I will talk this week about police militarization in the US and point to how it happens in areas designated International Economic Zones which is why Clinton neo-liberals and Bush neo-cons think they can simply ignore Constitutional rights and laws.  The focus on killing by police of black citizens mostly in cities only happens because police policy is being used as a development tool.  In Iraq---the US military used this same kind of policing to push rebels from neighborhoods with tons of collateral deaths surrounding these actions----AND THEY DID NOT CARE.  This is what is happening in cities like Baltimore.  They want to push the poor and working class out of neighborhoods slated for Master Plan development and they use any method they want because we have no Federal justice agencies enforcing Rule of Law.  State Assemblies are stocked with the same global corporate pols building these International Economic Zone structures so they too pass unconstitutional laws and turn a blind eye.

THIS WILL MOVE FROM INJUSTICE FOR ONE TO INJUSTICE FOR ALL IF WE ARE SILENT......SILENCE IS COMPLICITY.

After decades of zero tolerance policy that often went to unconstitutional policing for this same development process-----the closer Trans Pacific Trade Pact comes to being installed---the more third world this policing becomes. 

ALL AMERICANS ARE SHOUTING AGAINST MILITARIZED POLICING---FROM CONSERVATIVE REPUBLICANS TO SOCIAL DEMOCRATS---IT IS ONLY THE GLOBAL CORPORATE 'CENTER' NEO-CONS AND NEO-LIBERALS PUSHING THESE POLICIES.

Media comes to play in all this by having mainstream media simply report all this as single incidents rather than reporting of national events and how people are responding.  I've talked with all reporters of national media about all that is happening in Baltimore wanting a series of reports that show a complete picture of police actions over several years.

ALL THIS HAPPENS BECAUSE BALTIMORE CITY HALL AND BALTIMORE MARYLAND ASSEMBLY POLS PUSH THE MOST UNCONSTITUTIONAL LAWS THAT OPEN THE DOOR FOR THESE ABUSES ALL WHILE WALKING WITH PROTESTORS POSING PROGRESSIVE.


Ending Police Militarization, One City at a Time


Tuesday, 29 September 2015 00:00

By Ana Conner and Tara Tabassi, Truthout | News Analysis

Oakland police participate in Urban Shield training in October 2012. (Photo: San Leandro Privacy / Flickr)

Urban Shield, the world's largest SWAT training and war-weapons expo, was held in September in California's Bay Area, beginning on the 14th anniversary of 9/11. Hosted each year since 2007 in the Bay Area's Alameda County (last year in Oakland, this year in Pleasanton) with exercises all across the Bay, it is attended by hundreds of local, federal and international law enforcement agencies and weapons manufacturers.

Since his tenure began in 2007, Alameda County's sheriff, Gregory J. Ahern, has been waging war on Black and Brown communities across the Bay Area. Urban Shield solidifies Ahern's war, and makes it a profitable one. As the Bay Area Urban Shield's core organizer, he has received over $100,000 in contributions for his electoral campaign from Urban Shield vendors, such as 511 Tactical, Adamson Police Products and Corizon Health. But he's not the only one. Local, federal and international agencies coordinate through police trainings and weapons expos all over the world, much like Urban Shield, to trade tactics and military-grade weaponry.

Urban Shield is just one such police militarization expo: a convenient "one-stop shop" for anything a police department might need to turn regular beat cops into SWAT-like robo-cops. Granted, Alameda County police forces were committing brutality long before Urban Shield first began in 2007. It has been occurring since the mid-1960s to 1980s, as high-level military equipment and techniques were nationally transferred to police departments for "war on drugs" activities. Post-9/11 saw a morphing of these weapons transfer programs between the military and police for the "war on terror" and for the "enhancement of officer safety." However, the centralizing and systematizing of militarism, and police militarization in particular, under the guise of emergency preparedness and public safety, is a relatively new and expanding phenomena of police militarization, with Urban Shield as one of the clearest and most spectacular examples of how the militarism of state violence drives deeper into US communities.



Urban Shield brings together police departments, SWAT teams, fire departments and emergency medical services to partake in training exercises and attend the expo featuring global arms manufacturers' newest surveillance and weapons technology, from drones and armored vehicles to DNA-identification machines. Urban Shield appeals to growing fears of climate change emergencies and natural disasters, by selling itself as an "emergency preparedness exercise" for "high-threat, high-density urban areas." However, because Urban Shield is funded by the Department of Homeland Security, all training scenarios, workshop topics and vendor goods at the expo have to have a "nexus to terrorist threats." The weekend of September 11 to 14 effectively functioned as an international counterterrorism conference. Simply put, Urban Shield is selling militarism.
 
)While Urban Shield's flashier items for sale in Oakland, such as aerial weapons and armored tanks, continue to draw much media attention year to year, militarism takes other forms as well: This year at Urban Shield, T-shirts were sold with slogans such as "Black Rifles Matter" and in 2014, "This Is My Peace Sign," with a picture of a gun scope. Militarism comes in obvious forms, from weapons to surveillance technology, but militarism - the state of mind that is required in order to maintain global and national state control - is also spread through humor, "gaming" culture and a normalization of violence against those already deemed disposable, dangerous and/or "radical." It is only then that militarized mentalities - mentalities that rely heavily on cultures of fear, white supremacy, heteropatriarchy and warfare logic - successfully permeate through agencies, such as police departments, and dramatically amplify the force of police violence through our communities.

The Urban Areas Security Initiative

Though coordinated by the Alameda County Sheriff's Office, Urban Shield is actually made possible through the Urban Areas Security Initiative, or UASI, a grant program of the US Department of Homeland Security (DHS). UASI is an almost $600 million grant program from DHS, which is administered through the Federal Emergency Management Agency (FEMA) to grant funding to agencies across the United States. UASI strengthens and unifies state repression, though they claim to be a program that assists 39 "high-threat, high-density Urban Areas in efforts to build and sustain the capabilities necessary to prevent, protect against, mitigate, respond to, and recover from acts of terrorism." In response to controversy over "the [DHS] funding formula [for high-threat urban areas], in April 2003, Congress introduced the Urban Area Security Initiative (UASI), which was intended to supplement the security budgets of the most vulnerable cities." However, according to a New York City official, "The aid is not based on threat. It's based on formulas that allow the government to spread it around the country. That's politics; that's not threat assessment."

UASI and Urban Shield are expanding: UASI grew by nearly $30 million in 2014 alone, and since 2007, Urban Shield has been hosted in Oakland and Pleasanton, California; Boston, Massachusetts; as well as central Texas (Fort Worth, Dallas and Austin). The highest recipient of UASI funding is the New York City area, which received $178 million in 2014, perhaps funding New York City Police Department Commissioner William Bratton's "strategic response group" counterterrorism units this year. In descending order after New York, the highest recipient areas of UASI are Chicago, Los Angeles/Long Beach, National Capital, Bay Area and Houston, all above $20 million annually. While some UASI funding is spent on expos such as Urban Shield, other cities obtain war toys, such as Chicago's surveillance cameras, BearCat armored trucks in Fargo, North Dakota, and Keene, New Hampshire, and Long Beach's armored cars.



In the Bay Area, however, for the period of November 1, 2014, to February 28, 2016, Alameda County has received $6,358,300 in funding from UASI. Of this, $1.7 million is designated to Urban Shield. The Alameda County Sheriff's Office does not receive any funds from Urban Shield to offset the costs of holding such activities in the Bay Area, thus causing the county to pay using the hard-earned money of its people. Urban Shield states that it "has no funds available to offset the costs of overtime for employees who may wish to participate in the exercise planning or on the dates of the exercise itself. Nor does Urban Shield pay to offset the costs of backfilling on-duty employees who wish to participate." However, the county accepts these conditions of costing the people in order to secure funding through UASI.

Resisting Militarization

The Stop Urban Shield Coalition, based in Oakland, California, is a unique example of a cross-community grassroots effort united to resist militarization of Black and Brown communities. From local, community-based organizations to national organizations, the Stop Urban Shield Coalition includes members from various race, faith, political and social backgrounds, though it unites around following the leadership of those most impacted by policing and militarization. The coalition calls for "decreasing violence in our communities by ending police militarization, an end to the use of our communities as testing grounds for tactics of global repression, to affirm our right to community self-determination, and on our communities to continue fighting back and resisting state violence and repression."

Urban Shield normalizes the constant state of militarized emergency in marginalized communities across the nation.In 2014, the Stop Urban Shield Coalition successfully pressured city administrators enough that on the first day of the expo, Oakland Mayor Jean Quan announced Urban Shield would no longer be held in Oakland city borders. While momentarily exciting, with time it became clear that Urban Shield merely moved to Pleasanton, a town near Oakland, and still in Alameda County. Because the coalition's goal is to end Urban Shield and hold our cities and counties accountable in their collaboration in racialized repression and violence, the coalition again organized Bay Area residents this year to push city administrators to reject Urban Shield from Alameda County completely. From organizing a national call-in day to Alameda County's Board of Supervisors, appealing to them to stand with communities, not war profiteers, to blocking traffic with guerrilla theatre and hosting a rally outside of the Alameda County Sheriff's Office building, the Stop Urban Shield coalition used many organizing tactics to draw attention to the real impacts of police militarization on communities, particularly people of color. Far from training agencies for emergency preparedness, the Stop Urban Shield Coalition argues that Urban Shield normalizes the constant state of militarized emergency in Black, Arab, Muslim, migrant and poor communities across the nation.

While it is clear how Urban Shield will affect communities across the Bay Area, as well as any towns and countries with police departments that attend the Urban Shield trainings, the effect of emergency respondents and fire fighters attending militarized SWAT trainings rife with anti-Black and Islamophobic tropes is less clear. Urban Shield training increasingly includes scenarios that involve "homegrown domestic terrorists" and political protesters. In 2014, Urban Shield Bay Area hosted a training exercise based at the University of California, Berkeley, where competitors were presented with a scenario of a "Muslim man that took a Jewish man hostage" who had "read a website on jihad against Israel," and was going to use chemical weapons to "hurt the Jew for what he's done to his people." This dramatic scenario only fuels the already normalized trope of terrorist Muslim, but also suggests that "a military grade response, like those used in US wars against Iraq and Afghanistan or in support of the apartheid state of Israel against Palestine is appropriate for law enforcement to take in day-to-day contact with Arab and Muslim communities," according to Rachel Herzing in the brief "Why Arab and Muslim communities should say No to Urban Shield." Furthermore, Arab and Muslim communities have been targeted by the Department of Homeland Security, the FBI, the Joint Terrorism Task Force and other federal agencies through surveillance, police harassment, physical brutality and arrest since 9/11.

The Islamophobic profiling and criminalization enacted within the United States as part of the "war on terror" further the fear and distrust of Muslim, Arab and Middle Eastern communities. Inside Urban Shield's trade show, vendors push the same surveillance technologies and weapons that have been used in repressing Black communities in Ferguson, Baltimore and nationally, and these same technologies have also been used against Arab and Muslim communities across the country and globe. Employing militarized weapons and tactics to policing strategies - whether biometric or drone surveillance, SWAT raids and no-knock entries, or armored personnel carriers - targets the communities against which they're used as enemies to be neutralized. These weapons and tactics can be even more harmful when they are aimed at a community already targeted as enemies inside the United States.

SWAT Raids and Racist Policing

Black, Indigenous, Chicana and Muslim communities, communities of color and poor people, particularly homeless people, are most impacted by police militarization, including SWAT raids, extrajudicial killings, police brutality, racial profiling, suspicious activity reporting policies, fusion centers and the rapidly expanding prison industrial complex. In the United States, according to the Bureau of Justice Statistics, Black people are arrested at about double the rate of white people and at a proportionally higher rate than any other racial group. As the foot soldiers of the notoriously racist "war on drugs," SWAT teams have historically brought a war-making mentality to the daily practice of policing and arrest. The state profiled Black and Latino men as the primary targets for this war, and the police trained to carry the war out and treat them as threats to be neutralized. However, those impacted by SWAT raiding of targets, such as children and families, are voices often unheard.

Maria Calvillo, a 13-year-old member of Xicana Moratorium Coalition (XMC), speaking at a September 11 Stop Urban Shield rally in Oakland, described her home being raided by SWAT in the middle of the night while she was home with her mother and baby sister. "As soon as I hit the door, I opened it and they started screaming at me, tell me to put my hands up, pointing rifles at me," she told Truthout. "I looked around, and it seemed like a movie, I couldn't believe it.... The police had a tank in front of our house. An actual tank."

If we push Urban Shield, a product of the global war on terror, out of the US, we delegitimize the US war machine at its core.The murder of Aiyana Jones, a 7-year-old girl who was shot in a Detroit no-knock SWAT raid in 2010 after a flash grenade was thrown through the front window, made abundantly clear how war mentalities are enacted through SWAT killings. SWAT teams are deployed nearly 50,000 times per year. According to The Economist, "Roughly 90% of all police departments in cities with populations over 50,000 have a variation of a SWAT team, as do federal departments including the Department of Agriculture and the Department of Education. Given the frequency with which SWAT is employed by law enforcements, we can see that SWAT isn't so much specialized policing as the mainstay these days."

Urban Shield focuses heavily on SWAT teams. According to the American Civil Liberties Union (ACLU), 39 percent of people impacted by SWAT deployments are Black versus 20 percent for white people (Black people make up about 13 percent of the US population and white people about 63 percent). SWAT-style teams (sometimes named "counterterrorism" or "strategic response") are also frequently deployed to suppress protests and political dissent. Recent examples from Occupy and the Black protest movement provide clear demonstrations of how quickly policing tactics escalate through militarism, regardless of the types of cops on the streets. For anyone engaged in direct action and civil disobedience, and in particular for policed peoples, the danger of interaction with police deployed to suppress dissent should not be underestimated.

Police departments from around the world, counterterrorism units and border patrol agencies come each year to Urban Shield to partake in the trading of tactics of state repression, crowd control and weapons technology. In past years, agencies from Israel, Bahrain, Greece, Singapore, Brazil, Jordan, Qatar, the United Arab Emirates and Canada have participated in Urban Shield. This year's Urban Shield hosted domestic police from Texas and Florida, and international teams from South Korea, Jordan, Uruguay, Colombia, Thailand and China. Organizers of these types of gatherings often proudly claim that the next will be "more international than ever."

This kind of collaboration impacts every policed person around the world, including those under formal colonial occupations and those under neo-imperialist regimes. Further, Urban Shield's reach is felt globally, with platinum vendors featured such as Safariland. This key weapons manufacturer exports tear gas and other repressive technologies to Brazil, Bahrain and Canada, just to name a few. The day after Urban Shield closed, on September 15, London's Defense and Security Equipment International (DSEI), the largest arms fair in the world began, hosting many of the same vendors, such as BAE Systems, the third-largest arms producer from warships to missiles.


It is obvious to us as Black and Muslim activists in the United States that our communities are connected through the ways we are targeted. But we can also connect through the power of our organizing. The Stop Urban Shield Coalition provides a unique example of how to build power across our races, religions, classes and sects, and connect urban area to urban area to resist militarization nationally. If we push Urban Shield, a product of the global war on terror, out of the United States, and disempower police departments, the Department of Homeland Security and the Department of Defense, we delegitimize the US war machine at its core. Then we can really begin to resist militarism around the world.
________________________________________________

The article above from TruthOut is great at outing the players in all these policies-----Homeland Security is militarizing our communities by sending military equipment being brought from Iraq and Afghanistan back to America and being installed across America because as they know----taking the US to an International Economic Zone with autocratic global corporate tribunal rule will not be taken well by any of the American people.  SEE WHY IT IS SO IMPORTANT THAT NO MEDIA OR NATIONAL JUSTICE NON-PROFIT TALK ABOUT ALL THESE CONNECTIONS?! TruthOut does not either.....

Obama upon election immediately installed Janet Napolitano-----a raging Clinton neo-liberal as head of this Homeland Security and a Barbara Mikulski as head of the Senate Appropriations Committee appropriated all the money needed for this expanded militarization----including to Baltimore City----where the most cruel policing policy is operating with the approval of Baltimore City Council and Mayor who work for Wall Street Baltimore Development and a very neo-conservative Johns Hopkins.  Hopkins is of course the source of all the most repressive of social policy.

ALL OF THIS IS HAPPENING WHILE CLINTON NEO-LIBERALS FROM OBAMA AND CONGRESS ARE BEING CALLED 'PROGRESSIVE DEMOCRATS'.....WELL, THEY DID SUPPORT GAY MARRIAGE AND THAT'S ALL WE NEED TODAY TO BE PROGRESSIVE.

Keep in mind that this same Napolitano that moved all the most militarized of policy was appointed Head of California's public school system with no background in education with the mission of moving California's schools system to these extreme neo-liberal corporate education policies as exist in Asian nations.  That happened because all of California's pols running as Democrats are Clinton neo-liberals----the same in Maryland except Baltimore's Democrats serve as Hopkins neo-conservatives. 

IF YOU HATE ALL THESE POLITICAL TERMS IT SIMPLY MEANS----GET ALL THESE WALL STREET GLOBAL CORPORATE POLS RUNNING AS DEMOCRATS OUT OF THE DEMOCRATIC PARTY AND WE CAN REVERSE THIS.

If all you are doing is shouting thinking these corrupt pols will change----that is why we have had these few decades of going downhill as a nation.  BE THE CANDIDATE THAT RUNS IN PRIMARIES AGAINST THESE CRONY POLS---GET RID OF THEIR FARM TEAM ESPECIALLY IN BALTIMORE.

You see how media are using Ferguson as a focus for military policing while cities like Oakland, California and Baltimore, Maryland where this policing has been far worse are off the radar and it is because Oakland, California and Baltimore, Maryland are slated to become International Economic Zones free from any US Constitutional protections or laws.  Cities like Ferguson in a state that is conservative Republican are building military policing for social unrest to lost Constitutional protections WHICH IS A REPUBLICAN STANCE

Get the Military Off of Main StreetFerguson Shows the Risks of Militarized Policing


By ELIZABETH R. BEAVERS and MICHAEL SHANKAUG. 14, 2014


WASHINGTON — FERGUSON, Mo., has become a virtual war zone. In the wake of the shooting of an unarmed black teenager, Michael Brown, outsize armored vehicles have lined streets and tear gas has filled the air. Officers dressed in camouflage uniforms from Ferguson’s 53-person police force have pointed M-16s at the very citizens they are sworn to protect and serve.

The police response has shocked America. The escalating tension in this town of 21,200 people between a largely white police department and a majority African-American community is a central part of the crisis, but the militarization of the police is a dimension of the story that has national implications.

Ferguson’s police force got equipped this way thanks to the Pentagon, and it’s happening all over the country. The Department of Defense provides military-grade weapons and equipment to local law enforcement agencies through the 1033 program, enacted by Congress in 1997 to expand the practice of dispensing extra military gear. Due to the defense industry’s bloated contracts, there is a huge surplus. To date, the Pentagon has donated military equipment worth more than $4 billion to local law enforcement agencies. And the giving goes on, to police forces in all 50 states in the union.

Ferguson’s police department is just one recipient; small towns all over America are now the proud owners of “MRAP” armored vehicles. The largess has gotten so out of hand that a congressman, Hank C. Johnson, is introducing a bill to block the 1033 handouts.

Whereas the Department of Defense hands over weapons directly, the Department of Homeland Security provides funding for arms. It has distributed more than $34 billion through “terrorism grants,” enabling local police departments to acquire such absurd items as a surveillance drone and an Army tank.

For a police department like Ferguson’s, the path to becoming a paramilitary force is a short one. After loading up with free military gear, it is no surprise that law enforcement agents want to use it. In fact, the 1033 program’s regulations require that the police use what they receive within one year.

In the absence of extreme violence or actual terrorist threat, what happens — as the American Civil Liberties Union has documented — is that the equipment and weapons are used by SWAT teams in routine situations, such as low-level drug raids or the execution of search warrants. As Ferguson shows, this militarizing of routine police work exacerbates tensions and increases the likelihood of disorder. This, in turn, appears to justify a militarized police response, and so the cycle continues.


The federal government can stop this increased militarization at its source. The Pentagon must end its transfer of military-grade weapons through the 1033 program. And the Department of Homeland Security should stop handing out the terrorism grants. The ease with which police departments can avail themselves of Homeland Security funding for enormous caches of weapons and ammunition in the name of counterterrorism is deeply disconcerting.

Continue reading the main story Write A Comment Veteran police chiefs who have served on the front lines of America’s biggest police forces are voicing their concern. Norman H. Stamper, the former police chief of Seattle, has written with regret about the military-style tactics employed during the protests against the 1999 World Trade Organization conference in Seattle; he now advocates “an authentic partnership in policing the city,” involving rank-and-file officers, civilian employees and community representatives.

Militarizing our police officers does not have to be the first response to violence. Alternatives are available. Attorney General Eric H. Holder Jr.’s statement Thursday highlighting resources like the Department of Justice’s Community Oriented Policing Services office is welcome. This is where the government should be investing — instead of grants for guns.

Police militarization is a growing national threat. If the federal government doesn’t act to stop it, the future of law enforcement everywhere will look a lot like Ferguson.

Elizabeth R. Beavers is the legislative associate for militarism and civil liberties, and Michael Shank is the associate director for legislative affairs, at the Friends Committee on National Legislation.

_______________________________________

If people knew how widespread this military policing has become and the goals of economic policy that will expand military policing in the US-----they would be more angry about what happened below----citizens were mad because they had not been given notice and not that militarized use of tear gas was being practiced in their vicinity.  Maryland citizens are no doubt thinking all this is aimed at ending social programs that are going to send black citizens to work in some form.  They do not understand the concept of International Economic Zones and what that will mean to ALL MARYLANDERS.

The use of tear gas by police is now so mainstream and the health hazards are known as well-----it is very common that someone dies and/or is severely hurt by pepper spray and tear gas and yet----it is being allowed to be used in lieu of police officers simply getting out and tackling would-be criminals.  In Baltimore, I read that a grant was sent to train Baltimore police to fist fight----in other words subdue without lethal force----and those funds were never used for that purpose.  WE HAVE A SHOOT FIRST ASK QUESTIONS LAST APPROACH TO POLICING.  Forget trial by jury----you pass a fake prescription off to a pharmacist and the police can shoot you dead whether you have a weapon or not.


Tear gas training prompts neighborhood scare
Residents affected near Paper Mill Road

UPDATED 8:23 AM EDT Sep 16, 2015 

PHOENIX, Md. —Baltimore County Police said that wind might have carried tear gas into nearby neighborhoods during a training exercise Monday in Phoenix.


That gas caused discomfort, confusion and anger among residents, but police said they believe they have the problem under control. One indication of that is that police conducted a similar exercise on Tuesday.

Still, the whole incident left many resident feeling uneasy about the situation.

"My eyes were swollen shut (and) my nose was running," resident Diane Doccolo said. "I'm thinking 'What is this?'"

  It wasn't the relaxing Monday night that Doccolo anticipated. Doccolo quickly realized that she wasn't the only person in her Phoenix neighborhood dealing with a burning throat, eyes and skin, all of which she said felt like they were was on fire.

"Everybody else started calling," Doccolo said. "'Did we smell it?' 'Did we know what was going on?' (people asked). Police were going door to door."

Joseph Revak is another neighborhood resident who had a similar experience.

"I stepped out my front door for just a couple of seconds, and I had to go in and flush my eyes out because it was burning so bad," Revak said. "And when you don't know what it is, it's rather frighten."

Police confirmed Tuesday that the irritants floating over and around the Old York Manor neighborhood near Paper Mill and York Manor roads were smoke and tear gas.

Police were doing training with the agents at a facility nearby and they think weather conditions caused it to drift further than anticipated. Investigators said they got several calls from people complaining about the affects but no one was hospitalized.

The same training continued Tuesday night.

In a statement, police said the department has conducted this type of training before using the same training agents before without receiving any complaints.

A spokesman was unable to confirm exact protocol for training with possible irritants near residential communities. But, he said precautions were taken on Tuesday to ensure something similar didn't happen again.

"The Baltimore County Police Department takes into consideration how its operations impact the community and will review any incident where there is a negative impact," Cpl. John Wachter said in a statement.

Revak said he would have preferred a warning prior to the first exercise.

"Why didn't they tell us that they were going to be doing that?" Revak said. "Why the fire department when they were in the neighborhood didn't tell us to stay in close your windows and doors?"

_______________________________________________

This is where we have in the national media Republican voters being made to sound 'racist' as they call Obama a traitor and needing impeachment for his pushing all these unconstitutional policies---AND THEY ARE UNCONSTITUTIONAL AND TIED TO TRANS PACIFIC TRADE PACT.  Now, Republican voters do not make this connection because neo-cons keep them in the dark on these International Economic Zone policies just as Clinton neo-liberals do Democratic voters.  The south have more cities designated as International Economic Zones as the north so Republican voters are taking to the streets with the far-right approach of arming themselves.  Meanwhile, the left-leaning Democrats are using their voices in protest and marching. 

THE RIGHT WING TEA PARTY AND LIBERATARIANS ARE PROTESTING THE SAME THING AS SOCIAL DEMOCRATS ARE----BUT THEY ARE BEING PLAYED BY MEDIA AGAINST ONE ANOTHER BECAUSE NO ONE KNOWS ALL OF THIS IS INTERNATIONAL ECONOMIC ZONE AND TRANS PACIFIC TRADE PACT POLICY.

So, the Democratic base of labor and justice should be shouting that Obama and Clinton neo-liberals are traitors and need to be impeached as loudly as Republicans----but no one is educating on the goals of Clinton neo-liberal policy----the same as Bush neo-con policy.


Below you see students in California know this connection and they are saying----WTHeck??????  You are placing a global militarized police and autocratic corporate rule person as head of a public education system?  Does anyone in Baltimore know about all these protests and why California citizens have been marching for years?  NO, BECAUSE BALTIMORE MEDIA DOES NOT ALLOW ANY INFORMATION THAT HURTS CLINTON NEO-LIBERALS.

I again want to note as regards all this militarized policing getting ready for installing International Economic Zone and Trans Pacific Trade Pact policy-----that national women's justice organizations like National Organizations of Women supported Napolitano for Supreme Court for goodness sake-----and other national women organizations always support Clinton neo-liberal women because they have appointed Wall Street leaders. 

So, WE THE PEOPLE MUST BUILD OUR OWN LABOR AND JUSTICE STRUCTURES LOCALLY TO GET AROUND THIS CORPORATE CAPTURE OF OUR NON-PROFITS!

janet napolitano


Janet Napolitano: a militarized president for a militarized university

Submitted by Patrick on Fri, 07/12/2013 - 3:29pm




The Department of Homeland Security is a cabinet-level department with a budget in the tens of billions of dollars, and fills the role of the Defense Department's domestic counterpart: while DoD sends tanks and guns to Baghdad, Kabul, Tel Aviv, and Seoul, DHS sends tanks and guns to Detroit, Chicago, Washington DC, and Los Angeles. One of DHS' primary roles is the militarization of police departments across the country, through a combination of terrorism-related training programs and cheap military surplus hardware (everything from high-powered rifles to armored personnel carriers and tanks).


This militarization has resulted in more deaths and injuries at the hands of police as response to crimes and disturbances escalates dramatically. It has also meant a windfall for defense contractors as they expand their range of domestic offerings, including unmanned aerial drones.

Today we learned that current Secretary of Homeland Security Janet Napolitano will be tapped as the new President of the University of California system. In many ways, the UC red carpet has long been rolled out for her: the militarization of campuses against their own students (which has reached a new crescendo since OccupyCA, OWS, and the infamous pepper-spraying incident at UC Davis) the expansion of government and military contracts, and the ever-growing size of the administrative bureaucracy means that she'll likely find her new digs pretty familiar. As the LA Times put it:

Napolitano’s nomination by a committee of UC regents came after a secretive process that insiders said focused on her early as a high-profile, although untraditional, candidate who has led large public agencies and shown a strong interest in improving education.

UC officials believe that her Cabinet experiences –- which include helping to lead responses to hurricanes and tornadoes and overseeing some anti-terrorism measures -- will help UC administer its federal energy and nuclear weapons labs and aid its federally funded research in medicine and other areas.

What the Times doesn't mention is that some of those federal agency dollars are coming right from DHS itself.

We can't glean much about Napolitano's educational priorities beyond her tenure as governor of Arizona from 2003-2009.

During her time as governor, tuition at ASU went up 58%, much higher than the average 4-year public university's increase of 19% over that same period. (That being said, once Secretary of State Jan Brewer took over after Napolitano's DHS apppointment, tuition increases only got worse.)

While her appointments to the Arizona Board of Regents include the first Native American to the Board (LuAnn Leonard), they also include Dennis Deconcini and Anne Mariucci. Deconcini is a high-powered lobbyist, whose firm has the distinction (aside from representing such good citizens as Monsanto, Eli-Lilly, Pfizer, and the MPAA) of owning the domain LobbyCongress.com. Mariucci was head of Del Webb Corporation, a giant firm that builds retirement homes across the country, and later got into the private equity business. In 2011 she joined the Board of Directors of the Corrections Corporation of America. CCA, naturally, has spent millions lobbying DHS.

As Democratic governor in a state with a solidly Republican legislature and little worry about having to sign actual progressive legislation, Napolitano certainly talked a decent game. In 2008 she said she wanted to freeze tuition for in-state students, and guarantee a free ride to any Arizona student with at least a B average through high school (and a clean disciplinary record — problematic due to the racist and abelist discipline systems in most public high schools).

While Mark Yudof's tenure as current UC President is thankfully very nearly over, Napolitano's selection reinforces how tough the road ahead will be for student organizers. Her selection is in some ways a defensive response by the Regents against the pressures they face, both from Sacramento and from the very people who make up the University of California — the students, faculty, and staff. If she can manage to on the one hand get the legislature to widen the gates of privatization, and on the other squash insurgent activism on UC campuses, it will be a dream come true for the Regents. Thankfully, there are plenty of committed and organized Californians who stand in their way.

EDIT: Updated to reflect her position as President, not Chancellor. Thanks katminka!
_______________________________________________
THIS IS THE SAME THING HAPPENING IN THE US UNDER CLINTON/BUSH/OBAMA GLOBAL CORPORATE RULE POLS.

We can reverse all this easy peasy by getting rid of all Clinton neo-liberals by running REAL progressive social democrats in all primaries at all levels of government----BE THAT CANDIDATE!

Institutions like Johns Hopkins cut their surveillance and spying global corporate teeth building corporate structures overseas for International Economic Zones in Asia.  All of this was to protect the interests of US corporations central to these economic zones from a backlash of citizens not liking being made slaves for FOXCONN US corporate campuses.  Hopkins is central in this very right-wing militarized policing and grew especially during the Bush Administration overseas and now under Obama is being installed in the US.

IT'S NOT ABOUT TERRORISM----IT IS ABOUT AMERICAN CITIZENS BECOMING ENRAGED OVER BEING SENT TO THIRD WORLD STATUS WITH ALL US WEALTH STOLEN THROUGH FRAUD AND CORRUPTION.

So, in Baltimore----ground zero for Hopkins and its neo-conservative International Economic Zone policy----there is not a word from any labor and justice leadership or pols as to this connection and you know what?  I AM NOT A ROCKET SCIENTIST SO THESE LEADERS KNOW WHERE THIS IS GOING.


Title: Military and intelligence gathering activities in exclusive economic zones : consensus and disagreement : a summary of the Bali dialogue, a policy and research planning workshop held at the Hotel Nikko Bali, 27-28 June, 2002



Author:Military and Intelligence Gathering Activities in Exclusive Economic Zones : Consensus and Disagreement (2002 : Bali, Indonesia); Valencia, Mark J.; Garmendia, Jenny Miller; Van Dyke, Jon; Djalal, Hasjim
Date:2002
Publisher:Honolulu : East-West Center


Abstract:This report summarizes discussions held and conclusions reached at the Bali Dialogue, a meeting of senior officials and analysts from countries of the Asia Pacific region co-sponsored by the East-West Center and the Center for South East Asian Studies. The Dialogue facilitated unofficial, frank, and not-for-attribution discussions of issues concerning military and intelligence gathering activities in the Exclusive Economic Zones. This summary reflects the diverse perspectives of the participants and does not necessarily represent the views of the East-West Center, the Center for South East Asian Studies, Indonesia, or any particular participant.
Description:For more about the East-West Center, see http://www.eastwestcenter.org/
Sponsorship:Co-sponsored by the East-West Center and the Center for Southeast Asian Studies, Indonesia.
Pages/Duration:33 p.
URI:http://hdl.handle.net/10125/21571
Rights:East-West Center
LC Subject Headings:Military intelligence - Pacific Area - Congresses
National security - Pacific Area - Congresses
Territorial waters - Pacific Area - Congresses
Economic zones (Law of the sea) - Pacific Area - Congresses

One more day on media and the importance of local government to step in to rebuild local media that allows all viewpoints to be heard.  Obama and Congressional neo-liberals are sending hundreds of billions of dollars to build what will become global education and health care infrastructure and that is what local governments need to be doing----subsidizing public and private tooling for local media and printing.  Having a government printing press that is open to communities that want to start local media in their communities would break the monopoly Baltimore Sun has on local print media for example.  The Sun not only has its flagship paper---it owns all of the surrounding county news journals as well.  Remember, if all national media is consolidated----and all local media controlled by national media-----and all social media like Facebook end----where will public voice be?

A REAL PROGRESSIVE SOCIAL DEMOCRATIC BALTIMORE CITY HALL WOULD REBUILD IN-HOUSE PRINTING AND OPEN IT TO COMMUNITIES FOR MEDIA CO-OPTS AND COMMUNITY NEWSLETTERS.

If you look at Baltimore City and realize how captured news information is to very corporate and conservative sources---you see why a city of labor and justice is left not knowing public policy and long-term goals.  Wall Street Baltimore Development addresses the need for community media with corporate donations to non-profits that control what kind of media is pushed.  We see all kinds of online media---we see almost no print or local TV and radio media. 

If we know online is going to disappear for most----we want to move away from corporate non-profit to public funding as this builds a lasting structure in communities.

PLEASE TAKE SERIOUSLY THE REBUILDING OF LOCAL MEDIA THAT IS NOT CONNECTED TO INTERNET ACCESS.  MOST CORPORATE NON-PROFITS ARE FUNDING ONLINE MEDIA VENUES ONLY....FOR A REASON.

This article is long but please glance through to see how all the media venues we depend upon for local news are now controlled by national media corporations controlled by a few people.

September 26, 2011

How People Learn About Their Local Community

By Tom Rosenstiel, Amy Mitchell, Kristen Purcell and Lee Rainie

Contrary to much of the conventional understanding of how people learn about their communities, Americans turn to a wide range of platforms to get local news and information, and where they turn varies considerably depending on the subject matter and their age, according to a survey by the Pew Research Center’s Project for Excellence in Journalism and Internet & American Life Project, produced in association with the John S. and James L. Knight Foundation that asks about local information in a new way. Most Americans, including more tech-savvy adults under age 40, also use a blend of both new and traditional sources to get their information.

Overall, the picture revealed by the data is that of a richer and more nuanced ecosystem of community news and information than researchers have previously identified.



The survey echoes longstanding research that more Americans report watching local TV news than any other source—which has led to widely held idea that people go there for most of their community news and information. But it also finds that Americans tend to rely on the medium for just a few topics—mainly weather, breaking news, and to a lesser degree, traffic. These are the most widely followed local subjects. Yet consumers rely on other sources for most other local topics. Younger adults, moreover, rely on local television less, a fact that suggests more vulnerability for the medium in the future.

The survey also yields some striking findings for newspapers. Most Americans (69%) say that if their local newspaper no longer existed, it would not have a major impact on their ability to keep up with information and news about their community.

Yet the data show that newspapers play a much bigger role in people’s lives than many may realize. Newspapers (both the print and online versions, though primarily print) rank first or tie for first as the source people rely on most for 11 of the 16 different kinds of local information asked about—more topics than any other media source. But most of these topics—many of which relate to civic affairs such as government—taxes, etc., are ones followed by fewer Americans on a regular basis.

In other words, local TV draws a mass audience largely around a few popular subjects; local newspapers attract a smaller cohort of citizens but for a wider range of civically oriented subjects.

The survey also sheds light on the emerging role of the internet as people seek local news and information. The internet is defined here as web-only online destinations. For adults generally, the internet is a main source for information about restaurants and other local businesses, and it is tied with newspapers as a top source for material about housing, jobs and schools—all areas that place a special value on consumer input. Yet when one looks at the 79% of Americans who are online, the internet is the first or second most relied-upon source for 15 of the 16 local topics examined. For adults under 40, the web is first for 11 of the top 16 topics—and a close second on four others.




At the same time, the survey finds both citizen-based information sources and some very old forms of media remain vital as well. Print newsletters, online listservs and old-fashioned word of mouth are important means by which people learn in particular about community events and local schools.

