and Human Services (HHS) announced that requiring most employers to cover birth control, abortificients and abortions as part of employee health care coverage, there has been a firestorm of attention pill in handfocused on the mandate. Both secular and religious employers have fought the order, stating that it violates their moral and/or religious principles to pay for these things, which many do not believe fall into the category of “health care.” (See Acton PowerBlog posts here, here, and here.)

Today, August 1, was the date the mandate was to go into effect. However, HHS has given a “stay” for religious non-profits until January 2014. That isn’t good enough for the group “Women Speak For Themselves” (WSFT), founded by Helen Alvaré, Professor of Law at George Mason University. In today’s Washington Post, Alvaré and Meg T. McDonnell give 5 reasons why women care about this mandate. She says, in the words of one of the organization’s members that these women “don’t want anyone buying the phony message the government is selling…that ‘women care more about free birth control than freedom of religion.’” WSFT backed up their convictions by protesting today in Lafayette Park across from the White House. (more…)

Blog author: ehilton
posted by on Tuesday, July 16, 2013

If the National Bureau of Economic Research is to be believed, Obamacare stands to cause more than 1 million Americans to shift from work to welfare. Why? America will lose an abundance of low-paying full-time jobs to relieve employers ofoperation-game health-care cost burdens. The Wall Street Journal recently reported:

[A] number of restaurants and other low-wage employers say they are increasing their staffs by hiring more part-time workers to reduce reliance on full-timers before the health-care law takes effect.

“I’d be surprised if the Affordable Care Act didn’t have something to do with” the pickup in part-time hiring, said Paul Dales, senior U.S. economist at Capital Economics. “Companies don’t want to pay for health care unnecessarily if they can avoid it, so they’ll try to avoid it.” However, he said “the effects will be harder to discern in the data.”

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The Federal Drug Administration (FDA) has cleared the sale of the “morning-after pill” (such as Plan B) for teens as young as 15, with no need for parental consent, and mandated that the drug no longer can be kept behind the pharmacy counter. Nancy Northup, president of the Center for Reproductive Rights, believes there are “daunting and sometimes insurmountable hoops women are forced to jump through” when faced with a crisis pregnancy and that this measure is a step forward for women’s health. While there are conflicting opinions as to whether or not these medications cause abortions, there is no doubt that the side effects for the female taking the medication can be harsh, including hypertension, depression and ovarian cysts. morning after

What is disturbing to many is the fact that this move by the FDA now gives human traffickers a way to stop or end pregnancies in young girls being trafficked, with no medical care or follow-up. For instance, LiveAction did several “sting” operations at Planned Parenthood facilities around the country to see if workers in those facilities would follow mandated laws to report suspected sexual abuse of a minor. Over and over, workers were complicit in covering up what was presented as minor girls acknowledging having sex with much older men. In 2008, MSNBC reported that sex trafficking victims were “compelled to perform sex acts 12 hours a day and were subjected to beatings, rape and forced abortions.” With now-easy access to “morning-after” pills, sex traffickers won’t even have to visit a clinic; they can simply send a girl into the local pharmacy for the drug. No fuss, no muss…no medical follow-up, no chance for a medical professional to question the teen for her safety, her health, her well-being. (more…)

Blog author: jballor
posted by on Monday, April 1, 2013

In the current Acton Commentary, I take a look at what I call a “modern-day Robinson Crusoe,” the survivalist Richard Proenneke of “Alone in the Wilderness” fame.

But as I also note in the piece, there are some other instances of this classic shipwrecked literary device, including the TV show Lost. The basic point of these reflections on community and the human person is that no man is an island, even when they are on an island.

Consider this speech with the conclusion “if we can’t live together, we’re going to die alone,” from Jack Shephard, in Lost episode 1.5, “White Rabbit.”

As the tagline of the “Hang Together” blog reminds us, the dynamic between human sociality and community is at the heart of the American experiment in ordered liberty. As Benjamin Franklin put it, “We must indeed all hang together, or most assuredly we shall all hang separately.”

In addition to internal logical inconsistencies which raise serious concerns of long term economic sustainability regarding the Affordable Care Act (ACA), recently analyzed by John MacDhubhain, Robert Pear reports in the New York Times over the weekend how confusion over certain ambiguities in the law (ironically over the meaning of the word “affordable”) would end up hurting some of the people it is precisely designed to help: working class families.

