Profit-Driven Medicine Violates American Patients Young and Old

Thursday, April 26, 2012 by Common Dreams

by Donna Smith

 

Though my grandson and I are in two different sections of the country and both facing different cancer scares, we share one thing more prominently than anything else.  We are being violated as human beings in need of medical care by our health providers’ need to protect profits.  The money comes first; the patient is but a necessary cog in the healthcare revenue wheel.

I know that most of the time when those who advocate for a more sane system under an improved and expanded Medicare for all, for life model target their list of “evil-doers,” we tend to focus on the for-profit health insurance industry.  Clearly, having to fund all the administrative costs, shareholder profits, and CEO salaries for those companies is a driving factor in the ever rising costs of healthcare in America.

But the insurance companies aren’t the only ones targeting patients for profits.  The providers of care are right there in the middle of the mix with the insurance industry and the pharmaceutical companies.  Everyone wants their bite of the cash to be made, and the patients are caught in the middle of this epic struggle of financial giants in the U.S. economy.

Back to the two stories playing out in my own family as I write this since our family with all its glory and flaws seems pretty representative of people across the nation.  My 18-year old, not-yet-graduated from high school grandson was required to sign a guarantee of payment for his biopsy procedure before being treated, and I discovered one of my providers is creatively “unbundling” services provided in one appointment in order to collect a co-payment from me for each segment of my clinic visits.

"Oh, it’s all legal all right.  It just isn’t ethical or just."

For my young grandson, taking on this financial obligation before he is even out of high school is shocking and frightening.  He was born (along with his twin brother) in late November, so began school when he was just short of six years old.  He is preparing to graduate from high school in May, right on time.  He lives at home with his parents and siblings, and he is a really great, young man.  But a couple months ago, he started losing weight, and he found a lump just underneath his ribs.  The imaging studies show that the mass needs to be biopsied.  His mom, my daughter, made the appointment for his biopsy.  We were all upset and frightened.  But imagine our horror when not only was our daughter required to sign papers promising to pay the $1,000 deductible but our grandson also was asked to step up to the desk and sign his own set of promissory paperwork.  It’s all legal, they said.  He is 18, after all.  They both signed their own sets of documents. His biopsy is tomorrow and now he fears not just the results of the tests but also being dunned by the hospital where he’ll have his procedure.

On the other side of the country, I am still in the process of getting test results for my cancer work-up. After always paying my $15 co-payment required before I am treated, I began getting multiple billings from one of my providers (a large, teaching hospital with a world-class reputation) that showed me owing more co-payments of $15.  If I didn’t pay those multiple bills very quickly, the provider was almost instantly turning those $15 “debts” over to a very aggressive collection agency.  For $15, I was receiving calls several times a day.  When I called to ask why I am getting these bills when I always pay my co-payment at the front desk when I sign in for appointments, the billing clerk told me that the $15 I pay when I come in is only going toward the physician services portion of my visit and that the new bills I am getting are for the clinic charges for the same visit.  What?  They are splitting one doctor visit into two or even three bills and requiring me to pay a co-payment of $15 for each segment of that bill as if it were three separate visits? 

Yes.  That’s exactly what they are doing.  And before I even have final test results and treatment plans, the world-renowned provider is sending one of those split-billing co-payments to collection?  Yes.  I paid $30 more to stop the calls, and the clerk advised me that I should ask my insurance company if I am responsible for multiple co-payments and get reimbursed from them as the provider is billing legally for their services.

Oh, it’s all legal all right.  It just isn’t ethical or just.  Patients like me and my grandson – and millions of other people all over the country -- are being injured by our healthcare system and all of the profit-takers within that system.   This week we all learned about breast cancer survivor Lisa Lindsay of Herrin, Illinois, who was thrown in jail over a mistaken $280 medical debt.  But even if our debts are really ours or assigned to us in error, we have almost no recourse in the face of aggressive providers who hire aggressive collection agencies to aggressively collect their profits.  Yet, we often direct the outrage at collection agency practices and not back to the source:  the providers who stand right alongside the for-profit health insurance companies and pharmaceutical giants as they all injure patients and families in pursuit of the almighty dollar.

It’s ugly out here for patients in America.  And if any other nation thinks emulating our healthcare system is a better way, please think of your children and your grandchildren and imagine them standing at the front desk of the clinic signing legal documents to protect provider profits, and then think again.  Our profit-first healthcare system is brutal from top to bottom, and we won’t change that brutality until we identify all of the culprits and put health first over profits. 

