Eradicating Disease – Healthcare Industry’s Worst Nightmare?

Take just one pervasive disease, diabetes. The American Diabetes Assn. notes that: “The American Diabetes Association… released new research on March 6, 2013 estimating the total costs of diagnosed diabetes have risen to $245 billion in 2012 from $174 billion in 2007, when the cost was last examined… This figure represents a 41 percent increase over a five year period.” And the number keeps rising as Americans put on the pounds (type 2). MedScape.com adds: “Researchers using a simulation model have put a price on the direct medical costs of treating diabetes and its complications, during a lifetime, in the United States. The figure ranges from around $55,000 to $130,000, depending on age at diagnosis and sex, with the average being $85,200.” Plus the downtime and productivity losses.

You just have to look at the TV ads for treatment options, noting how much money pharmas make from everything from injectable insulin, insulin monitors, needles and the varying forms of lesser treatments. Plus the loss of digits and limbs, pain treatment, vision loss and the host of complications, direct and indirect like those from increased susceptibility to other ailments (e.g., heart disease).  For many endocrinologists, treating and monitoring one form of diabetes or another has become the bulk of their medical practices.

Cure diabetes, and all this stops. That the U.S. government is dramatically cutting back on supporting scientific and medical research has to come as good news for all those healthcare suppliers and professionals. I mean, if diabetes and all the suffering it causes can be eradicated, what is going to replace those treatment revenues for all those totally dependent on the assumed incurability of diabetes. That there are clear signs from European researchers that they really believe that diabetes can be cured with a bit more research. You can bet that there is a huge contingent of medical sectors that never want to see that happen.

Indeed, as we begin to embrace an entirely new approach to chronic ailments, based gene modification and splicing, we are increasingly likely to be able to cure some of the most expensive diseases with a single genetic treatment. While that treatment might not come cheap, most believe that it will be increasingly less expensive than the lifetime regimens needed to treat so many of these diseases today… a lot less expensive.

You’d think that given the statements of so many in politics and the medical profession, seeking a path to universal healthcare… or at least for now dramatically reducing healthcare costs… that this is tremendously good news. But if you lift the curtain slightly, you just might shocked at how hard some elements of the healthcare sector want to work to crush such developments. The economic impact on those in the healthcare field who are dedicated to such lifetime treatments is obviously devastating.  So kill the research. Make the FDA drag its feet for extra years if necessary, but make sure that they do not lose that income stream!!!

Perhaps this excerpt from the April 13^th Daily Kos (coincidentally Friday the 13^th) might shed some light on how financial analysts look at this subject:

On April 10 in the year of our Lord, 2018, analysts at Goldman Sachs allegedly released a report titled “The Genome Revolution.” According to numerous news reports, the report delved into a pretty awkward subject—cures.

"The potential to deliver 'one shot cures' is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies," analyst Salveen Richter wrote in the note to clients Tuesday. "While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow."

It isn’t “good business,” to be absolutely frank. We all know it isn’t. There are entire fringe worlds of conspiracy that continue to exist based on this one single kernel of truth. Why is this news now? Because science and medicine are getting very close to big and meaningful breakthroughs on diseases and maladies that were once only somewhat treatable with very expensive routines of medications. Gene therapy breakthroughs have been a big part of this, with the FDA approving promising gene therapy trials, and even more exciting results coming in from around the world. But as CNBC reports, solving serious problems for the public doesn’t mean you get to keep buying mega-yachts. Goldman Sachs analyst Salveen Richter has some bad news for our current “free market” system:

Richter cited Gilead Sciences' treatments for hepatitis C, which achieved cure rates of more than 90 percent. The company's U.S. sales for these hepatitis C treatments peaked at $12.5 billion in 2015, but have been falling ever since. Goldman estimates the U.S. sales for these treatments will be less than $4 billion this year, according to a table in the report.

"GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients," the analyst wrote. "In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise."