Pear writes,

The new health care law is known as the Affordable Care Act. But Democrats in Congress and advocates for low-income people say coverage may be unaffordable for millions of Americans because of a cramped reading of the law by the administration and by the Internal Revenue Service in particular.

Under rules proposed by the service, some working-class families would be unable to afford family coverage offered by their employers, and yet they would not qualify for subsidies provided by the law.

Read more . . .

Acton On The AirKishore Jayabalan, Director of Acton’s Rome Office, was called upon this morning by America’s Morning News to weigh in with the view from Rome on the Obama Administration’s HHS mandate that most employers – including religious institutions – provide contraceptives, sterilization, and abortifacient drugs as part of health care coverage. He did so, and you can listen to the interview by using the audio player below:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

Previous Acton commentary on the mandate decision:
Audio: Dr. Donald Condit on the Trampling of Conscience Protections
Jayabalan: Obamacare vs. the Catholic Bishops
Dr. Samuel Gregg: Obama and the Dictatorship of Relativism

Blog author: kspence
posted by on Friday, September 16, 2011

Even though Ron Paul clarified himself at the Tea Party debate, and explained that he doesn’t think those who can’t afford medical care should be laid out on the curb to die, the Left went about painting his answer as morally abominable. Before we deal with their abuse of Christian doctrine, let’s see what Paul said:

I practiced medicine before we had Medicaid, in the early 1960s, when I got out of medical school. I practiced at Santa Rosa Hospital in San Antonio, and the churches took care of them. We never turned anybody away from the hospitals. And we’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves, our neighbors, our friends, our churches—would do it.

A great answer, it seems to me, and thoroughly Christian, unless you take the United Nations as an instantiation of the Gospel command to “love thy neighbor as thyself.” Liberals latch onto the Good Samaritan aspect of the commandment and think, if my neighbor, then why not the fellow two counties over, two states over, or two countries over?

Newsflash: prudence is a part of moral calculations.

The Good Samaritan was passing by the man who had been beaten and robbed, and was in a position to help him. But while residents of Alaska and Florida are each others’ neighbors in one sense, they cannot be of service to each other in the same way that they can those on their own streets. Moral considerations involve not only intention but also acts themselves, and whether they are likely to succeed (cf. Catholic just war principles).

Furthermore, the federal government might be practically able to assume some of the responsibilities of the Good Samaritan, but no one on the Christian Left has provided an argument why it should—why it would be better for two neighbors to love each other through the government, in some sort of progressive trinity. Otherwise, isn’t it best to let people practice love of neighbor themselves, so that they can store up treasure in Heaven?

Finally, most of the people making these arguments don’t think Congress should pass some sort of Obamacare law for the entire world, but that’s exactly where their thinking leads. Really why not preemptively cover any Martians without access to dental care and free contraception? Well because that would cost too much.

Blog author: kspence
posted by on Friday, August 12, 2011

Last week the Federal Circuit Court handed down what seemed to many a funny decision: that human genes are patentable. Myriad Genetics owns patents for two tumor suppressor genes, BRCA1 and BRCA2 (mutations of these genes are correlated with increased incidence of breast cancer, making them of great interest to doctors and scientists). Myriad was sued by doctors and researchers who claim that genes fall into the category of “products of nature,” which makes them unpatentable, but the court disagreed.

Myriad’s patents allow it to charge licensing fees to doctors who wish to screen their patients for BRCA1/2 mutations, and also to researchers developing drugs that would target BRCA1/2 abnormalities in breast cancers. Myriad claims that its patents allow it to recover the costs of identifying the two genes, and so are just like the patents for Velcro, ShamWow, or the Segway. Aside from the legal dispute—i.e., the majority’s facially risible argument that “the molecules as claimed do not exist in nature,” since bits of the BRCA1 gene aren’t floating around in ponds—there are two problems with the patenting of genes: a moral one and a practical one.

In his Acton monograph The Social Mortgage of Intellectual Property, David H. Carey addresses intellectual property rights vis-à-vis the distribution of medicine. He focuses on the AIDS epidemic and infectious diseases in the Third World, and presents the Vatican’s 2001 argument that the principle of solidarity supersedes patent rights where the lives of the poor are at stake, even though the long-term consequences of a suspension of intellectual property might be severe.

