Phony “Free Market” for meds puts U.S. prices 300% above global median

Prescription drugs in the United States rank as the most expensive by a long shot, a report published this week has found, with the average cost of medications in the US exceeding the global median price by some 300 percent.

The study by digital healthcare provider Medbelle – based in the United Kingdom – reveals substantial differences in prescription drug prices around the world…

The index compares the affordability – or lack thereof – for the same drugs across 50 countries, showing how prices in each nation deviate from the global median.

” “The medications chosen for comparison span a variety of common conditions: from heart disease and asthma, to anxiety disorders and erectile dysfunction…”

“The average prices of both the brand compound and their generic versions were included in order to have a complete profile of each medication,” it added, saying that the dosage size was also normalised.

Read it and weep, sisters and brothers. I’d suggest asking your friendly neighborhood elected officials what their response is to this criminal state of affairs. But, first, I’d ask if they turn down the payola Big Pharma offers to just about every federal-level elected official. I wonder if anyone in Congress does?

Trump now deporting kids being treated for cancer!

❝ When you’ve already separated families, thrown children in cages, and held them in conditions that “could be compared to torture facilities,” it’s a bit of a challenge to come up with your next act. Evil takes creativity, and once you’ve forced migrant kids to go weeks without a shower or change of clothes and fed them expired food, it’s tough to continue nailing those Hitler comparisons. Somehow, though, the Trump administration always rises to the occasion…

❝ Severely ill immigrants, including children with cancer, cystic fibrosis, and other grave conditions, are facing deportation under a change in Trump administration policy that immigration advocates are calling cruel and inhumane.

… The program granted stays of deportation in two-year increments and didn’t promise immigrants a future in the United States, just access to care in a time of need, said Dr. Sarah L. Kimball…Boston Medical Center…

❝ …The outrages now come with such regularity that each tends to distract from the last. But it’s important to protest not just these changes, but also their overriding intent: to remove all vestiges of compassion from the immigration system and make life as miserable as possible for immigrant families. Can this administration sink any lower than threatening to deport kids with cancer?

Once again, I see no need whatsoever to separate the fools who continue to support this thug – and the scumbag, himself. We all see what his time in office contributes to diminishing human rights, human dignity. He doesn’t care. I see no reason to believe those who support this fake president and his policies are any different.

Candida auris

❝ Candida auris is an emerging fungus that presents a serious global health threat. CDC is concerned about C. auris for three main reasons:

❝ It is often multidrug-resistant, meaning that it is resistant to multiple antifungal drugs commonly used to treat Candida infections.

It is difficult to identify with standard laboratory methods, and it can be misidentified in labs without specific technology. Misidentification may lead to inappropriate management.

It has caused outbreaks in healthcare settings. For this reason, it is important to quickly identify C. auris in a hospitalized patient so that healthcare facilities can take special precautions to stop its spread.

Useful commentary follows this CDC notice. Check it out!

Mexico closes 5 immigrant detention centers — “lacking…shelter and services”


mintpressnews.com

❝ Mexico’s federal immigration agency shuttered five of its detention centers late last month, as the agency’s new chief says he wants to improve the treatment of undocumented migrants.

The closings included the detention center in Reynosa, across the border from McAllen, Texas, just days after the director of that office was fired. A report from TV network Telemundo had found officials at that office had extorted migrants being held there, and officials have said they’re investigating the complaints.

The remaining closures were in Nogales, across the border from Nogales, Arizona, on the coasts in Acapulco, Guerrero, and Tuxpan, Veracruz; and toward southern Mexico in Morelia, Michoacan…

❝ Top immigration officials, appointed by the newly elected President Andres Manuel Lopez Obrador, appear to be making an effort to reform the agency, said Gretchen Kuhner, director of the Institute for Women in Migration, a Mexico City-based nonprofit.

Mexico now working to improve the lot of undocumentados while the home of the brave and the land of the free couldn’t care less. At least the Executive branch and a chunk of Congress.

Same as it ever was


Click to enlarge

This goes along with the “noble savage” school of utopian naturalism. Surviving nature still requires potable water, shelter from the elements – especially in a climate with seasons. Everything you can purchase or rent in civilization you now have to build or provide on your own.

First thing I always remember with images and expressions like this is completing an idyllic couple of weeks hiking through a stunning, isolated region in the highlands of Scotland. I was OK living within the boundaries of carrying everything I needed for protection from the elements + a fair amount of sustenance on my back for that time period.

And a week after I returned to urban America I learned some wandering sheep must have pooped just at the right time upstream in some delightful mountain stream where I filled my water bottle. And I needed another month to recover from a less-than-happy critter named giardia I had consumed – probably in that mountain stream.

I would have been a lot worse off if I wasn’t back in a city with easy access to a physician, etc..