One of the very reasons government needs to spearhead such research is to avoid this very obvious conflict of interest between private industry and the needs of the general public. Unfortunately, the Trump administration is completely committed to the profitability of the private sector, so as long as that is our priority, don’t hold your breath on any hope of containing healthcare costs or providing great economically affordable access to the healthcare system. Then again, there is an election later this year where your vote could make a difference.

I’m Peter Dekom, and I guess in the long run, we get what we vote for!!!

Loser Secret Science vs Winner Cutting Edge Technology

There is deep suspicion of science and scientists within Donald Trump’s policies and the evangelical supporters in his base constituency. Experts with advanced degrees, years of technological experience, are precisely the kinds of “elites” that need to be “drained” out of their Washington influence, they tell us. Scientific truths, particularly the notion of man-induced climate change embraced by virtually the entire scientific community worldwide (and even by Pope Francis – in his encyclical on climate change) and other major religious leaders, conflict with their very narrow and not-universally-held interpretation of the Bible.

“In its enunciation of a ‘Biblical Perspective of Environmental Stewardship,’ the Cornwall Alliance, an evangelical organization dedicated to combatting climate change activism, declares:

“We deny, due to God’s faithfulness to His covenant, in which He proclaimed, after the Flood, that He would sustain the cycles on which terrestrial life depends for as long as the Earth endures (Genesis 8:22), that God’s curse on the Earth negates either the dominion mandate (Genesis 1:28) or the robustness and self-correcting resilience of the God-sustained Earth.” ReligiousNews.com, January 26, 2015.

Or you can interpret the Bible, as does Pope Francis, that God gave mankind both access to natural resources as well as a responsibility not to waste or squander that gift. So many American evangelicals, not the case with evangelicals in most other nations, believe that God was unconcerned with such notions of wastefulness or irresponsibility.

That businesses wish to be exempt from having to install pollution controls, avoid having to increase fossil fuel efficiency and replace legacy equipment/end-products with machines driven by alternative energy sources, be able to dump toxic effluents, by-products of their antiquated but less expensive manufacturing/extraction processes, into public waterways, landfills and the atmosphere without financial costs or any resulting responsibility, and that mine owners and petroleum/natural gas extractors want government support for increased fossil fuel use… all just happen to play into the hands of those who denigrate scientists as snobby elites and those who have rather dramatically unfounded religious beliefs that God wouldn’t let man’s actions cause an unfixable climate change.

The poster-boy for that irresponsible wastrel mentality is the rather openingly corrupt head of the agency he spent most of his adult life trying to defeat, the Environmental Protection Agency’s head, Scott Pruitt. “The Trump administration launched an attack on the science behind many of the nation’s clean air and clean water rules, announcing a proposal [4/24] that would in effect prevent regulators from considering a wide range of health studies when they look at new regulations.

“The plan by Environmental Protection Agency Administrator Scott Pruitt would prohibit what he and industry advocates call ‘secret science’ — studies that make use of data that are kept confidential, often for privacy reasons.

“The embattled EPA chief, whose own secrecy on his personal finances and his activities in office has drawn the attention of investigators, framed the action as crucial to government transparency.

“‘The era of secret science at EPA is coming to an end,’ Pruitt said in a statement. ‘The ability to test, authenticate, and reproduce scientific findings is vital for the integrity of the rule-making process. Americans deserve to assess the legitimacy of the science underpinning EPA decisions that may impact their lives.’… Many of the country’s most prominent research organizations, however, say the studies that Pruitt wants to ban are crucial to effectively protecting the environment.

“The proposal threatens to cut off the federal government’s access to essential data and subject science to political manipulation, the research groups say. That is because many health studies involve large amounts of patient data, which can be accessed only under condition of confidentiality.

“Banning such studies would prevent the EPA from considering many health impacts when looking at rules to limit pollution. Identical proposals stalled in Congress after protests from research groups, including the University of California system and the American Assn. for the Advancement of Science.

“Environmentalists said Pruitt’s motive is not to improve scientific integrity, but to stifle regulation…‘This is a blatant attack on science that undermines the EPA’s ability to protect our health and environment,’ said Tiernan Sittenfeld, the chief Washington lobbyist for the League of Conservation Voters. She called the proposal a ‘sham’ that would ‘limit the EPA’s ability to use the best research on the health effects of pollution, which form the basis for vitally important protections.’” Los Angeles Times, April 25^th.

