Posts Tagged ‘doctors’

Big Pharma: Even Worse Than Used Cars as a Market for Lemons?

Big Pharma: Even Worse Than Used Cars as a Market for Lemons?

Courtesy of Yves Smith at Naked Capitalism 

Fruit at market

Some readers have wondered why this blog from time to time runs posts on the US health care system. Aside from the fact that it’s a major public policy problem in America, it is also a prime example of bad incentives, information asymmetry, and corporate predatory behavior. It thus makes for an important object lesson.

Reader Francois T pointed to an example, a commentary on a paper presented by Donald Light at the annual meeting of the American Sociological Association, “Pharmaceuticals: A Two-Tiered Market for Producing ‘Lemons’ and Serious Harm.” It still appears to be embargoed, but Howard Brody provides an extensive summary on his blog.

Light uses George Akerlof “market for lemons” as a point of departure. For those not familiar with the famed Akerlof paper, a “market for lemons” can occur when consumers are unable to distinguish product quality. The used car market is the paradigm, since the dealer has a much better idea than the buyer of whether a particular car is any good. Unscrupulous operators can stick a lot of hapless chump customers with overpriced clunkers. However, as crooked vendors become more common, buyers wise up a tad and are not longer to pay as much for cars they cannot evaluate. So while the prices buyers are now willing to pay are probably still too high for rattletraps, they are too low for decent cars. People with good merchandise start to look for other channels. Akerlof posits that the market eventually falls apart.

Note that used cars dealers did not set out to create lemons; the cars were bad deals by being overpriced (presumably, if they had been presented, warts and all, they still would have found purchasers, presumably people who thought they could repair them and those who wanted them for parts and scrap). Light contends, by contrast, that major pharmaceutical companies create bad products:

[T]he pharmaceutical market for ‘lemons,’ differs from other markets for lemons in that companies develop and produce the lemons. Evidence in this paper indicates that the production of lemon-drugs with hidden dangers is widespread and results from the systematic exploitation of monopoly rights and the production of partial, biased information about the efficacy and safety of new drugs…Companies will design and run their clinical


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Cause of Death: Sloppy Doctors

I didn’t find the statistics too surprising, but electronic prescribing really seems like a great solution. – Ilene 

Cause of Death: Sloppy Doctors

By Jeremy Caplan, courtesy of TIME

A doctor in Virginia uses a hand-held device to write an e-prescription.

Alex Wong / Getty

Doctors’ sloppy handwriting kills more than 7,000 people annually. It’s a shocking statistic, and, according to a July 2006 report from the National Academies of Science’s Institute of Medicine (IOM), preventable medication mistakes also injure more than 1.5 million Americans annually. Many such errors result from unclear abbreviations and dosage indications and illegible writing on some of the 3.2 billion prescriptions written in the U.S. every year.

To address the problem—and give the push for electronic medical records a shove—a coalition of health care companies and technology firms will launch a program Tuesday to enable all doctors in the U.S. to write electronic prescriptions for free. The National e-prescribing Patient Safety Initiative (NEPSI) will offer doctors access to eRx Now, a Web-based tool that physicians can use to write prescriptions electronically, check for potentially harmful drug interactions and ensure that pharmacies provide appropriate medications and dosages. "Thousands of people are dying, and we’ve been talking about this problem for ages," says Glen Tullman, CEO of Allscripts, a Chicago-based health care technology company, that initiated the project. "This is crazy. We have the technology today to prevent these errors, so why aren’t we doing it?"

One of the reasons is that doctors haven’t invested in the needed technology, so it’s being provided to them. The $100 million project has drawn support from a variety of partners, including Dell, Google, Aetna and numerous hospitals. "Our goal long-term is to get the prescription pads out of doctors’ hands, to get them working on computers," says Scott Wells, a Dell vice-president of marketing. Google is designing a custom search engine with NEPSI to assist doctors looking for health…
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Medicare Implodes – Doctors Opt Out of Medicare at Alarming Rate; Fountain of Youth Sought

Medicare Implodes – Doctors Opt Out of Medicare at Alarming Rate; Fountain of Youth Sought

Serbian soldiers prep unexploded ordnance outside the town of Zvornik, Bosnia-Herzegovina,

Courtesy of Mish

Doctors losing money doing "God’s Work" in Medicare, are tired of the losses. Many refuse to take new patients. Others have thrown in the towel altogether.

The Houston Chronicle has the details in Texas doctors opting out of Medicare at alarming rate.

Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.

Two years after a survey found nearly half of Texas doctors weren’t taking some new Medicare patients, new data shows 100 to 200 a year are now ending all involvement with the program. Before 2007, the number of doctors opting out averaged less than a handful a year.