In all, the data in a new national survey show that the majority (64%) of American adults use at least three different types of media every week to get news and information about their local community—and 15% rely on at least six different kinds of media weekly.

And nearly half of all American adults, 45%, say they do not even have a favorite local news source. Instead, in the modern local news information system, different media outlets, and in many cases entire platforms, are gaining footholds for specific topic areas.

While this can help news sources establish an identity with audiences, it also raises a critical question: If a platform were to wither or disappear, would parts of the community go unmonitored?

About the survey

The new survey was administered from January 12-25 among a nationally-representative sample of 2,251 adults age 18 and older on landline and cell phones. It has an overall margin of error of plus or minus 2 percentage points.

Conventional research has tended to ask people about local news and information generically with some variation of a simple question: Where do people turn most often for their news? Asked that way, the majority of people answer local TV, which has made it the most popular news source in America. That is reinforced by ratings data that shows that the combined ratings of local television news programs exceeds that of other local media. The biennial media consumption survey of the Pew Research Center for the People and the Press similarly finds that local TV news is the medium most people turn to for news and information of any type. And this new survey, too, finds that local TV is the most frequently used medium for news and information, with 74% watching local newscasts or visiting local TV websites at least weekly, compared with 50% who turn to newspapers and their websites, 51% to radio (on air and online), and 47% who turn to web-only sources.

But this survey also took a new approach as well, asking people about the information sources they rely on to get material about 16 different specific local information areas.

The result is a more complex portrait of how people learn and exchange information about community. The new data explodes the notion, for instance, that people have a primary or single source for most of their local news and information.

Rather, Americans appear to discern significant differences in the strengths of different information sources. They recognize that there may be more information about their child’s school on a parent-run listserv than on television or even their neighborhood weekly paper. They recognize that if they want information about zoning or local government, it may be more available in the newspaper they do not regularly buy than on the television station they watch many days for traffic and weather.

(For this survey, the “internet is defined as web-only sources such as search engines, specialty-topic websites, and social networking sites. If respondents said they relied on the website of a newspaper, it was considered reliance on the newspaper and was combined with references to the print version of the local newspaper. Similarly, if respondents said a local television website was their preferred sources for a particular type of local news, it was combined with references to watching local news on television and considered reliance on the local TV news platform rather than the internet.)

Other key themes

Other notable themes that emerge from the survey:

• The most popular local topics are weather (89% of people get it), breaking news (80%); local politics (67%) and crime (66%). The least popular on our list of topics are zoning and development information (30%), local social services (35%), job openings (39%) and local government activities (42%).
• Nearly half of adults (47%) use mobile devices to get local news and information. Not surprisingly, mobile is particularly popular for “out and about” categories of information, such as restaurants. And 41% of all adults can be considered “local news participators” because they contribute their own information via social media and other sources, add to online conversations, and directly contribute articles about the community. Both these groups are substantially more likely than others to use the internet to get local news and information on almost all topics.
• Social media is becoming a factor in how people learn about their local community, but it is not as popular as other digital forms. In all, 17% of adults say they get local information on social networking sites like Facebook at least monthly.
• Mobile phone applications, or “apps,” have yet to emerge for most local topic areas. Even now, though, 5% of Americans say they rely on a mobile app for weather information.
• Old-fashioned word of mouth is still a factor in sharing local news and information, especially at the neighborhood level for information about local businesses, restaurants and schools. In all 55% of all adults get local news and information via word of mouth at least once a week. Word of mouth is particularly likely to be cited by younger residents as one of their top platforms for community events. Adults age 40 and older are more likely to prefer word of mouth as a source for local politics, local government activity, housing and real estate, zoning, and social services.
• The websites of newspapers and TV stations do not score highly as a relied-upon information source on any topics. They have gained modest footholds as sources that users rely upon for a variety of topics, including weather information, crime, politics, and breaking news, but overall they consistently score in the low single digits when it comes to being the source that people rely upon on any of the topics we queried.

Age is the most influential demographic




While there are a variety of demographic dimensions that are linked to the way people get local news and information, the most striking is the difference between younger and older information consumers. Simply put, one generation into the web, older consumers still rely more heavily on traditional platforms while younger consumers rely more on the internet. Among adults under age 40, the web ranks first or ties for first for 12 of the 16 local topics asked about.

If someone is under age 40, she tends to get the following kinds of local news and information from the following places:

• Internet: weather, politics, crime, arts/cultural events, local businesses, schools, community events, restaurants, traffic, taxes, housing, local government, jobs, social services, and zoning/development
• Newspapers: crime, arts/cultural events, community events, taxes, local government, jobs, social services, zoning/development
• TV stations: weather, breaking news, politics, crime, traffic, local government, and social services
• Radio: traffic
• Word of mouth: Community events

If she is 40 or older, she tends to get the following kinds of news in the following places:

• Newspapers: politics, crime, arts/cultural events, local businesses, schools, community events, restaurants, taxes, housing and real estate, government activities, jobs, zoning/development, social services
• TV stations: weather, breaking news, politics, traffic, crime
• Internet: local businesses, restaurants

This move by younger users to rely on the internet for local information puts considerable pressure on traditional news organizations. Even though most have moved aggressively online with ambitious websites and social media strategies, there is evidence in the data that people find specialty websites and search engines a preferable way find the local material they want.
___________________________________________
BALTIMORE CITY MUST BUY PUBLIC AIRWAVES IN THE TV AND RADIO RANGE!

Below you see Brooklyn in the same place---probably for the same reason----its public access is on cable. National financial analysts have already told everyone that cable is dead---as Comcast and Verizon go strictly digital.  Comcast owns NBC and NBC just changed its name to NBC International.  So, as Baltimore and Brooklyn public access tie to cable and online---both of these media outlets are being killed for main street.

WE MUST HAVE LOCAL GOVERNMENTS BUYING PUBLIC AIRWAVES IN THE TV AND RADIO RANGE TO KEEP THESE MEDIA ACCESSIBLE.

Brooklyn Free Speech
Media dreams begin here...

Brooklyn Free Speech is a premiere, state-of-the-art media center for filmmakers, television artists, and organizations to learn and create innovative media. Every week on our three Public Access television channels, we showcase over 650 hours of TV shows, films, and shorts created by Brooklyn-based community producers that reflect their perspectives on the world.

Watch in Brooklyn on Cablevision 67, 68, 69 | Time Warner 1995, 1996, 1998 | and RCN 82, 83, 84; watch in all five boroughs on Verizon FiOS 42, 43, 44; watch our three channels worldwide to the right.
_________________________________________


For people not understanding why internet speeds need to go faster and faster----you don't know the goal is to move all internet access to global online corporations in health care and education that need all internet space to conduct these huge functions and they need this done fast in order to provide the real-time accuracy needed for things like telemedicine.  All of this is being done for global corporations and as we see here----the price for access to all this will keep rising.  Now, the Federal government has started to create subsidies for people not affording fees as they are today---just as the subsidize for heat and electricity.  All those subsidies WILL DISAPPEAR under a global corporate tribunal TPP government so it is just a matter of time before over 80% of Americans will not be able to access the internet for other than corporate services.

As cities like Baltimore build more and more community media online----they are allowing what will be real media access outlets to die.....local print media----public airwaves for TV and radio.

Comcast's 2Gbps internet costs $300 per month with huge install fees
Incredible speeds don't come cheap

• By Chris Welch
• on July 13, 2015 12:47 pm

Comcast's faster-than-Google Fiber internet was always going to be expensive, and now the company has officially revealed just how much 2Gbps will cost you: $300 monthly. Gigabit Pro is what Comcast calls its fastest-ever consumer broadband tier, which offers twice the download and upload speeds of Google Fiber for $230 more per month. Just like Google's service, this isn't available to everyone; Comcast says you "must generally live within a third of a mile of our fiber network" in eligible cities to receive Gigabit Pro. The below map shows where that fiber network extends so far.


That's not where costs end, though. Comcast's fine print for Gigabit Pro notes that customers must sign a two-year contract to receive service, and (significant) early termination fees apply if you decide 2Gbps is overkill. And then there's this:

So you're potentially looking at an installation window of two months, and while the "up to" language gives Comcast wiggle room, some people could pay $1,000 before they've even used Gigabit Pro. Google also charges "construction fees" — usually $300 — for Fiber customers who opt for its most basic internet tier. But the fee is waived if you're on the more popular 1Gbps internet plan or an internet / Fiber TV bundle. Gigabit Pro cannot yet be bundled with other Comcast services.

On the plus side, Comcast is offering people who agree to that two-year contract an early promotional rate of $159 per month, according to DSL Reports. That makes the whole thing slightly easier to swallow. And if you're the type of person who can afford $300 internet every month, maybe the tacked on installation costs won't influence your thinking much anyway. Gigabit Pro could make sense for small businesses with colossal bandwidth needs, though Comcast seems to hope that business users stick with their own, more expensive plans. If nothing else, Gigabit Pro should make for a smooth experience watching Stream on every conceivable device inside your home.


____________________________________________
We see the Federal subsidy for phone service materialize as this free-phone give-away in underserved communities complete with the worst of cheap phones and service.  At best a corporation is making hundreds of billions of dollars producing these throw-away phones.  So, when the FCC under an Obama corporate executive says the Federal government will subsidize access to internet as they allow monopolies and deregulation to cause rates to soar-----we know this is progressive posing.  Think how many Americans are reaching that poverty line-----not the $21,000 for a family of four they pretend is a current poverty line----but the $58,000 for a family of four that is the LIVING WAGE poverty line.  Over 70% of Americans are at that line and with the coming economic crash from bond market fraud----that will climb to 80% and higher.  Remember, the goal for Clinton neo-liberals and Bush neo-cons is to have 90% of Americans in third world poverty.

HOW WILL YOUR COMMUNITY COMMUNICATE IF THESE MEDIA ACCESS OUTLETS DISAPPEAR?  THAT IS WHAT A REAL PROGRESSIVE SOCIAL DEMOCRAT WOULD PREPARE FOR!

The FCC wants to expand Internet subsidies for the poor


By Brian Fung May 28

FCC Chairman Tom Wheeler speaks during his keynote conference at the Mobile World Congress in March in Barcelona. (David Ramos/Getty Images)Federal regulators hope to bridge a yawning gap in Internet adoption by expanding a subsidy program for poor Americans that for years has helped millions connect to basic telephone service.

Tom Wheeler, the chairman of the Federal Communications Commission, will circulate a proposal to his colleagues Thursday that would radically update the 30-year-old aid program, known as Lifeline, according to FCC officials who spoke on the condition of anonymity because the plan is not yet public.

For the first time, the proposal would allow program participants to apply their discounts to standalone high-speed Internet service. Although Lifeline supports broadband when it comes bundled with phone service, it currently does not allow the poor to use the $9.25-a-month subsidy to pay for independent Internet plans.

The amount of the monthly credit will not rise under Wheeler's proposal, an agency official said. Rather, it will focus on expanding choices for low-income consumers so that they aren't limited to buying certain devices or plans. It will also establish a minimum standard for the kind of service available to Lifeline benefit recipients. For instance, the program could require service providers to offer Internet to Lifeline subscribers of at least a certain speed, or voice service with a certain number of minutes. The proposal will also seek to increase the number of telecom and broadband providers that participate in Lifeline.

"As communications technologies and markets evolve, the Lifeline program also has to evolve to remain relevant," said Wheeler in a blog post. "Broadband is key to Lifeline’s future."

The FCC could approve the measure by as early as its next meeting, on June 18. In so doing, Wheeler would be reinforcing his argument that the Internet is as crucial a tool for connectivity and development as phone service was in the 20th century.

[Should the government pay for people's iPhones?]

Ninety-nine percent of the wealthy are connected to the Web in some way, according to the Pew Research Center. But poorer Americans lag far behind. Top FCC officials have argued that greater Internet access would help pull these Americans out of poverty.

"Too many of our citizens are stuck in digital darkness," FCC Commissioner Mignon Clyburn said in a speech last week, "without the primary tool needed for seamless communications for health care, education, civic participation and professional advancement."

_____________________________________

I looked at Baltimore City's budget for printing costs -----it is now $3,086,353 for 2015.  I don't have time to look at which corporations all this is outsourced to -----but what probably started as small businesses in Baltimore is now no doubt national printing corporations.  The budget says that funding at this level creates a $7.167 million deficit----

BALTIMORE CITY IS PAYING A LOT OF MONEY FOR PRINTING AND YET-----THE CITIZENS OF BALTIMORE HAVE TO PAY FOR COPY COSTS FOR GOVERNMENT DOCUMENTS AT 50 CENTS A POP OFTEN.

They are now telling us more and more needs to go into the CLOUD-----digital because of these high prices.  Now, call me skeptical----but a fast research of buying a government-sized printing machine is a few hundred thousand initial investment with ink and paper costs each year not able to reach $3 million.  Add to that open printing presses for communities wanting to rebuild print journalism -----and for the price of one corporate tax credit----we easily have a public printing operation that can subsidize citizens wanting to be journalists.

THEY ARE RUNNING THESE PRINT COSTS UP SO HIGH JUST TO MAKE IT APPEAR WE CANNOT AFFORD HARD PRINT COPIES----AND YOU CAN BET AN AUDIT WILL FIND FRAUD AND PROFITEERING.

Republicans and neo-liberals like to pretend that small government is best----taxes are lower and businesses are created.  Well folks, global corporations are now getting all our tax revenue and they are going to come back for more-----so please stop this small government mantra-----rebuilding our local government to be the source of local economic growth does not add to taxes and it helps small business growth!

The invention of the printing press was the great enlightenment that brought all information to people then called citizens.  Before this scribes wrote by hand all information that was kept to the rich and Catholic Church only.  Think what is happening today-----as all information is moved online----Google has scanned all libraries into its digital library-----only the rich are going to be able to access this information online.

THAT IS THE GOAL.  PLEASE STOP ALLOWING THEM TO CREATE THIS INFORMATION VOID.

Below is a great article too long to post.  Please Google to read-----what it states is what everyone knows will occur-----consolidation and corporatization of the internet will end with people not able to access it for personal use.  So, as Clinton neo-liberals make everything about technology in building business-----they know any small internet business will be gone----including media outlets.



How Industry Intends To Kill
The InterNet As We Know It
By Jeff Chester
Executive Director
http://www.democraticmedia.org/
Center for Digital Democracy
10-30-2

But beyond political and press circles are another equally important development: new technologies being developed and embraced that can, in practice, transform today's open Internet into a new industry-regulated system that will prevent or discourage people from using the net for file-sharing, internet radio and video, and peer-to-peer communications.
bBy charging a toll for every bit, the industry can simultaneously extract great profits from the new applications that it allows on its networks, as well as restrict access to those that it finds problematic, i.e. those that compete with its own content offerings. In short, the industry finally sees a way to make money online.
 
Of course, these calculations are utterly self-serving, ignoring the fact that the net was developed with tax dollars and has been an incubator for an array of innovations that extend far beyond creating new profit centers for big media companies. The envisioned control structures will inhibit robust Internet use by early broadband adopters, and discourage development of new high-speed applications such as Internet-based telephone and video-on-demand, thus slowing overall broadband growth.
 
Worse, this business model will erect high economic and technical barriers to entry for non-commercial and public interest uses of the high-speed Internet, threatening civic discourse, artistic expression and non-profit communications. In moving to implement this highly centralized vision for broadband, the cable industry does not simply ignore the democratic and competitive history of the Internet -- it is actively hostile to it.
 
Consumption-based pricing and other restrictive access controls contradict the spirit of openness and innovation that built the Internet in the first place, and will do irreparable harm to its future as a medium for small business initiatives, non-commercial users and democratic discourse. New threats to privacy are also clear, given the intrusive nature of the technology to closely monitor all online use. If you think spam is bad now...y young people; they also are the tools for fundamental new ways of conducting business and politics.

Media images of American people made desperate and having no Rule of Law or voice with the instability of protests and riots IS EYE CANDY to Wall Street and global corporations wanting to bring global corporations back to the US to these US cities to operate as they do in Malaysia and Vietnam.

  WHAT COMES TO US CITIES WILL NOT STAY IN US CITIES---IT WILL DRAW FROM SURROUNDING COUNTIES AND STATES.

I want to continue for a few days on media and looking at a formerly progressive news journal----Baltimore City Paper now owned by a very Wall Street Johns Hopkins Master Plan Baltimore Sun.  Remember, all national media outlets that were REALLY social progressive have closed and the names bought by Clinton neo-liberal globalists posing progressive.  From Mother Jones to New Republic----from The Nation to The Progressive---these national media pose progressive but they are Clinton neo-liberal.  Since Obama came on board media consolidation has soared such that all of the local news media are now rolled into national media corporations.

The image of Devon capturing the Baltimore protests and riots on camera and then posted to social media shows yet another end game for Americans as far as voice ----and it is deliberate.  Social media corporations WILL GO OUT OF BUSINESS LEAVING AMERICANS NO PLATFORM FOR VOICE.  As Americans lose voice in mainstream media---they are being pushed to online media and called 'alternative'---and as one of these outlets---I am seeing Facebook becoming harder and harder to post to.   Articles in mainstream media that had FB share options are now removing that choice.

If you read national financial journals you understand that Facebook was on the way out when it went public----it's IPO listing.  It was just like the subprime mortage loan market becoming a massive and systemic criminal enterprise the last few years before the crash----Wall Street was simply squeezing the last few billion dollars of profit before throwing the market aside.  Johns Hopkins likes to take the claim for the idea of Facebook and their intent was no doubt social media for surveillance---which is exactly for what it is used.  Once Zuckerberg made billions on this idea----he has no need to keep the corporation---he is divesting.  The point is this-----as people lose voice in national media and all Constitutional protections designed to keep media fair, balanced and open to public voice are dismantled----moving people to what is a media outlet unprotected by FCC laws and then pulling the plug as millions of people connect to it----

IS A GREAT PLAN TO END COMMUNICATIONS IN A DEMOCRACY THAT WAS THRIVING IN MEDIA OUTLETS, FREE SPEECH, AND GOVERNMENT PROTECTIONS AGAINST OPEN LYING IN MAINSTREAM NEWS.

So Devon, with his camera will have no where to post these videos in a very short time.

THIS IS HOW GOVERNMENT CONTROLLED BY WALL STREET GLOBAL CORPORATE NEO-LIBERALS AND NEO-CONS THINK----REAL PROGRESSIVE SOCIAL DEMOCRATS FOUGHT THESE KINDS OF MEDIA GOALS.

Marketing Japan
All things about the media, marketing, business, Japan and other musings

by Mike in Tokyo Rogers.

Sunday, July 29, 2012Why Facebook Will Go Bankrupt?

I getting a lot of feedback from Japanese friends that they are getting "burned out" on Facebook and that they are beginning to think it is a waste of time and boring (that was fast!) 

Many are complaining about boring posts from friends like photos of what people had for lunch or their desserts... Or pictures of their kids...

It gets tiring. Like I said, I'm sensing a loss of excitement in Japan over Facebook. When the average Joe-Suzuki loses interest so fast, then that spells problems in Japan.

Besides that, Facebook can't make any money on their website. Their big plan to save the company rests solely upon the notion that their mobile platform will generate enough revenues to pay of the party.

Sorry, folks. No way. No one has figured out a way to make mobile advertising work. Facebook isn't going to be able to do so, either.


Facebook finishes the week down (and another drop after hours)

I don't really mind ads on my PC or Facebook (I never click them, either) but, on my iPhone, with the small screen, the last thing I want on there is advertising. Space is a premium on a mobile phone screen and I can't imagine that anyone wants to see advertising on that small space cluttering up the view.

It's hard enough to see what's on the screen as it is without pop up ads and more noise.

Facebook is not going to be able to figure out how to make mobile advertising work... I doubt that anyone will for a long time, if ever.

Nevertheless, people are still hoping for better results from Facebook.

From Motley Fool: A Fool Looks Back:

Despite the chatter that the social-networking website is fading in popularity, having a whopping 955 million monthly active users is a 29% increase over the past year. And despite concerns about mobile and monetization in general, revenue growth at a 32% clip shows that the company is making more money per user.

Right! Never mind the fact that research shows 40% of all Facebook users are Spammers. From 40% of Facebook's Supposed 900 Million Users Don't Exist:

“Social spam can be a lot more effective than e-mail spam,” says Mark Risher, chief executive officer of Impermium, which sells anti-spam software. “The bad guys are taking to this with great abandon.”


Spammers create as many as 40 percent of the accounts on social-media sites, according to Risher. About 8 percent of messages sent via social pages are spam, approximately twice the volume of six months ago, he says. Spammers use the sharing features on social sites to spread their messages. Click on a spammer’s link on Facebook, and it may ask you to “like” or “share” a page, or to allow an app to gain access to your profile."


I also added:

"Woo-boy! Did I say "Facebook shares in the mid-20s by December?" I did. Good. But I was wrong. Look for the mid-10s!" 

OK. I was wrong. I said mid-20s by December. It's not even August yet and they are in the low-20s. Mid 10s? Quite possibly. I like this prediction for 2012.


Facebook since IPO: Down 38% in three months. Down 47% since IPO.

But what about Facebook's other success stories, you say? OK. How about Zynga, the Facebook game that many said was one of the high points for Facebook? Yeah. That's a Cinderella story. From Reuters:


Zynga shares have fallen 70% since its December 2011 Initial Public Offering. The investigation stems from concerns that Zynga misrepresented and/or failed to disclose materially adverse facts about its business and financial condition. Furthermore, certain Zynga executive officers sold a combined 43 million shares of Company stock during the second quarter of 2012, shortly before Zynga reported poor financial results. 

As Karl Denninger says about Facebook: 

"As for my price target on the company I will simply note that there is very strong technical support at $0."
__________________________________________

All of those investigative journalists pushed out of national media under the guise of falling newspaper profits and the pushing out of public universities academics like me who now can only share progressive data through social media WILL LOSE THIS OUTLET VERY SOON.  Look below to see the year 2020-----it is no coincidence that 2020 will be the year or soon after that Obama set Medicare to end by ending Medigap insurance at a time of soaring health costs that will leave Americans unable to meet a 20% deductible.  It is the year all of this secret Trans Pacific Trade Pact -----if approved as expected by this coming 2016 election is slated to be made public----remember, Obama and Clinton neo-liberals and Bush neo-cons wrote into these TPP policies the fact that WE THE PEOPLE will not be allowed to know what is in these pacts for 5 years after they are approved----which would be around 2020.

So, Facebook will be used as a surveillance tool to monitor the voice of Americans ----and to circulate Clinton neo-liberal propaganda---most FB political outlets are Clinton neo-liberal----and then when the effects of this economic crash from bond market fraud sets in with all kinds of 'forced austerity' by Federal, state, and local governments----global corporations will be handed control of American government at all level and social media will no longer be allowed----autocratic societies do not allow free speech.

WHERE WILL BALTIMORE ACTIVISTS AGAINST POLICE INJUSTICE ET AL POST ALL THOSE VIDEOS? HOW ABOUT CINDY WALSH AND CITIZENS OVERSIGHT MARYLAND?


Facebook Will Disappear by 2020, Says Analyst

By Sam LairdJun 04, 2012Facebook's sliding stock price has at least one hedge fund manager predicting a dismal decade ahead for the social network.

"In five to eight years they are going to disappear in the way that Yahoo has disappeared," Ironfire Capital founder Eric Jackson told the CNBC show Squawk on the Street on Monday.

"Yahoo is still making money, it's still profitable, still has 13,000 employees working for it, but it's 10% of the value that it was at the height of 2000," Jackson added. "For all intents and purposes, it's disappeared."

So how exactly does Jackson see Facebook's power eroding by decade's end? He says it will be the continued emergence of the mobile web — and Facebook's struggle to adapt to that paradigm shift.

"The world is moving faster, it's getting more competitive, not less," he said. "I think those who are dominant in their prior generation are really going to have a hard time moving into this newer generation.

"Facebook can buy a bunch of mobile companies, but they are still a big, fat website and that's different from a mobile app."

Facebook bought the wildly popular mobile photo-sharing app Instagram — which some saw as a potential rival — for $1 billion in April. Still, the company has acknowledged mobile as a potential stumbling block for sustained growth.

In its required initial pre-IPO disclosure of 35 "risk factors" released in February, the company admitted that as mobile use of Facebook and the web in general continues to expand, its ad-free mobile platform will become more problematic. In an amended filing in May, the company underscored that challenge again.

Facebook stock officially went on sale on May 18 at $38 per share. It closed Monday at $26.90.

Jackson sees Facebook as a member of the second of three generations of modern Internet companies. The first generation, highlighted by businesses such as Google and Yahoo, served as portals that organized and aggregated the web's wealth of information. The second generation, most notably Facebook, capitalized on an emerging social web.

The third generation is made up of companies whose sole goal is leveraging and monetizing mobile users.

"When you look over these three generations, no matter how successful you are in one generation, you don't seem to be able to translate that into success in the second generation, no matter how much money you have in the bank, no matter how many smart PhDs you have working for you," Jackson says.

"Look at how Google has struggled moving into social, and I think Facebook is going to have the same kind of challenges moving into mobile."

What do you think Facebook's status will be in five years? Share your predictions in the comments.

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FEDERAL COMMUNICATIONS COMMISSION LAWS REGULATE MEDIA OUTLETS FOR PUBLIC INTEREST BROADCASTING AND EQUAL OPPORTUNITY---BUT THERE IS NO COVERING OF INTERNET MEDIA.  A GOVERNMENT ON THE INTERNET WOULD NOT BE HELD TO TRUTH.

Now, if you know social media corporations are moving towards bankruptcy and closing-----how can a Baltimore City Hall and State Assembly work to keep media outlets functioning for citizens?  BY ENFORCING PUBLIC MEDIA FCC LAWS REQUIRING FREE AND FAIR ACCESS TO PUBLIC AIRWAVES AND TO BUY AIRWAVES UP FOR AUCTION TO KEEP PUBLIC ACCESS IN TV AND RADIO-----WE MUST KEEP ENOUGH OF OUR AIRWAVES PUBLIC.

The other thing a REAL progressive social Democratic City Hall would do is subsidize new local media outlets to compete with a captured, corporate Baltimore Sun et al in Maryland.  Remember, Baltimore now has such a level of consolidation in media to ALLOW PUBLIC SUBSIDY OF NEW, SMALL, LOCAL PRINT MEDIA.  We have a good source of local media----Baltimore Brew ---that does good journalism.  Yet, it is now funded by corporate non-profits and that means it will curb its voice.

THIS IS CRITICAL FOLKS----IF WE DO NOT GET A BALTIMORE CITY COUNCIL AND MAYOR THAT WANTS TO REBUILD PUBLIC MEDIA AND SUBSIDIZE NEW PRIVATE, LOCAL PRINT MEDIA---WHEN SOCIAL MEDIA GOES BANKRUPT PEOPLE WILL HAVE NO AVENUES FOR VOICE.

So, what does all this social media in the public sector mean?  Well, the first thing I think----since government is controlled by Clinton neo-liberals---it will not work for people---but corporate power and control.  Imagine why social media was not allowed in government earlier? The police department in Baltimore recently had police officers banned from even communicating on social media off the job.  Anything on the internet is not bound by FCC or many Federal laws so we cannot be assured the information is true.  If government were to have the same format on public media and local TV----it would.  America has had open and broad public service programming in which public policy was talked about on local morning talk shows, policy specialists with many different views on one policy.

WE HAVE THE MECHANISM TO DO WHAT THIS MOVE TO SOCIAL MEDIA DOES-----ONLY THEY ARE KILLING PUBLIC AIRWAVES AND PRINT MEDIA TO MOVE ALL ONTO INTERNET---WHICH THEN WILL DISAPPEAR OR BECOME PURE PROPAGANDA.

What kind of social media platforms will exist when Facebook, MySpace et al disappear?
Social Media in the Public SectorMore and more government agencies are using social media tools to disseminate information, to share ideas and to communicate with the general public.


by John O'Leary | October 4, 2010

   
 Not long ago, public agencies were blocking access to social networking sites such as Facebook to prevent their employees from wasting time at work. Nowadays, more and more public agencies are looking to social media tools as a way to boost productivity.

A recent study from the National Association of State CIO's (NASCIO) found an increasing shift toward the use of social media such as Twitter, YouTube, and the like, as a way to better reach constituents. According to the report, "state CIOs may recently have found themselves unblocking YouTube to allow greetings from public officials or Flickr to mount photos of a bridge opening or to document some other important announcement. CIOs may not have been immediately convinced of the business value of these tools as they entered the workplace, but the fact is that this is how effective governments are communicating now, and this is not just a fad."

One of the pioneers in this space is the Transportation Security Administration's Idea Factory, which is a way for management to quickly tap into the collective wisdom of the more than 40,000 TSA employees, many of whom have ideas about how TSA could work better. The Idea Factory is an internal website that uses a wiki platform to allow management to tap into that pool of knowledge.


Instead of just a passive online suggestion box, the Idea Factory allows for dialogue and collaboration. Management may ask the community about a specific challenge, such as "how can we improve the check-in process?" Or "What should our new uniforms look like?" In its first two years, the site has generated 40 innovative ideas that have actually been implemented.

While the Idea Factory enables collaboration within an agency, GovLoop fosters sharing not only between agencies, but between public officials at all levels of government. GovLoop is a free, members-only online community for those who work in and around the public sector.

GovLoop was started in 2008 by Steve Ressler, then with the Department of Homeland Security, and now GovLoop's CEO. Originally geared to federal IT workers, GovLoop has broadened its scope and now boasts 35,000 members, nearly 30 percent of them state and local officials.

Why would an agency want their employees on GovLoop?

"The benefit to the agencies is they get to leverage the lessons learned and best practices from other state and local agencies," says Ressler. A GovLooper can quickly "learn what others are doing on important issues and replicate those practices." Those facing a problem can ask 35,000 government specialists, and bring more brains to bear on whatever problem they are trying to solve. One GovLooper, struggling to name a new website at her agency, put the question to her GovLoop peers and quickly generated 50 replies -- including the winning suggestion.

Like all online communities, GovLoop creates connections. Government auditors, web 2.0 professionals, and regulators all face similar challenges, whether they work for the Department of Agriculture, L.A. County or the state of Missouri.

"The number one benefit of users is they can do their job better since they don't have to work alone," says Ressler. "They have a community of 35,000 others in government working on similar issues."

GovLoop can also help agencies create private networks within GovLoop to collaborate internally. There are a number of cross-cutting topical groups, from acquisition to telework, where agencies can benefit by sharing knowledge with peers working on the same issues.

"People are hungry to collaborate," says Ressler. "I get e-mails and messages every day on how lonely, isolated public-sector employees felt when working on problems and how happy they are that GovLoop provides a forum for them to meet others."

More and more government agencies are using social media tools to disseminate information, to share ideas, and to communicate with the general public.

As with any emerging technology in government, there are concerns, particularly around privacy and data security. The media is so new, no one really knows the rules yet. For example, if a public agency solicits ideas on a Facebook page, are the results subject to FOIA disclosures? Ironically, it turned out that the Paperwork Reduction Act had serious ramifications for the use of online media. The rules were based on an old technology (paper) and were producing confusion when applied to social media.

To clarify these issues, earlier this year the Office of Management and Budget provided guidance around the acceptable use and disclosure rules regarding social media. The NASCIO survey also noted that state government's rules and policies really haven't caught up with the use of social media: "[T]he survey in the aggregate documents a parallel lag between use and policy or governance mechanisms..."

That isn't slowing down the explosion of these tools, however. As the survey notes, "The bottom-line -- social media tools are being actively adopted and used throughout state governments across the country." The first wave has hit shore, and is sure to be followed by more widespread use of these technologies. What government CIO's were recently banning is now understood as a powerful tool in the effort to provide cost-efficient public services.

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A REAL SOCIAL DEMOCRAT WOULD BE STRENGTHENING PUBLIC MEDIA, ENFORCING FCC LAWS, AND SUBSIDIZING SMALL BUSINESS LOCAL MEDIA GROWTH.


So, Clinton neo-liberals are allowing all FCC media outlet circumvent FCC regulations and print media are so consolidated as to eliminate free speech----the internet has no regulation and will lose social media geared to public ----and it will move to being a government tool.

When Democrats voted Obama as President over Hillary they did so because Obama pretended to be more progressive than Hillary.  The expectation was Federal protection of progressive Constitutional rights including public media.  What we got was someone more right of center than Hillary----and Obama has allowed media outlets free rein to print anything----to operate during primary elections in anyway-----because he embraced Federalism Act saying he would not enforce Federal law.

We see national media telling us the FCC is protecting net neutrality for example while the FCC is allowing a massive online takeover by health and education global corporations of the internet that will force the American people off the internet.  Any Clinton neo-liberal is going to kill all regulations and oversight of all media----allowing for a 'state media'----one consolidated corporate media structure handling all news.  This is what moving government to social media will lead to.  Killing access to all public airwaves for TV, radio, and social media corporations like Facebook closed----with internet consolidation falling into the hands of a few global corporations that will price over 80% of Americans out of the internet market.  Right now a large number of Americans are already getting their internet access at public libraries----how long will we have public libraries under neo-liberalism?

Below you see an FCC law ignored in Baltimore because Obama does not enforce Federal laws----the equal time/opportunity laws for elections.  Candidates in Baltimore and Maryland are allowed to be censured-----always the REAL progressive social democrats-----and it is not legal.  We are moving to the point where no Constitutional rights will exist---which is to where Trans Pacific Trade Pact leads.  As Clinton neo-liberals and Bush neo-cons write new internet law---it will be geared to TPP.

WE CAN REVERSE ALL OF THIS IF WE RUN AND ELECT SOCIAL DEMOCRATS TO ALL LEVELS OF GOVERNMENT ----GETTING RID OF CLINTON NEO-LIBERALS.

The Media

←
Government Regulation of the Media
→Even though the Constitution guarantees freedom of the press, the government does regulate some media. Print media are largely unregulated, and newspapers and magazines can print nearly anything as long as they don’t slander anyone. The Internet has also gone largely unregulated, despite congressional efforts to restrict some controversial content. Broadcast media, however, are subject to the most government regulation. Radio and television broadcasters must obtain a license from the government because, according to American law, the public owns the airwaves. The Federal Communications Commission (FCC) issues these licenses and is in charge of regulating the airwaves.

FCC Police

The FCC also acts as a police agency of the airwaves, and it can fine broadcasters for violating public decency standards on the air. In extreme cases, the FCC can even revoke a broadcaster’s license, keeping him off the air permanently. The FCC has fined radio host Howard Stern numerous times for his use of profanity, for example, and fined CBS heavily for Janet Jackson’s “wardrobe malfunction” during the halftime performance at the Super Bowl in 2004.


Media Doctrines

The FCC has also established rules for broadcasts concerning political campaigns:

• The equal time rule, which states that broadcasters must provide equal broadcast time to all candidates for a particular office.
• The right of rebuttal, which requires broadcasters to provide an opportunity for candidates to respond to criticisms made against them. A station cannot air an attack on a candidate and fail to give the target of the attack a chance to respond.
• The fairness doctrine, which states that a broadcaster who airs a controversial program must provide time to air opposing views.

The FCC has not enforced the fairness doctrine since 1985, and some allege that the FCC has taken a lax approach to enforcing the other rules as well.

Media Consolidation

The government has also regulated ownership of media outlets to ensure that no one broadcaster monopolizes the market. Since the 1980s, however, the government has loosened restrictions on media ownership, and Congress passed the Telecommunications Act in 1996 to allow companies to own even more media outlets.

Due to the loosening of ownership restrictions, more and more media outlets are falling under the control of a few giant corporations, a tendency called media consolidation. The Hearst, Knight Ridder, and Gannett corporations own most of the nation’s newspapers, whereas Clear Channel Communications owns many radio stations. Large companies also own the major networks and other television stations. The Walt Disney corporation, for example, owns ABC and ESPN, along with the Disney Channel, and Viacom owns CBS and MTV. Rupert Murdoch’s Media Corporation, meanwhile, owns all of the Fox channels, several radio networks, satellite television providers, and newspapers in many countries. And Time-Warner owns dozens of magazines, including Time, Life, and Sports Illustrated, as well as the CNN and Turner television networks.

Critics of Media Consolidation

Critics contend that media consolidation limits consumers’ choices because a small number of companies own all the media outlets. They argue that consolidation is not competitive and that corporate owners might restrict or manipulate news coverage. Some critics also lament the homogenization of American culture due to media consolidation. Because radio and television formats have become increasingly uniform, people throughout the country receive the same broadcasts.

Cable Exceptionalism

It is not clear if the FCC has the authority to regulate cable television. The FCC is entitled to regulate those who broadcast over the airwaves because the people (not the broadcasters) own the airwaves. Cable television, however, is not sent over the airwaves: Cables transmit the programs directly into people’s houses. Presumably this means that cable television cannot be regulated, but some members of Congress have still sought to do so.

