When people hear about drug companies buying up data on which doctors are prescribing prescription drugs, as we discussed in Thursday's Dispatch,
they worry about their medical privacy. But when drug companies use
that data to market unneeded drugs, consumers should be even more
worried about how that and other shady dealings in the medical field
are driving up health costs. When New Hampshire became the first state
to ban "data mining" of prescription drug records, Representative Cindy Rosenwald (D-Nashua) saw the bill as a chance to "curb the ever-increasing cost of prescription drugs.”?
The last few years have seen a cascade of books and reports detailing the waste and obscene profits of the prescription drug industry. Even as they rake in large profits, most of their spending goes
to marketing, advertising, and administration-- rather than research
and development of new drugs as their public relations claims.
In a system where profits, not patient health, is the top priority of
many health care providers, states are beginning to develop "pay for
performance" incentives and promoting other innovations to hold
providers more broadly accountable.
That fragmentation of the health care system lies at the root of much
of the waste and fraud in our health care system. Each player tries
to pump up profits and often waste through excessive billing of third
parties. Each party avoids taking responsibility by shifting
the increased costs onto government or other third party providers.
Short-term profiteering means long term investments in preventive care
or technology gets shortchanged.
Target management apparently didn't get the memo. Faced with stagnating
wages and increasing inequality, American workers and taxpayers are
waking up to the big box gambit where irresponsible employers subsidize
their low wages through favorable tax packages. When Target threatened
to stop opening new stores in Chicago if the Windy City gave final approval to its ordinance requiring a living wage for retail workers (see this Dispatch
for more details), it opened up a new debate over why cities are
offering low-wage retail stores tax subsidies in the first place. As a new report
produced by the Neighborhood Capital Budget Group documents, Target
received $9.9 million in tax-increment financing (TIF) to subsidize its
existing stores in Chicago.
Here's a shocking fact. When doctors prescribe prescription drugs,
the big drug companies get access to data on which doctors are
prescribing which drugs to patients. Pharmaceutical companies then load
the data up on sales reps' laptop computers to help figure out which
doctors are the best targets for their next sales pitch.
A number of state leaders have been promoting what seems like a free
lunch. Hand over control of government services to private industry and
those companies promise better service at a lower price. Like most
promises of a free lunch, privatization has mostly ended up being a
deceptive boondoggle, a point the non-partisan news sourceStateline.org emphasized this past week:
There are few more potent tools for impacting the outcomes of elections
than changing what appears on the ballot. And there are no more direct
paths from public outcry to passed legislation than through ballot
issues. For years, the rightwing has been advancing policy goals,
shaping message, and marshalling voters through ballot issues (we've
already highlighted many of their current-year endeavors in this very
newsletter). Progressives increasingly are fighting back using ballot
issues -- which shouldn't be surprising, since initiatives and
referedenda were originally a progressive reform.