HUD Clean, Says GAO, But Is It?

For the first time in 13 years, the Government Accounting Office has taken the Dept of Housing and Urban Development off their “high-risk” list. Corruption and mismanagement charges have been flying thick and fast for a decade, and if this report can be believed the clean-up at HUD should be cause for celebration.

For much of the 1980s, HUD was buffeted by allegations of corruption and influence-peddling that often masked systemic problems caused by poor financial management, inadequate record-keeping and staff shortages.

HUD worked through its problems, and, by 2001, had only two programs left on the GAO list — single-family-housing mortgage insurance and rental-housing assistance. The GAO said the department has significantly improved its oversight of lenders, appraisers and property management contractors and does a better job of estimating subsidy costs and defaults by borrowers.

But is it believable? If this were any administration other than Bush’s I wouldn’t hesitate to extend kudos where they were due, but it isn’t. Long years of lies and misdirection, misinformation and manipulation, have made me properly suspicious. Coming from the BA, this just doesn’t make sense. Continue reading

Prescription Drugs in America: A Daughter Turns Smuggler

This is a personal anecdote, it’s true, but it’s a story that is being replicated by the millions every day. The Bush Administration’s fawning over the heavily-contributing pharmaceutical industry has made America into a Third World country where everyone except the very rich may have to break the ‘laws’ that govern drug sales in the US if they want to keep sick relatives from dying. The FDA, originally intended to protect us from dangerous or poorly manufactured drugs, has become under Bush the profits-protector and dogsbody of the pharmaceutical industry, cracking down on Americans trying to find alternate foreign sources for drugs they can’t afford to buy legally here.

The new drug my father’s oncologist was prescribing for him was well known to me (for legal reasons, I will omit its name and the manufacturer’s name), for it had a fearsome reputation from decades earlier. How expensive could this drug be, I wondered, when all the research and development had been done 40 years ago, at a fraction of the modern costs? A hell of a lot, was the answer. I still don’t know why. But in my father’s case, it was about $47,000 a year, with the potential to triple, based on his clinical response, to $141,000 a year. At this rate, in seven years, he could conceivably have spent a million dollars. Although he had profited from decades of employment in North America, he had not profited well enough to pay for that, and he was realistic enough about his medical future to resist becoming “spent out”—the current jargon for those who have anted up all in pursuit of staying alive—leaving him and my mother financially ruined (at which point, ironically, they would have been eligible for free drugs).

Like millions of frustrated others, I turned to the Internet, hoping to find some way of acquiring what my father needed. There was a whole cadre of us out there, I learned, seeking drugs for ill parents, or spouses, or children. There were those looking, and those giving—including the survivors of the deceased, who were willing to pass along the remnants of no-longer-needed prescriptions.

This was new to me, this drug-recycling, and sadder perhaps than the need to go outside the US to find affordable medications. The idea that in the United State of America, the richest and most powerful country on earth, its citizens–and not just the poor–are being reduced to stockpiling old, left-over prescriptions in order to pass them on to others who cannot afford to pay the outrageous prices drug companies charge for them, almost made me cry–and scream in rage at the same time.

I know what this means. It means going through the drawers and the medicine chest and the bedside table of a deceased relative after the funeral, and then checking the wastebaskets for what might have been thrown away and the closets and pockets and nooks-and-crannies where medicine may have been left and forgotten in the last days. It means knowing that someone’s life may be saved by your doing this, yes, but it also means understanding that someone else may die who doesn’t have to if you don’t.

Think about that: people are conceivably dying in America because bereaved survivors either don’t know of the need or can’t bring themselves in their grief to separate a loved one’s drugs into what is useful and needed and what is not. In other words, someone is dying because someone else isn’t picking through the trash of one who has passed. Like vultures, we have been reduced to feeding off the leavings of the dead. I’m having a hard time getting my head around that.

Upon my father’s retirement in 1991, he automatically became covered by Medicare and chose to purchase supplemental AARP hospitalization insurance. He decided against the supplemental prescription-drug insurance because, as he later told me, he could not conceive of any drug costing enough to justify paying $2,400 a year for it. For me, one of the more painful aspects of our predicament was the fact that my father, a son of the Depression and of World War II, prided himself on always being prepared for the bleakest prospects the future might deliver. But not even his darkest imaginings could prepare him for the breathtaking ascent in the price of drugs—costing Americans $213.4 billion in 2003—which he regarded as a personal failure of his preparedness skills.

