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Geoffchef's picture

Of the four men I have now seen debating, the least impressive was George Bush. By a landslide. Cheney's a tough nut and Edwards is smart as a whip.

 


 


The Arctic trails have their secret tales that would make your blood run cold.


-Robert W. Service

 

ADAM'S APPLE, n.
A protuberance in the throat of man, thoughtfully provided by Nature to keep the rope in place.
Ambrose Bierce - The Devil's Dictionary

 

Geoffchef's picture

(post #42756, reply #31 of 109)

Let's hope. No shortage of rocks lying around.

 


 


The Arctic trails have their secret tales that would make your blood run cold.


-Robert W. Service

 

ADAM'S APPLE, n.
A protuberance in the throat of man, thoughtfully provided by Nature to keep the rope in place.
Ambrose Bierce - The Devil's Dictionary

 

MadMom's picture

(post #42756, reply #32 of 109)

Let's face it - when was the last time Dick Cheney said anything you could believe?

Things are going to get a lot worse before they get worse.
Lily Tomlin

Biscuits's picture

(post #42756, reply #33 of 109)

When he talked about his daughter being gay.  I think he really adores her and supports her, I really do. 

Life is tough - but it's tougher when you're stupid - Major Jeffrey F. Richardson, USMC

Ancora Imparo -

MadMom's picture

(post #42756, reply #34 of 109)

I have to agree.  I think he has really been put in a horrible position by Bush's handlers, whom I'm sure would rather he hide his daughter.  I read a really sad story yesterday about how she often travels with him, because she is very active in his campaign, but she normally exits off the back of the plane, rather than the front stairs, to avoid media exposure.  Also, at the Republican National Convention, his other daughter was on stage with him after his acceptance speech, but the gay daughter wasn't.  I think that is evil and sad.  I'm sure he is torn between his obvious acceptance of her and the right-wing concept that all gays are evil because of the lifestyle they "chose." 

Things are going to get a lot worse before they get worse.
Lily Tomlin

Ballottine's picture

(post #42756, reply #39 of 109)

...at the Republican National Convention, his other daughter was on stage with him after his acceptance speech, but the gay daughter wasn't


The gay daughter's name was announced, as Cheney's family was gathering around him, but she did not come out with her mom, sister and children.  In other words, she was expected to come out and at the time I wondered why she did not.  Bal


 


So much to cook; so little time.

 

So much to cook; so little time.

KarenP's picture

(post #42756, reply #35 of 109)

  Very true.  Would you speak with the doctor that I worked with yesterday?  She'd like lower prescription costs for seniors like you know who created and the safety of she and her family. In her mind, that equates to the other team.  I try to understand......

MadMom's picture

(post #42756, reply #36 of 109)

Karen - the senior's drug prescription bill is a joke.  Why do you think so few seniors have taken advantage of it?  It should have been named The Pharmaceutical Lobby's Price Protection Act, because it forbids the importation of lower cost drugs from other countries, forbids negotiation with pharmaceutical companies for lower prices, and basically guarantees the obscene profits which they have been making off American consumers.  It is a tragedy, because with the number of people in our medicare system, the government could have negotiated real price savings for seniors, but instead they chose to protect the drug companies.  Anyone who looks at this as a bill to protect seniors is woefully misinformed.

Things are going to get a lot worse before they get worse.
Lily Tomlin

StevenHB's picture

(post #42756, reply #38 of 109)

My cousin works for a drug company (no names will be revealed).  He tells me that other governments control the prices of drugs - frequently telling the drug companies how much they are willing to pay.  Last year, the Italian government announced a 10% reduction in a cost-saving effort, across the board, in drug payments.  The companies comply or lose all sales in the country.


In the end, what this means is that almost all of the R&D expenses are borne by American consumers.


Fixing the problem requires changing the behavior of other countries in addition to using the negotiating power of the US government to pressure prices.



Without coffee, chocolate, and beer, in that order, life as we know it would not be possible

Without coffee, chocolate, and beer, in that order, life as we know it would not be possible
CookiM0nster's picture

(post #42756, reply #40 of 109)

Sounds like the standard drug company party line to me.

The Economist published an article on this not too long ago. They argued, rather convincingly, that the claim drug companies make that they need to charge those high prices in order to cover R&D is bogus. That money goes largely into marketing, not R&D. And when you look at where the newly discovered or created drugs that they are marketing have been developed, it's the rare one that was actually worked out by a drug company's R&D team to begin with. Most come from publicly funded laboratories (i.e. those who's grants have just been cut by the downsizing of NIH and NSF budgets).

I tried to link to the article, but it's only available to paid subscribers.


Edited 10/7/2004 12:09 pm ET by COOKIM0NSTER

StevenHB's picture

(post #42756, reply #41 of 109)

My point is that we are paying a disproportionate share (of something) in the US.


