The Importance of Earnest Service

Several friends shared stories of others dropping significant balls without owning to or acknowledging their mistakes, much less apologizing for them.

This ducking blame trend is longstanding and goes far beyond issues with significant repercussions. Have you noticed that some baristas or deli workers will blame the customer for mistakes? “You did—or did not—ask for milk or mustard or multigrain bread.”

So Taxing

The IRS contacted one friend this summer about a large outstanding balance–that she had already paid–plus interest/a late fee. She called her accountant who said he’d get back to her. He didn’t. She assumed all was well.

Last week she received another letter from the IRS and the original $260 had jumped to $420 reflecting more interest on the late fee—that shouldn’t have been charged to begin with. She called the accountant who claimed that they had discussed this. Nope. The fault, he said, consistently steering the conversation away from his mistake and the issue, was because she wasn’t paying quarterly.

Testy

Another friend discovered that a test that the school should have administered to her child last year had not been. The school psychologist did not respond to her query, so she copied the principal in her follow up. The test was to be given every three years. She finally heard back from the psychologist with no apology.

Read the Small Print

A pal takes medication for a chronic condition. She also has high blood pressure. Before checking her record, a social worker suggested she try a new medication. A side effect of the new meds? High blood pressure.

Do you count on others to do what they say they will or what they should?

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I feel wonder when I read about a long-time super scammer and all the people bamboozled and harmed. And then there are those who think that they can whitewash dirty deeds with good ones. They’ve all been at work for centuries. How is it that each thinks they’ll be the ones to get away with their dastardly deeds?

Artful Theft
The incidence that triggered half this post involved a Canadian dealer who collected art on consignment or to appraise and instead of returning pictures or giving the original owner the sales proceeds he kept the money or a thousand works to the tune of tens of $millions, according to Jo Lawson-Tancred on artnet.com.

Police haven’t identified the thief, though he has been arrested and released. Lawson-Tancred postulates his name and his gallery based on other news sources.

What a Pill
The Sackler family, whose marketing methods to promote painkiller Oxycontin for Purdue Pharma helped addict millions while making bucket loads of money, had for decades burnished the family name by supporting cultural institutions and initiatives here and abroad. Artist Nan Goldin, who once suffered from opioid addiction, founded an advocacy organization, Sackler P.A.I.N., to pressure museums to cut ties with them. As a result a few more have just erased the Sackler name from walls and websites according to Sarah Cascone, also with artnet.com.

She reported that although it took a while, The Guggenheim in NYC has finally removed Sackler from its Center for Arts Education and in London, the National Gallery made a similar move. About its Room 34 she wrote: “The name had been in place since 1993, when Mortimer and Theresa Sackler funded the renovation of the room, rehanging works by British masters in a space once dedicated to 18th-century Italian paintings, according to the London Times.”

Cascone further reported: “The latest draft of the bankruptcy settlement will allow institutions in the U.S. to remove the family name without penalty.” Yet there are a few dragging their feet. The Sackler Institute for Comparative Genomics and Sackler Educational Laboratory remain in place at the American Museum of Natural History in NYC. Tristram Hunt, director of the V&A in London, “has been outspoken in his continued support of the family,” and its name remains on the Sackler Courtyard.

Artist Goldin told Cascone: “We hope that billionaires who shower institutions with their blood money watch the Sacklers’ cultural reckoning and take note that they can be next.”

Is the art world more vulnerable to scams than other industries? Have you heard about any skillful scammers of major proportions of late? Do you agree that the Sackler name and reminders of the family’s generosity from money made off opioid addiction should be removed from the museums it has supported?

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I feel increasingly insecure and cynical about who makes decisions that are crucial to my life and welfare because so many are not up to the specialists such as doctors and scientists, it’s the judgment or ultimatum of those who hold purse strings. For years I’ve shuddered at countless examples of insurance companies determining how long a friend or relative stays in the hospital either after a procedure or to recover from a disease. Insurance companies OK the medicines they’ll cover, consistently ignoring a doctor’s recommendations about patients’ requirements.

