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Some People May Experience Detonation of the Eyeballs...

One thing that needs to be high on the Democrat’s agenda is healthcare reform. One small part of this will be undoing the harm done to the regulatory structure by the Republicans. The three main parts of this are the conflicts of interest of the FDA towards approval of drugs, deregulation of supplements and the advertisement of prescription drugs on television.

The joke of the title, of course, is the often long list of side effects listed on television commercials, often so long they take up half the commercial. One of the most famous examples of such prescription drug ads are the Vioxx and Celebrex commercials, now as rarely seen as the medicines themselves.

There are a class of medicines known as COX-2 Inhibitors, Non-Steroidal Anti-Inflammatory Drugs (NSAID) that interfere with a particular enzyme related to the production of Prostaglandins, some of which factor in causing inflammation and signaling pain. The COX, or Cyclooxygenase, enzymes play a part in the synthesis of different kinds of Prostaglandins, and have two main varieties varieties. Aspirin and Ibuprofen affect both general varieties, which can be a problem, since production of COX-1 originated Prostaglandins is important for digestive tract health. The COX-2 inhibitors have the virtue of selectively inhibiting the second kind, as the name implies. Trouble is, as the theory now goes, that these drugs have a unhealthy effect on blood clotting, increasing the likelihood of heart attacks and strokes.

How did this happen? In no small part, it was about a change in the law that had drug companies paying for the testing the FDA does, with the result that the culture in the FDA skewed towards the industry, and towards drug approval, rather than ensuring safety and efficacy. This is just one example of the former GOP majority's tendency to create conflicts of interest in government, thereby creating a more corrupt system. Here, it would have deadly effects.

The reason to test drugs so thoroughly should be plain from the above description of the COX-2 enzyme's action. If you click through the link, you will find my explanation a bit of a simplification of what really happens. Our bodies are not linear, clockwork deterministic systems. They are highly complex, with much of our function emerging from the all around performance of processes in our body, rather than being simply determined by one process. Maybe one day we can simulate this in a computer, but even with the current horsepower under the hoods of modern supercomputers, even modelling the way a protein folds is difficult. So for now, we test, first on animals, then on humans. We do this so that physicians know that they can prescribe these drugs without endangering patients unnecessarily. Unfortunately, the corporate culture in many drug companies is tuned to keeping the bottom line going. Makers of these drugs knew that something bad was happening, that a significant risk of heart disease was coming with these drugs. Not only did they not do something about that, they decided to actively cover it up.

It's not quite foxes in the henhouse. It's more like letting the inmates run the asylum. Many of the people running these companies have a poor understanding of the consequences of their actions, being businessmen rather than doctors. Death of patients is always a risk in pharmaceuticals, are in fact practically guaranteed for certain classes of drugs. Folks certainly don't seek to have their drugs kill people, but many times their response to the discover that their drugs endanger their patients directly is to protect the company at the expense of the patient.

Can we trust a drug company to always do what's in the patient's best interests? No. As the Vioxx scandal shows, many drug companies treat disclosure of these facts as an unnecessary financial risk. The point of running a for profit enterprise like a corporation, both legally and practically, is to make money. People discovering that your wonder drug dramatically increases the likelihood of heart trouble is not going to make you more money. Corporations aren't stock full of psychopaths, but groupthink is a common issue in business. It's not unusual for a worldview to emerge out of a company or any organization, especially under amoral leadership, that pulls otherwise reasonable people towards despicable acts and pathological mindsets.

It's also not unusual for the market to fail to punish such mindsets until obvious bad results come about. It's happened time and again under the post-Reagan, post-Gingrich regulatory environment. The thing that is being missed by the Republican supporters of such efforts to free companies from legal obligations towards safety and transparency is that in the Business world the Customer, far from always being right, can actually be seen as a enemy of the business's interests, and treated according.

It's a screwed up way of looking at things, but if your all-consuming goal is to make money, anything that stands to lose you it becomes a hostile force to you. In todays hypercompetitive business environment, the people who end up running things are often those who make it their all-consuming goal to make money for the corporation. Making money itself is not evil, nor is being competitive, but as C. S. Lewis would put it, that which you would make a god of will become a demon. That demon can become so pathologically possessive of someone's personality that they end up even betraying the company for their own interests. We've seen this with Worldcom and Enron, with the results being that thousands, if not millions have had a lifetime of investments swept away.