Without coffee, chocolate, and beer, in that order, life as we know it would not be possible

Without coffee, chocolate, and beer, in that order, life as we know it would not be possible
CookiM0nster's picture

(post #42756, reply #42 of 109)

And my point is that nobody should be paying it, not the U.S., Italy, France, Canada, or any other country. Our prices are not higher because drug companies really need to make up for the caps on drug prices elsewhere. Our prices are higher because they use them to feed already bloated marketing budgets (while claiming the money is needed for R&D, which is really crass).

TracyK's picture

(post #42756, reply #43 of 109)

Our prices are higher because they use them to feed already bloated marketing budgets


And don't forget bloated salaries/bonuses for pharmaceutical company execs...



That's just bad pigs.

ashleyd's picture

(post #42756, reply #44 of 109)

Declaration of interest, I work for a major pharm company. Just a few things to mention. It costs around $1 billion to discover, develop and test a major new drug to reach approval by the FDA. Not market it or all those other costs, just to get it approved, and remember for every drug that gets approved tens of thousands of compounds are screened and get some way through the process, some a long way, before being rejected. Even when it gets approval later tests may cause the drug to be withdrawn (as shown very recently with Vioxx from Merck, a company that is now in some difficulty as a result).


Now when a promising compound is patented the company has a 20 year patent on it. Unfortunately it takes around 12 years or more to bring it to approval so we have 8 years or less to make a return on that investment, assuming of course that nobody beats us to the market with a similar drug, or comes after us with a more effective compound. So if you have spent $1 billion on developing something and have a short time to recoup it how are you going to market it? Cheaply? Timidly? Give me a break! Do GM quietly slide their cars onto the market? Do movie makers just let their films get shown in theatres without publicity? I think not! First rule of business, cover your investment or suddenly you're no longer in business.


This is before you get the patent-infingement merchants now springing up round the world to muscle in on your market and of course we must not forget the litigators who sue at any hint of a side effect.


And if countries cap the prices that can be charged for new drugs then they effectively destroy the pharmaceutical industry in that country, how many Italian pharma companies do you know? How many Canadian? Sure you can cap prices in the US but you can kiss goodbye to any major new drug development and your pharmacy doesn't currently stock an effective medicine for what you've got then in never will.  And this business about core research being done in publicly funded labs just doesn't wash, yes they can identify some promising therapies (although most of ours started "in-house") but it is the development and testing which takes the serious money. Pharmaceutical R&D is a high cost, high risk business and, if you get it right, high return. But you have to keep getting it right, year after year after year. If you don't you quietly drop out of the game. If it was the easy money that everybody seems to claim it is then how come the number of pharm R&D companies decreases every year?


Drugs can improve the quality of and extend life and can be a cost-effective medical treatment.  They can remove the need for surgery (also not cheap) or just let people move, or breathe properly or simply live free of pain. Now if you want cheap drugs you can have them, just don't expect any new ones.


/rant



“In victory, you deserve <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />Champagne, in defeat, you need it.”
Napoleon Bonaparte

Age is unimportant unless you’re a cheese.

CookiM0nster's picture

(post #42756, reply #45 of 109)

Well, according to the Economist, even a fair bit of the testing that has to be done is covered by public money.

Anyway, as for my own rant...

As with most things, I think it's a question of degree. Do I think that Pharm companies should eliminate marketing? No, but I do think they engage in a lot of shady marketing practices that may be in their own economic self-interest, but certainly aren't in the interest of the general public. For example, there's the re-branding of drugs to treat different ailments when their patents run out (Prozac being the most current example I know of). There's the problem that to get FDA approval, all you need to do is show that the drug works better than a placebo. Never mind if there are older, cheaper drugs on the market that are much more effective. I'm blanking out on the drug names, but one of the newest blood pressure medications is actually much less effective than an older counterpart, yet drug companies push the new, more expensive, less effective version. And don't even get me started on the tv and magazine ads, or the drug reps and doctor's incentives.

You make an analogy to car sales. Maybe that's the problem. Of course pharmaceutical companies are big businesses, just like car companies, and of course are going to act in their own self-interest. But filling a prescription for a life-saving drug shouldn't be like buying a car. Consumers should be able to expect that what they are getting is the best available treatment, not what provides the pharmacetical industry with the greatest profit. And if they're forced to behave this way because of the pressures you mention, I'm sorry, but it's still no excuse for poor ethics.

Lword's picture

(post #42756, reply #46 of 109)

>And don't even get me started on the tv and magazine ads, or the drug reps and doctor's incentives.


No kidding! Or that Viagra is covered on most health plans but not birth control. Shouldn't all the abstinence people be on top of this, so to speak? Of course not. They're hypocrites.


