organization:medicare

  • Publication des prix pratiqués par les hôpitaux états-uniens

    U.S. makes data available on wide disparity in hospital charges | Reuters
    http://www.reuters.com/article/2013/05/08/usa-healthcare-hospitals-idUSL2N0DP26R20130508

    The Obama administration revealed what over 3,000 hospitals charge for common medical procedures in an early effort to challenge healthcare costs by showing consumers how prices for the same service can vary by tens of thousands of dollars.

    Le gouvernement publie les prix pratiqués dans 3337 hôpitaux pour les 100 actes les plus courants. Les prix sont ceux déclarés à Medicare (tous les hôpitaux ne le font pas). Les données (2011) sont issues de presque 7 millions de factures, soit 60% de ce que traite Medicare.

    Le site du gouvernement http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/index.html avec un lien vers un fichier Excel et un fichier texte (csv) (163 000 lignes).

    Les critiques font remarquer
    • que les données (brutes) sont difficiles à exploiter,
    • qu’il n’y a pas d’indication quant à la qualité des interventions
    • que la liste des interventions n’est pas pertinente

    La publication est favorablement accueillie par les associations de consommateurs et sera suivie de la publication d’autres informations.

    #santé #hôpital #open_data


  • Hospital Billing Varies Wildly, U.S. Data Shows - NYTimes.com

    http://www.nytimes.com/2013/05/08/business/hospital-billing-varies-wildly-us-data-shows.html?nl=todaysheadlines&emc=ed

    By BARRY MEIER, JO CRAVEN McGINTY and JULIE CRESWELL
    Published: May 8, 2013

    How Much Hospitals Charge Medicare

    A hospital in Livingston, N.J., charged $70,712 on average to implant a pacemaker, while a hospital in nearby Rahway, N.J., charged $101,945.

    In Saint Augustine, Fla., one hospital typically billed nearly $40,000 to remove a gallbladder using minimally invasive surgery, while one in Orange Park, Fla., charged $91,000.

    Et ici la carte interactive

    http://www.nytimes.com/interactive/2013/05/08/business/how-much-hospitals-charge.html?ref=business

    How Much Hospitals Charge
    For the Same Procedures
    Data released by the federal government on Wednesday shows that hospitals across the country charge Medicare differing amounts for the same procedure. The data includes bills submitted in 2011 by 3,300 hospitals nationwide for the 100 most commonly performed treatments and procedures like hip replacement, heart operations and gallbladder removal, among hospitals that reported at least 11 cases.

    #santé #etats-unis #inégalités #sécurité-sociale


  • The social crisis in America - World Socialist Web Site
    http://www.wsws.org/en/articles/2013/05/04/pers-m04.html

    The social crisis in America
    4 May 2013

    US stock markets surged Friday to new record highs as Wall Street traders seized on a tepid jobs report to engage in a fresh orgy of speculation.

    The official line promoted by the Obama administration is that the United States is in the midst of an accelerating economic recovery. For the corporate and financial elite that runs America, and the section of the upper-middle class that hangs on its coattails, a soaring stock market is indeed what defines economic health. For the vast majority of the population, however, life five years after the Wall Street crash of 2008 is dominated by the daily struggle to make ends meet.

    #états-unis #pauvreté #crise


  • The great unmentionable : Mass unemployment in America - World Socialist Web Site

    http://www.wsws.org/en/articles/2013/04/15/pers-a15.html

    The great unmentionable: Mass unemployment in America
    15 April 2013

    Judging by the official political debate and its media reflection in the United States, one would hardly know that the country remains in the grips of the deepest jobs crisis since the Great Depression. Virtually all attention is concentrated, on the one hand, on record stock prices and corporate profits, declared to be proof of a robust economic recovery, and, on the other, the supposed need for ever-deeper cuts in social programs upon which tens of millions of people depend.

    #états-unis #emploi #chômage #travail #entreprise


  • Obama budget slashes Social Security, Medicare - World Socialist Web Site

    http://www.wsws.org/en/articles/2013/04/11/budg-a11.html

    Obama budget slashes Social Security, Medicare
    By Andre Damon
    11 April 2013

    US President Barack Obama unveiled his budget proposal Wednesday, calling for a historic attack on Medicare and Social Security. The move, coming after the imposition of $1.4 trillion in spending cuts over the past two years, marks a new stage in the US ruling class’s offensive against the social rights of the population.