Similar issues pop up with the supplement market, which has experienced an explosion of business. Unfortunately, that business strongly resembles that which the Pure Food and Drug act was passed to address about a century ago. So many of the supplements are sold nowadays with brief disclaimers that they are not meant to diagnose or treat any disease, but you couldn't tell that from the message the commercials are sending. As in the old days, when the ads told us that drugs could treat everything from dropsy to impetigo, nowadays these herbal supplements promise weight loss, energy boosts, treatment of cold and flu, and of course natural male enhancement. These people advertise their Alternative Fix, promising much the same things that snake oil merchants long ago did. Some forms of alternative medicine are relatively harmless, or even helpful, but with supplements nowadays, nothing much stands between them and the consumer to really ensure that the drug can do what it is desired, without harmful side effects. This isn't an accident. The former majority, seeking to boost the fortunes of those who dealt in folk medicine because of many of the member's cynical attitude towards science's authority on biological truth, deregulated alternative medicine.

What's the harm? Plainly put, these people promise something they have not proven definitively they can deliver, and the substances they put into people could in fact have a negative effect on health. The real key here goes back to the complex situation in the body that made Vioxx a problem. In short, if these supplements are harmless, people are being cheated. If they stand a chance of hurting people, they are a threat to public health. If they actually are as powerful as they claim, this should be established scientifically, and the side effects determined, because as we've seen with Vioxx, anything powerful enough to substantially affect the body can also be powerful enough to kill. This can even happen with over the counter drugs.

Acetaminophen (also known as Paracetamol), in fact, the rather benign painkiller we know and love, can be deadly if overdosed. The line between a healthy dose and a toxic one is thin. It's an effective painkiller, no doubt, but like Aspirin and Ibuprofen and other widely available drugs, being powerful enough to change the way the body operates, it's also powerful enough to cause problems. The difference here is a metabolite that interacts toxically with the cell walls of the liver if it's not neutralized with glutathione.

The reason why Acetaminophen and other drugs like it are allowed over the counter is that they are typically not dangerous at the doses given. The care of a doctor is not required with their class of painkiller. A lot of medicines can't be so easily managed by non-experts in medicine. As those commercials, whose disclaimers I parody in my title are required to remind us, a whole lot of nasty things can happen even with supposedly safe medicines.

Which brings me to another point. I know they're trying to market the hell out of these drugs, but we're doing it to people who don't know really what they're getting into. I know some would malign the notion that the average person could not choose their medicines for themselves, but there's something to be said for letting experts handle things where the average person is too untrained to appreciate the situations at hand.

We wouldn't let a CEO of most companies pick the alloy mix for the steel in their buildings. Nor would we put the average scientist to work keeping the books of the company. We definitely wouldn't have a person with a business degree and nothing else supervise the chemical processes that go into refining oil. We pay people the big bucks to train themselves to a point we're unwiling or unable to go. having chosen our own field of expertise. Why should we be asking our doctors about a particular medicine, if we don't know what the hell we're talking about? The whole point of a prescription medicine is that the stuff is not typically safe enough or well understood enough to just let folks without medical knowledge make the decision alone.

These chemicals in our daily lives are not to be taken lightly. As people who take multiple medicines know, the issues of what happens with a drug can get pretty complex, by themselves, and with other drugs. The rhetoric of self-determination can be positive in many areas, but it isn't our decisions that make these drugs affect us the way they do, it's their chemistry, and ours, and we don't have a heck of a lot of knowledgeable control over either. Willpower does not determine how we metabolize a painkiller, and how it works its effects.

It's become fashionable in this day and age to question the wisdom of established science, of scientific principles and methods, in favor of folk wisdom, in favor of personal choice. In this world, though, where many of the medical technologies applied to us work on principles beyond our expertise, it's much smarter to accept these people's help. We can't all be metallurgists, filmmakers, accountants, chemists, or doctors. It's only common sense that we defer to experts for many decisions.