“This new data shows the Medicare system is beginning to implode,” said Dr. Susan Bailey, president of the Texas Medical Association. “If Congress doesn’t fix Medicare soon, there’ll be more and more doctors dropping out and Congress’ promise to provide medical care to seniors will be broken.”

More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010, according to data compiled by the Houston Chronicle. Texas Medical Association officials, who conducted the 2008 survey, said the numbers far exceeded their assumptions.

The largest number of doctors opting out comes from primary care, a field already short of practitioners nationally and especially in Texas. Psychiatrists also make up a large share of the pie, causing one Texas leader to say, “God forbid that a senior has dementia.”

The opt-outs follow years of declining Medicare reimbursement that culminated in a looming 21 percent cut in 2010. Congress has voted three times to postpone the cut, which was originally to take effect Jan. 1. It is now set to take effect June 1.

In 2008, 42 percent of Texas doctors participating in the survey said they were no longer accepting all new Medicare patients. Among primary-care doctors, the percentage was 62 percent.

“You do Medicare for God and country because you lose money on it,” said [Dr. Guy Culpepper, a Dallas-area family practice doctor], a graduate of the University of Texas Medical School at Houston. “The only way to provide cost-effective care is outside the Medicare system, a system without constant paperwork and


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Pfilthy Pfizer Pfined

Joshua’s views on drug companies marketing drugs – good points I agree with. – Ilene

Pfilthy Pfizer Pfined

pfizer

I have friends who work as pharmaceutical sales reps and quite frankly, I’ve never gotten a good answer as to why the pharma industry is even allowed to push drugs on doctors or the general public at large, either with gifts, dinners or television commercials.

I am by no means anti the drug industry, I just get very uncomfortable with the possibility that a doctor may be prescribing a drug for reasons other than that it is the best possible drug for the patient.

Anyway, the Obama administration’s Justice Department has just fired a signal flare over the entire industry with its massive, record-breaking criminal fine against Pfizer (PFE) over it’s marketing activities.  I’d be surprised if the rest of the drugmakers don’t make big adjustments as a result of it.

From the AP via Yahoo Finance:
WASHINGTON (AP) — Federal prosecutors hit Pfizer Inc. with a record-breaking $2.3 billion in fines Wednesday and called the world’s largest drugmaker a repeating corporate cheat for illegal drug promotions that plied doctors with free golf, massages, and resort junkets.

Announcing the penalty as a warning to all drug manufacturers, Justice Department officials said the overall settlement is the largest ever paid by a drug company for alleged violations of federal drug rules, and the $1.2 billion criminal fine is the largest ever in any U.S. criminal case. The total includes $1 billion in civil penalties and a $100 million criminal forfeiture.

If we were to judge degrees of criminality by the size of the fine levied, then we’d have to conclude that Pfizer is the largest criminal entity in the history of the United States.  Now of course that isn’t true (AIG is). 

What is true is that Pfizer has settled a marketing corruption case 4 times this decade, is a repeat offender, and is so large that only a massive fine like this would actually have the power to act as a true deterrent.  Anything less may have just been chalked up by the industry as “a cost of doing business”.
 
$2.3 billion is no joke.
 
Now as far as the whole television commercial thing, can someone explain to


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Zero Hedge

China Set To Make History With Record Number Of Bond Defaults In 2019

Courtesy of ZeroHedge View original post here.

While China is bracing for what may be a historic D-Day event on December 9, when the "unprecedented" default of state-owned, commodity-trading conglomerate Tewoo with $38 billion in assets may take place, it has already been a banner year for Chinese bankruptcies.

According to Bloomberg data, China is set to hit another dismal milestone in 2019 when a record amount of onshore bonds are set to default, confirming that something is indeed cracki...



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Phil's Favorites

NATO meeting: solidarity reinforced despite uncomfortable time for alliance to be in the spotlight

 

NATO meeting: solidarity reinforced despite uncomfortable time for alliance to be in the spotlight

Courtesy of Megan Dee, University of Stirling

Anniversaries are meant to be a celebration. They represent a moment of reflection – a marker, a milestone, a time to look back. And therein lies their biggest problem. For anniversaries have that unfortunate effect of turning any subject – be it a past event, a married couple, or indeed an international institution – into an object of intense scrutiny. For the North Atlantic Treaty Organization (NATO) celebrating its 70th anniversary in London on December 3-4, that scrutiny has come at an unfortunate time.

Founded in 1949 with the signing of the Washington Treaty, NATO at 70 represents one the longest-standi...



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Kimble Charting Solutions

Homebuilders Nearing Crossroads at Pre-Financial Crisis Highs

Courtesy of Chris Kimble

The latest leg higher for the bull market has been supported by a resilient U.S. economy that continues to climb a wall of worry.

And that theme has carried over to the stock market. This has helped stocks rise over 20 percent in 2019.

