The Market Ticker
Commentary on The Capital Markets- Category [Health Reform]

Seriously. Unless you have $500 to blow on a speculative emergency item, you should die.

Note that the purchase is speculative because (1) the drug expires, and (2) you don't know if you'll need it.  But if you do need it, and don't have it, you're ****ed.

Now here's the ball-buster: These pens were $18 a year ago.

Most people (even the very poor) can scrounge up $18 for a speculative purchase such as this, especially when it might save their life if they need it.  Yes, it's low odds you will need it but if you need one of these you need it now, not in a few minutes or hours.

So how did this happen?  The drug in these things is not on patent, but our system of government has made it possible for a handful of manufacturers to form an effective monopoly and then raise the price by 2,500% -- 25 times what it used to cost just a year ago.

Oh by the way, if you are an EMS department you can still buy a vial with 1mg of the drug (3 doses, approximately) for $4.13.  A syringe costs pennies (diabetics use them daily.)  So why can't you simply buy both and keep them around?  Because of the scammers in the medical industry that advocate for, and got passed, laws that make it illegal for you to do so.

Why isn't this the issue in our political system right now?  Why isn't everyone involved in this crap under indictment for violations of the Sherman and Clayton Acts?  Why aren't you in the streets insisting that this garbage be stopped across the board and those who refuse or resist be indicted, prosecuted, convicted, imprisoned and asset-stripped to their underwear.

Come talk to me about all the other things you want to argue over in the political realm when -- and only when -- this has been addressed.  This (monopoly-related pricing in the medical industry) is the only issue that bears on the budget, the issue that bears on your household disposable income and the issue that will, if we don't address it, destroy this nation economically within the next couple of decades -- after it destroys you economically within the next five to ten years.

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I have a small business quote here in my hot little hand.

The quotes range in increase (depending on the option the firm chooses) of 54.4 to 81.6%, and they include a mandatory underwriting review that has not yet been completed.

This sort of crap is going to destroy businesses and severely depress wages.  It simply must; nobody can afford this sort of increase without it utterly decimating their operating margins.

When does the revolt begin folks?  You either stand now and start demanding prosecution and imprisonment for those in the medical and insurance sector or you will be financially destroyed unless you are both willing and able to opt out.

"Opt out" means cutting your income below about $25,000 so as to access Obamacare subsidies at or near the higher levels and being healthy so you can use a "Bronze" plan, or cutting your income under somewhere between $16,000 and $11,000 a year and being healthy so you are exempt from the individual mandate (which only works if you're in a non-Medicare expansion state.)

Otherwise, you're ****ed.

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Here it comes folks... (sent to me by a reader; looks authentic)

Don't worry, that's only a 56% increase and roughly $250 (more) a month you can't spend on vacations, cars, groceries, your house, at the local bar or anywhere else.

Where are the handcuffs for the medical and insurance industry?

Better find 'em and the balls to prosecute under 15 USC Washington and State AGs, because we're coming for you if you don't take care of this crap right here and now.

No more hearings, no more excuses, no more BS.

Indictments, handcuffs, prosecutions and imprisonments -- NOW -- or your asses are all out of a job.

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President Barack Obama’s stimulus put taxpayers on the hook for $30 billion in electronic medical records, many of which have turned out to be technological disasters.

But don’t expect to hear about the problems from doctors or hospitals. Most of them are under gag orders not to discuss the specific failings of their systems — even though poor technology in hospitals can have lethal consequences.

A POLITICO investigation found that some of the biggest firms marketing electronic record systems inserted “gag clauses” in their taxpayer-subsidized contracts, effectively forbidding health care providers from talking about glitches that slow their work and potentially jeopardize patients.

Once again we're aiming in the wrong direction.

If the Government wants to get involved then do it from a point of view of "weights and measures."

That is, specify a format for coding (e.g. an XML data dictionary), a set of codes that are required to be supported and an interchange message format.  Limit your view to enforcement of those aspects then shut up and go away.

Further, change the system so that records are owned by the consumer and any breaches, such as storing key components in any way, are severely punished with huge statutory fines on a per-person basis collectible by the consumer him or herself.

That is, I should be able to walk into a medical provider's office bringing a USB key with me.  On that key is a two-factor key managed encrypted database.  One part of the key is "me" (some biometric information such as a fingerprint or digital iris scan) and the second is a passkey.  I need both to unlock the database; the provider plugs it in, updates it, closes it and after closing it the software runs a cryptographic hash on it to insure that the data on the USB key is good and then hands it back to me.

If providers wish to, as a service, keep a copy of the encrypted database for consumers that's fine.  But doing that doesn't give the provider access to anything because the database is two-factor encrypted and the provider has neither part of the key.  So the provider can thus restore a copy onto a new key (if I lose mine) but can't decrypt it without my personal presence and consent.

This is not difficult, and further if providers keep copies of the encrypted database (which could be mandated) then if you show up at a hospital provided someone can identify where you were last (or even not-last, but somewhere in recent history) your data can be accessed if necessary because now you're there.  There is no EMR interchange problem because you carry the data with you and in an emergency situation where that's not accessible a simple database file copy is sufficient to co-locate the encrypted data and your authentication to access same.

This is not a difficult problem to solve given consistent data definitions -- a weights and measures sort of thing, which is one of the businesses that governments have always been in.  You know what a gallon, pound, kilogram or liter is because there is a standard set by governments and those who cooperate with them to do so.  If someone tries to redefine what a "gallon" is so as to screw you then the law comes down on them like a ton of bricks.

At the core of this problem is the idea that some medical provider owns your personal health data.  That's scandalous, outrageous, and must be stopped!  You own that data -- it's arguably the most-confidential information about that exists.

Stop the stupid folks.

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C'mon folks, this isn't complicated.

Hill used Indian government data on the cost of pharmaceutical ingredients and allowed for a 50-percent profit margin - but no money for investment in research - to work out the costs of producing certain drugs.

On this basis, he found that Novartis' leukaemia drug Glivec actually cost $159 for a year's treatment, against the $106,000 charged in the United States.

Roche's Tarceva for lung cancer cost $236, against a U.S. price of $79,000, and Novartis' Tykerb cost $4,000 against a price of $74,000.

In all these cases the U.S. cost was far above that charged in certain western European countries, where Glivec costs approximately $29,000-35,000, Tarceva $26,000-29,000 and Tykerb around $35,000, Hill reported.

How do you have a price that is double to triple that charged in other western European nations in the United States?

There is only one way: You must both eviscerate private property rights -- that is, the right to do with something you lawfully acquire as you wish and you must completely ignore 15 USC which criminalizes attempted price-fixing.

You cannot price-fix in the market if you charge different prices in different places without both -- at least not by more than the cost of transportation plus a relatively small amount of profit!

There is no "market" in these drugs and the drug-makers have lobbied for and obtained the legal environment that makes this so.  This is trivially easy to correct -- put a stop to that crap by enforcing the "first sale" doctrine (that which I own is mine to dispose of as I wish) and vigorously prosecute any attempt to constrain markets, sales and distribution where market power exists.

This would result in an immediate leveling of prices across the world for these drugs.  They might rise in some other nations, maybe in a lot of other nations.  But they would drop like a stone here.

Everyone wants to talk about forcing price levels for US sale.  There is no need to force anything.  Simply enforce the right to sell whatever you own and prosecute any corporation (and its executives) that try to restrict distribution and cross-border shipment of such drugs.

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