Houston Health Care Initiative

Federal Government Goofs Delayed Coronavirus Tests By 6-8 Weeks

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The United States badly bungled coronavirus testing.
The United States badly bungled initial coronavirus testing. Federal Government Goofs Delayed Coronavirus Tests By 6-8 Weeks.

Federal Government Goofs Delayed Coronavirus Tests By 6-8 Weeks. On his regular podcast Dr. Steven Goldstein described how failures within the federal government delayed proper testing for the Coronavirus/Covid-19 virus by several weeks.  The outcome? Tracking and tracing the infection early in the process was impossible. The Houston Healthcare Initiative Podcast is available on SoundCloud, iHeartRadio,LibSyn, Spotify,  iTunes, Radio.com, Stitcher, ListenNotes, Podcast Addict, or the Houston Healthcare Initiative web site.

Early Kit Troubles

Early in the testing process the Food and Drug Administration (FDA) sent Coronavirus/Covid-19 test kits to approximately 100 health labs across the country. Initially the FDA had done all the testing in in-house, but more cases meant that tests had to be available in more locations. There was just one, very important mistake and that was there was no way to validate the tests and its ingredients all acted the same way when used, regardless of the location.

Thirty-six of the approximately 50 tests returned results to the FDA that were ‘inconclusive’. Manufacture of new ingredients for the tests took 3 weeks. The failure to get working test kits into public-health labs came at a really bad time. Early in any outbreak, contact tracing, isolation, and individual quarantines are used to contain the spread of disease. These steps don’t work when suspected cases cannot be tested. The gap made by the bad test kits made it impossible for public-health officials to get a read on how far and fast the disease was spreading. The result, Covid-19 spread undetected for several weeks. “The government was not prepared when it came to identifying and quarantining contacts of the first patients and preventing sick patients from entering the country,” Dr. Goldstein told his listeners. “Government bureaucracy delayed the development of laboratory tests for 6-8 weeks.”

Worse still, when an Emergency Use Application (EUA) test was sent via email and followed up with phone calls from the University of Washington Virology Lab to the FDA for approval, the applicants learned that U.S. law required a hard copy of the applications be sent with a CD or thumb drive via the U.S. Postal Service to be considered. Instead of using more advanced communications like e-mail the lab was forced to use ‘snail mail’. (The F.D.A. has since dropped the requirement to send a CD-rom or USB drive with a copy of the application).

Bureaucrats Want More Power Not Less

According to Dr. Goldstein, issues like this have more to do with the bureaucratic class maintaining its influence than protecting the public or any devotion to science. “People ensconced in government bureaucracy want to preserve their authority and it seems that they are willing to take drastic measures to preserve that power,” Dr. Goldstein said. “These people are very invested in expensive, high tech treatments. Low tech measures like contact tracing and quarantining and testing anyone entering the country could have controlled the epidemic early on.” One possible lesson from this is to remember that government takeover of any health crisis will persist long past any benefit is exhausted. Finding ways around these career government employees should be part of any proposed reform for the healthcare industry.

About the 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. Federal Government Goofs Delayed Coronavirus Tests By 6-8 Weeks.

 

Best Selling Author Gerald Posner Discusses ‘Pharma: Greed Lies and Poisoning of America’

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Gerald Posner on the podcast this week.
Gerald Posner latest work is “Pharma: Greed, Lies, and the Poisoning of America.” This book describes something we here are all very interest in which is the history of the pharmaceutical manufacturing industry.

In a special edition of the Houston Healthcare Initiative podcast best-selling author and investigative journalist Gerald Posner discusses the sordid history of the drug business from his most recent work, ‘Pharma: Greed Lies and the Poisoning of America.’ It reads like a ‘true crime’ novel, though everything in the volume is true. ‘Pharma: Greed Lies and the Poisoning of America’ is available at Amazon, just click here: ‘Pharma: Greed Lies and the Poisoning of America.’

The Houston Healthcare Initiative podcast can be heard on SoundCloud, iTunes, iHeartRadio, LibSyn, Spotify, and the Houston Healthcare Initiative web site. In the book and podcast Posner tells a compelling story that links the history of the pharmaceutical industry from the mid-19th century to the twenty first. It is not a flattering narrative. Many of the practices that were incorporated into marketing and selling heroin and cocaine in the early 20th century were and are still used today. And like they did before, the same companies are deliberately downplaying of the risk of modern-day medicines like opioids that have led to addiction and death for so many Americans.

Interests Intersect

Mr. Posner’s work and the interests of the Houston Healthcare Initiative coincide in several important ways. “The reform of the entire healthcare industry including the pharmaceutical business is our mission,” said Dr. Steven Goldstein who founded the Houston Healthcare Initiative. “We were very flattered he took time to talk with us and the audience about this important topic and we hope that everyone who reads his new book is inspired to act.”

Profits, Then Everything Else

Marketing, sales, advertising and abuse of patent law are all used against the American public to boost sales and stock prices of drug companies. This is part of the historic heritage that links the business’ past to today. “Only by knowing its history,” Mr. Posner writes, “is it possible to fully appreciate how the battle between noble ambitions and greed is a permanent conflict.” Mr. Posner tells many stories about the people behind the industry and the some of the ethically questionable things they did and still do.