Thanks, Ursarodinia

Prescribing addictive opioids is OK — prescribing treatment for that addiction ain’t OK

Almost 1 million U.S. physicians can write a prescription for opioid painkillers such as Vicodin and OxyContin — one pathway to opioid addiction. But, because of regulatory hurdles and other factors, fewer than 32,000 doctors are permitted to prescribe buprenorphine, a medication to treat such addiction.

That is a statistic worth thinking about since opioid painkillers and heroin contributed to the deaths of nearly 30,000 Americans in 2014, triple the number in 2000. Perhaps many of these lives could have been saved with buprenorphine…

Taking buprenorphine or methadone, alongside counseling, is the most effective approach to opioid addiction treatment. Because the drugs relieve patients’ cravings for heroin or narcotic painkillers, patients taking them can focus more on recovery and less on getting high. When taken properly, the drugs can help addicted patients and their families get their lives back to normal while reducing the risk of fatal overdose, crime and their societal costs.

But the need for these treatments far outstrips available supply. Less than half of the 2.5 million Americans who could benefit from medication-assisted treatment for opioid addiction receive it.

Expanding the use of methadone will be difficult. Methadone is provided only in dedicated clinics, which patients must visit daily. But many communities resist clinics because they attract patients with addictions, a highly stigmatized population.

Work by Christopher Jones, a pharmacist and public health researcher, showed that the number of patients treated at them has barely increased in more than a decade. Most methadone clinics operate at or near capacity, and some have waiting lists…

Since 2000, buprenorphine can be prescribed by qualified doctors to a limited number of patients to take at home. Buprenorphine use has expanded as a result, but availability is limited by regulation. Doctors may prescribe it only after taking an eight-hour course and applying for a special license. No such hurdles are required for prescribing any opioid painkillers…

“Increasing availability of medication-assisted treatment will require far more than just allowing doctors to prescribe buprenorphine to more patients,” Dr. Bradley Stein said. “Fostering greater ability and willingness among doctors to effectively manage the growing numbers of addicted patients is an uphill battle.”

So, we are to believe doctors can’t be bothered dealing with addicts – even though many of those addicts got their start down that primrose path with the aid of a physician. How about requiring the pharmaceutical companies making a bunch of dollar$ from the production of opioids to kick in a percentage to sell physicians on treatment as hard as they did getting them to prescribe opioids?

Melancholia must be understood as distinct from depression

In Western nations – or nations whose ethos is philosophically Western – this is a relevant discussion. Economically, politically – on a global scale – we are diminished. Mostly by the incompetence of our own leaders. Yes, that is not limited to our political leaders.

First described by Hippocrates, “melancholia” or melancholic depression was considered a specific condition that commonly struck people out of the blue – and put them into the black. In modern times, it came to be described as “endogenous depression” (coming from within) in contrast to depression stemming in response to external stressors.

In 1980, the third edition of the Diagnostic and Statistical Manual (DSM-III), the official classificatory system of the American Psychiatric Association, re-modelled depressive disorders. The new classification operated largely on degrees of severity, comprising “major” depression and several minor depressions.

This is how depression came to be modelled as a single entity, varying only by severity (this is known as the dimensional model). And over the last decade, this model has been extended to include “sub-clinical depressions”, which is basically when someone is sad or down but not diagnosable by formal mental illness criteria.

The changes generated concern about the extension of “clinical depression” to include and “pathologise” sadness. While everyone feels down or sad sometimes, normally these moods pass, with little if any long-term consequences.

The boundary between this everyday kind of feeling down and clinical depression is imprecise. But the latter is associated with a greater severity of symptoms, such as losing sleep or thinking life isn’t worth living, lasts for longer and is much more likely to require treatment.

The dimensional model is intrinsically limited; “major depression” is no more informative a diagnosis than “major breathlessness”. It ignores the differing – biological, psychological and social – causes that may bring about a particular depressive condition and which inform the most appropriate therapeutic approach (be it an antidepressant drug, psychotherapy or social intervention)…

My research team is trying to establish melancholia’s categorical status and detection, and so improve its management. Here’s what we know – or think we know – about the distinctness of melancholia.

First, it shows a relatively clear pattern of symptoms and signs. The individual experiences profound bleakness and has no desire to socialise, for instance, finding it hard to obtain any pleasure in life or to be cheered up…

Episodes commonly emerge “out of the blue”. Even if it follows a stressor, it’s disproportionately more severe than might be expected and lasts longer than the stressor…

Melancholia has a strong genetic contribution, with sufferers likely to report a family history of “depression”, bipolar disorder or suicide. It’s largely biologically underpinned rather than caused by social factors (stressors) or psychological factors, such as personality style.

The illness is also unlikely to respond to placebo, whereas major depression has a placebo response rate in excess of 40%. But melancholia shows greater response to physical treatments, such as antidepressant drugs (especially those that work on a broader number of neurotransmitters), and to ECT (electroconvulsive therapy). ECT is rarely required, however, if appropriate medications are prescribed.

Phew!

