Category: Politics in healthcare

Let’s Give “Breakthrough Infections” a Break

Check this out. A dollop of common sense here. Words are always important. We have sort of known all along that the specific words we choose to make a point can be our best friends or our worst enemies.  But the COVID-19 pandemic has given this concept new meaning. Think about the word “mandate.” As in “mask mandate” or “vaccine mandate.” In both phrases, the use of the word mandate is (has been made to be?) inflammatory, to put it mildly. Prior to the pandemic, the primary use that I recall of the term “mandate” was when a politician won an election by a large majority and declared that he had received a mandate from the electorate. In the good old days, a mandate was a good thing.

For those of you interested in getting a more erudite view of this topic, you might like to tap into this book. What you will see is a thoughtful review of how words can be crafted in such a way as to take advantage of such behavioral economics principles as biases and heuristics, and in turn can be used to influence desired healthcare attitudes and behaviors.

Now we focus on the point of the article referenced here. The use of the term “breakthrough infections” is unfortunately providing evidence for anti-vaxxers to use in making the point that the “vaccines don’t work.” Unfortunate since, as I have noted before, most people originally interpreted “90%” efficacy as “works for everybody,” responding to the behavioral economics principle of “rounding,” when in fact, it clearly means something very different. And then there are “little details” like the fact that most of the “breakthroughs” are milder cases, with very few hospitalizations or deaths. 

Bottom Line. Is it too late to undo the public health damage being done by these few words? Probably! As a wise teacher once taught me, “Until you say them, you are the master of your words. After you say them, they are the master of you.”

BUT. Hopefully going forward, we can avoid the setting of any more semantic traps which would likely contribute to even more lives being lost to the coronavirus.

AND. More generally, we hopefully will come to understand the emotional impact of words and how to work with them to society’s public health benefit rather than to its detriment.

Is a Pandemic About “War” or “Natural Disaster???”

The answer actually matters. Check this out. Here we have a blogging cardiologist arguing that we should not be making the mistake of dealing with COVID as if we are in a war with the coronavirus. Wars give governments pervasive powers and often turn citizens against each other. Rather, we should deal with the pandemic as a natural disaster. Something that we expect citizens to ban together to deal with, rather than fragmenting into factions. And the government to focus on helping the citizenry, rather than issuing mandates.

Bottom Line. Interesting. Metaphors can have very important and pervasive psychological consequences. See how we have been (mis!)-handling COVID-19 for reference!

Dr. Sean Conly…White House Physician…National Mentor for Physicians

Check this out. What you will see is a really great tongue in cheek schtick from our old friend, Whistleblower MD. Here, we see him do a riff on the portion of the Talmud, shown here that asks, “Who is wise?” and answers “One who learns from every man.”  

Given this premise, WB decided that he should have learned a lot from watching Dr. Sean Conly’s handling of the President’s COVID infection, as revealed in Conly’s few-and-far-between, less than totally informative news briefings. The purported result of this learning? Take a look at his predictions as to the way his patient interactions will sound now that he has gotten this “wisdom.” An exercise in unadulterated evasion and obfuscation.    

Bottom Line. Funny, right? Actually, maybe not so much. Of all the times for physicians to speak, like Conly, in ways that strain credulity and destroy our confidence in them and in the medical profession, now during a pandemic is far from ideal.  

And then there is Dr. Scott Atlas…and…

Doctors And Politics

Check this out.  What you will see is the asking, and the purported answering, of the question as to whether physicians should discuss politics with their patients. We can make this quick. The line of reasoning espoused here is that since “social determinants” of healthcare are now considered the prime factors in the determination of a patient’s health, and since many of these determinants are the direct or indirect results of “political decisions,” it is well within the purview, or maybe even the professional responsibility, of a physician to discuss politics with patients in the exam room.  

Bottom Line. Yeah, I get that. But to put it mildly, I have a couple of problems with this line of reasoning. Three to be more exact. First, we all know that, especially in these pandemic times, there are many pressures on a physician’s time spent with each patient. How much of this precious time should be spent “chatting” about politics? I’m going with not much.

Second, what is the desired outcome of such a conversation? Converting the patient to the physician’s own political ideology? Given the oft discussed differential in the power bases of the physician and the patient, this seems to me to be a little Machiavellian. Maybe even unethical.

Finally, I don’t know about you, but at this point I am so sick and tired of “talking politics” that the last thing I need is somebody making the case that such conversations should take place in one more venue, especially one long thought to be sacrosanct and impermeable to such discussions.

What do you think?

Is Pharma Really Still The “Bad Guy” In 2020?

Those of you who have followed my blog for a while know that I never talk politics, and despite the picture above I am not breaking that rule with this post. Nope! I am just continuing my ongoing hypothesizing/hoping that our industry’s work on COVID vaccines and treatments will turn the tide for us in PR as virtually nothing else possibly could. In fact, in previous posts I’ve noted survey evidence that the reputations of companies called out for working on such products, as well as that of the pharmaceutical industry as a whole, have already risen for this reason.

Against that backdrop, check this out. What you will see is the announcement that Trump has unleashed an ad campaign “slamming” Joe Biden as being the “Big Pharma Favorite.”

Bottom Line. Why do I find this at all interesting? Simple. I am very curious to see how attacks on “Big Pharma” play out on the way to the November election. In the pre-pandemic days, slamming a candidate by associating him with our industry was good sport and likely a reasonable thing to do. Outrageous pricing and all of that. BUT. As Americans bank on drug companies to save them from the pandemic, such an approach might well backfire. What will be reaction to pharmaceutical slamming in 2020?

