Don’t Tread on Me

May 17, 2019

The late George Wallace, former Alabama Governor, was noted for his rigid and often harsh opinions which he shared freely with the rest of the world.  In his 1963 inauguration speech, Wallace proclaimed, “Segregation now, segregation tomorrow, segregation forever.”

In response to what he felt was federal government overreach in its attempt to desegregate the University of Alabama, Wallace said, “The unwelcomed, unwanted, unwarranted, and force-induced intrusion upon the campus of the University of Alabama today of the might of the central government offers frightful example of the oppression of the rights, privileges and sovereignty of this state by officers of the federal government.”

Or, slightly modified to address current events, “The unwelcomed, unwanted, unwarranted, and force-induced intrusion upon the reproductive rights of women across the State of Alabama today of the might of the state government offers frightful example of the oppression of the rights, privileges and sovereignty of individual citizens by elected officials of the state government.”

It’s one thing to observe the sons, male cousins and grandsons of the late George Wallace as they link hands with the remaining white male disciples of the former Alabama Governor to assert their testosterone-fueled dominance over whatever they find annoying or objectionable.

It’s another thing to listen to female elected officials in Alabama proudly proclaiming victory over the right of women — as individuals protected by the same rights the US Constitution conveys to men — to make determinations over their own reproductive health.

Alabama House Rep. Terri Collins, who sponsored the bill, publicly identifies as female, as does Alabama Governor Kay Ivey who signed the bill into law.

Have they completely lost touch with reality?

Someone recently said, “I don’t know of any woman who engaged in sexual activity – forced or consensual – with the hope to have an abortion.”

Abortion is not a sport; it is a deeply personal and painful decision which should be made carefully and rationally, because it has lifetime repercussions.

Those who fly the Gadsden flag and rail against government intrusion on individual rights are often the very same folks who are adamantly pro-life and who vehemently oppose a woman’s right to self-determination.

The Gadsden Flag says it all…

 

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Dear Senator Scott:

I live in Clearwater, FL so I write to you today as an alert and engaged constituent.

You are an accomplished and admired American leader.  After volunteering for military service during the Vietnam era, you honorably served your country in the U.S. Navy as a radar technician aboard the USS Glover. You overcame significant social and economic obstacles to earn a J.D. from the SMU Dedman School of Law.

You are a former Chairman and CEO of one of the largest private sector health care corporations in America (Columbia/HCA).  You then admirably served two terms as Governor of Florida; and you now serve as one our two U.S. Senators from the Great State of Florida.

In fact, you have been recognized as a uniquely qualified American leader who ran the largest health care company in the world, and who cares deeply about the costs and quality of health care to consumers.

I tuned into watch and listen to Face the Nation (CBS) on March 31, 2019, eager to learn from your current perspectives on health care in America.

I was disappointed by your responses to Margaret Brennan’s questions about a renewed partisan focus to repeal the ACA (President Trump, March 26, 2019).  I was particularly concerned about your focus on drug prices as a key driver of excessive costs in our health care sector. While your observations contain some truth, you failed to disclose the background behind persistent high prices of ethical pharmaceuticals in the U.S.

On April 1, 2019, you were interviewed by Steve Inskeep from Morning Edition (NPR).

Mr. Inskeep attempted to draw out your unique expertise on some of the most critical issues facing our nation relative to our health care delivery system, noting that ‘President Trump says he wants Republicans to be known as the party of health care’.

You zeroed in on high prescription drug costs, and you cited a bill you are introducing, the “Transparent Drug Pricing Act” which aims to stop drug companies from charging more for medication in the U.S. than in other countries.

In both cases, you responded to some solid direct questions with sadly incomplete ‘softball’ answers.

I did not hear you mention the “non-interference” clause of the Medicare Modernization Act of 2003 which is frequently cited as the core reason for excessive drug costs in the U.S.

Medicare accounts for more than 25% of annual national retail prescription spending, and taxpayers currently pay nearly 70% more for drugs in the Medicare program than through the Veteran’s Administration, which has direct negotiating power with drug companies.

The Medicare Modernization Act of 2003 precludes the Secretary of Health and Human Services (HHS) from negotiating directly with drug manufacturers on behalf of Medicare Part D enrollees. A simple act of Congress, supported by the executive branch, can repair this problem quickly.  In fact, a recent survey conducted by the Kaiser Family Foundation shows that over 90% of the public believes that allowing the federal government to negotiate drug prices for Medicare beneficiaries is needed.

