The Damage of Legalized Lying
Amazingly, with the pharmaceutical industry as an example, the amount spent by them on marketing is far greater than the amount spent on research and innovation, as it approaches 30 billion annually spent on their marketing efforts, as this presently takes priority over the research and development, so it seems. This includes 5 billion that is spent on drug reps, who implement the tactics created by their marketing departments. Some biopharmaceuticals place double the amount of revenue into their R and D than typical big pharma corporations.
Marketing in some form exists with every business regardless of the industry of the business and its purpose. Essentially, marketing in itself is a complex activity- consisting of many specialty elements of various areas and levels, typically of an aggressive nature. However, with the pharmaceutical industry, marketing needs to become more specialized and altered due to the delicate nature of health care in order to prevent harm and ensure quality health care for all. Tactics that ignore such caution and consideration possibly could cause harm to patients in a number of ways, as this occurs presently. And recently, the marketing exposure of the drug industry has become an unfortunate issue for this industry for many reasons that remain a reality aside from what drug PR firms may try and tell us, as presently it seems as if the pharmaceutical industry, once viewed as very ethical, are now viewed as motivated by profit and greed. Such unwise and irresponsible methods include:
1. Advertising directly to the consumer. This method of bypassing what should entirely be decided by the heath care provider, as disregarding the determining factor of the heath care provider can possibly lead to inappropriate prescribing upon demand of the viewer of the advertisement, usually greatly unqualified to dictate their own medicinal treatment, yet makes such a demand simply on belief of a visual medium that clearly lacks accuracy and completeness. Furthermore, it potentially removes the discretion of the provider regarding the best treatment for the patient through such frequent methods of marketing to potential consumers by such advertisements directly to consumers, as the doctor-patient relationship historically has not been one of unbalanced debate.
2. Assessment of a patient by a health care provider is required and necessary, most believe, in order to determine the best treatment for a patient, as well as the provider considering their patient’s complete medical history as well as other variables necessary to consider the best course of any possible treatment initiated by the provider. Ignoring this premise could be damaging to the patient seeking treatment through marketing in this form. DTC advertising is now occurring in doctors’ office as well. Pharmaceutical companies pay a company what may be a million dollars a year to have a TV in a doctor’s waiting room that constantly pitches primarily the sponsor’s desired product.
3. Clinical evidence is the ultimate determining factor for treatment selection, as long as this evidence is proven to be authentic. This is followed by drug sample availability, yet a correctly informed health care provider is the one who will provide the best care to their patients, along with their experience from a historical perspective in their practice.
4. Education not only trough sponsored doctors paid by a drug company, but more authentic methods should be discovered, which mean from the doctor’s own research and review of literature, but also dialogues with the colleagues of the doctor. The Medical Letter is an example of acquiring information free from what may be dangerous bias, regarding pharmacological treatment considerations.
5. As an ex seasoned big pharma drug rep, I can assure you that education is not the purpose of a pharmaceutical company, and they have no interest in this valuable area as demonstrated by their marketing being the apex of their objectives. Offering various inducements to others tops the list, though, with their marketing efforts. Perhaps research of novel and innovative medications should instead be the sole purpose and focus of pharmaceutical companies.
6. The over-saturation of drug company sales reps who in the past have initiated questionable tactics upon the direction of their marketing department of their drug company employer, regardless of the validity or legality of such tactics that are normally not questioned or known by the drug reps in the first place regarding the legality of some tactics, further complicated by the public being largely unaware of how big pharma in particular really operates. Such forms of manipulation developed by some drug companies include questionable inducements for the health care providers. This is allowed to happen as well as forced to occur by the pharma company representatives regardless of whether or not it is legal. As a result, many medical establishments are progressively prohibiting the activity or presence of drug reps at their locations. With the pharmaceutical company, sales reps are required by their employers to follow the direction of their marketing departments without exception. And the questioning of these directives is not tolerated by their employers. Because of this, the drug company’s image becomes more damaged as a result, as this is the case presently. To further illustrate this drug rep description of what they are forced to do, their employers require them to spend huge amounts of money annually to spend for doctors or to doctors that is void of any benefit for the patients, as the representative is typically void of any medical training or experience necessary to be a true asset in the medical community.
