Drug Wars: How Shortages Threaten Health Care

Imagine you are hospitalized with a life-threatening cancer.  Your oncologist recommends treatment with a chemotherapy drug called fluorouracil.  The hospital has no supplies of the drug and its regular wholesaler has no inventory on hand.  You face a grim future unless the drug arrives soon.

Meanwhile, as the hospital scrambles to locate the drug, unscrupulous firms are inundating the facility with emails and faxes offering the hard-to-get chemotherapy drug at exorbitant prices. The hospital is left with an untenable choice.  It can pay an outrageous amount of money, perhaps as much as several hundred times the customary price, or it can wait months for the normal supply chain to catch up with demand.  

Confronted with those paradoxical options, many hospitals pay the extortionate markup to take care of their patients.

Unfortunately, this scene is being played out too often in hospitals and health care facilities across the country.  This growing trend is documented in a newly issued federal report prepared by congressional staffs.  Until now, not much was known about how the gray market companies acquired the drugs when hospitals were unable to obtain them.    

The report is entitled, "Shining Light on the Gray Market: An Examination of Why Hospitals Are Forced To Pay Exorbitant Prices For Prescription Drugs Facing Critical Shortages." It was released July 25, but has attracted precious little news coverage in the mainstream media.

That's too bad because Americans need to know hospitals are being bilked out of millions of dollars by these so-called gray market companies which take advantage of regulatory loopholes to reap unconscionable profits.

The explosive report describes how individuals established fake pharmacies for the sole purpose of buying up drugs that were in short supply.  Instead of dispensing the drugs to patients, these faux pharmacies peddled the drugs to wholesalers owned by the same individuals or their shell companies.  The conniving businesses then sold the drugs with astronomical markups to desperate hospitals.

Using this and similar schemes, these gray market firms marked up some drug prices by as much as 3,000 to 4,000 percent over the conventional contract price.  The price-gouging is not illegal, but a handful of companies have been shuttered for violating state licensing laws covering pharmacies and drug wholesalers.

Despite enforcement efforts, drug shortages are becoming more common.  Nearly every hospital in the United States (99.5% to be exact) reported at least one serious drug shortage in 2011, often forcing delays in treatments or procedures.   Drug shortages quadrupled between 2005 and 2011.

Many drug shortages can be traced to manufacturing problems.  When drug makers decide to shut down facilities for quality issues, it interrupts the steady flow of drugs.  However, unethical gray market firms exacerbate the problem by quickly snapping up all available supply, creating a crisis.

In many cases, the medications in short supply are administered for cancer treatment.  Examples include drugs to treat colon, stomach, breast and pancreatic cancer.  The list also includes supplies commonly used in hospital emergency rooms, such as anesthetics for surgery and electrolytes for intravenous feeding.

The price tag for the shortages is staggering and escalating.  A 2011 report by the American Society of Health-System Pharmacists estimated insufficient supplies of drugs cost the nation's hospitals more than $400 million in a single year.  Ultimately, these costs are passed on to insurers, businesses and patients.   

The federal report on gray market drug firms is a wake-up call for states. Tougher enforcement is required to make certain pharmacies and drug wholesalers operate within the law.  In some cases, stricter licensing requirements are needed to weed out unscrupulous operators.

Americans need to be assured hospitals and health care facilities have adequate supplies of drugs for treatment in medical emergencies. Life is too precious to allow the gray market practice to continue endangering lives and threatening medical treatment.     

TARP: More Fraud, Less Transparency

The Department of Treasury's recent report on TARP can justifiably lay claim to the title of best fiction written this year.  It is a glossy, self-congratulatory piece of puffery that ignores the rampant fraud in the program, turns a blind eye to mounting taxpayer losses and offers little transparency.

The laudatory analysis, issued July 10, was presented to Congress to provide an assessment of the Troubled Asset Relief Program (TARP), a $700 billion bail out of Wall Street banks, automobile companies, homeowners and multinational insurance firm AIG in 2008.

"By any objective standards, TARP has worked," the fluff piece boasts.  "It did so at a cost that is far less than what most people expected at the time the law was passed."  Whoever authored that tripe has a future in writing fairy tales for children.

For a more unbiased critique of the massive taxpayer rescue, consider the report card from the Office of the Special Inspector General for the TARP program.  Its unflattering review was released July 25, a little more than two weeks after Treasury's self-aggrandizing essay.