______________________________________________

Baltimore City Paper under a Baltimore Sun ownership printed in its Best of issue------WHAT HAPPENED TO A VERY PROGRESSIVE O'MALLEY IN THIS PRESIDENTIAL ELECTION----HE IS STUCK AT 1%?

Well, I think a Baltimore City Paper without Baltimore Sun ownership printed articles as to why O'Malley is not progressive and not a politician anyone wants.  The first thing a Baltimore Sun-owned City Paper did was 'accidentally' purge all previous City Paper issues backed-up onto computer files.  THEY PURGED THE PROGRESSIVE MEDIA RIGHT OUT OF CITY PAPER.

The answer to this question is the nation knows O'Malley is a raging Wall Street globalist who could care less about people or environment.  They know that because much of the nation still has functioning local media and labor and justice organizations providing information locally WHERE BALTIMORE AND MARYLAND HAS NONE.  Citizens in Baltimore have no idea what is going on----whereas the world knows O'Malley is Tammany Hall Boss Tweed.

The Baltimore Sun and other local media are used by O'Malley to print only what politicians say----not what is real.  O'Malley spent his career pretending to do all this progressive stuff----providing successful policies that helped the underserved and communities-----then an outside justice or news organization would publish that all the data was untrue.  O'Malley never enforced progressive law----he simply pretended to support progressive laws.  THAT COULD NOT HAPPEN IF NOT FOR MEDIA CAPTURE.

Do you hear your pols shouting for subsidizing local print media businesses?  Are they shouting against the failure to enforce FCC laws and to protect the public in TV and radio airwaves?

The difference between the NEW CIVIL RIGHTS by Clinton neo-liberals and the OLD CIVIL RIGHTS by social Democrats is supporting civil issues that do not cost corporations money and create businesses.  So, goodbye Equal rights, labor rights, women's rights, rights of disabled, and protection of social programs-----ALL OF WHAT MAKES A SOCIAL DEMOCRAT PROGRESSIVE-----and in with issues that generate money------GAY MARRIAGE, MARIJUANA, MORE IMMIGRANTS IN THE WORKPLACE.  Wall Street loves to say------we make tons of money on gay marriages----while ignoring all the equal protection of gay partners in the workplace.  Many corporations are not.  Marijuana as a corporation will move billions to the same rich global corporations.  Immigrants will flood the US under Trans Pacific Trade Pact so these laws prepare for this.  Immigrants are still exploited and fleeced and will be sent to global FOXCONN sweat shop factories if allowed to come to American cities.  So, these may seem progressive----but they were allowed simply because they made markets.  I've spoken lots about his real environmental record.....

WHEN NATIONAL MEDIA ALLOWS O'MALLEY TO RUN NOT ONLY AS A PROGRESSIVE BUT WITH NO HISTORY OF CORRUPTION AND FALSIFYING DATA----AND A LEGACY OF TYING THE STATE OF MARYLAND AND BALTIMORE TO EXTREME WALL STREET FINANCIAL INSTRUMENTS LOSING A TRILLION DOLLARS TO WALL STREET FRAUD AND SENDING BALTIMORE INTO BANKRUPTCY BECAUSE OF CREDIT BOND LEVERAGE-------luckily, I appears that local media across the nation is educating against O'Malley as a progressive or Democrat.

• But as governor, he left a liberal legacy on nearly every front? Where? Handing the citizens of Maryland to a national energy corporation Exelon and then pretending to be green with alternative energy handed again to global corporations while pushing FRACKING AND EXPORTING NATURAL GAS? This is how media is captured. O'Malley did end the death penalty as a gesture to Catholic voters and gay marriage, both REAL progressive issues.
   Governing named O'Malley public official of the year no doubt wonders how the nation got the real information on O'Malley---ALL MEDIA NEWS CREATED BY BALTIMORE SUN.


• O'Malley has little support in Md. for a...

1. www.baltimoresun.com/news/maryland/politics/bs-md-sun... Oct 14, 2014 · Do Maryland voters want Martin O'Malley to run for president? Poll: Nearly 6 in 10 Maryland voters said they would not back O'Malley for a presidential run ...
   
   

Mayor Martin O'Malley Versus Governor Martin O'Malley

Baltimore's unrest has cast a negative spotlight on the probable presidential candidate's tough-on-crime policies as mayor. But as governor, he left a liberal legacy on nearly every front.


by Alan Greenblatt | May 7, 2015 Governing


Critics say Martin O'Malley's zero-tolerance policies as mayor of Baltimore contributed to the city's recent unrest. (David Kidd)


   
 Martin O'Malley is testing the notion that there's no such thing as bad publicity.

The former Maryland governor has faced both in-person heckling and media criticism in the past couple of weeks. Detractors say the zero-tolerance policies he pursued as mayor of Baltimore contributed to distrust between residents and police, and ultimately the recent unrest there.

Appearing on NBC's "Meet the Press" last Sunday, O'Malley defended his record on crime, taking credit for lowering Maryland's rates of violent crime, recidivism and incarceration. He also argued the nation hasn't had a coherent urban strategy since the presidency of Jimmy Carter. He pledged to make such issues central to his own, as-yet-unannounced campaign for the Democratic presidential nomination.


"We need an agenda for American cities," O'Malley said. "We need to stop ignoring, especially, people of color and acting like they're disposable citizens in this nation."

Having his city erupt into protest and violence isn't the reason O'Malley would have chosen to appear in the national spotlight, but he hasn't done so well hustling in the early primary states. As a national candidate, he's always been a longshot.

"The bad news is that the country is paying attention to O'Malley and policing in Baltimore because now that's a negative issue," said Thomas Schaller, chairman of the political science department at the University of Maryland, Baltimore County. But the good news is that O'Malley's "name is in the news now in a way that never would have happened otherwise."

O'Malley, who Governing named a "Public Official of the Year" in 2009, was term-limited out of office this past January. In his eight years as governor, he successfully championed many pieces of liberal legislation, including same-sex marriage rights and the abolition of the death penalty. He also provided in-state tuition for undocumented students and decriminalized marijuana. The governor achieved the $10.10 hourly minimum wage that President Obama promoted. (O'Malley is now calling for $15.) And after the Newtown school shooting, Maryland was one of a handful of blue states to enact gun-control legislation, banning 45 types of semiautomatic rifles.

"It was like he had a checklist, marking off a bunch of liberal priorities," said Matthew Crenson, a retired political scientist at Johns Hopkins University.

In terms of finances, O'Malley raised the state's income tax on top earners and gas taxes, devoting substantial funding to transit. He inherited a deficit of $1.7 billion and increased spending significantly on both K-12 and higher education.

O'Malley could push a progressive agenda in a state that's among the nation's most Democratic. (The party enjoys a 2-to-1 edge over Republicans among registered voters in the state.) And he wasn't afraid to seek direct voter approval for his ideas, putting same-sex marriage, in-state tuition rates for so-called "Dreamers" and an expansion of gambling all on the ballot in 2012 alone. But Republicans counter that O'Malley went too far, even for Maryland.




Gov. Martin O'Malley speaks during a rally to increase Maryland's minimum wage to $10.10 an hour, which the state eventually did. (AP/Jose Luis Magana)

Last fall, the current GOP governor, Larry Hogan, beat O'Malley's lieutenant governor, Anthony Brown, in part by portraying their time in power as an era of unbridled tax-and-spend policies. Hogan complained that a stormwater management fee amounted to a "tax on rain." Not only did Hogan win, but the GOP made inroads in the legislature.

"O'Malley's legacy is the strongest Republican Party since the 1920s," Joe Cluster, the executive director of the Maryland GOP, told the Baltimore Sun as the governor was leaving office.

O'Malley's liberal record stands in contrast to the more moderate image he'd brought with him to Annapolis. He was known in his Baltimore days for expanding the use of data in measuring government performance, through the CitiStat program. He'd also been involved in the centrist Democratic Leadership Council. Centrist leadership means Clinton Wall Street global corporate neo-liberals of which Maryland Democratic Party is controlled.

Back in 2007, O'Malley was an early endorser of Hillary Clinton over Barack Obama. Now, he's seeking room to Clinton's left.

"His image as governor was much different from how he was as mayor," said Crenson, the Johns Hopkins professor. "As mayor, he was a hard-line, anti-crime politician."
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Congress placed a policy into the open market to public airwaves targeting existing national media and telecommunications that supposedly gave local public groups the ability to create local media as I describe above.  I tried to connect to this program and it needed a hundred thousand and more of seed money to start the process of small business media and this is why it fizzled.  All we see now is corporate subsidy of non-profit media-----again, all controlled with terms and willingness of that funding to continue.  THIS IS NOT PUBLIC SUBSIDY FOR SMALL BUSINESS MEDIA---PRIVATE OR PUBLIC.

Baltimore has the rights to a public access station that one needs to have a cable provider to access.  This was supposed to justify handing Comcast growing control of our telecom market.  What we need is free TV station access and a demand that local ABC, NBC, and CBS include real public interest media that is not cooking shows and corporate infomercials.   We need public subsidy for a printing press that allows open access to people willing to market/distribute their own media.

Let's be clear----if you are not enforcing already on the books Constitutional law against monopoly and FCC regulations---you are posing progressive when you place these policies into larger deregulation laws.


FCC media report shows how interest in government subsidies for local journalism fizzled

by Rick Edmonds Published June 10, 2011 5:00 am Updated Nov. 25, 2014 8:03 am

There is a lot to like in the Federal Communication Commission’s exhaustive, 478-page study of shortfalls and potential solutions in media.

I’m particularly glad Steve Waldman, who oversaw the report, and his collaborators rejected an assortment of false dichotomies. Old vs. new media, professional or citizen reporters, commercial or nonprofit? “Obviously we need both,” the report says.

In a similar spirit, Waldman concludes that the proliferation of digital news outlets “masks a shortage of reporting …This illusion of bounty risks making us passive.”

Good enough. But when Waldman and company get to what the FCC or Congress can do about deteriorating local accountability reporting, they pretty much punt. Better broadband access, favorable tax treatment of news nonprofits, better digital disclosure of government data and regulatory filings — most of it is familiar stuff.

There are a couple of provocative ideas, such as redirecting to local media the massive, $1-billion-a-year federal ad spend for such things as legal notices and military recruiting. But it is not so clear who could make that happen.

Maybe this outcome could have been foretold. In pulling together some background material, I realized it had been. When Waldman posted FCC’s announcement of the project and his appointment to lead it on his blog in October 2009, the first commenter, Charles Cosimano, wrote:

“Good luck playing hopscotch in the bureaucratic minefield that is the FCC. If you look at what they are really saying, it is, ‘We are faced with media that we cannot hope to regulate and we have to find creative ways to explain to various pressure groups that they are wasting their time trying to get us to do the impossible.’”

Over the 18 months since, the notion that the FCC would adopt the report faded, and it was simply presented as an informational study, not necessarily the agency’s view. The title was changed from “The Future of Media” to “The Information Needs of Communities” (echoing an earlier Knight Commission report).

In speeches and a visit to Poynter, Waldman suggested that the FCC’s regulatory power was mainly in broadcast and that the report would tilt that way.

In fact, though, the report gives equal attention to the losses in newspapers’ reporting capacity. And as my colleague Al Tompkins’ account of Thursday’s FCC meeting makes clear, the recommendations for television and radio are small steps forward, too, such as requiring better disclosure of pay-to-play coverage.

How we got hereThe federal interest in weakened journalism and its impact on democracy started in May 2009 with a Senate hearing sponsored by John Kerry (D-Mass.) and a smaller event in the House put together by Adam Schiff (D-Calif.). At the time, newspaper advertising was in free fall. The Rocky Mountain News had closed and the Seattle Post-Intelligencer had ceased printing, and it seemed quite possible that The Boston Globe and San Francisco Chronicle would fail.

When the Federal Trade Commission held its initial workshop in December 2009, the backpedaling had already begun. As both a participant and an observer, I was struck by remarks of FTC Chairman Jon Leibowitz and Rep. Henry Waxman (D-Calif.), who artfully framed the problem but by no means promised government help.

As Leibowitz concisely put it, there remains “an open question whether the changes to newsgathering amount to ‘creative destruction’ or just plain destruction.”

Waxman, personally open to some subsidy to boost local news efforts, complained that there was no consensus within the media community about whether government help would be in the public interest.

That effectively took off the table a proposal, first voiced by Leonard Downie and Michael Schudson in a study for Columbia’s School of Journalism, that a pool of money be set aside and distributed state-by-state as grants to support quality, local reporting.

The discussion had deteriorated further at a subsequent FTC workshop six months later. In the spring of 2010, FTC staff had prepared a draft paper cataloging various recommendations it had heard, including several for direct subsidies. Critics jumped on that, reporting the subsidy idea as the FTC’s own recommendation. The FTC issued a press release complaining of “misinformation” from critics, and one of the FTC commissioners kicked off the workshop by defensively repeating the point.

A year later, the FTC report remains unfinished, release date to be determined.

At those two workshops, several executives of public radio and television argued that if federal money for local reporting would be forthcoming, they should get it because they have an existing infrastructure.

Since then, public broadcasting has come under attack by the Republican-led House and has scrambled to hold on to existing levels of support.

Early on, the Newspaper Association of America said thanks-but-no-thanks to any government funding, citing First Amendment concerns. I, however, didn’t think that an arms-length fund for reporting was ridiculous on its face. Much of the federal support for scientific research is distributed on that model, and vigorously democratic countries like France and Sweden underwrite newspaper circulation.

Yet I have come to believe that for now, the newspaper industry and other legacy media need to chart their own path to stability, and that market forces will help identify winners in the new media space. Foundations, other philanthropists and citizen donors assess rigorously and quickly what is worth continued support.


Bigger governmental initiatives may make sense, but later — if the shortfall in local reporting gets markedly worse and a constructive intervention opportunity becomes more evident. Perhaps a well-documented and wide-ranging report on problems and possibilities is the best the two agencies can do for now.
__________________________________________


States like Maryland controlled by Wall Street Clinton neo-liberals and Bush neo-cons place state funding of public media into hands of directors that make sure that is all heard on public media.  This is why NPR, PBS, and local public media are now nothing but Clinton neo-liberal and Bush neo-con policy and market-place money news.  Maryland public media---both TV and radio openly act to exclude primary candidates who are social progressives without apology----breaking FCC laws.  We already know they are talking of ending Public Broadcasting System and Maryland funding of Maryland public television and public radio like WYPR is already operated by a corporate non-profit branch of Johns Hopkins.  Morgan State, fighting for its funding, works for Clinton neo-liberals now in power to fund them.  So it matters who you elect as we try to rebuild our local media outlets.....private or public.  If the City of Baltimore subsidized WEAA and then held it to FCC laws requiring access to all----then we could hear REAL progress social democratic issues discussed on WEAA.....and WYPR's consolidation and corporate funding sources would be questioned.  How many actual INDIVIDUAL DONORS does WYPR have?  A requirement of public media.

Clinton neo-liberals will pose progress with policy like that tied to its selling off of public airwaves to global corporations-----and like tying the only public access station to a Comcast cable deal placing it where few people go-----or pretending to be fighting for net neutrality all while creating massive global health and education industries that will take all access to internet------public media funding is fair when a government entity is monitoring content and enforcing equal access to all public policy stances as existed last century!


Media state subsidies are behind the times
Are public media subsidies fair?


A recent study by The Reuters Institute for the Study of Journalism has tallied up the amount of public money that either directly or indirectly subsidises media in the U.K., Finland, France, Germany, Italy and the US.




Unfortunately, the study discovered that strategies for funding news organisations have not changed to accommodate the developments of he digital age.




Finland gave the most public money, per capita, to support the media - around £46 a year per head via indirect subsidies, such as tax and VAT exemptions - and France gave the most in terms of direct public funding to media, through initiatives such as the 'My Free Newspaper' scheme, donating around £5 per capita. Germany was found to be the nation that invested the most in public service broadcasting.

Evidently, public media funding is an issue which need to be regularly assessed, as while it can improve circulation by keeping costs low for the consumer and help the industry through difficult times, state media funding potentially has significant consequences for press freedom, especially when it comes to direct funding. Clearly there is a fine line between offering financial support to an organisation and influencing it.




What the author of the study, Dr. Rasmus Kleis Nielsen, found to be most pertinent was the fact that these subsidies did not reflect the digitisation of news and media.

For instance, in the U.K., VAT exemption is extended to newspapers, defined by law as "several large sheets folded rather than bound together, and contain information about current events of local, national or international interest'", but not to their digital content. This means some newspapers, like The Express and Star of Wolverhampton, have to charge more for their digital only packages than they do for subscription packages that include both digital and paper formats, as The Press Gazette explains.





Nielsen concludes that state funding needs to be addressed in order to "bring them in line with the principles purportedly behind them and with the times that we live in" and acknowledge that digital strategies and start ups are a vital part of the media industry.

THE SIGNS ARE ALL THERE IN BALTIMORE FOR WHAT A MASTER PLAN HAS AS A GOAL---INTERNATIONAL ECONOMIC ZONE OPERATING SEPARATELY FROM US SOVEREIGNTY AND US CONSTITUTIONAL PROTECTIONS OF WE THE PEOPLE.  WAKE UP AND WORK TOGETHER TO REVERSE THIS BY ENGAGING IN POLITICS!  NO ONE WINS IN ALL THIS!

GET RID OF THE CRONY!

Today, I would like to talk elections and media looking at Baltimore and its media coverage of political issues.  I want to start with Baltimore City Paper and its Best of Baltimore edition with Devin Allen on its cover----just as with Time Magazine.  City Paper started as a very progressive local newspaper a few decades ago and today----it has sold out to national media outlets like Baltimore Sun Media Group.  We all know that Baltimore Sun works for the rich and Wall Street Baltimore Development and the International Economic Zone Master Plan so at this point, almost all that is journalism is controlled by global corporate interests.  Time Magazine has been known for decades as a very neo-conservative global Wall Street news journal.  If you make Time's front page----it is probably because you make corporations rich and powerful.

If that is true---then why did Devin Allen and Baltimore riots make
Time Magazine's cover?  If you look at the same picture on the cover of Baltimore's City Paper you see only Devon's head-----if you look further you see Devon's body and he is wearing an UnderArmour T-shirt.  I'm sure Devon does not know the significance of this image to Wall Street---and that is why Baltimore City has been allowed to be third world in its repression and poverty having never installed civil rights laws or allowed Federal War on Poverty and New Deal social funding make it to 600,000 working class and poor in Baltimore....all of this with a city hall filled with black politicians.

The image on this cover is great---very artistic and meaningful---but meaning can be interpreted differently.

Go Behind TIME’s Baltimore Cover With Aspiring Photographer Devin Allen

• Olivier Laurent @olivierclaurent

April 30, 2015Devin Allen, who shot this week's TIME cover, is a Baltimore residentDevin Allen
Protestor at city hall In Baltimore on April 25, 2015.
1 of 12A few days ago, Devin Allen, a 26-year-old West Baltimore resident, only aspired to be a professional photographer. For the past two years, he had been photographing models and had tried his hand at street photography, drawing his inspiration from photographers such as Gordon Parks and artists like Andy Warhol.

But, when protests took over his city in the aftermath of Freddie Gray’s death, the young amateur photographer took to Instagram and found himself propelled on the global stage.

His photographs of the demonstrations — peaceful at first, then more violent — grabbed the headlines: they were featured on the BBC and CNN, and shared by thousands of Twitter and Instagram users, including Rihanna.


Photograph by Devin AllenNow, one of his most iconic images, shot at the heart of the protests on April 25, is featured on this week’s cover of TIME.

The photograph shows a man running away from a pack of charging policemen. “When I shot that, I thought it was a good picture, so I uploaded [from my camera] to my phone,” he told TIME LightBox earlier this week. “By the time I’d done that, the police was all around me. I was in the middle of it.”

The shot perfectly captures the intensity and chaotic nature of the protests, making it the natural choice for TIME’s cover.

“For me, who’s from Baltimore city, to be on the cover of TIME Magazine, I don’t even know what to say. I’m speechless,” says Allen. “It’s amazing. It’s life changing for me. It’s inspiring me to go further. It gives me hope and it gives a lot of people around me hope. After my daughter, who’s my pride and joy, this is the best thing that’s happened to me.”

Read our full interview with Devin Allen: Meet the Amateur Photographer Covering Baltimore’s Protests

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When you see Devon with his eye to the camera you know the movement in black America is to video everything having to do with the police.  If it wasn't for video only the police versions would be known.  This is important in showing how the American people are losing their rights as citizens and US Constitutional law is being thrown aside for this global corporate tribunal law through Trans Pacific Trade Pact.  When people lose their voices in government----when they lose their voices in courts-----and finally they cannot even report crimes committed against them without a video to back them up----they are third world----when police officers are known to openly abuse citizens and fabricate all kinds of ways to hide it-----they are third world. 

THIS IMAGE OF DEVON SYMBOLIZES THE LOSS BY AMERICAN PEOPLE OF ANY VOICE OR RIGHTS.  WE WANT TO SAY THIS IS AIMED AT BLACK CITIZENS BUT IT IS AIMED AT ALL OF US.

Baltimore was taken to such third world injustice by what is black leadership.  A very neo-conservative Johns Hopkins and Wall Street Baltimore Development did in Baltimore what they do in Afghanistan or Nigeria-----they identify people that will ignore civil rights for their own gain and then give them access to lots of money.  Make a few affluent to repress the many. So, today we have black communities with crony political machines funding a few people's wealth tasked with making sure everyone else does not know the goals of public policy.  What makes me upset is this is done while these pols run as Democrats making a large sector of the Democratic base hate Democrats---which is why Clinton neo-liberals and Hopkins neo-cons do this.

UnderArmour goes out of its way to make green/human rights pledges TO WIN BUSINESS FROM SWEAT SHOP NIKE as it locates its global factories in the most labor and environmentally abusive nations.  Malaysia is raging neo-liberal and abusive.....NO ONE BELIEVES THAT.

'Along with these statistics, this past May students from the University of Missouri through the organization United Students Against Sweatshops began protests against the unfair labor practices of several companies, including Under Armour'.

'I WANT TO SHARE SOMETHING WITH YOU. THROUGH THE NIGHT, I HAVE SEEN ANOTHER -- A NUMBER OF YOUNG PEOPLE STOP ME AND SAY TO ME, YOU NEED TO TALK TO US AND GET OUR VOICE HEARD. I SAID, YOU ARE ABSOLUTELY RIGHT'.

Locked up with no charges: Many arrested amid Baltimore riots languish for days
By Colin Daileda and Megan SpeciaApr 29, 2015BALTIMORE — Many arrested in Baltimore early Sunday morning and late Monday in separate riots have yet to be charged, released or have a bail hearing. Some criminal defense attorneys say court officials don't want to release them ahead of large demonstrations planned for this weekend.

Officials have set stunningly high bail for some of the arrestees, as high as $750,000, Mirriam Seddiq, who works for Seddiq Law in Greenbelt, Maryland, told Mashable. Court officials are doing this in the name of protecting the city from violent criminals, she said, but some arrested during the looting that took place in Baltimore on Monday say they were simply watching what was happening in their neighborhoods when they were swept up by police in mass arrests.

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I have spoken about the goal of installing International Economic Zone status on Baltimore and surrounding counties and described the concerns with UnderArmour buying huge parcels of land for a global campus complete with FOXCONN global factories that will pull citizens from all over the area into these sweat shop factories especially from Freddie Gray's neighborhood.  Baltimore City Hall and Baltimore's Maryland Assembly pols are the ones pushing all the laws allowing all this to occur----including Carl Stokes and Brandon Scott.  So, it was not without coincidence that Stokes and Scott were assigned best politicians simply for saying rioters are not thugs and for yelling about policing at the last minute when they knew communities were going to explode. 

STOKES AND SCOTT ARE THE FACE OF WALL STREET BALTIMORE DEVELOPMENT AND HOPKINS GLOBAL ECONOMIC ZONE POLICIES THAT KILL COMMUNITIES AND CREATE THE POVERTY AND UNEMPLOYMENT----and Baltimore City Paper names them best pols.  Baltimore City Paper names the Mosby's a power couple----which you do not do when you know the Mosby's are deep in a cesspool that is Baltimore City Hall corruption and fraud.  Marilyn is of course supposed to be arresting her husband Nick for what we know are racketeering and frauds---that doesn't include what we don't know.  So, a main stream news journal connected to a national media group is making legitimate what the country knows to be one of the most corrupt and fraudulent cities.  Below you see what was racketeering-----Exelon was given a $100 million dollars tax break for absolutely NO REASON. You cannot just give these tax credits for no reason.

THAT IS WHEN YOU KNOW YOU ARE THIRD WORLD.

When you try to get national press written on fraud and corruption in Baltimore there are none because there are never any government corruption and criminal actions brought to court.  To make the corruption stats you have to have functioning prosecuting States Attorney's office.  So our media bestow the title of POWER COUPLE on two people most engaged in creating and allowing the corruption. 

THIS IS WHY FREDDIE GRAY'S NEIGHBORHOOD IS CRUMBLING AND THIRD WORLD----NO JUSTICE SYSTEM IN BALTIMORE.


Beatty lavished funds on mayor and City Council as they lavished tax credits on Harbor PointPART 1: Neither the mayor nor the City Council members who received Beatty’s cash publicly disclosed the contributions during the $107 million TIF debateMark Reutter March 18, 2014 at 1:17 pm Story Link 26


Of the six elected officials in this picture, five accepted campaign cash from developer Michael Beatty (at podium). Any guesses?

Photo by: Mark Reutter



Should it be called “back scratching,” “quid pro quo” or simply “business as usual” at City Hall?

Recently-released campaign reports reviewed by The Brew show that Michael Beatty, developer of Harbor Point, contributed $5,750 last year to his City Council allies – while his wife, his late father’s architecture firm, his development company and his general contractor paid $16,000 into Mayor Stephanie Rawlings-Blake’s campaign kitty.

What makes this significant? The contributions came during a time when Beatty was actively pushing for approval of a $107 million TIF tax credit from the city.

Neither the mayor – nor any of the City Council members who received Beatty’s cash – publicly disclosed the contributions during or after the long and heated debate over the tax financing subsidy.

_______________________________________
What editors of Time Magazine saw in Devon's front page image was the third world instability that UnderArmour sees as a plus in locating its manufacturing factories.  Taking a look at where in the world UnderArmour factories are located gives you knowledge that this global corporation is about maximizing profits any way possible.  International Economic Zones under Trans Pacific Trade Pact is all about global corporations being able to go nations tied to this treaty anywhere in the world to operate under the same legal constraints.  Baltimore City with its complete lack of Rule of Law, Equal Protection, and with no access to public justice is ground zero for these structures to install TPP and International Economic Zone policy. 

THIS IS WHY BALTIMORE CITY HALL COMPLETELY IGNORES RULE OF LAW.....THEY ARE WORKING UNDER WALL STREET BALTIMORE DEVELOPMENT AND JOHNS HOPKINS' MASTER PLAN.

Listen to Maryland pols running as Democrats all still posing progressive after allowing tens of trillions of dollars in corporate fraud to stay with the looters and after staging the coming bond market crash that will be so deep as to force cities like Baltimore into the hands of these global corporations.

THAT WON'T HAPPEN BECAUSE BALTIMORE WILL BECOME A SOCIAL DEMOCRATIC CITY HALL.

All that needs to be done to stop this and protect families and communities from the coming economic crash is to have Baltimore City Hall and Maryland Assembly pols working to protect public assets and not allow fraud to stand and continuing to ignore US Constitutional Rule of Law.

Good Governance:
Rule of Law, Transparency,
and Accountability

by Michael Johnston
Department of Political Science,
Colgate University


Executive Summary
Improved governance requires an integrated, long-term strategy built upon cooperation between
government and citizens. It involves both participation and institutions. The Rule of Law,
Accountability, and Transparency are technical and legal issues at some levels, but also
interactive to produce government that is legitimate, effective, and widely supported by citizens,
as well as a civil society that is strong, open, and capable of playing a positive role in politics and
government.

I will end today these discussions on health care by looking at mental health and finally reminding people that all this talk of telemedicine and remote medical microchips will come to all Americans ----not just what you think are the underserved in Baltimore, Maryland.  We need everyone in the US shouting loudly that JOHNS HOPKINS SHOULD NOT BE DOING THESE J-CHIP POLICIES!

Below you see what your Baltimore City pols running as Democrats and serving as Hopkins neo-conservatives have been doing-----this is what deregulating health care looks like.  It breaks down the meaning of doctor and subprimes it to mean lots of different things....just as they are doing to the meaning of teacher and public schools.  We already know remote medicine can take place anywhere in the world so like corporate call centers based in India-----these controls can exist in any global corporate location attached to US global health care.  So, all those jobs, jobs, jobs, these policies are supposed to create will again be temporary----part time------same with small businesses and non-profits.  This will be a few decades from now as they build the internet capacity for global health tourism-----so initially, they will just bring foreign doctors and workers to do these jobs.  Meanwhile, these health systems growing nationally will rake in what is several billions of dollars in Medicare and Medicaid while rarely seeing people.  You have to imagine doctors in Maryland spending time on telemedicine patients in California and then expand it globally to see access to care for main street disappearing with quality falling to dangerous.

THIS IS WHAT OBAMA AND CLINTON NEO--LIBERALS CALL EFFICIENT, DATA-DRIVEN, COST EFFECTIVE HEALTH CARE.  DON'T VOTE REPUBLICAN BECAUSE ALL THIS IS REPUBLICAN HEALTH POLICY AND NONE OF THIS IS CONSTITUTIONAL---

All Baltimore City Council and Mayor has to do is enforce Federal laws surrounding War on Poverty, equal protection, Medicare and Medicaid, and Federal public health regulations and VOILA----Johns Hopkins cannot treat Baltimore citizens like citizens in Cambodia.

Remote Medicine Tests Physician Licensing Rules

• March 07, 2014


• By Christine Vestal

Psychiatrist Terry Rabinowitz consults with nurse Leslie Orelup at Helen Porter Nursing Home in Burlington, Vt. States are considering an interstate compact that would make it easier for doctors to practice telemedicine across state lines. (AP)


Demand for doctors – whether in person or via a computer screen – is expected to surge as millions more Americans become insured under the Affordable Care Act. About 10 million people already rely on telemedicine, often from doctors who live in another state.

As a result, more physicians are applying for medical licenses in multiple states – a costly and time-consuming proposition for some. Without a license to practice medicine in the patient's state of residence, both doctors and patients may be at legal risk.

Many states are embracing telemedicine by encouraging it in their Medicaid programs and requiring private insurers to pay for it. But they have made little progress in removing medical licensing barriers that proponents of the technology say have kept doctors and hospitals from expanding even more.

Telemedicine was once the purview of small town doctors who needed to consult with specialists available only in larger urban areas. Today, telemedicine technology is even being used to conduct surgeries using robotics, typically only in emergency situations such as during war.

Most telemedicine consists of video teleconferencing between a doctor and a patient. Doctors also routinely use telemedicine technology to transmit and discuss diagnostic images and to remotely monitor patients with chronic diseases so they don't have to leave their homes or nursing facilities.

For some consumers, it is the primary way they receive medical care. Using Skype on a computer or FaceTime on an iPhone, patients discuss their symptoms and show their doctors any visible evidence of their conditions, such as a swollen eye or skin rash. Patients most often conduct these consultations from home or their workplace. In some cases, patients go to a medical facility and use high-end, secure equipment to teleconference with a doctor in another location.

Much of the growth in telemedicine is expected to be in remote monitoring of patients with heart and lung diseases and diabetes, who have recently been discharged from a hospital. The aim is to detect health problems early enough to prevent them from being sent back to the hospital.

States have argued that easing licensing requirements could jeopardize patient safety. If doctors practice in a state without obtaining a license there, regulators maintain that they have no power to conduct an investigation or explore a consumer complaint. Also, these doctors would not benefit from any legal protections the state may have against malpractice lawsuits.

Proponents of telemedicine argue that since doctors take standardized national exams and most requirements are set by federal agencies such as the U.S. Department of Health and Human Services, states should recognize other state licenses. They say state medical boards are simply trying to shield doctors from out-of-state competition and preserve state revenues from licensing fees.

At What Cost?The cost to doctors of obtaining multiple licenses is estimated at $300 million a year, according to Gary Capistrant, public policy director at the American Telemedicine Association. That does not include the fees doctors pay for their primary licenses in their home states. For hospitals and medical practices that operate in multiple states, the burden of licensing limits the number of doctors who are willing to participate, he said.

State medical licensing fees vary from a low of $150 in Michigan to a high of $1,290 in Rhode Island. Most range from $200 to $600, with lower renewal fees. Of the roughly 850,000 practicing physicians in the U.S., 17 percent have at least two state licenses and 6 percent have three or more, according to a 2010 survey.

Now, under pressure from major telecommunications and health care firms that want to create nationwide telemedicine businesses, state medical licensing boards are set to consider an “interstate medical licensure compact” that would give doctors and patients legal protections in any state that signs on. Patients would have greater protection than exists now, because states that join the compact would share data on any ongoing investigations of licensed doctors.

The proposal, to be considered at the annual meeting of the Federation of State Medical Boards in April, would expedite the licensing process for doctors who want to practice across state borders. Similar interstate compacts have been used for other types of licensing, including driver's licenses.

Even the most pro-telemedicine states have not yet taken a stand. The compact, which was developed by a task force of 22 state medical boards, may represent the first step. Lisa Robin, chief advocacy officer for the federation, expects there will be some early adopters. “I believe there will be some proliferation,” she said. “We'll see in April.”

The federation's compact is modeled on an agreement adopted by the National Council of State Boards of Nursing in 2000. That compact has been adopted by 24 states. Legislation is pending in Illinois, Massachusetts, Minnesota, New York and Oklahoma. 

In addition to reimbursement and licensing, proponents say states need to define what types of telemedicine may be practiced, whether patients need to sign special consent forms and when doctors can prescribe medications remotely. Several state legislatures are considering those issues this year.

Growing PainsSince its beginnings in the mid-1980s, the number of patients cared for through telemedicine has risen from a few thousand to an estimated 10 million people in rural as well as urban settings. The vast majority of the growth has occurred in the last decade, according to the American Telemedicine Association.  

Market analyst IHS estimates U.S. telemedicine spending will grow to $2.2 billion in 2018 from $240 million this year. A new lobbying group, the Alliance for Connected Care, formed last month to promote federal and state policy changes to spur the industry's growth. Led by former U.S. Senate Majority Leaders Tom Daschle, Democrat from South Dakota, and Trent Lott, Republican from Mississippi, the group's members include health care and technology giants Verizon, WellPoint, CVS Caremark and Walgreens, as well as smaller companies Teladoc, HealthSpot, Doctor on Demand and MDLIVE that offer online access to medical services. 

Widely considered an effective way to reduce overall health care costs, increase patient access to care and improve overall health, telemedicine has broad support within state governments and Congress. At least five bills designed to further its use have bipartisan sponsorship in Congress.

“Until we are able to attract more physicians to rural communities and tighten the access gap,” one bill's sponsors wrote, “the next best alternative is to use technology to connect health professionals with underserved populations – rural and urban – through telehealth networks.”

Four of the bills under consideration would allow doctors who provide services under Medicare and TRICARE (the insurance plan for military personnel), and accompany sports teams when they travel from state to state to have just one state license. The U.S. Department of Veterans Affairs, a vigorous proponent of telemedicine, already considers a medical license in one state sufficient to provide services in all 50 states.

For soldiers returning from Iraq and Afghanistan, telemedicine is the primary way they've been receiving medical care already.

“We're fast becoming a 24/7 world,” said Capistrant. “People don't just get sick 9 to 5. Many work at night. For some, finding a doctor that speaks their language can be a problem. Technology can help deal with some of those issues and we should use it.”

Who Pays?The biggest issue at the federal level is that Medicare reimburses only for telemedicine services on a limited basis. To qualify, patients must meet a narrow definition of residing in a rural area, and even then the federal health plan for the elderly and disabled will pay for only certain types of services.

The other huge government health program, Medicaid, pays for a wide range of telemedicine procedures for the poor, according to the Center for Connected Health Policy, in all but Iowa, Massachusetts, New Hampshire, New Jersey and Rhode Island, where health care plans for the poor do not currently cover telemedicine services.

Only 21 states and the District of Columbia require private plans to cover telemedicine, despite strong support from employers who want to see the cost of premiums go down as telemedicine is used more often to keep people out of hospitals. An added benefit for employers is that telemedicine allows workers to receive care without taking time off from work to go to a doctor's office.