In the past, the pharmaceutical industry was viewed as research-driven, innovative, and patient focused- entirely for the benefit of patient heath. This is why the industry was at a time viewed as an ethical one. Clearly, this is not the case today. Instead, many view this industry as one with their primary goal is to initiate market-driven profiteering, regardless of the attempts of the industry to convince the public otherwise, as stated previously by the industry’s supporters, who have attempted to place value to the medical community as the goal of the pharmaceutical company. So the view by the public of drug companies has been damaging to what should be a concerning degree because of their tactics and deception. So the pharma industry seems to be in great need of repair and re-evaluation of their purpose. This should performed by action instead of empty statements by the industry. It is the author’s opinion that actions by this industry for the sole benefit for the patients are displaced if they exist, unless my interpretation and perception are flawed greatly. The repair can only be done by the refocus of the industry towards convincing the public of the industry’s concern of their restoration of the patient’s health in several ways. One way is to always make the medical community aware and with conviction that their products are solely for the benefit of the patients, which is rarely discussed in full detail with such people. Fortunately, medications historically have been for this reason and are often necessary for the restoration or benefit of the health of those in medical need. The need should be more clearly defined by those who determine this, and these are the health care providers, who are caregivers, and not marketers. In summary, the medicines now available to us are for the benefit of the patients, and not the developers who should create these medicines for this reason.
“Marketing is the act of making something seem better than it really is” --- Suso Banderas
Dan Abshear
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About Me
Wednesday, July 9, 2008
The Fallacies of Government Health Care Programs
In 2005, Missouri experienced the most severe Medicaid cuts since the program began 30 years from then. Already, near 1 million Missourians are uninsured. So Blount chops 100,000 from Medicaid this year, who needed the medical resources the most. In addition, Blount had another 300,000 Medicaid patients have their medical benefits greatly reduced. Why? Possibly to build more athletic stadiums in the state of Missouri. Futhermore, Blount created a ‘war room’ for corporate lobbyists to dispense gifts during the state’s legislative session for this egotistical psychopath to enjoy those obsequious to him, yet also seems to enjoy the suffering experienced by others, as illustrated with the Medicaid issue, which was the largest cut of any state in the history of the program for those in the most need of resources he cannot conceptualize or care about, as he should.
Limited income parents suffered the most with this atrocity, as more than 50,000 of them lost medical coverage for their families. And after Blount stated in 2007 that Missouri is now strong, prosperous, and vibrant regarding the state’s budget and the robust economy, he never repaired at all the damage he did to those suffering Missourians in 2005, and never indicated to do what he should have done. Remember that most on Medicaid in Missouri are children. In the U.S., the total cost of Medicaid is around 300 billion dollars a year. States have their own discretion on how their Medicaid programs are operated, and this is largely unexamined by the other contributor to Medicaid, the federal government.
The joy he must experience in seeing or knowing of the suffering of others must continue still, as the Missouri House of Representatives rejected a bill to expand Medicaid coverage greatly needed due to the actions of the governor those years ago.
Medicaid is also a necessity for the over 500 nursing homes in Missouri. The Nursing Home Inspectors already are accused of ignoring deficiencies in these nursing homes, which may include malnutrition and bed sores of the residents, and their inappropriate use of pharmaceuticals as well. Further unsettling is that such inspections normally take place only once a year. The inspectors should be more monitored by the GAO because of safety issues in nursing homes that continue and appear unresolved. For example, around 25 percent of Missouri nursing homes were found to have deficiencies recently. The rest of the nation only has a rate of 15 percent. Also, the Nursing homes in the United States are only covered by Medicaid.
Typically, Nursing Homes cost each patient there over 5000 dollars a month without Medicaid support. Yet patients tend to experience loneliness and displacement due to staying at such facilities, aside from noted neglect of these patients in other obvious ways.
Dementia is a common disease as we get older and is seen in Nursing homes. Basically, it is a disease of cognitive and brain dysfunction that usually is not reversible. If it’s the cortical kind, it is combined with Alzheimer’s disease. If it is the subcortical kind, look for Parkinson’s disease to be experienced for these patients. Such patients are inappropriately prescribed and given medications, such as atypical anti-psychotics, which cause high rates of pneumonia and premature death in the elderly population.
To complicate Missouri’s health care situation further, because close to 90 percent of Missouri counties are rural, with most lacking hospitals, there is only one doctor for every 3500 or so residents in such counties in this state. There is something to help called a Certificate of Need, or CON. Issued by regulatory agencies, they authorize healthcare facility creation and expansion as determined by the perceived needs of any community.
