Then our Maryland Assembly does the same with all health appropriations from the state------with again, Baltimore's pols leading the way-----Maggie McIntosh heads appropriations and made sure funds allocated went again to global health corporations and their NGOs----not to our city coffers.
THIS IS HOW ALL FEDERAL FUNDING THESE FEW DECADES OF CLINTON/BUSH/OBAMA WALL STREET POLS SIMPLY MOVED TO EXPANDING CORPORATIONS INTO MONOPOLY CONTROL. NOW THEY ARE INSTALLING GLOBAL CORPORATE CAMPUS MONOPOLIES-----BUT THEY ARE ONLY DOING THIS FOR THE POOR.
Dems campaign on Medicaid increase
By Jennifer Haberkorn
06/04/14 05:04 AM EDT
Updated 06/04/14 09:30 AM EDT
Democrats have found a big piece of Obamacare that nearly all factions of their party can back — and they say it’ll be a winning issue on the campaign trail this fall.
Even some of the Democrats running for reelection in red states are embracing the Affordable Care Act’s optional Medicaid expansion and, along with their compatriots, pressuring Republican governors and legislatures to do the same.
This growing support to expand Medicaid comes as Democrats feel increasingly comfortable touting the health care law, a slow change buoyed this spring by the positive news of Obamacare’s 8 million enrollees. They frame it as an issue that forces Republicans to explain why they want to deny health care access to poor people at zero cost to states — at least for the first three years while the federal government picks up the entire tab.
Moreover, polls show that Medicaid expansion could provide a big political boost. It’s far more popular than Obamacare itself.
“We’re going to have, for the first time in a little while, Democrats in vulnerable states and safe states all speaking with one voice in part because of the political momentum growing behind Medicaid expansion,” Sen. Chris Murphy (D-Conn.), the Senate Democrats’ point person on health care messaging, told POLITICO in an interview.
Murphy and other Senate Democrats are asking 18 Republican governors to agree to expand the program in a letter to be released Wednesday.
“There is a fundamental inequity playing out in your state and others that have chosen to not expand this basic health care coverage,” the 20 Democrats write in the letter. “A political difference should not result in almost 6 million Americans falling into a coverage gap because their income is too high for Medicaid coverage, but below the level for a premium tax credit for coverage through a Marketplace plan.”
However, even four years after Obamacare’s passage, Murphy admits that Democrats still have a hard time talking about it, although the law represents the pinnacle of decades of attempts by the party to pass a universal health care bill.
“Having cowered in a corner for a good part of the last four years, it’s hard to change your behavior,” he said. “It’s hard for people to immediately pivot from being on the defense in the fall [as HealthCare.gov crashed] to being on the offense. The news went from terrible to great in an instant, and sometimes it’s hard for your strategy to catch up.”
Medicaid is one aspect of the law where Democrats are falling into line — more so than with many other elements. In some cases, they’re touting Medicaid on its own, with little mention of Obamacare.
The Affordable Care Act required states to expand Medicaid to 138 percent of the federal poverty level, but a 2012 decision by the Supreme Court instead made that optional for states. So far, the District of Columbia and 26 states have chosen to expand their programs. Most of those states are controlled by Democrats.
Sen. Kay Hagan of North Carolina, one of the most vulnerable Democrats running in a state where the health care law is not particularly popular, pushed Sylvia Mathews Burwell to explain the benefits of Medicaid expansion in one of the nominee’s confirmation hearings to lead Health and Human Services.
Hagan will continue to press for Medicaid expansion in her campaign against North Carolina House Speaker Thom Tillis, according to spokeswoman Sadie Weiner. “Like all of the issues in this race, health care is a stark contrast between Kay’s record of pushing for common-sense fixes to this law and Thom Tillis, who brags about rejecting health care for 500,000 people,” Weiner said.
Sen. Mary Landrieu, another Democrat facing voters this fall, has been saying that Louisianans who find themselves without Medicaid because of lawmakers’ decision not to expand are in the “Jindal gap,” a reference to Republican Gov. Bobby Jindal, an expansion opponent.
Sen. Mark Begich (D-Alaska) has encouraged his governor to expand the program there, and Michelle Nunn, the Democrat running for the open Senate seat in Georgia, has supported expansion, too.
To be sure, it’s not universal. Alison Lundergan Grimes, who is trying to retire Senate Republican leader Mitch McConnell in Kentucky, has said that she wants to “fix” the health care law but hasn’t weighed in on Medicaid specifically.
Republicans aren’t universal in their opposition, either, particularly in states that have already expanded or are in the process of doing so. Terri Lynn Land, the Republican Senate candidate in Michigan, praised her Republican governor’s decision to expand Medicaid.
In New Hampshire, which just approved Medicaid expansion, Senate candidate Scott Brown has said that eligible residents could be covered in another way.
“You can incorporate any of the considerations for those people on Medicaid expansion into a plan that works for us,” he told The Boston Globe recently. Brown has repeatedly refused to directly say whether he approves or supports New Hampshire’s move.
But overall, Republicans have largely scoffed at expanding Medicaid, arguing that it is fruitless to add people to a broken program that will eventually cost the states more money. These GOP critics worry that there is nothing to prevent the federal government from pushing all of the cost to the states in the future.
The Democrats’ argument for expansion is easy: It’s giving more people care in an already familiar system, they say. And without Medicaid, some people would have no health coverage at all. In many states, hospitals are also aggressively pushing expansion so that more of their customers have coverage and don’t need their charity care.
Polls suggest that Medicaid expansion could be a political winner. A March survey by the Kaiser Family Foundation found that 74 percent of respondents had a favorable view of Medicaid expansion — far more than the 38 percent who had a favorable opinion of Obamacare overall.