The document lists 150 criminal and civil investigations involving fraudulent use of TARP funds.  To date, 67 individuals have been convicted and 28 have been handed prison terms for their roles in the schemes which siphoned off millions of taxpayer dollars.

Court orders for restitution, forfeiture and civil judgements have eclipsed $4 billion.  Chances are slim the Treasury Department will ever see a penny of that money.

In addition, Treasury has written off losses of $15.6 billion that taxpayers will never get back. That amount does not include another $4.5 billion in TARP funds dumped into housing rescue programs without expectations of a payback, according to the inspector general.

The inspector general's office verified that taxpayers are still owed $109.1 billion as of June 30. The biggest chunk of that amount includes outstanding loans made to General Motors, which carries a $50 billion TARP debt on its books.  Of course, the media has ignored the inspector's findings.

In February, the Office of Management and Budget report for fiscal 2013 contained an estimate of the likely taxpayer losses under TARP. The forecast, provided by the Obama Administration, pegged the number at $67.8 billion.  That was an increase of $14.6 billion from the 2011 estimate.

Noting the staggering losses, Inspector General Christy Romero used harsh language to describe the recalcitrant Treasury Department's handling of TARP.

"...There was often a lack of detailed and complete documentation of government decision-making during the financial crisis and TARP," testified Romero before a House Committee.  In her report, Romero cited the Obama Administration's refusal to answer questions about bailouts of General Motors and Delphi Automotive.

Romero's predecessor, Neil Barofsky, also has minced no words in his assessment of the government program.  He has accused the administration of "resorting to trickery" to cover up how "badly TARP has failed."

Not surprisingly, the Obama Administration no longer brags about how TARP saved America from stumbling into the financial abyss.

In spite of the Treasury Department's fanciful report designed to burnish its image, TARP stands as a shameful example of why so many Americans have lost faith in their government.        

The 22 Billion Dollar Question

What could the nation do with $22 billion?  Fund research to cure cancer?  Build hospitals in under served rural areas?  Issue grants to study Alzheimer disease?  Bankroll shelters to house battered women? Support efforts to end cruelty to animals?

There are many good uses for that large sum of money. Unfortunately, the $22 billion already has been spent and not a single worthy cause benefited.   

Instead those billions ended up in the pockets of politicians. From 1998 through 2010, groups, individuals and corporations funneled more than $22 billion into federal campaigns to help elect candidates for president, senate and the house.

Those eye-opening dollar signs were calculated by the Center for Responsive Politics, a non-partisan group which publishes the numbers on its website, OpenSecrets.org.  The figures do not include the millions spent in local and state elections every year.

The media would have you believe that most of that money lined the pockets of fat-cat Republicans.  However, in recent elections, Democrats hold a decided edge over their GOP brethren, outspending Republicans in three of the last four election cycles. 

This election year will likely be no different.  According to the latest data, President Obama has outspent his challenger Mitt Romney by more than $70 million.  Obama has tallied $204 million in spending versus $131 million for the former governor.

Some political pundits are forecasting spending in this presidential election will eclipse $2 billion.  Obama is doing his part to reach that plateau.  The president already has hosted 197 fundraisers since launching his re-election campaign in 2011, triple the number (86) George W. Bush held for the entire 2004 campaign, according to a report in USA Today.   

The mind-numbing dollars showered on political candidates raise legitimate questions about the impact on elections.  The cash tsunami has corrupted the political system, stymied good candidates from running and made influence peddling a Beltway parlor game.

Here are three common sense suggestions on how to take most of the money out of politics:

FREE MEDIA:  Every candidate for federal office gets a limited amount of free air time on television along with gratis radio and newspaper ads.  The media donates the advertising space and writes it off its corporate taxes.  If necessary, the Federal Communications Commission (FCC) could force television and radio stations to cooperate as a license requirement.  Outside of news coverage, candidates cannot buy another smidgen of advertising. 

TIME LIMITS:  Candidates for federal offices cannot begin campaigning until three months before the election.  No exceptions. Today's campaigns are prolonged marathons which add millions to the cost.  In many countries, such as the United Kingdom, there are time restrictions on campaigns.

THREE DEBATES:  The four major networks host three debates for president, senator and representative.  No more, no less.  The debates would give every voter a chance to near the candidates. Questions would be submitted in advance to help candidates prepare and to eliminate the media's penchant for reserving its harshest questions for Republicans.

