Peter Rost is running a story about potential murky dealings in Pfizer’s subsidiary in India, which smack of (perhaps typical) corrupt practices in emerging economies. Essentially the story seems to be that local management ripped off shareholders, lone accountant raised stink with Corporate in NYC, and got fired for his trouble. Here’s part one and two. Of course Peter is trying hard (perhaps too hard?) to link this to the current Chairman and CEO, but it’s all good fun reading. I do think that sometime around now Pfizer probably wishes that it had just given Rost the job he wanted when they bought Pharmacia, and reacted with less paranoia. But you make your bed, and….
HEALTH PLANS/POLICY: Bob L– keeping you in touch on Medicare Advantage
While I’ve been running a little frantic over the Health2.0 Conference and some other stuff you’ll hopefully hear about soon, Bob Laszewski has been keeping you in touch with the latest on Medicare Advantage Funding.
And somehow he managed to host Health Wonk Review yesterday without me noticing. I’ve now noticed!
POLICY: DOJ/DEA insanity runs amok
Meanwhile over in the through the looking glass world of Federal drug policy–Ed Rosenthal has already been convicted & sentenced. Now he’s being tried again — double jeopardy—for performing not only laudable but actually legal activities in a city where 87% of the population thinks that he’s in the right and in a country where more than 70% of the adults most likely to be ill thinks he’s right. Given what we know about the impact of different drugs on different people, is there any excuse at all for the continued persecution of those who believe that medical marijuana helps them?
POLICY/INTERNATIONAL: The best health care system in the world!
God Bless America.
Zeke Emmanuel is a pretty prominent ethicist and with my former economics teacher/prof Vic Fuchs author of a not bad proposal for universal health care. He’s more famous as the least famous Emmanuel brother—the one who’s not in The West Wing or Entourage. And he thinks that the health care system is a mess. Now you’d assume that if he was fired one of his two very, very rich brothers could step in to keep his family out of the workhouse. But apparently not.
President Bush frequently has said Americans have the world’s best health care system, but Emanuel stopped short of calling Bush clueless in his essay (behind JAMA firewall)and during an interview with The Associated Press. “I work for the federal government. You can’t possibly get me to make that statement,” Emanuel said in the interview.
But don’t worry, the AP found a rent-a-quote to make the article fair and balanced:
David Hogberg, senior policy analyst at the National Center for Public Policy Research, said a strong case can be made that the U.S. health care system is the best. “It depends on what measures you use,” Hogberg said. Life expectancy is influenced by many factors other than health care, he said, and nations measure infant death rates inconsistently. Other measures show the United States performing well, he said.
Just in case you wondered the National Center for Public Policy Research may sound like its some official well respected non-partisan body but its header title describes it as a “A Conservative Think Tank” (an oxymoron perhaps). Yeah, those guys know all about health care, I’m sure.
However the reason for this fuss is the latest edition of the Commonwealth Fund’s six-nations report. What does it say? Same thing it’s said for ages. (Shorter version here) The US system costs more and is no better—nay, it’s worse. But Karen Davis and pals have this little zinger in the tail
Findings in this report confirm many of the findings from the earlier two editions of “Mirror, Mirror”. The U.S. ranks last of six nations overall. As in the earlier editions, the U.S. ranks last on indicators of patient safety, efficiency, and equity. New Zealand, Australia, and the U.K. continue to demonstrate superior performance, with Germany joining their ranks of top performers. The U.S. is first on preventive care, and second only to Germany on waiting times for specialist care and non-emergency surgical care, but weak on access to needed services and ability to obtain prompt attention from physicians.
Did you notice that? We’re not even Number One in shortest waiting times for elective surgery. Want to get your hip replaced most quickly? Move to FrankFurt!! I assume that David Gratzer and Sally Pipes are brushing up on their Deutsch right now.
And in other news…apparently Michael Moore isn’t a thorough fact checking reporter and according to his supporters(!) leaves behind a “trail of broken promises to colleagues, exaggerations of facts, and footage used out of context. Hmm, I’d never have guessed that (actually I’ve read one of his books and yup his “research” is incredibly sloppy. In fact so sloppy that apparently PhRMA and AHIP are on to him:
The Pharmaceutical Research and Manufacturers of America issued a statement attacking Moore’s record. "A review of America’s health care system should be balanced, thoughtful and well-researched," the statement said. "You won’t get that from Michael Moore.
And given the quality of “research” from those two organizations, do I have to add the next sentence for you?
HOSPITALS: Most Innovative Acute Care Hospitals
My old employers and friends at FierceHealthcare are out with their Top Ten list of the Most Innovative Acute Care Hospitals.
POLICY: Podcast with Jon Kingsdale, Massachusetts Connector
Crossposted from the Worldhealthcareblog, this is the interview I did at WHCC with Jon Kingsdale, who created and is running the Massachusetts Connector–the organization at the center of that reform effort. Many of you have many opinions about what’s going on in that state, so now you’ve heard it from the horses mouth, feel free to comment.
Matthew Holt: This is Matthew Holt, again on the floor at the World Healthcare Blog this afternoon. Coming towards the end of the session, I have Jon Kingsdale with me. Jon is the executive director of the Commonwealth Insurance Health Connector Authority, better known as the Massachusetts Connector. This is the central body in the middle of the new Massachusetts Health Plan arrangement. And Jon gave a very interesting talk about how that is playing out in a session early this morning. So I thought I would grab him and grab a few minutes of his time. So Jon, thanks a lot for doing the conversation.
Jon Kingsdale: My pleasure.