_____________________________________________
While Congress was taking gun control issues to the floor they were at the same time touting the mental health policy they were installing in ACA....after all, most mass shootings are by people having mental illness who most often cannot get help because America's mental health system has been reduced to PHARMA dispensation.  Below you see where funding is going-----to train school teachers how to identify mental illness-----to send police officers out into communities to force people determined a threat to communities into what is yet to be known. Again, as always with the Affordable Care Act----this gives preventative care for mental health which means PHARMA.  As I said, Obama and Clinton neo-liberals broadened the definition of depression-----allowed for more mental health PHARMA to be included in health plans.   Add to this the plan to use this medical microchip technology for this enhanced preventative care and you have remote dosing for what is now a very broad definition of having a mental illness.

I already have issues with the methodone treatment of heroin addiction---the quality of life from many PHARMA used to treat these broad categories are often impacted.  One can see this moving to a place where people never leave where they live and becoming incapacitated with a home health care service checking in every now and then.

The second thing ACA did was make it legal to dose people without their permission.  The US has always denied these actions because who determines this need and how debilitating these mental health PHARMA can be----it is a very, very, very slippery slope to people having these policies used against them with no cause----AS AUTOCRATIC DICTATORSHIPS DO WITH DISSIDENTS, ANTI-SOCIAL BEHAVIOR, AND REVENGE FOR GOODNESS SAKE.  This is why the US has never allowed forced dosing of mental health meds.  Now, given the timing of this law-----the US is becoming autocratic moving to global corporate rule and corporate fascism----THIS IS NOT THE TIME FOR INSTITUTIONS TO HAVE THE POWER OF FORCED DOSING.

Below you see where ACA places more emphasis on drug and alcohol as mental health issues-----and it broadens attention to more severe mental illness.  All of this would be good if it were not tied to involuntary treatment defined as simply being determined to need help by institutions----remote microchip dosing----and outsourcing outpatient mental health facilities to private contractors.  This article sounds very repressive----we are going to go out and identify people with mental health issues!

THIS IS SERIOUS STUFF FOLKS!!!!!!!!!!!!!

The Affordable Care Act and Expanding Mental Health Coverage

August 21, 2013 at 4:00 PM ET by Cecilia Muñoz
Twitter Facebook Email 
Summary: 
Health care providers, mental health advocates, and individuals who have personally experienced mental illness came to the White House to talk about the intersection of two important Presidential priorities: the Affordable Care Act and mental health.President Barack Obama delivers remarks during the National Conference on Mental Health in the East Room of the White House, June 3, 2013. Standing with the President, from left, are: Health and Human Services Secretary Kathleen Sebelius, Education Secretary Arne Duncan, and Veterans Affairs Secretary Eric Shinseki. (Official White House Photo by Pete Souza)

Last June, the President hosted the National Conference on Mental Health to talk about how we can raise awareness of mental health issues and make it easier for Americans of all ages to reach out and get help. The President’s Fiscal Year 2014 Budget proposal includes a strong focus on mental health by investing in helping teachers and other adults recognize the signs of mental illness in students and referring them to help if needed; supporting innovative state-based programs to improve mental health outcomes for young people ages 16-to-25; and helping to train 5,000 additional mental health professionals with an emphasis on serving students and young adults. 

Dr. Howard Koh, Assistant Secretary for Health for the U.S. Department of Health and Human Services; Christen Linke-Young, Director of Coverage Policy in the U.S. Department of Health and Human Services’ Office of Health Reform; Pamela Hyde, Administrator of the Substance Abuse and Mental Health Services Administration in the U.S. Department of Health and Human Services; and Stephanie Valencia, Special Assistant to the President and Principal Deputy Director of the White House Office of Public Engagement discuss the Affordable Care Act and mental health at the White House, August 21, 2013.

But we know that it’s not enough. If we’re going to help more Americans seek treatment, we also need to make sure they have coverage when they do. That is why implementation of the Affordable Care Act is a major focus of our mental health agenda. Today, health care providers, mental health advocates, and individuals who have personally experienced mental illness came to the White House to talk about the intersection of two important Presidential priorities: the Affordable Care Act and mental health. The gathering focused on the mental health benefits in the health care law and what we all can do to help Americans get the affordable health care coverage – including mental health care coverage – they need.

The Affordable Care Act builds on the Mental Health Parity and Addictions Equity Act to expand mental health and substance use disorder benefits and federal parity protections for more than 60 million Americans. New health plans are now required to cover preventive services like depression screenings for adults and behavioral assessments for children at no additional cost. And starting next year, insurance companies will no longer be able to deny health care coverage to anyone because of a pre-existing mental health condition.

This Administration is committed to helping people with mental health and substance abuse issues get the care they need, and the Affordable Care Act is playing an important role in achieving this goal. To learn more about the Affordable Care Act and to sign-up for updates, visit healthcare.gov.

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We already know that in the US states are ignoring Federal laws protecting people from this very kind of involuntary dosing with drugs.  They do this because they think a President can use Executive Order to install the Federalism Act and that gives states carte blanche to do anything they want----AND THEY ARE.  Below you see where this has been going for a few decades and with Affordable Care Act law and funding geared towards mental illness in ways that weaken protection for civil rights and liberties.  Add to that the process of remote medical microchips and dosing with people assigned to outpatient facilities that are simply yet another round of privatization to anyone that gets a license.  I don't disparage all existing treatment programs and outpatient facilities---what I am saying is now they are super-sizing these situations at the same time they are subpriming the laws that protect people against mental health treatment abuses.



U.N. Questions U.S. on Forced Psychiatric Drugging
By Tina Minkowitz, Esq.

Featured Blogs March 15, 2014

Last week was the culmination of more than a year's worth of advocacy towards the U.N. Human Rights Committee on the issue of forced psychiatric drugging in the United States.  The Human Rights Committee is a committee of independent experts elected to review compliance with the International Covenant on Civil and Political Rights, a treaty to which the U.S. is a state party.

Aubrey Shomo, Patricia Bauerle and I spent the week talking to Committee members and holding side events to give information and personal testimonies beyond what we presented in the written shadow report, including global perspectives.  We were joined in side events by our colleagues from the World Network of Users and Survivors of Psychiatry, Hege Orefellen from Norway and Jolijn Santegoeds from the Netherlands, as well as Richard Pearshouse from Human Rights Watch and moderators Facundo Chavez Penilla, Disability Adviser to the Office of High Commissioner for Human Rights, and Jorge Araya, Secretary of the Committee on the Rights of Persons with Disabilities.  Our international team did amazing work, and was supported by the Geneva-based secretariat of the International Disability Alliance, of which WNUSP is a member.  I will write more about what I am learning about shadow reporting, and we will also be sharing video and audio from our presentations, but now I want to report on what happened on Friday in the Interactive Dialogue of the Committee with the United States.

On Friday March 14, 2014, Human Rights Committee member Ms Zonke Majodina from South Africa questioned representatives of the United States government on forced psychiatric drugging.  While we await the video archive and transcript, here are my notes of what she said:

Regarding the nonconsensual use of psych medication in psych institutions:

We are told that U.S. constitution constrains the government’s use of nonconsensual treatment & clinical investigations.  That they are permitted only in carefully controlled situations & also constitutional safeguards such as federal PAIMI program, and regulations on use of restraint on patients in mental institutions.

On the other hand, information from nongovernmental organizations shows that there is ample evidence that state & local governments routinely apply and allow neuroleptic medications and electorhosck to be applied without informed consent & against their will.  It is not limited to psychiatric institutions but allowed in nursing homes for older persons especially those with dementia and people in situations of particular vulnerability such as children in foster homes and prison inmates.  New York law permits compulsory treatment of persons confined against their will, in particular where consent lacks capacity to make a reasoned decision.  The law also allows for forced drugging in prison and even after release from prisons.

Scientific literature reveals neuroleptic drugs have serious side effects.  They are mind altering, and cause shivering, trembling, contractions and all kinds of other physical side effects.

The Special Rapporteur on Torture recently called for an absolute ban on all forced and non-consensual medical interventions against persons with disabilities, including the non-consensual administration of psychosurgery, electroshock and mind-altering drugs such as neuroleptics, the use of restraint and solitary confinement, for both long- and short- term application.

Furthermore the U.S. National Council on Disability recommended, "Laws that allow the use of involuntary treatments such as forced drugging and inpatient and outpatient commitment should be viewed as inherently suspect, because they are incompatible with the principle of self-determination. Public policy needs to move in the direction of a totally voluntary community-based mental health system that safeguards human dignity and respects individual autonomy."

Against this background, I pose the following questions:

Is the U.S. government concerned about this widespread use of nonconsensual psych medication, electroshock and other coercive practices?

Has the U.S. or another state given consideration to imposing ban recommended by the Special Rapporteur on Torture?

What have states done to reform criminal law and procedure, policies and practices against people labeled with psych disabilities including drugging as a condition for release?

Has the President or Congress taken any action regarding the recommendation of the National Council on Disability?

The U.S. representative from the Department of Health and Human Services, Dr Wanda Jones, answered as follows (also my notes):

Ms Majodina asked about nonconsensual medical treatment.

Although US federal law prohibits nonconsensual treatment, it can be provided without consent for life threatening interventions.

This is governed by state law, which cannot violate constitutional provisions on due process, privacy and equal protection of individuals.  Professional organizations may also have guidelines on practice.

We are concerned.  We established the Protection and Advocacy for Individuals with Mental Illness program, which operates in all 50 states, DC, all territories and in consolidated Indian territories.  PAIMI supports state-designated projects that are specifically designed to investigate allegations of violations in mental health settings, including seclusion & restraint.

The program reported over eighteen thousand complaints and closed thirteen thousand.   About ten thousand were substantiated, of which about a fifth were abuse and a fifth neglect.  There were over 6200 rights violations.  2500 cases were not substantiated.   Where intervention was substantiated, they achieved positive changes in environmental community or living arrangements.  We are constantly working on getting better.

Medicare conditions of participation for hospitals including psychiatric hospitals detail restrictions on the use of restraints including drugs and medications when used to manage behavior or restrict freedom of movement.  This implements standard that is set in regulation, monitored by Center for Medicare and Medicaid Services.

The Department also supports the training and development of consumer/peer mental health workers, designated to assist those who are receiving services to access needed services.

We expanded comprehensive community mental health services to children and families, and expanded program of cooperation with the justice system, transitioning into civil society.

The Affordable Care Act will mean one of the largest expansions in substance abuse and mental health treatment services in a generation.

SAMHSA has had a significant impact on culture of treatment environments.  Many facilities funded through state grants have reduced traumatizing practices, facilitated recovery and consumer directed care.

Regarding medication and treatment of federal prisoners including those with mental disabilities, a strict set of federal regulations governs the extent to which medication can be administered involuntarily, including an administrative hearing, except in emergency circumstances.

Ms Majodina followed up by saying (from notes taken by a staff person from the secretariat of the International Disability Alliance):

On non consensual medical treatment, I understand there are special rules and appreciate efforts on monitoring at the state level.

But I am still surprised that states have been left to devise their own rules. I’m wondering whether any states have considered the ban which has been recommended by the Special Rapporteur on Torture made February last year, available on the UN website of documents.  So given that it is really at state level that there is no compliance with the requirement to prohibit coercive treatments especially in mental health settings, I think the matter cannot just be left, there should be some form of good faith undertakings by federal government that these recommendations by UN bodies is taken seriously also at state level.

The final step will be the Committee's adoption of Concluding Observations and recommendations for the United States.
____________________________________________
The movement from defining when a person can be involuntarily dosed or committed from doing harm to themselves or others to simply being determined to 'NEED HELP'......IS HUGE.

Already in Baltimore, City Hall has used this ACA funding to send police to homes they identify as having people 'needing help'.  I am not sure yet what happens to them.  We all understand the frustrations of communities with violence, drug abuse, and mental health issues.  The solution was to have public community centers, public health clinics, and public social services staffed well enough to be that source for community.  NOT THE POLICE FORCE.  I spoke with a young lady whose boyfriend was killed by several police officers sent to a house with just someone giving a tip he had a gun so this entire process will be fraught with injustice.  WHEN THEY NEED TREATMENT.


'The bill would require states that get federal mental health grants to change their standards for involuntary psychiatric commitment, allowing people to be hospitalized against their will when they need treatment, not simply when they pose a danger to themselves or others – the standard in about half of states. That change could allow patients to get care sooner, Murphy says'.

The second piece of this is the preventative care taking over in-patient access.  This is how we know real mental health policy is being dismantled when people are being denied the ability to spend time with real professionals and instead being outsourced to out-patient treatment and houses that are often staffed with people less trained for such a broad group of people.  This is happening because Congress is filled with Clinton neo-liberals who are with Republicans in wanting fast, cheap ways of getting people out of circulation that are determined 'different'.  It was Reagan/Clinton neo-liberalism that joined Republicans back in the 1980s and 90s to dismantle and close all public mental health institutions and clinics to send them to prisons and jails----now the same neo-liberals are legislating away civil rights and liberties to such an extent---that anyone can be described as 'needing help'.

Mental Health Groups Split on Bill to Overhaul Care

By BENEDICT CAREYAPRIL 2, 2014  New York Times


Lawmakers, patient advocates and the millions of Americans living with a psychiatric diagnosis agree that the nation’s mental health care system is broken, and on Thursday, Congress will hear testimony on the most ambitious overhaul plan in decades, a bill that has already stirred longstanding divisions in mental health circles.

The prospects for the bill, proposed by Representative Tim Murphy, Republican of Pennsylvania, are uncertain, experts say, given partisanship in both the House and the Senate and the sheer complexity of the mental health system. And its backing of the expanded use of involuntary outpatient treatment has drawn opposition from some advocacy groups.

But the bill, the Helping Families in Mental Health Crisis Act, does have more than a dozen Democratic co-sponsors in the House, and several mental health organizations are supporting it. Last week, both houses of Congress adopted one of its central provisions, expanding funding for outpatient treatment programs through other legislation. On Thursday, the House Energy and Commerce health subcommittee is scheduled to hear testimony on the entire bill, which includes more than two dozen measures.

“It’s the most comprehensive mental health bill we’ve seen in a long, long time, and that in itself is an accomplishment,” said Keris Myrick, chief executive of the Project Return Peer Support Network and president of the board of the National Alliance on Mental Illness, which supports some parts of the bill. “I think almost everyone sees things in the bill that are long overdue, but also things they’re very concerned about.”

Among those opposing the bill because of its involuntary treatment provisions is the Bazelon Center for Mental Health Law, whose president, Robert Bernstein, said, “Many serious organizations seem to have an ‘any port in the storm’ mentality, supporting this bill even though it includes dangerous provisions.”

Mr. Murphy, a clinical psychologist from Pittsburgh, put together the legislation at the behest of House Republican leaders after the massacre at Sandy Hook Elementary School in Newtown, Conn., in 2012. He spent a year hearing testimony about the current system, a patchwork of community clinics and state hospitals chronically short of funding that leaves millions of people with mental illness without treatment, often homeless or in prison.

“It’s a broken system, and we’re not going to fix it by throwing a little money here or there,” Mr. Murphy said in an interview. “We know that when people get care, they get better, but there are simply not many options: Clinics are reducing services, there are not enough psychiatrists or psychologists to go around — we found all sorts of barriers to care.”

Widely backed provisions of the bill include streamlining payment for services under the Medicaid program, and providing funds for clinics that meet standards for rigorous, scientifically supported care.

The bill also provides money for suicide prevention programs and for so-called telepsychiatry, or remote video therapy, which is seen as especially crucial in rural areas.


Provisions calling for increased training for police officers and emergency medical workers in how to identify and treat people with mental disorders are also widely approved. The police and paramedics often act as ad hoc social workers, dealing with people with mental problems when they are hurt or break the law.

About 350,000 Americans with a diagnosis of a severe mental illness like schizophrenia or bipolar disorder are in state jails and prisons, while the number of psychiatric beds available has shrunk to 35,000, according to a coming analysis by the Treatment Advocacy Center, a nonprofit group that favors expanded access to treatment.

“The situation has been getting progressively worse for 50 years, to the point where we now have 10 times more people with severe mental illness in prisons and jails than in mental hospitals,” said Dr. E. Fuller Torrey, of the Stanley Medical Research Institute, a nonprofit organization supporting research in schizophrenia and bipolar disorder, and a strong supporter of the bill.

But the bill’s backing for involuntary treatment is highly contentious. It would provide state grants for so-called assisted outpatient treatment programs under which certain mentally ill people with a history of legal or other problems get court-ordered therapy, which in most cases means trying to ensure they take their medication.

The result: more people treated earlier, and more treated against their will.

“This becomes a civil rights issue quickly, and it can drive people away from seeking services when they fear treatment will be forced on them or they’ll be locked up,” said Gina Nikkel, president and chief executive of the Foundation for Excellence in Mental Health Care, which advocates a more holistic, less medication-oriented approach to recovery.

In the last two decades, 45 states have adopted laws allowing compelled treatment in some cases, with varying requirements and levels of enforcement. Kendra’s Law, passed in New York in 1999, is one that researchers have monitored closely. One recent analysis, led by investigators at Duke University, found that since the law was passed, patients were much less likely to land back in the hospital or be arrested. Mental health and Medicaid costs for them dropped by about half.

But involuntary treatment programs have led thousands of former psychiatric patients to become fierce critics of the mental health system.

Dr. Bernstein of the Bazelon Center and Dr. Nikkel said that extending such programs would “eviscerate civil right protections” and further erode trust between patient and provider.

The Murphy bill also proposes amending federal medical privacy protections — the now-familiar Hipaa laws — to allow parents or other caregivers access to a patient’s medical information. Under current law, those records are private once a person becomes an adult, and as a result, caregivers are often effectively cut out of treatment decisions. The bill seeks to bring them back in, with a provision that will also generate strong political resistance, experts said.

Finally, the bill proposes to sharply scale back many of the programs funded by the Substance Abuse and Mental Health Services Administration. This agency, with a $3.6 billion budget, has long financed programs that critics say are not backed by good evidence.

“When something has been funded for a long time, it’s tough to let it go,” Mr. Murphy said. “What we’re saying is that if a program works, then show us the evidence that it does, and we’ll keep it. If the evidence is not there, then the taxpayers shouldn’t pay for it.”

Correction: April 2, 2014
An earlier version of this article misstated the name of a bill proposed by Representative Tim Murphy, Republican of Pennsylvania. It is the Helping Families in Mental Health Crisis Act, not the Helping Families in Mental Crisis Act.

________________________________________________
If you are affording a Silver or Gold health plan today you will not in the very near future so do not think all of this dismantling of public health access will only hit the poor and working class----it will come to all. The poor are not getting more care----they are being pushed to preventative access only where before they could access most care needed----unless you live in Baltimore. The Affordable Care Act allows for all preventative health care -----KAISER PERMANENTE MAKES NO BONES THAT ITS ALL ABOUT PREVENTION-----the middle-class will be sent into bankruptcy trying to access ordinary care and that's what Clinton neo-liberals and Bush neo-cons want to see----the goal after all is third world poverty in the US.
This article is long but please glance through.  Remember, all of what is described below is what the Affordable Care Act was designed to do---they want all Americans out of first world quality health care and into third world preventative care only.  THAT IS FOR WHAT YOUR CLINTON NEO-LIBERAL CONGRESSIONAL POL/OBAMA WORKED.  Your national labor union leaders and justice organization leaders knew and I described all this back in 2009.  Baltimore's Maryland Assembly and City Hall pols worked hard to install the policies Johns Hopkins needed for these health care reform results.
When people hear my say--80% and more of Americans will be on gutted of funding Medicaid for All---you see below that corporate plans will disappear to only preventative care and they are the bulk of private plans.  Medicare and Medicaid already handle 1/3 of Americans.  Managed care for these 80-90% of Americans will be this remote microchip/telemedicine.

THIS IS FOR WHAT YOUR LABOR AND JUSTICE LEADERS BROUGHT YOU OUT TO SHOUT FOR===THIS IS FOR WHAT MARYLAND HEALTH CARE FOR ALL WORKED FOR.  GET RID OF THESE LEADERS AND POLS!

Gold standard sullied?

Employees' deductibles balloon to 80%
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Physician Praveen Arla is witnessing a reversal of health care fortunes: Poor, long-uninsured patients are getting Medicaid through Obamacare and finally coming to his office for care. But middle-class workers are increasingly staying away.

"It's flip-flopped," says Arla, who helps his father run a family practice in Hillview, Ky. Patients with job-based plans, he says, will say: " 'My deductible is so high. I'm trying to come to the doctor as little as possible. … What is the minimum I can get done?' They're really worried about cost."

It's a deep and common concern across the USA, where employer plans cover 60% of working-age Americans, or about 150 million people. Coverage long considered the gold standard of health insurance now often requires workers to pay so much out-of-pocket that many feel they must skip doctor visits, put off medical procedures, avoid filling prescriptions and ration pills — much as the uninsured have done.

A recent Commonwealth Fund survey found that four in 10 working-age adults skipped some kind of care because of the cost, and other surveys have found much the same. The portion of workers with annual deductibles -- what consumers must pay before insurance kicks in — rose from 55% eight years ago to 80% today, according to research by the Kaiser Family Foundation. And a Mercer study showed that 2014 saw the largest one-year increase in enrollment in "high-deductible plans" — from 18% to 23% of all covered employees.

“People put off care or they split their pills. They do without.”

Karen Pollitz, a senior fellow at KaiserMeanwhile the size of the average deductible more than doubled in eight years, from $584 to $1,217 for individual coverage. Add to this co-pays, co-insurance and the price of drugs or procedures not covered by plans — and it's all too much for many Americans.

Holly Wilson of Denver, a communications company fraud investigator who has congestive heart failure and high blood pressure, recently went without her blood pressure pills for three months because she couldn't afford them, given her $2,500 deductible. Her blood pressure shot so high, her doctor told her she risked a stroke.

And LaRita Jacobs of Seminole, Fla., who gets insurance through her husband's job and has an annual family income of $70,000, says $7,500 a year in out-of-pocket costs kept her from dealing with an arthritis-related neck problem until it got so bad she couldn't lift a fork. She's now putting off shoulder surgery.

"How did we get to this crazy life?" asks Jacobs, 54. "We're struggling to pay our bills like we were struggling when we first got started."

Why is this happening? Many patients and doctors blame corporate greed — a view insurers and business leaders reject. Some employers in turn blame the Affordable Care Act, saying it has forced them to pare down generous plans so they don't have to pay a "Cadillac tax" on high-cost coverage in 2018. But health care researchers point to a convergence of trends building for years: the steep rise in deductibles even as premiums stabilize, corporate belt-tightening since the economic downturn and stagnant middle-class wages.

LaRita Jacobs has severe arthritis and delayed a neck surgery until it got so bad she couldn’t lift a fork. Now, she is delaying shoulder surgery that her doctor recommends and opting for less expensive physical therapy and enduring the pain. Here, she readies the needle for her weekly injection of Methotrexate, a type of chemotherapy regularly used for people with autoimmune diseases like rheumatoid arthritis.
(Photo: Melissa Lyttle for USA TODAY)

"It's a case of companies trying to offer workers health insurance and still generate profit," said Eric Wright, a professor of sociology and public health at Georgia State University. "But whenever costs go up for the consumers across the board … it promotes a delay in care."

Others disagree, saying that when people pay for their care, they shop more intelligently. Chris Riedl, Aetna's head of product strategy for its national accounts, says her company's research does not indicate that insured patients are showing up sick in emergency rooms with long-neglected illnesses — which to her means, "intuitively, they're not avoiding care."

But many doctors contend it's only a matter of time before the middle class begins crowding ERs. They say putting off care can be dangerous, exponentially more costly and, if it continues and spreads, can threaten the health of the nation.

Monitoring the trend'Can I stop taking this medication?'Praveen's father, Mohana Arla, says being forced to pay so much out-of-pocket "is as good as not having insurance" in an era of ever-rising health care costs. Inpatient care last year averaged $17,553, and insurance plans require people to pay a portion of that even after meeting their deductibles, up to an out-of-pocket maximum that can easily exceed $10,000 a year for families. Median household income in the U.S. is around $53,000, and the average American has less than $6,000 in savings, according to a 2012 report by Pitney-Bowes Software. A quarter have no emergency savings at all, Bankrate.com reported in June.

Bullitt County, Ky., family practitioner Mohana Arla, right, and intern Dominique Rhymes examine Lee Curry, 54. Curry was injured while working to pull a passenger from a wrecked vehicle as a Sheriff's Department employee when his wrist was slammed in a truck door by a wind gust on Oct. 31, 2014.
(Photo: Alton Strupp for USA TODAY)

"Health expenses tend to come up unexpectedly, or if you have a chronic condition, they come up relentlessly," adds Karen Pollitz, a senior fellow at Kaiser. "People put off care or they split their pills. They do without."

Mounting evidence backs that up:


• Nearly 30% of privately insured, working-age Americans with deductibles of at least 5% of their income had a medical problem but didn't go to the doctor, the Commonwealth Fund found. Around the same percentage skipped doctor-recommended medical tests, treatments or follow-ups.

• Nearly half of middle-class workers skipped health care services or fell into financial hardship because of health expenses, according to a survey by the Associated Press and NORC Center for Public Affairs Research.

• Use of hospital care among insured workers has been dropping since 2010, and use of outpatient care, such as doctor visits, dropped slightly for the first time from 2012 to 2013, according to insurance claim data analyzed by the Health Care Cost Institute.

• Medical professionals across the USA see the reality behind the research. The Arlas' patient load used to be 45% commercially insured and 25% Medicaid; those percentages are now reversed. Stan Brock, founder of Remote Area Medical, which runs free clinics around the nation, says the group's volunteer workers found that around 7% of patients who came to one of the clinics had job-provided insurance — and some waited for days just to keep a prime spot in line.

Patients often do a sort of medical and financial triage when they get sick. Jacobs, a former college professor, says every time a doctor suggests a new test, procedure or medication for her severe arthritis, she asks herself: " 'Is it critical?' You're always playing the odds. ... And I'm constantly asking my doctor: Can I stop taking this medication?"

When her shoulder started hurting a couple of years ago, she had an X-ray but put off the recommended MRI for two years. It worsened, and she couldn't move her arm without pain or lift her right hand above her head. She finally got that surgery in October but is now forgoing a shoulder procedure, opting for less expensive physical therapy and planning to "tough out the pain."


"You don't want another surgery … another bill," she says. "It may be more of a problem later, but that's the risk you take."

While all out-of-pocket expenses play a role in such decisions, experts say the driving factor is the deductible, which averages $2,000 or more for single coverage for nearly one in five workers and from around $2,000 to $4,500 for families, depending on the type of plan. Companies may help fund health-savings accounts to pay some of these costs, sometimes with only a few hundred dollars.

"I can remember when $1,000 was considered a high-deductible plan. Now that's become kind of the norm," Pollitz says. "We're kind of in high-deductible land."


The cost shift extends to workers in government jobs, long known for bountiful benefit packages. Lee Curry, a sheriff's deputy in Bullitt County, Ky., says his county health plan comes with a $1,500 deductible, which keeps him from going to the doctor at all.

"Health insurance doesn't cover much of anything until you cover your deductible," says Curry, 54. "It puts a burden on you. You've got to have the money to be seen."

Is Obamacare to blame?Stagnant salaries also skew budgetsSince the ACA took effect, "there's been an accelerated movement" to these types of health plans, says Brian Marcotte, president and chief executive officer of the Washington, D.C.-based Business Group on Health.

Marcotte, whose group represents 400 large employers, says that the looming Cadillac tax is one factor but acknowledged that managing health care costs is another.

Companies have cited the ACA for cutting medical benefits in other ways. For example, United Parcel Service partly blamed the law when it removed thousands of spouses from its plan because they are eligible for medical coverage elsewhere.

But DeAnn Friedholm, director of health reform for Consumers Union, says she's skeptical when employers point to the ACA. "This isn't new," she says. "Companies have been cutting back on benefits and cutting costs for decades."

Sara Collins, vice president for Health Care Coverage and Access at the Commonwealth Fund, says two ACA requirements — keeping children under 26 on their parents' plans and covering preventive care — didn't add much to companies' health care tabs, partly because most already covered preventive care such as physicals and mammograms. Pollitz says the ACA actually holds down the consumer burden by capping out-of-pocket expenses at $6,300 a person — which, although that amount is "more than most people have in the bank," is better than no cap at all.

Experts point out that the ACA requires preventive care to be covered fully and exempt from deductibles — although surveys show many workers still forgo screenings and physicals because they're unaware of this or know they can't afford follow-ups if illnesses are found.

Several experts say the consumer crunch has less to do with the health system overhaul than stagnant salaries. The average hourly wage is nearly identical to what it was 50 years ago in today's dollars: $19.18 in 1964 compared with $20.67 in 2014, according to U.S. Bureau of Labor data analyzed by the Pew Research Center. Meanwhile, U.S. health spending ballooned from 5% of gross domestic product in 1960 to 17% in 2013.

Physician Praveen Arla says he's seen a role reversal since the implementation of the Affordable Care Act. Middle-class patients are now avoiding regular care due to high-deductible plans and out-of-pocket expenses. VPC

"People are very close to the line in terms of their budgets," Collins says. "What consumers are really seeing is their incomes have grown even slower than the slower growth in health care costs" in the past few years.

Insurers also blame the cost of care, saying that can't be absorbed just by premiums. But Wilson and other patients put much of the blame on insurers.

"Insurance is all about the dollar," Wilson says. The never-ending cost shift to consumers "is something that basically all kinds of people screwed up. … Obamacare is a step in the right direction. But it's not enough. I expected more out of it than I got."

The ugly side effectsA spiral of painful debtWhen consumers skip care, they enter a downward spiral that imperils their physical and financial health.

Jennifer Ross, an arthritis sufferer in Florida insured through her husband's job, says she recently made the wrenching decision not to take a medication that might allow her to get around without her wheelchair. The $2,400-a-month medicine would cost her $600 a month out-of-pocket even with insurance, and she simply can't swing it. To make matters worse, Ross' 12-year-old daughter was recently diagnosed with arthritis, too.

"It's a no-win situation," Ross says.

Surgeon Paul Ruggieri of Fall River, Mass., says his patients with high-deductible plans often blanch at the out-of-pocket cost to electively treat two common ailments he sees regularly — gallstones and hernias — until they become potentially dangerous and costly emergencies.

If the procedures are done electively, patients are required to pay half of the cost upfront; a hernia repair done laparoscopically would cost about $4,000 at a surgery center. That's often about the amount of some patients' deductibles, so they would have to pay the full bill out-of-pocket. If the procedure is done at a hospital, even laparoscopically, it can cost as much as $17,000. If patients delay and are rushed to the emergency room for the procedure, the hospital would charge at least two to three times the amount of the surgery, Ruggieri says. It would also mean a two- to three-day hospital stay vs. two hours for the elective procedure, and much longer at-home recuperation.

Paul Ruggieri, with medical assistant Monica DePonte, is a surgeon who sees a lot of hernia and gall bladder patients who put off care until it becomes an emergency.
(Photo: Josh T. Reynolds for USA TODAY)

Ruggieri sees the same issues with gallstones, which are simple to treat electively before they get so painful a patient can't stand it anymore and heads to the ER.

When patients do get needed care, some find themselves in massive debt. Kim Brown, an administrative assistant in Louisville who was earning about $40,000 a year, owes many thousands — the bills are still coming, so she doesn't know exactly how much — after battling thyroid cancer. She says her annual out-of-pocket costs are $7,500, and she also has to pay 15% for things like hospital stays. No longer able to work because of her illness, she reluctantly signed up for Medicaid and will likely declare bankruptcy.

'Skin in the game'The push for preventive care"I've worked for 35 years. I never wanted to go on Medicaid," says Brown, 50. "It's horrible. I paid for insurance for all those years, and still ended up in this situation."

But insurers, employers and others say that such stories are the exception and that high deductibles generally encourage consumers to seek the best value for their dollar.

"By having deductibles, it puts skin in the game," says Divya Cantor, senior clinical director for the insurer Anthem in Kentucky.

Joel Diamond, a Pittsburgh primary care doctor, thinks high-deductible plans are a smart choice for people who can't afford higher premiums and are generally in good health.

He cites the case of a young woman who couldn't afford insurance on her own who stopped having periods and went to the emergency room with severe headaches. Diamond discussed doing testing for possible ovarian and endocrine problems. When blood work showed abnormal levels of the hormone prolactin, he recommended an MRI to rule out a pituitary tumor. Her bill for just a few hours in the emergency room was $15,000, something that will take her years to pay off.

If she had had a high-deductible plan, he says, it would have paid for a large chunk of the cost, and her debt could have been a third to half as much.

"We don't have car insurance for windshield wipers and oil changes, but we need it for the catastrophic stuff, just like our health care," says Diamond, who is also chief medical officer for the health care IT company dbMotion.

Aetna's Reidl says her company allows people to compare prices easily on its website. Some tests, for example, could cost hundreds of dollars or less at some hospitals and thousands at others.

Aetna, the first national insurer to move to high-deductible plans — which it coined "consumer-directed plans" — more than a decade ago, says the plans help employees and employers save money.

Reidl says she has heard the criticism that they "may cause some individuals to put off care," but counters that Aetna members with these plans get routine preventive care and screenings at higher rates than those with other plans. And their employers save an average of $208 per employee per year after they switch to high-deductible plans.

"We've seen that over 10 years consistently," she says.

Aetna recommends companies pair the plans with health reimbursement or savings accounts — which allow employees to set aside tax-free money to use for cost sharing — to ease the burden of out-of-pocket costs on employees.

But Wendell Potter, who used to work in public relations in the insurance industry and has since written a book about the experience called Deadly Spin, says insurers who study high-deductible plans are "not disclosing everything they find."

"They do these reports based on their populations to try to sell more of these plans to employers," he says. Population-based reports don't necessarily reflect the fact that "individuals and families are having to file for bankruptcy because they are in their plans."

Potter left his public relations job at Cigna in 2008 in part because "I was expected to be a champion" of high-deductible plans. He says these plans are "taking us in the wrong direction ... back to a system that we would have thought the ACA prevented."

The futureWill time heal all?There are no signs high deductibles are going away.The Centers for Medicare and Medicaid Services last month cited these plans as one of the reasons health care spending hit a record low in 2013. But CMS statistician Micah Hartman says his office is "not looking forward to what the impact would be going forward" if consumers who delay care need far more expensive emergency care later.

Meanwhile, experts say Americans will need to take further steps to control their health costs.

Wilson, the Denver patient, says that after her doctor scolded her for stopping her blood pressure pills, she now takes them daily. But keeping up with her six medications is a constant struggle given her $33,000-a-year income, so she copes by asking for samples from the doctor, using a prescription discount plan and sometimes buying just a few pills at a time.

Doctors and doctor groups say such individual coping strategies can be helpful, but action is needed on a national level. The American Academy of Pediatrics recently came out with a policy statement saying high-deductible plans "may be a less desirable way to lower health care costs than other means … even if 'other means' require more work by government, insurance companies and other health policy participants."

They say policymakers should consider requiring that the plans cover only adults, not children, as adults may suffer more from reduced care. The group also suggests exempting outpatient care from deductibles and requiring employers to put a lot more money in health-savings accounts that go with the plans.

Oncologist Ezekiel Emanuel, the former special adviser for health care policy to the director of the Office of Management and Budget, says insurers and employers moved to high-deductible plans rather than trying to come up with "a more intelligent plan design."

Emanuel, who is considered an architect of Obamacare, says that he is "not a fan of high-deductible plans" and that what's needed are "smart deductibles" that don't discourage people from using the services they really need to stay healthy. He cites the preventive care visits that aren't subject to deductibles under the ACA.

Higher deductibles, he says, should apply to "discretionary services" like knee replacements and low or no deductibles should be for important treatment such as for insulin or ophthalmologist visits.

But Wright, the Georgia professor, says he doesn't see any major changes on the near horizon.

"I wish I could be optimistic, but I'm not sure," he says. "There's a lot of reason to be worried about the future."

Not everyone understands the science of chemical PHARMA we have used for a century and these new biologics that use living interventions for treatment.  THAT'S OK.  What is important is to understand that chemical PHARMA went through long studies creating basic science data on how all those chemicals acted in our bodies in all kinds of ways.  Then, if a business wanted to come along to make a generic version by making a small change in the drugs formula---it did not have to go through all kinds of clinical trials all over again.  THIS IS WHY GENERICS ARE CHEAPER.  Biologics are far more complicated then chemical PHARMA and they have done very little basic science studies----and the clinical trials being done are not the quality Americans are used to and are required by law.  One change in biologic formula makes it a completely different product that can act completely differently in our bodies.  Since sophisticated lab facilities are needed----there will be no 'generics' for biologics.  Biosimilars are not the same as chemical PHARMA generics.

The Affordable Care Act was written to end all public subsidy and public health trusts like Medicare because its all about the profit.  Just in the few years since ACA was installed----what were thousands of generic-producing facilities have consolidated into a monopoly and this is why generics are now soaring in price.  THIS WILL IMPLODE THE GENERICS INDUSTRY AS IS THE GOAL OF ACA.


