Where is the Single Payer Debate?

With all of the attention on the pending health care overhaul focusing primarily on scare tactics, misinformation, and rowdy town hall meetings, one option has flown conspicuously under the radar: a national single-payer system, or more easily understood as Medicare-for-all. The benefits of such a system, which President Obama supported as a Senator, include:

• health care delivery would remain private, i.e. private doctors, private hospitals, etc
• the government would act as the sole provider of health insurance which would drastically reduce paperwork and administrative costs (medicare operates at a 3-4% overhead as compared to 30-40% for the average for-profit insurance company)
• no more insurance executives making hundreds of millions or, in the case of GroupHealth executive Bill McGwire, billions of dollars off of the sick and dying
  
• by creating the largest pool of insureds possible, it would maximize the spreading of risk and provide the cheapest possible form of insurance

So why hasn't this potential solution been a part of the debate even though recent polls suggest that it is the option most Americans would support, while they may not even know they are supporting it?

According to Fairness and Accuracy in Reporting, FAIR, the answer simple: interlocking boards of directors among the media, pharmaceutical, and insurance industries. Their investigative reporting found that:

"nine major media corporations and their major outlets, Disney (ABC), General Electric (NBC), CBS, Time Warner (CNN, Time), News Corporation (Fox), New York Times Co., Washington Post Co. (Newsweek), Tribune Co. (Chicago Tribune, L.A. Times) and Gannett (USA Today) found connections to six different insurance companies. Five out of the nine media corporations studied shared a director with an insurance company; two insurance companies—Chubb and Berkshire Hathaway—were represented by more than one media corporation director.

"The study also found crossover between these media corporations and several large pharmaceutical companies, such as Eli Lilly, Merck and Novartis, whose profits would also likely be negatively impacted by a single-payer system. Out of the nine media corporations studied, six had directors who also represented the interests of at least one pharmaceutical company. In fact, save for CBS, every media corporation had board connections to either an insurance or pharmaceutical company."

This overlapping wouldn't be cause for concern had FAIR not discovered the following trend:

"single-payer was mentioned in only 164 articles or news segments from January 1 through June 30, 2009; over 70% of these mentions did not include the voice of a single-payer advocate. Over 45% of the pieces that did include a single-payer advocate were episodes of the Ed Show, an MSNBC program whose host, Ed Shultz, frequently advocates for single-payer healthcare. Without the Ed Show, just 19% of articles or news segments that mentioned single-payer would have included an actual advocate of the plan."

So the next time you hear a negative portrayal of a national single-payer system, such as Canada's, ask yourself if the media corporation telling you that has a conflict of interest in doing so...

Big Pharma

A new study featured on MSNBC.com found that from 1996 to 2005, the number of Americans on antidepressants doubled from 13 million to 27 million, or almost 10% of the population.

According to IMS Health, in 2008 there were more than 164 million prescriptions written for antidepressants, which totalled $9.6 billion in U.S. sales. The reason this should be alarming, however, isn't mentioned in the study.

Psychologists from the University of Hull in England studied 50 clinical trials of modern antidepressants (4 Selective Serotonin Reuptake Inhibitors, or SSRIs for short, were tested including Prozac and Efexor) and found that, for mildly depressed patients, they work no better than a sugar pill. Even the results of their efficacy for the most severely depressed patients were inconclusive.

As a results of the study, Professor Irving Kirsch from the university’s psychology department has stated:

The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great. This means that depressed people can improve without chemical treatments. Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients.

The bad news doesn't end there. There is a huge collection of anecdotal evidence that SSRIs cause violent episodes and increase the patients risk of suicide. For example, both Eric Harris of the Columbine tragedy and Cho Seung-Hui of the VA Tech massacre were taking or had taken SSRI's. Because a study of 2200 children on SSRIs done by the FDA found that thoughts of suicide occurred at roughly twice the rate of a placebo, SSRIs currently have the most serious type of FDA warning: the "Black Box" label warning.

All that being said, why isn't our government doing something to protect the record number of current consumers from the potentially dangerous class of drugs? In my opinion, it again has to do with the power of money in our current political system. Courtesy of citizen.org, who produced the graph seen above, here are some interesting facts about the profitability of the drug industry:

• "it was rated the most profitable industry in 2000 and has been consistently ranked number one or two by Fortune over the past few decades"
• "Fortune reports that the 11 drug companies in the Fortune 500 enjoyed rates of profitability (measured in return on revenue) that were three to four times greater than the median for all industries in the Fortune 500. Pfizer, the second-largest drug company, has seen the value of its stock increase a stunning 1,454 percent over the last decade"
• "Public Citizen found that Fortune 500 drug companies plowed 30 percent of their revenues into marketing and administration, while committing just 12 percent of revenues to research and development"
• "The largest American drug company, Merck, had profits of $6.8 billion in 2000, which was more than the profits of all the Fortune 500 companies in the airline, entertainment, food production, metals and hotel/casino/resorts industries combined."
• "The drug industry’s success in Fortune 500 profitability rankings has become a rite of spring. In the 1970s and 1980s, Fortune 500 drug companies enjoyed rates of return on revenue that were two times greater than the median for all industries in the Fortune 500. In the 1990s, the drug industry’s rates of return on revenue were almost four times greater than the median for all industries in the Fortune 500."

In an example of what happens when the lobbyists win, all you have to do is look at Medicare Part D. By getting the now famous the-government-can't-negotiate-drug-prices-with-the-drug-companies donut hole in the program, the ten largest pharmaceutical manufacturers saw a combined $8 billion increase in their profits in just the first 6 months of the program. Also, because President Bush did not fund the program, Medicare Part D added an unfunded liability of almost 9 trillion to the national debt. Let's hope they don't get their hands on the current health care overhaul...

So, to summarize: A record number of Americans are taking a medication that may or may not be more effective than a sugar pill that has the most dangerous FDA warning because of increased risk of suicide and violence while at the same time bankrupting the nation and enriching the executives of a handful of multi-national corporations.