At the same time, there are obstacles: That survey also found that only 60 percent of people even knew about the Medicaid expansion piece of the law.
When we know CLINTON/OBAMA are far-right 1% Wall Street global corporate neo-liberals working for extreme wealth and corporate empire-building---then we understand when media is telling us CONGRESSIONAL DEMOCRATS are pushing expanded Medicaid fighting for the poor----this is all progressive posing. Republican states for decades have misappropriated Federal funding for Medicare and Medicaid allowing hundreds of billions of dollars be lost in health industry fraud these few decades. All this money was used to build global health corporations. That is why we see below the leaders of expanded Medicaid are southern pols----it is why a very 1% Wall Street global corporate neo-conservative state like Texas embraced expanded Medicaid---it becomes a pool of money for corporate subsidy when our pols all work for corporations.
The Affordable Care Act was used to privatize all Federal public health including Medicare and Medicaid making them simply block grants sent to private state health systems. So, we are seeing all of what is called a health system for the poor simply funding used to build clinics inside existing global corporations. They get the subsidy---they will decide what our health care looks like----and they will close down these health structures when global corporate campus health tourism infrastructure is built---saying they are not profitable. This could be only a decade or so.
THIS IS HOW FAR-RIGHT 1% WALL STREET GLOBAL CORPORATE POLS HAVE BEEN DOING THESE FEW DECADES---CLINTON/BUSH/OBAMA.
When our local politicians bring these same talking points locally-----filled with the progressive posing of helping the poor----we lose all of what would be organized funding for a strong, public health system in our communities and cities.
REPUBLICAN THINK TANKS DECADES AGO WROTE HEALTH POLICY TO END OUR FEDERAL MEDICARE AND MEDICAID---CALLING IT ----SINGLE-PAYER UNIVERSAL CARE----AND IT IS NOTHING BUT GUTTED OF FUNDING MEDICAID FOR ALL.
That is the goal of these policies----and what we see being build in our communities is just that-----moving more wealth to global corporations for something that will be temporary.
Cohen, 33 Democrats Announce Formation of New Congressional State Medicaid Expansion Caucus
July 23, 2014
Press Release[WASHINGTON, DC] – Continuing his efforts to bring high-quality health coverage to Tennessee’s most needy, Congressman Steve Cohen (TN-09) joined Congressmen Hank Johnson (GA-04) and G.K. Butterfield (NC-01) and many others this morning to launch the new Congressional State Medicaid Expansion Caucus. The Caucus, which includes 34 Members of Congress, is being launched to highlight the need for all Governors and state legislatures—including Tennessee Governor Bill Haslam and the Tennessee General Assembly—to expand their Medicaid systems as prescribed by President Obama’s landmark Affordable Care Act and provide benefits to low-income citizens currently caught in a politically-caused coverage gap.
“By not expanding Medicaid, Governors around the country—and at home in Tennessee—are conveying a message that they have little concern for the neediest, sickest, and most desperate of their constituents,” said Congressman Cohen “While this may not be Governor Haslam’s intention, the reality of the situation is that 234,000 of our state’s most needy are going or will go without the health coverage that they need and that President Obama’s health care reform law says they should have. Studies have even shown that thousands of Americans each year will die avoidable deaths because of lack of access to Medicaid. That is unacceptable.”
This morning’s launch launch of the State Medicaid Expansion Caucus follows a White House Council of Economic Advisors report showing that 234,000 Tennesseans who would be eligible for health insurance coverage under the state’s Medicaid program, TennCare, will not be covered in 2016 and that more than 40,000 residents will face financial hardship, many catastrophically, as a result of not being covered by an expanded TennCare program.
“I remain committed to ensuring that all Tennesseans are able to take advantage of the important protections made available by the President’s landmark Affordable Care Act, and I am proud to join so many of my socially-conscious colleagues in calling on every governor to do the right thing, take swift action, and expand Medicaid for the good of our country’s citizens.”
Several times this year, Congressman Cohen has offered to help the Tennessee Governor extend health coverage to those who cannot afford coverage and are unable to take advantage of important protections of President Obama’s Affordable Care Act (ACA) because of the state’s inaction. In a recent letter to the Governor on this topic, Congressman Cohen also highlighted how a number of conservative governors—including Ohio’s John Kasich and Arizona’s Jan Brewer—have worked with the U.S. Department of Health and Human Services (HHS) to expand Medicaid coverage to their states’ less fortunate.
“Even Conservative Arizona Governor Jan Brewer expanded Medicaid,” continued Congressman Cohen. “If Governor Brewer with the recalcitrant legislature she has can do it, Governor Haslam can do it, too. But instead we’re losing all of this money. It is immoral for our state to not provide this basic necessity to those who need it desperately, especially when the vast majority of the cost is covered by the Affordable Care Act.”
Representatives from healthcare advocacy groups including Families USA, Center on Budget and Policy Priorities, Coalition on Human Needs, the Catholic Health Association of the United States; and the Georgetown Center for Children and Families also joined Congressman Cohen and his colleagues to help launch the State Medicaid Expansion Caucus this morning.
'though state analysts say Maryland is actually spending less on its Medicaid population because federal health care reform is covering 100,000 people who used to get health care paid entirely by the state'.
Baltimore City and Maryland have used Federal funding to pay for lots of public services and as we see here public programs. So, Federal funding for Medicaid is sent to cover state employee benefits and then the rest is sent to build CVS clinics, Hopkins/UMMS global health tourism structures. When I hear Baltimore citizens saying they feel they are receiving benefits-----as with each privitization of public agencies IT IS JUST TEMPORARY.