Preferring to cut taxes for the very rich, as the United States continues to defund public education and government-supported scientific and medical research, treating science and scientists as little more than a nuisance to be marginalized if not purged from positions of influence, China has done the reverse. She has elevated education and those same scientists and researchers in what is increasingly an easy path to supplant the United States as the world’s technology leader. Under a new campaign, the People’s Republic is pouring billions of fresh cash into training new scientists and supporting their research, even luring home Chinese nationals with tenured science and engineering faculty posts at prestigious U.S. universities, to embrace artificial intelligence and cutting-edge technologies to become the future leader of hi-tech exports.

“Made in China 2025 is a blueprint for transforming the country from a labor-intensive economy that makes toys and clothes into one that engineers advanced products like robots and electric cars. The Trump administration views it as an attempt to steal U.S. technology and control cutting-edge industries.

“Officials aimed to temper the initiative this month when they announced potential tariffs on $50 billion in goods. But Chinese leaders consider the plan key to the country’s development and refuse to alter its course.

“‘China is trying to achieve a clear goal and America wants to stop it,’ said Andrew Polk, cofounder of Trivium/China, a Beijing research firm. ‘And that’s where the competition is.’

“Here’s what Made in China 2025 is all about and what it means for the trade war:

“What’s the objective?

“The plan funnels billions into 10 industries, including biopharmaceuticals, aerospace and telecom devices. It calls for 70% of related materials and parts to be made domestically within a decade. A separate document details China’s strategy to lead in artificial intelligence by 2030.

“Officials modeled Made in China after a German initiative called Industrie 4.0, which envisions greater automation in manufacturing and ‘intelligent factories’ that operate with wireless sensors. They didn’t have much choice. The world’s biggest population is aging and rising wages are sending low-tech factories to other countries.

“‘The labor supply is decreasing,’ said Ashley Qian Wan, China economist for Bloomberg Economics in Beijing. ‘And that’s going to be a big problem for China.’… [But the PRC plan is well underway.] For example, China developed its first bullet train last year, the Fuxing [pictured above], which can reach a top speed of 248 mph. Engineers have also built the first Chinese jetliner.” Los Angeles Times.

In the end, these Trump administration efforts, already leaving the United States and Syria as the only two Paris climate accord holdouts, place the United States globally at an increasingly severe competitive disadvantage that will only accelerate as time passes. When the GOP loses its iron grip on U.S. policy-making, it will take billions of new dollars and decades of time – assuming we can even generate that kind of needed capital – to get the United States back to its once-unchallenged lead as the engineering/science entrepreneurial capital of the earth – to make America great again.

I’m Peter Dekom, and such catastrophic leadership based on ignorance, isolationism, false nationalism and clearly unworkable slogans just may be the “big undoing” of the entire United States of America.

I-Ran So Far

One of the most salient aspects of the Trump administration is how much of its most important policy decisions are made “shooting from the hip” based on ill-thought-out campaign slogans without the slightest understanding of what is happening in the real world. Despite having a coterie of exceptionally experienced and well-educated government functionaries at the Department of State and the major federal security and intelligence, Donald “I really didn’t do that well in school” Trump believes that he knows better, that such expertise needs to be part of the swamp-draining he promised his constituents. Let me be absolutely clear: Donald Trump is the least informed president in modern American history. He even tells us how much he hates to read and how much he distrusts so-called “experts.”

Nothing brings this home like his position on Iran. Make no mistake, Iran is a destabilizing force in the Middle East, not even slightly trustworthy, but pulling out of the UN-sponsored six-party nuclear accord literally hands Tehran a new rallying point to solidify its brutal repressive hand against its own people. As much as Trump believes that Iran is a unified malignant tumor, a blight on the planet, with its government and people aligned in ill-will against the United States, that repressive theocracy is anything but solidly in control; in fact, it is beginning to implode.