Now, with business interests–not science–to back it IMHO, NYC Mayor Adams has removed proof of vaccination and face covering mandates starting today, with the speed the Covid pandemic overcame us to begin with.

I was delighted to show my Covid-19 Excelsior Pass Plus proof-of-vaccination to the guard on the street in front of the Metropolitan Museum of Art last week. Everyone was wearing masks inside. I felt relaxed while visiting my familiar picture friends and new visual acquaintances.

What clearer example do you need to illustrate that money, not science, is in charge when you read the first sentence in Emma G. Fitzsimmons, Sharon Otterman and Nicole Hong’s New York Times article: “The day after announcing that he planned to end New York City’s mask mandate for public schools and a proof-of-vaccination requirement for indoor dining, gyms and entertainment venues, Mayor Eric Adams smiled broadly as he rang the opening bell at the New York Stock Exchange.” [I added bold.]

I still have my hopes pinned on Adams but I fear he’s being pushed by business to jump the gun to open up the city. I don’t blame him his mission and hope that it is not at the cost of the health of its citizens. Why can’t he do it one step at a time: Evaluate the result of removing the mask mandate and wait before lifting the one requiring vaccines.

Face coverings are still required on public transportation, in taxis, nursing homes–all health care settings– prisons, and homeless shelters.

According to The New York Post: “Private establishments such as restaurants, shops, museums, gyms and entertainment centers can also still require patrons and workers to mask up. For example, theatergoers are still required to be vaccinated and wear masks while attending Broadway shows at least through April 30.”

The Times reporters shared city data that 87 percent of adults are fully vaccinated and 56 percent of children 5 to 17. They wrote: “Asked about concerns that visitors from other places, particularly those with lower vaccination rates, could spread the virus, Mr. Adams said he was not worried: ‘We want tourism back. It’s a major economic boost for us.’”

So do we know what the vaccination rate is among tourists? What will the cost be if we end up back where we were at the height of Covid-19 or its super contagious, persistent variant?

“’We have been fooled too many times, and I would like to wait longer, at least until more of the world is immunized, or we have a good sense of where these variants are headed, because we absolutely do not know what the next variant is going to look like,'” said Dr. Stephen Morse, a professor of epidemiology at Columbia University Medical Center. This might be in another month or two he told the Times reporters.

“Dr. Ayman El-Mohandes, dean of the City University of New York Graduate School of Public Health, said that ‘now is as good a time as any’ to lift mask mandates. But he was skeptical about lifting vaccine requirements at the same time.”

Have you ripped off your face coverings for good? Are you unconcerned about the vaccine status of others in restaurants and entertainment venues you plan to visit? Does the inconsistency give you pause where vaccines and masks are required to attend a Broadway show but not in other entertainment venues? Will you retreat to your home until you see how the lifting of major pandemic restrictions goes? Is your preference a prudent one, to experiment first to see whether there’s an uptick in the virus after removing one mandate before letting go of the second?

Astonishing how some are willing to harm themselves, and others in some cases, believing harum-scarum theories over science or thinking they are clever to cut a crucial corner and cheat at their own and others’ peril.

Don’t Horse Around

A Facebook posting this week made me laugh: “Anti-vaxxers who ingest horse dewormer Ivermectin shall hereby be referred to as neighsayers.”

But it’s not funny especially because politicians have given the dewormer credibility as a potential cure for Covid-19 in spite of FDA warnings. According to Dominick Mastrangelo on thehill.com: “Sen. Rand Paul (R-Ky.) suggested researchers are not pursuing ivermectin as a possible COVID-19 treatment because of their disdain for former President Trump.” Reminder: Sen. Paul is a physician who should know that when it is prescribed for humans, it’s often in a head lice lotion.

Steve Benen wrote on msnbc.com: “Republican Rep. Louie Gohmert of Texas also pushed ivermectin at an event late last week.” He quoted a CDC health advisory: “Clinical effects of ivermectin overdose include gastrointestinal symptoms such as nausea, vomiting and diarrhea. Overdoses are associated with hypotension and neurologic effects such as decreased consciousness, confusion, hallucinations, seizures, coma and death.”