The laws and regulations in Washington have placed important matters of medical safety to a greater extent in the hands of those unwilling or unable to understand the consequences of their actions. We should require more rigorous and more independent studies of medications before they are put on the market, by tightening regulations on supplements and requiring pharmaceutical level testing of supplements for efficacy and safety, and finally by limiting advertisement of medications whose use can only be had under a doctor's care anyways. The health of the patient should come before the business of the pharmaceutical company. Let the people who know what they're talking about make the decisions on these matters.

The time has come to put American medicine back under the care of physicians.

Posted by Stephen Daugherty at January 23, 2007 11:55 AM
Comments
Comment #204606

Pharmaceutical advertising drives me crazy for many reasons. The most rage-inducing but least consequential is when they say that viral infections are a side effect of medication, or other stupidly worded disclaimers (suceptibility to viral infection may be a side effect, but unless they’re putting the viruses into the medicine, viral infection is not a side effect!!!!).

More importantly is that the ads make people believe that the latest and most expensive medication is the best, and they have to have it. For example, nexium is just prilosec with a minor modification. Both pills work almost equally well. However, once the patent on prilosec was ending, the company dropped advertising it and promoted the daylights out of nexium. Same stuff, more money. Many of the older, generic drugs (like ibuprofen instead of celebrex) work just as well if not better than the new ones, and unless you have certain risk factors, are just as safe if not more so. Advertising, however, makes people demand the new stuff, and feel like they are getting ripped off if they don’t have it.

A third thing that bugs me is the deceptive nature of the advertising. The king of this is “indoor vs outdoor allergies”. This is complete crap. Allergies are pretty much the same. “Approved for both indoor and outdoor” only means they made an effort to test two different kinds of allergens, not that other medications wouldn’t work equally as well. When your drug just blocks histamine the allergen doesn’t matter that much!
Thanks for providing the space and topic for my rant. I could also go off on “supplements”, but I’ll restrain myself.

Posted by: Brian Poole at January 23, 2007 1:26 PM
Comment #204607

Testing finds lead in vitamins, other problems

Posted by: womanmarine at January 23, 2007 1:26 PM
Comment #204610
by limiting advertisement of medications whose use can only be had under a doctor’s care anyways

The advertising money would be so much more useful for research and development.

Having worked for a doctor, the pharmaceutical reps are some of the worst.

Posted by: womanmarine at January 23, 2007 1:31 PM
Comment #204611

Oh, the fourth thing that really, really bugs me is the creation of demand for ridiculously expensive medication for minor or nonexistant problems. I don’t remember the name of the medication, but it’s the nail fungus one that is the best example of such a tactic. The medication costs several hundred dollars a month, and it takes three months to show any effects. Not to mention that you’re ingesting powerful anti-fungals over a period of months. Insurance covers it, which just means we all pay more for insurance. But hey, you can’t have a thick tonail, can you?

Posted by: Brian Poole at January 23, 2007 1:55 PM
Comment #204613

Get rid of the middlemen.

Having worked for a doctor, the pharmaceutical reps are some of the worst.
I too have witnessed how the pharmaceutical Reps literally wine-and-dine doctors and Physicians Assistants.

There’s definitely something drastically wrong when 106,000 Americans die annually due to Adverse Drug Reactions (ADRs), and 195,000 die annually due to preventable medical mistakes.

Of course, insurance companies are going to fight nationalized healthcare tooth-and-nail.

Nationalized healthcare isn’t a very good solution, but it might be slightly better by eliminating one of the unnecessary middlemen (insurance companies).

The best solution is for Healthcare providers to start dealing directly with their customers again.

Otherwise, many healthcare providers will continue to get squeezed by the current middlemen (government, insurance companies, and greedy ambulance chasing personal injury lawyers), and consumers that simply can no longer afford their services or insurance. Already, many doctors find it increasingly difficult to afford the malpractice insurance (which can cost several hundred thou$and per year), and some states won’t allow doctors to practice without that insurance.