    #etats-unis #santé


  • Ethan Rome: Big Pharma Pockets $711 Billion in Profits by Robbing Seniors, Taxpayers
    http://www.huffingtonpost.com/ethan-rome/big-pharma-pockets-711-bi_b_3034525.html

    Here’s an outrage that must be changed: Big Pharma has been systematically price-gouging the Medicare program for seniors and people with disabilities — and raking in billions in excessive profits....

    ... unlike other industries, such as Big Oil, drug companies get something even better than a tax subsidy — they get a government program.

    ...

    The drug companies, of course, say they have no choice and need to charge outrageous prices to pay for research that enables them to innovate and develop new drugs that save our lives. But that’s not true. Half of the scientifically innovative drugs approved in the U.S. from 1998 to 2007 resulted from research at universities and biotech firms, not big drug companies. And despite their rhetoric, drug companies spend 19 times more on marketing than on research and development.

    ...

    It’s against federal law [sic] for Medicare, the nation’s biggest health plan, to use its unparalleled market power to reduce the cost of prescription drugs. This makes no sense. If the policy were changed, taxpayers and consumers would save huge amounts of money.

    Simply empowering Medicare to get the same bulk purchasing discounts on prescription drugs as state Medicaid programs would save the federal government $137 billion over 10 years, according to the Congressional Budget Office.

    ....


  • Sida : l’Afrique du Sud lance les antirétroviraux les moins chers du monde

    L’Afrique du Sud, qui compte un record de près de six millions de séropositifs, soit 11% de la population, a lancé lundi un nouveau programme de distribution de médicaments antirétroviraux (ARV) pour simplifier le traitement, réduit de trois à un seul comprimé par jour, au prix « le moins cher du monde ».

    http://www.liberation.fr/monde/2013/04/08/sida-l-afrique-du-sud-lance-les-antiretroviraux-les-moins-cher-du-monde_8

    • Le programme est le fruit d’un accord annoncé en novembre avec trois laboratoires pharmaceutiques (Aspen Pharmcare, Cipla Medpro et Mylan Pharmaceuticals) pour simplifier la prise des traitements et réduire son coût avec comme objectif de prendre en charge 2,5 millions de personnes au cours des deux prochaines années.

      #pharma #sida #santé #afrique_du_sud

    • en Afrique du Sud, c’est pris en charge par le ministère de la santé ; dans le reste du monde, pour les pays qui n’ont pas de moyens suffisants, il y a des programmes d’achat, financés notamment par le Fonds mondial créé à cet effet

    • il n’y a pas de mystère : la réduction des coûts est un processus volontaire : ici nous avons affaire à un programme d’état, qui ira sans doute aussi loin que possible.

      Ce qui souligne ce qu’est une priorité nationale.

      A Cuba, la santé est gratuite, la doyenne de l’humanité y réside, et 5 fois plus de centenaires par habitant qu’au Japon y vive. En France, on a HADOPI, le nucléaire, les commandos anti-bougnoules et la DCRI. Choix de société.


  • À la suite des restrictions budgétaires sur #Medicare, plusieurs cliniques annoncent qu’elles vont cesser d’administrer des chimiothérapies pour les patients de plus de 65 ans atteints de cancer.

    Los recortes económicos dejan a miles de pacientes sin ’quimio’ en EE UU | Sociedad | EL PAÍS
    http://sociedad.elpais.com/sociedad/2013/04/04/actualidad/1365102758_601124.html

    Varias clínicas han anunciado esta semana que dejarán de tratar con fármacos como la quimioterapia a los pacientes con cáncer cubiertos por Medicare (seguro federal que da asistencia sanitaria a los mayores de 65 años) en los servicios comunitarios de Estados Unidos. La razón principal que argumentan es el recorte presupuestario del 2% que este servicio sufrió el pasado 1 de abril. Una situación de desamparo que sufren también otros sectores del país, como la educación o el empleo público, tras el recorte de 85.000 millones de dólares (66.000 millones de euros) del gasto público que entró en vigor el 1 de marzo como consecuencia del llamado “secuestro”.

    “Para mantenernos a flote nos hemos visto obligados a no tratar a estos pacientes. Si lo hacemos, cerraríamos en seis meses”, ha explicado a The Washington Post, Jeff Vacirca, director ejecutivo de North Shore Hematology Oncology Associates en Nueva York. “Es una decisión que hemos tomado tras debatir si atender a estos enfermos o mantenernos en el negocio”, ha añadido.

