Possible Remedy for the Coronavirus/Covid-19 Global Pandemic Invites Immediate Controversy

Blood Plasma
Possible Remedy for the Coronavirus/Covid-19 Global Pandemic Invites Immediate Controversy
Treatment with blood plasma from recovered patients is an accepted practice that goes back to the early 20th century.

Possible Remedy for the Coronavirus/Covid-19 Global Pandemic Invites Immediate Controversy.

On August 23, 2020 the Food and Drug Administration (FDA) announced a decision to grant blood plasma treatment for Coronavirus/Covid-19 patients with a fast-track authorization for its emergency use as a treatment for hospitalized COVID-19 patients.

The next day, claims about the effectiveness of this treatment were retracted. Subsequent news coverage about this potential treatment did little to clarify blood plasmas’ usefulness or lack thereof. The idea that there could be a political motivation behind the fast track authorization for this potential treatment, other than looking for a useful therapeutic, is troubling.

Who Can Americans Believe?

On his regular ‘Houston Healthcare Initiative’ podcast, respected neurologist Dr. Steven Goldstein defines how this decision triggered an outcry from scientists and doctors, who said the decision was not supported by adequate clinical evidence and criticized the FDA for what was perceived as bowing to ‘political pressure’.

Dr. Goldstein also reviews those who believed this approach was worthwhile. Generally, treatment with blood plasma from recovered patients is an accepted practice that goes back to the early 20th century. Many believe the possibility that blood plasma from recovered Coronavirus/Covid-19 patients could help people fight off the virus was worthy of further investigation.

Who is correct? Who should the American public rely on for the best information about treatment for this global health emergency?

The Houston Healthcare Initiative podcast can be heard on: SoundCloud, Apple Podcasts, Stitcher, Listen Notes, iHeartRadio, and the Houston Healthcare Initiative web site.

About Houston Healthcare Initiative And Dr. Steven Goldstein

Dr. Steven Goldstein is a Houston based neurologist. He founded the Houston Healthcare Initiative and is an advocate for common sense solutions to the healthcare crisis that confronts the citizens and residents of the United States of America. Blood plasma treatment for Covid-19 patients invites controversy.

Blood Plasma Covid Treatment and Pharmaceutical Industry Reform

Blood plasma covid treatment and pharmaceutical industry reform. On August 23, 2020 the Food and Drug Administration’s announced a decision to grant blood plasma treatment for Coronavirus/Covid-19 patients with a  fast-track authorization for its emergency use as a treatment for hospitalized COVID patients. This “emergency use authorization” triggered an outcry from scientists and doctors, who said the decision was not supported by adequate clinical evidence and criticized the FDA for what was perceived as bowing to political pressure.

Should Pharma choose people over profit?
Big Pharma has a big influence on the congress from multi-million dollar lobbying effort.

News coverage about this potential treatment has done little to clarify whether its useful or not. The idea that there could be a motivation behind the fast track authorization for this potential treatment other than looking for a useful therapeutic is troubling. More to the point, who should decide what patients receive in treatment for their illnesses? To help us make sense of how reforms for the pharmaceutical industry could potentially help separate facts from spin and who we should all listen to is respected neurologist, Dr. Steven Goldstein. Click below to listen.

To read more about this issue please click below: https://www.sciencemag.org/news/2020/08/fda-s-green-light-treating-covid-19-plasma-critics-see-thin-evidence-and-politics.

The Reforms Big Pharmaceutical Companies Need

Reforms for the pharmaceutical industry.
Dr. Steven Goldstein has ideas that will make the pharmaceutical industry more responsive to the American public.

The Reforms Big Pharmaceutical Companies Need. On his regular podcast, Dr. Steven Goldstein advocated dramatic reforms for the pharmaceutical industry and with good reason. To hear the podcast go to: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, or the website at www.houstonhealthcareinitiative.org. Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

What Has To Change – Ban Pharmaceutical Lobbying

“Corporate lobbying by pharmaceutical companies should be illegal,” Dr. Goldstein told his audience. “It isn’t right.” The companies who make more expensive treatments for ailments that could be treated with generic medicines spend millions of dollars lobbying the congress. According to a study by Brigham Young University, the health sector lobby’s spending increased more than 10% in the first quarter of 2020 while the non-health lobby sector increased 1%. Meanwhile, the number of new lobbyists registered in the health sector increased a staggering 140% while non-health sector registrations increased 63%.