5 million people in Missouri are and have Medicaid. Missouri pays 20 percent of that bill, with the government paying the rest. While the states manage Medicaid for their state, CMS monitors and regulates the states, but that does not mean that this DHHS division actually does this. In 1990 Medicaid came out with the drug rebate program, which helped many. The Missouri Healthnet Division is responsible for making the best of the MO Medicaid funds, with frequent drug utilization reviews to determine the level of access to covered pharmaceuticals.
With Medicaid, over 6 million people in the U.S. also have Medicare, and they are known as ‘dual eligible’s’. In the U.S., over 40 million people have Medicare. Medicare costs 300 billion per year as well.
With seniors, government health care programs pay for quite a bit. Long term care costs Missouri about 2 million dollars a year. About 10 million elderly U.S. residents are in LTC. Only Medicaid pays for this as well, as mentioned earlier. Homecare is one form of LTC, and preferable to many.
The Medicaid for children is called SCHIP, and was created over 10 years ago. This program is facing funding shortfalls in many states, with Missouri topping the list thanks to the governor. Of course, Bush vetoed a bill for SCHIP expansion and reauthorization recently, and the House was unable to over-ride this veto and some others he has implemented for the benefit of the U.S. citizens. The cost for this program for children is around 4 billion dollars a year, and residents are concerned about children not receiving medical attention, perhaps in Missouri in particular. Some governors, however, appear to be void of such concern.
MO Health Dept. Head: Jane Drummond
MO Medicaid Director: Steven Renne
Dan Abshear
Limited income parents suffered the most with this atrocity, as more than 50,000 of them lost medical coverage for their families. And after Blount stated in 2007 that Missouri is now strong, prosperous, and vibrant regarding the state’s budget and the robust economy, he never repaired at all the damage he did to those suffering Missourians in 2005, and never indicated to do what he should have done. Remember that most on Medicaid in Missouri are children. In the U.S., the total cost of Medicaid is around 300 billion dollars a year. States have their own discretion on how their Medicaid programs are operated, and this is largely unexamined by the other contributor to Medicaid, the federal government.
The joy he must experience in seeing or knowing of the suffering of others must continue still, as the Missouri House of Representatives rejected a bill to expand Medicaid coverage greatly needed due to the actions of the governor those years ago.
Medicaid is also a necessity for the over 500 nursing homes in Missouri. The Nursing Home Inspectors already are accused of ignoring deficiencies in these nursing homes, which may include malnutrition and bed sores of the residents, and their inappropriate use of pharmaceuticals as well. Further unsettling is that such inspections normally take place only once a year. The inspectors should be more monitored by the GAO because of safety issues in nursing homes that continue and appear unresolved. For example, around 25 percent of Missouri nursing homes were found to have deficiencies recently. The rest of the nation only has a rate of 15 percent. Also, the Nursing homes in the United States are only covered by Medicaid.
Typically, Nursing Homes cost each patient there over 5000 dollars a month without Medicaid support. Yet patients tend to experience loneliness and displacement due to staying at such facilities, aside from noted neglect of these patients in other obvious ways.
Dementia is a common disease as we get older and is seen in Nursing homes. Basically, it is a disease of cognitive and brain dysfunction that usually is not reversible. If it’s the cortical kind, it is combined with Alzheimer’s disease. If it is the subcortical kind, look for Parkinson’s disease to be experienced for these patients. Such patients are inappropriately prescribed and given medications, such as atypical anti-psychotics, which cause high rates of pneumonia and premature death in the elderly population.
To complicate Missouri’s health care situation further, because close to 90 percent of Missouri counties are rural, with most lacking hospitals, there is only one doctor for every 3500 or so residents in such counties in this state. There is something to help called a Certificate of Need, or CON. Issued by regulatory agencies, they authorize healthcare facility creation and expansion as determined by the perceived needs of any community.
5 million people in Missouri are and have Medicaid. Missouri pays 20 percent of that bill, with the government paying the rest. While the states manage Medicaid for their state, CMS monitors and regulates the states, but that does not mean that this DHHS division actually does this. In 1990 Medicaid came out with the drug rebate program, which helped many. The Missouri Healthnet Division is responsible for making the best of the MO Medicaid funds, with frequent drug utilization reviews to determine the level of access to covered pharmaceuticals.
