NY State Medical Society Maintains Opposition to Aid in Dying/Assisted Suicide Bill

Here is the press release from the Medical Society of the State of New York.  Advocates for legislation to support aid in dying/assisted suicide had a lobby day today (May 14) to push for the bill sponsored by Assemblywoman Amy Paulin and Senator Diane Savino.  Governor Cuomo weighed in on the issue in recent weeks saying the bill needs to be addressed.  New Jersey passed similar legislation but Maryland and Connecticut defeated attempts to pass the bill.  The legislation here in New York still does not seem to have enough votes to pass.  It has not yet been scheduled for a vote in the health committees of the Assembly or Senate.

For Immediate Release
May 14, 2019

MSSNY Statement re: Medical Aid in Dying

Statement attributable to:
Arthur Fougner, MD
President, Medical Society of the State of New York

“As physicians, we value the importance of each person’s life. There are great disparities in access and quality of care at the end of life and we are particularly concerned about the impact of Medical Aid in Dying on vulnerable populations.

“Medical Aid in Dying is a complex issue with great variations in the wishes of patients as to the application of care as they approach the end of their natural lifespan or are faced with a terminal illness. The Medical Society of the State of New York is opposed to physician assisted suicide, but we continue to examine the issue through MSSNY’s  Task Force on End of Life Care, which is looking at all aspects of the issue.  MSSNY is committed to work with physicians and groups on both sides of this difficult question to improve access and quality of palliative care for all of our patients, particularly in their last days.“

“60 Minutes” Highlights Major Lawsuit Against Generic Drug Makers

CBS News 60 Minutes newsmagazine broadcast a major story on Sunday night about a lawsuit brought by the State of Connecticut and forty other states against major generic drug makers, charging them with a conspiracy to price gouge and limit competition.  The program said this may be the “biggest price fixing scheme in US history.”  The Attorney General of Connecticut William Tong appeared on the program and noted the outrageous increases in drug prices.  The broadcast reported:

Between 2013 and  2014, a bottle of doxycycline shot up 8,281 percent from $20 to more than $1800. A bottle of asthma medication, albuterol sulfate, jumped more than 4000 percent, from $11 to $434. Pravastatin, a cholesterol drug, up more than 500 percent, from $27 a bottle to $196.

The drug companies said that prices rose due to shortages and market forces.  Attorney General Tong, said that the generic drug makers are “too big to care” about the impact of the drug increases.  He showed how investigators had phone records showing how prices were driven up by several major generic drug companies within hours after their executives had phone conversations and told each other they were raising prices.

Tong said:  “We have evidence, hard evidence, in the form of text messages, emails, documents, witnesses that demonstrate clearly that it wasn’t about product shortages. It was about profit. It was about cold, hard greed.”

The report also said, “It all snapped into sharp focus when he matched phone logs to thousands of text messages from Heritage Pharmaceuticals. This exchange, with competitor Citron Pharma, showed collusion to increase the price of a diabetes medication. The text messages implicate two other companies: Aurobindo and Teva, the world’s largest generic drug maker. The national accounts manager at Heritage wrote:

A.S.: “We are raising the price right now — just letting you know, Teva says they will follow”
A.S.: “Aurobindo agrees too”

A corporate account representative from Citron answered:

KA: “…we are def [initely] in to raise pricing … are doing this immediately”

The Heritage executive responded:

AS: “We are raising our customers 200% over current market price.”

A director of a health care clinic in a rural southern Illinois area said that Medicaid and Medicare cap what they pay for generic prices so patients have to pay the difference and are struggling to do so.

Here’s a link to the story:

https://www.cbsnews.com/news/sweeping-lawsuit-accuses-top-generic-drug-companies-executives-of-fixing-prices-60-minutes-2019-05-12/

Cabrini Foundation Opens as Largest in NY State; Will Award $150 Million in 2019 for Health Related Projects

The Mother Cabrini Health Foundation has opened its online portal for letters of inquiry from nonprofit organizations with projects to serve the health needs of poor New Yorkers.  The foundation was created with the assets of the Roman Catholic, non-profit health insurer Fidelis which was sold to a private company.  New York State law requires privatized nonprofits to provide the monetary value of their assets for public purposes.    Those assets are valued at over $3 billion which makes it the largest foundation in the state.

The new foundation has listed its priorities on its website at http://www.cabrinihealth.org.  Populations included are:

  • low income individuals and families;
  • older adults;
  • immigrants and migrant workers;
  • formerly incarcerated individuals;
  • persons with special needs;
  • veterans;
  • young children, pregnant women and new moms; and
  • youth and young adults

The foundation is giving priority this year to organizations which have a budget of at least $750,000 though it will consider those with less than that.   Grant requests must be at $75,000.  Health services to older New Yorkers are one of the priorities.  Letters of inquiry have to be submitted online by Thursday, May 9th for competition in a statewide category.   In June, the foundation will then invite accepted inquiries to submit a formal application with decisions and awards of money by the end of the year.  Other regional projects will be solicited on an invitation-only basis.

Organizations which apply must submit proposals “consistent with the ethical principles, tenets, and teachings of the Roman Catholic Faith.”  This guideline will exclude some organizations which are in conflict with church positions on health care issues.

Democratic Candidates Push Big Plans for Universal Health Care and Major Political Reforms

We are only three months into the new year and the 2020  campaign for the Democratic presidential nomination seems to be in full swing, just waiting now for former Vice President Joe Biden to join the race.    What is amazing about presidential campaigns is that we get to hear big ideas expressed and candidates emerge taking a different approach and sketching out programs that have not seemed  in the past to have enough political support to be possible.