    Esta reducción del 2% en el presupuesto ha sorprendido a médicos y pacientes cubiertos por Medicare. En comparación con otro tipo de medicamentos, los fármacos del cáncer requieren de la intervención de un médico para ser aplicados, requisito que ha provocado que estén incluidos en estos recortes -la reducción económica afecta principalmente a los sueldos y al personal facultativo-

    Comme la baisse des dépenses ne peut pas se répercuter sur le prix des médicaments, le seul poste sur lequel cela serait possible serait les rémunérations…

    • En anglais, sur le même sujet

      Federal Sequester Cuts Force Cancer Patients to Move | http://www.nbcnewyork.com/news/local/Federal-Sequester-Cuts-Medicare-Cancer-Patients-Long-Island-201695891.ht

      “I have to be financially responsible to be here,” said Vacirca. “I owe it to my patients to not go out of business.”

      Vacirca has already told many of his 16,000 Medicare patients they will need to get treated at hospitals because of the sequester cuts.

      Donc, les cliniques privées ne prennent plus les patients couverts par Medicare et les renvoient vers les hôpitaux publics…

      Pour l’intéressé interviewé (qui vient de prendre sa retraite à 81 ans…),

      As for Rosen, who should be peacefully living out the rest of his life, he is saddled with the burden of having to change treatment centers and disrupt a regular routine.

      “I’ve worked my whole life. In fact, I just retired two months ago at 81,” said Rosen. “I’ve paid Social Security and all that, and I don’t see why a senior should have his benefits taken away at this point in his life.”


  • Affaire Novartis : l’Inde préserve les médicaments génériques
    http://www.lemonde.fr/planete/article/2013/04/01/affaire-novartis-l-inde-preserve-les-medicaments-generiques_3151530_3244.htm

    C’est (...) une nouvelle étape vers un accès plus large des populations défavorisées aux médicaments génériques. En rejetant, lundi 1er avril, la demande de brevet déposée par le laboratoire pharmaceutique suisse Novartis sur le Glivec, un traitement contre la leucémie, la Cour suprême de New Delhi a confirmé et mis en application pour la première fois une clause de la loi indienne qui exclut de protéger par des brevets les médicaments qui n’apportent que des améliorations mineures à des molécules découvertes avant 1995. L’Inde devient ainsi le premier pays au monde à rejeter un brevet sur le Glivec, qui est en vigueur dans près de 40 pays dans le monde comme en Chine ou à Taiwan.

    (...)

    Ce jugement va faciliter la fabrication de génériques en Inde, où sont élaborés près de la moitié des médicaments contre le sida utilisés dans les pays en voie de développement. « Il va sauver des vies en offrant des traitements à bas coût aux patients qui en ont besoin », a déclaré Kiran Hukku, la responsable de l’association d’aide aux malades du cancer.

    ..

    Selon Leena Menghaney, responsable en Inde de la « Campagne d’accès aux médicaments essentiels » de Médecins sans frontières (MSF), le Glivec est vendu 4 000 dollars (quelque 3 100 euros) par patient et par mois, alors que la version générique est disponible à moins de 73 dollars (...)

    "(...) La décision de la Cour suprême indienne va-t-elle freiner les investissements dans la recherche ? « Les investissements vont plutôt se concentrer sur la création de nouvelles molécules, et pas sur leur amélioration, ce qui bénéficiera aux patients », répond Anand Grover * , l’avocat de l’association d’aide aux malades du cancer.

    Enfin, pour un grand groupe pharmaceutique comme Novartis, l’Inde ne se résume pas qu’aux génériques. Le géant suisse effectue dans le pays de nombreux tests cliniques alors que la législation en la matière est quasiment inexistante, notamment l’obligation qui est faite aux médecins d’informer les patients des risques qu’ils encourent en testant de nouveaux traitements.

    Si les associations d’aide aux patients ont remporté une première victoire dans la lutte pour l’accès aux médicaments génériques, la bataille n’est pas pour autant terminée. D’après Médecins sans frontières, l’accord de libre échange qui est en ce moment négocié entre l’Inde et l’Union européenne prévoit des clauses qui pourraient durcir la loi indienne sur la propriété intellectuelle.

    (...)