With Medicaid, over 6 million people in the U.S. also have Medicare, and they are known as ‘dual eligible’s’. In the U.S., over 40 million people have Medicare. Medicare costs 300 billion per year as well.
With seniors, government health care programs pay for quite a bit. Long term care costs Missouri about 2 million dollars a year. About 10 million elderly U.S. residents are in LTC. Only Medicaid pays for this as well, as mentioned earlier. Homecare is one form of LTC, and preferable to many.
The Medicaid for children is called SCHIP, and was created over 10 years ago. This program is facing funding shortfalls in many states, with Missouri topping the list thanks to the governor. Of course, Bush vetoed a bill for SCHIP expansion and reauthorization recently, and the House was unable to over-ride this veto and some others he has implemented for the benefit of the U.S. citizens. The cost for this program for children is around 4 billion dollars a year, and residents are concerned about children not receiving medical attention, perhaps in Missouri in particular. Some governors, however, appear to be void of such concern.
MO Health Dept. Head: Jane Drummond
MO Medicaid Director: Steven Renne
Dan Abshear
Sunday, July 6, 2008
Innovation For An Unfortunate Chronic Illness
An Artificial Kidney for those Who Have Failed Kidneys
Kidneys are necessary human organs, which is probably why humans have two of them, as they are balancing organs for our well being, from a physiological perspective. They remove toxins for the blood and maintain electrolyte balance in our bodies as well, to name a few of the many functions of these what are termed end or target organs that are dependent on our circulatory system as we are dependent on their optimal function for our existence.
While the process of dialysis has been improved over the past century or two, the first actual dialysis center was created by a man named Belding Scribner in the early 1960s. Rumor has it that he never patented his creation so more could have access to this vital procedure location with trained staff.
About ½ a million people are dependent on dialysis devices annually and the cost is completely covered by those with Medicare, as this cost for this treatment approaches or exceeds tens of billions of dollars a year for all of these types of patients. In fact, this is the only medical treatment that s completely financially covered chronic medical treatment by Medicare since the early 1970s. This cost is about a million dollars per patient per year. Hem dialysis is the most beneficial type of dialysis, which removes toxins from the blood of the patient over a period of a few hours about three or four times a week, with anemia being the most common complication of this treatment.
If there are patients who need financial assistance, there is a support group who fortunately have a web site that is: www.aakp.org that has helped more dialysis patients than other similar organizations financially.
While there are now about 5 thousand independent and hospital owned dialysis centers presently in the United States, there is also the possibility of home dialysis that are options as well, as determined by the dialysis patient’s doctor, who is a nephrologist, or kidney doctor.
Non for profit dialysis centers have been shown to have better quality than the for profit centers for a number of reasons- some of which are entirely known and unknown. This is important because monitoring of kidney failure patients is a great responsibility, as the average patient takes about 10 drugs routinely in addition to dialysis treatment and are chronically sick patients typically.
One reason for the large number of medications taken by these patients is due to the two primary causes of kidney failure, which are uncontrolled hypertension and diabetes. With high blood pressure, over time the kidneys become progressively impaired due to nephrosclerosis, which is nephritis that is caused, or causes, restricted blood flow and possibly toxins that aggravate this condition within the failing kidneys of these patients. With diabetes, most can discover the disease by detecting protein in the urine, which is a quite simple urine test. If uncontrolled, diabetic nephropathy develops and progresses to the point of kidney failure. Most dialysis patients are there because of diabetes related effects from under treatment or absence of treatment.
How it is determined regarding the damage of the kidneys of such patients is measured by the suspected kidney impaired patient by their GFR- gloumular filtration rate, which measures their fluid output of these patients. If a patient reaches a GFR of stage5, they usually are placed on dialysis for life support, essentially.
For unclear reasons, the larger the size of a dialysis center, the better patient compliance will be experienced, which means more patients show up for treatment and follow directed protocol regarding their illness.
In addition, nephrology staff members of such centers, which include nephrology nurses, have increasingly greater responsibility. Such courageous and skilled people freely accept rather challenging professions that some are reluctant to challenge themselves in such a way. There is actually an American Nephrology Nurses Association. And there is a dialysis museum in Wisconsin called something close to Dialysis Central.