In Maryland Johns Hopkins moved into the only avenue for what would be public Medicare and Medicaid by funding Beilenson's EVERGREEN NGO. This was supposedly our PUBLIC OPTION----it is simply a corporate NGO pooling more and more and more Maryland citizens falling out of what used to be strong health insurance coverage.....
THIS WILL BECOME THE GUTTED OF FUNDING PRIVATIZED MEDICAID FOR ALL.
We will hear in a decade or so that this PUBLIC OPTION CORPORATE NON-PROFIT----EVERGREEN-----WILL NOT BE ECONOMICALLY FEASIBLE. ALL WE NEEDED WAS TO EXPAND AND IMPROVE OUR EXISTING FEDERAL MEDICARE AND ALL CITIZENS WOULD HAVE REAL DEVELOPED NATION UNIVERSAL SINGLE-PAYER HEALTH CARE.
Why do you think all these Federal and state laws regarding raising minimum wage and this Medicaid expansion is tied to 2020----or 2022? This coming economic crash will be so deep with government debt that Congress and Maryland Assembly will simply say----SORRY, NO MONEY. That is how all this will be dismantled.
'The federal government agreed to pay all costs for the new enrollees through 2016, but it will begin lowering its share in 2017. States will pay 10 percent of the costs by 2020'.
As US middle-class is disappearing ----now maybe 17% of Americans this coming economic depression/repression will make this lower still. With higher unemployment for US citizens OVER 80% AND MORE WILL BE ON THIS GUTTED OF FUNDING MEDICAID FOR ALL. It will literally be for US citizens MEDICAID FOR ALL. So, it won't be WE THE PEOPLE accessing all that hundreds of billions of dollars in global health tourism and telemedicine----CLINTON/BUSH/OBAMA WALL STREET PLAYERS HAVE WORKED HARD TO INSTALL.
Maryland Medicaid Expansion Much Higher Than Forecast
July 19, 2015 12:36 AM
Filed Under: Maryland Medicaid, Maryland Medicaid Expansion, Medicaid, Medicaid Expansion
ANNAPOLIS, Md. (AP) — Maryland is one of more than a dozen states where new Medicaid enrollees under President Barack Obama’s health care law have surpassed initial projects, though state analysts say Maryland is actually spending less on its Medicaid population because federal health care reform is covering 100,000 people who used to get health care paid entirely by the state.
The projected newly eligible enrollment for fiscal year 2015 initially was 164,724 in Maryland. The initial estimated cost was about $31 million for fiscal year 2017, when states begin paying their share.
The actual enrollment for fiscal year 2015 ended up being about 220,442, with an estimated cost of about $54 million in fiscal year 2017. Maryland is currently in the process of setting rates for managed care organizations for calendar 2016, so the projected $54 million cost could change again later this year.
However, about 100,000 people who were covered entirely at state expense under the state’s Primary Adult Care program are now covered by Medicaid with shared state and federal costs. Also, people who once received health care through PAC receive added benefits under the full range of Medicaid.
It’s expected that Medicaid will take up an increasingly larger percentage of the state budget moving forward. The state has found alternative revenue sources to reduce pressure on the state budget.
Maryland has significantly increased provider taxes on hospital and nursing homes in recent years, and the state has continued to rely on other state funds sources to alleviate Maryland’s reliance on general funds.
Vincent DeMarco, president of Maryland Citizens’ Health Initiative, said health care reform has led to a drop in costs related to uncompensated care.
TO WHAT DEMARCO REFERS IS THIS----HOSPITALS IN MARYLAND CAN NOW REFUSE TO ACCEPT PATIENTS----AND THIS HAS LOWERED UNCOMPENSATED CARE COSTS. THE HIGHER TAXES ON PROVIDERS FALLS ON COMMUNITY FACILITIES OFTEN FORCING THEM TO CLOSE. MARYLAND ALLOWS ROOM TAX AT HOSPITALS TO BE TAKEN FROM MEDICARE FUNDING FOR EXAMPLE.
“The fact of the matter is we don’t let people die in the street,” DeMarco said. “It’s better, I think, to have it done through the taxes that go to pay for Medicaid at the federal or state level than higher premiums for uncompensated care.”
But critics of federal health care reform question whether it will truly reduce uncompensated care. Del. Anthony O’Donnell, a Calvert County Republican, said he is concerned it will worsen doctor shortages in primary care in rural parts of the state and exacerbate wait times.
“I have a lot of concern that the people that are selling the virtues of this aren’t being honest about the downsides and the costs of it, and they’re covering it up and they have been from the beginning,” O’Donnell said.
Thirty states and the District of Columbia expanded Medicaid to include all non-disabled adults with incomes at or below 138 percent of the federal poverty level, currently $16,243 for an individual. The federal government agreed to pay all costs for the new enrollees through 2016, but it will begin lowering its share in 2017. States will pay 10 percent of the costs by 2020.
Here we have what many other 1% Wall Street global pols added to a very private health insurance system-----EVERGREEN. The goal was to end corporate, public sector, and Federal public health programs that provided a developed nation coverage of health care to all US citizens---and move it to ONE WORLD International Economic Zone developing nation health care status where only the 1% and their 2% can afford to access a US-level of health care. We are watching as corporations shed their strong health insurance policies-----building preventative care only structures in which they are invested and profiting. We see national labor union leaders DELIBERATELY setting up their members to lose CADILLAC HEALTH POLICIES because they constantly support the Wall Street neo-liberals committed to doing this. They too are profiting from all this FOR NOW. Then we have our Federal, state, and local public sector unions-----all set up to lose their pensions and health benefits in this coming bond market fraud leading to economic crash. These several years of Obama and Clinton neo-liberal health policies have set the stage for US citizens losing all of what used to be developed nation public health care access.