Patent Reform

Drug companies should not be permitted to obtain patents because of small modifications to already existing patented medication. “That is not what the spirit of patent protection was meant for,” Dr. Goldstein said. He also advocates that existing antitrust laws be enforced to stop price fixing. “An example is the predatory practice of larger drug companies paying off small generic manufacturers in order to eliminate competition,” Dr. Goldstein said.

Prescription Reform; Physicians Prescribe Not Pharmacists or Bureaucrats

Physicians should be free to prescribe drugs “off-label” without fear of lawsuit or sanctions from state or federal regulatory boards. “Full stop, no questions from non-physicians, pharmacists or government regulators,” Dr. Goldstein stated.

FDA Reform

The Food and Drug Administration (FDA) is charged with making sure drugs are “safe and effective”. “If you think about it, there is no such thing as a drug that is 100% safe or 100% effective,” Dr. Goldstein said. “Even aspirin can cause gastritis and intestinal bleeding that in rare instances can cause death. Drugs used to treat epilepsy are only about 50% effective.  How then does the FDA decide what drugs to approve? After randomized controlled trials are performed, a panel of “experts” decides which drugs to approve.”

About Houston Healthcare Initiative and Dr. Steven Goldstein

Dr. Steven Goldstein is a Houston based neurologist. He founded the Houston Healthcare Initiative and is an advocate for common sense solutions to the healthcare crisis that confronts the citizens and residents of the United States of America. The Reforms Big Pharmaceutical Companies Need.

 

 

The Source of the Misunderstanding: Retracted Article Mischaracterizes Hydroxychloroquine

Like un-ringing a bell.

Retracted Article Mischaracterizes Hydroxychloroquine. No one can un-ring a bell. No article can be ‘un-read’ or any eventual retraction definitely seen and understood. There are few more illustrative examples lately than when respected medical journals published information about the use of Hydroxychloroquine as a possible treatment for the Coronavirus/Covid-19 virus they later retracted.

HCN
Large French Real World Observational Study Reveals Hydroxychloroquine Azithromycin-Associated with Reduction in Hospitalization-Death for COVID 19 Patients.

On his podcast, respected, Houston based neurologist Dr. Steven Goldstein describes how the well-established, inexpensive drug Hydroxychloroquine was mischaracterized. To listen to the podcast please visit: SoundCloud, Libsyn,iHeart, and the Houston Healthcare Initiative web site.

Article Retracted But Damage Done

Early in the pandemic, Hydroxychloroquine looked like it could be a possible treatment for Coronavirus/Covid-19 ,but use of and studies about the drug quickly lost favor after articles in the Lancet and New England Journal of Medicinecast doubt. The later retracted study and reporting about it had an immediate impact. The World Health Organization (WHO) stopped their research into hydroxychloroquine. Multiple news web sites carried the message that Hydroxychloroquine was not effective, citing the New England Journal of Medicine as its source. One example was from the NBC News web site read, “Hydroxychloroquine fails to prevent COVID-19, large study finds.”

Damage Done

While the articles were retracted the information originally published, could not be ‘unseen.’ “The news media touted these articles, that falsely claimed there was no evidence that treatment with Hydroxychloroquine was effective,” Dr. Goldstein told his listeners.  “A French study published March 20, 2020 suggested the drug helped people with coronavirus, reporting it “is significantly associated with viral load reduction/disappearance in patients with COVID-19.”

The article and its author, French physician and scientist, Dr. Didier Raoult, who authored papers showing favorable results, were personally and professionally attacked (The New York Times) among others. Suffice to say that way more people saw and continue to see these refuted articles, even though they were retracted. But the harm from them remains.

About The Houston Healthcare Initiative

Houston Healthcare Initiative is a group of physicians and health conscious patients that have joined together in a Healthcare cooperative to maintain and improve the physical and mental health of each member of the group. Visit online at https://houstonhealthcareinitiative.org.