Wrote Mastrangelo: “The Food and Drug Administration (FDA) warned Americans last week not to take ivermectin….. “You are not a horse. You are not a cow. Seriously, y’all. Stop it,’ the FDA said in a widely shared tweet.”

Dangerous Fake ID
What about the essential workers who populate hospitals, nursing homes and schools who endangered those they are entrusted to care for as well as themselves? They–some 250 in all–paid $200 to Jasmine Clifford for fake Covid-19 vaccine documents. Molly Crane-Newman wrote about this bunch in The Daily News in “13 charged with paying ‘AntiVaxMomma’ for fake documents to avoid free vaccine, say Manhattan prosecutors.” The “AntiVaxMomma is Clifford’s Instagram pseudonym.  She promoted her scam on this social media platform.

For $250 more, reported Crane-Newman,  a collaborator who worked at a medical clinic entered false proofs-of-vaccine into New York State’s official Excelsior Pass database system, the smartphone passport to enter New York restaurants, sporting events, gyms and the like. They found 10 of these.  

“The DA charged the 13 essential workers with felony criminal possession of a forged instrument and conspiracy, a misdemeanor,” she wrote. “Prosecutors also accused one of the 13 with offering a false instrument for filing, for paying the extra $250 to be entered in the Excelsior Pass database.”

Manhattan DA Cy Vance, Jr said “We need companies like Facebook to take action to prevent the fraud happening on their platforms. Making, selling and purchasing forged vaccination cards are serious crimes with serious public safety consequences. This investigation is ongoing.”

What makes people believe in untested ivermectin and not the Covid-19 vaccine vetted by scientists and taken safely by millions?

What twisted minds think they are getting away with anything by cheating about having taken a life-saving vaccine? More important, have they harmed their charges?

Image by Spencer Davis from Pixabay

The business of removing face masks indoors in public, permitted in most states if you’ve had both vaccines, got me to thinking about the honor system. Do I trust my fellow New Yorkers to cover up if they’ve chosen to pass? Can they be trusted to be true-blue and wear a mask until they change their minds? It’s small comfort to hear, “don’t worry about getting sick if you’ve had both vaccines–you won’t be hospitalized and you won’t die, most likely.”

In a New York Times opinion piece “Just How Dishonest are Most Students,” Wake Forest professor Christian B. Miller claimed that honor codes are “surprisingly effective” in curbing cheating. “But many schools and programs, from elementary to graduate level, take their honor codes seriously. And for good reason. Empirical research has repeatedly found that schools that are committed to honor codes have significantly reduced cheating rates compared with schools that are not.”

The operative words are “significantly reduced.” Is that enough where health is concerned?

Image by Juraj Varga from Pixabay

Professor Miller wrote: “Donald McCabe at Rutgers Business School and Linda Treviño at the Smeal College of Business at Penn State found a 23 percent rate of helping someone with answers on a test at colleges without an honor code, versus only 11 percent at schools with an honor code. They reported impressive differences as well for plagiarism (20 percent versus 10 percent), unauthorized crib notes (17 percent versus 11 percent) and unpermitted collaboration (49 percent versus 27 percent), among other forms of cheating.”

“Cheating in Academic Institutions: A Decade of Research,” the study to which Professor Miller refers, begins “This article reviews 1 decade of research on cheating in academic institutions. This research demonstrates that cheating is prevalent and that some forms of cheating have increased dramatically in the last 30 years.” The article was published in January, 2010.

There is no honor code for society at large. The percentages of cheaters in the study above for 2000 to 2010–49, 23, 20 and 17–if anywhere near what happens with the public in general, give me goosebumps. This is a city with $215 million worth of fare-jumpers [in 2018] according to Jay Willis in an article in gq.com, not that sneaking in bus or subway for free means that you’ll take off your mask when you shouldn’t.