Prices of generic drugs soar as mergers reduce competition

By Dan Dundon Tue, Jul 8, 2014 @ 4:35 pm | updated Tue, Jul 8, 2014 @ 4:43 pm

• McClatchy Newspapers

Prices have spiked for some generic medications because of industry mergers resulting in fewer manufacturers. In the 34 years Gary Roberts has been a pharmacist, he has never witnessed such large percentage increases in the cost of many generic drugs.

Roberts, president of Roberts’ South Bank Pharmacy in Jacksonville, doesn’t pretend to know all the reasons, but suspects one factor may be the recent rash of consolidations and mergers in the pharmaceutical industry.

He isn’t alone in his suspicions.

Many other observers of the pharmaceutical industry see consolidation as a troubling indicator of continued price increases, which will have a dramatic impact on consumers.

Hardly a week goes by without news of another acquisition in the pharmaceutical industry. The airline and the cable industries are prime examples of how those consolidations lead to higher prices. But while consumers can choose to travel by car or cut their cable cord, they are frequently compelled to pay higher generic drug prices to treat their ailments.

A generic drug must contain the same active ingredients as the brand-name product and must be comparable in quality, dosage form, strength and performance. When the patent of a brand-name drug expires, competition increases, hence the far lower prices of generics.

Much, much lower prices — until now. That’s troubling for Roberts and other pharmacists because more than 85 percent of all prescriptions are for generics.

The rise in generic drug prices first became evident in 2013 and the increases are continuing this year, Roberts said.

“Generic drug inventories that have been plentiful for years suddenly won’t be available for a time,” he said. “When they come back on the market, the price is exorbitant compared to what it used to be.”

One example is the eye drop Pred Forte, the brand name for a generic equivalent of prednisolone acetate ophthalmic suspension. It is prescribed as an anti-inflammatory drug for eye surgery patients.

Roberts said he had been able to acquire the generic drops for $6 per bottle as recently as last year. Today, that price has shot up to nearly $90 a bottle.

“Our biggest problem is patients who simply walk away when they learn of the price increase,” he said. “Even if they have insurance, the new plans have high deductibles. Years ago, if you had a deductible, it was usually on major medical expenses. Now they are all lumped together.”

Pacific Pharma Inc., a generic manufacturer, produces the eye drops ordered by Roberts. The company is owned by the pharmaceutical giant Allergan USA Inc. based in California, which developed the brand Pred Forte.

Allergan therefore controls both the branded and a generic manufacturer of the drug. Allergan is in the midst of a hostile takeover battle with Valeant Pharmaceuticals. An Allergan representative did not respond to repeated email and telephone requests to comment on the price increases.

But in a transcript of May 7 earnings teleconference, Allergan’s CEO David E.I. Pyott discussed Pred Forte with industry analysts. He said after competitor Sandoz increased the price of its generic drug, Allergan “increased our prices of the generic to parity with Sandoz as well as increasing the price for branded Pred Forte by 80 percent.” Allergan reported first-quarter sales increases of 12 percent, marking the fourth sequential quarter of year-over-year double-digit growth for the company.

Sandoz is the generics unit of pharmaceutical giant Novartis. Leslie Pott, vice president of communications at Sandoz, confirmed price increases for the eye drops, citing supply issues caused by equipment problems at the Sandoz manufacturing plant. Nevertheless, she said, even with the increase, their generic drops were 50 percent less expensive than the brand price.

“Pricing of key products is reviewed regularly, taking into account all relevant factors including regulatory and production costs,” she said.

Sandoz and Pacific Pharma are the only two generic manufacturers of the eye drops. Large brand-name pharmaceutical companies therefore control both generic companies and consequently the market for these drops.

The eye drops aren’t an unusual example of what is happening with many generic drugs. According to the National Community Pharmacists Association, 77 percent of their members experienced 26 instances of a large increase in the acquisition price of a generic drug within the last six months.

More than 84 percent of pharmacists said price fluctuations resulted in some patients refusing their prescriptions because of costs. For independent pharmacists already squeezed by large chain pricing, this trend has raised concerns about some of them remaining in business.

“There is no question that with generic drugs with multiple manufacturing sources, there are much lower price increases because competition is a factor. Generally, we find the more competitors in the market, the lower the price. Today, we are seeing fewer manufacturers and consequently the competition decreases,” said Robert Navarro, clinical professor in Pharmaceutical Outcomes and Policy at the University of Florida. Navarro has practiced pharmacy as a medical center pharmacy co-owner, hospital clinical pharmacist, medical school geriatrics pharmacology instructor and a long-term care consultant pharmacist.

Another university pharmaceutical expert, Robert Kemp, an economist at the University of Louisiana at Monroe, sees price increases occurring in particular generic therapeutic areas.

“If you have one company with multiple products in one therapeutic area such as hypertension you will see improved capability to get and maintain premium prices,” Kemp said.

The Department of Justice and the FTC have been active in the pharmaceutical industry. Pharmaceutical companies have agreed to pay more than $13 billion to resolve allegations of fraudulent marketing practices. One of the largest settlements ever was paid by a pharmaceutical company. In 2009, Pfizer agreed to pay $2.3 billion to settle charges that it illegally promoted certain drugs.

The FTC also has also filed actions forcing pharmaceutical companies to divest interest in certain generics before a merger. In Fiscal 2012, for example, the agency challenged proposed mergers by Valeant, Novartis and Teva Pharmaceutical Industries because it alleged competition in the generic drug area would be harmed by the proposed acquisition.

Despite these actions, merger activity in the pharmaceutical industry continues. And at the current pace, Roberts fears his pharmacy and his customers will likely see price increases for generic drugs well into the future.
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We already see what a profit-driven health care system will do----it will move corporations away from medical products and procedures that are the least profitable and everyone will move to 'innovative' high-cost medicine.  It's just like the movement away from a family doctor that did everything to medicine with all kinds of specialists that cost more.  The problem comes when these global corporate health systems sit around and talk about what makes health care less costly----they don't say well, let's keep chemotherapy and radiation therapy for those not affording biologic cancer treatment----they don't even tool hospitals with equipment to do cancer radiation treatment.  Now we are seeing global cancer centers popping up that do only cancer and we are now expected to travel to that state for cancer treatment that is if our heath plan even allows for this.  We already know global health insurance will not be funding this process very long and so, cancer treatment for main street is disappearing.  If you do  not have an expensive private health plan---you will not access cancer treatment.  This same thing is happening for many of the most common diseases.

HEALTH COST ARE CONTAINED BY NOT OFFERING EXPENSIVE TREATMENTS AND IF YOU DO---YOU ARE CATERING TO THE GLOBAL WEALTHY TOURISM INDUSTRY

Below you see a simple description of a biologic for cancer that will become the only game in town for treatment and below that you see where ordinary cancer treatment from the drugs used to the equipment needed to do chemo and radiation see costs soaring to a point they will be declared too expensive for health insurance corporations to pay . 

HILLARY TRIED TO DO ALL THIS WHILE BILL WAS DEREGULATING AND CONSOLIDATING AND GLOBALIZING THE FINANCIAL INDUSTRY BUT OBAMA AND A CLINTON NEO-LIBERAL CONGRESS DID IT----AND IT IS ALL REPUBLICAN POLICY-----WRITTEN IN REPUBLICAN THINK TANKS.  YOUR POLS KNEW ALL THIS WOULD HAPPEN JUST AS THEY KNEW THE WALL STREET MESS THAT WOULD COME FROM THE SAME DEREGULATION AND GLOBALIZATION.  None of this has to do with cost containment---it will suck the Medicare Trust dry by 2020 at which point the Affordable Care Act ends the Federal Medicare.


Biologic Therapy for Breast Cancer Breast Cancer


 Monoclonal Antibody Therapy-Herceptin and Avastin

Monoclonal antibodies are laboratory-produced substances that are directed against cancer cells. They can be used to deliver drugs, toxins or radioactive material directly to the cancer cells. Many monoclonal antibodies are used in cancer therapy. Each one recognizes a different protein on a variety of cancer cells. Herceptin Trastuzumab (Herceptin) is an antibody directed against the HER-2/neu receptor on the surface of the breast cancer cells of some patients. Not all cancers have this characteristic. HER-2 (human epidermal growth factor receptor 2) is a gene that helps control how cells grow, divide and repair themselves. The HER-2 gene directs the production of special proteins, called HER-2 receptors. Because heart muscle cells also have the HER-2/neu receptor, trastuzumab can cause heart damage. It should be used cautiously when combined with other heart-damaging drugs such as anthracyclines (doxorubicin and epirubicin). Trastuzumab is given to women whose breast cancers have tested positive for the HER-2/neu receptor and who have metastatic cancer (that has spread). It is used in combination with chemotherapy as adjuvant treatment in women with HER-2/neu breast cancers and who are node-positive (cancer found in the lymph nodes). It may be considered for women with node-negative (cancer not found in the lymph node) tumors greater than or equal to 1 centimeter. Avastin The results of a recent clinical trial showed that bevacizumab (Avastin) is an effective addition to chemotherapy in women with metastasized breast cancer. Bevacizumab blocks the growth of blood vessels that can feed the tumor and promote growth. Targeted therapy with novel (newly discovered) therapies is in the forefront of ongoing research. -
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National leaders from labor and justice to news media knew where all this Affordable Care Act led and all we heard was ----it will protect the poor and it will give all Americans access to health insurance.  All voices like mine were silenced.  Labor unions were brought out to support it-----NAACP and National Organization of Women were brought out to support it----all led by Clinton neo-liberal leadership knowing it would keep over 80% of Americans from ordinary health care.  People of color and women are hurt most as usual-----labor unions are going to join them as their pensions and benefits end.  So, what is now 1/3 of Americans on Medicare and Medicaid will soar to 2/3 and grow from there all having what will be called A SINGLE PAYER SYSTEM THAT WILL BE GUTTED OF FUNDING ------MEDICAID FOR ALL.  This is the goal of Affordable Care Act.  Republican voters are fighting this as hard as they can thinking this is ObamaCare and not Republican policy.  The Democrats with the Democratic base of labor and justice are silent and supporting it because they do not know to where all this is going. 

Making costs soar will give these health systems excuses for not offering these medical products and procedures and it will allow them to move to these 'new, innovative' designer medicine policies tied to global health tourism and telemedicine.

None of this is good for anyone other than Wall Street and the executives at the top.  It's not good for the nations that should be building our first world public health structures and not telemedicine----it is not good for any American ----even the affluent -----as quality will fall no matter what you pay for private insurance.


Exclusive: Americans overpaying hugely for cancer drugs - study

By Ben Hirschler
A scientist prepares protein samples for analysis in a lab at the Institute of Cancer Research in Sutton, Britain July 15, 2013. Reuters/Stefan Wermuthleft



A man buys cancer drug Glivec for a relative who is suffering from cancer at a pharmacy in Ahmedabad, India April 2, 2013. Reuters/Amit Daveleft1 of 2right A scientist prepares protein samples for analysis in a lab at the Institute of Cancer Research in Sutton, Britain July 15, 2013. Reuters/Stefan Wermuthleft2 of 2right A man buys cancer drug Glivec for a relative who is suffering from cancer at a pharmacy in Ahmedabad, India April 2, 2013. Reuters/Amit Daveleft1 of 2right Americans are paying way over the odds for some modern cancer drugs, with pharmaceutical companies charging up to 600 times what the medicines cost to make, according to an independent academic study.

The United States also pays more than double the price charged in Europe for these drugs - so-called tyrosine kinase inhibitors (TKIs), a potent class of cancer pills with fewer side effects than chemotherapy.

The analysis by pharmacologist Andrew Hill of Britain's University of Liverpool, who will present his findings at the Sept. 25-29 European Cancer Congress in Vienna, is likely to fuel a growing storm over U.S. drug costs.

ADVERTISING  Democratic presidential candidate Hillary Clinton's declared aim to lower the cost of prescription drugs by ending what her campaign describes as "excessive profiteering" triggered a sell-off in drug stocks this week.

Hill told Reuters he had shared his work on the cost of producing TKIs with the World Health Organization (WHO), which is keen to add such treatments to its list of medicines deemed essential for a basic healthcare system. WHO officials have used the findings in determining that the drugs can be made at low cost, he said.

The first such TKI was added to the WHO's latest draft Essential Medicines List earlier this year.

Several widely-used TKIs are expected to become available as generics within the next five years, as patents expire. Hill calculated that large-scale production could achieve treatment prices in the range of $159 to $4,022 per person a year, against current U.S. prices of around $75,000 to over $100,000.

"It shows there is a lot of scope for prices to come down," he said. "There has to be some middle ground between the prices that companies are charging, which may not even be cost-effective by the standards set by some healthcare authorities, and the actual production cost."

RESEARCH COSTS

Drug companies argue that they need to make decent profits to pay for the billions of dollars needed for drug research. Many companies also have extensive low-cost or even free access schemes for patients who cannot afford their medicines.

But the high prices charged for modern drugs is generating increasing push-back from healthcare providers, patients and some doctors.

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' leukemia 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.

Novartis said the price of medicines was determined by many factors beyond manufacturing costs, including their value to patients and healthcare systems.

"We invest in developing novel and current treatments to find ways to make more cancers survivable. This is challenging and risky and needs to be taken into consideration when discussing pricing of treatments," a spokeswoman said.

Roche declined to comment.

The issue is not unique to cancer drugs. Earlier this month, for example, Amgen launched its new injectable cholesterol drug Repatha in Europe at around half the U.S. price.

"Why should the U.S. bear this huge burden cost? It is not as if the GDP of the United States is so much higher than that of European countries, but they just seem to pay these big premiums," Hill said.

The future pricing of TKIs could also have major implications for developing countries, Hill believes, since mass production could open the way to widespread cancer treatment in the same way that cheap generic drugs helped fight HIV/AIDS.

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The biologic industry likes to paint the picture of well-researched and tested products and they are lobbying hard for dismantling of all Federal regulations and standards that would try to provide oversight and accountability.  As the article shows here for one state---Utah----it will fall to states and cities to enforce existing health laws and provide the oversight of this industry until we can get rid of Clinton neo-liberals and Bush neo-cons in Congress.

Baltimore City is becoming a progressive social democratic city getting rid of the very, very neo-conservative Johns Hopkins and Wall Street Baltimore Development from our government.  In doing so we will install the platform for EXPANDED AND IMPROVED MEDICARE FOR ALL rebuilding the public health sector and this will be where Medicare and Medicaid patients will fall to escape these repressive and exploitative health policies.

The only reason the BIO----Biotechnology Industry Organization is lobbying NOW for access to main street patients is there has been no clinical trial or basic science done in this industry and they want to include all of us during this research stage and then -----GOODBYE----THE PRICES WILL SOAR.  Given how quickly they feel proof of safety can be found----main street may have access to biologics for a handful of years if they want them.


“Interchangeable biologics are not generics. Even slight changes to a biologic drug can change its properties entirely,” said Greenwood. “Unlike conventional generic medicines, interchangeable biologics are not the same as the drugs they seek to substitute. In fact, two biologics made using different cell lines and differing manufacturing processes will rarely, if ever, be exactly the same. Those suggesting interchangeable biologics and generics are the same are wrong.”



Below BIO is telling us there will be open and transparent processes for the public to see what is being used et al and I ask you----DO YOU SEE ANY OPENNESS SO FAR? Do you think I could go to Johns Hopkins and ask to see the data of J-CHIP? I could not even see data taken from a community garden survey for goodness sake.

BIO Urges Governor Herbert to Sign Bill That Ensures Patient Access to Interchangeable Biologic Medicines



Posted: March 17, 2015 American Laboratory


The Biotechnology Industry Organization (BIO) has called upon Governor Herbert to sign important legislation that serves to update existing Utah laws governing substitution of interchangeable biologic medicines.

“When they become available, these therapies will be safe, effective, and similar to innovator biologics. Furthermore, they will provide patients with more opportunities to address their unmet medical needs, particularly severely ill patients who rely on cutting-edge medical treatments.”

The Utah Senate unanimously passed House Bill 279 last week, a bill that amends provisions of the 2013 Pharmacy Practice Act. This action follows House passage of the same bill earlier this month.

House Bill 279 represents a significant step forward, ensures transparency and communication between patients and their treatment teams, and is fully consistent with BIO’s principles on biologic substitution. Therefore, BIO supports this important legislation and encourages Governor Herbert to sign the bill when it reaches his desk.

“House Bill 279 enjoys the support of physicians across the country, patient groups, and both innovator biologic and biosimilar manufacturing companies. This bill includes transparent communication on all biologic medicines dispensed in order to maintain a consistent and complete medical record,” said Jim Greenwood, BIO’s President and Chief Executive Officer.

While the U.S. Food and Drug Administration (FDA) oversees approval of biologic medicines and designation of interchangeability, policies governing whether one product may be substituted in place of a doctor's prescription and whether a pharmacist must inform patients and doctors are covered by state law. House Bill 279 seeks to properly preserve patient access to accurate prescription information, maintains incentives for innovation and promotes a competitive market for biologic therapies. BIO will continue to advocate for full transparency in the substitution process, as patients and their physicians should have the right to know what biologic medicine the patient receives from the pharmacy.

While the FDA recently approved the first biosimilar product for sale in the U.S., the agency continues to develop a pathway for the development and approval of safe and effective interchangeable biologic products in the United States. In fact the FDA has indicated they expect to see applications for interchangeable biosimilar product approvals this year. However, there is still a major role for states to play in ensuring substitution practices remain transparent and physicians remain engaged in the process.

“Interchangeable biologics are not generics. Even slight changes to a biologic drug can change its properties entirely,” said Greenwood. “Unlike conventional generic medicines, interchangeable biologics are not the same as the drugs they seek to substitute. In fact, two biologics made using different cell lines and differing manufacturing processes will rarely, if ever, be exactly the same. Those suggesting interchangeable biologics and generics are the same are wrong.”

Patients and physicians managing chronic conditions are generally aware of which biologic treatments work best in their unique circumstances. Communicating with patients and physicians allows everyone involved the opportunity to discuss past treatment experiences so that any possible unexpected issues can be better understood and avoided.

As the Utah State Legislature continues to address issues related to biologic medicines, BIO encourages policy makers to continue to put patients first.

_________________________________________________
'On December 24, 2009, the U.S. Senate passed the Patient Protection and Affordable Care Act (H.R. 3590), its version of comprehensive healthcare reform legislation. On March 21, 2010, the U.S. House of Representatives also passed this legislation. Included therein is a provision (Section7002) amending the Public Health Service Act to permit approval of biosimilar biological products through an abbreviated biological license application (ABLA) submitted to the Food and Drug Administration (FDA).'

Below you see there is really no expectation that main street will access these new, 'innovative' medical technologies that are receiving tons of Federal funding to build private research facilities for processing and manufacturing. You see as well where the Affordable Care Act was used to deregulate the FDA process by giving an abbreviated license application. In 2009 Democrats has a super-majority in House, Senate, and Obama so the Republicans did not make them do it. They did it because the Democratic Party is controlled by a small percentage of people running as Clinton neo-liberals. The only people affording these health plans that will include health care access all Americans had will initially families earning over $200,000 a year but they will soon be priced out as the global rich become the consumers of American health care. For the rest of Americans pushed into ever-lower poverty---we get remote controlled microchips and telemedicine. I will escape most of this as a baby boomer---but if left unchecked all of this could be happening in little over a decade. So, it is our children and grandchildren that will feel the brunt of Wall Street global predatory, profit-driven health care. JUST GET RID OF THE GLOBAL CORPORATE POLS AND REBUILD OUR PUBLIC HEALTH IN STATES AND CITIES TO REVERSE THIS MESS.

The article below is long but please glance through----it gives a clear look at why over 80% of Americans AND HIGHER will only be accessing preventative health care and much of that will be remotely=====it looks like this agency for oversight-----CER will act as the SEC does---it will work for the BIO industry, not the American people.  You don't create a public private partnership or quasi-governmental status unless you are killing transparency and public voice.

a public-private partnership that will commission CER.

*******************************************************************

'What do current trends in biologics coverage suggest about access in the PPACA era?

In the run-up to 2014, plans are placing greater access restrictions on biologics'
*********************************************************************


Biotechnol Healthc. 2011 Winter; 8(4): 6–10. PMCID: PMC3278131


How Will Biologics Fit Into Healthcare Reform?

With so many variables, it’s hard to predict what kind of market will exist for biologics and other specialty drugs in 2014. Current trends may provide some insight

.MICHAEL D. DALZELLAuthor

This article has been cited by other articles in PMC.Oct. 6, 2011, could become a red-letter day in the annals of healthcare policy. On that day, the Institute of Medicine took a big step forward in the national discussion about the finite quality of healthcare resources. In its recommendations to the Department of Health and Human Services on how to develop a minimum benefit package for health plans to be offered through the coming state healthcare exchanges, the IOM took the view that the scope of the benefits should be determined not by services but by costs.

If HHS follows through on the IOM’s recommendations, we could get as close to the R word as we have ever gotten in this country. Then again, nobody wants to hear about rationing.

Although the IOM report on “essential health benefits” touches on just one of the many moving parts of healthcare reform, it gets to the question: How will access to and coverage of biologics be affected by healthcare reform? The eventual makeup of the essential benefit set is an important factor in how biologics will fare under reform, but it’s only one factor.

Employer concerns about the so-called Cadillac tax, comparative effectiveness research, and biosimilar development and its potential effect on innovation all represent both threats and opportunities for biologics — and are causing some lost sleep among health plans, providers, and manufacturers.

“Everyone’s got a bull’s eye on biologics because they are the fastest-growing trend in the healthcare sector,” says Dea Belazi, PharmD, MPH, vice president of payer and health-care solutions for Wolters Kluwer Health and a consultant for MCOs and biopharma companies. “The scare is, what happens when they come out with a biotech drug for asthma or diabetes — something that targets a common chronic condition — for $25,000 a year? What is going to be the repercussion that might come from the government?”

Go to:Lots of moving parts

Arguably, the biggest questions about healthcare reform’s effects on biologics zero in on barriers to access.

Several provisions of the Patient Protection and Affordable Care Act (PPACA) are intended to keep premiums down:

• Next year, HHS will issue regulations dictating the minimum, or essential, benefits that must be offered by individual and small-group plans sold through the exchanges. The bigger the benefit package, the more expensive the plan is likely to be.
• Health plans offered through the exchanges, which begin operating in 2014, are under pressure to limit premiums. Individuals who can’t find coverage at a cost of 8 percent or less of income are exempt from the individual mandate.
• Beginning in 2018, employers whose premiums exceed $10,200 for individual coverage and $27,500 for family coverage will be slapped with a 40 percent excise tax — the so-called Cadillac tax on benefits deemed too costly.

Now, factor in that specialty drug expenditures under the pharmacy benefit rose more than 17 percent in 2010, according to the Medco “2011 Drug Trend Report,” add it all up, and you can see that the days of comprehensive health benefit offerings are numbered, regardless of whether you get your insurance through your employer or on the open market.

All this raises several questions: Will insurers be able to maintain current levels of coverage for biologics after 2013? Given the IOM’s focus on cost-efficiency and the PPACA’s squeeze on premiums, will biologics be considered essential? Or will they be deemed too expensive and placed outside the core benefit set?

“Biologics are likely to be considered for inclusion in the definition of essential benefits but will carry a hefty price tag,” says Jim Parker, president and founder of Health Market Strategies, an Indianapolis-based healthcare consultancy, and former president of Anthem Blue Cross and Blue Shield of Maine.

If biologics are not included in the definition of essential benefits, then, Parker says, MCOs and government programs will likely consider the cost of the biologic and balance that cost with the efficacy of the treatment; “A biologic that costs $80,000 to fight cancer will receive a hard look before being included in a health benefit.”

Considering that many groups — oncologists, manufacturers, and patient advocacy organizations among them — are affected by what’s included and what’s left out of the essential benefit set, politics will almost certainly play a role, Parker believes. HHS Secretary Kathleen Sebelius has promised the public will get its say before HHS issues a proposed rule.

“This is going to be high stakes for many people,” says Ian Spatz, JD, senior adviser in the national health care practice of Manatt, Phelps, & Phillips, in Washington. And, he notes, the degree of specificity in the HHS regulation will be an important determinant of coverage.

“The law says that pharmaceuticals have to be covered. Well, what does that mean? Which pharmaceuticals? When do they have to be covered? What’s the cost sharing related to their coverage?” asks Spatz. “If you’re producing a cholesterol-lowering medicine, there’s a good chance it’s going to be covered. But what if it is a new, expensive treatment — let’s say for cancer where there hasn’t been a lot of proof of its life-extending or curative powers?”

Without changes in their benefit packages, 60 percent of employers will face the Cadillac tax in 2018.

Exclusion from the essential benefits package doesn’t mean that buy-up options won’t be available. “I think there will be some variations around ‘You can have this kind of pizza, but if you want 10 toppings on it, it might cost a little extra,’ that will go beyond the essential benefits requirement,” says Belazi.

But a buy-up option could be out of reach for many people, curtailing their access to costlier benefits. This could especially affect those just entering the health benefit market — including individuals with poor health literacy, low incomes, or both, who are at greater risk for chronic disease.

“I think there’s going to be a lot of discretion left to the state health benefit exchanges” about the scope of affordable coverage, says Ian Spatz, JD, at Manatt, Phelps, & Phillips. Healthcare reform, he believes, will not impose “a complete, top-down, command-and-control effort that specifies the same content for every plan in the United States.”

Go to:The same — and more of it

What do current trends in biologics coverage suggest about access in the PPACA era?

In the run-up to 2014, plans are placing greater access restrictions on biologics. In The Zitter Group’s Spring 2011 “Managed Care Benefit Design Index: Emerging Trends in Access,” 74 percent of payers and employers thought healthcare reform would have a significant impact on their costs. As such, 35 percent of payers increased deductibles, out-of-pocket maximums, and nonfinancial access restrictions on biologics this year, and 35 percent said they would do it again in 2012. “Neither payers nor employers waited for all provisions of healthcare reform to become applicable before reducing access and increasing patients’ costs,” the authors wrote. “Payers are having current consumers pay more for the same or less access in anticipation of their reduced ability to manage the risk pool.”

Meanwhile, if existing trends hold, new and existing biologics will drive two thirds of drug spending increases, according to the Medco “2011 Drug Trend Report.” In oncology alone, drug treatment costs will balloon from $125 billion in 2010 to $207 billion by the end of the decade, fueled in part by a 31 percent jump in the number of cancer survivors among us.

Go to:A perfect storm gathers

And so, Belazi says, what we see now, we will continue to see in 2014 — just more of it.

“We’re going to see higher out-of-pocket coverage. Rather than 30 or 40 percent of the market using co-insurance for specialty products, I think we’ll see 60 percent,” he says. “Utilization management will be much more prevalent in the biotech space — things like prior authorization, utilizing a diagnostic, or anything to help tailor therapeutics around these products.”

Though it restricts access, shifting costs to the consumer may reduce premiums enough to support the inclusion of wider biologic coverage within the essential benefit set. Indeed, cost sharing is built into the PPACA’s requirement that insurers offer bronze, silver, gold, and platinum plans — that is, plans whose average enrollee out-of-pocket liability is 40, 30, 20, and 10 percent across all benefits. Insurers operating in the exchanges must offer at least one silver and one gold plan. Each variation must cover the essential benefits; the degree of cost sharing attached to a particular benefit will differ, depending on the plan level.

“This all depends on what rules the government comes back with,” says Belazi. “If they create funky benefit designs like they did with Medicare Part D — where there was the donut hole and variations on out-of-pocket — then that’s what we’ll get from payers.”

The funky benefit design we could see from HHS could well be a biologics benefit carved out of the essential benefit set. “I think that’s exactly what they’ll do,” says Belazi. “I keep going back to Medicare, because I think that’s our blueprint. As the rules come out, I think we’ll see some very interesting things: ‘These are the drugs we will not cover. These are the benefit designs that payers have to adhere to.’ We don’t know what HHS will do until those rules are released, but it’s a fair assumption to say, ‘Yes, that’s probably what they will do.’”

Go to:Employers are wary

Concerns about the scope and cost of benefits are not limited to small-group and individual plans sold through the exchanges. Though the PPACA doesn’t specifically hold employer-sponsored plans to the same minimum benefit requirement as plans offered through the exchanges, the law’s definition of what constitutes a “qualified health plan” has caused benefit consultants to differ on whether employers will ultimately have to conform to it. At the very least, employers are expected to view the essential benefit package as a benchmark; anything in excess may risk being too generous — an issue that looms large, given the threat of the Cadillac tax.

“It’s an opportunity [for biotechs] to build CER into clinical trial design.... It does nobody any good to have a product that nobody will pay for.”

— Matthew Hudes, Deloitte Life Sciences and Healthcare


“Once premiums become unaffordable, we’re forced to look at the costs and ask, ‘What should our priorities be?’” says Jim Parker, of Health Market Strategies.

“Employers want to provide these benefits, but they’re bound by the limitations of the marketplace,” says Parker. “Employers will do whatever they need to do to remain competitive, even if it means cutting benefits. As long as the cost of benefits increases faster than the rate of competitive growth, an inducement will exist to do that.”

A Towers Watson survey released in August suggests that unless they change their benefit offerings, 60 percent of employers will be subject to the excise tax. These employers face the challenge of curtailing some benefits in order to avoid the tax while retaining those that provide value to beneficiaries. Most employers don’t even know what they spend on biologics, according to a survey done by the Biologics Finance and Access Council published in Biotechnology Healthcare last summer.

Go to:The short, medium, and long of evidence

The IOM recommended that HHS take an evidence-based approach to benefit selection. The evidence might include data on the efficacy and safety of long-term use of biologics in patients with chronic diseases or whether their use can achieve meaningful downstream cost avoidance. The rap on biologics, though, is that longitudinal data to justify their cost is often lacking.

Although 38 tests for biomarkers in oncology have reached the market in the last five years, their clinical utility is not well understood, leading payers to reserve judgment.

In the short-term, the lack of evidence could push health plans to limit the market for biologics. Parker thinks the economic environment that healthcare reform creates will intensify payer efforts to clamp down on off-label uses of biologics when the benefit is unclear.

“These types of real-life experiments should be part of a randomized, controlled test. We should deal with this in an orderly, organized, and scientifically driven fashion,” says Parker. “Without application of the scientific method, we really aren’t learning much at all. And real-life experimentation is a very expensive form of experimentation.”

Over time, though, healthcare reform could prompt scientific discovery and generate research to support the inclusion of benefits for a range of biologic therapies.

The medium-term perspective gives a nod to pharmacogenomics as a means for effectively targeting biologic interventions. Scientific refinement of this promising area continues in earnest — more than 1,600 articles on pharmacogenomics were published in 2010 alone.

Later this year, the U.S. Food and Drug Administration is expected to issue regulations for the development of companion diagnostics. Currently, companion tests are being developed in conjunction with biologic therapies for solid and blood cancers, cystic fibrosis, multiple sclerosis, and Alzheimer’s disease.

“Healthcare reform will encourage pharmaceutical companies to develop molecular diagnostic capabilities to support the precise application of their therapies,” says Parker, noting that doing so can open access to targeted uses of biologic therapies. “In the future, manufacturers won’t claim that a new drug will work effectively on 40 percent of a population; they’ll say that the therapy works 100 percent of the time on 40 percent of the population. But they’ll have to demonstrate which 40 percent that is.”

The long-term effects of health-care reform on the evidence-based approach may hinge on comparative effectiveness research (CER). The American Recovery and Reinvestment Act of 2009 set aside $1.1 billion for CER. One year later, the PPACA established the Patient-Centered Outcomes Research Institute, a public-private partnership that will commission CER.

Matthew Hudes, U.S. managing principal for biotechnology with Deloitte’s Life Sciences & Health Care practice, says CER could have a significant impact on creating market access to biologics.

“I think it’s an opportunity for certain companies to take advantage of this, to build CER into clinical trial design and protocols and, therefore, not have to redo work or do a lot of postmarket studies,” he says. “It’s important to look at that because it does nobody any good to have a product that nobody will pay for.”

Hudes says that CER will force a more holistic approach to healthcare. “It introduces a deliberate process to look at the medical impact that each product will have and to evaluate that process in terms of the optimal course of care. It not only looks at one pharmaceutical product versus another, but at the context of the total care of the patient.”

The biggest questions about CER are about limited resources and whether biologics-oriented CER will be a funding priority. The stakes are high — according to a Deloitte analysis, by 2014, biologics will comprise up to 60 percent of the 10 top-selling drugs. Those stakes are raised even higher, says Hudes, by the fact that biosimilars won’t put that big a dent in total spending on specialty pharmacy. (See “What’s the Effect of Biosimilars?” on page 9.)

What’s the effect of biosimilars?Biosimilars represent another aspect of healthcare reform with profound implications for the biologics market. Most of the discussion in the popular media has focused on cost reduction, though insiders say what’s really at stake is whether the PPACA environment will hurt or help innovation — and with it, access.

“There’s still a lot of definition and work to be done,” says Matthew Hudes, U.S. managing principal for biotechnology with Deloitte’s Life Sciences & Health Care practice, “but I think this is both an opportunity and a threat for the biopharmaceutical industry.”

HHS will need until late 2012, at the earliest, to develop a pathway for generics manufacturers to follow. Until then, manufacturers and would-be generics manufacturers will have to wrestle with the question, “How similar is similar enough?”

“I’m particularly concerned about the area of immunogenicity,” says Hudes. “What kind of testing has to be provided to determine safety and efficacy?”

Dea Belazi, PharmD, MPH, vice president of payer and healthcare solutions for Wolters Kluwer Health, says a lot is riding on what the FDA pathway will eventually look like. “If the FDA makes it easy for a biosimilar product to come out, that’s the last nail in the coffin where there will be little to no innovation,” he says. “But if they make it pretty tough for a copycat to come onto the market, then I think patent-life issues become a little less important.”

The answers to questions about scientific concerns will also determine the impact that biosimilars will have on costs, says Hudes.

“Follow-on biologics will have some impact on slowing the growth rate of biologic [costs], but it may be only in the range of 6 to 8 percent,” he says, quashing more optimistic predictions.

“There may be a 30 or 40 percent price reduction on an individual product, but if you look at the overall biologics market, those are older products that are being replaced with more effective products. That’s why if you look at the growth rate of the spend on biologics, it may slow it a bit, but there’s still a lot of innovation and development that’s going on in this very vibrant area.”

Go to:Update with care

Few expect HHS to find the perfect balance between cost containment and coverage, and the PPACA requires HHS to update the minimum benefit package annually. Those annual revisions make the evidence question imperative, because advances in medical technology account for more than half of healthcare spending growth.

“If we fix a definition of what’s essential, meaning that it’s a technology that works, we might still get ourselves into a position where the essential benefits become more expensive and the individual mandate becomes less binding,” says Gerard Wedig, PhD, an economist and associate professor of business administration at the University of Rochester Simon School of Business. “Even if we use cost-effectiveness as a criteria for essential, premiums can outstrip inflation over time.”

Wedig stresses the importance of using clinical or financial outcomes or applying some other evidence-based criteria in revising benefit packages, because the alternative may lead to a political circus. “Let’s say something is shown to be over time less cost-effective than we initially thought. Then think about the politics of pulling that out of the essential benefit package. On one hand, HHS can say ‘cost, cost, cost,’ and on the other hand there is the emotional appeal that ‘People are going to be deprived of this service.’ It may be hard to get benefits out once they’re in there because of the emotional appeal that can be made.”

In a recent article in the UCLA Law Review, Jessica Mantel provided an example, recapping the U.S. Preventive Services Task Force’s 2009 evidence-based recommendation to drop routine screening mammograms in women aged 40 to 49. Powerful interest groups swiftly condemned the recommendation, prompting the Senate to amend its healthcare reform bill to include coverage for annual screenings for women age 40 and older.

“Rather than assuming a hands-off approach as HHS develops national coverage standards, federal lawmakers will often support efforts to mandate coverage of certain conditions or treatments in response to public or interest group pressure, no matter how misguided, for fear that opposing these efforts would alienate voters,” Mantel wrote.

What patients want is to have access to the latest and best treatments, and they want insurance to pay for them. Healthcare reform efforts are forcing us to have a hard conversation about limited resources. Where that will leave biologics is unclear.

“The cost of a drug becomes more of a social and moral question: How much should society be willing to pay to extend the life of one individual?” says Parker. “Through the insurance mechanism, everyone pays for it. It’s a great mechanism for covering costs as long as the premiums are affordable, but once they become unaffordable, then we’re forced to ask: What should our priorities be?”

Spatz, at Manatt, Phelps, & Phillips, doesn’t think the discussion will go down that road — at least not now. “I don’t think this is the time that we will struggle in this country with what’s truly essential and should be shared among us in terms of the taxes we pay and the subsidies we provide or what we might have to do without because we can’t afford it. I don’t think we’re going to go that far at this stage because of PPACA’s guidance that these plans should look much like private plans.”