As all those avenues to health care collapse----here is the global corporate NGO installed to catch these citizens and transition them to third world levels of health care. We see they PRETEND to connect to private health systems---Evergreen is simply the same Johns Hopkins' Beilenson that started another MARYLAND HEALTH CARE FOR ALL organization that worked to privatize Medicare and Medicaid into that Republican block-granted funding that disappears in misappropriation, fraud, and corruption. What is called a corporate non-profit will become that lower-tiered clinic care access----sending citizens to CVS clinics et al-----until they simply stop PRETENDING to help the poor with health care access.
EVERGREEN AS DR BEILENSON KNOWS is a medical term for protecting patented medical and PHARMA products from losing those patent rights. That is exactly what TRANS PACIFIC TRADE PACT policy for health care says-----Beilenson is simply creating the structure to meet the terms of TPP for health care in International Economic Zones.
It is highly likely that a Mr Cohen of Baltimore Sun knows all this PROGRESSIVE POSING too. It is media's job to PRETEND what 1% Wall Street global corporate pols are saying is true----that all this really is meant to help the poor.
Evergreen Health Insurance Co-op Hopes to Succeed in Maryland
By Rick Cohen | February 3, 2015
January 17, 2015; InsuranceNewsNet.com (Baltimore Sun)
Maryland’s state exchange during the first year of the Affordable Care Act was pretty much of a dysfunctional mess. That was the challenge as much as any that impeded the Evergreen Health Co-op in its first year, leading to its signing up only 400 customers. This year, so far, it has signed up 2,129 customers, lagging behind CareFirst BlueCross Blue Shield’s 72,000 enrollees.
Last month, the co-op serving Iowa went under, finding itself undercapitalized for the number of customers it had signed up. Evergreen found itself not only undermined by one of the nation’s worst state exchanges, but having to face off against CareFirst, which, as Evergreen CEO Dr. Peter Beilenson noted, was “basically…a monopoly.”
Undercapitalized and restricted in what they could do with the federal start-up loans they received, the nonprofit health insurance cooperatives created under the Affordable Care Act have actually done better than expected. Although they enrolled as a total fewer customers than the government had projected, the Baltimore Sun’s Meredith Cohn says that much of the shortfall could be attributed to state health exchange dysfunctions. As our review of nonprofit health insurance cooperatives revealed, there were also fewer co-ops available than planned because in the budget deal Congress cut off funding for new cooperatives.
Evergreen anticipates at least breaking even this year and beginning to pay back its $65 million in federal loans. To do so, Evergreen is going to have to do what other health insurance cooperatives have done, going after small business accounts and large employers’ business. In addition, Evergreen will have to market aggressively, lower premiums, and control costs. So far, Evergreen is one of nine co-ops that offer the lowest cost Silver plans in their states. Evergreen has added to its offerings by operating its own health centers, apparently the only one of the two dozen nonprofit co-ops in the nation to do so. The health centers have attracted consumers who didn’t already have health insurance, according to Beilenson.
The key to the health centers—and to the potential of the cooperatives in general--is focusing on preventive care, what might be considered health care as opposed to sick care. Cohn cites Jean Donnell, a resident of Pikesville, Maryland, whose church switched to Evergreen. Initially she was unhappy duo to her inability to keep her previous doctor, but she found herself “pleasantly surprised” by her treatment at Evergreen’s White Marsh health center.
“I’ve had nice doctors before and maybe I’d tell them some things,” she said, “but no one ever inquired about my health quite like this—and was willing to do something about it.”
MARYLAND HAS GROWN PLENTY OF MEDICAL CORPORATIONS FROM CALLING WHAT ARE CORPORATE STARTUPS----NON-PROFITS. WATCH AS THIS 'NON-PROFIT' EXPANDS NATIONALLY. JOHNS HOPKINS IS A GLOBAL CORPORATION STILL NOT PAYING TAXES BECAUSE OF NON-PROFIT STATUS.
Cohn reports that at the Evergreen health centers, “Doctors, nurses and staff ‘huddle’ each morning to discuss the day’s patients and who may need what services, which means everything from intervention in domestic violence situations to help quitting smoking.” According to Cohn, “Dr. Joy Baldwin, the center’s salaried doctor, also spends 30 minutes with each patient. At her previous job in a traditional medical office, she said she was often triple-booked for 15-minute appointments.”
Remember, there is a reason that the nonprofit health insurance cooperatives exist. It is because Congress nixed President Obama’s push for the “public option” to provide effective competition with the big insurers.
A NON-PROFIT IS A CORPORATION-----PUBLIC HEALTH IS PUBLIC.
Evergreen and the other co-ops are demonstrating competition as more than a matter of health insurance premiums. By emphasizing quality healthcare and preventive care, by offering better service, and by treating each customer, as Donnell put it, as a “whole person,” nonprofit insurance cooperatives like Evergreen are trying to change what Americans should accept as medical care. Whether or not as new start-ups that didn’t exist a couple of years ago these co-ops ever get to the scale to challenge the behemoth monopoly insurance providers, the cooperatives are providing yardstick competition in the U.S. medical system generating changes in what consumers should expect at the hands of doctors, hospitals, and insurance companies.—Rick Cohen
Since Maryland's elections are captured with election rigging and cronyism-----those working for the 1% Wall Street are bold in their disregard for the 99%----they name a corporate non-profit after the very process that will end up denying 99% of global citizens access to life-saving PHARMA and medical procedures. This is done to protect global health profits by seeking to keep patented name brand pricing and block the making of generic PHARMA most people can afford. So, TPP seeks to end generics to maximize profits for name brands-----and international health justice organizations call this EVERGREENING.