Do you think that vaccinations for any killer virus should be required for entrance in public venues? Vaccines are already required in some instances. According to the New York Department of Health, “Children attending day care and pre-K through 12^thgrade in New York State must receive all required doses of vaccines on the recommended schedule in order to attend or remain in school. This is true unless they have a valid medical exemption to immunization. This includes all public, private, and religious schools.”

Do people brought up in schools with honor codes remain honorable or do they need honor code booster shots after graduation? Will you trust that the man or woman near you at a store, a wedding, in a theater or religious institution has been vaccinated because they aren’t wearing a mask? Do you plan on wearing one indoors at least until 70 percent of the population in your city or state are vaccinated?

Image by Free-Photos from Pixabay

I admire anyone who volunteers to test a potentially lifesaving drug. I was curious as to why piling on $billions from the US Government and Bill Gates Foundation, among many, helped speed up discovery of a vaccine by over three years. I guess it’s because the human guinea pigs are paid and to have the numbers injected to ensure efficacy and safety at $250 or more a pop requires deep pockets on the spot.

Carl Zimmer and Noah Weiland pose a dilemma in their New York Times article, “Many Trial Volunteers Got Placebo Vaccines. Do They Now Deserve the Real Ones?”  Seems it’s not an easy “yes” or “no.”   The tens of thousands injected with the placebo who thought they’d get a real shot in the arm after the vaccine was approved may wait as long as two years they reported.

Some scientists think these volunteers “should be moved toward the front of the line in exchange for [her] service for the greater good.” Last week “18 leading vaccine experts — including a top regulator at the Food and Drug Administration — argued that vaccinating placebo groups early would be disastrous for the integrity of the trials. If all of the volunteers who received placebo shots were to suddenly get vaccinated, scientists would no longer be able to compare the health of those who were vaccinated with those who were not.”

As background they explain that “It’s vital that neither the volunteers nor the staff running the trial know who is randomly assigned to get the vaccine or the placebo. This ‘blinding,’ as it’s called, eliminates the chance that people will behave differently depending on which treatment they get, potentially skewing the trial’s results.”

Pfizer “said it would propose to the F.D.A. that volunteers who got the placebo could get the real vaccine.” Richard Peto, a medical statistician at the University of Oxford and his colleagues argue that “once a placebo group disappears from a clinical trial, the chance to collect rigorous data about a coronavirus vaccine will vanish.”

Researchers claim they need to keep secret the placebo group to learn about how long the vaccine protects the recipients, how many get sick in subsequent months as compared to the placebo group.

Zimmer and Weiland reported that “If the companies were to encourage unblinding their trials, that could also harm their chances of receiving the F.D.A.’s full stamp of approval — a license. And allowing a trial to continue may also be good for their bottom line, because knowing when immunity from a vaccine begins to wane will dictate how frequently people will need their product.”

Dr. Anthony Fauci had a great solution: everyone gets an injection in reverse: Those who received the vaccine get a placebo and vice versa. Secret is preserved.

Assuming that there are fixed costs to discovering a vaccine and putting it through its approval paces, why else, other than the cost of assembling and paying sufficient numbers of human volunteer guinea pigs, would money be the answer to the record breaking time it took for discovery? Why wasn’t money used before to attack such pestilence as polio, cholera and AIDS? Do you know anyone who has volunteered to take a drug during a trial period? Do you agree that Dr. Fauci’s compromise, while costly, would be the solution to protecting the volunteers who received the placebo? Are you planning to be vaccinated?

I get that people want to make smart decisions about their health, especially these days when many doctors don’t have time to explain the pros and cons of the meds they prescribe. And in spite of thorough vetting by the FDA before a drug is approved there often are discoveries of adverse side effects over time when patients take new drugs.

But when there are no alternatives the information we read and hear via consumer media can serve to frighten more than enlighten, and to what purpose?

Here’s the headline that inspired this post: “New Study Adds to Concern About Certain Drugs and Dementia Risk.”

Lisa Field wrote: “As people get older, they’re more likely to need medications on a regular basis to manage one or more chronic conditions. Some of these medications fall into a class known as anticholinergics and may not be ideal to take for long periods because they could increase the risk of dementia.” In an article on nextavenue.org Field highlighted results of a study published in a recent issue of JAMA Internal Medicine.