But the IOM report pushes us closer to that discussion. Ultimately, the consumer drives the market. Cost, evidence, and politics all will play a role in determining the fate of biologics under healthcare reform, but only time will tell if Oct. 6, 2011, was a red-letter day in the annals of healthcare policy or just another day and another false start.

When Obama and Clinton neo-liberals in Congress sent hundreds of billions of dollars to build research facilities mostly on Ivy League universities these BioTech Parks are geared towards all of these microchip and molecular/genetic technology.  All this technology is geared towards designer medicine.
You think....well, that stuff may be needed by my family some day only the costs for these procedures will remain high for decades according to changes in patent laws meant to protect brand names.   I want to look at patent law today to show how Obama and Clinton neo-liberals are installing a very Republican policy of getting rid of public health and making health Wall Street profit-maximizing.
If you look at Affordable Care Act and then at Trans Pacific Trade Pact---two Clinton neo-liberal economic policies---you see the movement away from businesses making and selling generics----WHICH ARE THE PHARMA MOST PEOPLE CAN AFFORD---and moving towards brand name patent extensions especially in this biotech medical arena that only a few will afford.  The biotech word for generic is
biosimilar----they are not the same.

Keep in mind that 'only slightly different' in medical chemistry can mean life or death.  It is not a small matter.

What is the difference between a generic and a biosimilar?

BioSimilars vs. Generic Drugs: What’s In a Word?

"How do biosimilars differ from so-called generic drugs? Generic drugs are essentially “copycat” versions of small molecule drugs – drugs that can be synthesized in the lab by following standardized, pre-defined procedures. Using well-established analytic techniques, the generic version of a small molecule drug can be demonstrated to be chemically and structurally identical to the innovator drug.
Biologic drugs, however, are much more complex than small molecule drugs. These drugs are proteins that must be produced by a living cell – they cannot be chemically synthesized in the lab by following a standard set of procedures. The cell makes these proteins by following a recipe provided by a short sequence of DNA – a gene – that is inserted into the cell. Here’s the catch: even if two different cells are provided the exact same recipe, the final product may be slightly different." 

Posted by Timothy Craig Allen, M.D.,J.D. at 10:17 AM

__________________________________________

Clinton neo-liberals always posing progressive sold the ACA as good for seniors allowing more funding for generics and closing that donut hole.  What the ACA actually does is push seniors to privatized Medicare Advantage to get those generic savings----allowing no such savings with public Medicare.  At the same time they are sending seniors to private Medicare for drug affordability----they are making it harder and harder for any business thinking of manufacturing generic drugs----at the same time strengthening the patent rights to brand names.  THIS WILL PLACE MOST PHARMA OUT OF THE REACH OF MOST SENIORS.

Remember, they are now selling US drugs to the world's rich--they don't need US seniors with cost-cutting on the mind.

What the ACA does is ensure that these new biotech patents will be the only PHARMA game in town and that they will retain profitability with longer patenting rights.  No generics in this biotech world because---the whole point of biotech is BIOSIMILARS PATENTED EACH TIME AS A DIFFERENT BIOLOGICS.

I know this is all confusing for the lay-person---basically Clinton neo-liberals made sure that old-school PHARMA with all its generics will die----and new school biologics will live free to do anything for profit. People will access biologics in the trials/validation stage---but if proved safe----these prices will soar.

NEW PROCESS TO FIGHT CANCER THROUGH BIOLOGICS----THE AFFLUENT WILL HAVE ACCESS.  MAIN STREET WILL BE PUSHED TO THE CHEAPEST TREATMENT---CHEMOTHERAPY FOR EXAMPLE.

When they use the phrase----'innovator drugs' in biologics----it means product mill as single changes to biologics create biosimilars----a new brand name product.  By creating law that makes generics unlikely---product mill brand name products will soar.....each geared towards smaller groups.


Biotechnol Healthc. 2010 Winter; 7(4): 22–23. PMCID: PMC3008392

The Biosimilars Act: Promoting or Discouraging the Development of Generic Biologics?

A tug-of-war between generic and innovator biologics seems to be where drug developers are headed.

JOANNA T. BROUGHER, ESQ, MPHJoanna T. Brougher, Esq., MPH, is an intellectual-property consultant and adjunct lecturer on health policy and management at the Harvard School of Public Health.

Signed into law by President Obama on March 23, 2010, the Biosimilars Act is part of the health-care reform provisions included in the Patent Protection and Affordable Care Act. The act outlines the requirements for determining “bio-similarity” and “interchangeability,” provides the timeline for engaging in infringement, and sets forth the exclusivity period awarded to the innovator biologic as well as the first-filer biosimilar.

Like the Hatch-Waxman Act, the Biosimilars Act provides innovator biologics manufacturers with market exclusivity and delays market entry for manufacturers of generic biologics. Moreover, the act presents higher hurdles for manufacturers of generic biologics to overcome before they can enter the market, effectively delaying generic competition for a longer period of time. Rather than promoting the development of generic biologics, the Biosimilars Act may instead encourage the development of new innovative biologics.

Go to:Background

Biologics are defined by the Public Health Service Act as “a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, or analogous product.” Drugs, on the other hand, are defined as small-molecule compounds produced by purely chemical means.

Biologics are quickly gaining in the pharmaceutical market. Of the top 15 pharmaceuticals on the market in 2009, about one third are biologics. In 2008, biologics accounted for about 30 percent of sales of the top 100 pharmaceutical products, and by 2014 are expected to account for half of all pharmaceutical sales. Moreover, biologics are being approved by the U.S. Food and Drug Administration at a higher rate than are the so-called traditional, or small-molecule, drugs, suggesting that biologics may soon overtake them in the marketplace.

Despite the growth and success of biologics, manufacturers of generic biologics have struggled to enter the market. Biologics are more difficult to replicate because they are derived from living cells, and their molecules can be 100 to 1,000 times larger than traditional drugs. Moreover, the costs to develop the necessary manufacturing capacity are greater because of the complexity of biologics. In addition, the FDA approval process for biologics is longer, more complicated, and, therefore, more expensive.

The Biosimilars Act may present higher hurdles for manufacturers of biosimilars to overcome before entering the market, says Joanna T. Brougher, Esq., MPH.

Go to:Exclusivity period

One way that market entry for generics is delayed is by the market exclusivity period awarded to innovator biologics. Whereas the Hatch-Waxman Act provides innovator drugs with 5 years of market exclusivity, the Biosimilars Act provides innovator biologics with 12 years of market exclusivity.During this 12-year period, the FDA is prevented from granting final approval to a biosimilar that references the innovator’s biologic. As a result, generic biologics must wait longer before entering the market.

Generic biologics are further delayed by the exclusivity period awarded to the first approved generic biologic. Under Hatch-Waxman, a 180-day period of market exclusivity is awarded to the first approved generic drug applicant, after which time subsequent generic drugs can enter the market. Under the Biosimilars Act, the period of exclusivity depends on a number of factors and can range between 12 months and 42 months. In a basic scenario, for instance, the first generic biologic can have an exclusivity period of one year after commercial product launch. Only after that one-year period expires can any subsequent generic biologics be approved. In another scenario, approval of subsequent generics may be delayed by 18 months, which may occur when there is a final court decision or dismissal (with or without prejudice) on all patents-in-suit against the first approved generic biologic. In other words, if the first approved generic biologic and the innovator biologic engage in patent infringement, the innovator biologic may maintain market exclusivity throughout the duration of the infringement suit, and only upon a final court decision or dismissal can the first approved generic biologic be rewarded with 18 months of exclusivity. If the innovator biologic can prolong the duration of the infringement suit to at least 42 months, any subsequent generic biologic must wait 42 months after approval of the first generic biologic product.

In the event that the generic is not sued for infringement by the innovator, any subsequent generic biologics must again wait 18 months after approval of the first generic biologic. Under this scenario, the innovator and generic manufacturers may enter into a settlement agreement that would allow them to share the exclusivity period. Use of settlement agreements can occur because, unlike with Hatch-Waxman, patent litigation is not required under the Biosimilars Act — instead, negotiation is encouraged. As a result, the innovator manufacturer can avoid litigation and negotiate a settlement with the generic manufacturer, thereby obtaining an additional period of marketing exclusivity as the generic manufacturer markets the innovator’s product and pays royalties to the innovator. During this exclusivity period, the innovator can control the market, delaying generic biologics competition by up to 18 months.

Go to:Implications for the healthcare industry

The hurdles presented by the Biosimilars Act may have significant consequences for both healthcare providers and consumers. Such hurdles, coupled with the initial difficulty of copying biologics, may discourage biologics manufacturers from even developing a generic version. Instead, they may choose to develop and commercialize an innovator biologic, leaving the biologics industry with even fewer generic options.

One consequence of limited generic competition is high prices, which may, in turn, affect access to biologics — if there is no generic version of a particular biologic, patients will be faced with paying a higher price for the innovator biologic. If the price is prohibitively high, patients may even have to forgo that line of treatment altogether. The public’s health, accordingly, may be affected by the limited availability of generic options.

On the other hand, by potentially discouraging generic competition, the Biosimilars Act may encourage the development of new biologic products. Rather than assuming the time and costs of replicating biologics that are already on the market, manufacturers may be more willing to develop new products that target different diseases and different populations. As a result, treatment options for more diseases may become available.

Go to:Conclusion

The Biosimilars Act may be considered to be the biologic industry’s response to the Hatch-Waxman Act. Although the act provides an approval pathway for generic biologics similar to the approval pathway for generic drugs, it may also present higher hurdles for generic biologic manufacturers to overcome before entering the market. These hurdles may effectively delay generic competition for a longer period of time and instead encourage innovation and the development of new biologics.

____________________________________________
IT'S NOT PUZZLING FOLKS----IT IS WHERE GLOBAL POLICY TAKES AMERICAN MEDICINE.
The generics we have always been able to afford are now becoming less affordable was Wall Street is geared towards getting rid of anything that tries to interfere with highest market price.  Now, businesses that would have jumped into the generics manufacturing are being paid by PHARMA not to create generics.  That was not allowed before these health care reforms.

Look at the last article to where Trans Pacific Trade Pact being pushed by Obama and Clinton neo-liberals in Congress writes policy that makes generics a thing of the past world-wide----that is free market, deregulated naked capitalism----
The goal of Affordable Care Act is having over 80% of Americans on preventative care only----so making old-school PHARMA unavailable and/or unaffordable will lower longevity for Americans very fast

--THE PHARMA WE WILL BE ABLE TO ACCESS IS THE PHARMA WE NEED TO SET ASIDE---LOTS OF PAIN MEDICATION---LOTS OF DEPRESSION MEDICATION----LOTS OF ANTIBIOTICS----NOT SO MUCH CHRONIC CARE/HOSPITAL PROCEDURE.

The rising cost of generic drugs is even puzzling experts

Ben Allen, witf news  | 12.11.14

For decades, generic prescription drugs have been considered the bargains of the pharmaceutical world. An industry group says Americans have saved more than $1.5 trillion in the past 10 years on brand name drugs, thanks to generics. But in recent months, prices on some of the most popular drugs have soared, and experts are trying to figure out why.

Buying generic prescription drugs feels like trading on the stock market for Cory Minnick.

"Just seems to snowball every month, it gets worse and worse. You see stuff you used to buy for pennies for a hundred, and now you're paying $70 to $80 just to get it in," he says.

Minnick, pharmacy manager at Royer’s on Sharp Avenue in Ephrata, Lancaster County, says he’s constantly checking with his three wholesalers to see what it’s going to cost to get a drug in the hands of a customer.

The popular antibiotic doxycycline is used to treat common problems like urinary tract infections and pneumonia. It cost a mere $20 for a 500 pill supply in October 2013. Yet this past April, its price had hit more than $1,800. Don’t do the math on the percentage increase, it could get ugly.

By the way, doxycycline has been on the market for 40 plus years, and the formula hasn’t changed.  So what’s going on here?

Drugs have "life cycles"

"These recent drug shortage and price hikes illustrate a third stage of the life cycle of a drug that we haven't really paid much attention to yet," says Jeremy Greene, a Johns Hopkins professor and author of Generics: the Unbranding of Modern Medicine.

"What happens when a drug is no longer particularly attractive to generic manufacturers? Or when the interests of the generic marketplace continue to go towards the second pipeline, the pipeline of drugs that are going off patent now and the drugs that have been off for patents for a while are no longer particularly attractive and get neglected," he says.

Greene says drugs used to have two cycles – the brand name stage, where the patent protects the work done by companies like Pfizer, and helps them recoup their investment in research.

But then the patent expires, and all manufacturers have a shot to make and sell the drug, ideally, at a much lower cost.

That what Ralph Neas, President of the Generic Pharmaceutical Association is focusing on.

"It may go up 50% or a 100%, whatever it might but you’re still in the pennies and sometimes you get up to a couple dollars. A very few number are more than that," says Neas.

Here’s what we know: In 2010, the average cost of one of the 50 most prescribed generics was $13. In 2013, it hit $62.

That data comes from Catamaran, which manages pharmacy benefits for 32 million people.

Why are prices rising?

A lot of theories are floating around, but the most prominent ones deal with raw material shortages and less competition.

"The generics industry has really consolidated quite a bit in few years into several large companies, so it's no longer accurate to call the generic drug industry little pharma, as opposed to big pharma of multinational brands," says Greene.

It's a common refrain heard in every industry – through consolidation, companies can make more money because they can keep overhead down. And Greene says manufacturer in the health care world act like any other out there – always looking out for their best interests. 

Adds Neas: "Well the margins aren’t very good. Remember, they're selling them for pennies.  it’s very different than the brand business. It’s a robust industry, it's a successful industry, it's benefitted not just hundreds of millions in America but around the world, but it's also a demanding business, and the margins are low."

With all this said, one thing needs to be said – few are really noticing a change in what they pay.

That’s for two reasons: it’s virtually unheard of for insurance companies to adjust prescription drug copays in the middle of a year, and some of the increases may be built into monthly premiums for the whole system. That means even if you never get doxycycline, you still may be sharing in part of the increase.

What's next?

It may not be long before plans start to adjust, says Sumit Dutta, the Chief Medical Officer at Catamaran, the pharmacy benefits manager.

"Now we may see two tiers, one for low cost generics, one for high cost generics, so that consumers can become aware of some of the drugs that may be hundreds, if not thousands, of dollars for a generic versus the ones that are less than $15 for a generic," says Dutta.

And that’s where the hit to the wallet could come. 

At Royer’s in Ephrata, Cory Minnick is left to call for Congress to get involved, as much as he doesn’t like how that sounds.

"I don’t see an end game. It seems as though the manufacturers right now know what they'll be able to charge," says Minnick

"It almost, I don't want to call it collusion, but it almost seems like collusion because one of the manufacturers will raise their price, and sure enough, two days later, they're all up there at the same range, and certainly their manufacturing costs haven't increased that much in the same amount of time."

The federal government is also curious as well – the Department of Justice has subpoenaed generic manufacturers to get information on their dealings with competitors.

As for relief from the price hikes on pills that have been around for decades, well, the only answer right now is to swallow them.

______________________________________________
One way to 'close the donut hole' is to end Federal Medicare and make it too expensive for seniors to access PHARMA-----that is how a Clinton Wall Street neo-liberal thinks.

Intellectual property is big in TPP and it includes all this biologic technology.  TPP seeks to make sure nations aren't setting up generic mills as India did with old-school PHARMA. 

How does all this relate to medical microchips?  The goal of corporations seeking profit will be to use the American people during the development stages in lieu of clinical trials and then allow costs to soar once a drug or biologic seems safe enough.  That's where main street access to these designer products will start and end.  As with the J-CHIP technology I shared yesterday-----FIRST HUMAN TESTING IN 2012-----we already know they are creating a tiered health system that does not shy away from using American citizens as research patients just as has happened overseas for decades.

ALL OF THE CONSTITUTIONAL PROTECTIONS AND REGULATIONS THAT HAVE MADE AMERICA ONE OF THE BEST AND SAFEST IN THE WORLD IS BEING DISMANTLED.

Add to that the drive to sell their own patented products-----Johns Hopkins and UMMS are  great big biologic product patent mills-------and health systems will be fleecing Medicare and Medicaid for what has always been Research and Development under clinical trials to subsidize this research even more.  We are assured by FDA leader who is a corporate executive that FDA has a strong approval process and yet-----we see medical/PHARMA class action cases soaring from BAD MEDICINE.

All of this incentive towards getting innovative product to market combined with gutting of funding for staff, quality control, and oversight will take an already compromised health system to a dangerous level as they try to install technology that makes all this error increasingly likely.  People may not be fearful of these new technologies----they are about how fast this is happening with a breakdown in regulations that protect.


Medical Errors Harm Huge Number of Patients

What will it take to make America’s hospitals safer?

By Steve Sternberg Aug. 28, 2012 | 5:25 p.m. EDT


Critics Question FDA's Approval Of Zohydro

February 26, 2014 5:00 AM ET Laura Sullivan  NPR

• 
  

Prominent universities and drug addiction organizations are asking the FDA to reconsider its approval of a controversial painkiller called Zohydro. It's 10 times more powerful than OxyContin.



How TPP Would Harm You At the Drug Store and On The Internet



February 24, 2014 Campaign For America's Future.

Intellectual Property and Drug Prices

One example of the way the intellectual property provisions favor giant, multinational corporations over smaller, innovative corporations and regular people around the world is in pharmaceutical prices.

A company with a drug patent is granted a monopoly to sell the drug at any price they choose with no competition. Currently a drug might be patented for a limited number of years in different countries. When the patent runs out other companies are able to manufacture the drug and the competition means the drug will sell at a lower cost.

Leaked documents appear to show that TPP will extend patent terms for drugs. Countries signing the agreement will scrap their own IP rules and instead follow those in TPP. So giant drug companies will have the same patent in all countries, for a longer period, and the patent will prevent competition that lowers drug prices.

Currently smaller, innovative companies can produce “generic” drugs after patents run out. Because of competition these drugs can be very inexpensive. Walmart, for example, sells a month’s supply of many generic drugs for $4, while drugs still under patent protection can cost hundreds or even thousands. This is of particular concern to poor countries that will be under TPP rules.

Please read Expose The TPP‘s section The Trans-Pacific Partnership and Public Health, which begins:

The TPP would provide large pharmaceutical firms with new rights and powers to increase medicine prices and limit consumers’ access to cheaper generic drugs. This would include extensions of monopoly drug patents that would allow drug companies to raise prices for more medicines and even allow monopoly rights over surgical procedures. For people in the developing countries involved in TPP, these rules could be deadly – denying consumers access to HIV-AIDS, tuberculosis and cancer drugs.

I want to spend this entire week speaking on this J-CHIP medical management by microchip that is being developed in Baltimore but will come to all state health systems if it is left to be installed.  First, I want to point out that it is a President running as a progressive liberal toting his desire to help the poor with education and health care-----sending in the most Republican of education and health policies-----and handing Johns Hopkins---the most neo-conservative health institution in the world in a city known to have the worst of health conditions and outcomes-----the green light in what will become a highly abusive health structure for profiteering and far-right health policy.

AGAIN----THEY ARE CALLING ALL OF THIS REPRESSIVE HEALTH POLICY OBAMACARE AND MAKING IT SEEM PROGRESSIVE WHEN THE GOALS ARE MAXIMIZING HEALTH INDUSTRY PROFITS USING WINNING AT ANY COST NEO-LIBERAL POLICY.

These microchip technologies have good applications.  There are people who would want to have this kind of individualized medical oversight------the aging patient who forgets to take meds for example-----the chronically ill who worry about taking meds late or under the wrong biochemical conditions in their bodies.  If this was not the age of global corporate neo-liberalism controlling our government----anything goes with no oversight and accountability----then we could see working these microchip technologies into health care in a responsible way. 

KILLING HIPPOCRATIC OATH KILLS RESPONSIBLE HEALTH CARE.

I want to begin by outing that all of this BIOTech health policy that once functioned in the confines of REAL clinical trials that actually looked out for the welfare of people-----are now totally controlled by people working only to move products to market and maximize profits who fight any attempts at oversight and accountability.  This means----WHAT IS COMING OUT OF CORPORATE UNIVERSITY BIOTECH FACILITIES WILL NOT BE GOOD SCIENCE-----

I worked in medical research for a few decades----I know the processes.  For example, I worked in the development of PCR technology and biomarkers.  I was part of prostate cancer treatment by biotechnology.  Now, almost all of this was funded by Federal NIH and NCI funding and yet----they are patenting these processes and have used them far beyond the time professional data was proving them ineffective.  We heard the same mantra----the development costs for these medical procedures must be recouped.  So, the process in place under Clinton neo-liberals and Republicans under deregulation and no oversight and accountability is to allow medical products to market with little testing to recoup development costs and to monitor symptoms and efficacy on the general population.

Below you see how complex clinical trials have been----all of this trial system is being dismantled as too costly-----and we will not have data that tell us a medical procedure or process does not work---they will only release data that sells the idea that this product helps.

Long-Term Trial Results Show No Mortality Benefit from Annual Prostate Cancer Screening






New data from the Prostate, Lung, Colorectal and Ovarian (PLCO) randomized screening trial show that, after 13 years of follow up, men who underwent annual prostate cancer screening with prostate-specific antigen (PSA) testing and digital rectal examination (DRE) had a 12 percent higher incidence of prostate cancer than men in the control group but the same rate of death from the disease. No evidence of a mortality benefit was seen in subgroups defined by age, the presence of other illnesses, or pre-trial PSA testing. The results were published January 18, 2012, in the Journal of the National Cancer Institute.

When the PLCO researchers published their initial prostate screening results in 2009, which also revealed no prostate cancer mortality or overall mortality benefit from annual screening, critics countered that participants had not been followed long enough to detect a difference in prostate cancer mortality, if one existed.

“The natural history of prostate cancer is so long that 10 to 15 years of follow up is usually the window we look for” when determining the effectiveness of a screening intervention, explained first author Gerald Andriole, M.D., who is chief urologic surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital in St. Louis and the Washington University School of Medicine.

The persistent increase in incidence of prostate cancer in the screening arm of the study may indicate that regular screening can lead to overdiagnosis—finding tumors that never would have caused symptoms or death. “Even if there was just a tiny mortality benefit [from prostate cancer screening], overdiagnosis wouldn’t be so bad if we didn’t hurt people. But we do hurt people by finding a lot of trivial cancers that are most often overtreated,” explained Dr. Andriole.

The PLCO began in 1993 and enrolled men through mid-2001. More than 38,000 men were randomly assigned to annual screening for 6 years (including DRE for the first 4 years and PSA testing for all 6), and the same number of men were assigned to usual care.

Because prostate cancer screening is so common, more than half of the participants in the control arm underwent at least one prostate cancer screening test outside the trial. This contamination made it more difficult to determine whether annual testing affected mortality. However, “the level of screening in the intervention arm was substantially greater than that in the control arm throughout the trial screening period,” wrote the authors.

“Every time we screened [in the intervention arm] we got a bump of excess cases,” said Philip Prorok, Ph.D., a lead NCI investigator on the study. “What we can’t say for sure is whether we would have seen more of an effect on mortality had there been absolutely no screening in the control arm.”

Another recent large trial, called the European Randomized Study of Screening for Prostate Cancer, did report a mortality benefit for prostate cancer screening. Although that trial had less contamination in the control arm, it had other limitations that could bias the results, such as differences in the treatments given to men in the screening and control arms.

To help reconcile the differing results from these two trials—the largest trials to date of organized prostate cancer screening—an effort is under way by the NCI-funded Cancer Intervention and Surveillance Modeling Network (CISNET) to use mathematical modeling to tease out how differences in the trial designs and populations may have contributed to the disparate trial results, explained Paul Pinsky, Ph.D., an NCI investigator on the PLCO trial and consultant to the CISNET project.

“Even though the results seem to be disparate, because one [trial] found a [statistically] significant protective effect [on prostate cancer mortality] and one didn’t, it could be because of the ways the trials were designed and carried out,” he said. The CISNET study began in 2011 and is examining data from the two trials.

Men and their health providers agree that a more definitive answer is needed as doctors and policy makers seek to understand which, if any, men may benefit from routine prostate cancer screening. In October 2011, the United States Preventive Services Task Force released new draft guidelines for prostate cancer screening for public comment. The new draft guidelines, which are based in part on PLCO findings, recommend against routine PSA testing in men who do not have prostate cancer symptoms.

Some doctors think the new recommendations go too far in not accounting for the informed decisions of individual men. “If prostate cancer constitutes a continuum of disease and its overdiagnosis and overtreatment are mainly limited to low-grade disease, then instead of completely eliminating the potential benefits of screening along with the risks, why not consider managing low-risk patients differently?” asked Jeri Kim, M.D., and John W. Davis, M.D., of the University of Texas M. D. Anderson Cancer Center in a commentary published December 28, 2011, in JAMA.

Practice appears to be moving in this direction, with a greater emphasis on active surveillance instead of immediate treatment for some men who have prostate cancer that is thought to be at low risk of progressing. A big advance, explained Dr. Andriole, would be the ability to predict, even before a biopsy, whether a man with an elevated PSA level is likely to have an aggressive versus a nonaggressive cancer.

“There’s a lot of effort now being put into this, and not just for prostate cancer, but for a lot of other cancer types as well,” added Dr. Prorok. “If we diagnose someone with symptoms, or you find something on a screening test, can we eventually find a way to determine for which individuals the cancers are in fact aggressive and need more aggressive treatment, versus some that need less aggressive treatment or don’t need any treatment at all?”

Researchers are looking for biomarkers, including genes and proteins, that may give clues to a cancer’s aggressiveness. “If we could selectively change our criteria for biopsy such that only men who are at high risk for aggressive cancer get biopsied, we might be able to substantially shift the overall risk/benefit [ratio] of screening,” said Dr. Andriole.

• Posted: February 17, 2012
  
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• This is a long article but if you glance through you will see what is an industry being built and released to the public BEFORE all of the foundation principles are identified and validated.  These medical processes are now structured like computer technology where the drive is to roll out one product after the other with no research as to whether it is a positive value for society or if these technologies will be used for the public good.  THERE IS NO ETHOS OR MORAL DISCUSSION HAPPENING AT ALL.  Social democratic principles built all that oversight and accountability and a clinical trial structure that made sure all sides of medical advancement were studied-----Clinton neo-liberals and Republicans deregulated and dismantled all this because the goal is to get new products to market....bad effects will be mitigated with money payoffs as always.
  
  The most blaring issues raised by this article and it is the number 1 reason people do not like Federal funding and public health involved in all this-----IT IS VERY COSTLY BECAUSE IT TARGETS SPECIFIC GENETIC CHARACTERISTICS THAT MAKE EACH TREATMENT UNIQUE TO A SMALL GROUP OF PEOPLE.  INDIVIDUALIZED MEDICINE WILL ONLY BE AFFORDED BY AFFLUENT PEOPLE WITH THE HIGHEST LEVEL OF PRIVATE INSURANCE.
  
  Fast forward to BIOTech facilities tied to mostly Ivy League universities geared to global health tourism. Meanwhile, over 80% of Americans are being tied to these telemedicine-----microchip level of care.  THE ENTIRE PROCESS IS BACKWARDS BEING BUILT FOR VERY FEW.  It does not take a rocket scientist to know that these techologies will be made main stream and be given over and over again earning billions of dollars for corporations and then we will see the data that shows most of those tests proved/improved nothing.  This is because they are not taking the time to develop the basic science.
  
  MEANWHILE, LAW FIRMS TIED TO MEDICAL MALPRACTICE HAVE CLASS ACTION LAWSUITS SOARING FOR BAD MEDICINE----THEY EVEN HAVE THIS CATEGORY----BAD MEDICINE.
  

Biotechnol Healthc. 2004 May; 1(2): 37–41. PMCID: PMC3555164
Explaining The Cost Of Biotech Therapies

BILL EDELMAN



ALL OR NOTHING“The biotech drug market is different from the traditional retail market, in that you have high-cost drugs and few people taking them. Many of these are orphan-status drugs that get propelled through the FDA approval process as a result,” says Greg S. Weishar, president and CEO of PharmaCare Management Services, a pharmacy benefit manager and parent company of PharmaCare Specialty Pharmacy. “Health plans are in the insurance business, and they’re in a dilemma. They’re trying to control costs, and these drugs have very few alternatives.”

Weishar gives this example: For multiple sclerosis, there are few, if any, viable therapeutic alternatives to interferon β-1a (Avonex or Rebif) — the gold standard for MS patients for MCOs.

When the MCO must choose between a chemical therapy and a biotech therapy, the principal variables to weigh are safety, efficacy, and cost. But when the choice is between covering a biotech therapy or providing no viable coverage, the equation is simpler, because depriving an MS patient of the only effective treatment available invites a public relations disaster.

Though only a few patients in a given plan population are diagnosed each year, Weishar observes, the MCO providing this therapy takes a big financial hit.

“At its most fundamental level, insurance is about taking care of people who have a very expensive condition to treat. That’s what it is all about; insurance is catastrophic,” Weishar says. “It’s a question of risk exposure to the insurance company. Only 1 percent of its population needs the drug. The question is, how should the insurance company or health plan manage that 1 percent of covered members who need Avonex [or Rebif]? Probably, the best way to manage those patients is to give them the drug.”

Jeff Kimmell, RPh, vice president and general manager of pharmacy for drugstore.com, agrees that the nature of orphan biotech drugs means that they have an easier path through the MCO approval process: “Uniqueness buys you something, though MCOs will still question whether the patient needs that particular drug. If you can find the item that is unique and provides 5 or 10 percent more effectiveness or 5 to 10 percent fewer side effects, that is what patients will want and physicians will demand. If physicians tell the MCOs, ‘Don’t make me jump through hoops; this is, far and away, the better product,’ the MCOs will start paying for it without question.”

VIABLE OPTIONS

In contrast to Avonex, omalizumab (Xolair) has multiple competitors and is used to treat a common condition, asthma. “Because there are some quite good treatment alternatives for asthma, step therapy is a viable strategy and health plans have the ability to winnow that one tenth of 1 percent of asthma patients who really need Xolair,” Weishar points out. At $700 per prescription, Xolair is reserved for those few patients who cannot obtain acceptable results using chemical-based options.

Indications for the use of biotech drugs are expanding, and physicians are prescribing them increasingly. Joel Owerbach, PharmD, vice president and chief pharmacy officer for Excellus BlueCross/BlueShield estimates that the expense of biotech drug therapy increases by 30 to 50 percent annually. To decrease waste and its inherent expense, ensuring appropriate use is vital. “We need to evaluate whether a person should get the drug, determine who has the best chance of responding to it, and make sure we get the best return on the investment, which means getting the best outcome,” Owerbach says. “We need adequate proof that the patient is responding to treatment, the drug is controlling the condition, and the patient is going to avoid complications later.”

Kimmell likens this paradigm to the emergence of the earliest mass-market drugs. “When we first developed traditional pharmaceuticals, we were able to develop a few strains to take care of everybody and his brother. Anybody in the world who had an infection was able to take penicillin and get better,” Kimmell observes. “Then we had to make erythromycin because of penicillin allergies. Now, we’ve progressed to biotechnological drugs.”

Pharmacogenomics likely will yield effective drugs to people with similar genetic make-ups. Despite physical differences, persons can be so genetically alike that they can be grouped; a drug custom-designed to produce positive clinical outcomes in them may not be as effective for other genetic types. Yet finding patients who will respond best to a specific therapy necessitates biologic assays costing $100 to $700 or more. Many assays are either not covered by health plans or are covered at the Medicare rate — which often amounts to a fraction of the cost of the test.

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Not many people know or understand what has been the focus of medical research for two decades-----with Wall Street corporations bought and sold like crazy.  BioTechnology has taken the concept I show above-----finding genetic markers and then targeting those markers with different treatments----sometimes involving light, chemicals, and even living combatants.  These technologies are as interesting as all nanotech and robotics being installed.  The problem falls in the variability and arbitrary nature of these processes.  PHARMA used a chemical compound as in aspirin that was known to migrate through body systems to the point of inflamation.....the precision needed for these new technologies----and the specificity of applications to individuals and treatment will assure problems for far into the future----a few decades let's say.  The J-CHIP being developed by Johns Hopkins seeks to integrate what is an already complex set of biotechnical activities. 

When Hopkins says it is taking these technologies out into Baltimore's underserved communities for testing and development----we are talking very serious medical invasion.  Just the faith in a technology's reliability in releasing whatever chemical treatment into someone's body remotely -------and then the measurements and data capture-----can be a great risk.  Not to mention the intent to use treatments that are as of yet not proven efficacious.... meaning providing improvement.


HOW MUCH CLINICAL TRIAL TESTING ON HUMANS HAS THESE TECHNOLOGIES HAD -----OR IS THIS MOSTLY LAB TESTED? 

We have no Federal public health or Baltimore City public health reporting these figures that I know of.  IMEC below is a partner global corporation in these technology applications ----having a broad field of applications including human body tracking.  We know it is these corporations and their data being presented as successful -----and the Federal government whether Department of Health and Human Services or the Food and Drug Administration are NOT LOOKING AT THE VALIDITY OF THESE DATA.


About IMEC Technologies


IMEC Technologies is a supplier of data collection and Track and Trace solutions for use in regulated industries and healthcare environments. Our customers include some of the world’s leading organisation including Pfizer, American Airlines, Kerry Group and GlaxoSmithKline. Headquartered in Urbana, Illinois the company also has development and sales offices in the UK and Ireland.

IMEC Technologies’ solutions include

• HazMat T&T, a Waste Management system used to track and trace all waste streams within organizations such as hospitals, oil and gas companies, chemical and pharmaceutical companies;
• Inspector T&T a web based inspection system that will schedule, track, manage and report on any type of equipment, asset, location inspection or audit on a predefined planned schedule or on and ad hoc basis;
• Navigation Material Movements, an RF Material Tracking System to track and report on material movements within a manufacturing company, Navigation Enterprise Labelling(NEL) which is a FDA and GMP compliant label design, approval, control, printing and reconciliation system for use in life science industries.

Biomedical chip technology: Small but powerful tools for our health


By Kris Verstreken, MD, PhD and Hanne Degans, PhD –  Imec

March 9, 2011 — How will nanoelectronics and nanotechnology contribute to prevention, diagnosis, therapy and post therapy of diseases? Will the introduction of nanoelectronics in pharmacy bring a breakthrough in developing revolutionary therapies such as immuno- or gene therapy? The continued scaling of chip technology resulted in nanoelectronics dimensions evolving increasingly toward cell dimensions, cell parts, and even molecules. As a result, electronic and biological functions can interact, and new applications arise in the area of biomedical electronics.

Biosensor technologies combining a biological identifying element (protein, DNA/RNA, virus, cell) with a physicochemical detector component are widely applicable in drug development at all stages of the development track (from lab to clinical tests), for localized therapy, for inexpensive and comfortable tools for post-therapy, for early diagnosis (genetic profiling) and even for prevention. Innovative biosensors based on nanoelectronics and nanotechnology will be key to creating a better, patient-oriented and less expensive healthcare in the future.

The pharmaceutical industry’s interest in disease diagnosis is growing. These days, diagnosis is being carried out especially by post-symptomatic analysis and diagnosis in laboratories. In the future, technologies based on nano-electronics will enable diagnosis by means of genetic or other early screening of patients, and therapies will be administered with personalized observation. Biomedical electronics will also improve treatment efficiencies and reduce its costs. Sensor-based technologies will enable localized therapy, only intervening when necessary and reducing the side effects of a treatment. Post-therapy based on nanoelectronics will be less burdensome on the daily life of the patient. Such instruments should be low-cost, portable, and comfortable in maintenance and operation.

An essential aspect for the pharmaceutical industry is that new measuring methods are not only fast and efficient; they should also be widely applicable and therefore can be produced in large volumes at reasonable cost. The industry is looking for instruments that can be used not only for drug development, but also during the post-therapeutic stage, to keep an eye on the patients that participated in the clinical tests for drug development. These instruments that will be used for genetic profiling for disease diagnosis and prevention.



Figure. General concept of a biosensor to detect a target in blood.

New measuring methods using nanoelectronics-based biosensors are of key interest to the pharmaceutical industry because of the variety of applications. They are useful for diagnosis, but also in lab studies (genetic profiling), for preclinical and clinical tests, and for therapy and post therapy. Molecular biosensors detect a biomarker (antibodies, enzymes, DNA, diseased cells, foreign substances such as radioisotopes) in blood. They allow fast, exact and very specific measurement of a biomarker or of several different biomarkers at the same time. Biomarkers are blood substances that are characteristic for a certain biological condition and therefore can be used to determine diseases. A biomarker can be a genetic code within the DNA that is characteristic for a particular disease; but it can also be a diseased cell, such as a cancer cell. Additionally, biomarkers can be foreign substances such as radio isotopes, which are being injected into the blood to examine, for example, organ functions. In order to detect biomarkers in the blood, a blood sample needs to be analyzed. Currently, time-consuming and expensive lab tests have to be carried out in several steps to detect biomarkers. When molecular biosensors are integrated into an electronic system (lab-on-chip), detection can be done much faster and cheaper. Imec develops lab-on-chip systems, such as a breast cancer diagnostic system that can detect cancer cells.