We shall see!  

Healthcare Reforms That Might Actually Work???

The guy pictured above, Bob Laszewski, blogs about healthcare policy and related political issues. In this post, he opines that only three of the Democratic candidates for president (Biden, Bloomberg and Buttigieg) have reform proposals on the table that actually might be voted into law. Warren and Sanders, he believes, have programs that are “politically unrealistic.” How, he wonders out loud, will “their paying providers Medicare rates for everything not bankrupt hospitals and doctors?”

My readers know that I don’t spend a lot of time thinking, much less talking, about politics. It sort of gives me a headache. BUT. As professionals in the healthcare marketing vertical and as just plain citizens, we need to pay special attention to the fact that health care is once again going to be a, if not the, major issue in the upcoming presidential election. Moreover, plans that are being bandied about differ widely in terms of their likely impact on patients, on our provider customers and therefore on us. Can we really depend on Bob’s perspective that the really iffy ones won’t pass in Congress to protect us?

Bottom Line. We  need to keep our eyes on this one, and to be able to discuss this issue knowledgably.  It matters!

If At First You Don’t Succeed

Aw c’mon.  Check this out.  I am really getting a lot of blog mileage out of this. I posted when the Feds tried to require LIST prices to be shown on all DTC advertisements. At the time, I called that a really stupid form of disinformation for patients, virtually none of whom would wind up paying anywhere near this amount, and many of whom might be scared away from taking medicine that they really needed.

And then, I posted when a court ruled against that regulation. I applauded.  

And now, here we go again. The Feds are once again taking a shot at requiring list prices on all DTC advertisements. 

Bottom Line. What can I say this time that I haven’t already said? Sharing LIST prices of drugs with patients is both vapid and dangerous. Hopefully, the plug will get pulled on this again.  

Watch for it!

Will Anything Stick???

Check this out. What you will see is a report that the Trump Administration is working on a plan that would allow Americans to import drugs legally from Canada. Why? To permit our patients to “get the benefit of the deals” that our pharmaceutical companies have struck with other countries. Wow! Think of everything that would possibly be affected by this move. Do patient safety concerns arise as drug companies are asserting? How do patients get reimbursed for their drug spends? What happens to pharmaceutical companies profits and stock prices?

BUT. How likely is this bill to pass. I am going with “not very.” Several Trump drug price reduction initiatives have tanked recently. Remember my post on the absurdity of requiring drug companies to include drug prices in DTC advertisements? Waste of time. This errant move got trashed in Federal Court.  

The bill that would have cut out drug rebates paid by drug companies to PBM’s? Withdrawn by the White House.  

Bottom Line. And so it goes. Cockeyed notion after cockeyed notion of how to reduce drug costs to Americans biting the dust. Will that happen with this Canadian import notion? Probably!

All causing me to ask again. What kind of drug pricing approach would the American government, and the American people, find reasonable,  while still permitting drug companies to make appropriate risk adjusted profits, and what is thebest way to get there?  

The “pot shot” fixes don’t seem to be working. What will?

Most Favored Nature Rx Pricing

Check this out. What you will see is an announcement by President Trump that he is “working on” a “favored nation clause” that would cap the price that the U.S. pays for a drug at parity with the lowest price paid by any other country. No great surprise that pharmaceutical stocks fell significantly at that news. 

But folks, it is not going to stop there. In comments made on a different occasion, Trump said that lots of people have been taking commercial advantage of the U.S. “. . . like China, pharmaceutical companies . . . ”

Bottom Line. Here’s a hint. Any time drug companies wind up being presented as being in the same league as China, you know our industry’s PR problem has just gone from bad to worse. And as the Democratic Presidential Debates clearly indicated, we are not going to do a lot better PR  if one of those 20 candidates gets general election traction either.  

In brief, there could be a significant profitability inflection point in our industry if this sentiment, and resulting “Executive Orders,” continue unabated. We’ve all heard these doomsday scenarios before in our careers. But, is this just another red herring, or might something of consequence actually happen here?

Stay tuned!

Does The Cost Of Insulin Really Keep Patients From Treating Their Diabetes?

Check this out.  What you will see is fact checking on Kamala Harris’ recent proclamation that ¼ of Type I Diabetes patients in the U.S. are forced to let cost drive their use of insulin. Let me cut to the chase. Having examined several different studies dealing with this matter, the author of the article reports that about 25% of Type I diabetes patients do indeed either ration their insulin or stop medicating for a period altogether because they can’t afford the drug. Yikes!

Let’s face it. If you watched any of the recent Democratic presidential debates, you are well aware that healthcare is going to be a BIG issue in the 2020 election. And you heard very specific comments indicating that a major focus within this issue will be the cost of prescription drugs. Moreover, Type I Diabetes makes a wonderful poster boy for this issue, with the high incidence of the condition, the fact that the cost of insulin has doubled in recent years, etc. helping to make this disease likely to draw a lot of attention in the month to come.  

Bottom Line. It will be interesting to see what impact on all of this will be had by Lilly’s recent announcement that it will begin manufacturing a generic version of its own product at 50% off list price. My bet is that most of the candidates who are most rabid on this issue will pick up on this announcement as an admission that drug prices are too high, even at this discounted rate.  

Stay tuned! This will likely get interesting!