At any rate, looking to government to solve the problem is not the best solution. Especially since irresponsible incumbent politicians in Congress, for decades, appear unable to solve many of the nation’s pressing problems, and why should they when voters keep rewarding them by repeatedly re-electing them.

For example, one of the obvious burdens on the healthcare system is illegal aliens. Many hospitals and ERs have closed after being overrun by illegal aliens. But, politicians in Congress still refuse to enforce existing laws, despicably, pitting American citizens and illegal aliens against each other.

Posted by: d.a.n at January 23, 2007 2:22 PM
Comment #204647

Brian Poole-
As I said, the body’s complex. Some medicines suppress the immune system, others sort of lower resistance from some other sort of interference.

As for going off on supplements? Don’t mind me. just rant away. I want people vent their frustrations here! My least favorite is Enzyte. The man looks like the fricking Joker. Perhaps the secret ingredient is Smilex!

All that aside, if this stuff really is capable of male enhancement like they’re suggesting, it must be wreaking some kind of havoc on the Endocrine and/or reproductive system, and should be treated with appropriate regulation to that end. If it’s not doing anything, it’s a fraud and it needs to be taken off the market.

Dan-
The government here has clear and historic authority to regulate food, drugs, and supplements. I’m not sure nationalized healthcare is the best solution. The reason why people are so intent on it nowadays likely stems from the dysfunctional regulatory system we have now, and the this conflict of interest that comes from having hte people who foot the bills often be the same people as those who run the hospital.

gw-
Funny you should mention the experts, because the experts told Bush and Rumsfeld they needed more soldiers, that wholesale De-Baathification was a dumb idea, as was firing the police and the disbanding the Iraqi army. My views on Iraq are in fact supported by a number of former and current military officers.

The closest these subjects relate on things is this: The Republicans never listened to the right people on the subject.

Posted by: Stephen Daugherty at January 23, 2007 5:20 PM
Comment #204671
Stephen Daugherty wrote: d.a.n , The government here has clear and historic authority to regulate food, drugs, and supplements.
Yes, but what’s going on with so many annual (195,000) deaths due to medical mistakes? Is the FDA doing its job? Or just giving in to pill-pushing pharmaceuticals in a big hurry for a profit?
Stephen Daugherty wrote: I’m not sure nationalized healthcare is the best solution.
Me neither. I don’t see why medical care providers can’t deal directly with customers like everyone else?
Stephen Daugherty wrote: The reason why people are so intent on it nowadays likely stems from the dysfunctional regulatory system we have now, and the this conflict of interest that comes from having hte people who foot the bills often be the same people as those who run the hospital.
That’s part of it. The other part is a sense of entitlement. However, I’m not convinced we can all live at the expense of everyone else. The other big part of the problem is Medicare. Many doctors don’t accept or limit their number Medicare patients, because the fees are ridiculously insufficient. Government meddling created the whole mess. So, doctors and hospitals pass the cost onto to the rest of us not covered by Medicare. The middlemen (government, insurance companies, and ambulance chasing lawyers) not only add no net benefit, but are a burden on the system.

Healthcare providers need to start dealing directly with customers like they used to do. If they don’t, they’ll soon find themselves with nationalized healthcare. The bureaucracy will probably be a nightmare, like those stories in Europe where people wait for years to get medical attention. Some get tired of waiting and choose to save up the money to pay for the operation themselves in another place or country.

Why did doctors and healthcare providers slip into the habit of expecting payment from insurance companies? Because the insurance companies tapped into their laziness and greed.

The insurance companies and Medicare set themselves up as guarantors of payment. What Healthcare providers failed to realize is that all those middlemen are squeezing them and their customers, and often trying to make medical decisions. And some greedy ambulance chasing lawyers are making things much more expensive as they make millions on other peoples’ pain and misery (like John Edwards, who made $12 million or more on 4 cases).

Posted by: d.a.n at January 23, 2007 6:44 PM
Comment #204680

I overheard an interesting conversation between two drug reps at my doctor’s office a while back. They incindently were atttractive women. The doctor is an older man.

They were trading stories about the way doctors treated them. This doctor once told me he wished Vioxx was not banned.

The women discussed how some of their best sellers had been pulled, and what up and comers were showing good sales.