Chip technology’s role in healthcare has the world’s attention. Nanoelectronics will help more patients than we can today, at a lower cost price and for a larger number of diseases, or at least such is the hope. Imec’s research supports the necessary innovation of biomedical instruments for prevention, diagnosis and therapy. Within its life science program, imec cooperates with industrial partners for smart electronic systems in order to study diseases, diagnosis and disease therapy: lab-on-chip systems, nanoparticles for treatment of diseases, technologies for intelligent implants, etc.

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This list of research on microchip delivery systems is not all that has been done of course----I simply wanted to show how new all of this is-----below you see the first in  human testing in 2012 for goodness sake.  The rest fall within the last decade.  Clinical trials have historically taken a decade or so and that was not for basic science like this which takes much longer.  Because we have Clinton neo-liberals and Bush neo-cons making all policy about maximizing profit-----the goals here are simply to move products to market as fast as possible and then pay off people getting harmed.

If you are like me----regardless of the efficacy and research ---I do not want to be forced to be involved in remote medicine.  What Affordable Care Act did was to require health insurance and gave corporations the power to tell citizens what they must submit to in order to stay on a health plan.  They will boost the rates if you decline to a point you cannot afford----just as they are pushing all this SMART METER technology on everyone.

Publications Farra, Robert, et al.


"First-in-human testing of a wirelessly controlled drug delivery microchip." 

Science Translational Medicine 4.122 (2012): 122ra21-122ra21.


This first-in-human clinical trial evaluated the pharmacokinetic profiles of human parathyroid hormone (hPTH(1–34))delivered by the microchip-based implant versus subcutaneous injections. Results indicated that the release profile of hPTH(1–34) from the microchip-based implant was comparable and bioequivalent to the profile of subcutaneous injections. In addition, patients reported positively when surveyed about their implant experience.

Prescott, James H., et al.

"Chronic, programmed polypeptide delivery from an implanted, multireservoir microchip device."

 Nature biotechnology 24.4 (2006): 437-438.
This first-in-animal study evaluated the ability of the microchip-based implant to deliver leuprolide (an analog of a luteinizing hormone-releasing hormone that is marketed for the treatment of prostate cancer and endometriosis) over a 6-month period in dogs. Results supported the feasibility of applying microchip-based implant technology to deliver other therapeutic peptides and proteins. In addition, the study suggested that drug delivery from an array of discrete reservoirs is not restricted to solution-phase drug formulations, and that stability-optimized, solid-phase drug formulations can be packaged and released in vivo.

Grayson, Amy C. Richards, et al.

"Multi-pulse drug delivery from a resorbable polymeric microchip device." 

Nature materials 2.11 (2003): 767-772.
The Microchips Biotech IP portfolio includes both electronically-controlled reservoir implants as well as preprogrammed, non-electronic reservoir-based implants, made of resorbable polymers. This study evaluated the functionality of a biodegradable microchip implant and demonstrated that timed, pulsatile delivery is possible by varying the molecular mass of the membranes covering each reservoir.

Just to update people on Medicare under Obama -----I have already shown that Obama spent these several years outsourcing all of Federal Medicare and Medicaid agencies to private, global health corporations and after gutting funding of Medicare and Medicaid of a $1 trillion dollars with the help of Clinton neo-liberals in Congress, now have 'streamlined' the Medicare and Medicaid process so that the American people cannot access care even when it means life or death.  Obama is saving Medicare billions by making sure people cannot access health care and yes, a record number of American citizens are dying from ordinary health conditions just as any third world nation.

The Affordable Care Act was simply meant to end Federal Medicare and Medicaid and create in the US the same health delivery model using wellness and preventative care only to replace what was a first world quality health care people paid payroll taxes for decades to receive----sorry, the Medicare Trusts was looted by massive health industry fraud and this coming bond market crash FROM BOND FRAUD is designed as an excuse to say ----NO MORE SOCIAL SECURITY AND MEDICARE TRUSTS!

You know something is terribly wrong when a President running as a progressive liberal wanting to save and strengthen Medicare partners with Johns Hopkins University---the very neo-conservative health institution that pushed for Maryland's exemption from Medicare for decades creating what was an ability to deny citizens of Maryland and especially Baltimore access to the level of Medicare and Medicaid coverage ALL OTHER STATES WERE LEGALLY MEANT TO PROVIDE.  So, Maryland pools all Federal health care funds for Medicare and Medicaid and then does with them what corporate pols want---much never reaching seniors and the poor.  Hopkins is the face of ending Medicare and Medicaid and has communities surrounding its campus with people dying 20-30 years earlier than more affluent communities all because of this exemption from Medicare that kept people from accessing ordinary health care.

THIS EXEMPTION WAS NEVER LEGAL-----BUT WHEN CLINTON NEO-LIBERALS CONTROL THE PEOPLE'S DEMOCRATIC PARTY---NO ONE CONTESTS THIS.

The goal of Affordable Care Act was to move all US citizens over to a private Medicare called Medicare Advantage and then end Medicare Advantage.  Obama and Clinton neo-liberals wrote law to end Medicare Advantage in 2020.  This will keep over 80% of people from accessing the Medicare for which they paid payroll taxes for decades.

100 million is already 1/3 of Americans tied to these Federal health programs that are being privatized.

CMS covers 100 million people......through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace. But coverage isn't our only goal. To achieve a high quality health care system, we also aim for better care at lower costs and improved health.


But we can't and we don't do it alone. We need your help to find the way forward to a better health care system for all Americans.


Learn more about how we can help each other so all Americans have access to coverage, better care, and improved health.

• Medicare Advantage premiums remain stable; enrollment at all-time high
• CMS Releases First Ever Plan to Address Health Equity in Medicare
• CMS awards $67 million in Affordable Care Act funding to help consumers sign-up for affordable Health Insurance Marketplace coverage in 2016
• CMS announces Value-Based Insurance Design Model to improve care and reduce costs in Medicare Advantage Plans
• 2015 Special Enrollment Period Report – February 23 – June 30, 2015

J-CHIP by Medicare and Medicaid will create public private partnerships run by an institution controlling health care in Baltimore while it racked up life-expectancy numbers lower than anywhere in the nation----or third world.  J-CHIP is the installation of micro-chips to manage all aspects of your body!


Johns Hopkins Medicine Awarded $19.9M Innovation Grant from CMS for its J-CHiP Program


Release Date: June 18, 2012

The Johns Hopkins University School of Medicine, in collaboration with the Johns Hopkins Health System (together known as Johns Hopkins Medicine, or JHM), has been awarded a $19.9 million grant by the Centers for Medicare & Medicaid Services (CMS), over a three-year period, to improve the quality and efficiency of health care delivered to JHM patients.

The grant is part of CMS’s $1 billion Healthcare Innovation Challenge, a competitive initiative that seeks to identify and support innovative opportunities to improve care delivery and achieve its three-part aim of “improving the individual experience of care, improving the health of populations, and reducing the per capita costs of care for populations.”  

“This grant gives us the unique opportunity to expedite our work to reform health care delivery, provide increased value to our patients, and improve the health of our community,” says Edward D. Miller, M.D., dean/CEO of Johns Hopkins Medicine.

According to Miller, the Johns Hopkins Community Health Partnership (J-CHiP), recipient of the grant, will create a unique Baltimore-based partnership to achieve the three-part aim through the collaboration of many entities: The Johns Hopkins University, including the university’s schools of medicine, nursing and public health; Johns Hopkins Community Physicians, one of the largest primary care networks in Maryland; Johns Hopkins Home Care Group, the full-service home care provider arm of JHM; the Johns Hopkins Urban Health Institute; CMS; the state of Maryland; the city of Baltimore; Priority Partners, a Medicaid managed care organization owned jointly by Johns Hopkins and the Maryland Community Health System, a consortium of federally qualified health centers including Baltimore Medical System; five local skilled nursing facilities; and several other community organizations. J-CHiP will work closely with community representatives to ensure that its efforts are directly responsive to the unique needs of the East Baltimore community.

“This grant will permit the J-CHiP program to have a significant impact on JHM care delivery,” Miller says.  “By its third year, J-CHiP will reach over 50,000 patients; create over 100 innovative health care jobs, such as care coordinators, behavioral coaches and nurse case managers; and train or retrain thousands of health care workers. By reducing unnecessary admissions and readmissions, emergency department visits and other expenditures through improved care coordination and high-quality care programs, J-CHiP will simultaneously reduce health care costs.” Through improved care measures, it is estimated that the J-CHiP program could save Medicare and Medicaid just over $50 million during the three-year window.


According to Miller, J-CHiP will accelerate ongoing efforts to promote high-quality, patient-centered care by:

• Improving community health and reducing health disparities for the underserved East Baltimore population in the seven zip codes surrounding The Johns Hopkins Hospital (JHH) and Johns Hopkins Bayview Medical Center (JHBMC) by coordinating and enhancing primary care services for Medicare and Medicaid patients with chronic disease, substance abuse, and/or mental illness. These patients account for a disproportionate share of health care services and dollars. Full integration of behavioral health care into care delivery is a key feature of J-CHiP.
  
• Improving acute and post-acute care delivery using transdisciplinary care coordination that will touch nearly every patient admitted to JHH and JHBMC. This program builds on the ongoing efforts of the Johns Hopkins Health System Readmissions Task Force, and it includes a bundled intervention: multidisciplinary rounds, risk screening for post-acute services, medication management, patient-family education and post-acute transition services.  It will forge partnerships with five skilled nursing facilities in the neighboring seven zip codes to deploy JHBMC Care Center best practices and staff to avert unnecessary returns to acute care.

Because of the importance of this CMS grant and its potential to transform how Johns Hopkins delivers health care, it will be directed by the top leadership of JHM. Miller will initially serve as project director for J-CHiP, a role that will be assumed by incoming Dean/CEO Paul Rothman on July 1. Patricia Brown, president of Johns Hopkins HealthCare LLC (JHHC), will act as deputy project director. Miller and Brown, as well as Johns Hopkins physicians, faculty, administrators, medical directors, behavioral health experts, nurses and other staff, have been working for months to refine and improve the J-CHiP program while awaiting a funding decision.

According to Brown, J-CHiP will be further strengthened by JHHC’s longstanding successful experience in managing a major Medicaid managed care program and championing innovative care delivery models in support of population health. A leader in innovative health care solutions, JHHC was created in 1995 as a partnership between the Johns Hopkins Health System and the Johns Hopkins University School of Medicine to develop and administer contractual health care relationships with managed care organizations, government programs, employers and health care providers.

A major focus will be the health of the surrounding East Baltimore community. J-CHiP will work to reduce glaring health disparities in East Baltimore and translate its experience to inform other urban medical centers around the country. “J-CHiP will create new jobs, strengthen community and public-private partnerships, improve the quality of care for our patients and better enable JHM to serve as a ‘public trust,’” Brown says. “By developing and testing health care innovations, as a ‘learning laboratory,’ JHM seeks to demonstrate how academic medical centers can add significant value to care delivery in the health care reform era.” 

John M. Colmers, JHM vice president of transformation and strategic planning adds, “JHM aims to become a leader in providing integrated, patient-centered care across the care continuum. The J-CHiP program, and federal grant funding in support of it, takes us one giant step closer to that goal.”

_______________________________________________

The entire world has all of last century been amazed at the performance of America's Medicare System.  It is the largest public health system ever and it worked like a charm.  People received accurate easy to understand statements------the data was kept private as HIPPA requires------and analysis of all this massive database was always ongoing to provide stats that allowed medical researchers and government to know health outcomes were good and people were receiving quality and safe health care.  AS WITH THE FEDERAL HOUSING AGENCY----AS WITH THE FEDERAL STUDENT LOAN AGENCY----AS WITH THE SMALL BUSINESS AGENCY----AS WITH THE FEDERAL AGRICULTURAL AGENCY-----all these Federal agencies worked effectively and efficiently until they were outsourced to corporations that simply wanted to use them for fraud and implode these Federal programs to end them.  Well, that is what Obama and Clinton neo-liberals in Congress are trying to do with Federal public health Medicare and Medicaid. 

The effective use of Medicare ended when Reagan/Clinton started the privatization and downsizing of these agencies allowing massive and open fraud of our Medicare Trust----just as Bush did.  Medicare data was then not used to assure quality and safety----it was used for private medical research sold to produce products that were then largely found to harm people.

Below you see where Baltimore has become the home base for Medicare and Medicaid technology privatization and the super-computers at Hopkins will receive all Medicare and Medicaid data where absolutely no public interest analysis will occur. 

April 30, 2013
Contact Mark Meudt
Tel: 703 995 4994
Mark.Meudt@gdit.com

General Dynamics Awarded $20 Million for Centers for Medicare & Medicaid Services


IT SupportFAIRFAX, Va. – General Dynamics (NYSE: GD) has been awarded a contract by the U.S. Department of Health & Human Services’ Centers for Medicare & Medicaid Services (CMS) to support the Beneficiary Eligibility Suite of Systems Transactions (BESST) program.  The BESST systems maintain Medicare beneficiary eligibility information and support critical components of CMS’s core healthcare mission.  This contract has a potential value of $19.9 million over five years.

Under this contract, General Dynamics will help maintain and enhance BESST systems.  The company will create and maintain critical links between new and existing CMS systems as well as implement software enhancements.  Additionally, General Dynamics’ experts will provide program management, documentation and training services and support special projects for the HIPAA Eligibility Transaction System.  Work will be performed in the Baltimore, Md., area. 

“The systems maintained by the Centers for Medicare & Medicaid Services are critical to ensuring beneficiaries receive accurate and efficient services,” said Marcus Collier, senior vice president of General Dynamics Information Technology’s Health and Civilian Solutions division. “General Dynamics supports CMS on many of its core programs and we will leverage this experience to bring additional value to the BESST program.”

General Dynamics delivers operations and maintenance support for several Centers for Medicare & Medicaid Services programs including the Early Retiree Reinsurance Program (ERRP), Retiree Drug Subsidy (RDS) program and the ViPS Medicare System (VMS).

For more information about General Dynamics Information Technology, please visit www.gdit.com.

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Below you see where the world understands that Baltimore citizens have living conditions no better than third world nations and it centers on Johns Hopkins and Wall Street Baltimore Development's control of government and all revenue in the city.  The conditions for huge health problems coming from poverty happens because Hopkins wants a stagnant economy with high unemployment and public policy is written and passed by Baltimore pols to do just that.

Failure to allow Federal funds meant to be directed to public housing, public health, public education, etc and moving those funds to grow Hopkins' corporate control in the city and overseas gives Baltimore its third world status.  Now, as someone who spent much of a career in medical research and academics -----KNOWING WHAT HIPPOCRATIC OATH AND THE ETHOS OF DOCTORS TO HEALING WHAT AILS PEOPLE-----we understand that Hopkins has served as a very negative force in the health of the citizens of Baltimore.

People say ALL THEY DO IS HAVE US ANSWERING QUESTIONS----PARTICIPATING IN HEALTH STUDIES----and indeed---that is the extent of real health care in Baltimore.  Trauma victims coming into emergency rooms because Federal law prohibits people being refused care in these emergency cases is a social good that is lost in the complete lack of trust citizens have in intent of Hopkins as an institution.

WHY WOULD OBAMA AS A DEMOCRAT PLACE A LARGE AMOUNT OF CONTROL OF A PRIVATIZED MEDICARE AND MEDICAID TO AN INSTITUTION THAT HAS PROVEN DISREGARD TO WHAT THEY SEE AS HUMAN CAPITAL?

The goal of Affordable Care Act was simply to make global health systems for profiteering and to meet Trans Pacific Trade Pact requirements that public health in nations be minimal.


One American City Rivals the Poor Youth of New Delhi, India for Some of the Worst-Off Teens in World



By Kara Pendleton (10 months ago) | Culture, Economy, Nation, World

A recent “WAVE” study highlights the problem of child poverty in the United States and around the globe, with findings that are shocking.

The researchers found many similarities—in all five cities, adolescents were exposed to unsanitary conditions, substance abuse and violence—but the differences between each area were especially compelling. Overall, teenagers in Baltimore and Johannesburg, despite being located in comparably wealthy countries, had far worse health outcomes and tended to perceive their communities more negatively.

The main categories studied were social cohesion, physical environment and witnessing violence in the community.

Baltimore, the only U.S. city in the study, ranked among the highest of the five study cities in witnessing community violence (only Johannesburg was higher). It ranked lowest in social cohesion, which is the level of emotional support teens get from family and neighbors. And Baltimore was in the middle of the pack in the physical environment measurements.

Voactiv notes about the disparities:

In Baltimore, which is located in the world’s richest nation per capita and just 40 miles from the White House, adolescents exhibited considerably high rates of mental health issues, substance abuse, sexual risk-taking, sexual violence and teen pregnancy.

In comparison, adolescents in New Delhi exhibited far fewer of those behaviors and outcomes, despite residing in a much less prosperous nation.

Forbes has also reported on child poverty and how the global financial crisis has impacted it. This chart, courtesy of Statistica, is particularly revealing:

In Greece, for example, the financial crisis hit so hard that charities and churches saw a massive spike in children being given up for adoption.

Families were too poor to provide for them, and likely felt that by ceding their offspring to churches and other charities they would at least have shelter and food. The BBC reports:

Cases like this are shocking a country where family ties are strong, and failure to look after children is socially unacceptable – and it’s not happening in a country ravaged by war or famine, but in their own capital city.

The startling fact the chart reveals is that as bad as childhood poverty has gotten worldwide, our own childhood poverty level in 2008 was among the worst and was higher than some nations that saw massive spikes in 2012.

BALTIMORE UNDERSERVED COMMUNITIES NEVER RECEIVED ALL OF THE FEDERAL SAFETY NET FUNDING---THESE WERE DIVERTED SO DON'T SAY SAFETY NETS FAILED IN BALTIMORE.

While some may conclude that the need for a stronger social safety net is needed for these communities, after more than fifty years of that approach, it may be time for fresh ideas.

What is glaring in these poor communities is not how much damage and injustice has been done to people by free market capitalism, but how much it is sorely lacking. Worldwide, the marketization of economies has led to a drastic reduction in poverty. Why not try introducing it in impoverished communities in America? It’s worth a shot.

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When all your health stats are captured by a private health corporation like Johns Hopkins the health data that comes out is not accurate---it is juked.  Maryland data states that all the funding sent to address health issues around lead paint are working and stats look good when as we see below----the problems are worse as people are being allowed more and more to live in unsafe housing.  I attended a social health justice meeting in which doctors stated openly health policies are not pursued that may curtail the business of specific health specialties and this happens when health care in a state like Maryland has been made all about profits with no oversight and accountability of patient care.

If you think having a health institution that does not care about people simply because they cannot PAY WHAT THE MARKET BEARS-----you are getting ready to join Baltimore citizens in the worst of health care ----third world clinic care gets you a checkup and a shot/meds for communicative diseases. 

THIS IS WHERE THE AFFORDABLE CARE ACT EXPECTS TO HAVE OVER 80% OF AMERICANS -----WITH ALL OF HEALTH PROFITS CENTERED ON HEALTH TOURISM.

Creating a system that denies health access to US citizens while expanding to look for consumers elsewhere-----THAT IS WHAT SOCIOPATHS LOOK LIKE.

The US Constitution has laws that require this health access be available to all citizens-----it requires that payroll taxes paid for Medicare and Federal funding for Medicaid be used to provide access of all citizens to the health procedures developed USING FEDERAL, STATE, AND LOCAL TAX REVENUE.  Federal funding paid for the medical research for ordinary procedures now being denied many citizens.

I HAD A YOUNG STUDENT VISTA FROM OUT OF TOWN SAY TO ME-----IT LOOKS LIKE THEY ARE JUST THROWING MONEY IN THESE COMMUNITIES WITH NO GOALS OR OVERSIGHT----I SAID---THAT IS WHAT US NGOs DO TO FUNNEL MONEY TO THEMSELVES!




'restoring it to $15 million in 2014. Just cleaning up Baltimore’s problem could easily cost that much.'

$15 million falls out of the pockets of the mayor coming from a Board of Estimates meeting in one day!


Public Health 8:51 AM May 7, 2015

Baltimore’s Toxic Legacy Of Lead Paint


By Anna Maria Barry-Jester

The red brick rowhouses on Inez Robb’s block in West Baltimore feature ornate cornices and detailed carvings above the doors and windows. Leaves are beginning to fill the trees along the median that divides the pristine block, though slender trunks betray their young age. Robb moved into her home in 1987 with a first-time home buyer’s grant from the city, just a few years before Freddie Gray and his family would move to a building that looks remarkably similar from the outside, just over a dozen blocks away.

Both blocks are located in Sandtown-Winchester, a neighborhood less than a square mile in size that came to national attention last month when Gray, 25, died after sustaining injuries while being transported in a Baltimore police van. As the media reported details of Gray’s past, it emerged that in his early years, he’d been poisoned by lead, one of the most devastating neurotoxins on the planet and one that’s especially common in Baltimore because of its poverty and the age of its housing stock.

State tests found more than 65,000 children in the city with dangerously high blood-lead levels from 1993 to 2013. Across the United States, more than half a million kids are poisoned by lead each year, and the majority come from cities like Baltimore: rust belt towns built up during the first half of the 20th century when leaded paint was dominant. As populations and employment opportunities shrank in recent decades, poverty and neglect combined with older housing allowed lead paint poisoning to plague the city.

Despite sharp declines, the city of Baltimore still has nearly three times the national rate of lead poisoning among children, and a look at the data reveals that, like other health disparities, just a handful of neighborhoods are responsible for almost all of the city’s cases over the last five years. Sandtown is one of them.

But even these relatively stark statistics hide much of the problem. The data here represents children with blood-lead levels of 10 micrograms per deciliter (ug/dL), while the acceptable limit was halved to 5ug/dL by the Centers for Disease Control and Prevention in 2012 after decades of research showed there is no safe threshold for lead exposure. More than a thousand children tested for blood-lead levels between 5 and 9 ug/dL in 2013 in Baltimore, according to the Maryland Department of the Environment.

Lead paint can be absorbed through the skin, and even a small amount of dust from frequently used doors and windows is a risk without professional abatement. Exposure to larger, lethal doses of lead is mostly non-existent in the U.S. today, but ingesting even tiny amounts can have lifelong effects, and is particularly dangerous for children under age six. Speech delays, lack of impulse control, aggressive tendencies, ADHD and other learning disabilities have been associated with exposure to lead. While it’s impossible to draw relationships between lead paint and an individual’s behavior, what happens when a population is exposed to lead is pretty clear, and it’s not pretty.

Though Baltimore has had a long and toxic relationship with lead paint, the city was originally at the forefront of enacting legislation to limit exposure for children. In 1949, the Maryland legislature was the first to ban the use of lead paint in children’s toys, but the law was overturned after pressure from the lead industry. Baltimore was the first city to offer free blood-lead level testing under the watch of an enterprising health commissioner who also spent decades showing the damage it did to the city’s children. Johns Hopkins University, located in Baltimore, was the epicenter of knowledge on the effects of lead poisoning in the 1950s, years before it approved a notorious study that knowingly exposed children to paint and dust in an effort to find cheap abatement techniques, and ended in a class-action lawsuit.

In the book “Lead Wars,” David Rosner, a professor at Columbia University, and Gerard Markowitz, a professor at the City University of New York, cite internal documents from the lead industry and other sources to write a compelling history of industry manipulation of data to both lay the blame on parents and families for the crisis of lead poisoning, and to keep it in products through the 1970s. In reality, the authors argue, the federal government was aware of the many dangers posed by lead, and in bowing to pressure from industry, allowed millions of children to be poisoned.

Federal legislation finally banned the use of lead paint in 1978, but by then it was in homes all over the city, and Baltimore had begun what would be a steep economic decline, leaving an increasing number of children at risk for lead poisoning as the old housing stock deteriorated.

Though dramatic reductions in lead poisoning have been made over the last two decades, inner-city kids from low-income black families still bear the burden of this legacy.

A national survey conducted in 1998-1999 found that an equal percentage of black and white families lived in homes with federally recognized risk for lead exposure. A follow-up study in 2006, the most recent national survey on housing hazards, found that, while there had been a significant drop in the percentage of white families who lived in homes with a serious lead-based paint hazard, the percentage of black families had actually increased from the previous survey [page 36].

Ruth Ann Norton, the president and CEO of Green & Healthy Homes Initiative, a national organization based in Baltimore that works to eradicate childhood lead poisoning, said the city’s historic blind eye to enforcement of laws regulating dangerous homes, and lack of will for serious investment, has left people languishing in toxic housing. In some ways, she said, the recent successes in reduction are hurting the people still at risk.

“When we tell people we’ve had a 98 percent reduction, I sometimes get applause,” Norton said in phone interview. “But the rest of that sentence is that we still have 535,000 children a year being poisoned in the United States.”

Funding for lead abatement has been subject to the same political and economic push-and-pull as many social programs. Back in 1990, the Department of Health and Human Services planned to spend $33 billion to clean up homes around the country, but only a fraction of that has been spent. In 2013, amid cutbacks, Congress slashed funding for lead abatement from $23 million to $2 million before restoring it to $15 million in 2014. Just cleaning up Baltimore’s problem could easily cost that much.

Inez Robb bought her home in 1987, at a time when the city was planning to fix up Sandtown-Winchester. Her entire block was remodeled as part of a revitalization project, and the homes are safe from lead. Today, most of the units on the block are occupied, even as the number of vacancies in the neighborhood grows. She and her neighbors don’t like the way the community has been portrayed over the last couple of weeks (“If you didn’t know, you would think that everyone was impoverished and uneducated, and it was a neighborhood full of rentals,” she said), but she acknowledged that vacant lots, empty buildings and decaying structures are holding the neighborhood back. While some people question what good came of the revitalization money, Robb sees her block as proof that housing problems can be fixed. But there is much more to be done.

CLARIFICATION (May 7, 9:52 a.m.): This article has been updated to clarify remarks made by Ruth Ann Norton reflecting the fact that while enforcement of lead laws has historically been a problem in Baltimore, it has improved over the last 15 years.

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Obama and Clinton neo-liberals are doing to health care and public education what Republicans have tried for decades to do-----privatize and deregulate these industries so they can do what they want to earn profit.  Predatory health care will become VERY SCARY STUFF and no regulatory oversight will create the conditions for death and harm to soar all while no public interest data surfaces to let us know.

Handing the Federal Medicare and Medicaid along with all health delivery to ACO----health organizations that are simply global health corporations made rich robbing our Medicare Trust and Medicaid funding dry with fraud-----is not how to create an efficient and effective system. 

IT WAS NEVER MEANT TO----IT IS GEARED TO THE CHEAPEST OUTLET AND SENDING THE HUNDREDS OF BILLIONS OF DOLLARS FROM OUR FEDERAL PROGRAMS TO GLOBAL CORPORATIONS IN SUBSIDY AND THEFT.

Each state can install the platform for an Expanded and Improved Medicare for All which would bring back all those funds stolen by fraud and profiteering and build the oversight and accountability to STOP ALL THESE LOSES.  At a time when Wall Street and global pols are using the bond market to implode the economy again all to say----

SORRY, THERE ARE NO FEDERAL TRUST FUNDS---NO CORPORATE HEALTH PLANS------ONLY PREVENTATIVE CARE FOR ALL!

A Healthy Bottom Line:
Profits or People?

By Claire Andre and Manuel Velasquez

In Alameda County, a private hospital turned away a woman in labor because the hospital's computer showed that she didn't have insurance. Hours later, her baby was born dead in a county hospital.

In San Bernardino, a hospital surgeon sent a patient who had been stabbed in the heart to a county medical center after examining him and declaring his condition stable. The patient arrived at the county medical center moribund, suffered a cardiac arrest, and died.

These two hospitals shifted these patients to county facilities not for medical reasons, but for economic ones -- the receiving hospitals feared they wouldn't be paid for treating the patient. These patients simply weren't "good business."

With little public warning, a concern for "good business" has moved to the heart of health care, a sector once relatively insulated from the pursuit of profit that drives the rest of the U.S. economy. Throughout our history, medical institutions have largely been "charitable," nonprofit establishments existing primarily to serve the community. But during the past 20 years, the number of for-profit health care facilities, ranging from national hospital chains affiliated with major academic institutions to local dialysis centers, has grown at a rate exceeding even that of the computer industry.

The ethical implications of the growing commercialization of health care have become a matter of heated controversy. Those favoring the trend toward health care for profit claim that an increased role for entrepreneurs and competition in the delivery of health care will result in a more efficient and effective health care system. For others, the pursuit of profit is antithetical to the values central to medicine.

Opposing the commercialization of health care are those who base their arguments on considerations of justice. They argue that a society as wealthy as ours has a moral obligation to meet the basic needs of all of its members. Every American, rich or poor, should have access to the health care he or she needs. The escalating costs of care and a growing unwillingness of insurance companies to cover these costs, along with government budget cutbacks, have severely restricted access to health care for the poor, the aged, and those with catastrophic health problems. The rise of for-profit health care only exacerbates the growing problem of access to care.

Studies show that the growth of for-profits decreases the availability of health care for "unprofitable" patients. Traditionally, non-profits have financed care for the poor by overcharging paying patients to subsidize services for the poor. For-profits, by refusing to serve nonpaying patients while at the same time taking a great share of paying patients, leave non profits with more of the poor to serve but with fewer paying patients to subsidize their care. Furthermore, by serving only profitable patients and offering only profitable services, for profits are able to generate high revenues, which enables them to charge lower prices for their services and to invest in attractive facilities located in areas convenient to paying patients, both of which create substantial competition for non-profits. As a result, it has become increasingly difficult for non-profits to continue to serve those who can't pay.

Opponents of commercialized health care also argue that for-profit health care institutions do not contribute their "fair share" to society. In view of the benefits health care institutions derive from society, it is unfair for them to refuse to help society serve those who can't afford care or are too costly to treat. All hospitals benefit from government subsidized programs like Medicare and Medicaid. They also profit from medical research and medical education paid for by taxpayers' money. In fairness, hospitals have an obligation to serve society's needy. Investor-owned corporations that turn away patients who can't afford to pay fail to discharge this obligation. Moreover, by not taking their fair share of unprofitable patients, for-profits place an undue burden on nonprofit and public hospitals. It's unjust that the costs of serving these patients should fall more heavily on nonprofit institutions.

Further, critics of health care for profit maintain that all persons have a right to live their lives with dignity. Mixing business with medicine will inevitably lead to abuses that violate patient dignity. A patient is in a vulnerable position, necessarily trusting that the doctor's decisions about his or her medical care will be guided solely by the patient's best interests. But in a system of for-profit health care, doctors will become subject to the control of lay managers accountable to share-holders whose primary aim is making a profit. Such hospitals will encourage doctors to promote profit-producing drugs, surgeries, tests and treatments. And, medical treatments and counseling lacking profit potential, however effective, will be discouraged. Even more worrisome are physicians who themselves own the facilities they operate. Doctors owning dialysis centers, for example, have been accused of putting patients on dialysis sooner than necessary and putting off kidney transplants that would eliminate the need for dialysis altogether.

In a system of for-profit health care, the opportunities for patient manipulation and exploitation are endless. Society must not allow the motive of economic gain to enter so directly into the practice of medicine, placing the well-being of patients in serious jeopardy, and undermining the trust so essential to the physician-patient relationship.

It is also argued that commercialized medicine will harm society, yet produce little in the way of benefits. Nonprofit hospitals undertake costly, but needed, research and maintain services which are not economically viable but which provide doctors with the training experiences necessary to medical education. Where profits rule, however, such necessary, but unprofitable, research and services important to medical education will be neglected. Furthermore, as for-profits come to dominate the health care sector, society will suffer a severe shortage of unprofitable, but critical, services, such as emergency rooms. Meanwhile, scarce resources will be squandered to produce and aggressively market lucrative, but unnecessary, services, such as cosmetic surgery.

While for-profits promise to harm society, critics continue, they fail to deliver any of the promised benefits, such as controlling health care expenditures, reducing the costs of care, and lowering the price of care. How will for-profits help control health care expenditures and the overuse of health services when, by definition, they are in the business of increasing total sales? For-profits are also unlikely to reduce the costs of care. Studies show that the rise of investor-owned hospitals has increased rather than lowered costs. Moreover, studies show that the prices charged by for-profit hospitals to paying patients, as well as the per-day expense of providing care, are higher than those of non-profits. The economic benefits promised by for-profits have not been demonstrated.

Finally, some critics of for-profit health care claim that the commercialization of medicine will lead to the abandonment of certain virtues and ideals that are necessary to a moral community. Most non profits continue to uphold an ideal of service to humankind. The virtues of caring, compassion, and charity, and a sense of community have guided their decisions about the range of services to provide and the kinds of research or education to support. The ideal of altruism has been perpetuated by physicians whose primary concern has been the alleviation of human suffering and the restoration of health. Society must not allow such important and fragile virtues and ideals to be extinguished by the self-interest that drives for-profit enterprise.

Those favoring the growing commercialization of health care argue that society ought always to follow that course of action that will bring about the greatest benefits at the least cost. A health care system run by for profits will provide the greatest benefits at the least cost.

First, for-profit health care will lower the costs of care. The amount we spend on health care every year has grown from $75 billion in 1980 to nearly $500 billion today. If this rate continues, by the year 2020, we will be spending 40 cents of every dollar we make on health care. Commercialized health care is our only hope for controlling the soaring costs and over-utilization of health services. Only the businesslike efficiency and the discipline that accompanies the drive to maximize profits can cure the ills of a system plagued by inefficiency and waste.

Under the present system, administrators and physicians have no incentives to operate in a cost-efficient manner. More concerned with institutional prestige than with the bottom line, administrators of nonprofit organizations acquire sophisticated equipment and highly trained personnel, without regard for their need or likely use. Costly technologies are adopted and services added that are only marginally beneficial. Physician's themselves are offered little incentive to concern themselves with the cost of care, and go about ordering treatments that yield little or no benefit. Moreover, the nonprofit health care system is rife with costly, under-used facilities. Cardiac operations are performed in 100 different hospitals. Millions of dollars could be saved if these 15,000 procedures could be done in 30 centers specifically built for that purpose.

As the number of for-profit health care facilities increase, we can expect to see an end to such gross inefficiency. Aiming to maximize profits, for profits will invest only in the equipment and the personnel necessary to provide services that patients actually need. Decisions about what technologies should be adopted will be based on whether the benefits of these technologies outweigh their costs. The entrepreneurial spirit will give rise to innovation in the delivery and management of services, leading to more efficient methods of production and treatment. Doctors will be forced to come to terms with what will really benefit patients, resulting in fewer unnecessary hospitalizations, shorter hospital stays, and fewer needless tests.

Lower costs also can be expected from the economies of scale achieved by for-profit corporations. Unlike nonprofit health care institutions which often operate independently of each other, for-profits are often linked together as chains, allowing for economies in financing and management, and for centralized services and shared equipment, all resulting in lower costs.

Second, society will benefit from the enhanced access to care promised by for-profits. Currently, 37 million people are without the coverage needed to afford care. For-profits can pass on savings they achieve through more cost-efficient operations by lowering the price of care, so more people are able to afford it.

Third, for-profit health care enterprises produce benefits for society because for-profits have greater and quicker access to capital at lower costs than do non-profits. At a time when massive investments of capital are needed to keep up with the state of the art in medicine, non-profits are experiencing increasing difficulty in attracting funding. For-profits, on the other hand, can lure investors by issuing stocks, securing the money sorely needed to build and renovate facilities and to replace and modernize outdated equipment.

Proponents of for-profit enterprise in health care also support their position by maintaining that all persons have a basic right to freedom and thus a right to use their property in ways they freely choose. They argue that owners of for-profits have no special obligation to provide free services to the poor. While public funds may indeed subsidize research and medical education, it is patients and doctors who benefit from this education and research, not the owners of hospitals. If there is any obligation to serve the community in return for such subsidies, it is with patients and doctors that it lies. Nor does the possibility that hospitals have profited from an expanded market for services generated by government-subsidized programs oblige their owners to provide free care to the poor. Defense contractors profit greatly from the business generated by public funds. Yet, they are under no obligation to provide free public services. Nor can it be said that for profits unfairly impose a burden on non-profits by not assuming a fair share of the costs of caring for the poor. For-profits, unlike non-profits, pay taxes, and in doing so, can be said to pay their share in serving the poor through tax-supported public programs. To impose on owners of for profits a social obligation over and above an obligation to pay taxes is to impose an obligation on them that is not imposed on owners of other businesses.