Aggressively treating dialysis patients is controversial. One issue is those patients with CV disease, as overly aggressive dialysis treatment has been correlated with premature death.
Technology and quality of life continues to improve for these patients, yet an artificial kidney would be great, once developed. This has not become available yet.
So, if you are a health care professional who wishes to challenge themselves and gain the confidence of nephrologists. I would suggest involvement with such a devastating disease that relies on quality and compassionate staff for their livelihood and appropriate treatment. Of course, this means dealing with the stress of treating kidney failure patients.
“Only those who risk going too far with deliberate intent can possibly discover how far they can actually go.” --- T.S. Elliott
Dan Abshear
Kidneys are necessary human organs, which is probably why humans have two of them, as they are balancing organs for our well being, from a physiological perspective. They remove toxins for the blood and maintain electrolyte balance in our bodies as well, to name a few of the many functions of these what are termed end or target organs that are dependent on our circulatory system as we are dependent on their optimal function for our existence.
While the process of dialysis has been improved over the past century or two, the first actual dialysis center was created by a man named Belding Scribner in the early 1960s. Rumor has it that he never patented his creation so more could have access to this vital procedure location with trained staff.
About ½ a million people are dependent on dialysis devices annually and the cost is completely covered by those with Medicare, as this cost for this treatment approaches or exceeds tens of billions of dollars a year for all of these types of patients. In fact, this is the only medical treatment that s completely financially covered chronic medical treatment by Medicare since the early 1970s. This cost is about a million dollars per patient per year. Hem dialysis is the most beneficial type of dialysis, which removes toxins from the blood of the patient over a period of a few hours about three or four times a week, with anemia being the most common complication of this treatment.
If there are patients who need financial assistance, there is a support group who fortunately have a web site that is: www.aakp.org that has helped more dialysis patients than other similar organizations financially.
While there are now about 5 thousand independent and hospital owned dialysis centers presently in the United States, there is also the possibility of home dialysis that are options as well, as determined by the dialysis patient’s doctor, who is a nephrologist, or kidney doctor.
Non for profit dialysis centers have been shown to have better quality than the for profit centers for a number of reasons- some of which are entirely known and unknown. This is important because monitoring of kidney failure patients is a great responsibility, as the average patient takes about 10 drugs routinely in addition to dialysis treatment and are chronically sick patients typically.
One reason for the large number of medications taken by these patients is due to the two primary causes of kidney failure, which are uncontrolled hypertension and diabetes. With high blood pressure, over time the kidneys become progressively impaired due to nephrosclerosis, which is nephritis that is caused, or causes, restricted blood flow and possibly toxins that aggravate this condition within the failing kidneys of these patients. With diabetes, most can discover the disease by detecting protein in the urine, which is a quite simple urine test. If uncontrolled, diabetic nephropathy develops and progresses to the point of kidney failure. Most dialysis patients are there because of diabetes related effects from under treatment or absence of treatment.
How it is determined regarding the damage of the kidneys of such patients is measured by the suspected kidney impaired patient by their GFR- gloumular filtration rate, which measures their fluid output of these patients. If a patient reaches a GFR of stage5, they usually are placed on dialysis for life support, essentially.
For unclear reasons, the larger the size of a dialysis center, the better patient compliance will be experienced, which means more patients show up for treatment and follow directed protocol regarding their illness.
In addition, nephrology staff members of such centers, which include nephrology nurses, have increasingly greater responsibility. Such courageous and skilled people freely accept rather challenging professions that some are reluctant to challenge themselves in such a way. There is actually an American Nephrology Nurses Association. And there is a dialysis museum in Wisconsin called something close to Dialysis Central.
Aggressively treating dialysis patients is controversial. One issue is those patients with CV disease, as overly aggressive dialysis treatment has been correlated with premature death.
Technology and quality of life continues to improve for these patients, yet an artificial kidney would be great, once developed. This has not become available yet.
So, if you are a health care professional who wishes to challenge themselves and gain the confidence of nephrologists. I would suggest involvement with such a devastating disease that relies on quality and compassionate staff for their livelihood and appropriate treatment. Of course, this means dealing with the stress of treating kidney failure patients.
“Only those who risk going too far with deliberate intent can possibly discover how far they can actually go.” --- T.S. Elliott
Dan Abshear
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