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“John,” you plead; “what’s the New England Journal of Medicine saying now?” The August 15, 2019 issue has an article titled “The ‘All of Us’ Research Program” and it says “diverse” or “diversity” at least eight times. You’re welcome! I mean not just to this news; I also mean you yourself can join this hip […]

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Jim Geraghty of National Review unleashes an epic rant about the re-emergence of Anthony Scaramucci – this time as an anti-Trump figure suddenly loved and respected by the press – and the Trump culture that created the Mooch. But first, he and Greg Corombos of Radio America celebrate Planned Parenthood withdrawing as an applicant for […]

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Jim Geraghty of National Review and Greg Corombos of Radio America are back! Today, they enjoy watching Democrats wasting time and money in pushing Rep. Joseph Kennedy III to launch a primary challenge against incumbent Democratic Sen. Ed Markey, but Jim also explains why it’s long past time to stop fawning over the Kennedys. Jim […]

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Still gettin’ the New England Journal of Medicine. Still gettin’ The New Yorker too, but that goes straight into the trash. Well, I did peek at a recent issue. There was something overlong about Al Franken: the great man looked persecuted and wan. And there was a lame cartoon by Roz Chast. Definitely a bottom-of-the-batting-order […]

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The Economic Trap of ‘Medicare For All’

 

January 19, 2019, San Francisco, CA – Participant in the Women’s March holds “Medicare for all” sign while marching on Market street. (Shutterstock.com)
When an untested program looks too good to be true, it is almost certainly far worse than anyone could imagine. Case in point: the Medicare for All program set out in Senate Bill 1129, introduced this past April by Senator Bernie Sanders (VT) and cosponsored by three fellow presidential candidates, Senators Cory Booker (NJ), Kamala Harris (CA), and Elizabeth Warren (MA). The legislation proposes a government takeover of the nation’s entire health care system—the same government that is notoriously unable to address the endless waste in its very own Veterans Administration health care program. The obvious explanation for the government’s abysmal performance in health care is its lack of ownership stake and the associated lack of accountability for costs and performance. This difficulty is inherent in all government-run enterprises, which explains why the United States Post Office is far less efficient than Federal Express and UPS.

A self-described democratic-socialist like Sanders finds these pesky details of business management and incentives irritating irrelevancies that can eventually be solved by clever government officials. After all, if you don’t believe that markets solve problems, why would you think that the market can untie the nation’s health care gridlock? Warren, who has described herself as “capitalist to my bones,” should know better than to trust the federal government to bring order to the national health care system. But the truth is, she deeply disdains markets. Just consider her outlandish proposal to make corporations stack corporate boards with outside stakeholders ultimately accountable to her.

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Large numbers of our population are curious about their ancestry, and are using the services that tell them about their kin.The ancestry tests are now offering a new kit that tests for potential health risks. For example, with 23andMe you can request additional reports for the APOE gene, which could be an indicator of a […]

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Drug Pricing Made Easy

 

President Trump was both lucky and smart this week in his approach to the thorny issue prescription drug pricing. Lucky, because a district court threw out on First Amendment grounds his executive order that drug companies supply list prices for all the drugs that they produce. Smart, because at the eleventh hour he decided against issuing an executive order that would have required pharmaceutical companies to offer a system of “most-favored-nation” pricing, which would cap the prices that drug companies could charge in the United States to the lowest price charged for that drug in any country outside the United States. Eliminating poor price signals is a modest benefit. But the implementation of the executive order would have slashed revenues, putting pharmaceutical companies at serious financial risk and perhaps ruin.

The basic flaw behind both proposals is that they assume that there is a unique “price” at which pharmaceutical drugs sell. That assumption often works in competitive markets in which the costs of development are low relative to the marginal (i.e. additional) cost of production for each unit. But so-called marginal cost pricing does not work for new pharmaceutical drugs whose development costs are already high and getting ever higher. Companies are constantly researching and trying to develop new drugs with strong therapeutic properties and tolerable side effects. They also face huge costs in shepherding promising drugs through three stages of clinical trials, each one more complicated than the last. Many promising new drugs wash out in these clinical trials, which means that a pharmaceutical company can remain solvent only if its blockbuster drugs yield enough revenue to offset the costs of its duds. And finally, companies incur huge financing costs as they bring drugs to market. Development and clinical trials take years to complete, and drug companies have to find ways to finance expenditures made in year one with revenues that will only start, typically, some eight to 10 years later.