Meet the Sacklers

The mindset of these and other actors id’ed in the book can be better understood with one of many informative stories Mr. Posner relates. According to Mr. Posner, eight people in a single family ‘made the choices that caused much of the opioid epidemic.’ The family in question is the Sacklers, notably Arthur, who “had some clever ideas of how to disguise product promotions as ‘news’ covered in consumer press.” According to media experts, the ad made to look like news or ‘advertorial’ is a really low rung on either the paid ad or public relations ladder.

Nazis? Really?

Mr. Posner detailed this during his interview on the podcast. “In 1947, defense attorneys for Nazi doctors charged with war crimes for human experimentation at concentration camps cited the malaria experiments in a failed effort for an acquittal. He went on, “when Nazi doctors are citing clinical trials from your industry as grounds for an acquittal in their own legal trials, you have erred.”

To learn more about Gerald Posner visit his web site at https://www.posner.com/.

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.

 

 

 

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

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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

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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.

A Retracted Article Drove Misunderstanding of Hydroxychloroquine

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A Retracted Article Drove Misunderstanding Hydroxychloroquine

A Retracted Article Drove Misunderstanding of Hydroxychloroquine. No one can unring a bell. When articles published in the Lancet and the New England Journal of Medicine published and then retracted an article critical about the possible use of hydroxychloriquine as a treatment for Coronavirus/Covid-19 they may have shown good faith with the retractions but the damage was done. On his regular podcast, Dr. Steven Goldstein discusses how and why the use of an inexpensive drug was widely criticized. An article from Tablet magazine (Hydroxychloroquine: A Morality Tale) describes the issue in detail.

The criticisms were based on the retracted articles, but there was more to it. Political agendas and money both added to the manufactured confusion about a drug that was used to treat malaria, lupus and others without controversy. Dr. Goldstein believes that reforms for government and the pharmaceutical manufacturing industry were never more obvious than in this example. A Retracted Article Drove Misunderstanding of Hydroxychloroquine.

Was There Ever A Better Time To Reform Drug Prices?

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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?

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buy canadian drugs

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

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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.

 

Court Rules Against the Hospital Industry Mandates Price Disclosure

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Court Rules Against the Hospital Industry Mandates Price Disclosure. Hospital prices that were historically rigged by the medical business along with the insurance industry, and kept secret from the public, will see the light of day January 1, 2021. This because on June 23, 2020 a federal judge in Washington D.C. dismissed a suit brought by the American Hospital Association (AHA) that challenged the Department of Health and Human Services rule mandating hospitals to disclose their privately negotiated prices with health insurance companies.  This ruling, and what it means for doctors, patients and the industry, is the subject of the latest edition of the Houston Healthcare Initiative podcast. The Houston Healthcare Initiative podcast can be heard on SoundCloud, iTunes, iHeart, Spotify and on the Houston Healthcare Initiative website.

Court Ruling Allows Transparency

Hospital Price Transparency
Court Rules Against the Hospital Industry & Mandates Price Disclosure.

The court ruled that an executive order from the Trump administration requiring hospitals to disclose pricing was legal. A federal judge upheld a policy that requires hospitals and health insurers to publish their negotiated prices for health services, numbers that are typically kept secret. The policy is part of a major push by the Trump administration to improve transparency in health care. Insurers and health providers usually negotiate deals behind closed doors, and patients rarely know the cost of services until after the fact.

Healthcare Industry Public Relations Offensive

The meaning of the ruling and what will happen are different. As Dr. Goldstein told his audience, “there will be an appeal accompanied by a full court public relations press by the hospital industry to derail this effort.” Dr. Goldstein went on to say, “if the battle can be dragged out until after the presidential election, hospitals and insurance companies can hope a new administration will rescind the executive order.”

Four organizations are now urging the Department of Health and Human Services to delay implementation of the price transparency rule until after the appeals court makes a decision in the case. The American Hospital Association, the Federation of American Hospitals, the Association of American Medical Colleges and the Children’s Hospital Association made their request in a letter to HHS Secretary Alex Azar on June 29, five days after these associations and others filed an appeal against the ruling which would implement a rule on price transparency on January first. The groups said the rule would ‘pose a burden to hospitals and health systems responding to the COVID-19 public health emergency.’ Thirty-four hospital groups have already urged HHS to delay the start of the price disclosure.

In an article published in “Becker Hospital Review” AHA General Counsel Melinda Hatton said, “the proposal does nothing to help patients understand their out-of-pocket costs.” She added, “it also imposes significant burdens on hospitals at a time when resources are stretched thin and need to be devoted to patient care. Hospitals and health systems have consistently supported efforts to provide patients with information about the costs of their medical care. This is not the right way to achieve this important goal.”

About The 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. Court Rules Against the Hospital Industry Mandates Price Disclosure.

What The Court Ruled About Hospital Price Transparency

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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.