She continued: “If there are no effective non-anticholinergic medications or other non-drug interventions, then I think whether the benefits of taking the medication outweigh the potential risks depends very much on the individual circumstances and the severity of the condition for which treatment is needed,” said the professor of medical statistics in primary care at the University of Nottingham’s School of Medicine.” Carol Coupland authored the study.

Tell me the point of worrying patients with this information if their chronic condition forces them to take an essential medicine for the rest of their lives which, one hopes, is longer than the time a dreaded side effect like dementia might set in? Should consumer editors and bloggers, TV and radio news producers table articles and programs that spotlight dire drug side effects until alternatives exist for these patients?

Of course the math in the headline is wrong. I’m writing about drug prices in this country and nothing about what they cost and why computes either.

Did you see the alarming New York Times editorial, “Getting Answers on Drug Prices,” published the day before last week’s hearing at which seven heads of pharmaceutical companies were to meet the Senate Finance Committee? They represented Pfizer, Sanofi, Janssen, Bristol-Myers Squibb, AstraZeneca, Merck and AbbVie.

Between DJT’s trip to Vietnam and the Michael Cohen hearing, the results of the big pharma exec hearings were largely buried, at least on the news shows I hear/see. What I found didn’t really answer one eye-opening fact—why drugs cost so much more here than elsewhere. According to the editorial, a month’s worth of Actimmune to treat malignant osteoporosis costs under $350 in Britain versus $26,000 here. The editorial contends that drug prices have skyrocketed to the point that many who take them for such ailments as high blood pressure, cancers, allergies and more ration them “at great peril.”

NBC News politial reporter Leigh Ann Caldwell reported that the top exexs “could not commit to lower the price of commonly used prescription drugs even as they admitted that they control those prices. And one executive acknowledged that the high cost of medicines hits poorest patients the hardest.” That executive was Kenneth Frazier, Merck Chairman and CEO. Note: According to Caldwell the pharma industry spent a record $28 million on lobbying last year.

The execs blame Medicare regulations. “‘The system itself is complex and it is interdependent, and no one company could unilaterally lower list prices without running into financial and operating disadvantages,’ Frazier said.” He suggested that by sitting all parties around a table “‘I think we can come up with a system that works for all Americans.’

“They pointed to a statistic that consumers on Medicare pay 13 percent out-of-pocket for prescription medication, compared to just 3 percent for a hospital stay. Some senators connected the large salaries of executives or the profitability of the company to drug costs.” In 2016, Medicare Rx drug spending, according to the Kaiser Family Foundation, accounted for 30 percent of all.

In a Wall Street Journal analysis of the hearings, Peter Loftus summarized questions directed at AbbVie CEO Richard Gonzalez, responsible for “about the biggest-selling medicine in the world, Humira, a treatment for rheumatoid arthritis and gut disorders. Humira generated $19.9 billion in global sales for AbbVie in 2018, up 8% from the year before.” In 10 years list price for a box of two pre-filled syringes went from $1,524 to $5,174 today. The company has maintained exclusivity on the drug by taking patents out on the nine or 10 diseases the drug addresses.

People—and companies that pay for their health care—are desperate to find reasonable alternatives not always with acceptable success. Sheila Kaplan wrote about the F.D.A. accusation against Canadian drug distributor CanaRx. According to her New York Times article the F.D.A. claimed that the company was selling “unapproved and mislabeled medicines to unsuspecting Americans looking to save money on prescriptions, and warned it to stop.”

F.D.A. commissioner Dr. Scott Gottlieb “was especially concerned about CanaRx’s sale of drugs with special safety requirements because they were high-risk and needed to be carefully managed to protect vulnerable patients.” Tracleer, for pulmonary arterial hypertension and CellCept, for transplant patients, were two on the agency’s warning list.