Melancholia shows a lower response to psychotherapy, counselling and psychosocial interventions – these treatments are more salient and effective for non-melancholic depression.

Melancholia shows similar “treatment specificity”, with medication being the treatment of choice.

When is it anything else?

Clearly, melancholia needs to be recognised as a distinct psychiatric condition – not simply as a more severe expression of depression. This recognition could lead to improved clinical and community awareness, which is important because managing melancholia requires a specific treatment approach.

Though no mention is made of societal context, economics, socio-political realities, I presume to hope that treatment providers have the sophistication to peer around more broadly than suggested here. The feeling that Life Sucks sometimes is a direct reflection of the fact that Life Sucks. Not only for an individual; but, a whole class of people. That class defined in economic, ethnic, caste or gender terms.

When you live in a nation where the predominant political rulers, liberal or conservative, seem bent upon ruling the world through military and economic might – and their diminishing returns seem more and more likely to end in destruction of our species and a good deal of the world as well – melancholia rooted in political ineffectuality seems a logical choice.

Sometimes.

Vietnam War vets still suffering from PTSD

A small, but significant, portion of Vietnam War veterans still experience symptoms of post-traumatic stress disorder (PTSD) even 40 years after the war ended, according to the results of a survey-based study.

When examining veterans over the course of a 25-year period, 10.8%, or about 271,000, of male “theater veterans” – those who served in the Vietnam theater of operations – reported experiencing current clinical and subthreshold war-zone PTSD symptoms based on CAPS-5 criteria, said Charles Marmar, MD, of New York University’s Langone Medical Center…

More than a third (36.7%) of all veterans with PTSD directly related to the war also experienced comorbid major depression. In addition, 30.9% met the criteria for current major depressive disorder…

Marmar told MedPage Today that he was surprised at the persistence of symptoms for veterans over the course of time.

“We did know that PTSD symptoms could persist in a minority of war fighters, or civilians for that matter, but it was surprising to find that 11% of those who served in the Vietnam theater had either PTSD or significant symptoms of PTSD that interfered with their functioning,” he said. “So the persistence was an important finding…”

Marmar said he did the study not only to honor the Vietnam generation and answer some questions for them, but to see what the road ahead may look like for veterans of the Iraq and Afghanistan wars.

“Nobody has known before this study what the true lifetime effects of military service are on psychological health in an epidemiologically drawn, representative sample,” he said. “People have done studies of longer term effects of war, but not in a proper sampling frame where you’re getting a picture of every man and every woman from all branches of the services in all levels of combat…”

While not involved with the study, Gary J. Kennedy, MD…told MedPage Today…that the results demonstrated the majority of veterans did not suffer from PTSD or depression. However, he pointed out that for those who were impacted, there may be inadequate resources to offer assistance.

“The optimistic finding of rather remarkable resilience is contrasted by the complicated needs of those who do not recover,” he said. “Just as in the post Vietnam era, the VA is not adequately funded to meet the mental health needs of returning service personnel…”

He concluded that similar to World War II veterans, Vietnam war veterans also deserve quality care for their physical and mental well-being, both from clinicians and from the nation itself.

Overdue.

My closest friend till his death was a WW2 vet who still had occasional bouts with PTSD – and little substantive help from the VA. Fortunately, one of his main areas of study – courtesy of the GI Bill – was in psychology and he did a pretty good job of managing things on his own. Still, I’ll never forget a couple of times when he was roused unexpectedly from a sound sleep and thought he was back in Bastogne.

243 medical “professionals” busted in $712 million Medicare fraud


Digitizing medical records tracks provider accounts as well as individual histories

The U.S. Justice Department charged 243 people, including 46 doctors, nurses and other medical professionals, with defrauding the Medicare system of $712 million through false billing.

Attorney General Loretta Lynch announced the charges…calling the case the largest sweep of individuals in the history of task forces that target such fraud.

“The defendants charged include doctors, patient recruiters, home health-care providers, pharmacy owners, and others,” Lynch said. “They billed for equipment that wasn’t provided, for care that wasn’t needed, and for services that weren’t rendered.”

The defendants were accused of money laundering, conspiring to commit health-care fraud and violating anti-kickback laws. The scams involved treatments ranging from home health care to psychotherapy. The Justice Department alleged that participants in the scams submitted claims to Medicare and Medicaid for treatments that were medically unnecessary and often never provided…

Government efforts to combat health-care fraud led to the recovery of $3.3 billion in taxpayer dollars in the fiscal year that ended Sept. 30, according to a March report. During that period, U.S. prosecutors opened 924 new criminal health-care fraud investigations, the two departments said in the joint report.

The medical-industrial complex still hasn’t learned how to steal from taxpayers with the skill and cunning of their counterparts in the military-industrial complex.

Tub-thumping politicians in Congress blather day-in and day-out that they must oppose real single-payer healthcare because the people can’t be trusted to treat the system honestly. Yet, time and again, the real crooks turn out to be the practitioners, profiteering frauds within the medical community.