By George W. Chapman
Our new Secretary of Health Robert Kennedy Jr. is laying off 20,000 of the 82,000 employees of the U.S. Department of Health and Human Services. He is closing five of 10 regional offices. The goal is to save $1.8 billion a year. Employees were informed via email accompanied by the tried and true “it’s not you, it’s me” reason. Kennedy will consolidate 28 various divisions like HHS (Health and Human Services), NIH (National Institutes of Health) and FDA (Food and Drug Administration) to 15 divisions under an all-encompassing brand-new moniker called “Administration for a Healthy America” or AHA. (This should not be confused with the American Hospital Association (AHA) or the Norwegian ‘80s pop band A-ha.)
Former Fox journalist Sara Carter, with absolutely zero experience, has been named as drug czar. Top vaccine official Peter Marks, who led operation Warp Speed, which fast tracked COVID-19 vaccine development, was unceremoniously pushed out after eight years stoking fears of “vaccine hesitancy.” About 1,900 scientists sent a letter to the administration accusing them of an all-out assault on science in response to the slashing of funding for research the administration deemed “unacceptable.”
Among hundreds of research projects being terminated were vaccine safety during pregnancy and the effectiveness of the shingles vax.
The purge of researchers and scientists has led to a virtual US brain drain. Seizing the opportunity, Europe is offering positions to out-of-work American scientists and researchers. For example, Brussels Free University has allotted $2.7 million in funding for at least 12 new post doctorate roles to “censored Americans.” Normally reticent organizations like the Alliance for Regenerative Medicine and the biotech industry have expressed their fears over the erosion of scientific standards. So, all things considered, what could possibly go wrong?
FDA Reorganization
In his defense, Kennedy has this right. He is a well-known strong proponent of removing or at least reducing the amount of chemicals that are part of processed food. He is little known, however, as a critic of the FDA’s user fees which are paid to the FDA by Big Pharma. User fees make up almost half of the agency’s budget, which invites conflicts. These fees are paid every time there is an application for approval of a new drug. The fee is substantial, which limits applications by smaller upstart firms. The symbiotic wink and a nod relationship between the FDA and Big Pharma is tightened by this user fee. Both Obama and Biden have decried user fees. In fairness, to reduce the Big Pharma influence on the FDA, it has been suggested that user fees should be eliminated and 100% of the FDA budget should be taxpayer supported.
Weight Loss Drugs
They work and it seems like everyone is taking them. But they are still very expensive. Consequently, their cost effectiveness, at current prices, was challenged by the JAMA Health Forum. Basically, does the lifetime cost of the drug exceed potential savings on weight-related health costs. So, beyond users looking thinner, are they cost effective? If the price comes down, cost effectiveness goes up. Fortunately, a couple weight loss drugs are on Medicare’s radar and are slated for price negotiation with manufacturers next year. But until then, you begin to understand the insurance industry’s reluctance to cover them.
J&J Troubles
Remember the talcum powder fiasco? Thousands of cases of cancer, purportedly, were caused by the product. A bankruptcy judge has recently rejected J&J’s offer to settle all past and future cases for $9 billion. This is strike three for J&J as they tried to use the bankruptcy court to settle in 2021 and 2023 as well. To make matters worse, a year after a jury fined J&J $150 million for misleading marketing tactics for two of its HIV meds, a judge stepped in and jacked the fine up to $1.64 billion.
Avoidable Deaths
More bad news for the most expensive healthcare “system” in the world. Between the years 2009 and 2019 avoidable deaths in the U.S. increased by 33 per 100,000 people, according to the JAMA, (Journal of the American Medical Association). In all other countries in the study, avoidable deaths decreased by 23 per 100,000. In the European Union, avoidable deaths decreased by 25 per 100,000 people. All countries in the EU have national healthcare plans.
Short-Term Insurance
Caveat emptor. (Buyer beware.) Lower premiums are an enticing lure, but you need to really understand the benefits and what you will end up owing after an outpatient procedure or hospitalization. Your out-of-pocket will most likely far exceed any savings in your monthly premium. Short-term health insurance companies do not have to follow rules promulgated by the Affordable Care Act for all regular plans. They do not have reduced premiums based on your income like normal plans offered on the exchange. The dollar cap on procedures and hospitalization are far below what the providers will bill. You will end up owing thousands. The insurer has the last and final word on interpreting their own unregulated rules. Short-term insurers can request a physical and then exclude coverage for the very condition that got you to purchase short-term coverage in the first place. Most have very limited drug coverage if any at all. You are far better off paying another $200 a month or so for legitimate insurance of the exchange. Concerned that consumers will be ripped off by these short-term plans, the Affordable Care Act limited coverage to 90 days. The hope was consumers would turn to longer and more comprehensive coverage offered on the exchange. In his first term, Trump allowed these plans to cover a year. Calling them what they are, “junk insurance.” Biden knocked coverage back to four months. It is expected that once he gets around to it, Trump will allow coverage up to a year again. Are we ready for national health insurance yet?
Allergy Season Is Here
You may have noticed it starts earlier and ends later every year. According to the HHS, (or should I say the former HHS?) you’re right. It comes with warming global temperatures. Over the past 30 years pollen, nationwide, has increased 21%. The Allergy and Asthma Foundation says 25% of adults and 20% of children suffer from seasonal allergies. The allergy season is so long now that a lot of people stay on drugs all year. Spring arrives earlier thereby giving plants more time to produce pollen.
In a list ranking our top 100 cities from worse than average to better than average Wichita, Kansas, ranks No. 1 for worse than average. Boston ranks No. 1 for better than average. Albany, Rochester and Syracuse are in the middle of the ranking so basically average. Dead leaves and grass and wooded areas yield more mold so avoid those as much as possible, Allergists recommend finding out just what you are allergic to and treat accordingly with meds or injections. Nasal sprays are often misused. They are most effective on the outside of your nasal passages versus being shot straight up your nose.
George W. Chapman is a retired healthcare business consultant who worked exclusively with physicians, hospitals and healthcare organizations. He used to operate GW Chapman Consulting based in Syracuse.