Through its attorney Joseph Morris, CanaRx denies the charge. He told Kaplan “Every prescription that is dispensed through a CanaRx program is dispensed directly to the patient from a licensed, regulated, brick-and-mortar pharmacy in Canada, Britain or Australia, and the patient can be sure that medicine she receives is the medicine that her doctor ordered.” Morris explained that CanaRx “serves as a broker between the companies’ employees and pharmacies and physicians in Canada, Australia or Britain.” The employees are encouraged to buy their meds to save their employer money by sending their Rx to CanaRx “which finds a foreign doctor to reissue it, and have it filed locally.”

The Times editorial began by comparing the promise of these hearings with one in 1994 in which the heads of seven of the country’s biggest tobacco companies admitted the truth about cigarettes. “The hearing ushered in a public health victory for the ages.” I fear nothing like this will result from last week’s hearings with big pharma.

I’d accept a difference of a few hundred dollars between medicine sold in the UK and here to make up for our complex Medicare and Medicaid pricing regulations and rules, but isn’t a difference of $25,650, in the instance of Actimmune, a bit of a stretch? With technology on the side of efficiency and cost-savings, why does a vial of insulin cost $1,500 today vs. $200 a decade ago? Could the paucity of TV news coverage about these hearings be related to the enormity of pharma ads on these shows? Will anything rattle the industry sufficiently so it becomes more responsible and less greedy?

I don’t always read labels and instructions on over the counter remedies. After dousing my poison ivy-inflamed arms and face with the tonic recommended by a pharmacist my husband asked, “Did you read the instructions?” I hadn’t and I was using it incorrectly. I just popped in my mouth an Airborne lozenge that belongs in a cup of water. With my label reading record, lucky I don’t take fancy supplements—just vitamins and calcium.

A surgeon, Sreek Cherukuri, in Sumathi Reddy’s Wall Street Journal article said “Avoid supplements marketed for sexual health, weight loss and muscle building, which are most frequently tainted with illegal ingredients.” He added “The majority of products are unproven. Even if they aren’t dangerous, they could be a waste of money.”

Reddy reported findings from JAMA Internal Medicine in “The Illegal Ingredients in Your Dietary Supplements.” Even after the FDA warned about experimental stimulants that increase blood pressure and heart rate that are not approved for use by humans in dietary stimulants, they remain in some. DMAA, oxilofrine, BMPEA and DMBA can cause heart attacks and strokes. “By 2017, researchers found DMAA in two supplements, oxilofrine in nine, BMPEA in one and DMBA, previously found in none, in four.”

Reddy wrote that no manufacturers were identified. “The researchers looked at nine weight-loss supplements, two sports supplements and one cognitive-function one and tested them for the stimulants in 2014 and 2017.”

An earlier California Department of Public Health study also published by JAMA analyzed FDA warnings between 2007 and 2016 mostly in sexual enhancement, weight loss and muscle building supplements, wrote Reddy. It “found that prescription-drug ingredients were in 776 dietary supplements, many even after the FDA issued public warnings about the products. There were 157 products containing more than one unapproved ingredient.” Reddy reported that “The analysis found that the FDA recalled the products less than half the time.”

FDA Spokesperson Jeremy Kahn wrote this in an email to Reddy: “The FDA is committed to doing everything within its resources and authorities to identify and remove unsafe products from the market, and we continue to work collaboratively with all of our stakeholders to help ensure that products marketed as dietary supplements are safe, well-manufactured and accurately labeled.” According to Kahn, “Even when the FDA issues a recall or takes enforcement action against a distributor, other distributors often continue to sell the recalled product, or distributors relabel products to evade detection.”

Pieter Cohen, an associate professor at Harvard Medical School and general internist at Cambridge Health Alliance told Reddy: “Whatever the FDA is doing to try to eliminate these experimental stimulants from supplements is not working and consumers are going to continue to be exposed to this if the FDA doesn’t step up and become much more aggressive in its enforcement.”

Do you take supplements? Do you know what is in them? Were you aware that they are not vigorously regulated? Do you tell all your doctors about what you take as some might impact surgery and/or interact with prescribed drugs?

