Bill Moyers on our health-care ‘debate’
At Salon:
Let’s get on with it, Mr. President. We’re up the proverbial creek with spaghetti as our paddle. This healthcare thing could have been the crossing of the Delaware, the turning point in the next American Revolution — the moment we put the mercenaries to rout, as Gen. Washington did the Hessians at Trenton. We could have stamped our victory “Made in the USA.” We could have said to the world, “Look what we did!” And we could have turned to each other and said, “Thank you.”
As it is, we’re about to get healthcare reform that measures human beings only in corporate terms of a cost-benefit analysis. I mean, this is topsy-turvy — we should be treating health as a condition, not a commodity.
As we speak, Pfizer, the world’s largest drug maker, has been fined a record $2.3 billion as a civil and criminal — yes, that’s criminal, as in fraud — penalty for promoting prescription drugs with the subtlety of the Russian mafia. It’s the fourth time in a decade Pfizer’s been called on the carpet. And these are the people into whose tender mercies Congress and the White House would deliver us?
Come on, Mr. President. Show us America is more than a circus or a market. Remind us of our greatness as a democracy. When you speak to Congress next week, just come out and say it. We thought we heard you say during the campaign last year that you want a government-run insurance plan alongside private insurance — mostly premium-based, with subsidies for low-and-moderate income people. Open to all individuals and employees who want to join and with everyone free to choose the doctors we want. We thought you said Uncle Sam would sign on as our tough, cost-minded negotiator standing up to the cartel of drug and insurance companies and Wall Street investors whose only interest is a company’s share price and profits.
And, about that unprecedented fine for Pfizer, it seems Wall Street couldn’t care less. Wonder why.
Unless the President utterly surprises everyone tomorrow evening, there’s not going to be any major overhaul of the health-insurance system in this country. As was done with the bankers, the deal has been struck to make sure that the pharmaceutical industry will not feel threatened. Where is all the change we were told to expect from this administration?
It is no more yes we can but how to get reelected. Yes his foes are greedy and corrupt. Yet he should go down fighting as Bill Moyers suggests. Obama would be admired if he fought all his contributors. He is very close to being another politician. Afghanistan and now health care. These are two prodigious lacuna in a president who campaigned on just the opposite.
The thing is, it’s not up to just him. If it were, we’d have a single-payer system. If the Congress can’t muster the votes for health care overhaul, whose fault it is? One man’s? That’s absurd. The simple reality is that there are lots and lots of people who are vehemently opposed to health care reform of the kind Obama’s talking about, and he has to contend with that fact. There are Democrats who WILL NOT VOTE for a bill if it includes a public option. How – how how how? – can anyone change that reality? Reason and argument aren’t working, since the objection is largely ideological, and hence, un-shiftable. Should Obama bribe them? Coerce them? How well does that reflect our democratic inclinations?
Trying again; don’t know why that last one broke through the margins.
Two of the comments here – Joe Komanchak’s “Where is all the change we were told to expect from this administration?” and Bill Mazzella’s “It is no more yes we can but how to get reelected” – led me to recall a recent piece by M.J. Rosenberg at Talking Points Memo’s TPM Café:
By the way, the media narrative (at least in the Times) has been shifting gears all over the place on the Health Care Saga. One minute it’s the end of the initiative, the next the White House is removing its kid gloves. Which goes to show, no one knows what’s going to happen or how.
Gene: I don’t think there’s much chance that the President will say anything like what Rosenberg proposed. I didn’t like the speech Obama gave the other day. It sounded too much like a campaigner. I’m hoping to hear a President tonight.
By the way, wouldn’t it be great if a president, when addressing the Congress, were to announce that he would appreciate it if all applause were kept until the end of the speech? He could then modulate his speech as he wishes, and journalists would have to find something more worthwhile to do than reporting on who did or didn’t applaud at which points, etc.
So your theory is that Wall Street didn’t care, not because it was aware that Pfizer had set money aside, but because a mere $2.3 billion is so small in comparison to the $80 billion that the White House was trying to get drug companies to promise?
Something Bill Moyers ought to read: http://www.forbes.com/2009/09/08/pfizer-bilion-dollar-settlement-fda-opinions-contributors-david-r-henderson-charles-l-hooper.html
My theory is that Wall St. knows that the fine, while record-breaking, will not seriously hamper the company’s ability to make money, especially given assurances drug manufacturers recently received from the White House.
Why should Moyers or anyone read that disingenuous op-ed? You could forgive Forbes readers for failing to grasp that Pfizer pleaded guilty to criminal charges in this case–and that they pleaded guilty to the same criminal charges in 2004, that they had been under federal supervision since, and did it anyway. The authors, one of whom still works as a consultant to drug manufacturers, offer no new facts. Rather, they assert their own speculation about the government’s motive–an interpretation that is apparently built on libertarian ideals. “Why hasn’t the FDA’s power to prevent off-label prescribing been challenged?” the authors ask. As far as I can tell, that isn’t at issue. It’s how Pfizer marketed those uses to doctors that came under scrutiny. Note, too, that part of the government’s claim is that Pfizer made misleading claims about the drugs’ safety and efficacy. And, in a laughable move, they compare with the prohibition of off-label marketing with the several uses of a pickup truck? Are they joking? Are you?
My theory is that Wall St. knows that the fine, while record-breaking, will not seriously hamper the company’s ability to make money, especially given assurances pharmaceutical makers recently received from the White House.
That’s not a very good theory. You don’t have to be a believer in strong EMH to think that the White House deal had already been taken into account in the stock price, and that the $2.3 billion fine would then have had an independent effect had Pfizer not already set aside the money for it.
I’m very much not a fan of the drug company tactics to sell drugs to physicians — kickbacks, etc. Nonetheless, your scoffing is a puzzling attitude to take here. Should it really be a criminal offense for someone to say that a drug approved by the FDA for osteoarthritis pain (at the time) could also be used for pain after knee surgery? That was part of the case here. And that seems to be a serious question, does it not?
Consider also Eloxatin, a colon cancer drug that had been used in France as of 1996, and was used in many other countries besides. The FDA finally approved it in 2002 for the following use: “to treat patients with colorectal cancer whose disease has become worse following initial therapy.” Then, in 2004, the FDA approved it to use for the “initial treatment” of colon cancer.
So, between 2002 and 2004, using Eloxatin in America (but not most other countries) for the initial treatment of colon cancer was an off-label use. Criminal?
As I said, Wall St. is not worried about Pfizer’s ability to make money.
I don’t have the time to nail this down right now, but, as I said in my initial reply, it seems the crime–which, again, Pfizer admitted to–is improperly marketing an off-label use. Unless I’ve missed something (always a possibility), it is not a crime to prescribe a drug for off-label use. Indeed, I have firsthand experience with such prescriptions. I can’t speak to the issue of the quality of the charge–criminal or civil–but do citizens want less federal oversight for prescription medications? The fact is we don’t know a lot about the way some of these compounds function in the body. Nobody wants another Vioxx.