With these modest changes, spending on campaigns would plummet. The biggest losers would be the television networks, who depend on federal campaigns to generate billions of dollars in advertising revenue to fill up their corporate coffers.

This campaign season television stations are expected to grab 75 percent of political advertising budgets.  Research firm Washington Analysis projects $4 billion could be spent on advertising this year on behalf of federal, state and local campaigns across all media platforms, including the internet.

For that reason, big media will lobby furiously against any change in the status quo.

Without change, the cost of American elections will rocket into the stratosphere.  From 1998 to 2010, election spending for federal candidates, including president, soared by 125 percent.  When will the political arms race end?

Never.

Not unless Americans elect candidates dedicated to reforming the current political system.  Now, finding a candidate willing to forfeit the political pot of gold may be nearly impossible.

But there are at least 22 billion good reasons to make this a priority for the nation.    

Dirty Harry Plays Dirty

Shameless Harry Reid, the Democratic Party's Grim Reaper, is the least qualified person in America to lecture anyone on the issue of financial disclosure.  The Nevada senator has a dreary record of lapses in personal financial reporting and a checkered past of ethical blunders.

It was comical to watch the pompous Senate majority leader taunt Republican presidential candidate Mitt Romney over a scurrilous charge that the former governor had not payed taxes for 10 years. Reid offered no proof, yet the mainstream media hounded Romney to answer the uncorroborated slur.

Romney placed the onus on the dour Reid, telling him to "put up or shut up."  Undeterred, Reid has continued to launch one salvo after another against Romney. The media has dutifully bandied the insinuation without bothering to shine a light on Reid's past ethical improprieties.

It is time for Romney to counterattack and there is plenty of ammunition at his disposal.

In 2006, Senator Reid was embroiled in a serious ethics scandal involving financial reporting.  He was forced to amend his personal filings with Congress over a Las Vegas land deal after news organizations got wind of the shadowy trail of ownership changes that went unreported.

The dubious transaction involved property that netted Reid a cool $1.1 million in 2004. The Democrat collected the tidy profit despite the fact he had not personally owned the property for three years. That raised the eyebrows of news organizations that reported at length on the business deal.

After the chicanery was exposed, Reid tried to cover his tracks.  He amended his ethics report with 42-pages of camouflage, admitting he had not disclosed salient facts about the original transaction.  In the filing, Reid also divulged that he had failed to report two other land deals to Congress.

Ethics attorneys at the time questioned whether Reid had violated Senate rules.  But he managed to sweep the whole sordid mess under a Congressional rug, where it has remained until now.

There have been other ethical issues nipping at Reid's heels. In 2006, Reid was linked to disgraced lobbyist Jack Abramoff.  The Associated Press (AP) reported that Reid intervened in government matters at least five times to help Abramoff's Indian tribal clients.

In addition, Reid's staff "regularly had contact" with Abramoff's team about legislation affecting other clients.  Documents obtained by AP showed that Abramoff's lobbying partners billed for nearly two dozen contacts, phone calls and meetings with Reid's office in 2001 alone.

Reid piously claimed all that attention had no affect on his votes. Surely it was just coincidental too that Reid collected nearly $68,000 in donations from Abramoff's firm, lobbyists and clients.  A grateful Abramoff once threw a cozy fundraiser for Reid at his Washington office.

Hypocritical Harry even had the audacity to call for other lawmakers to come clean about their tainted relationships with Abramoff at a January 16, 2006 Washington news conference.

As he has always done, the officious Reid dodged an ethics investigation.  Meanwhile, Abramoff pleaded guilty to fraud and bribery and earned jail time.

For dirty Harry Reid to call anyone on the carpet for ethical misconduct is the height of absurdity.  If Reid wants to spotlight blatant dishonesty, he needs to look no further than the nearest mirror.

Playing Chicken With Freedom of Expression

Thousands flooded Chick-fil-A restaurants last week with a blunt message: Americans are sick and tired of the insidious campaign to silence public expression of religious beliefs.  They've had their fill of the anti-religious media, hate-mongering gay extremists and the cultural dictators running the Democratic Party.

The latest firestorm was sparked by an interview in Baptist Press with Chick-fil-A president Dan Cathy.  In the publication and in a subsequent media appearance, Cathy endorsed traditional marriage between a man and a women.