Matthew: Let’s start in with the basics. Most people know that Massachusetts has gone in with some kind of individual combined with an employer mandate. And know that there’s some arrangement in the middle of that so people can actually buy into an affordable health plan. There’s been come controversy about what affordable means. But what’s the Connector doing in the middle of all that? What does the Connector do?
Jon: Well, we have a number of functions, Matt. One is a whole set of regulatory functions to decide some of the tough policy issues, frankly, that the legislature grappled with and decided they wanted to let the next generation of decision makers handle.
Matthew: Pass-off.
Jon: You might well say that. I wouldn’t. So those include, what is the affordability schedule? So adults in Massachusetts, starting later in 2007, need to have health insurance if they can find something affordable. Well, given your income, what is determined to be affordable? And what is the minimum amount of insurance that you would have to have? So regulatory policy decisions like that, on the one hand.
And on the other hand, we’re actually running a couple of insurance programs, one that’s subsidized for low-income uninsured. And we set the benefits and the enrollee contribution and actually enroll people, and serve as a market for them. And the other is, private unsubsidized health insurance, particularly for uninsured individuals above 300% of the federal poverty level, who are going to be buying out of their own pocket. And a big piece of what we do there is organize the market for them and try to do almost like some group buying for them. And create sort of a shopping mall for health insurance.
INTERNATIONAL: Medical tourism–the Singaporean story
My interview with Dr Jason Yap who runs medical toursm in Singapore is up over at worldhealthcareblog.
(Link is fixed now)
INDUSTRY: You can’t buy publicity like this
The kids at AHIP and PhRMA must be holding their heads in their hands this morning. Everyone in health care knows that Michael Moore’s Sicko is coming out soon. But in case you thought there wasn’t going to be enough publicity, the US Government has launched an investigation to see whether Moore’s trip to Cuba—where he followed some American patients seeking free care in a publicity stunt—violated US law. Apparently you have to be a journalist to go to Cuba…and by the Treasury department’s definition Moore might not be one.
This is so stupid that you have to believe that whoever launched this in the government is a mole for single payer interests or owns stock in the movie. Moore must be laughing his ass off with delight!
PHARMA: What the Zubillaga affair may suggest, by The Industry Veteran
We haven’t spent much time over here talking about the “buckets of cash” scandal that’s been keeping the pharma-focused bloggers very busy, and even less comment on the apparently expensive and rather bizarre purchase of MedImmune. Both concerning AstraZeneca. But The Industry Veteran has been wondering around on the grassy knoll and has come up with a very interesting explanation that links the two:
I spent a good part of the past two weeks in the unaccustomed position of defending AstraZeneca. Equity analysts and others in the pharmaceutical industry seemed astonished by the high price the company paid (a 52 P/E ratio) to acquire MedImmune. Their basic criticism amounts to a complaint that AZ acquired neither an auspicious, late-stage pipeline or a significant cash flow. Both observations are correct but AZ gained other benefits for this steep price. What AZ bought was a place for themselves in two businesses when they acquired MedImmune. Companies typically have to overpay when they want to get into a new game. Ten years ago Abbott paid 40 times earnings when they bought MediSense to get into the blood glucose monitoring business. More recently Novartis paid through the nose to belly up to the vaccine business bar. A few weeks ago Schering-Plough overpaid to buy Organon but Fred Hassan gained stronger positions for himself in the women’s health and the dermatology businesses. Given the current trough in Pharma’s new product development, it’s simply a fact of life that anyone seeking to consummate a merger or acquisition must be prepared to overpay. Fifteen billion dollars for MedImmune is certainly no more outrageous than paying a 42-year old pitcher $15 million for half a season.AZ placed a toe in the water of the vaccine business, something that does not resemble Pharma’s traditional goldmine because a high proportion of vaccine customers are public agencies. Nevertheless, the vaccine business is poised to grow, and if it receives a boost from a pandemic flu epidemic, it will grow enormously. It will also grow substantially if someone makes good on the effort to develop an oncology vaccine or immunizations for the many viral infections that threaten the length and quality of life.In buying MedImmune AZ also acquired capabilities for entering the biologicals business. At this point the multi-billion dollar products of companies such as Amgen and Genentech do not face the precipitous revenue losses that occur when Pharma companies lose patent protection on their products. This is because most regulatory agencies have not developed guidelines for determining acceptable thresholds to approve generic versions of biological products. Congressional waterboys for the biotechs, such as Sen. Ted Kennedy, want makers of generic biologicals to conduct the same sort of clinical trials for their products as the original developers of the branded biologicals. Faced with such high development costs, the generic model of low cost equivalents becomes unsustainable. Nevertheless, despite the disingenuous concerns of Sen. Kennedy and others, Congressmen wise to Pharma such as Henry Waxman and Bernie Sanders will eventually succeed in creating some form of "bio similar" legislation. The country can only tolerate so many stories about people who died because they were unable to make even the co-payments on biological medications costing between $40,000 and $200,000 per year. At that point there will be a major demand for an entire industry of generic biologicals.During the two weeks I was defending AstraZeneca’s purchase, CEO David Brennan and John Patterson, the VP for Clinical Development, did their best to undermine my claims about their wise purchase.
POLICY: The New York Times, sigh
I guess I spend too much time getting grumpy about the use of space in the NY Times, but come on. Atul Gawande is a great writer who writes fascinating articles for The New Yorker. But when it comes to his solution for health care? He gets not one but two op-ed columns in the New York Times. And what does he say in Curing the System? Following the Massachusetts system might be an option. Or we can expand SCHIP. That’s it. To say the same thing I used one line. I think the NY Times
owes me (or someone) 2 columns to really discuss health care. After all
they’ve spent plenty of time licking sores about the issue.
