Editorial: The U.S. Healthcare System is NOT "Broken"!

When an organization wishes to get something done in a rush, they make it appear to be an emergency. Then, the facts, different angles, or valid points of view that should be determined by investigations and/or studies are prevented.

It seems now that a few feel that the U.S. healthcare system is broken and needs a total overhaul. I disagree. I agree that there are a few parts that need to be changed, including insurance availability across state lines and malpractice litigation, to name a few. It is also true that some individuals are not covered by insurance for medical care; some by choice and some by circumstances. It would be good if these individuals could be covered by a reasonable program (state or federal), if they wish to be covered, until they got back on their feet.

While growing up, my dad taught my brother and me how to fix things. We learned carpentry, electronics, electrical wiring, plumbing, automobile mechanics, and many other things. We also learned that if something is broken, you analyze the situation, find the problem, and repair it. You don't throw out the entire automobile or do an overhaul just because it needs a new fuel pump, water pump, tires, etc.; you just fix the problem and go on your way.

I am reminded of a sign I just saw on the back of a pickup truck this past week while driving back from Dallas, Texas. It said,

"If it ain't broke, fix it till it is!"

I'm afraid that is exactly what Congress and the leadership in Washington are going to do, i.e., "fix" healthcare until it is truly broken.

Very, very few individuals in the U.S. are unable to get healthcare if they really need and want it. Hospitals, clinics, emergency rooms, etc. treat millions of uninsured patients each year, knowing they are not going to get paid. Pharmacists fill many prescriptions each year for those in need and don't get paid for them. Large numbers of people from throughout the world come to the U.S. to get healthcare. Our system is not broken, it just needs some attention and "some" changes made.

Let the healthcare providers do the work and get fair and reasonable compensation. Let the insurance companies compete across state lines for participants in their programs, and you will see insurance rates drop. Change the legal system where frivolous lawsuits disappear and only those cases that are substantiated are successful, with reasonable limits as well as limits on what attorneys can receive in these lawsuits. Allow for more competition in the costs of drugs. Minimize the overhead charged by PBMs. Select some of these options and implement them, wait a few years, and then make further changes if necessary. We need a rational approach to improving and providing healthcare for all while not ruining it for the elderly, etc.

Please, let's not "fix the system until it's broken"!

Testosterone for Men Gets A Study
The federal government is funding a national study to see whether older men with low testosterone benefit from supplementing it. The study, led by University of Pennsylvania endocrinologist Peter Snyder, is a $45 million clinical trial, which is now recruiting 800 men older than 64. The study is by far the largest ever to compare the effects of the male hormone with a placebo. It will investigate whether symptoms of aging such as ebbing energy, limp libido, and muddy memory are partly due to testosterone deficiency in some men.

Still, sponsors say, the "T Trial" will not follow enough men for enough years to settle larger questions such as: What are the risks? Can younger, healthier men benefit from increased testosterone levels? This study involves 12 medical centers across the country. The study design addresses several questions, including the questions of whether experts can even agree how to define "low" testosterone.

The number of testosterone prescriptions soared from 648,000 in 1999 to 3.3 million in 2008; this follows the 2000 approval of Solvay Pharmaceuticals' AndroGel.
http://emailactivity.ecn5.com/engines/linkfrom.aspx?b=204057&e=27500279&l=http://pharmalive.com/news/index.cfm?articleID=669811&categoryid=9&newsletter=1&premium=1

Pfizer's Kindler Warns Against Fueling Public's Anger
Three months after his company paid the largest criminal fine in U.S. history, Pfizer Inc. CEO Jeffrey B. Kindler called on government and business leaders Tuesday to face up to the "real and legitimate anger" of citizens fed up with ethics breaches.

"If we fail to change, the future will not be pretty -- for business or for society as a whole," Kindler said in a keynote address to the Boston College Chief Executives' Club at the Boston Harbor Hotel. "People have had enough, and the backlash is real."

"When the majority don't trust you, they will find a way to force you to change," he said. These changes, he added, could include limits on businesses' licenses to operate and might affect private-sector innovation.

Pfizer has changed. Golf trips, fancy dinners, etc. for doctors are now out, and there are fewer company sales representatives in the waiting rooms. Results of clinical trials are now posted for all to see.

Kindler pointed out that drug companies have cut between 130,000 and 140,000 jobs in the past year. Some of those cuts have come with three major pharmaceutical mergers announced this year, including Pfizer's $67 billion buyout of Wyeth Pharmaceuticals.
http://pharmalive.com/news/index.cfm?articleID=670940&categoryid=9&newsletter=1&premium=1

Direct-to-consumer Ads Associated with Higher Medicaid Costs
Direct-to-consumer advertising for a commonly prescribed antiplatelet drug does not appear associated with increased use, but may be associated with increased drug costs and Medicaid pharmacy expenditures.

Drug costs to public and private health insurance programs have been a long-standing source of concern among policy markers. Millions of Americans participate in Medicare Part D programs. In these programs, prescription drugs are cited as one of the three top reasons for Medicaid expenditure growth. Prescription drug costs have increased by an average of 15.4 percent per year between 1994 and 2004. Meanwhile, spending for DTCA has increased more than 330 percent in the last 10 years.
http://pharmalive.com/news/index.cfm?articleID=669142&categoryid=43&newsletter=1&premium=1

Molecular Biopharmaceutics
Steffansen B, Brodin B, Nielsen CU, eds.
London, UK: Pharmaceutical Press
2010; Hardback; 371 pages; $199.99

The content of this book involves aspects of drug characterization, drug delivery, and dosage form evaluation. Molecular biopharmaceutics concerns physicochemical characterization, membrane transport, and bioavailability of primarily small drug and prodrug substances. It includes experimental and predictive methods, for example, of chemical stability, dissolution, passive diffusional, and carrier-mediated membrane permeability to biosimulation of oral absorption and bioavailability. Although written primarily for Ph.D. students in graduate programs, the content is very informative for compounding pharmacists.

The four main parts include: (1) Introduction, (2) Physicochemical Characterization of Drug Candidates, (3) Membrane Transport of Drug Candidates, and (4) Describing and Predicting Bioavailability. Some specific chapters of interest include Mechanisms of Decomposition of Drug Candidates, Kinetics of Decomposition in Aqueous Solution, Structure and Function of Absorption Barriers, Passive Diffusion of Drug Substances: The Concepts of Flux and Permeability, and The Biopharmaceutics Classification System in Drug Discovery and Development. These topics should be of interest to advanced compounding pharmacists that wish to "dig deeper" into formulation development and possibly prepare better for the future in compounding.

�with unemployment over 10% and actually reaching to over 20% in some cities, it may be time for "Corporate America" to bring back some jobs to the U.S. from other countries. The pharmaceutical industry would be a good place to start. With over 70% of bulk drug chemicals being synthesized in other countries, that industry could be revived here in the U.S. if Congress would address the EPA and OSHA requirements they implemented a few years ago as well as some other changes.

Lighting Control

Save time in turning on and off your Christmas decorations in your store or at home. Remote controlled "on-off" devices are available where all lighting, etc. can be controlled by a single push of a button.