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Jim Geraghty of National Review and Greg Corombos of Radio America scrutinize Ilhan Omar’s call to impeach President Trump in the aftermath of his racially-charged Twitter tirade. They discuss Joe Biden recycling an old Obamacare sales pitch for his new healthcare reform plan. And they try to figure out why former South Carolina Gov. Mark […]

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The G-BA is the worst

 

A group of regulators from Germany published in the British Medical Journal a recommendation on how drug companies should design clinical trials. These “recommendations” curiously align with Germany’s unwillingness to pay for efficacious drugs.

There are two regulatory bodies in Germany that check whether a new drug is better than an old treatment and pay accordingly, IQWiG and the G-BA. Not surprisingly when the Germans decided to check most new drugs they found that a majority of them (56%) showed “no added benefit.” Notwithstanding the obvious conflict of interest with the German government both approving and paying for new drugs, there are two major problems with Germany’s approval process. The unnecessary cost they are asking the drug companies to absorb and the capricious way they judge whether a drug is efficacious.

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Considering how shocked and ill I suddenly felt, and while driving at highway speed, I should be able to say exactly when I had my first panic attack. Well, it was exactly or approximately 26 years ago when I did. And over the ensuing summer I had several more. Some involved heart palpitations. The violence […]

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But these days, many places are. Even Brazil, Mexico, and Detroit, pretty much. I cannot say that El Salvador in 2015 was dirty. Untidy, yes. But not awash in filth. I fear however that India remains apart from whatever salutary trends sweep the rest of the world. In a human life normally led, nearly all […]

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David French of National Review and Greg Corombos of Radio America discuss Harvard’s decision to rescind the admittance of Kyle Kashuv, a Parkland shooting survivor and conservative, for controversial past statements. They analyze the general misinformation and public ignorance about Medicare-for-All. And for today’s crazy martini, they discuss O.J. Simpson joining the Twittersphere. More

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Jim Geraghty of National Review and Greg Corombos of Radio America discuss the lineup of the two Democratic debates. They also evaluate Joe Biden’s vow that cancer will be cured if he’s elected president and Joy Behar of ‘The View’ suggesting climate change makes a cure much tougher. And they break down the political battle […]

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Jim Geraghty of National Review and Greg Corombos of Radio America discuss the American Medical Association rejecting call for single-payer healthcare system. They’re also disgusted as prolific “Jeopardy!” winner James Holzhauer faces a massive tax hit courtesy of the state of California. And Jim and Greg discuss how Democratic voters in Virginia are returning a […]

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Jim Geraghty of National Review and Greg Corombos of Radio America discuss ongoing negotiations between the United States and Mexico concerning border security and tariffs. They also roll their eyes as Joe Biden flip-flops a third time on his longtime support for the Hyde Amendment, which bans federal funding for abortion. And they get a […]

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Paper maps had made this clear. The ride from Pico da Neblina National Park back down to São Gabriel da Cachoeira had indeed been as my title describes. But recently I’d made the mistake of checking the latter’s location online and those coordinates put it north of the Equator. I now see the figures are […]

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Jim Geraghty of National Review and Greg Corombos of Radio America reflect on the 75th anniversary of D-Day and applaud President Trump’s address at Normandy. They also discuss Democratic presidential front-runner Joe Biden walking back his position change on the Hyde Amendment and facing criticism from his rivals for not backing taxpayer-funded abortions. And they […]

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Alexandra DeSanctis of National Review and Greg Corombos of Radio America cheer Democratic Louisiana Gov. John Bel Edwards for making good on his promise to sign pro-life “heartbeat” legislation that was also sponsored by a Democrat. They also shudder as a pro-life lawmaker in Illinois explains just how expansive pro-choice lawmakers there want to make […]

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Jim Geraghty of National Review and Greg Corombos of Radio America tackle ESPN’s decision to stop with the politics and stick with the sports. They also cheer Democratic Louisiana Gov. John Bel Edwards for vowing to sign a heartbeat bill if it reaches his desk. And they step carefully while discussing San Francisco spending more […]

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Alexandra DeSanctis of National Review and Greg Corombos of Radio America applaud Alabama legislators for passing a sweeping abortion ban but Alexandra wonders how well it will stand up to legal challenges. They also shake their heads as Beto O’Rourke relaunches his presidential campaign by apologizing for his privilege, calling Stacey Abrams his hero, and […]

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