Sources and Links

“Retraction: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19.” N Engl J Med. DOI: 10.1056/NEJMoa2007621. https://www.nejm.org/doi/full/10.1056/NEJMc2021225.

June 25, 2020 N Engl J Med 2020; 382:2582. DOI: 10.1056/NEJMc2021225

“Retraction—Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis.” Published: June 05, 2020.

By: Mandeep R Mehra,   Frank RuschitzkaAmit N Patel.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31324-6/fulltext

“Two elite medical journals retract coronavirus papers over data integrity questions”

By: Charles PillerKelly Servick Jun. 4, 2020 , 5:30 PM

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31324-6/fulltext

“He Was a Science Star. Then He Promoted a Questionable Cure for Covid-19.” The New York Times By Scott Sayare. Published May 12, 2020 Updated May 21, 2020

“French Doctor Leads Charge for Treating Coronavirus With Antimalarial Drug”

Health authorities say evidence is inconclusive that the treatment, which President Trump has backed, is effective. By Nick Kostov and David Gauthier-Villars

Updated April 11, 2020 7:52 pm ET

https://www.wsj.com/articles/french-doctor-leads-charge-for-treating-coronavirus-with-antimalarial-drug-11586629801

Retracted Article Mischaracterizes Hydroxychloroquine.

Retracted Article Mischaracterizes Hydroxychloroquine.

Was There Ever A Better Time To Reform Drug Prices?

US & Canadian Drug Prices

In the Coronavirus/Covid-19 Pandemic Age Come Ideas for Drug Price Reform

In the coronavirus/covid-19 pandemic age drug reform is topical.

According to Dr. Steven Goldstein on his podcast, “without meaningful modification, drug prices and pressure on patient’s ability to pay and manufacturers resources for discovery will reach a tipping point.” Dr. Steven Goldstein lists the reasons for the discrepancy and how the U.S. could reform the laws that govern the ways therapeutic medicine gets from the lab bench all the way to the patient for whom it is intended.

Some of these include:

  • Reform drug patent law. The patent system for drugs needs to be reformed so that drug development costs can be recouped along with a profit. Once this occurs, the patent should expire.
  • Streamline approval. The FDA needs reform so that drug authorizations are more efficient. Possibly, an international FDA funded by a consortium of countries could approve drugs.
  • Eliminate monetary incentives from drug companies for writing prescriptions.
  • Drug discounts to insurance companies and Medicare should be illegal.
  • Enforce the laws already passed. Antitrust laws for price collusion need to be enforced.

    US & Canadian Drug Prices
    In the coronavirus/covid-19 pandemic age drug reform is topical. For U.S. drug prices to be affordable and provide enough resources for continued research serious reform is needed. 

To hear Dr. Goldstein’s podcast listen on SoundCloud, iHeartRadio, iTunes, Stitcher, and the website at www.houstonhealthcareinitiative.org.

 

Why Are Prescription Drugs Cheaper in Canada?

Why Are Prescription Drugs Cheaper in Canada?

Even those with private, employer funded health insurance gasp at the price of some prescription medications. Learning that the same medicine is available north of the border at a substantially reduced price often produces other emotional reactions from surprise to anger. There are plenty of reasons those drugs are priced differently.

drug prices in Canada are lower because the Canadian government regulates the price.
Why Are Prescription Drugs Cheaper in Canada? Prices in Canada are lower because the Canadian government regulates the price.

Listeners to the Houston Healthcare Initiative podcast will learn why as respected neurologist Dr. Steven Goldstein explains how the combination of foreign government requirements and U.S. government non-regulation combined to give the American public sticker shock at the drug store.

The Houston Healthcare Initiative podcast can be heard on SoundCloud, iHeartRadio, iTunes, Stitcher, and the website at www.houstonhealthcareinitiative.org.

Canadian Government Declares Prices

In short, drug prices in Canada are lower because the Canadian government regulates the price. In Canada, a review board decides on pricing and what they believe are reasonable or excessive prices. If they decide a drug is priced too high, they will not allow it on the drug formulary. This board, the Patented Medicine Prices Review Board, is described in Canada as a quasi-judicial agency.

