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We have The Donald,once a classic psychopathic Democratic ass who is now running for president of 325 million people as a crazy psychopathic Republican elephant. He likes his name in twenty-foot high gold letters on everything. We have former Minnesota Representative Michele Bachmann, a religious Dominionist nutcase who believes Barack Obama is the Anti-Christ, who says he will lead all of us to the Christian Rapture in which the saved enter heaven as naked as jaybirds. She now proclaims she is advising Donald Trump on foreign policy! A Michigan prosecutor is seriously considering calling a 19-year-old African Grey parrot as a witness in a wife-killing-her-husband murder case. If the three give testimony on anything, I will only believe the parrot. It looks as if we are truly entering the silly season.
On top of these three situations, the Food and Drug Administration is really hyping the silly season by approving a new weight-loss program called AspireAssist. For people who have failed many diets, this program emphasizes a few basic principles: chewing well and long, drinking plenty of water—and aspirating. After eating a meal, the AspireAssist allows you to “aspirate” 25-30% of what you have eaten through a hole in your stomach into the toilet via a tube. In everyday language we call that “puking your guts out.” I quote the program director: “Successful patients “aspirate” three times a day after each meal, even when life gets busy. Patients must chew everything well-into very small parts—so the tube doesn’t clog.” This program is a real “yuck.” Wouldn’t it be easier to eat 70% of a meal and then quit? These four situations point out that humankind has a long way to go to achieve simple equilibrium.
Have We Also Forgotten About The “Public Good?”
Just for a minute let’s examine the case of the man who lived on a private gravel road in the suburbs. There were about a dozen homes in the neighborhood that used the road and the man lived in the first one. He claimed he should only pay for the gravel he used to get home. He said that the party at the extreme end of the gravel road should pay more because he used more of the road to get to his house. Does that make any sense? Or should every resident pay the same amount? We used to have a gravel road to our lake cabin in a similar situation. About 20 people used the road. Sometimes we would have a user object to paying for gravel and maintenance of the road. The rest of us covered the cost. All of us benefitted from maintaining the road because of garbage pickup, mail delivery, safety, maintenance of property values, and fire, emergency, and other utility services. We all benefit from an interdependent society and serving the “public good.” A New Yorker cartoon has an ornate tombstone with the following forlorn message carved in stone: “I Can’t Believe I Ate All That Kale For Nothing.” But kale is a healthful food and should be eaten by all of us.
I remember Rep. Bachmann arguing against the EPA decision to phase out incandescent light bulbs because by adopting LED bulbs we would save a lot of money on electricity and save a lot on bulbs. She was opposed to the phase out because it took away her conservative personal freedom to make a choice! The EPA continued to argue its case. Suppose we need 800 lumens (A candle produces about 13 lumens) to light a space for 50,000 hours. We need about 50 incandescent bulbs and 3,000 kilowatt-hours of electricity costing $350 for both. If we use the new LED technology we would get the same illumination with one $5 six-watt LED bulb lasting 50,000 hours for only $35! This is a remarkable public good! I have always wondered what Bachmann’s definition of “conservative” is.
Should every residence in Minnesota have access to high-speed broadband? Isn’t it a public utility like sewer and water, electricity, and garbage pickup? The country of Finland has installed broadband and a computer in every residence so that many transactions can take place by a fiber network. Most Finns bank on the Internet, communicate by e-mail instead of letters, and pay their taxes by e-mail. In the end, savings are enormous. Minnesota taxpayers paid $600 million to help build a stadium for billionaires so they could watch overpaid athletes from very expensive seats and suites. That money would have been a great start for installing broadband in every residence in the state. What a boost for education and the economy! People could then run a national business from Greenbush or Gregory.
“Capitalism May Be The Best Economic System Ever Devised, But………..”
New York Times writer Jeff Sovern starts his article “The Risks Of Unfettered Capitalism” with the above line. He completes it with this warning: “But one of its drawbacks is that it provides financial incentives to harm and even kill people. Just ask those people who say they have been victimized by cigarettes, predatory lenders, Volkswagen diesel emissions, Takata air bags, General Motors ignition switches, Trump University, Vioxx, asbestos, or other products.” Millions have died early from smoking, thousands from asbestos, dozens from airbags and faulty switches. Millions have lost their homes from predatory lending and other Wall Street shenanigans and fraud.Sometimes unregulated capitalism is controlled by consciences, self-interest, personal ethics, and fear of damaged reputations. But there is considerable evidence that the desire for profits often overrules honesty, integrity, and science.