Obviously, their goal was sales, pure and simple. I wondered how they had been chosen by their employer. I wondered how a doctor’s choices were influenced by their relationship to the doctor.

The truth is many “questionable” drugs may be helpful to some individuals. There is also truth in seeing greed as a dangerous influence. Another sad truth is that most “professional” organizations do nothing to police themselves.

Picking a good doctor is crucial to getting good healthcare. Good luck figuring which ones are. My philosophy is to read as much as you can, ask lots of questions, trust your instincts, and hope for luck.

The best thing we could do for healthcare(other than eliminate the insurance industry) would be more openess. Doctors and Hospitals resist this, as unfair. I say tough, life is unfair, especially when patients play Russian Roulet at the doctor’s office.


Posted by: gergle at January 23, 2007 7:49 PM
Comment #204685

I go to a doctor that doesn’t accept insurance.

Posted by: d.a.n at January 23, 2007 8:08 PM
Comment #204693

Dan-
Too much “blame the government”. If you just focus on the government’s role, you forget that there are plenty of people taking advantage of, even being the ones to propose the legislation and other B.S. that gets us into this trouble.

If you keep on making the government the villain in healthcare, you deny the role of personal responsibility.

The key, as I’ve been saying, is not more government or less government, it’s good government, and a good attitude towards government in return.

One thing is to prevent conflict of interests. We cannot trust business owners or stockholders to do that. This must be legally mandated.

Another thing would be to clear up what sort of shenanigans will not be allowed by the insurance industry. What are the patient’s rights. One, indeed, should be the right to see one’s own doctor. This rigamarole of having to go to a certain doctor if you have a certain plan stifles competition.

We should untangle the paperwork requirements, and obligate better information transfer. The paperwork is one of the major preoccupations of the industry.

As for lawsuits? Well, the quandary here is how you punish malpractice. Many of the doctors screwing up here are serial screwups. That’s much of the reason for high premiums. blaming lawsuits on lawyers, exorbinant insurance rates on lawsuits, and everything else just removes responsibility from those who are really responsible. Doctors should make medical decisions and be held accountable for them. Doctors should not be held accountable for somebody else’s mistakes. The insurance companies are abusing that. Lawsuit caps will only hurt the victims.

As for John Edwards? One of his clients was somebody who had their guts sucked out through their lower quarters by defectively covered pool drains. If you want to stop frivolous lawsuits? Well most frivolous lawsuits are by corporations, so you should start there.

The point is to get this crap sorted out, not simply find somebody to blame and punish them.

The point here, I would think, would be to reform healthcare to the point where there is no need to nationalize it.

Posted by: Stephen Daugherty at January 23, 2007 8:52 PM
Comment #204697

Stephen,

First I would like to thank you for writing this article; rarely do we see prescriptions drugs discussed in the context of safety rather than expense.

The only disagreement I have with you is on where you place the blame (i.e. the Republicans); while I do agree that some of their policies have worsened this situation in many ways, they are not the sole contributor to these woes. The poisoning of the American people has truly been a long-term bipartisan effort.

Pharmaceutical companies have been skirting regulations and manipulating their own study data in order to push dangerous drugs onto an unsuspecting populace for decades. While you did touch on this, I think it is important to again point out that the entire system is one giant conflict of interest when the companies themselves are the ones testing the safety of the drugs. Their financial interest in the outcome should be more than enough to preclude them from conducting these clinical trials.

The Vioxx scandal has been both a blessing and a burden for those like myself who try to raise awareness about this issue; a blessing because it has brought it into the public’s consciousness and a burden because many people now think that the threat has been acknowledged and contained. Most believe that Vioxx was the entire iceberg, rather than just the tip.

Fluoroquinolone antibiotics such as Cipro and Levaquin are seriously and permanently maiming countless thousands of people every year (and killing hundreds); hundreds of thousands of people have suffered terribly from these drugs since their precursor, nalidixic acid, was discovered in the 1960’s, yet rather than stop this travesty the FDA is now in the process of approving them for infants and children as young as six months old. An older example, DES (diethylstilbestrol), destroyed the lives of millions of women and their children between 1939 and the 1970’s (when it was still being prescribed despite studies in the 50’s which proved conclusively that the drug was useless and only caused harm).