Finally, it is argued, health care is like food, clothing and shelter. Just as these "basic needs" are sold on the market and distributed according to ability to pay, so too should health care. If some cannot afford to pay for such basic needs, it is up to the government or voluntary agencies to see that they secure it.

What is the moral response to the increasing commercialization of health care? The arguments in favor of for-profits appeal to the values we place on the freedom of free enterprise and the economic benefits that may flow from a more efficient health care system. But are we willing to uphold these values at the cost of other important values, including a concern for justice, the dignity of persons and a community-centered ethics that places the needs of people before profits? What is a "healthy" bottom line?

"I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witness, that I will fulfill according to my ability and judgment this oath and this covenant...I will apply...(treatment) for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice." -Hippocratic oath

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Drug costs are soaring because US PHARMA corporations used Affordable Care Act and Trans Pacific Trade Pact policy to end Medicare's effects on containing costs and oversight and accountability to regulations have been dismantled so no one is enforcing health laws meant to contain costs.

Bill Gates used his health foundation pretending to be a non-profit to build a global PHARMA corporation just as profit-driven as any in the world.  Gates is behind privatizing Medicare and Medicaid just to maximize health corporate profit and he is behind the most repressive of health policy in Trans Pacific Trade Pact.  Obama appointed a Gates executive as head of Medicare to do Gate's bidding----ending Federal Medicare.

Trans Pacific Trade Pact and Obama and Clinton neo-liberals in Congress want to dismantle laws that allow PHARMA to go to generics----to dismantle laws that require clinical trials to assure safety for PHARMA and medical devices.  They want to dismantle distribution regulations in the US to allow imported PHARMA and devices flow from the developing nations where all is being manufactured.  THIS IS WHAT DEREGULATION OF HEALTH CARE MEANS.  It will not allow any medical research proving harmful effects of a health product result in pulling it from the market-----now, they wait until millions of people are harmed or die----then they REFORMULATE AND SEND IT OUT AGAIN.  Forget America being concerned about products being sent all over the world knowing them to be harmful-----SHOW ME THE MONEY IN BILLIONS OF PROFITS AND WE WILL SETTLE LATER FOR A FEW MILLIONS TO HARMED FAMILIES.  Neo-liberalism in health care will be scary stuff if allowed to continue.

Make no mistake-----Federal funding to all of these medical research facilities are soaring------while Americans are being told---sorry, no Federal health trusts or Constitutionally required funding for all.

National labor and justice organization leadership knew all this was what Affordable Care Act was about----and they also know the JOBS, JOBS, JOBS mantra is bogus as well as all this will end up in International Economic Zones and FOXCONN factories overseas-----and soon coming to the US where workers will work as they do in Asian sweat shops.  So, nothing good happening in any Wall Street policy!


Drug Prices Soar, Prompting Calls for Justification


By ANDREW POLLACKJULY 23, 2015  New York Times


As complaints grow about exorbitant drug prices, pharmaceutical companies are coming under pressure to disclose the development costs and profits of those medicines and the rationale for charging what they do.

So-called pharmaceutical cost transparency bills have been introduced in at least six state legislatures in the last year, aiming to make drug companies justify their prices, which are often attributed to high research and development costs.

“If a prescription drug demands an outrageous price tag, the public, insurers and federal, state and local governments should have access to the information that supposedly justifies the cost,” says the preamble of a bill introduced in the New York State Senate in May.


In an article being published Thursday, more than 100 prominent oncologists called for support of a grass-roots movement to stem the rapid increases of prices of cancer drugs, including by letting Medicare negotiate prices with pharmaceutical companies and letting patients import less expensive medicines from Canada.

“There is no relief in sight because drug companies keep challenging the market with even higher prices,” the doctors wrote in the journal Mayo Clinic Proceedings. “This raises the question of whether current pricing of cancer drugs is based on reasonable expectation of return on investment or whether it is based on what prices the market can bear.”

Pressure is mounting from elsewhere as well. The top Republican and Democrat on the United States Senate Finance Committee last year demanded detailed cost data from Gilead Sciences, whose hepatitis C drugs, which cost $1,000 a pill or more, have strained the budgets of state and federal health programs. The U.A.W. Retiree Medical Benefits Trust tried to make Gilead, Vertex Pharmaceuticals, Celgene and other companies report to their shareholders more about how they set prices and the risks to their businesses from resistance to high drug prices.

Photo
A demonstration last year against Gilead Sciences, whose hepatitis C drugs, which cost $1,000 a pill or more. Credit AIDS Healthcare Foundation The trust cited the more than $300,000 per year price of Vertex’s cystic fibrosis drug Kalydeco and roughly $150,000 for Celgene’s cancer drug Revlimid.

Even former President Bill Clinton, in a speech to pharmaceutical executives in Philadelphia last month, said it would be in the industry’s best interest to say more about its costs and pricing.

“Explain, explain, explain and disclose, disclose, disclose,” Mr. Clinton said, according to The Philadelphia Inquirer. “Don’t expect everybody to love you, but at least they will hear your side of the story.”


The pharmaceutical industry has already had the veil lifted on various practices. Drug companies now have to report the payments, including meals and entertainment, that they make to doctors for research, consulting and giving promotional speeches. The companies have also had to disclose more results of their clinical trials and in some cases have started to provide raw data to outsiders.

It is unclear if cost and pricing will become the next such area. The state bills, which are supported by some health insurers and consumer groups, have not progressed. The two senators, Republican Charles E. Grassley of Iowa and Democrat Ron Wyden of Oregon, have not reported the results of their inquiry. And shareholders of Gilead, Vertex and Celgene voted down the resolutions proposed by the U.A.W. trust, though the trust says it reached settlements with Eli Lilly and with two other drug companies it would not identify.

The pharmaceutical and biotechnology industry trade groups say the transparency bills would be costly to comply with and would provide misleading information.

Even some people concerned about drug prices say that the cost to develop a particular drug has little to do with that drug’s price and that knowing such information will not keep prices down.

“The past R&D cost is really kind of a red herring,” said Len Nichols, a health care economist at George Mason University, referring to research and development. “The current revenue doesn’t pay for past R&D; it pays for current R&D.”

Prices for cancer drugs, some of which extend lives by only a couple of months, routinely exceed $100,000 a year, and some new ones exceed $150,000. And it is not unusual for the list prices of existing drugs to rise 10 percent or more year after year, far beyond the rate of inflation. The prices of older drugs for multiple sclerosis have risen from about $10,000 per year in the late 1990s to more than $60,000 now, according to a study, even as competition in the market has intensified with the introduction of new products.

Cost transparency bills have also been introduced in California, Massachusetts, North Carolina, Oregon and Pennsylvania.

Three of the bills require disclosures for drugs costing $10,000 or more per year. The others have different criteria. Besides development costs, some of the bills would require disclosure of the costs of manufacturing, marketing and advertising. At least some of the bills also ask for a history of price increases, the profit attributable to the drug and how much a company spends in providing financial assistance to patients using the drug.

Two of the bills would allow the states to act on the information, not just require disclosure. Pennsylvania’s would allow insurers to refuse to pay for a drug if the manufacturer did not file the required report. In Massachusetts, a state commission would be able to set a maximum price for a drug if it determined that the price set by the manufacturer was significantly high compared with the benefits, costs or prices in other countries.

Most of the bills have not been acted upon, though hearings were held in California and Oregon.

The sponsor of the California bill, Assemblyman David Chiu, pulled it back shortly before a committee was to vote on it, apparently because it did not have sufficient support. The bill could be picked up again next year.

“This is a new topic for many of my colleagues to grapple with,” said Mr. Chiu, a Democrat from San Francisco. He said the bill was necessary because “greater transparency leads to better policy results.”

Mitch Greenlick, a Democrat from Portland who is chairman of the Health Care Committee in Oregon’s House of Representatives, said the bill was prepared with input from the health insurance industry, but was “not ready for prime time.” He added that the issue would be further studied.

“What are we going to do with that information?” he said. “It’s interesting to have, I suppose, but the drug companies are shameless, and they charge what they can get away with.”

Insurers and consumer groups told the Oregon Legislature that more disclosure was needed because the state had to decide whether to pay for certain drugs. Representatives of the pharmaceutical industry said the bill was unfair and would discourage industry investment in Oregon.

She also said that focusing on costs ignored the value of the drugs. Some drugs, for instance, can save money for the health system over all by keeping people out of the hospital, she said.

Pharmaceutical executives do not typically tie the price of any particular drug to its development cost. But they do say that their sales have to recoup their investment in research and development if the companies are to stay in business.

They often cite the Tufts Center for the Study of Drug Development at Tufts University, which last year said companies spent an average of $2.6 billion to bring a drug to market, up from an estimate of $800 million in 2003. That includes the cost of failures. And almost half the figure is opportunity cost, the amount a company might have earned if it had invested money elsewhere rather than spending it on drug development.

Critics are skeptical of that figure, saying that the Tufts center gets funding from the pharmaceutical industry and uses data supplied by the drug companies, but does not disclose which drugs are used as the basis of the estimates.

Pharmaceutical executives often say they price the drugs based on the value they provide, though often a detailed explanation of that is not provided. In many cases, it appears, the price of new drugs is set in comparison to rival drugs already on the market, and usually a bit higher. Companies then can raise their prices for the older drugs.

“We all look at each other and keep pace with each other,” said a director of one multiple sclerosis drug developer, who spoke on the condition of anonymity. “Honestly, there is no science to it.”
Write A Comment John Rother, chief executive of the National Coalition on Health Care, a group of insurers, consumer organizations, labor unions and employers concerned about drug prices, said his group hoped to introduce transparency legislation in Congress, but aimed at determining how drug companies estimate the value of their drugs, not the research and development costs.

“The industry has used R&D costs for the justification, but anyone who is reasonably sophisticated understands those are sunk costs and have little to do with pricing,” Mr. Rother said. “The more important information is any calculation of value. If the drug actually cures people, then what costs in health care are you saving?”

Dr. Jerry Avorn, a professor at Harvard Medical School and critic of some drug company practices, said the industry “has brought this on itself by charging prices that are so astonishing, it makes citizens wonder, ‘Where did this figure come from?’ ”

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Obama and Clinton neo-liberals are again posing progressive by using terms like---bringing health care to the poor----saving Medicare-----all while the goal is the opposite.  Defunding the Federal program required by the US Constitution having this program supplement payment for health care that American citizens cannot afford was the cornerstone to opening Federal funding to medical research projects and meeting New Deal and War on Poverty health laws.  The poor in America have had access to all the care they needed without Affordable Care Act unless they live in Republican areas like Baltimore that deliberately designed health policy that kept citizens from this access.  What the Affordable Care Act does is keep people from going to any hospital for life-saving medical procedures so as to make hospitals more profitable with this exclusion.

Since these policies will send tens of millions of Americans to an early death-----and that number growing far higher as more Americans fall into poverty-----they needed to make it sound progressive by saying NOW PEOPLE HAVE HEALTH INSURANCE.  Of course having health insurance and accessing health care are VERY DIFFERENT THINGS.  The Affordable Care Act also sends Medicaid to a gutted-of-funding third world clinic care-----preventative only -----when it used to provide access to low-income people to most of ordinary hospital care.

WHO KNEW REPUBLICAN STATES WOULD REFUSE TO EXPAND MEDICAID WHEN THEY ARE SET ON ENDING THE PROGRAM?  OBAMA AND CLINTON NEO-LIBERALS IN CONGRESS THAT PASSED THE LAWS MAKING SURE PEOPLE WILL NOT BE ABLE TO ACCESS HEALTH CARE.

All Maryland pols supported Affordable Care Act as did national labor and justice organizations all knowing it would end access to ordinary health care guaranteed to Americans through Federal programs Constitutionally protected.

Having insurance does not mean you get health care

Joseph Paduda | Policy  | January 30, 2011


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There’s no question the Accountable Care Act needs work – everyone agrees on that.

So let’s talk about the specifics – what needs fixing, why, and how can we get those fixes passed.



First, let’s understand how bad our current system is. Some who want to repeal and/or replace the ACA continue to publicly state we have “the best health care in the world.”







  
While that may – or may not – have been true at some point, it is increasingly clear that the US health care system is not anywhere close to best in class. A study done by the Commonwealth Fund compares our system to those in ten other industrialized countries, with sobering results.





Here are key findings:
◾Adults in the United States are far more likely than those in 10 other industrialized nations to go without health care because of costs, have trouble paying medical bills, encounter high medical bills even when insured, and have disputes with their insurers or discover insurance wouldn’t pay as they expected.
◾One third (33%) of U.S. adults went without recommended care, did not see a doctor when sick, or failed to fill prescriptions because of costs, compared to as few as 5 percent to 6 percent in the Netherlands and the U.K.
◾One-fifth of U.S. adults had major problems paying medical bills, compared to 9 percent in France, the next highest country, 2 percent in the U.K., 3 percent in Germany, and 4 percent in the Netherlands.

One finding is particularly scary: “Although the uninsured were at highest risk for skipping needed care, working-age U.S. adults with below-average incomes who were insured all year were significantly more likely than those with above-average incomes to go without needed care because of costs and have serious problems paying medical bills -- nearly half (46%) went without needed care and one third had one bill problem, double the rates reported by above-average income insured adults.”

You read that right – having insurance does not mean you get health care, and if you do, you still have to pay a substantial portion of the bill out of your own pocket.



The study examined health care and health insurance in eleven countries, all with much lower costs than the US — a differential that undoubtedly helps them compete in international markets. As globalization continues, American companies will find the disparity in health care costs will be a growing problem, diminishing their ability to compete with companies from Germany, Japan, Korea, and Switzerland.That said, ACA is anything but perfect. Let’s start our discussion with something that isn’t in the bill: Medicare physician payment reform.

Fixing Medicare’s horrendously broken physician reimbursement scheme known as RBRVS is critical. Congress has to come up with a long term solution that:

a) better recognizes the primary importance of primary care

b) incentivizes outcomes rather than pays for piece work

c) is less likely to be abused by Congressional cowardice and ineptitude

A big part of the solution is already in place – the Independent Payment Advisory Board (IPAB). This from California Healthline:


Beginning in 2014, IPAB must recommend Medicare spending cuts if the program’s growth rate exceeds the average of the consumer price index and the Medical Care CPI. Barring congressional action to make equivalent cuts, IPAB’s recommendations would become law. The board would exempt decisions affecting hospitals and other provider groups until 2020, but the Congressional Budget Office estimates that IPAB still could hold down Medicare spending by $15.5 billion between 2015 and 2019, according to a new report from Stephen Zuckerman of the Urban Institute.

A good start to be sure, but just a start. And note that we’ve still got to wait ten years before IPAB can address hospital costs, ten years that will likely produce significant inflation driven by technology, utilization, and price increases. We’re already seeing hospitals successfully thwart the new severity-adusted DRGs through more sophisticated coding…

Instead, we should move up IPAB’s effective date by at least a year, and ideally two for physicians and perhaps seven years for facilities.

If we are serious about deficits, then let’s get serious. What the new Congress does about IPAB will tell us a lot about whether it will live up to the oft-voiced commitment to reduce government spending.

What does this mean for you?

Watch what Congress does about physician payment reform. If this isn’t addressed in a meaningful, comprehensive, and sustainable way than there’s little chance Medicare costs will be controlled until IPAB goes into effect.

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Below you see what will become the only access to health care in the US for over 80% of Americans----and it is tied to corporations receiving money to dole out a wellness program that will evolve into REQUIRED/MANDATORY PARTICIPATION to these programs.  Now, Americans can do with encouragement to get active -----the US has the best results in the world in Federal health activism and fitness programs.  We are getting people engaged with no mandatory participation.

What will evolve from these Affordable Care Act laws is complete control of a person's health through monitoring from birth to death with the patient having no control over what is prescribed and what products are required.  All health institutions have to say is that what is being demanded will improve health.

Think what this will look like in a deregulated health system where medical and PHARMA patents are soaring from research having no checks and balances---and a doctor invested or working for an institution involved in the money-making patent will force a patient to use a product that they know may harm the patient down the road.  I say doctor----but health insurance corporations/hospitals/doctors/medical device corporations are now one great big global health system all tied to you using their products. 

Failing to participate in wellness will result in ever-higher insurance rates and ultimately lost employment.  Forget wanting to create your own way to approach wellness---or better yet--- forget not being concerned about those pounds on your hips----

THIS WILL BE MILITARY BOOT CAMP ----GET DOWN AND GIVE ME FIFTY SOLDIER!

All of this wellness is tied to lab testing to monitor blood levels of all kinds of now medically important biotechnological measurements.  Whereas grandmom and pop sat down every day to eggs, bacon, fat-back gravy, and a large serving of meat and potatoes and lived to be 90------that is freedom of choice that does not exist in data-driven health care.

It's the same as having to create all kinds of education measurements and data to justify creating new global education corporations.  IT IS NOT NEEDED----IT CREATES PROFITS.


Wellness Program Incentives and the Affordable Care Act
July 1, 2013
Page 2
Wellness Corporate Solutions, LLC | Wellness Program Incentives and the Affordable Care Act
I. Introduction
Federal law generally prohibits group health insurance plans from discriminating based on health factors.
However, special rules exist to allow employers to make financial incentives a part of their wellness
programs — provided they follow certain guidelines.
On June 3, 2013, the federal government issued new rules governing wellness program incentives. The
purpose the rules is threefold:
1. To define the responsibilities of wellness program providers and plan administrators
2. To prevent discrimination in group health coverage
3. To increase the maximum rewards allowable under the law
This following is a brief outline of the law and should not be construed as legal advice. Click here to
download a complete copy of the regulations.
II. Types of Wellness Programs
The rules define two categories of wellness programs: Participatory and Health-Contingent.
a. Participatory Wellness Programs
Participatory wellness programs either do not provide rewards of any kind, or do not require participants to
satisfy any standard relating to a health factor. Examples include:

Subsidized gym membership

Reward for participating in a biometric screening (regardless of the results)

Reward for attending an optional health education seminar

Reward for completing a smoking cessation program (regardless of whether the individual stops
smoking)
Participatory wellness programs must be made available to all similarly-situated individuals regardless of
health status. These programs are not required to adhere to the five requirements described in Section III
below.
b. Health-Contingent Wellness Programs
The rules divide health-contingent wellness programs into two categories:

Activity-only: Reward is based on completing an activity related to a health factor

Outcomes-based: Reward is based on attaining or maintaining a specific health outcome

I will talk about health care policy this week.

I want to end for now this discussion of education with a focus on COMMUNITY EDUCATION.  Community education back in the 1960s and 70s saw lots of community events held at public schools, community centers, libraries, and people's homes discussing the politics of the day----for Democrats---that was progressive social democracy----womens, labor, disabled, veterans, and civil rights.  People packed schools in the evening to debate all of this.  Community center hours were booked for groups wanting to meet to educate on their views on politics of the day.  Flash forward to today----none of these venues encourage and may not even allow political discussion or debate.  Two years ago I went to a few public K-12 schools in Baltimore asking the principals and VISTA people to organize after-school events to discuss EDUCATION POLICY----GIVING THEM A LIST OF BILLS BEING PROMOTED BY BALTIMORE POLS PRIVATIZING EDUCATION.  Not one dared allow education policy debate in a public school.

Baltimore has deliberately closed any discussion of public policy to only captured venues that deliberately seek to limit all discussion to targeted talking points.  WE WILL LET A PANEL FRAME THE QUESTIONS TO BE ASKED AT THIS PUBLIC FORUM  we hear over and over.  If you go outside the panel's canned questions----they rush to take you out of the gathering.  You have 2 minutes generally---not enough to set the groundwork for your comments.  Whether the organization sponsoring these events----the people on these panels-----or the Baltimore pols pretending to give voice on an issue---IT IS DESIGNED TO CAPTURE OPEN DISCUSSION ON PUBLIC POLICY. 

Below you see what Cindy Walsh for Mayor of Baltimore wants to build on a local level to bring political primaries and general elections back to grassroots and take the power of capture from larger venues.  The political history of CAUCUS has been used for Presidential elections or as we see here----Congressional caucuses used to create committees joined by support of a political view on policy.  What we want to do in Baltimore takes away all the rules and procedures making this a technical process and simply adopt the concept of having multiple community meetings in homes to invite candidates to talk to a dozen or so citizens in that community---and have several of these in different homes in each community during the course of a few month primary election season.

NO CORPORATE FUNDED NON-PROFIT OVERSEEING THESE EVENTS----NO POLITICIAN OVERSEEING THESE EVENTS----NO PANEL OF 'SPECIALISTS ON POLICY' DECIDING THE QUESTIONS----OPEN DISCUSSION OF PUBLIC POLICY.

This happens informally in white communities in Baltimore as with the current BERNIE SANDERS HOME ELECTION EVENTS.  We need this structure to become formal in all communities and if candidates do not come to these grassroots venues ready for open discussion---YOU KNOW NOT TO VOTE FOR THEM AND THE COMMUNITY NEEDS TO RUN PEOPLE THAT DO ATTEND THESE MEETINGS.

WHAT IS A CAUCUS?

The term caucus apparently comes from an Algonquin word meaning "gathering of tribal chiefs," and the main crux of the caucus system today is indeed a series of meetings.


Affinity groups

Congressional caucuses

Main article: Congressional caucus

Another meaning is a sub grouping of officials with shared affinities or ethnicities who convene, often but not always to advocate, agitate, lobby or to vote collectively, on policy. At the highest level, in Congress and many state legislatures, Democratic and Republican members organize themselves into a caucus (occasionally called a "conference"). There can be smaller caucuses in a legislative body, including those that are multi-partisan or even bicameral. Of the many Congressional caucuses, one of the best-known is the Congressional Black Caucus, a group of African-American members of Congress. Another prominent example is the Congressional Hispanic Caucus, whose members voice and advance issues affecting Hispanics in the United States, including Puerto Rico. In a different vein, the Congressional Internet Caucus is a bipartisan group of Members who wish to promote the growth and advancement of the Internet. Other congressional caucuses such as the Out of Iraq Caucus, are openly organized tendencies or political factions (within the House Democratic Caucus, in this case), and strive to achieve political goals, similar to a European "platform", but generally organized around a single issue.

Caucuses within liberal organizations

Among American left-wing groups, a caucus may be an openly organized tendency or political faction within the group.
___________________________________________
I want to emphasize my intent is not to follow the modern use of the CAUCUS as regards replacing primary elections.  My intent is to use the CAUCUS to build a structure in communities that take away power at the top of city/state politics and brings it back to the communities WHERE IT BELONGS.  The article below speaks of rules and procedures that would not relate to my construct.  We simply want several families willing to open their homes in each community to however many people with whom they are comfortable---hopefully allowing for differing opinions---and then allow those families to ask the questions they want answered.  These gatherings would include open discussion of public policy BEFORE AND AFTER politicians arrive with the expectation that politicians would be part of these discussion---NOT CONTROLLING THEM WITH LONG DIATRIBES.

Rotating families and homes each month gets more and more people involved in public policy discussion and feeling they have more control over the election primary. 

INCUMBENT CANDIDATES MAY NOT COME----AND THAT WILL TELL THE COMMUNITY FOR WHOM NOT TO VOTE.

Incumbents in Baltimore are used to election formats that have them simply popping in to churches or non-profit meetings and simply saying whatever they want and that's it.  If questions are allowed the time limits do not afford discussions of issues.


What’s the difference between a caucus and a primary?

by Dave Roos



Every four years, television news crews from New York to Los Angeles set up camp in the frigid cornfields of rural Iowa. The Iowa Caucuses, held in early January, represent the first chance for regular Americans from both major political parties to show support for a presidential candidate. The national press covers every minute of pre-caucus excitement as presidential hopefuls spread out across all 99 Iowa counties to shake hands at local diners and give stump speeches in elementary school gyms.

As the earliest event of the primary election season -- you know, the free-for-all that determines the nominees in each party -- Iowa serves as a bellwether of national sentiment, helping to launch or sink candidacies and separate the wheat from the chaff -- or in Iowa's case, the corn from the husk. But what exactly is a caucus? And how is it different from a primary?

Caucuses and primaries are the two ways in which the Democratic and Republican parties choose the delegates who will attend the parties' national conventions. The national convention is where the delegates officially choose the party's nominee for the presidential race.

Primaries offer a relatively straightforward way of assigning delegates to the national convention. Voters from each party cast their vote for one of the candidates on the primary ballot. Like the general presidential election, primary voting is done on an assigned day at an assigned polling place. Voting is private and anonymous. Depending on the state's rules, delegates are either distributed in proportion to the amount of votes received by each candidate (known as a proportional primary), or all delegates are given to the candidate who gets the most votes (called a "winner take all" primary).

Caucuses, on the other hand, are far from straightforward. (Interestingly, before the 1960s and 1970s, most states chose their delegates through caucuses, not primaries.) For one thing, caucuses aren't exclusively for presidential elections. In addition, caucuses were traditionally held every two years so that local members of each political party could meet, discuss the issues of the day, and help to shape the political platform of the state and national party [source: Redlawski et al].

How do caucuses and primaries function today? Find out on the next page.
_____________________________________________
What Clinton and Obama neo-liberals are doing is killing all public avenues to political discussion along with Republicans.  The FEDERAL IRS election laws make clear------non-profits can only participate in elections by including all candidates in a race---they cannot harm any one candidate with exclusion.  Back in the 1980s and 1990s during Reagan/Clinton----AND BEFORE THIS----attacks on equal opportunity for all candidates required by FCC election laws resulted today with media being allowed exclusion from this right due all candidates in a race.  Media of course takes this exclusion from equal opportunity for all candidates to an extreme today by openly censuring any candidate it wants from having any time on media----THAT IS WHAT MARYLAND DOES----AND BALTIMORE MEDIA ESPECIALLY.  Media does have to give equal opportunity---BUT THEY DO NEED TO GIVE OPPORTUNITY TO ALL CANDIDATES IN WAYS THAT DO NOT HARM A CANDIDATE'S CAMPAIGN.

Now we see Obama and Congressional neo-liberals doing the same to IRS election laws giving equal opportunity by creating all kinds of exceptions with non-profits---saying non-profits don't need to allow all candidate and policies be heard-----BUT THIS DOES NOT HOLD TRUE DURING ELECTIONS---ONLY THROUGHOUT THE YEAR.  These are called political action non-profits.  Baltimore Education Coalition is a political action coalition pushing Michelle Rhee privatization education policy. These non-profits are capturing all political discussion on public policy and have leadership that controls discussion as much as politicians with panels----they capture email and phone lists of like-minded people-----and are often funded by the rich to capture public policy discussion.

CLINTON AND OBAMA ARE SUBPRIMING ALL ELECTION LAW PROTECTION FOR EQUAL OPPORTUNITY FOR ALL CANDIDATES DURING PRIMARY ELECTIONS BY CREATING EXEMPTIONS THAT ARE THEN MISUSED.

This is why having a structure of grassroots caucuses in place during primaries circumvents this control and opens public policy discussion to everyone.

Organizing For Action | | Non-Profits & Political... my.barackobama.com/page/event/detail/gpgf33
Non-Profits & Political Campaign Activity (Meeting)

A lawyer will discuss IRS rules and guidelines that govern non-profit political activity. Forum is geared toward churches and 501(c)(3) tax-exempt organizations. If you are a member of a church, sorority, fraternity or non-profit organization and want to ensure that your organization is operating within legal limits in regards to political campaigns, this presentation is for you.


Types of Advocacy Groups

501(c) Groups — Nonprofit, tax-exempt groups organized under section 501(c) of the Internal Revenue Code that can engage in varying amounts of political activity, depending on the type of group. For example, 501(c)(3) groups operate for religious, charitable, scientific or educational purposes. These groups are not supposed to engage in any political activities, though some voter registration activities are permitted. 501(c)(4) groups are commonly called "social welfare" organizations that may engage in political activities, as long as these activities do not become their primary purpose. Similar restrictions apply to Section 501(c)(5) labor and agricultural groups, and to Section 501(c)(6) business leagues, chambers of commerce, real estate boards and boards of trade.

527 Group — A tax-exempt group organized under section 527 of the Internal Revenue Code to raise money for political activities. These groups are typically parties, candidates, committees or associations organized for the purpose of influencing an issue, policy, appointment or election, be it federal, state or local. Such organizations can raise unlimited funds from individuals, corporations or labor unions, but they must register with the IRS and disclose their contributions and expenditures.

Hybrid PACs (Carey Committees) — A Carey committee is a hybrid political action committee that is not affiliated with a candidate and has the ability to operate both as a traditional PAC, contributing funds to a candidate's committee, and as a super PAC, which makes independent expenditures. To do so, Carey committees must have a separate bank account for each purpose. The committee can collect unlimited contributions from almost any source for its independent expenditure account, but may not use those funds for its traditional PAC contributions.

Political Action Committee (PAC) — A political committee that raises and spends limited "hard" money contributions for the express purpose of electing or defeating candidates. Organizations that raise soft money for issue advocacy may also set up a PAC. Most PACs represent business, such as the Microsoft PAC; labor, such as the Teamsters PAC; or ideological interests, such as the EMILY's List PAC or the National Rifle Association PAC. An organization's PAC will collect money from the group's employees or members and make contributions in the name of the PAC to candidates and political parties. Individuals contributing to a PAC may also contribute directly to candidates and political parties, even those also supported by the PAC. A PAC can give $5,000 to a candidate per election (primary, general or special) and up to $15,000 annually to a national political party. PACs may receive up to $5,000 each from individuals, other PACs and party committees per year. A PAC must register with the Federal Election Commission within 10 days of its formation, providing the name and address of the PAC, its treasurer and any affiliated organizations.

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Caucusing in the classroom means more than students organized by teachers-----it means schools open up for the community to organize these election primary public policy discussions.  This article shows what is critical in fostering this ethos-----we must have our students engaged in every avenue of this process.

Then we take this process home to communities where parents foster this same ethos in the neighborhood.  It can start with political primary events and then grow into regular public policy discussion throughout the year.  As important as having people over for open and free discussion of public policy is recording both on video and handwritten notes these discussions......given people allow themselves to be recorded.  Creating a flyer distribution from these events is simply having the dozen people attending commit to making copies and distributing just on their streets where to go for the video----and including the thoughts and feelings of those attending.

If we allow names and contact information be shared then people can reach out for like-minded people to create more community PUBLIC ACTION. 

Candidates in an election should want to join these talks and SHOULD NOT BE ALLOWED TO DIRECT THESE TALKS.

Caucusing in the middle school classroom

Caucusing enables students to practice the elements of responsible citizenship, including persuasive writing and speaking.

By Pamela Myrick and Sharon Pearson

Caucus data sheetA sample data sheet is provided here.

In a democracy, delegates are selected through caucus groups to represent their constituents. Undergirding caucusing is the premise that, in a democracy, citizens should be informed decision makers. Students can put this same premise into action in classroom caucuses. They can investigate an issue, form an opinion, and make a decision, selecting individuals to represent their views in a class-wide caucus. In doing so, students are practicing the tenets of responsible citizenship.

Caucusing in the classroom works best when it focuses on issues that interest students and that evoke a range of passionate student response. Under these circumstances, the caucus provides an engaging forum for students to share their ideas, discuss their opinions, validate information, and form a position on thought provoking and challenging current issues. Should students be required to wear uniforms? Is urban sprawl endangering the environment? Should there be random drug testing at school? By selecting topics that students are interested in, providing opportunities for students to develop deeply informed opinions, and allowing students to discuss their findings in a caucus setting, teachers can introduce students to the idea of the political caucus while also encouraging responsible and informed political engagement and civic pride.

Preliminary research and setupResearch portfolios Caucus groups are formed after the students have researched both sides of an issue. We have our students compile their research in research portfolios. Not only have students recorded data, but they also have included personal reflections on each article. Researching and reflecting is a process enabling the students to develop their point of view. Basic research requirements for the portfolio should include a minimum of five sources for each student. However, the teacher should be aware of student levels and modify the requirements.

Forming caucus groups The teacher initiates the grouping by posting two charts. The issue is listed at the top of each chart. One chart is labeled "pro" and the other "con." Based on their opinions, students sign either the pro or con chart. Giving students choices in their learning — in this case, by selecting their own groups — helps them to become vested and self-motivated individuals. In the process, a positive climate for learning is established reinforcing both academic and social skills

In order to facilitate the caucusing process, teachers should designate the size of each caucus group. For example, in a classroom of twenty-eight students, seven caucus groups may form. Of the seven groups, three could be pro and four could be con. If student opinion is unbalanced, it is also acceptable for five to be pro and two to be con. In fact, it may be somewhat of a challenge for the two groups to persuade others of their opinion! Flexibility is the key.

Student activities and assessmentCaucus data sheet In caucus groups, students share their research portfolios to identify the most compelling arguments to support their point of view. Selecting the most compelling evidence, students organize and record their information on a "Caucus Data Sheet."

Each student will replicate the data sheet on his or her notebook paper. The number of rows on the data sheet is dependent on the amount of information. Students work collaboratively, and so the source, date, supporting facts and details will be the same for each student in a group. However, the explanation of the data should vary. Supporting facts and details need to be relevant to the issue. The explanation should reflect the student’s understanding of the research and its correlation to the stance.

The data sheet serves as a plan for writing a persuasive essay and a tool for evaluation.After completing the data sheet, students will have a framework that organizes their thoughts and information.

Persuasive essay Each student in the caucus group then writes a persuasive essay based upon the data sheet plan. After essays have been written, students meet again in the same caucus groups and share their essays.

Collectively, the students in each group choose the most compelling evidence in their essays and draft one persuasive speech. Whatever media students use (word processing or pencil and paper), all students should share a responsibility in the writing process. After the final document is completed, every student in the caucus group should have a copy of this collaborative speech. Students then self select a speaker from their caucus group to present to the entire class.
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When you have a Democratic city hall operating behind closed doors as regards public policy----AS WE DO IN BALTIMORE----you know you do not have REAL Democrats----the democratic party platform is nothing but protecting political freedoms and speech. We must move away from political machines-----from political non-profits-----and bring our election primaries into the homes of citizens in all communities. In order for this to work----people must be committed to OPEN AND FREE discussion as long as it is not offensive. Dividing on party lines-----Democrat vs Republican can occur during the election season but maybe these community caucuses could be open to all during the year!

'Even with the exemption, there’s an intent behind that law: to let sunshine into government, to let the public see their representatives in action. The council is on the wrong path. It shouldn’t be doing its work in private just because it can'.

Public interest is 'promoted' by closed door discussions?  REALLY?  These open door policy laws allowing closed door activities correspond to Clinton neo-liberalism and these privatization policies of public private partnerships which are not in the public interest.  Since then all avenues of public policy discussion has followed----until now, incumbent pols are being allowed to simply say what they want with no meaningful dialog with voters.


City Council Dems like their doors closed

November 16, 2012

Schenectady City Council Democrats excluded the council’s lone non-Democratic member, public and press from two recent meetings where important decisions about “public” business were made. Although they’re allowed to hold these so-called political caucuses under the state open meetings law, they violated the law’s spirit and showed disrespect for the public by doing so.

Some history is in order here. The open meetings law has had an exemption for political party meetings or caucuses ever since it was adopted in 1976. But courts, noting the law’s broad language favoring openness wherever possible, limited the exemption to such things as party business and agendas. If the party, either majority or minority, was to discuss public business, the meeting had to be open, the courts said.

In 1985, everything changed after the state Assembly was threatened with a lawsuit for denying a reporter access to its political caucuses. The Legislature quickly passed an amendment to the open meetings law giving itself and local legislative bodies the right to discuss even public business in closed-door conferences or caucuses. It said that the public interest was promoted by “private, candid exchange of ideas and points of view among members of each political party concerning the public business to come before legislative bodies.”

But even then, the Appellate Division in a 1991 decision said that a line could be drawn between “candid discussions” among party members and “the conduct of public business.” We’d venture to say that in a city like Schenectady, where one party is dominant, the decisions made in party caucuses — especially when those decisions are adopted the next day with minimal discussion, as they were with two important budget votes in recent weeks — effectively constitute the conduct of public business.

Do you support the Schenectady City Council's approach to discussing public issues in closed-door caucus sessions?
Yes

No



See the results.

Judging by the reaction at Tuesday’s regular council meeting, the public is not happy about this turn of events. But that doesn’t matter to the Democrats, who will hold caucuses regularly in the future, according to council President Denise Brucker.

Or maybe it depends on what the meaning of “is” is. Councilwoman Leesa Perazzo told us in a recent letter to the editor that these closed-door meetings, where no one but the Democrats are in attendance, aren’t “secret” meetings, because a) the law allows them and b) secret to her means "slimy people slinking through dark alleys to avoid being detected."

And Councilman Carl Erikson said what really matters is how he voted, not the debate or discussion that led to his vote. But if that were the case, why have an open meetings law at all?

Even with the exemption, there’s an intent behind that law: to let sunshine into government, to let the public see their representatives in action. The council is on the wrong path. It shouldn’t be doing its work in private just because it can.