"I think we are inviting God's judgment on our nation when we shake our fist at Him and say, 'We know better than you as to what constitutes a marriage,' and I pray God's mercy on our generation that has such a prideful, arrogant attitude to think that we have the audacity to try to redefine what marriage is about," Cathy said.

Cathy did not use discriminatory language.  He did not bash gays and lesbians.  He did not condemn relations between members of the same sex.  He simply aired his own personal views on marriage in response to questions by interviewers.

His stance can hardly be called heterodox.  Voters in 31 states have approved ballot issues defining marriage as a union between a man and a woman.  Even President Obama claimed in 2008 that he shared the same viewpoint of marriage and used the "C" word in explaining his perspective.

"I believe that marriage is between a man and a woman," candidate Obama said.  "For me as a Christian, it is also a sacred union." (Note to Democrats: This quote was published in The New York Times.)   Strangely, gay activists were mute in their response.

Yet as soon as Cathy's comments were brought to the media's attention, news outlets unleashed a torrent of outrage.  Pandering politicians deliberately twisted Cathy's words and mischaracterized his intent.  Intolerant gay extremists piled on, using venomous language to convict Cathy of hate-speech.

Overnight, the president of one of the nation's most successful, privately-owned fast food chains was branded an ignorant homophobic bigot.

Democratic mayors in Chicago, Boston and the San Francisco made it clear that Chick-fil-A was no longer welcome in their cities. "Enlightened" Chicago City Alderman Proco "Joe" Moreno leaped into the fray declaring, "Because of this man's ignorance, I will deny Chick-fil-A a permit to open a restaurant in my ward."

The flap attracted the attention of the liberal American Civil Liberties Union (ACLU).  The group's senior attorney Adam Schwartz acknowledged that government can regulate discrimination in employment or against customers, but it cannot "punish someone for their words."

"When an alderman refuses to allow a business to open because its owner has expressed a viewpoint the government disagrees with, the government is practicing viewpoint discrimination," Schwartz pointed out.

Schwartz is right.  But don't be fooled by the foot-stomping same-sex zealots.  This shabby episode is not about the rights of gays.      

In today's America, the media elite and its shrill voices in the Democratic Party are on a mission to censor any public expression of religious values.  They have made it clear that comments about faith have no place in the school, workplace, military, government, sports or in any public venue.

Forget the First Amendment guarantee of freedom of expression. It only applies to speech deemed correct by self-annointed cultural bullies.  They decide when and under what circumstances a citizen can voice personal religious beliefs.

Dan Cathy is just the latest victim in a long list of public figures ruthlessly threatened with boycotts and economic blackmail by those who disagree with a person's right to utter their convictions.  If the anti-religious enforcers win, all Americans, including gays, will lose the right to be heard.

Americans must demand that the religious oppressors quit playing chicken with their right to free speech.

Why Can't We All Just Get Along?

In light of the looming stalemate over extending the Bush tax cuts, the mainstream media has resurrected catcalls about political polarization.  If Republicans and Democrats could just get along, the nation would be better off, goes the media's disingenuous whine.

The talking heads and their keyboarding cousins act as if the current discord is a new phenomena.  Many claim today's churlish political climate is the worst ever.  Pundits pine for the days when bipartisanship was a Washington hallmark.  

The problem with the media's hypothesis is that it's sheer nonsense.  American politics, for better or worse, have always been fractured, chaotic and emotionally charged.  Sharp divisions between the parties have existed for as long as their has been a democracy.  It is a deliberate distortion to suggest otherwise.

The dirty little secret is that the news outlets have a vested interest in creating political dissension because they believe confrontation lures viewers and sells papers.  Reporters seek out those with opposing views, the more extreme the better, to produce compelling stories dripping with controversy.

That's why the media shoulders much of the blame for Americans' frustration with the tone of political discourse.  Online, on radio, in print and over the airwaves the constant negative media drumbeat has shaped the public's view of Washington's political stew.

There is no denying the media's influence.  Most Americans depend exclusively on big media for their news about Beltway politics. Media conglomerates belch political drivel almost non-stop, 24-hours a day.  That is a relatively new development, but the politics have never been polite.   

In fact, there has always been mean-spirited edginess to American politics.  President John Adams was skewered for being toothless and senile by his opponents.  Andrew Jackson was branded a jackass so often that the donkey became the symbol for the Democratic Party.