Wall Street global pols will tell you----IT DOESN'T END GENERICS----what it does for now is delay what is the best treatment today ----to maybe decades down the road at which time ONE WORLD GLOBAL CORPORATE TRIBUNAL will not even be PRETENDING to help the poor.
Here we see what Obama and Congressional Republicans and Clinton neo-liberals are working hard to fast track----TPP and all the health policies from Congress these several years under Obama have been to install these global health system structures.
I LIKE TO REMIND-----WHEN FAR-RIGHT 1% WALL STREET AUTHORITARIAN CORPORATE RULE TAKES HOLD-----HEALTH CARE BECOMES VERY REPRESSIVE/ABUSIVE FOR WE THE PEOPLE.
'One of the practices that would be allowed is known as "evergreening." It lets drug companies extend the life of a patent by slightly modifying their product and then getting a new patent. This is a video explaining the practice, produced by Doctors Without Borders.
NARRATOR: Evergreening. Sounds nice, doesn’t it? But evergreening is what drug companies do when they want to increase their profits. And it leaves people in developing countries without the medicines they need. Here’s how'.
Backlash Against TPP Grows as Leaked Text Reveals Increased Corporate Control of Public Health
June 11, 2015
Peter Maybardukdirector of Public Citizen’s Global Access to Medicines Program.
As the Obama administration praises the benefits of the Trans-Pacific Partnership (TPP), backlash continues to grow against the deal. WikiLeaks has just published another section of the secret text — this one about public healthcare and the pharmaceutical industry. Newly revealed details of the draft show the TPP would give major pharmaceutical companies more power over public access to medicine and weaken public healthcare programs. The leaked draft also suggests the TPP would prevent Congress from passing reforms to lower drug costs. One of the practices that would be allowed is known as "evergreening." It lets drug companies extend the life of a patent by slightly modifying their product and then getting a new patent. We speak to Peter Maybarduk of Public Citizen and John Sifton of Human Rights Watch about their concerns.
NERMEEN SHAIKH: House Republicans are set to push for a vote as soon as Friday on approving a measure to give President Obama fast-track authority to negotiate the Trans-Pacific Partnership deal. The secretive TPP deal involves 12 countries and nearly 40 percent of the global economy. On Wednesday, WikiLeaks released a leaked draft of another chapter of the secret negotiating text, this time the TPP’s so-called Healthcare Annex. Newly revealed details of the draft show the TPP would give major pharmaceutical companies more power over public access to medicine and weaken public healthcare programs. The leaked draft also suggests the TPP would prevent Congress from passing reforms to lower drug costs. One of the practices that would be allowed is known as "evergreening." It lets drug companies extend the life of a patent by slightly modifying their product and then getting a new patent. This is a video explaining the practice, produced by Doctors Without Borders.
NARRATOR: Evergreening. Sounds nice, doesn’t it? But evergreening is what drug companies do when they want to increase their profits. And it leaves people in developing countries without the medicines they need. Here’s how. A drug company develops a new drug and is rewarded with a patent. The patent stops other producers making the medicine for 20 years. So the drug company can charge very high prices without anyone else undercutting them—for 20 years. When the patent ends, other producers can come in and compete with each other, and bingo, the prices come tumbling down. So the medicines become affordable for everyone. But the drug companies want more profits, so they make a tiny little change to their drugs and ask for another 20-year patent.
AMY GOODMAN: Well, for more, we’re joined by two guests in Washington, D.C. Peter Maybarduk is director of Public Citizen’s Global Access to Medicines Program. And John Sifton is advocacy director with Human Rights Watch. Today he’s hosting a briefing at the National Press Club on human rights and humanitarian concerns about the Trans-Pacific Partnership, along with Oxfam America and the Council on Global Equality.
We welcome you both to Democracy Now! Peter, let’s begin with you on this issue of drugs. Talk about the TPP, and, for those who have never heard of it, explain its significance, and particularly as it relates to global access to drugs.
PETER MAYBARDUK: Sure. It’s great to be with you. The Trans-Pacific Partnership is an ongoing trade negotiation—been going for about five years now—among 12 countries, including developing countries like Vietnam, Peru, Malaysia, as well as the United States. And in this agreement, the U.S. trade representative and the Obama administration put forward a number of proposals that have nothing to do with trade. There are about 30 chapters. Only a few have leaked; the rest is negotiated in secret. And among the many harmful proposals that have been made by big business are demands to transform other countries’ rules with regard to medical patents and many rules affecting people’s access to affordable medicines.
We’re very concerned that the TPP would lead to preventable suffering and death in these countries where people rely on access to generics. There are many provisions in the TPP that would expand the pharmaceutical industry’s monopoly power. We’re also concerned about rules in this latest leak that potentially have implications for Medicare and for U.S. programming, and most particularly constraining our ability to make some of the healthcare reforms that the Obama administration has pledged to reduce healthcare costs for Americans.
AMY GOODMAN: And you’re just learning this now, because WikiLeaks has released the chapter on these issues?
PETER MAYBARDUK: Well, this annex, which is ironically an annex to a chapter called "Transparency," is the latest in a series of leaks that have been published that give us more particular idea of exactly what rules are being negotiated. The details—the details matter. You can’t get into the negotiations. We do our best to follow by talking to contacts that we know, but due to the secrecy, it’s really only through leaks that we’re available to evaluate the particular proposals and assess their impact. These are all rules that would otherwise be debated in our congresses and parliaments out in the open, rules that include many gifts to big business. And so it’s very concerning that we have to rely on someone taking the tremendous risk of leaking a document in order to have a real public debate about the issues.
