Wednesday, December 24, 2014

Capitalism, pharmaceutical companies, and morality


Gilead, the Pharmaceutical company selling the Hepatitis C cure Sovaldi, is tiering prices for the 3 month course of the drug: $84,000 in the U.S. $55,000 in Canada, $66,000 in Germany, and reportedly around $2,000 for a generic version that may be licensed to several Indian companies. Sovaldi costs about $130 to manufacture, reinforcing how outrageous its pricing is.

Gilead justifies its pricing by suggesting that it reflects the value of Sovaldi to the overall health care system because of downstream health savings. If you accept that logic, then you should be paying $10,000 for a penicillin prescription for a strep infection instead of $8. Or one step further in that logic - Should the charge for an appendectomy reflect the value of the patient's life earnings from that point onward?

The pricing of Sovaldi is the perfect illustration of how pure unfettered capitalism has no morality or ethic. It looks like any effective new drug treatment is going to be priced at what the market will bear, even if it bankrupts individuals and government programs. Yes, you need a profit incentive for the companies to develop these drugs, but allowing such wanton extortion from seriously sick people makes me feel ill also.

Thursday, December 18, 2014

The Military in a Democracy

12/17/2004  - First, let me set the stage.  Oklahoma Senator Tom Coburn has placed a hold on the Clay Hunt Suicide Prevention for American Veterans Act, claiming that the legislation is too costly and doesn't accomplish much, a claim which is widely disputed by veterans groups and despite the fact that it had nearly unanimous support on both houses of Congress, which is all but unheard of these days.  In the United States Senate, a hold is a parliamentary procedure permitted by the Standing Rules of the United States Senate which allows one or more Senators to prevent a motion from reaching a vote on the Senate floor.  In other words, this one senator prevented this bill from consideration.

Mr. Coburn, a medical doctor says this portion of the bill is duplicative since the VA already has the authority to offer incentives to understaffed specialties.  Alex Nicholson, legislative director for Iraq and Afghanistan Veterans of America, said Mr. Coburn’s staff are confusing psychologists, whom the VA already has authority to recruit with incentives, and psychiatrists.
Let me point out here that Tom Coburn has never served in the armed services, never worn a military uniform, and has no first-hand experience of living or fighting at any level.  This is not to attack Mr Coburn personally for his circumstances . . . he is among the more than 80% of the 113th Congress that has no primary experience, officer or enlisted, in the army, air force, navy, marines, coast guard, etc.  

The percentage of congressmen/women has been falling, and will continue to fall, because the younger one is, the less likely is a personal history of military service, and as the older members leave congress the newly elected members will less likely be veterans . . .

Why is this?  It is partially a result of the aging of the WW II veterans, but as time goes on it is more because of the elimination of the selective service draft in 1973.  As the chart below demonstrates, the percent of the US population on active duty is now less than 1%.  ( . . . and the number actually having live combat experience is a small fraction of that.)

Back to Mr Coburn; I disagree with his fiscal conservatism, targeting depressed veterans for his budget cuts rather than the oil and pharmaceutical elites.  (I will have to give him credit for voting "nay" on invading Iraq and later voting "nay" on funding Iraq.  I think he had good foresight in that matter, but on almost every other point of politics we totally disagree.)

Many of the hawks in Washington talk a good game because their sons and daughters are not and will not be serving. I’m certain if one of Mitt Romey’s five sons was serving, he wouldn't have been so aggressive on sending troops into Syria, Iran, North Korea and where ever else he felt we should be waging a ground war.  (Neither her nor his 5 sons are veterans).

American are quick to support our military but most are not quick to serve or have their son and daughters serve. That’s the disconnect. If you haven’t served or are not willing to serve, and your children or spouse have never served, I'm not sure your vote should count when it comes to the lives of those that do serve or have served.

Many western societies have adopted a universal service requirement for all citizens.  That does not mean they all have to be trained in the military as such, but have to be in some basic service for the good of their country at some point during or after their education.  I don't think I will ever see it, but I think it would make us a better country.