One core piece of the economy is the housing market. This shows up in sector ETFs like the Homebuilders (XHB).

After retesting the 2006 pre-financial crisis highs in early 2018, the Homebuilders fell sharply over throughout the year. But 2019 has been a different story (see chart below).

The rally in 2019 has helped the broader stock market move higher and has the Homebuilders testing their financial crisis highs once again at point (1).

...



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Insider Scoop

38 Stocks Moving In Wednesday's Mid-Day Session

Courtesy of Benzinga

Gainers
  • Ibio Inc (NYSE: IBIO) shares surged 47.8% to $0.2778 on continued momentum after the company joined the manufacturing USA's tissue Biofabrication initiative.
  • Protagonist Therapeutics, Inc. (NASDAQ: PTGX) shares climbed 44% to $6.75. On Tuesday, Protagonist Therapeutics announced results from mid-stage study of PTG-300 in transfusion-dependent beta-thalassemia.
  • Relmada Therapeutics, Inc. (NASDAQ: RLMD) gained 19.2% to $41.07. Relmada Therapeutics price...


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Digital Currencies

Chinese Crypto Exchange IDAX Locks Cold Wallet As CEO "Goes Missing"

Courtesy of ZeroHedge

By William Suberg via CoinTelegraph.com

Chinese cryptocurrency exchange IDAX has suspended deposits and withdrawals after its CEO allegedly disappeared.

In a blog post on Nov. 29, IDAX, which earlier this week warned it was seeing a run on withdrawals, said the whereabouts of Lei Guorong were currently unkno...



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Chart School

RTT browsing latest..

Courtesy of Read the Ticker

Please review a collection of WWW browsing results. The information here is delayed by a few months, members get the most recent content.

Date Found: Tuesday, 09 July 2019, 01:48:48 AM


 

Click for popup. Clear your browser cache if image is not showing.





Comment:
FED has no ammo in the next crisis!


Date Found: Friday, 12 July 2019, 02:38:12 AM
 

Click for popup. Clear your browser cache if image is not showing.





Comment:
YIP Corporate debt blows up when econ...



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Members' Corner

Sacha Baron Cohen Uses ADL Speech to Tear Apart Mark Zuckerberg and Facebook

 

Sacha Baron Cohen Uses ADL Speech to Tear Apart Mark Zuckerberg and Facebook

By Matt Wilstein

Excerpt:

Sacha Baron Cohen accepted the International Leadership Award at the Anti-Defamation League’s Never is Now summit on anti-Semitism and hate Thursday. And the comedian and actor used his keynote speech to single out the one Jewish-American who he believes is doing the most to facilitate “hate and violence” in America: Facebook founder and CEO Mark Zuckerberg.

He began with a joke at the Trump administration’s expense. “Thank you, ADL, for this recognition and your work in fighting racism, hate and bigotry,” Baron Cohen said, according to his prepared...



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Lee's Free Thinking

NY Department of Welfare Announces Increased Subsidies for Primary Dealers, Thank God!

 

NY Department of Welfare Announces Increased Subsidies for Primary Dealers, Thank God!

Courtesy of , Wall Street Examiner

Here’s today’s press release (11/14/19) from the NY Fed verbatim. They’ve announced that they will be making special holiday welfare payments to the Primary Dealers this Christmas season. I have highlighted the relevant text.

The Open Market Trading Desk (the Desk) at the Federal Reserve Bank of New York has released the schedule of repurchase agreement (repo)...



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The Technical Traders

VIX Warns Of Imminent Market Correction

Courtesy of Technical Traders

The VIX is warning that a market peak may be setting up in the global markets and that investors should be cautious of the extremely low price in the VIX. These extremely low prices in the VIX are typically followed by some type of increased volatility in the markets.

The US Federal Reserve continues to push an easy money policy and has recently begun acquiring more dept allowing a deeper move towards a Quantitative Easing stance. This move, along with investor confidence in the US markets, has prompted early warning signs that the market has reached near extreme levels/peaks. 

Vix Value Drops Before Monthly Expiration

When the VIX falls to levels below 12~13, this typically v...



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Biotech

Why telling people with diabetes to use Walmart insulin can be dangerous advice

Reminder: We are available to chat with Members, comments are found below each post.

 

Why telling people with diabetes to use Walmart insulin can be dangerous advice

A vial of insulin. Prices for the drug, crucial for those with diabetes, have soared in recent years. Oleksandr Nagaiets/Shutterstock.com

Courtesy of Jeffrey Bennett, Vanderbilt University

About 7.4 million people ...



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Mapping The Market

How IPOs Are Priced

Via Jean Luc 

Funny but probably true:

...

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Promotions

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In My Top Strategies for 2017, Phil's chapter is Secret Santa’s Inflation Hedges for 2017.

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