AMY GOODMAN: What is the possible justification for not revealing what is in the TPP? President Obama repeatedly says, "Trust me." He says, you know, Elizabeth Warren, Bernie Sanders, they’re getting it wrong. But we are not able to see. The senators can’t even see, unless they go into a room, what is in this deal?
PETER MAYBARDUK: Yeah, well, the U.S. trade representative has come out and as much as said that we can’t tell you what’s in the agreement because it would create political complications for the negotiation, which is effectively the same thing as saying if people saw what’s in it, they wouldn’t like it, and we wouldn’t be able to pass the deal.
NERMEEN SHAIKH: Well, Peter, I want to ask you about what you mentioned earlier about the possible impact of the TPP deal, from what has been revealed, on Medicare here in the U.S. The New York Times yesterday, Wednesday, cited officials at the U.S. Trade Representative’s Office saying rules in the TPP would have no impact on the U.S., because Medicare and Medicaid already adhere to them. Could you comment on that? Of course, they didn’t officially comment on the leaked draft, but these were comments that they disclosed to The New York Times.
PETER MAYBARDUK: Well, the administration makes that assertion. But as I say, the details matter. And if you read the leaked text and compare it to Medicare regulations, we’re quite concerned that it gives pharmaceutical companies opportunities to say, "Well, we have broader rights under the TPP than we have under Medicare regulations. We want to be listed in the formularies if we show any therapeutic value, we want to have opportunities to comment at all meaningful points according to our own definitions." And we’re concerned that that could mean potentially that pharmaceutical companies might even be able to bolster a claim in these secret investor-state tribunals, that are much more friendly to investor rules, in order to make their arguments about interpretation of the particular terms. So we’re concerned that there are potential consequences for Medicare A and B today, if pharmaceutical company lawyers and lobbyists exploit what they might now see as their rights if this agreement is signed. But we’re also concerned about what happens to Medicare Part D in the future.
The president’s budget includes a proposal to allow Medicare to negotiate for lower prescription drug costs, something that 75 or 80 percent of Americans support broadly across party lines, could save a tremendous amount of money if it’s implemented with a national formulary. And implementing a national formulary under these rules that have just leaked yesterday would be difficult, would be expensive, subject to a great deal of challenge. We know this, in part, specifically because the Veterans Administration, for example, which is considered a model for procurement practices, has been specifically excluded from the annex, we think, because it’s known that these rules would make it difficult for the VA to operate, similarly would make it difficult for us to negotiate drug prices the way we need to.
AMY GOODMAN: John Sifton, you’re holding a news conference today with other human rights groups. Can you expand on—I mean, health rights are also a human right, but go further and talk about your overall human rights concerns with the TPP.
JOHN SIFTON: Well, there are issues both within the agreement with respect to the health issues, but also labor rights issues. And then there are issues that are larger, on the geopolitical level. The simple fact is, this agreement rewards several countries which have atrocious human rights records. One of them is Vietnam, a one-party, undemocratic state ruled by the Communist Party of Vietnam, no elections, no freedom of speech. This is a country which lacks of dissidence for criticizing the government, voicing their own issues. So, that’s one trading partner.
Another, Brunei. The sultan of Brunei wants to impose Sharia law, which would result in adulterers being stoned to death, thieves having their hands cut off, homosexuals whipped. This is a country which is also nondemocratic, ruled by fiat, by a sultan who inherited his power through birth.
Then you have countries like Malaysia, which although emerging democracies have serious problems with freedom of expression and rights of lesbian, gay, transgender people. Singapore, the city-state next to Malaysia, also has serious problems with labor rights and freedom of expression.
All these countries would be rewarded by the United States. We’d like to see the United States use the agreement as leverage to compel these countries to improve their human rights records. And yet, over the last four or five years, that hasn’t really happened. A couple of the countries have made baby steps. Vietnam has done a few minor things. But by and large, no big agreements. Malaysia, in fact, its human rights record has gotten worse.
NERMEEN SHAIKH: Well, this is President Obama speaking last month about how the TPP would improve worker conditions in Vietnam as well as here in the United States.
PRESIDENT BARACK OBAMA: So, when you look at a country like Vietnam, under this agreement, Vietnam would actually for the first time have to raise its labor standards. It would have to set a minimum wage. It would have to pass safe workplace laws to protect its workers. It would even have to protect workers’ freedom to form unions for the very first time. That would make a difference. That helps to level the playing field. And it would be good for the workers in Vietnam, even as it helps make sure that they’re not undercutting competition here in the United States. So that’s progress.
NERMEEN SHAIKH: John Sifton, that was President Obama speaking. Could you comment on what he said about the likelihood of worker conditions improving as a consequence of the TPP?
JOHN SIFTON: Well, look, we give credit to the administration for pushing along a good labor chapter that would have provisions that would do some of the things that President Obama said. Problem is, all that would be on paper. The key issue here is: Would those provisions be enforceable? Would Vietnamese workers be able to actually compel the government of Vietnam to make those supposed paper reforms a reality? And that’s where the Obama administration has been very disingenuous. They suggest the labor chapter is enforceable. What they mean is that if Vietnam fails to meet the standards, a nonexistent Vietnamese union would bring a claim in a nonexistent tribunal to compel Vietnam to improve its rights? No. The only possibility is that an outside group, maybe an international labor federation, could compel another country, like the United States, to bring a complaint against Vietnam about its labor practices in the abstract, and maybe, after many years of tribunal litigation, that would result in some kind of penalty being imposed on Vietnam. That’s not enforceability. That’s merely a process which might potentially impact Vietnam’s reform process on the grand scale. There is nothing like the rights that investors have to compel governments to change their rules. And that, at the end of the day, is what’s wrong with the TPP. It creates rights for companies and investors, but it doesn’t create new rights for workers or civil society. It basically gives corporations more rights than people.