L.
L.
"If you can't feed a hundred people, then feed just one." Mother Teresa
StevenHB's picture

(post #42756, reply #47 of 109)

that Viagra is covered on most health plans but not birth control.


I don't think that statement is accurate.  It's true that some groups choose not to cover birth control, but, as far as I know, that's generally religious institutions that object on religious grounds (i.e. The Catholic Church).  From a financial perspective, it wouldn't make any sense: childbirth is way more expensive than prescription birth control medications like the pill.



Without coffee, chocolate, and beer, in that order, life as we know it would not be possible

Without coffee, chocolate, and beer, in that order, life as we know it would not be possible
TracyK's picture

(post #42756, reply #48 of 109)

Unfortunately, it's quite accurate, even though it has very little basis in common sense. Many health insurance plans cover Viagra because it is a corrective drug that treats a medical condition, but they do not cover birth control pills because they are a preventive drug (unless you get a written note from your doctor explaining that the prescription is to regulate menstruation, or some other medically corrective use).


 



That's just bad pigs.

StevenHB's picture

(post #42756, reply #49 of 109)

There wasn't a peep out of my insurance company when my wife's OB/GYN put her on BCPs (at the time, to induce her period since she's too young to be in the menopause that she's in).  I'm sure that there was no more documentation than the usual prescription form.


Without coffee, chocolate, and beer, in that order, life as we know it would not be possible

Without coffee, chocolate, and beer, in that order, life as we know it would not be possible
moxie's picture

(post #42756, reply #50 of 109)

Perhaps my situation is an anamoly, but I have had 5 different insurers since I started BCP's and the prescription has been covered by all of them. 


"I have always relied on the kindness of strangers." - Blanche Dubois

TracyK's picture

(post #42756, reply #51 of 109)

Steven: Just because it's never been an issue for you does not mean it's not an issue.


Some facts, provided by www.covermypills.org:


Lack of insurance coverage for contraceptive services is a widespread problem in the United States.


  • Half of all indemnity (fee-for-service) insurance plans in the U.S. do not cover any reversible contraception. Only 15 percent of these plans cover all six prescription contraceptive methods - oral contraceptives (The Pill), IUD, Norplant, Depo-Provera, the diaphragm and Lunelle.


  • While 97 percent of all traditional indemnity plans cover prescription drugs, only 33 percent cover "The Pill."


  • While traditional health maintenance organizations (HMOs) offer the most comprehensive contraceptive coverage, 7 percent do not cover prescription contraceptives and only 39 percent cover all five types.


  • Women of reproductive age currently spend 68 percent more in out-of-pocket health care costs than men, and much of this gender gap is due to reproductive health-related costs.

Full contraceptive coverage in health plans would be inexpensive, popular among health insurance consumers and effective against the cost of pregnancy-related absences.


  • Providing full contraceptive coverage in employment-based health care plans would cost employers, at most, only $21.40 per employee per year. For employers with plans that currently provide no contraceptive coverage, the average cost of adding it -- if employers contributed 80 percent of the cost -- would be $17.12 per year or $1.43 per month.


  • A recent study calculated that for an average employer, the total indirect cost of pregnancy-related absences per year per 1,000 covered female employees would be $542,000. It is estimated that the average cost to replace female employees who quit each year due to pregnancy is an additional $14,000 per employee.


  • 73 percent of privately insured adults support full contraceptive coverage in their health insurance plans, even if it would increase their costs by $5 per month, according to a nationwide poll conducted by the Kaiser Family Foundation.

 



That's just bad pigs.

MadMom's picture

(post #42756, reply #52 of 109)

Excellent points - similar to this which I found while googling:


The birth control pill has been on the market for over 30 years. Yet, strangely, it is the only prescription drug benefit routinely and consistently excluded by health insurance plans.  When Viagra, the male "impotency pill," debuted this past spring, many health plans quickly covered its cost. (Recently, a number of insurers have denied or restricted coverage of Viagra.) Nonetheless, most indemnity plans which cover prescription drugs as a matter of course continue to refuse to cover oral contraceptives. Only 15 percent of plans cover the five most commonly used (and FDA approved) reversible methods (IUD, diaphragm, Norplant, Depo Provera, and the Pill). Forty-nine percent fail to cover any of these methods.


Things are going to get a lot worse before they get worse.
Lily Tomlin

StevenHB's picture

(post #42756, reply #54 of 109)

So, 1/3 of indemnity plans and 93% of HMOs/PPOs cover BCPs.


Assuming that the market share of indemnity plans is less than 73.4%, most women who have health insurance coverage, have coverage for BCPs.