    Dans un marché indien occupé à 90 % par des médicaments génériques, les associations comme MSF entendent désormais livrer d’autres batailles pour diminuer le prix des traitements protégés par des brevets en Inde. Grâce à ses 8 000 laboratoires, l’Inde exporte la moitié de sa production vers les pays en développement.

    Brevets : Novartis perd son bras de fer contre la justice indienne - http://www.lemonde.fr/asie-pacifique/article/2013/04/01/bras-de-fer-entre-novartis-et-la-justice-indienne_3151132_3216.html

    LUTTE CONTRE L’EVERGREENING

    ... la technique dite d’evergreening consist[e] pour les groupes pharmaceutiques à déposer des brevets pour un produit faiblement modifié de façon à en conserver pour des décennies supplémentaires le droit exclusif d’exploitation.

    Quant au New York Times : http://www.nytimes.com/2013/04/02/business/global/top-court-in-india-rejects-novartis-drug-patent.html?_r=0&pagewanted=print

    un coup de pagaie à droite...,

    On the other hand, the ruling could cost lives in the future. Drug company executives and others argue that India’s failure to grant patents for critical medicines – and Gleevec is widely recognized as one of the most important medical discoveries in decades – is a shortsighted strategy that undermines a vital system for funding new discoveries.

    ... le suivant à gauche...,

    Anand Grover * , a lawyer who argued the case on behalf of Cancer Patients Aid Association in India, said the ruling had a sweeping effect since it confirmed that India has a very high bar for approving patents on medicines.

    “What is happening in the United States is that a lot of money is being wasted on new forms of old drugs,” Mr. Grover said. Because of Monday’s ruling, “that will not happen in India.”

    Indeed , the vast majority of drug patents given in the United States are for tiny changes that often provide patients few meaningful benefits but allow drug companies to continue charging high prices for years beyond the original patent life.

    In a classic example, AstraZeneca extended for years its franchise around the huge-selling heartburn pill, Prilosec, by performing a bit of chemical wizardry and renaming the medicine Nexium. Amgen has won so many patents on its hugely expensive erythropoietin-stimulating drugs that the company has maintained exclusive sales rights for 24 years, double the usual period.

    One result is that the United States pays the highest drug prices in the world, prices that only a tiny fraction could afford in India, where more than two-thirds of the population lives on less than $2 a day. While advocates for the pharmaceutical industry argue that fairly liberal rules on patents spur innovation, academics are far from united in sharing that view.

    ...et le dernier à droite...,

    But as the economies of emerging markets grow, their refusal to pay higher premiums for newer drugs could significantly reduce the money needed for innovation. The drug industry makes nearly two-thirds of its profits in the United States, a dependence that many in the industry fear is unsustainable. And even minor improvements in medicines – making a pill once-a-day instead of twice-a-day – can have significant impacts on patient wellness, industry executives say.

    The United States government has become increasingly insistent in recent years that other countries adopt far more stringent patent protection rules, with the result that poorer patients often lose access to cheap generic copies of medicines when their governments undertake trade agreements with the United States.

    Drug companies have relied on the American government to lobby on the issue because they have few tools to punish India and other countries. If the companies decide not to introduce high-priced drugs in India, the country could legalize generic copies under international law. And with major drug makers cutting back on research budgets anyway, large investments in research infrastructure may be unlikely even if countries adopt patent laws more amenable to the industry.

    * Rien, par contre, sur son très convaincant raisonnement cité par Le Monde.

    • Précisions sur la société Amgen dans un précédent article du « New York Times » :
      Fiscal Footnote : Big Senate Gift to Drug Maker http://www.nytimes.com/2013/01/20/us/medicare-pricing-delay-is-political-win-for-amgen-drug-maker.html?ref=busin

      ....deux semaines seulement après avoir plaidé coupable dans une affaire majeure de fraude fédérale, Amgen, la plus grande firme au monde de biotechnologie, a marqué un point au Capitol Hill qui est passé largement inaperçu : Les législateurs ont inséré un paragraphe dans le projet de loi sur le "mur fiscal" qui ne mentionne pas la société par son nom mais favorise fortement un de ses médicaments.

      Le libellé enterré dans la section 632 de la loi diffère une série de limitation du prix Medicare d’une classe de médicaments qui inclut Sensipar, une pilule lucrative d’Amgen utilisée par les patients sous dialyse rénale.