Don't forget Thomas Jefferson's running mate Aaron Burr shot and killed Alexander Hamilton over political skulduggery.  A trademark of the American political experience has been partisanship, name-calling and bitter personal disputes.  Like it or not, democracies are often messy like that.

Many in the media lay the blame for the current partisanship at the feet of the two parties.  Both are accused of adhering to entrenched political ideology instead of embracing compromise.  This too is a misguided notion perpetuated by the lame-stream media.

Throughout history, the two parties have more often that not embraced positions that are polar opposites. Think slavery and abolition during President Lincoln's tenure.  Or the row over big government when President Franklin Roosevelt presided over the country.  

Actually, competing ideologies are a good thing because it gives voters a clear choice.  When the two parties have been in harmony, the media and voters grumble there is not "a dime's worth of difference" between them.  You can't have it both ways.

Despite the natural tension between political parties, the nation's elected leaders have managed in the past to put aside acrimonious differences and work together.  In every case, there has been a president willing to risk political capital to negotiate the compromise.  Examples abound in recent years.

President Ronald Reagan famously collaborated with Democrat House Speaker Tip O'Neil to make changes in Social Security, despite opposition on both sides of the aisle.  President Bill Clinton and his nemesis House Republican leader Newt Gingrich joined together to pass a landmark welfare reform bill.

Even the much maligned George W. Bush reached across the party divide to Democrat Senator Ted Kennedy in passage of the No Child Left Behind Act, establishing national education standards for public schools.

Which brings us to today's political impasse in Washington.

President Barrack Obama cannot point to a single example during the last four years when his leadership was critical in reaching a middle ground on any national issue.  His signature Obama Care law was jammed down the throats of Republicans.

If the media really wants to find out why the current House and Senate are so dysfunctional, they need look no further than 1600 Pennsylvania Avenue.  The truth is President Obama has no intention of trying to mediate for the grand solutions championed by the American media elite.

He is the chief reason we can't all just get along.

Why Obama Care Is Here To Stay

While the mainstream media was dissecting the Supreme Court decision, the government labyrinth inside the Beltway was quietly doling out millions of dollars to hire bureaucrats to implement Obama Care and drafting thousands of pages of new health care regulations.

Those Americans who still hold out hope for repeal of the law must come to grips with the new reality.  The high court's ruling makes repeal an unachievable dream.  If that sounds fatalistic, consider that in the long history of the United States not a single entitlement has been eliminated by Congress.

Once the bureaucrats are in place, there is no turning back.  The Health and Human Services (HHS) has hired computer programmers, technicians and managers.  The Internal Revenue Service (IRS) has bulked up its payroll to enforce the new tax (penalty) on individuals and companies as part of the health care mandate.

There are 13,000 pages of regulations governing how doctors and hospitals are supposed to practice medicine under the new law.  And HHS is spinning out more rules every week.  More than 180 boards and commissions have been been created to oversee the new law's provisions.

Even a new Congress and administration will be hard pressed to undo it all.  Millions of Americans are already receiving benefits.  They would attain victim status if any attempt is made to alter Obama Care.  The mainstream media salivates at the notion that Republicans would tamper with health care benefits.

Imagine television cameras capturing weeping mothers with pre-existing medical conditions.  Newspaper headlines about young people dropped from the parents' insurance.  Radio interviews with uninsured migrant workers struggling with catastrophic illnesses.  It won't be pretty.

The GOP has shown it cannot withstand media pressure.  Republican leaders have blinked too often in the past two years when the media amped up its attacks.  Battles over the budget are a prime example. Every time Obama threatens to shut down the government, Republicans crayfish under the media glare.

GOP leadership lacks the spine to weather a withering media offensive.  Perhaps, a President Romney would make a difference. But history suggests otherwise.  The former Massachusetts governor was known more for comprising than confrontation during his tenure.

That's why the Supreme Court decision stings.  It was the last best hope for those who believe the law will fundamentally change health care for the worse.  

For that reason, apologists who defend Chief Justice John Roberts are dead wrong.  By siding with the liberal minority, the jurist enshrined Obama Care as the law of the land.  Forget all the legal mumbo-jumbo he sprinkled throughout his opinion.  It doesn't matter.  The law stands.

No matter how contorted the decision, it emboldened Obama Care proponents and the federal bureaucracy to move full speed ahead.

Americans are stuck with health care reform that most oppose.

It may not be popular to say so, but it is the sad reality.