NERMEEN SHAIKH: And, Peter, before we conclude, could you just explain specifically what you think the impact of this deal would be on drugs that are used over the long term—for instance, cancer or HIV drugs?
PETER MAYBARDUK: Certainly. Well, there’s a combination of provisions in the intellectual property chapter, enforceable, potentially, through the investment chapter, affected in terms of negotiation powers in this leak that just came out yesterday published by WikiLeaks, that show us that the generic competition, the affordable medicines on which people around the world in many TPP countries depend would be blocked through the expanding monopoly powers of the industry under this agreement. That includes the patent evergreening rules that you mentioned in your run-up. But, you know, for example, if we look at cancer, there’s a rule proposed that was tucked in through a massive lobbying effort by the pharmaceutical industry, tucked into Obamacare, for 12-year automatic monopolies on biologics, which include a great many cancer drugs. Eleven of 12 cancer treatments approved recently by the FDA cost more than $100,000. That’s a leading driver of bankruptcy for American families and leads to devastating consequences—routinely, to death for people in developing countries. So if competition is blocked for a long period of time, governments aren’t going to even be able to offer some of these treatments to their citizens, and people will suffer.
JOHN SIFTON: And it’s madness on the issue of antivirals for HIV/AIDS. It’s amazing that one part of this government, PEPFAR, which is the president’s agenda for combating HIV/AIDS worldwide, they’ll see higher costs to their budget as they try to help countries fight HIV/AIDS, because antivirals, second-stage antivirals, the kind you have to use once the initial ones wear off after a certain number of years of use, are going to be more expensive. Not to mention that all these groups, these humanitarian groups on the ground, are obliged to use subpar generic antivirals, even though there are better drugs that are coming on market, simply because of this expansion in the patent protections. It’s really unconscionable.
AMY GOODMAN: John Sifton, we want to thank you very much for being with us. I know you have to run off to your news conference over at the—you’re holding it at the National Press Club. John Sifton is with Human Rights Watch, and together with Oxfam America, as well as other groups, like the Council on Global Equality, they will be speaking out against TPP. And thank you very much to Peter Maybarduk, director of Public Citizen’s Global Access to Medicines Program.
This is Democracy Now! When we come back, has ISIS trumped al-Qaeda, actually begun to destroy it? We go to London to talk with a journalist with The Guardian. Stay with us.
All Americans should understand what these corporate patent laws do to citizens. It is not only health care but across industry abuse of what was a reasonable patent policy. As articles state---it sets the stage for global monopolies keeping what are inventions broadly stated so future citizens cannot replicate a product type EVER. In this case we are talking about health care and when it comes to life and death these issues of monopoly soar. CLINTON/BUSH/OBAMA and their pols spent these few decades re-writing patent law in favor of global corporate patent monopoly. This is super-sized now by Obama and Clinton neo-liberals making our UNIVERSITIES patent-machines----as with these BIOTECH PARKS. It was our public universities that did the research and development of what was most health care innovation last century and WE THE PEOPLE as taxpayers were able to access that. It was free-use research. This does the opposite---it makes all medical research private and patented---and now they want to maximize profits by writing patent laws designed to keep patents active indefinitely.
When Maryland and Beilenson names a corporate health non-profit after this very process of profits over people THEY ARE MOCKING THE 99% OF MARYLAND CITIZENS.
Using Patents To Needlessly Drive Up Healthcare Costs: The Economic Impact Of Evergreening Drugs
from the evergreening-profits dept
One technique in the world of pharma that has started appearing here on Techdirt is "evergreening" -- making small changes to a drug, often about to come off patent, in order to gain a new patent that extends its manufacturer's control over it. The advantages for pharma companies are evident, but what about the public? What economic impact does evergreening have? That's what a fascinating new paper in the open access journal PLoS Medicine seeks to establish:
The researchers identified prescriptions of eight follow-on drugs issued by hospital and community pharmacists in Geneva between 2000 and 2008. To analyze the impact of evergreening strategies on healthcare spending, they calculated the market share score (an indicator of market competitiveness) for all prescriptions of the originally patented (brand) drug, the follow-on drug, and generic versions of the drug. The researchers then used hospital and community databases to analyze the costs of replacing brand and/or follow-on drugs with a corresponding generic drug (when available) under three scenarios (1) replacing all brand drug prescriptions, (2) replacing all follow-on drug prescriptions, and (3) replacing both follow-on and brand prescriptions.
And here's what they found:
Using these methods, the researchers found that over the study period, the number of patients receiving either a brand or follow-on drug increased from 56,686 patients in 2001 to 131,193 patients in 2008. The total cost for all studied drugs was €171.5 million, of which €103.2 million was for brand drugs, €41.1 million was for follow-on drugs, and €27.2 million was for generic drugs. Based on scenario 1 (all brand drugs being replaced by generics) and scenario 2 (all follow-on drugs being replaced by generics), over the study period, the healthcare system could have saved €15.9 million and €14.4 million in extra costs, respectively. The researchers also found some evidence that hospital prescribing patterns (through a restrictive drug formulary [RDF]) influenced prescribing in the community: over the study period, the influence of hospital prescription patterns on the community resulted in an extra cost of €503,600 (mainly attributable to two drugs, esomeprazole and escitalopram). However, this influence also resulted in some savings because of a generic drug listed in the hospital formulary: use of the generic version of the drug cetirizine resulted in savings of €7,700.