      Cette disposition donne a Amgen deux années supplémentaires pour vendre Sensipar sans contrôles gouvernementaux. La nouvelle a été si bien accueillie que le chef de direction de l’entreprise l’a rapidement transmise à des analystes financiers. Mais cela devrait coûter à [l’assurance-maladie publique] Medicare jusqu’à 500 millions de dollars sur cette période.

      Amgen, qui a une petite armée de 74 lobbyistes dans la capitale, est la seule entreprise a avoir plaidé agressivement pour le délai, selon plusieurs aides des deux partis au Congrès.

      Les partisans du délai, principalement des responsables du Comité des finances du Sénat qui ont longtemps bénéficié des largesses politiques [financières] d’Amgen, ont déclaré qu’il était nécessaire de permettre aux régulateurs de bien se préparer pour le changement de prix.

      Mais les critiques, y compris plusieurs aides au Congrès qui ont été stupéfaits de constater la décision dans le projet de loi final, ont fait remarquer que Amgen avait déjà remporté un précédent délai de deux ans, et ils ont décrit le second comme un cadeau inutile.

      « C’est la raison pour laquelle nous nous trouvons dans le trouble où nous sommes, » a déclaré Dennis J. Cotter, chercheur en politiques de la santé qui étudie le coût et l’efficacité des médicaments de dialyse. "Chacun se taille son propre terrain et obtient qu’il soit protégé, et nous refilons la facture aux contribuables."

      L’inclusion de cette disposition dans cette loi (...) montre la puissance persistante des intérêts particuliers à Washington ..

      Amgen a de profonds liens financiers et politiques avec des législateurs comme le leader de la Minorité du Sénat Mitch McConnell, républicain du Kentucky, et les sénateurs Max Baucus, démocrate du Montana, et Orrin G. Hatch, républicain de l’Utah, qui détiennent une emprise massive sur la politique de paiement de Medicare en tant que dirigeants du Comité des finances.

      Amgen a également travaillé dur pour construire des liens étroits avec l’administration Obama, ses lobbyistes se présenteant plus d’une douzaine de fois depuis 2009 sur des rondins de visites à la Maison Blanche,

      Le succès de Amgen montre aussi que même une importante enquête pénale fédérale ne peut constituer une menace sérieuse à l’influence d’une entreprise au Capitol Hill. Le 19 décembre, alors que les négociations au Congrès sur le projet de loi budgétaire était à son acmé, Amgen a plaidé coupable pour avoir commercialiser l’un de ses médicaments anti-anémie, Aranesp, illégalement. Il a accepté de payer des amendes pénales et civiles totalisant 762 millions de dollars, un record pour une société de biotechnologie, selon le ministère de la Justice.

      Amgen, dont le siège est près de Los Angeles et qui avait 15,6 milliards de dollars de chiffre d’affaires en 2011, dispose d’un puissant panel de lobbyistes à Washington, qui comprend Jeff Forbes, l’ancien chef de cabinet de M. Baucus, Hunter Bates, l’ancien chef de cabinet de M. McConnell, et Tony Podesta, dont la firme de lobbying, qui a connu une fulgurante ascension, a des liens exceptionnellement étroits avec la Maison Blanche.

      ...

      Les chercheurs ont constaté que la manière de Medicare de rembourser les fournisseurs par des paiements distincts pour les médicaments et pour les traitements de dialyse a encouragé la sur-prescription parce que les fournisseurs réalisaient des profits consistants avec chaque dose. Ils ont également constaté que des doses élevées exposent les patients à des risques cardio-vasculaires.

    • Big Pharma down, not out, after Novartis patent blow | Reuters
      http://in.reuters.com/article/2013/04/02/india-pharmaceuticals-idINDEE93109M20130402

      Après ses menaces, pharma découvre tout d’un coup qu’elle peut vendre (beaucoup) moins cher tout en continuant à gagner (encore beaucoup) d’argent.

      With differential pricing common in industries from autos to mobile phones, he argues pharmaceutical firms must find new ways to make products affordable for lower-income groups.

      “Drugmakers will have to work out strategies for the lower sections, to give affordable access to medicines and make money by large volumes and smaller margins,” he told Reuters. “And then they will look at the middle and the upper sections and make money through smaller volumes but higher margins.”

      It is a calculated risk, yet a number of drugmakers are already coming around to the view that trading volume for price is the way forward.



