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Waiting on the Government
Perhaps those at the Food and Drug Administration (FDA) who are responsible for more delays in the approval of the drug Eteplirsen were inspired by the imaginative approach of their colleagues at the Department of Veterans Affairs, who compared the long delays in treating veterans to waiting in line at Walt Disney World. It is "the quality of the overall experience" that the VA says we should consider, not the time it takes. . . . Read more

First, Do No Harm: A Few Simple Rules for the FDA
You and your physician should not have to ask the FDA for permission to use a medication. If you have a terminal illness, you should especially not have to ask the FDA for permission to live. Unfortunately current law says that you do. The U.S. Supreme Court has ruled that you must comply with that law. . . . Read more

FDA Horror Stories
You may think you have the right of access to drugs that could save your life. But at the urging of the Federal Drug Administration, the U.S. Supreme Court does not agree.
 
The FDA has vigorously defended its power to deny drugs to the terminally ill, and it has been successful. Apparently, you have no right to the use of any drug without government permission, no matter how long it takes to get it, if ever. And the FDA has no sense of urgency about anything except the preservation of its own powers. . . . Read more

The Power of the FDA Must End
The Food and Drug Administration is a huge, unwieldy, distant and indifferent bureaucracy. After more than a century of regulation, it follows a well-established pattern in the history of the U.S. Government. It relentlessly, voraciously and persistently seeks to increase its spending, regulations, authority and staff. The result is the subordination of the best interests of patients in favor of serving the FDAs congressional and ideological patrons. . . . Read more

Asking the Government for Permission to Live
The Food and Drug Administration has gone to court to prevent the Colorado-based firm Regenerative Sciences from using stem cells developed in one part of your body (bone marrow) to repair damage in other parts of your body, such as joints. The FDA objects to the fact that these cells are chemicals, the use of which the agency has the power to regulate even though the cells are taken from your body to later be injected back into your body. . . . Read more

Freedom from the FDA
The FDA adds billions of dollars to the cost of developing new drugs and delays their use for years. Yet it is so obsessed with predicting exactly how each drug will perform for any patient—with any condition, in any dosage, for any length of time and in any combination with any other drug or combination of drugs in any dosage—that it often loses sight of safety. So a few years ago the FDA proposed the creation of a new "Drug Safety Board" to provide for drug safety. One would have thought that was the purpose of the whole agency. . . . Read more

Finding Alternatives to the Food and Drug Administration
First of all, we need to realize that neither the FDA nor anyone else can do the impossible. When a new drug comes to market, no one can know all of its side effects, nor the impact on all other medical conditions that a patient might have, nor how it might interact with any dosage of any combination of an infinite number of other drugs—nor the cumulative effect of ten, twenty, or thirty years of use. If omniscience is required, no new drug will come to market. The good news, however, is that computers and the Internet now provide excellent tools to accumulate and tabulate data on the impact of every new drug. . . . Read more

Free Markets: The Key to New Drugs at a Reasonable Price
The U.S. pharmaceutical industry spends $22 billion a year on research and development of new drugs. Unlike government-funded research—which can be spent to develop drugs that no one needs or that duplicate existing drugs—pharmaceutical companies must get results. In order to recover their investment, their new drugs actually have to work. The continuing flow of new drugs that these firms produce is the best hope we have to treat and cure our ailments. . . . Read more

A Prescription for Disaster
At a cost of $400 billion over 10 years, Congressional Republicans have agreed in Conference Committee—with the enthusiastic encouragement of a Republican president—to the greatest expansion of government in two generations. This new Medicare program can only result in what government supplied health care has always produced in the U.S. and elsewhere: fewer new drugs and a lot more government. Of course, after a few years in practice we all know the program will end up costing a lot more. . . . Read more

 


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Waiting on the Government

By Richard E. Ralston

Perhaps those at the Food and Drug Administration (FDA) who are responsible for more delays in the approval of the drug Eteplirsen were inspired by the imaginative approach of their colleagues at the Department of Veterans Affairs, who compared the long delays in treating veterans to waiting in line at Walt Disney World. It is "the quality of the overall experience" that the VA says we should consider, not the time it takes.

We should recall that the scandal about these waiting lists that broke two years ago was not just about the length of the wait time, but the corruption of officials altering records to falsely indicate that patients had removed themselves from the waiting lists. The "quality of the overall experience" at Walt Disney World would not be maintained if guests were involuntarily yanked out of line. Or died while waiting.

Should the little boys with Muscular Dystrophy, who lose their ability to walk as they wait for FDA approval of a new medication—while their parents helplessly watch that process—take comfort, before they die, from their "overall experience" with the FDA?

We must replace this ghastly kind of evenhandedness by U.S. government agencies toward military veterans and little boys with adequate and timely treatment.

For many years, private medical care in Canada has not been allowed, and Canadians have had to rely exclusively on the government system they call "Medicare." But there are limits even there. In 2005, the Canadian Supreme Court struck down a law in Quebec that banned private payment for services covered by Medicare Canada no matter how long such services were unavailable through the government system. The court ruled that "access to a waiting list is not access to health care."

Americans should not feel too comfortable about these restrictions in Canada. In the Balanced Budget Act of 1997, Section 4507, the Clinton administration forbade any physician who privately provided a service covered by Medicare from receiving reimbursement from all other Medicare patients for two full years. This has since been modified by litigation and regulation, but the wording remains on the books.

Whenever you hear a politician, government agency, journalist or academic promise that you will be provided with medical treatment—or anything else—be sure to ask them when, exactly, they will provide it. Then ask from whom they will take it.

These outrages will not get better by themselves. Despite the scandal in 2014, a report just released by the VA inspector general found that a VA medical center in Houston attributed the removal of patients from waiting lists by staff to cancellations of appointments by the patients themselves. That improves their statistics, you see.

Other little problems in the VA bureaucracy were noted last year when thousands of veterans received notifications that their benefits were ending because they were dead.

A frequent response to such incompetence in government agencies is the claim that they need more budget and staff. But the staff at the VA has increased by 130,000 since 2005.

The FDA, with all of its problems, recently announced that sugar is a major threat to our health that requires new powers and regulations to reduce its use. This is while the Department of Agriculture spends billions to subsidize sugar production.

More money and staff to simultaneously limit and promote sugar is unlikely to improve our health. The results can be good only for politicians and government employee unions.

But we must not wait for the major reform and restructuring of these huge government bureaucracies while veterans and other patients suffer and die. We need immediate emergency measures, including the provision of vouchers to veterans that they can use for private treatment, and much more rapid access to new drugs that have met Phase I safety clearance—especially for terminally ill patients.

What we need is more choice and a lot less government.

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.

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