When regulations are weak or don’t exist, consumers have to depend on moral businesses and CEOs to protect them from risks. Good luck. When CEOs and stockholders complain about too much regulation, ask them what harms-or harms- that regulation may prevent. If some tough moral bureaucrat in government would have raised serious questions about predatory lending and Wall Street malfeasance during George W. days, five million families might still have their homes. Sovern concludes with a great line: “Capitalism lifts standards of living—but regulated capitalism keeps us well enough to enjoy a higher standard of living.” Sovern is a professor of law at St. John’s University an d specializes in Consumer law.
The latest example of “unfettered” capitalism is the EpiPen ripoff by Mylan Pharmaceuticals, now a prominent member of Big Pharma, the creator of $1,000 pills by Pfizer and $300,000 annual individual drug bills by Vertex Pharmaceuticals. About four million people, mostly youngsters, use the drug epinephrine in the EpiPen to control anaphylaxis, an allergic reaction to peanuts, bee strings, and other things. The drug protects the victim from shock and helps to keep air passages open. Mylan bought the EpiPen drug from Merck in 2007 when the price was $93.88 for two “pens.” Mylan has now increased the price to $608.61 for two. In 2007 Mylan sold $200 million worth. In 2015 they sold $1 billion worth. The net profit on EpiPen is 55%. The drug has hardly changed since it was introduced almost 40 years ago. Mylan spent $4 million convincing Congress to pass a law in 2013 forcing public schools to keep EpiPens on hand. It gives schools special discounts at $112.10—if it agrees not to purchase similar products from other companies! In 2014 Mylan completed a corporate inversion to the Netherlands, a notorious tax haven for tax avoiders. Pittsburgh remains the corporate headquarters where most of its employees live. Mylan receives millions of taxpayer dollars through Medicare, Medicaid, and the Children’s Health Insurance Program.
CEO Heather Bresch made $4.9 million in salary in 2009, but after performing the “tax inversion” her salary went to $25.8 million. Some drugs prevent death. EpiPen is one of them. So is aspirin. I’m rather surprised aspirins are so cheap. In order to live with death, which we all face anyway, should we have to ransom our lives to greedy drug companies? Big Pharma has raised drug prices 38% in the last ten years—while the Consumer Price Index went up only 18%. How does the gouge in your back feel? Countries such as Canada and Great Britain regulate drug prices and negotiate with all drug companies. Congressional acts prevent Medicare and other agencies from negotiating drug prices with drug companies. Excessive profits allow companies to continue to buy politicians by the gross. Mylan is a splendid example of unregulated capitalism destroying a democracy through greed. Mylan says EpiPens are effective for only one year and then need to be replaced if not used—at another $608.61. I wonder…For a parent with a child with a life-threatening allergy, that’s real money.
Our Crazy Heathcare Dissystem Is A Disaster Happening
Remember that old Hippocratic oath about medicine that medical doctors swear to before “practicing” medicine: “First, do no harm?” This is a part of the modern version used in most medical schools:
1. I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
2. I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
3. I will remember there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
4. I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
5. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may be in my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
6. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
When Turing Pharmaceuticals raised the price of an infectious disease drug Daraprim from $13.50 a pill to $750, we didn’t hear a righteous outcry from all those Hippocratic doctors who took the oath. I see Pfizer Pharmaceuticals is buying anti-infection drugs from another drug giant AstraZeneca for several billion dollars. Two days before this deal Pfizer bought Medivation, a cancer drug maker, for $14 billion. Evidently Pfizer was motivated to buy Medivation so they could continue to make more obscene profits in a country that refuses to regulate drug prices for the “common and public good.”
The Food and Drug Administration approves drugs for marketing purposes but does not regulate surgical procedures. As cutting up hearts, knees, hips, and spines is very profitable, a lot of scalpels are used in the United States. Let’s use knees for an example. Surgical prices vary. In Texas alone, the charge ranges from $16,772 to $61,585 for knee replacement. In an article titled “Why “Useless” Surgery Is Still Popular” Gina Kolata covers four recent clinical trials that examined knee arthroscopic surgeries averaging $5,783. About 400,000 older Americans have meniscus surgery every year. Clinical trials prove that surgery is no better than alternative nonsurgical treatments such as supervised exercise and therapy or drug treatments. MRI scans indicate that many people with meniscus tears have no pain. Often osteoarthritis is the real source for the pain. Dr. David Kallmas of the Mayo Clinic, an expert in verteplasty (spine), says operations on joints, knees, and spines continue because insurers pay well for them—and that doctors might remember their own patients “who seemed better afterward.”
As a Marine officer I had to inform the troops annually about the Geneva Convention and our various treaties about the rules of war. Perhaps doctors and drug manufacturers—and hospital administrators—should be required to renew their Hippocratic oaths each year.