Before a prescription drug can be sold in Canada it is scientifically reviewed to make certain that it can do what it is supposed to do. A committee of experts known as the Human Drug Advisory Panel will make recommendations about other valid drugs on which to make comparison, in addition to recommendations for the categorization of new drugs. The level of therapeutic improvement of an existing patented drug is used to determine a ceiling price, known as the Maximum Average Potential Price, at its introduction.

U.S. Prices Set by Industry

The U.S. government is prohibited by law from negotiating prices for Medicare and other government programs. “Obviously, the drug company needs to recoup the cost of research, manufacture, advertising and the cost of getting the drug approved by the FDA,” Dr. Goldstein told his listeners. “The people in this country essentially pay for all of this work as countries like Canada do not allow their citizens to share the cost.” New drugs are issued a patent giving the drug company a monopoly on sale of the drug for 20 years. The drug company is free to set whatever price it likes for prescription drugs. Prices are then negotiated between insurance companies and the manufacturers.

Needed Drug Price Reforms

The U.S. and Canadian systems each present two very different models for drug pricing, neither of which is reasonable. The Canadian system does not allow enough incentive for new drugs to be created. The American system results in unaffordable prices. “There are several needed reforms,” Dr. Goldstein said. “We are not able to flip a switch and adopt the prices charged in Canada, though that would be nice.”

The reforms Dr. Goldstein recommends are:

  • Reform drug patent law. The patent system for drugs needs to be reformed so that drug development costs can be recouped along with a profit. Once this occurs, the patent should expire.
  • Streamline approval. The FDA needs reform so that drug authorizations are more efficient. Possibly, an international FDA funded by a consortium of countries could approve drugs.
  • Eliminate monetary incentives for writing prescriptions.
  • Drug discounts to insurance companies and Medicare should be illegal.
  • Enforce the laws already passed. Antitrust laws for price collusion need to be enforced.

“If these reforms were enacted, prices for drugs would be determined more by supply and demand,” Dr. Goldstein said. “This would ensure an adequate supply at the lowest price. For high priced drugs of marginal benefit, demand would be low and would tend to cause the price to drop. For new orphan drugs, the government could provide subsidies.”

About Houston Healthcare Initiative

Houston Healthcare Initiative (HHI) was founded by Dr. Steven Goldstein. Like many Americans, Dr. Goldstein is concerned about the state of the U.S healthcare system as well as the sorry state of the public’s health. The Houston Healthcare Initiative web site is an aggregator of news, healthcare pricing information, and resources for those who want to help drive reform for the healthcare industry. HHI’s emphasis for reform is on free market innovation and personal responsibility.

 

Patients Can Save Money When They Pay Their Doctor In Cash

Even for those who have private insurance…

Patients Can Save Money When They Pay Their Doctor In Cash

Even patients who have their own health insurance can often save themselves money by paying cash. The Houston Healthcare Initiative website (www.houstonhealthcareinitiative.org) now has a page that lists seventy-eight separate medical services that will accept cash payments. The number expands almost daily as independent providers look for ways to compete with the large conglomerates that provide most of the care here in the U.S. and provide more and better service to their patients. To go directly to the “Healthcare Pricing” page click here: https://houstonhealthcareinitiative.org/pricing.

There is no charge to visit the site, nor is there any fee to those who want to list their practice or

Medical Price Transparency
Save money when paying cash, even when patients have their own health insurance. 

facility.

Direct Payments Are Counter Intuitive

How could a patients’ direct payments be more affordable than those from their health insurance? “People who have health insurance assume that the insured price is always better than the cash price, but that is not always the case,” said neurologist and founder of the Houston Healthcare Initiative, Dr. Steven Goldstein. This has to do with meeting deductibles that are now higher than in years past. “Businesses who provide their employees with health insurance often require them to bare more of the cost in the form of higher deductibles, paying thousands of dollars on their healthcare before they can make a claim.” It is for these people and families that direct payments for service, on the day provided, makes sense.

But Do Not Go Without

Of course, this is not always the case nor is it a good reason to completely forgo health insurance. “Health insurance can protect people from high fees associated with serious long-term illnesses and accidents that could potentially bankrupt them,” Dr. Goldstein said. “But if someone has a high deductible and wants to save, this is a reasonable alternative that is at least worth investigation.”