As d.a.n. mentioned above, there are over 100,000 deaths from properly administered prescriptions drugs every year; I would like to add to that the 2,000,000 who are seriously and many times permanently injured to that number. Rather than source these numbers individually, I refer you to an article I wrote last year, located Here (references are at the end).

Again, thank you; I implore everyone reading this to please avoid fluoroquinolone antibiotics unless they are in immediate danger of dying (and please warn your loved ones as well).

Posted by: Liberal Demon at January 23, 2007 9:23 PM
Comment #204747

Left one out, truth in labeling on foods including their place of origin and how artificially treated. It’s a biggie which leaves Americans incredibly vulnerable to terrorist attacks via the food import and distribution system.

Posted by: David R. Remer at January 24, 2007 3:33 AM
Comment #204765
Stephen Daugherty wrote: d.a.n , Too much “blame the government”.
Pure nonsense. I can only surmise that such an accusation is partisan motivated now that Dems are the “IN PARTY”. We are ALL responsible. Politicians of BOTH parties AND voters are responsible. But blind party loyalists incessantly blame the OTHER party for everything, allowing the two-party duopoly to simply take turns gettin’ theirs, as evidenced by 30+ years of history and the nation’s most pressing problems that are still being ignored, and allowed to grow in number and severity.
Stephen Daugherty wrote: If you just focus on the government’s role,
I don’t. The two middlemen are insurance companies and government. Where do you get these flawed conclusions and then try to twist what I’ve written?
Stephen Daugherty wrote: … you forget that there are plenty of people taking advantage of, even being the ones to propose the legislation and other B.S. that gets us into this trouble.
No kiddin’ ? Now were gettin’ somewhere. Like I have said many times, it’s politicians of BOTH parties, and voters, and in this case, the greedy pharmaceutal corporations that are killing over 106,000 people per year due to Adverse Drug Reactions (ADRs) in their big hurry for profits and the incompetence of the FDA to do their job correctly.
Stephen Daugherty wrote: If you keep on making the government the villain in healthcare, you deny the role of personal responsibility.
Nonsense. Again, the role of responsibility lies with all of us. However, business sense and common-sense tells us that unnecessary middlemen can only drive up prices and complexity.
Stephen Daugherty wrote: The key, as I’ve been saying, is not more government or less government, it’s good government, and a good attitude towards government in return.
Really? In another thread, one of your comments stated …
Stephen Daugherty wrote: I am sick of being told about big government. This is a country of 300,000,000 citizens, technologically advanced, with interstate trade a constant reality.
Now, that is a strange statement. How can anyone say government is not bloated and inefficient? Surely they would have to be kidding, eh? Or, is this sudden defense of bloated government because the Dems are now the IN-PARTY ? Once again, it looks suspiciously like partisan bias. Especially since comments in the recent past have railed against Republicans growing government larger than ever. The comments are contradictory.
Stephen Daugherty wrote: One thing is to prevent conflict of interests.
Exactly, and too many middlemen produces just that.
Stephen Daugherty wrote: We cannot trust business owners or stockholders to do that. This must be legally mandated.
Of course. But laws must be enforced too, but look at the myriad of laws that government selectively enforces or ignores completely (such as illegal immigration).
Stephen Daugherty wrote: Another thing would be to clear up what sort of shenanigans will not be allowed by the insurance industry. What are the patient’s rights. One, indeed, should be the right to see one’s own doctor. This rigamarole of having to go to a certain doctor if you have a certain plan stifles competition.
Insurance companies provide no net benefit. 47 million Americans can’t afford it because it is ridiculously unaffordable. There is an entire industry of millions of people that make their living doing something that isn’t even necessary (or beneficial as a whole). Insurance companies are an unnecessary middleman.

The healthcare providers (doctors and hospitals primarily) had better get their act together, and start dealing directly with their customers (like most everyone else), or they will get stuck with a nationalized healthcare system. That’s where it is headed. And it won’t be the panacea many think it will be, because there will still be one unnecessary middleman (government), and since when did the government manage anything adequately or efficiently? Social Security? Medicare?

