HEALTH PLANS/PHARMA: Politics is all there is….

Sometimes you can sleep safe at night thinking that your elected representatives are going to leave some things alone.  But in the last couple of days it’s become apparent that political motivations are the only motivations left for those in government.  was as good as his word .  Now that’s not as bad as it sounds for the merger as a few years ago California set up a Department of Managed Health Care to regulate HMOs (which for some arcane reason had not been under the insurance commissioner but under the department of Corporations). The Department of Managed Health Care is part of the executive under Arnie the Guvornator, who is of course a Republican and in the pocket of state business interests (or at the least has taken a bunch out of their pockets– but as he says they’re "powerful interests" not "special interests"). So Managed Health Care’s approval, which OKs the sale of Blue Cross’ main health insurance businesses was a shoe-in, after a modest bit of back and forth.  Garimendi only has authority over the smaller Life and Health business which writes short-term indemnity policies and a few life insurance policies.  It can be easily jettisoned, but not before Wall Street had a fit about the ruling and knocked Wellpoint down 7% Monday morning. Given that Garimendi said his decision was final, expect this division to carved out and sold to someone else–there’s too much at stake for the Wellpoint and Anthem leaders to allow this to derail the whole thing. the front page of the New York Times. The Administration argument that has been actively pursued since 2002 is that essentially the FDA makes the best decision possible, hence you shouldn’t be able to sue a manufacturer for a product defect.

The first example is the Wellpoint Anthem merger.  There was a lot of fuss in California about the egregious package given to top executives at Wellpoint, and Democrat john Garimendi the insurance commissioner basically said he would not approve the merger unless Wellpoint paid out over $600m into public programs. And on Friday he

But you could tell exactly what was going to happen by who had power over what, and by what their political affiliation was.  But if you didn’t think that that ruling should have been so politicized (after all this is post-conversion and as part of its original conversion Blue Cross handed mega-billions over to the state for a couple of huge Foundations), you probably wouldn’t have thought that even this Administration would change the better part of a century’s practice and intervene in product liabiliy suits on behalf of big pharma.  But there it is on

Allowing consumers to sue manufacturers would "undermine public health" and interfere with federal regulation of drugs and devices, by encouraging "lay judges and juries to second-guess" experts at the F.D.A., the government said in siding with the maker of a heart pump sued by the widow of a Pennsylvania man. Moreover, it said, if such lawsuits succeed, some good products may be removed from the market, depriving patients of beneficial treatments.

Quite how that reconciles with the ability of the FDA to admit it made a mistake or didn’t have enough information when it first made a decision, I do not know. (Remember Rezulin perhaps?).  But it’s only the Administration’s politics (and the interests of its funders which amount to the same thing) taken to the extreme. And of course it’s not as if we’ve set up a rational system of Socratic dialogue to replace the legal system, we’re just now using the might of the Federal government to attempt to remove access to it from people attacking its friends.   It does make at least TCHB somewhat nostalgic for the days when apparently some decisions in government were made for vaguely commonsense reasons.  But I suppose that era has passed.

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