So far, most of the candidates have embraced Medicare for All in theory though they are differing in whether to support single payer health insurance which eliminates private insurance or opt for a public option to the Affordable Care Act.  Other proposals being touted would make Medicare a choice on the exchanges for the Affordable Care Act.   All of these ideas are focused on providing universal health care that is more accessible and affordable than the current system.

Outrage over high drug prices and out of network costs is growing.  Just last week, CBS News had a story about how some hospitals have out of network emergency rooms housed in their facilities and patients end up paying hundreds or thousands of dollars if that emergency room was not in their insurance plan.  That sort of arrangement would never exist under any of the universal health care plans.

It’s amazing that the candidates are also coming up with other ideas that no one dared speak of such as term limits for the Supreme Court, or expanding the number of justices, eliminating the Electoral College, a universal income for all Americans, a national holiday on election day and getting rid on gerrymandering.

To me, all of this is a reminder of the beauty of a real democracy.  Our system of government has been corrupted for so many years by big money controlling it and partisans trying to suppress voters and by growing inequality that it was inevitable that grassroots activism and an national political campaign would usher in an urgent call for some of the greatest reforms in decades.

Study of Apple Watch Shows Success in Identifiyng Irregular Heart Activity

A large new Apple watch study of over 400,000 persons who are using the watch which has sensors which can do an EKG has shown success in identifying irregular heartbeats and atrial fibrillation.  While the watch sometimes produces “false positives” that identify heart activity that is not irregular, most of the cases have helped people to follow up and get checked by a doctor.  34% of the people who were identified by the watch as having irregular heart activity had atrial fibrillation when tested.  Medical personnel say that percentage is good, given that a-fib is not a continuous heart activity but something that comes and goes over a period of time.

A media report noted the following:

“The study reportedly enrolled 419,297 people who had one of the earlier watches and an iPhone. Most were young people, but nearly 25,000 were aged 65 or older—the age group at the highest risk of the condition. The watches monitored for irregular heart rhythms and, if one was detected, notified the users and prompted them to set up a telemedicine consultation with a doctor involved with the study. The notified users were then able to get a separate ECG patch, which they were asked to use for a week to record their hearts’ electrical rhythms for comparison with watch data.

Apple and other companies are seeking to develop wearable products that can get personal health information which can promote more patient engagement and empowerment.  Apple has a health app on its IPHONE that allows patients to monitor exercise and other personal health data during the day.

 

 

Congress to Put Drug Executives on Hot Seat at This Week’s Hearing

On Tuesday, top representatives of pharmaceutical companies are coming before Congress and they will be challenged about their high drug prices.    The New York Times has editorialized on the need to confront them about the high prices such as the rapid escalation in the price of insulin which has been on the market for a century.  Certainly, they can’t cite research and development costs to drive up the price to $1500 per vial.

As the Times noted in today’s editorial, “A vial of insulin that cost less than $200 a decade ago now sells for closer to $1,500. Actimmune, a drug that treats malignant osteoporosis and sells for less than $350 for a one-month supply in Britain, costs $26,000 for a one-month supply in the United States. And the prices of many drugs — that treat cancers, high blood pressure, allergies and more — have risen so much that average consumers are rationing them, at grave peril. Not even experts seem to know how those prices are set or why they keep rising.”

The drug companies have traditionally justified their high prices by citing these research and development costs. Now, though, they seem to believe they should be entitled to charge what they determine the cost of averted health care costs, such as hospitalizations or even the value of extended health and life. That’s what their exorbitant prices represent. Imagine if Jonas Salk believed that. He didn’t. Congress has to return to promoting and protecting the public health of all Americans and ensuring costs are affordable certainly for basic drugs like insulin.

The day of reckoning is coming with Big Pharma as members of both parties in Congress are introducing bills that would increase competition and even use international pricing as a factor in determining prices here.  Other bills even promote the government producing key drugs.  With all the talk about some liberal Democrats pushing democratic socialism, this is one area where most people wouldn’t mind a little more government control.

 

New “Villages” Forming in Capital District; NYSOFA Commits Funds to Support Local Development

New and revived aging in place/community villages in the Albany suburbs of Bethlehem and Clifton Park have formed in recent months and other groups are meeting in the Schenectady suburb of Niskayuna as well as northern Columbia County to plan villages.   A steering committee has also been meeting in the City of Albany to consider how and where a potential village or villages would operate in city neighborhoods.  There is already a NNORC (Neighborhood Naturally Occurring Retirement Community) that has been operating for many years by Jewish Family Services in a part of the city.

Senior Services of Albany is also sponsoring Livingston Village in a renovated middle school turned into apartments.  Community Caregivers based in Guilderland, a suburb of Albany, has been providing village type services for over two decades and it is partnering to provide those services with Bethlehem Neighbors which recently was revived with a new Executive Committee after a dormant period.  Community Caregivers is also working with the Albany steering committee to consider partnering with a possible village there.

The Albany Guardian Society has played a key role in the development and support for villages, holding bi-monthly meetings for groups in the eastern part of the state.  Now, the Guardian Society has contracted with the New York State Office for the Aging (NYSOFA) to hire staff and run a Villages Technical Assistance Center (VTAC).   Last year, the Guardian Society was the conduit for small village seed grants to four communities that came from NYSOFA.

The national Village to Village Network has grown to over 200 grassroots communities seeking to develop services and social supports to enable older persons to remain living independently.  A national conference is held every year and local groups are gaining expertise and skills in how to help residents with transportation, home repair services, friendly visiting, health education and social activities.