(which is not meant to suggest that the anomalies and inconsistencies that you and others have identified aren't odd and offensive, just that most women with insurance have BCP coverage)




Without coffee, chocolate, and beer, in that order, life as we know it would not be possible


Edited 10/7/2004 5:10 pm ET by StevenHB

Without coffee, chocolate, and beer, in that order, life as we know it would not be possible
KitchenWitch's picture

(post #42756, reply #56 of 109)

in my entire working career (over 20 years before I "retired" to be a mom), only one plan (besides the military) covered BCPs. and even then it was a $15 co-pay. not per 3 month supply - $15 per pill pack.


our current insurance doesn't cover it. but they covered a vasectomy for DH 100%. which almost makes up for them only covering 80% of the baby.


~RuthAnn

~RuthAnn

MadMom's picture

(post #42756, reply #58 of 109)

You and I must be reading a different post from Tracy.  The statistics she posted cited that 7% of HMOs did not cover any birth control pills, and only 39% covered the five leading ones.  I suppose you could infer from that a statistic that 93% of women under those plans had a "choice" of one BCP, but for many women, that one BCP might not be acceptable.  Less than 40% offered a choice of the five leading pills.  It might also be interesting to know the actual percentage of women who are covered vs those who are not covered, as opposed to the percentage of plans which offer the coverage.

Things are going to get a lot worse before they get worse.
Lily Tomlin

StevenHB's picture

(post #42756, reply #60 of 109)

33% of indemnity plans cover "The Pill" (of which there are many variations).


7% of HMOs do not cover prescription contraceptives.


Yes, only 39% cover all five types of oral contraceptives but that doesn't mean that 61% cover only one type.


I suppose that I wouldn't expect my insurance to cover condoms, so I'm not surprised that insurance wouldn't cover a diaghram (which, I assume, is comparably cost-effective).


Re: RuthAnn's $15 co-pay for BCPs: this is a pretty standard co-pay for a month's supply of drugs.  I think that this is what I pay now.


Re: coverage of vasectomy, tubal ligation, etc: I'm impressed that they cover these optional surguries at all.  Of course, that would take us back to the cost of one or more babies vs. the cost of the surgury.


One last point about this argument: I don't think that there's anyone here who would choose not to use birth control because it wasn't covered by our insurance companies.  This is a significant point that is probably accounted for by the companies' actuaries.


Re: coverage of viagra vs. the pill: This would fall into the "offensive" category that I mentioned earlier.



Without coffee, chocolate, and beer, in that order, life as we know it would not be possible

Without coffee, chocolate, and beer, in that order, life as we know it would not be possible
KitchenWitch's picture

(post #42756, reply #53 of 109)

When I was self-employed, and paying 100% of the costs of my health insururance (Blue Cross) I called to find out why they didn't cover contraceptives. they couldn't tell me why, just that it wasn't covered. they did assure me, however, that if I accidently got pregnant, abortions were covered.


~RuthAnn


Edited 10/7/2004 5:06 pm ET by Kitchen Witch

~RuthAnn

MadMom's picture

(post #42756, reply #55 of 109)

From my same google source:  The irony in this debate, however, is that most insurance companies will pay for tubal ligations (86%), vasectomies (85%) and abortions (66%).   This is simply insane.

Things are going to get a lot worse before they get worse.
Lily Tomlin

TracyK's picture

(post #42756, reply #57 of 109)

That is insane.



That's just bad pigs.

Wolvie's picture

(post #42756, reply #78 of 109)

that is terrible. so wrong headed


"People that are really very weird can get into sensitive positions and have a tremendous impact on history."


George W. Bush


"Through pride we are ever deceiving ourselves. But deep down below the surface of the average conscience a still, small voice says to us, 'Something is out of tune."  Carl Jung

 

Lword's picture

(post #42756, reply #61 of 109)

Steven, I think Tracy posted some good links, yet another problem with the religious institutions is that they have never been good at abstinence by their leaders any more than the Presidents, so are in no position to preach it, much less get special funding (that "faith-based initiative").


Everyone else: All your examples are why our health care system doesn't work. Not one of us has equal care. Not one. Except the Senators.  


Guys: What about a 4-hour erection? Do you call your doctor? LOL Why on earth are they "advertising" this? We have a heap of horny men with erections and women with no birth control, oh boy! Maybe you'll understand when you have girl children?


This health care dilemma is one reason why I could find myself saying I'm embarrassed to be an American. Hell, we were told we were the smartest and best, and because we worked hard and gave to the less fortunate, people liked us the world was supposed to be a better place. Now people hate us and we still have no health insurance. This is backward, but maybe that's just my way of thinking. Oh well, it's about time for some sort of revolution if half the people in this country think it's ok to go to war for lies that kill thousands and that same half think impeaching a president for sex is balanced. Are they and their kids signing up for service in Iraq? Of course not! The whole deal is distressing.


L.
L.
"If you can't feed a hundred people, then feed just one." Mother Teresa