Admittedly, personalized cancer treatment in the United States alters the moral calculation, but the American public has made its consideration, and by the establishment of the National Cancer Institute (part of the National Institutes of Health), has decided to fund early stage cancer research publicly. Certainly in order recoup the billions of dollars of testing required to bring a cancer drug to market, companies need the assurance of patent protection, but the sequencing of a gene comes years before any drug begins testing (Myriad filed for its patents in 1994).

As Francis S. Collins, head of the NIH, explained in a recent book,

The information contained in our shared [genome] is so fundamental, and requires so much further research to understand its utility, that patenting it at the earliest stage is like putting up a whole lot of unnecessary toll booths on the road to discovery.

Whether the Supreme Court reverses the Federal Circuit’s decision, or Congress passes a law making clear the proper extent of patent protections, this intellectual property mess must be untangled.

Blog author: jmeszaros
posted by on Wednesday, July 6, 2011

Many politicians have talked of repealing the Patient Protection and Affordable Care Act (“Obamacare”).  Mitt Romney has said nullifying the healthcare law would be one of his first actions if he was elected president.  However, rather than just repealing the law and going back to the status-quo, with minor changes, the American people should demand true reform.

In 2001, Milton Friedman, the famed, Nobel-prize winning economist, published an article titled “How to Cure Health Care.” (Although worthy of serious consideration, Friedman’s analysis does not contain any explicit moral message, and is simply a policy analysis on healthcare.  For a more in-depth look at the moral dimension of healthcare reform, visit Acton’s special section on healthcare)

In his essay, Friedman stated that, “The United States spends a mind-boggling percentage of its GDP on a health care system that virtually everyone agrees is a disaster,” and that was in 2001.  Spending has only increased over the past decade.  In fact, according to the Department of Health and Human Services Center for Medicare and Medicaid Services, the United States spent 17.6 percent of its GDP on healthcare in 2009, and this figure is expected to grow over time.

In addition to out of control spending, studies in the United States and Europe at the time were showing “…public dissatisfaction with the increasingly impersonal character of medical care.”  Recently, a 2010 Gallup poll showed a majority of Americans are satisfied with the quality of healthcare they receive (62 percent rated quality as excellent or good), but only 39 percent rated the availability of coverage as excellent or good.

How did this happen? How has massively increased spending led to unsatisfactory coverage?

In four words: the government got over-involved.

Friedman explained, “In other technological revolutions, the initiative, financing, production, and distribution were primarily private, though government sometimes played a supporting or regulatory role.”  However, in healthcare, the government decided to intervene and regulate extensively.

It all started at the onset of World War II when, due to wage and price controls enacted during the war, “firms competing to acquire labor at government-controlled wages started to offer medical care as a fringe benefit,” which was not recorded as part of their salary due to the wage-controls.  As a result, employees came to expect healthcare from employers as part of their compensation.

The IRS eventually wised up to this and, wanting more revenue, started to tax the contribution.  Workers raised an uproar so Congress passed a law, The Revenue Act of 1942 (Section 127 specifically), allowing, in Friedman’s words, “… medical care expenditures to be exempt from the income tax, if, and only if, medical care is provided by the employer.”  This system, according to Dr. Donald P. Condit in his Acton Institute commentary “Should Business Be Responsible for Employee Health Care?”, “effectively punishes taxpaying citizens who are paying for health care benefits with after-tax dollars.”

Thus, if an employee paid directly for healthcare, this was added to their taxable income, but, if they went through their employer, it was not, setting up a large incentive to get insurance coverage from one’s employer.  Condit states “medical spending has increased with this ‘tragedy of the commons’ scenario, wherein resources [health care dollars] are overconsumed with the perception that someone else [the company, the government] is paying.”

Friedman similarly demonstrated the result of this and other policies dealing with healthcare with a simple example: “In 1946, seven times as much was spent on food, beverages, and tobacco as on medical care; in 1996, more was spent on medical care than on food, beverages, and tobacco.”  In 50 years, healthcare went from a minor expenditure to the major expenditure of most people, and, during this period, spending by individuals and government on healthcare approximately quadrupled.

Friedman explained, “On the evidence to date, it is hard to see that we have gotten much for quadrupling the share of the nation’s income spent on medical care other than bureaucratization and widespread dissatisfaction with the economic organization of medical care.”

What can be done?