Stephen Daugherty wrote: We should untangle the paperwork requirements, and obligate better information transfer. The paperwork is one of the major preoccupations of the industry.
Exactly, and that’s because there are two unnecessary middlemen (government and insurance companies).
Stephen Daugherty wrote: As for lawsuits? Well, the quandary here is how you punish malpractice. Many of the doctors screwing up here are serial screwups. That’s much of the reason for high premiums.
But who got a huge portion of the money? The lawyer did. John Edwards made his fortune that way (via other peoples’ pain an misery). John Edwards is a greedy ambulance chaser. John Edwards net worth (check it out at wikipedia) is $12 to $60 million from only four cases. Sure, make the guilty pay, but don’t make the ambulance chasers filthy right too. You say the quandry is how to punish malpractice? How about taking away their license to practice? Guess that would make too much sense, and be bad for business for the ambulance chasing lawyers.
Stephen Daugherty wrote: … blaming lawsuits on lawyers, exorbinant insurance rates on lawsuits, and everything else just removes responsibility from those who are really responsible.
Nonsense. Their greed is a huge part of the who is responsible. But a dysfunctional legal system and dysfunctional government paves the way.
Stephen Daugherty wrote: Doctors should make medical decisions and be held accountable for them. Doctors should not be held accountable for somebody else’s mistakes. The insurance companies are abusing that. Lawsuit caps will only hurt the victims.
Not true. Not when lawyers are taking millions (50% or more). Common-sense caps on the lawyers’ cut is what is needed, and the law and juries can control that. It’s that simple.
Stephen Daugherty wrote: As for John Edwards? One of his clients was somebody who had their guts sucked out through their lower quarters by defectively covered pool drains.
So what? Should John Edwards have received several millions for it? Careful. The defensiveness of John Edwardss (a Democrat) could be construed as yet another partisan bias, eh?
Stephen Daugherty wrote: The point is to get this crap sorted out, not simply find somebody to blame and punish them.
Exactly. I recommend eliminating the middlemen (government and insurance companies), like it used to be. But you choose to twist it into “blame and punish”, and some of it appears partisan biased now that Dems are the IN-PARTY, and John Edwards is a Democrat. Suddenly, since the last election, we are supposed to be patient, understanding, and accept over-bloated government, and supposed to believe it isn’t over-bloated?
Stephen Daugherty wrote: The point here, I would think, would be to reform healthcare to the point where there is no need to nationalize it.
Well, don’t get your hopes up, because it is looking more and more like that’s exactly what we’re gonna get. It won’t make things much better, but it would hopefully get rid of one middleman. However, if the nationalized healthcare still incorporates insurance companies in the healthcare system, it will become even worse than it is now.
David R. Remer wrote: Left one out, truth in labeling on foods including their place of origin and how artificially treated. It’s a biggie which leaves Americans incredibly vulnerable to terrorist attacks via the food import and distribution system.
Exactly. And wide-open borders and ports makes it even easier. Yet, despite the overwhelming negligence of government, some people say “too much blame the government” ?

What are voters supposed to do when government refuses to pay any attention to voters?
It certainly ain’t to keep rewarding irresponsible incumbent politicians by repeatedly re-electing them.

Posted by: d.a.n at January 24, 2007 9:38 AM
Comment #204872

Stephen,

You claim that the following: “The three main parts of this are the conflicts of interest of the FDA towards approval of drugs, deregulation of supplements and the advertisement of prescription drugs on television.”

Let’s start with Deregulation of supplements. The bill that did that was the 1994 Supplementary Health and Education act. This was passed by the 103rd Congress which was help by a near supermajority of Democrats in both chambers and signed by a Democratic President, was it not?

From you own cite regarding approvals, “More recently, the scrutiny over drug safety has weakened. In the study that we conducted of FDA physicians, they told us in 1998, compared with several years before, the standards were lower for safety and for effectiveness. In other words, the decision to approve a drug was more lax, more risky in a sense, in the late 1990s than it had been even three or four years before. We focused on those people that had been around long enough to be able to compare what was going on then with what was going on earlier.