Iran’s leadership is rapidly losing its cachet with the people; it is beginning to become a failed state. The dribbles of regional protests have accelerated to most obvious and powerful anti-government assemblages and messages. Iran needs to distract its own people from their social and economic plight, reinstate a “common enemy” to shift blame, and a blustering, tweeting, angry Donald Trump is the easy button, a “bad guy” made to order.

Assuming Trump ignores French President Emanuel Macron’s entreaties to keep that treaty alive – an imperfect accord that at least stays Iran’s nuclear weapons development – and withdraws the United States from that agreement in May, Iran would then be free to resume that weapons program and use Trump’s personality as a rallying point. Tehran can even point to her own protestors as aiding and abetting foreign powers seeking to destroy Iran, justifying further repression in the name of nationalism and Islam. So exactly what is Donald Trump failing to see in the real Iran?

The global warming that decimated farms in Syria and Iraq – loosing over a million of now jobless and homeless farmers (and their families) into angry hopelessness, easy prey for extremists like ISIS and al Qaeda seeking to topple governments and fight for regional, if not global, control – well, that same harsh impact of desertification that crushed livelihoods in Syria and Iraq is now settling in over large swaths of land in Shiite Iran with similarly devastating consequences. Please do not misinterpret the purging of ISIS fighters from Iraq and Syria as a remote extinguishing of Sunni extremists. Whack-a-mole realities continue to prove otherwise. But Iran is simply a mess that could prove its undoing.

The discovery of a body in Iran  might have shed some light on that country’s roiling discontent throughout. The April 26^th Los Angeles Times explains: “The latest threat to Iran’s theocracy — already struggling to contain public anger over unemployment, economic mismanagement, bank failures, social restrictions and environmental damage — seems to have risen from the dead.

“Construction workers renovating a Shiite Muslim shrine near the former tomb of Reza Shah Pahlavi [pictured above] in Tehran this week stumbled upon a mummified corpse, fueling speculation that it could be the missing remains of the king who died in 1944. The tomb was demolished soon after the 1979 Islamic Revolution as Iran’s new clerical rulers sought to erase all traces of a secular monarchy that by then was widely seen as corrupt, despotic and dissolute. The body was never found in the ruins, and over the years, the theocracy has quashed any appreciation of the royal period.

“But the passage of four decades, and deepening frustration with the clerics, has revived the reputation of Reza Shah, whom many now regard as an enlightened dictator who used taxes and burgeoning oil revenue to modernize the country.

“‘There is some nostalgia because of the utter failure of the regime in virtually every facet of Iranian life,’ said Abbas Milani, director of Iranian studies at Stanford University. ‘An economy in shambles, an international persona as pariah, double-digit unemployment and inflation, a failing financial system [and] profound oppression against women are good breeding grounds for either despair or nostalgia.’”

Iran’s theocracy is slowly unraveling. They have not delivered a better life for most Iranians… perhaps even lowering the standard of living even further. Their international support of Hezbollah, the Yemeni Houthis, interference in Lebanon, support for the Syrian Assad regime, meddling in Gaza and general support for militant Islamists around the world is draining the national treasury.

The impact of sanctions still stings, even as the nuclear accord released some of those economic restrictions. But the economic growth promised by Iran’s leaders, even following the elimination of some of those sanctions because of the treaty, just has not materialized. Dissention is growing fast. But a woefully under-informed Donald Trump could just give a failing Iranian government a whole new rallying point to justify the need for citizens to “sacrifice for the good of the state” and to crush any rebellion or protest to the contrary. Not to mention the power of operational nukes presented as a necessary goal to contain Western “aggression.” North Korea, which has aided Iran, is a good example of how the world responds to a nuclear power, and that lesson is not lost on the Ayatollahs. Donald might just become a willing pawn in sustaining and reinforcing Iran’s very unpopular government.

I’m Peter Dekom, and it is unfortunately that we have an under-informed president who so willingly can be played like a puppet by world leaders, from Bashir al Assad, Vladimir Putin, Kim Jong-un to now, the Ayatollah Khamenei.