Good For Doctors Too?

It is costly and labor intensive to administer health insurance. Healthcare providers benefit from accepting cash because of lower administrative and collection costs. “The labor required to file claims, negotiate with the insurance company and wait for payment, chase down their compensation from the insurance company or the patient saves the office manager a lot of time and hassle,” Dr. Goldstein said. “So much so that providers can pass that savings on to those who can pay cash.”

Potential Downside

The biggest potential negative for those who want to pay in cash is that often those payments will not count toward a deductible. All insurance companies have different rules for out of pocket payments and where the cap is for them. It is a good idea for those with such policies to investigate what the requirements and restrictions are in advance. Cash payment makes more sense for someone with a deductible not met or high enough that it likely will not be reached anytime in the same calendar year (deductibles reset annually). The insurance company web site or employer administrator will be able to answer these questions. “There is no substitute for knowing what a policy will or will not allow,” Dr. Goldstein said. “Before making a decision make sure it is informed.”

About Houston Healthcare Initiative

The Houston Healthcare Initiative web site is an aggregator of health news, healthcare pricing information, and resources for those who want to help drive reform for the healthcare industry. HHI’s emphasis for reform is on free market innovation and personal responsibility.

 

What The Court Ruled About Hospital Price Transparency

This week on the Houston Healthcare Initiative podcast, Dr. Steven Goldstein takes a deeper dive into a court decision where hospitals must reveal private negotiated rates with insurers starting this coming January 1, 2021. Plus, he will provide more insight into how hospitals decide what and how much to charge us, and man is that a story. It’s all more than a little complex. The podcast is available on all the popular podcast networks including SoundCloud, iHeart, and Spotify among others.

How Are Prices Now Assessed

Hospital prices are not based on the free market. Instead, prices are agreed on via secret agreements between hospitals and insurance companies. The truth is that pricing for medical services as paid by insurance companies are artificially set and not competitive at all. Prices are agreed to in advance by the hospital and the insurance company, not disclosed to the public. “We are led to believe that our insurance providers negotiate on behalf of their policyholders,” Dr. Goldstein told his audience. This is not the case. The court has ruled that this will no longer be permitted, that hospitals will have to reveal these negotiated rates and thus hospitals must reveal private negotiated rates .

Hospitals must reveal private negotiated rates to the public.
Hospitals must reveal private negotiated rates to the public.The court ruling that upheld a Trump Administration policy that forces hospitals to reveal their prices.

Why Hospitals Object

One reason many hospitals do not list their actual prices is that, according to them, some cases are more complicated than others. “An appendectomy may go smoothly or may be complicated by other factors such as adhesions from a previous surgery that caused scarring,” Dr. Goldstein said. “This may require additional operating room time resulting in a higher cost.  Thus hospitals claim they can only give estimates.”

Alternatively, this could be handled in one of two ways. 1). Publish the price for each procedure at what the hospital perceives as the average price. Then find ways to cut costs so that average cost is lowered resulting in increased profit for the hospital.  2). Alternatively, publish a price for operating room time by the hour that would include all the ancillary charges + publish the range of operating room times for each procedure.

How Prices Are Set Now

With the use of computer technology, hospitals are able to establish a charge for each product or service, no matter how small. “Every aspirin, every blood test, every x-ray, every bandage, every suture has a charge; Dr. Goldstein said. “Some of these charges beg credulity e.g. the $20 aspirin. All these charges are added up to give the total hospital charge. Of course, this doesn’t include multiple physician charges that are separate.” This all resulted in the Trump administration’s order that hospitals must reveal private negotiated rates to the public.

But the final charge is the “sticker price”. The insurance companies never pay this price. They have a secret, negotiated price based on the Medicare price for those services.

Secret Revealed on Pricing Practices of Health Insurance Companies & Hospitals

The actual price of what a medical test, procedure, exam and often prescription cost and how charges are assigned is not based on the free market. Instead, prices are agreed on via secret agreements between hospitals and insurance companies. This is the subject of the Houston Healthcare Initiative podcast with Dr. Steven Goldstein. To hear the Houston Healthcare Initiative podcast, please visit: SoundCloud, Apple Podcasts, iHeart, PlayerFM, or the Houston Healthcare Initiative web site. Secret Revealed on Pricing Practices of Health Insurance Companies & Hospitals.