Obviously, this is just one study, in one area, although on the plus side it involves quite a long time period, and many patients. Despite its limitations, it nonetheless offers a useful first analysis of the economic impact of evergreening drugs. It's certainly an aspect of drug prescription that hospitals and doctors need to consider. As the study concludes:
Evergreening strategies have been successful in maintaining market share in Geneva, offsetting competition by generics and cost containment policies. Hospitals may be contributing to increased overall healthcare costs by listing follow-on drugs in their RDF. Therefore, healthcare providers and policy makers should be aware of the impact of evergreening strategies.
That suggests we can expect to see many more evergreened drugs in the future as highly-profitable compounds start to come off patent, and pharma companies search for ways of maintaining their high profit levels.
When a city pays no attention to public health as in Baltimore---yes, they have a great street violence emergency department---we are talking everyday life public health---we can go to the source----Johns Hopkins under a Bloomberg School of Public Health has written public health policy----has controlled all movement of revenue designated for public health and now has global health corporations all over the world---from using that control of our health care funding. Let Beilenson know WE KNOW what EVERGREENING IS and let him know we do not appreciate a PRETEND structure named that as the only source for what should be a STATE PUBLIC HEALTH SYSTEM---STATE EXPANDED AND IMPROVED MEDICARE FOR ALL-----these are NOT intelligent or talented citizens---they simply misappropriate and deny good people what legally comes to them.
Think Big… Move fast
Dr. Peter Beilenson As Baltimore’s long-tenured health commissioner, Peter Beilenson daily confronts some of the nation’s most entrenched big-city health problems. He does it with political savvy, a flair for statistics, and one foot on the accelerator.
By Dale Keiger
Photos by David Colwell and Howard Korn
On a Tuesday morning in Baltimore in late June, Peter Beilenson is digging into some numbers. Baltimore has just had a bad weekend, with eight homicides. But none involved juveniles, to the relief of the dozen people assembled with Beilenson around a conference table. According to a bar graph projected on an overhead screen, since the first of the year 10 Baltimore kids have died by homicide. That’s 10 too many, but it’s a 33 percent reduction compared to this point last year, which is the kind of number this group is after.
“Peter has a towering intellect so he immediately understands a problem... Then he has the courage to take action.” —Stephen Teret, director of the School’s Center for Law and the Public’s Health
They meet weekly as part of a city health department data review called KidStat. Beilenson, MPH ’90, is the Baltimore City health commissioner. He’s held the job for the past 11 years, a long tenure for a big-city health commissioner. And the job gets more challenging all the time. Commissioners like Beilenson must deal with all the old problems—restaurant sanitation, vermin control, epidemics of sexually transmitted diseases, drug addiction—and new urban nightmares like bioterrorism, SARS, and “dirty bombs.” For more than a decade, Baltimore’s health problems have been Beilenson’s headache, and he’s responded by thinking big and moving fast.
“I would not want an extra day in this job unless I felt like we were really pushing things.”—Peter Beilenson
During Beilenson’s time on the job, Baltimore has not been the healthiest city in which to live. It has had high rates of violent crime, sexually transmitted diseases, and substance abuse, especially heroin. National television viewers of Homicide, The Corner, and The Wire know it mostly as that place where you’re either an overworked cop, a junkie, or a murder victim. Newspaper readers may recall it as the city that a few years ago managed what Beilenson, 43, ruefully calls “the trifecta”: the highest incidence of syphilis, gonorrhea, and Chlamydia among American cities. Baltimore ranks second in per capita violent crime, behind Detroit, with an appalling murder rate of five or six per week.
But Beilenson checks in on the city’s mobile needle-exchange program. to Beilenson, the city is becoming healthier by the day. He has a formidable memory, and he’s practiced at listing for reporters, legislators, and the public one sign of progress after another. Baltimore has had, for three years running, the biggest drop in violent crime of any major U.S. city—a 26 percent reduction since 1999—and the largest two-year drop in drug-related emergency-room visits. In what Beilenson has described as one of the most
Beilenson talks to reporters.
important accomplishments of his tenure, the city recently recorded the lowest infant-mortality rate in its history (10.4 deaths per 1,000 births, down from 11.9 deaths in 2001) and, for the first time last year, it saw infant mortality among blacks drop below the national average for blacks. Beilenson has set a goal to eradicate syphilis and tuberculosis in the city by 2008; he claims to be ahead of schedule on both. And in a time of straitened public finances, “we’ve increased drug treatment more per capita than any city in the United States, by far,” he says. “In fiscal ’97, we had 4,000 drug-treatment slots that treated 11,000 individuals that year. This year, we have approximately 9,000 treatment slots treating about 26,000 individuals.”
WHAT CAUSES HIGH RATES OF DRUG USE----STDs -----CRIME VIOLENCE----UNEMPLOYMENT AND DEEPENING POVERTY----WHICH INSTITUTION CREATES THE ECONOMIC POLICY THAT KEPT BALTIMORE STAGNANT AND COMMUNITIES CRUMBLING? JOHNS HOPKINS. IT DROVE THE CAUSES FOR ALL THESE PUBLIC HEALTH CRISES BECAUSE IT DIVERTED ALL THE CITIES ASSETS AND REVENUES TO EXPANDING GLOBALLY----AND BEILENSON DROVE THAT POLICY.