Colorado asks DEA to recognize marijuana’s medical value

By Stephen C. Webster - RAW Story
Thursday, December 29, 2011

 

The state of Colorado has become the third in the nation to formally ask the Drug Enforcement Agency (DEA) to reclassify marijuana in such a manner that would recognize its potential for medical value, similar to drugs like morphine and cocaine.

The letter, sent just before Christmas by Colorado’s Department of Revenue, was required by a law passed in 2010 that set up a state regulatory framework for medical marijuana. The law required the state to petition the DEA for reclassification of the drug before Jan. 1, 2012.

Current federal prohibitions mean “[there] is a lack of certainty necessary to provide safe access for patients with serious medical conditions,” director Barbara Brohl wrote.

The state became the first in the nation earlier this year to begin licensing businesses that sell marijuana and products containing the drug, a move that potentially puts them at odds with federal officials.

The Obama administration’s Department of Justice has made a practice of not prosecuting medical marijuana patients in states where the drug has been approved, but it still considers distributors to be fair game for arrest.

Colorado also allows people who’ve been given a doctor’s recommendation for marijuana to grow their own plants inside their home.

The governors of Rhode Island and Washington have also petitioned the DEA to change marijuana’s classification from Schedule I to Schedule II, more commonly reserved for addictive drugs that have clearly defined medical uses.

Marijuana is known to be helpful to cancer patients grappling with nausea from chemotherapy, AIDS patients with wasting syndrome and people with chronic pain. It also has been shown to reduce the size of certain brain and breast tumors.

Many pharmaceutical companies are also seeking patents on cannabis-based drugs that aim to solve dozens of different medical problems, including a drug that can kill cancerous tumors.

The Obama White House, as well, has admitted that “individual components of the cannabis plant” have at least “some” medical value, but the DEA remains steadfast in opposing any reclassification of the substance.

White House admits marijuana has ‘some’ medical value

By Stephen C. Webster - RAW Story
Monday, July 11th, 2011

Just days after the Drug Enforcement Agency (DEA) insisted that there is no medical value to marijuana, the White House appeared to contradict the position, saying in a report that there may actually be "some" medical value to "individual components of the cannabis plant" after all.

The statement was just a small part of the Office on National Drug Control Policy's yearly update on the progress of the drug war and its goals moving forward. Overall, the document only serves to affirm the federal prohibition of marijuana and what it calls "'medical' marijuana," which it still views as illegitimate.

But a single passage, under their "facts about marijuana," seems to loosen a bit from the generation-old line that there is no value to cannabis whatsoever.

"While there may be medical value for some of the individual components of the cannabis plant, the fact remains that smoking marijuana is an inefficient and harmful method for delivering the constituent elements that have or may have medicinal value," the report says.

Still, today's medical marijuana patients and proprietors don't have much to cheer in the report, as it goes on to insist that smoking the marijuana plant itself is harmful and dangerous, especially for teens, and perpetuates the largely discredited "gateway drug" theory.

Critics are likely to see the passage as offering a bit of wiggle room for major pharmesutical producers looking to grow marijuana to extract its psychoactive ingredient, THC, or other cannabinoid compounds that have been demonstrated to help abate symptoms of some chronic diseases, like wasting syndrome in AIDS patients or nausea in cancer patients.

In 2007, GW Pharmaceuticals announced that it partnered with Otsuka to bring "Sativex" -- or liquefied marijuana -- to the U.S. The companies recently completed Phase II efficacy and safety trials testing and began discussion with the FDA for Phase III testing. Phase III is generally thought to be the final step before the drug can be marketed in the U.S.

Sativex is the brand name for a drug derived from cannabis sativa. It's an extract from the whole plant cannabis, not a synthetic compound. Even GW defines the drug (.pdf) as marijuana.
Yet as the FDA is poised to approve the drug for Big Pharma, state-licensed medical marijuana dispensaries that provide relief for thousands of Americans are under attack by other federal agencies.

The National Organization for the Reform of Marijuana Laws (NORML) has warned just as much, claiming that federal authorities may be looking to shift policy slightly, if only to legalize marijuana-based medicines for Big Pharma only, which could step in and  potentially eradicate the medical marijuana market.

The Obama administration said in a recent memo that it fully intends to enforce the federal ban on marijuana, regardless of whether individual states have legalized its use for medical purposes.

It added that a 2009 memo, which seemed to take the pressure off state-authorized medical marijuana clinics and patients, was merely a guidance on the best uses of federal funds and not actually a change in policy.

An ABC News poll found last year that eight in 10 Americans favor legalizing medical marijuana.

