Martin Shkreli and the Imbeciles


martin shkreliIt’s not often that I say, “Thank God the New Yorker cut right through all this leftist cant,” but let’s give them credit where it’s due. On this one, they’re exactly right. Everyone hates Martin Shkreli and everyone’s missing the point:

But was Shkreli’s performance actually more objectionable than that of the legislators who were performing alongside him? Elijah Cummings, of Maryland, is the ranking Democrat on the committee, and he used his allotted time to deliver a scolding. … Cummings acted as if Shkreli were the only thing preventing a broken system from being fixed. “I know you’re smiling, but I’m very serious, sir,” he said. “The way I see it, you can go down in history as the poster boy for greedy drug-company executives, or you can change the system—yeah, you.” Cummings has been in Congress since 1996, and he is a firm believer in the power of government to improve industry through regulation. And yet now he was begging the former C.E.O. of a relatively minor pharmaceutical company to “change the system”? …

The Republican-led committee was no more impressive. As if to establish that Turing was unnecessarily profitable, the committee released documents showing that the company had thrown a lavish party—fireworks included—and given some executives six-figure raises. (If this now counts as corporate behavior worthy of oversight and reform, the committee may soon find its schedule overbooked.) And then there was John Mica, a Republican from Florida, who has vowed to “keep the government out of patients’ sick beds.” Notwithstanding his skepticism of government intervention, he expressed alarm that some drug prices have “skyrocketed.” Even more than his colleagues, he seemed taken aback by the star witness’s recalcitrance, as if he couldn’t fathom why a private citizen wouldn’t be more deferential to his government—at one point, he threatened to move to hold Shkreli in contempt.

On Fairness in Canadian Healthcare


shutterstock_249846172-e1453904472642I’m a week into my first trip to North America since 2011, and the first time I’ve been to Canada since my childhood. I’ve been visiting a famous Canadian healthcare complex and have been struck by a few things as an Aussie. I’m impressed by the professionalism of my colleagues and the standard of the technology being used to treat patients surgically. I am also struck by the fact that all the doctors I have spoken to are harshly critical of Canadian healthcare as it stands, and think that some kind of reform or change is needed.

Australia, like Canada, has universal healthcare but the similarity ends with this sentence. If you don’t like the waiting time, or the options presented to you, or your physician, or even just the decor of the public hospital in Australia, in most cases one can obtain the same service from a private doctor or hospital. In fact, once can choose to see the same surgeon from the public hospital in a private setting, if one wants. This usually comes at a price, but is always faster, and often in a “nicer” institution. None of that can happen if you are a patient in Canada, by law, because “fairness” and “equality.”

Fairness and equality as enshrined in the Canada Health Act make it illegal in that nation for a patient to be billed privately for medical treatment that is already covered by the public system. Physicians are also barred from providing both public and private health care. This was all very well thought out and designed by the left-leaning Liberal Party and enshrined into law by their majority government in 1984. (Message: Elections matter.)

The Other Drug War


Earlier this month, the Food and Drug Administration rejected the application of Biomarin Pharmaceutical to market its drug Kyndrisa™ (drisapersen) for use in the treatment of Duchenne muscular dystrophy. The FDA, as is often the case when it rejects a drug application, listed all sorts of technical reasons why the data presented was not sufficient to establish by respectable scientific means that the drug in question was safe and effective in its intended use. Without question, much evidence from the clinical trials revealed serious complications from the drug’s use, including blood-platelet shortages that were potentially fatal, kidney damage, and severe injection-site reactions. But the no-treatment alternative could prove far worse.

Duchenne is a rare but fatal genetic disorder that attacks only young boys, roughly 1 in 3,500 to 5,000. Typically, it first manifests itself between two and five years of age. With time, it relentlessly weakens the skeletal muscles that control movement in the arms, legs, and trunk. Most of its victims are wheelchair-bound between the ages of seven and 13. By 20, many have died.

Making Drugs Affordable


shutterstock_197494286Remember Martin Shkreli, the pharmaceutical executive who jacked up the prices of an off-patent drug used by some AIDS patients last year and who was recently perp-walked for securities fraud? The Left treated his arrest as a victory for the common man, but it hasn’t made pyrimethamine, the active ingredient in Daraprim, any more available to those who need it.

Mark Baum, however, has done just that: Since last year’s media fiasco, the compounding pharmacy he runs has been selling drugs with the same chemical properties (with an added, relevant vitamin) for about a $1 a pill. That’s among the reasons why Shkreli’s antics didn’t lead to a pile of dead bodies.

The reason Baum’s company has been able to do this so quickly and inexpensively is because compounding pharmaceuticals are not subject to the same regulatory scrutiny as generic manufacturers and are often able to charge prices closer to the costs of manufacture.

Unintended Consequences: Docs & Glocks Edition


shutterstock_151057025Several years ago, the American Medical Association instituted a new policy of recommending that doctors enquire about their patients’ firearms. This was pitched as a matter of household and child safety and — while the policy stressed “education” — its language makes it pretty clear that this is not something Eddie Eagle would endorse. Despite not having kids, I’ve been asked about my guns at least twice at the doctor’s. The first time, I wasn’t expecting it and simply answered the nice nurse’s question. The second time, I said something to the effect of, “Thank you, but I don’t think that’s a medical question.” The nurse shrugged and the appointment proceeded as before.