The FDA is a member of the executive branch, right? The problems cited in your link seem to have their root cause in poor executive management in the late 90’s. Wasn’t a Democrat President then?

I believe that the advertising you can somewhat lay at the feet of the Republican’s, though my research is not clear on that. But that seems the least of the three problems.

If you look at the hisotry of the FDA, you will see that many of the changes that were designed to make it easier to get drugs on the market were spurred on in the late 80’s and early to mid 90’s by concerns over delaying life-saving treatments to dying patients. This was done with bi-partisan support.

Funding of trials by manufacturers is also nothing new to the Republicans, nor is it wrong if monitored by peers and overseen by regulators.

Posted by: Rob at January 24, 2007 8:35 PM
Comment #204891

Thank you for your corrections. I should have been better informed. Still, though, the fundamental points should stand.

Even if the measures are meant to speed life-saving drugs, it’s not all that life-saving if it’s killing you. Intentions are not what matters, but results, and only by studying the results do we get truly self-correcting measures in place.

We must be willing to admit where we have been wrong if our mistakes aren’t to bring worse shame to us. If I fail to get the facts right, I should admit my error, rather than compound the error by trying to spin it.

If Democrats are responsible for part of this mess, then I still believe we should be responsible for cleaning it up. We have our old former mistakes to clear up, along with those of our rivals.

Posted by: Stephen Daugherty at January 24, 2007 10:19 PM
Comment #205277

I appreciate the response. I hope that you will take the time to become more informed on the history of deregulation generally because I think you will find that Democrats have driven it far more historically than have Republicans (to their credit in many cases).

I should have said before that I think that your initial analysis was heartful and their are some merits to your points. I too don’t like the advertising, nor do I guess that many doctors who are faced with patients who demand treatment paths that may not be the best couse of action.

Your point on needing more rigorous testing, I agree with generally though not in the specifics. It should be the responsibility of the company wishing to bring a new drug to market to do the testing. I believe this for two reasons:

1) There are thousands of tests going on at it any one particular time; the testing is expensive and time-consuming. Unless driven by the companies, the potential for backlog and overwhelming bureacracy at the FDA is so probable to be almost a forgone conclusion.

Then the FDA is faced with the position of having to choose which trials are conducted first. This can litteraly be a life or death choice for Americans that need not be made.

There is also the problem of politicizing the funding for testing. Plan B had a hard enough time getting through the regulatory process under Republican leadership. Do think such a contraversial product would ever have a turn in the testing cycles under a Republican FDA (much to my dismay, I believe it to be true)? Democrats on this board have been fond of pointing out how amusing it will be when Hillary (usually the one cited anyway) gets her hands on the expanded executive authority that Bush has crafted. Similar cautions must apply in the reverse.

2) it also makes the companies completely responsible for owning the results and the later problems.

There are several analogies in other parts of business. Lets take materials. Materials are developed by one company, tested by a second, and installed by a third, usually. If an unsound material causes a significant problem (bad steel buckles in bridge killing 3 for instance), the responsibility gets split 2 ways. When such an event happens, the first company sued is usually the installer, he proves that the installation is sound and no judgement is rendered. The second step is to go after the manufacturer, the material is deemed defective and judgement is given. The next step is for the manufacturer to sue the testing company for having signed off on the material because they guaranteed the results.

Now if the FDA were at the healm for testing, when (not if, because it will happen) a drug creates a rash of adverse reactions after being properly perscribed, the drug company will (partially rightly so), say these drugs have the full faith and credit of the U.S. government behind them, we are not responsible.

We do not need to take manufacturers off the hook. Now I will argue with the best of them that their is need for reform in the malpractice industry, but I have no real problem with punitive damages for companies that willfully plan for “collateral damage,” nor do I have a problem with compensutory damages for a company that unwittingly causes grief despite best intentions.

Posted by: Rob at January 26, 2007 8:48 PM
Comment #215749

You have to blame the drug companies who tell doctors to dispense drug as if they were candy so that the drug company can make more money. WBR LeoP

Posted by: Leonard at April 9, 2007 5:33 PM
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