New research restores psychedelics’ medical respectability

By Eric W. Dolan Tuesday, September 7th, 2010

Recently published studies suggest that 'magic mushrooms' and 'ecstasy' may have medical value.

Before the enactment of the Controlled Substances Act in the late 60's, psychiatrists had been eagerly investigating the use of psychedelic drugs as an aid to psychological therapy.

Unfortunately, as the government sought to eliminate the recreational use of these drugs, it consequentially eliminated nearly all research into their effects.

Although there was almost no research on psychedelic drugs from the early 70's to late 90's, within the last decade studies have reaffirmed that 'magic mushrooms' and ecstasy (MDMA) can be valuable tools for mental health professionals.

A study published in the Archives of General Psychiatry found psilocybin, the active substance in 'magic mushrooms,' can safely improve the moods of patients with advanced-stage cancer and anxiety.

The study was headed by Dr. Charles S. Grob, a professor of psychiatry at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center.

In Dr. Grob's study, twelve volunteers, ages 36 to 58, with advanced-stage cancer and anxiety were given a moderate dose of psilocybin and, on a separate occasion, a placebo. The study employed a double-blind procedure, meaning neither the volunteers nor the researchers monitoring them knew whether they'd been given a placebo or psilocybin.

After receiving a dose of psilocybin or a placebo, volunteers were monitored for six hours. They were encouraged to lie in bed, wear eye shades and listen to soft music during the first few hours after ingesting the medication or the placebo. The volunteers were then interviewed after the six-hour session and over the next six months to assess the consequences of the treatment.

The study found a significant improvement of mood and a reduction in symptoms of anxiety up to six months after receiving psilocybin-assisted therapy.

"We are working with a patient population that often does not respond well to conventional treatments," said Dr. Grob. "Following their treatments with psilocybin, the patients and their families reported benefit from the use of this hallucinogen in reducing their anxiety. This study shows psilocybin can be administered safely, and that further investigation of hallucinogens should be pursued to determine their potential benefits."

Although some may be concerned that a relatively unstudied and illegal substance such as psilocybin may pose health risks, a study published in the peer-reviewed journal Psychopharmacology in 2004 found there is "no cause for concern that [psilocybin] is hazardous with respect to somatic health" in healthy adults.

The only physiological side-effects the study found was a brief increase in blood pressure and a small increase in levels of thyroid-stimulating-hormone (TSH), prolactin, cortisol, and adrenocorticotropic hormone. None of these side-effects were considered dangerous to healthy adults.

"Typically, the experiences after [medium and high doses of psilocybin] were rated positive, with retrospective statements ranging from ‘pleasurable’ to ‘ineffably beautiful,’ " according to the study. One volunteer had a fearful experience after being given a high dose of psilocybin, but his anxiety was resolved without the need for pharmacological intervention.

Recently published research has also found Methylene-dioxy-methamphetamine (MDMA), better known as the club drug esctasy, to be a viable treatment for Post-Traumatic Stress Disorder (PTSD).

The study was headed by Michael C. Mithoefer and published in the peer-reviewed Journal of Psychopharmacology.

For their study, Mithoefer and his colleagues recruited twenty people who suffered from chronic PTSD. The majority of the participants in this study were women and had been diagnosed with PTSD for an average of 19 years.

Of these twenty participants, twelve were randomly assigned to receive MDMA-assisted therapy while the remaining eight were assigned to receive the same psychotherapy, but with a placebo pill instead of ecstasy.

The psychotherapy consisted of two, eight hour sessions at an outpatient office.

The method of psychotherapy used followed principles similar to those developed by Dr. Humphry Osmond, Dr. Stansilav Grof, and others in the 50's and 60's for LSD psychotherapy.

There was a significant difference between the group of participants who received ecstasy-assisted therapy and those who received psychotherapy without ecstasy.
Volunteers treated with a combination of MDMA and psychotherapy saw clinically and statistically significant improvements in their PTSD – over 80% of the trial group no longer met the diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV-TR) following the trial, compared to only 25% of the placebo group.

In addition, all three volunteers who reported being unable to work due to PTSD were able to return to work following treatment with MDMA.

Mithoefer and his colleagues believe that the use of ecstasy during psychotherapy may be effective because it allows the patient to emotionally engage traumatic memories without becoming overwhelmed by fear or anxiety.

"The goal of using MDMA is to temporarily reduce fear and increase trust without inhibiting emotions, especially painful emotions, allowing these patients a window where psychotherapy for their PTSD is effective."

Due to the preliminary nature of the study, these findings are limited, but Mithoefer and his colleagues are enthusiastic that long-term research will show similarly positive results.