Unsurprisingly, stories soon emerged about doctors dropping patients who refused to answer the question, as well as others who (chillingly) tried to talk to children about it behind their parents’ backs. In response, several states, including Florida, passed legislation that forbade doctors and other medical professionals to bring up the subject of guns under most circumstances.

Much has been written about this: I came across a discussion of it on Science-Based Medicine earlier this week, which made reference to a recent post on the Volokh Conspiracy that I’d missed. We’ve also talked about it on Ricochet. The most recent news is that the Florida law has again been found constitutional, this time on First Amendment grounds subject to strict scrutiny. That seems like a bad decision to me, but I’ll recommend you read others’ takes to form a legal opinion.

Greg Corombos of Radio America and Ian Tuttle of National Review appreciate Hillary Clinton providing material for many fall campaign ads by closely tying herself to President Obama on issues ranging from Obamacare to Iran to Syria.  They eagerly welcome the release of the American hostages from Iran but conclude the Iranians rolled the Obama administration again.  And they marvel that Bernie Sanders, an avowed socialist with poor debating skills, actually has a shot at the nomination.

Greg Corombos of Radio America and Jim Geraghty of National Review discuss the implosion of Al Jazeera America.  They also slam Secretary of State John Kerry for thanking Iran for its treatment of 10 U.S. sailors after our women and women were humiliated on video.  They slam Chelsea Clinton for suggesting Bernie Sanders and Republicans have the same position on Obamacare.  And they pay tribute to the late actor Alan Rickman, villain from “Die Hard,” the official movie of the Three Martini Lunch.

Obama’s Abortion Pill Mandate Sham Is No “Accommodation”


shutterstock_133423673-e1444998785546Several religious non-profit organizations — including Christian colleges, the Little Sisters of the Poor, and Priests for Life — filed their opening brief Monday with the US Supreme Court in a highly-anticipated challenge to the Obama administration’s abortion-pill mandate and the sham “accommodation” it offers religious non-profits.

The Department of Health and Human Services mandate forces employers, regardless of their religious or moral convictions, to provide abortion-inducing drugs, sterilization, and contraception through their health plans under threat of heavy penalties. Alliance Defending Freedom clients Geneva College in Pennsylvania and the four universities in Oklahoma – Southern Nazarene University, Oklahoma Wesleyan University, Oklahoma Baptist University, and Mid-America Christian University – specifically object to providing abortifacients.

So what distinguishes this case from the Hobby Lobby/Conestoga Wood Specialties victory against the abortion-pill mandate at the Supreme Court in 2014?

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Greg Corombos of Radio America and Jim Geraghty of National Review applaud Marco Rubio for slipping language into a recent spending bill that makes it much tougher for the government to bail out health insurers, which may provide an opportunity soon to change the system.  They also discuss a newly released email suggesting the Pentagon did have a military response ready to deploy to the Benghazi attacks.  And they shake their heads as Bernie Sanders ducks questions on ISIS.

Greg Corombos of Radio America and Jim Geraghty of National Review applaud Hawaii Democratic Rep. Tulsi Gabbard for being a fearless voice against her own party on the issue of national security.  They also rip United Health for just now realizing that Obamacare is a disaster for their bottom line.  And they groan as Hillary uses little girls in an ad to pitch the need for a female president.

The FDA’s Looming Regulatory Onslaught Threatens the Freedom to Vape


shutterstock_299809835Americans who are trying to kick their nasty smoking habit have found healthier alternatives in e-cigarettes and vapor products that could, quite literally, save their lives. But the bureaucrats at the Food and Drug Administration are trying to put this $3.5 billion industry out of business.

Small mom-and-pop shops have sprung up across the country to meet the growing demand for vapor products, which allow users to refill their vaporizers with their favorite e-juices. Separately, big tobacco companies have invested in non-refillable e-cigarettes.

Though these products are not always tobacco-free; there’s no ash or smoke involved. But they do contain nicotine, which users can gradually reduce if they choose. E-cigarettes and vapor products contain far fewer chemicals and carcinogens than traditional tobacco cigarettes, making them safer for the users, as well as those around them. “[T]he levels of potentially problematic substances in e-cigarette aerosol,” Reason’s Jacob Sullum wrote in March, “are about the same as those detected in ambient air.”

How To Talk to Your Progressive Niece about Obamacare This Thanksgiving


shutterstock_41145493As your family gathers around the table this Thanksgiving, the conversation may get a little heated if a left-wing relative brings up the 2016 race, the attacks by ISIS, or President Obama’s failing health reforms. In particular, the Affordable Care Act remains unpopular and misunderstood among the American public — a combination that makes it likely fodder for holiday conflicts.