Because more than a third of Medicare patients have no prescription-drug benefits, Congress enacted the Medicare drug bill last December, at an estimated cost of $400 billion over the next decade. In the weeks following its passage, it became a matter of morbid curiosity to me to assess whether or not the new law would have solved my father’s problems. If he had survived, here is what he might have looked forward to: After paying a $420 annual premium, plus a $250 annual deductible, the government would have covered 75 percent of his prescription costs up to $2,250; he would then have been responsible for all payments up to $5,100, at which time the government’s catastrophic aid would have kicked in, paying 95 percent of his drug expenses. So I estimate that he would have been responsible for $6,115 of his $47,000 cancer drug. Would he have paid that much? I can’t say for sure. Locked into a fixed income that was in decline along with the stock market, he might have decided against it. (emphasis added by me)

She’s probably talking about a pension plan, but that is what the next generation can look forward to if the Pubs go through with their plans to privatize Social Security–people will live or die, literally, based on how well their retirement stock portfolio is doing–if they have one.

If he had been a middle-income senior with modest drug costs, he would probably have fared no better and might have ended up paying more in annual premiums than his drugs cost. If his expenditures had fallen into the “doughnut hole,” between $2,250 and $5,100, he would have found little relief. Ironically, his worst-case scenario under the new plan would have been a complete reversal of what had been the best-case scenario, i.e., a retiree who still enjoys employer-paid health coverage. Such people were once the lucky few; but under the new legislation, all 3.8 million of them stand to lose that coverage entirely. And those whose new Medicare drug bene-fits will be provided via privately run programs could find themselves denied expen- sive drugs, say, ones that cost $47,000.

So who will fare well? Doctors and hospitals will get a boost, because a scheduled cut in their Medicare payments has been eliminated. The insurance companies will receive new subsidies designed to encourage them to cover seniors and the disabled. But the really big winners will be the drug companies, who are estimated to see a 9 percent increase in sales, or $13 billion in additional profits per year.

Hard as it may be to believe, that estimate is low–I’ve seen some reasonably reliable reports that project as much as twice that. The final numbers, according to one study, may depend on how many families choose bankruptcy over death–and how many of the dying choose ‘death with dignity’ over turning their loved ones into paupers in order to enlarge the already obscene profits of drug corporations.

It’s a long article I can only excerpt, but I urge you to read the rest of the story of what this woman went through trying to find the drug that would keep her father alive. It’s a sobering account of the fight we will all one day face if the drug corporations aren’t brought to heel. Along the way, she debunks the ‘R&D’ argument drug corporations use to justify their prices (predictably, they spend more than twice as much on marketing as they do on research–$45Billion to less than $20Billion for R&D) and describes the hoops the FDA made her jump through in order to satisfy the Corporations that her ‘need’ was genuine. It’s a terrifying picture of what happens when govt is ‘friendly’ with Big Business–they work together to give the rest of us the shaft.

I will leave you with this:

We had already tried this—back in the beginning—following the advice of one of my father’s doctors, who suggested that we need not be “entirely truthful” as to his financial situation on the application. So we lied, but only a little, and were rejected. Now, a year later, we would try again, and I was prepared to be utterly ruthless this time. It did not feel like stealing because, in all honesty, I didn’t feel bad about milking a company so willing to do the same to us.

In response to the high prices, a few states and municipalities are beginning to flex their bargain-hunting muscles too. Springfield, Massachusetts, is reimporting drugs from Canada for its city employees. Burlington, Vermont, plans to follow. Boston announced it will do so for 7,000 employees and retirees, saving an estimated $1 million a year. New Hampshire plans to reimport for its prison population and Medicaid patients. Initially, the U.S. government seemed to take this trend in stride. But last December, when Illinois announced its plan to save $91 million by reimportation, Governor Blagojevich was warned by the feds that such a move would be illegal. “Our law is very specific,” said a government spokesperson. “It’s not ‘will not.’ It’s ‘cannot.'” And drug companies are also being aggressive: GlaxoSmithKline warned Canadian pharmacies to stop selling to Americans or their supplies would be shut down.In the wake of this anarchy, a few in Congress are re-examining a bill sponsored by Rep. Gil Gutknecht of Minnesota that would allow reimportation from FDA-approved facilities in 25 industrialized countries and employ technology to prevent counterfeiting. But if the pharmaceutical industry gets its way, such legislation will die—turning an increasing number of sick and desperate Americans into outlaws, or forcing them into early graves.

Meanwhile, my contact information floats in cyberspace, and I continue to get requests from the others out there with first names only who are looking for the same drug my father once used. I am more than happy to tell them what I know, how to work the system, how to break the law. “Thanks so much!” one contact responded. “(And thank goodness for email and the wonderful network of caring people such as you.) This is terrific information! Until the FDA comes to its senses, it seems that those overseas are truly our friends.”