Donna Hammaker, Esq & Dr. Thomas M. Knadig, EdD

Did you know that:

• Congress defines what “equivalent” means when it comes to generic drugs and that the therapeutic effectiveness of a generic might actually be half as that of the brand according to this definition? More below.
• About 1/10^th of the U.S. population has no health insurance; most of them are earning middleclass incomes and the lack of coverage causes two deaths every hour?

I learned this at an eye-opening program of the Healthcare Public Relations and Marketing Society of Greater New York [HPRMS]. Nancie Steinberg, president, introduced the speakers Donna K. Hammaker, Esq. and Dr. Thomas M. Knadig, EdD, who addressed representatives of some of New York City’s most prestigious hospitals and health organizations and the marketers and PR professionals who counsel them.

While some of what I heard was shocking, the takeaway as a consumer was nothing new: When it comes to your health, be informed and ask questions.

About the reference to generic drugs above, Hammaker said you could not pay her to take generic drugs from India or Israel. She mentioned “brand generics” by Novartis and Pfizer that seemed to pass muster.

The speakers, on the faculty of Saint Joseph’s University, Philadelphia, and authors of three textbooks for students and health care managers, the most recent of which is Health Care Management and the Law, shared data-driven facts and statistics gathered in the last two years.

Laced in the discussion were factoids about the Affordable Care Act, such as that much of it was first addressed during the Nixon administration and that many people are unaware of what’s in it. Healthcare has been Hammaker’s professional focus as a lawyer and yet even she was surprised by bits that she learned by studying it. [One wonders how many lawmakers are still in the dark and yet they call for changes.]

A caveat: I’ve posted sound bytes throughout this post. On just one of these topics alone, Clinical Trials, Hammaker gives a three hour lecture in which she addresses the differences between brand and generic drugs. There is similar backup in her latest 830 page book and hours-long lectures relating to her other contentions and conclusions. For example in Health Care Management and the Law the authors reference court decisions relating to the use of reprocessed medical devices which, in the interest of brevity, I don’t go into here.

Following are just a few highlights based on a list the authors handed out and subsequent discussion.

• “Reprocessed medical devices are a cause for concern, as the FDA standards are not always strictly adhered to, patients are not necessarily informed they are receiving a reprocessed device, and such devices are often obtained from unregulated sources, such as the Internet.” Hammaker recommended that before undergoing a procedure that a patient specify on the hospital consent form that he/she wants a new device as well as the name of the manufacturer of the device. She explained, for example, that some hip replacement devices are made of cheaper metals that tend to break. In addition, she reported, the FDA is lifting restrictions in this area.
• “Over 60 percent of the yearly $1.9 trillion employers spend on health care costs go toward treating tobacco-related illnesses.” We learned that it is legal for an employer to refuse employment to a smoker. In addition, an employer can charge current employees who smoke more for insurance; force them to take smoking cessation classes as a term of employment and conduct random tests [of hair] to identify smokers.
• “Estimates indicate 90 million people in the US live with a preventable chronic disease [such as diabetes and hypertension often caused by such factors as smoking and obesity], the ongoing care for which amounts to 75 percent of the annual $3.3 trillion health care budget.” As health insurers are no longer covering illnesses and disease that could have been prevented, Hammaker asked, “Is this a direction we want to take?”
• “While the biggest burdens to the U.S. health care system are depression and gun violence, they receive scant attention in the health care reform debates; yet the cost of gun violence in the US is equal to the cost of smoking, obesity and other preventable health care illnesses combined. Estimates of civilian gun ownership have been as high as 330 million vs. the U.S. military and law enforcement that possess approximately 4 million guns. The nation’s risk pools absorb $1.4 billion yearly to cover anticipated costs of treating victims of fatal firearm assaults.”

There are a lot of hot topics here and no doubt people who disagree with some conclusions. [We know people who suffer from a disease–chronic Lyme–that many physicians and insurance companies don’t recognize.] Were you surprised by any of this information? Are you more assertive in dealing with your health issues and those of family members today than you were in the past? Are you concerned that information like this is not readily available making it hard to protect yourself appropriately?