As a highly accomplished expert in the field of health care, you are certainly familiar with a comprehensive study conducted by researchers at Harvard Medical School which examined peer-reviewed medical and health policy literature from January 2005 to July 2016. The study was published in the Journal of the American Medical Association (August 23/30, 2016, “The High Cost of Prescription Drugs in the United States”).

Their research studied scholarly articles addressing the sources of drug prices in the United States; examined the justifications and consequences of high prices; and investigated possible solutions for the pharmaceutical price conundrum we continue to face in America.

This independent professional research concluded that high U.S. drug prices are the result of U.S. government protected monopolies granted to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. They noted that the most realistic short-term strategies to address high prices include:

  • enforcing more stringent requirements for the award and extension of exclusivity rights;
  • enhancing competition by ensuring timely generic drug availability;
  • providing greater opportunities for meaningful price negotiation by governmental payers;
  • generating more evidence about comparative cost-effectiveness of therapeutic alternatives; and
  • more effectively educating patients, prescribers, payers, and policy makers about these choices.

Individuals in the U.S. are directly impacted by the cost of prescription drugs at the retail level, whether fully covered by their insurance provider; through a co-pay; or fully funded out of pocket.

Indirectly, each taxpayer in the U.S. helps to subsidize the cost of prescription coverage for current and retired local, state and federal government employees; veterans; and those of our neighbors who are eligible for Medicare/Medicaid benefits.  When drug prices are inflated due to a lack of appropriate government regulation, U.S taxpayers are subsidizing excessive profits which accrue to executives and shareholders of pharmaceutical companies.

It is – and has been – clear to me that our elected officials in Congress have failed the people of the U.S. over a rather long period of time.  Our elected representatives have failed to address the root causes of high drug prices which have been identified and delineated in (the previously cited) independent and non-partisan report published almost 3 years ago.

Senator Scott, I believe the great majority of my fellow Floridians join me to expect much more of you in this arena.

We count on you — A recognized expert in the field of health care — to give us the full, honest and unvarnished picture on these issues, and to support new and appropriate legislation which strategically addresses the rapidly changing operational landscape on which our economy and society operates.

ObamaCare?

February 1, 2012

Members of Congress have the Cadillac health insurance plan.

Why should we expect them to understand the plight of average Americans?

When things got ugly in France, Marie Antoinette said, “Let them eat cake.”

What people didn’t grasp back then was that Marie wasn’t being mean or sarcastic, she just didn’t know.

She was so disconnected, she had no clue what it was like to be a peasant in France at the end of the 18th Century. In fact, some historians believe that something may have been lost in the translation, and that Marie wasn’t referring to what we today think of as cake, at all.

Even so…

My sense is that most of those sitting in Congress today are so disconnected that they have no clue what it is to be a regular American at the beginning of the 21st Century.

So, we need to give them a break, stop the rhetoric, and come up with a plan to help inform those who have the power that we — the people who are getting jerked around — are just not happy with the fat cats working in the private insurance industry who travel in their private jets and chauffeured black cars while denying us health care; that we are not happy with our Congresspeople and other ‘government workers’ — who now make up around 30% of the workforce — and who have lifetime benefits.

We are not happy because the rest of us — the 70% who work in the private sector — are getting screwed.

Some of us have been working as virtual slaves to a corporation which recently determined that health care coverage for retirees was too much of a burden for them to shoulder.

Or worse, the company declared bankruptcy or closed down, leaving workers and retirees with nothing other than bad memories.

Others of us were counting on some sort of group plan that has now disappeared.

We need access to a group health plan that spreads the risks and the costs across a broad cross section of the population.

If we take this to the extreme, let’s take a peek at K-12 public education, which is typically funded with property taxes, levied on all property owners whether they have children or not, and whether they send their children to public or private schools.

Everyone shares in the cost of public education. Everyone.

Some pay twice: they pay their taxes; then they send their children to private schools. That’s their choice.

With our healthcare system as it stands today, people have no choice. Either you are at the top of the economic pyramid and have the Cadillac plan, or you are uninsured.

Is that a Socialist issue?

Then what about roads? Sewers? Libraries? Public education? How about parks? Sidewalks? Public transportaion?

It seems that the USA may be the last of the economically developed nations to stop and recognize the need for universal health care.

Will this be the very issue that precipitates our demise as a sovereign nation?