The liberal website ThinkProgress posted an article titled “How To Talk To Your Tea Party Uncle About Obamacare This Thanksgiving” while Vox published “How to Survive Your Family’s Thanksgiving Arguments.” So, if your niece is a progressive blogger and starts making wild assertions about the Affordable Care Act, here are some key points that will help keep your conversation on track:

Claim: Obamacare is not causing premiums to skyrocket.

If I Didn’t Know Obamacare Was Working Great, This Might Worry Me


Obamacare-train-wreck-002In times of trouble and crisis, one can find solace and stability in first principles. Example: “The Affordable Care Act is working just fine. No need to worry — ever.”

So when I read news that, on first take, would seem to possibly suggest — maybe, I dunno — Obamacare is not working just fine and one should worry … well, back to first principles.

This from Wall Street Journal reporters Anna Wilde Mathews and Stephanie Armour:

Beware the Wounded Animal


US-POLITICS-HEALTHObamacare is failing. Here’s the latest from The Wall Street Journal (behind pay wall):

The majority of ObamaCare’s insurance co-ops—12 of 23—have now folded, and their $1.24 billion in federal loans has all but vaporized. More will fail, nearly a million Americans may lose coverage, and now the contagion from their failures is spreading.

The co-ops are government-sponsored nonprofits that were supposed to increase competition, but instead they’re causing the greatest insurance disruption in decades. The co-ops aren’t merely jilting their displaced members or the taxpayers who supplied their “seed money.” Local regulators are defying the feds to close them because other insurers are liable for their toxic balance sheets.

What Gov. Jerry Brown’s Veto of “Right to Try” Means for California’s Terminally Ill Patients


1401317421000-OLSENEvery year, more than 60,000 Californians die of heart disease, the nation’s leading killer. Another 55,000 die of cancer, and more than 7,000 die of Alzheimer’s. But these are more than just statistics. These are our parents, siblings, relatives, and friends. For far too many, they run out of time waiting for a breakthrough drug or treatment.

That is why it was so troubling that Gov. Jerry Brown slammed the door shut on protecting terminally ill Californians’ right to try to save their own lives. To date, 24 states have a Right to Try law, which provides an important avenue for terminally ill patients to access potentially life-saving treatments.

Had the California Right to Try law been approved, terminally ill patients under the care of their physician, who had exhausted all treatment options and who did not qualify for a clinical trial would have been permitted to seek treatments that had successfully completed basic safety testing and continued to be part of the FDA’s ongoing approval process.

Is Washington killing you? That’s the question Darcy Olsen raises in her new book, The Right To Try: How the Federal Government Prevents Americans from Getting the Lifesaving Treatments They Need.

In a 10-minute conversation with The Bookmonger, Olsen describes how she got involved in a national movement to help severely sick patients, what she’s trying to accomplish, and how the U.S. Food and Drug Administration stands in the way.

Pain and Suffering in New England


imageHere in New England, it’s hard to get through a news cycle without at least one mention of the region’s opioid epidemic. Every media outlet covers it; governors are creating task forces faster than you can count; and the presidential candidates expect daily questions on the matter, often from parents who lost a child to an overdose. (Notably, Jeb Bush’s daughter has struggled with addiction for years, and Carly Fiorina’s stepdaughter died of an overdose.)

Is the problem worthy of the hype? More so than I had thought. In Massachusetts last year, there were nearly 1,100 confirmed deaths from opioid poisoning, and that number is likely to crawl higher as some investigations are completed. That’s up from 711 deaths in 2012, which constituted very nearly 30 percent of all accidental deaths in the state. Most depressingly, confirmed overdose deaths have increased every year since 2010, when the number was just 555. New Hampshire has only a fifth as many people as Massachusetts, but almost a third as many fatal cases. These rates are significantly higher than national averages.

Now, statistics like this are only a reflection of reality and often a distorted one: It’s wholly possible that the increase in the number of recorded incidents reflects, at least in part, a growing awareness of such causes of death (when you start looking for things, you tend to find them). Still, that’s a staggering number of deaths, both in absolute numbers and as a proportion of preventable deaths. I’m hesitant to use the word “epidemic” to describe things short of the Spanish Flu, but there’s a undoubtedly a very serious problem here.

Preventing Preventive Medicine


mammograms_health_care_reform_091120_wmainThe American Cancer Society has just released new breast cancer screening guidelines that substantially scale back its previous recommendations. They move much closer to the controversial recommendations made by the United States Preventive Services Task Force (USPSTF) in 2009. According to the ACS, screening should now be delayed until age 45, with annual screening until age 55, then biannual screening until age 75, when screening should stop. These new recommendations meet the USPSTF roughly halfway. (Until this week, the ACS recommended annual screening after age 40.)

I am no cancer specialist, but merely a simple country cardiac electrophysiologist. In general, I still have a residual amount of trust in the ACS (as opposed to, for instance, the American Heart Association). So I am open to the idea that the new ACS recommendations may in some way be reasonable.

However, admittedly without any direct evidence, I suspect that the ACS has instead chosen to interpret available clinical evidence in a way that moves them closer to the USPSTF, as a matter of institutional survival. For it will not pay, in the long run, for any professional organization to get on the wrong side of the USPSTF.