For starters, Friedman said: “If the tax exemption were removed, employees could bargain with their employers for higher take-home pay in lieu of medical care and provide for their own medical care either by dealing directly with medical care providers or by purchasing medical insurance.”  This would make families more responsible for their own healthcare and they could adjust accordingly, either spending less/more on healthcare or taking more/less in wages.  (It seems that most would probably spend less on healthcare and take more income in light of this National Journal article).

This kind of reform would help by “reprivatizing medical care by eliminating most third-party payment, and restoring the role of insurance to providing protection against major medical catastrophes,” rather than using insurance to pay “for regular medical examinations and prescriptions.”

This sounds great, in theory, but how would such a drastic change actually be accomplished?

Friedman advocated for medical savings accounts. He stated: “A medical savings account enables individuals to deposit tax-free funds in an account usable only for medical expense, provided they have a high-deductible insurance policy that limits the maximum out-of-pocket expense.”  This way, employees, not employers, would be responsible for their own healthcare spending, hopefully eliminating the third-party problem, while allowing the wages contributed to still be tax free.

Several companies, including Forbes, Quaker Oats, and the Golden Rule Insurance Company, tried out medical savings accounts instead of employer provided insurance and found that healthcare costs were lower and both management and employees were more satisfied than under the old employer provided system.

Friedman stated, “Families would once again have an incentive to monitor the providers of medical care and to establish the kind of personal relations with them that were once customary.”

This puts responsibility back on the individual to care for his or her family and brings to mind the words of 2 Thessalonians 3:10: “If a man will not work, he shall not eat.”  Modern healthcare is obviously not comparable to biblical food, but the concept of individual responsibility has largely been lost with employer provided healthcare. This reminds all that a family is better served caring for itself rather than relying on someone else to make choices, including healthcare, for them.  Condit, in his essay, says as much: “Employer, or any third party, involvement in providing health care can interfere with an employee’s ability to make his or her own decisions and distort individual responsibility.”

Also, allowing families to manage their own healthcare costs would allow for greater efficiency by means of more efficient spending.  For instance, instead of using insurance to pay for a doctor visit due to a cold or a small prescription, one could pay out of pocket.  If most people paid out-of-pocket, the cost would likely go down because what individual would pay $80 (like my insurance company does) for a 20 minute doctor visit?  By putting people in control and not insurance or government bureaucracies, one could expect people to “shop around” for quality doctors.  Then, doctors’ offices would likely offer better care to compete for patients, instead of expecting an $80 to $100 payout from the insurance company or the government.

In addition, Friedman advocated for the abolishment of Medicare and Medicaid, which sounds rather radical.  However, he said the government should “…replace them by providing every family in the United States with catastrophic insurance (i.e. a major medical policy with a high deductible).”

That way “the family would be relieved of one of its major concerns – the possibility of being impoverished by a major medical catastrophe – and most could readily finance the remaining medical costs.”

This should satisfy the concern that impoverished citizens would not get adequate coverage.  Even if a small portion of the population is chronically ill or unable to pay their medical bills, these people would be covered by a government catastrophic care policy.

It is a citizen’s duty to care for those individuals in their communities who simply cannot help themselves.  Condit states, “Christians, and others, are expected to fulfill a service obligation, with a preferential consideration for the poor and underserved.”  This corresponds to the principles of subsidiarity and sacrifice seen throughout Catholic and Christian teaching.

In Luke 3:11, John the Baptist states: “The man with two tunics should share with him who has none, and the one who has food should do the same.”  Jesus himself said, in Luke 14:13, “when you give a banquet, invite the poor, the crippled, the lame, and the blind.”  Again, in Jesus’ and John’s teaching, the focus is on “you”, the individual, caring for ones neighbor, rather than an entity such as the government (or a corporation).  The government, naturally being more impersonal and disconnected, could provide support in the severest cases, when communities and individuals could not support their own.

Rather than harming the less-fortunate and marginalized, this kind of health reform could free up time and hospital beds (many families would spend much less time and money on care) to help those chronically ill individuals who truly need the best care and doctors available. Friedman’s approach does not solve all the problems of healthcare (how do I know this doctor/hospital is reputable or provides good care since there is no rating service, what about those that refuse to or cannot pay out of pocket, etc.) and this is only a basic analysis, but it does offer a seldom discussed approach to improve care, allow for greater individual independence, and decrease costs.