Pay More Attention

Price Transparency
Price transparency from insurance companies and medical companies is a rare thing.

Most people get health insurance from their employer which is the reason, so few pay much attention to the price of the medical services and pharmaceuticals that Americans purchase. Employer funded insurance pays for most of what is charged with individuals picking up a smaller deductible. But according to neurologist Dr. Steven Goldstein, it is past time to start devoting attention to not just what is charged but how the health insurance companies, and the medical community decides what to charge and why. Spoiler Alert: it is not based on the free market.

The idea that pricing for medical services as paid by insurance companies are artificially set and not competitive at all. They are agreed to in advance by the hospital and the insurance company, not disclosed to the public, and we are all led to believe that our insurance providers were negotiating on behalf of the people that pay the premiums.

It Is Expensive But…

The fact that the charges for visits to the doctor, hospital and pharmacist are mostly paid for by employer funded insurance does not make us any less likely to get both overcharged and underserved. It is a lack of transparency that makes medical costs so high. It was not wrong to believe that research, new equipment, and pharmaceutical discovery were what was behind the increase in healthcare prices; they account for some. “The issue is that patients do not know the actual price of services,” Dr. Goldstein told his listeners. “The list price is the price charged to patients without insurance. Each insurance company negotiates a discounted price.”

Thus, there are multiple discounted prices depending on the insurance company plus a different price for Medicare and Medicaid. These prices have traditionally been secret. There is no competition between hospitals based on price. “Medicare sets the price standard based on costs,” he said. “Thus, hospitals are cost plus operations with little incentive to reduce costs.”

Why Not Just Pay Cash?

Cash prices are often much less than what is charged even to the insurance companies. People often can secure better deals if they don’t use their insurance. A 2016 Wall Street Journal investigation found that hospitals frequently offer far better deals for people who pay in cash rather than use their insurance. “Price transparency allows individuals to shop for the best nonemergency deal. It would also force hospitals to compete, thus saving consumers money. It gives them a choice,” Dr. Goldstein said. The way any of us chooses to spend our money is the most democratic thing anyone can do.

Price transparency allows individuals to find the best non-emergency deal. It would also force hospitals to compete, thus saving consumers money. “If prices were known, posted in public, people could shop for the non-emergency services,” Dr. Goldstein said.

About Houston Healthcare Initiative

Dr. Steven Goldstein is a Houston based neurologist. He founded the Houston Healthcare Initiative and is an advocate for common sense solutions to the healthcare crisis that confronts the citizens and residents of the United States of America.Secret Revealed on Pricing Practices of Health Insurance Companies & Hospitals

 

Why Healthcare Insurance & Hospitals Do Not Want You To Know About Pricing

Medical Price Transparency
Why Healthcare Insurance & Hospitals Do Not Want You To Know About Pricing

Transparency and the need for it in different industries is a word and requirement we hear a lot about. It should not surprise anyone that some insurers and hospital groups are working to block the implementation of federal rules that make hospital pricing transparent. They argue these will confuse consumers and potentially lead to higher costs. But there is good news. According to the New York Times, a federal judge has upheld a Trump administration policy that requires hospitals and health insurers to publish their negotiated prices for health services, numbers that are typically kept secret.

Most of us have our health insurance provided by our employers and we do not pay as much attention to the price of medical care as we do the cost of other consumer items. But maybe we should pay more attention? The fact that the charges for our visits to the doctor, hospital and pharmacist are mostly paid for by our insurance does not make us any less likely to get both overcharged and underserved. In fact, it is a lack of transparency that makes medical costs so high.

The issue is that patients do not know the actual price of services. The list price is the price charged to patients without insurance. Each Insurance company negotiates a discounted price. Thus there are multiple discounted prices depending on the insurance company plus a different price for Medicare and Medicaid. These prices have traditionally been secret. There is no competition between hospitals based on price. Medicare sets the price standard based on costs. Thus, hospitals are cost plus operations with little incentive to reduce costs.

Learn more by listening to the podcast.