  • États-Unis : La séquestration, une « machine infernale »
    http://alternatives-economiques.fr/blogs/behrent/2013/03/07/etats-unis-la-sequestration-une-%C2%AB-machine-infernale-%C

    En dehors de ces considérations macroéconomiques, il est certain que la séquestration fera mal à beaucoup d’Américains. Ces réductions sont particulièrement dangereuses parce qu’elles ne sont pas ciblées et qu’elles touchent de façon indiscriminée l’ensemble des dépenses fédérales (sont exclus seules l’assurance vieillesse – la Social Security – et l’assurance maladie pour les personnes âgées – le Medicare – alors même que ce sont les dépenses de ces programmes qui risquent d’augmenter le plus dans les (...)


  • Bitter Pill: Why Medical Bills Are Killing Us | TIME.com
    http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us

    When you crunch data compiled by McKinsey and other researchers, the big picture looks like this: We’re likely to spend $2.8 trillion this year on health care. That $2.8 trillion is likely to be $750 billion, or 27%, more than we would spend if we spent the same per capita as other developed countries, even after adjusting for the relatively high per capita income in the U.S. vs. those other countries.

    #santé #etats-unis #pharma

    • Je viens de tomber dessus et de parcourir les 11 pages…

      Avec analyse(s) détaillée(s) des surfacturations énormes faites par les hôpitaux, attaque du lobby hospitalo-pharmaceutique, défense du système public et plaidoyer pour une régulation et un contrôle draconien.

      http://timewellness.files.wordpress.com/2013/02/1500_cover_03041

      page 1

      America’s largest city may be commonly thought of as the world’s financial-services capital, but of New York’s 18 largest private employers, eight are hospitals and four are banks. (…) Health care is eating away at our economy and our treasury.

      The health care industry seems to have the will and the means to keep it that way. (…) That’s right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington.

      page 11

      Indeed, the only player in the system that seems to have to balance countervailing interests the way market players in a real market usually do is Medicare. It has to answer to Congress and the taxpayers for wasting money, and it has to answer to portions of the same groups for trying to hold on to money it shouldn’t. Hospitals, drug companies and other suppliers, even the insurance companies, don’t have those worries.

      Moreover, the only players in the private sector who seem to operate efficiently are the private contractors working — dare I say it? — under the government’s supervision.

      (…)

      Put simply, the bills tell us that this is not about interfering in a free market. It’s about facing the reality that our largest consumer product by far — one-fifth of our economy — does not operate in a free market.

      So how can we fix it?

      Changing Our Choices
      We should tighten antitrust laws related to hospitals to keep them from becoming so dominant in a region that insurance companies are helpless in negotiating prices with them.
      (…)
      Similarly, we should tax hospital profits at 75% and have a tax surcharge on all nondoctor hospital salaries that exceed, say, $750,000.
      (…)
      We should outlaw the chargemaster. [sans doute : les barêmes super trafiqués des hôpitaux]
      (…)
      We should amend patent laws so that makers of wonder drugs would be limited in how they can exploit the monopoly our patent laws give them. (…) Just bringing these overall profits down to those of the software industry would save billions of dollars.
      (…)
      Similarly, we should tighten what Medicare pays for CT or MRI tests a lot more and even cap what insurance companies can pay for them. This is a huge contributor to our massive overspending on outpatient costs. And we should cap profits on lab tests done in-house by hospitals or doctors.

      Plus diverses autres propositions mineures du genre :

      We could limit administrator salaries at hospitals to five or six times what the lowest-paid licensed physician gets for caring for patients there. That might take care of the self-fulfilling peer dynamic that Gunn of Sloan-Kettering cited when he explained, “We all use the same compensation consultants.” Then again, it might unleash a wave of salary increases for junior doctors.

      Or we could require drug companies to include a prominent, plain-English notice of the gross profit margin on the packaging of each drug, as well as the salary of the parent company’s CEO. The same would have to be posted on the company’s website. If nothing else, it would be a good test of embarrassment thresholds.

      Et la conclusion

      When you follow the money, you see the choices we’ve made, knowingly or unknowingly.

      Over the past few decades, we’ve enriched the labs, drug companies, medical device makers, hospital administrators and purveyors of CT scans, MRIs, canes and wheelchairs. Meanwhile, we’ve squeezed the doctors who don’t own their own clinics, don’t work as drug or device consultants or don’t otherwise game a system that is so gameable. And of course, we’ve squeezed everyone outside the system who gets stuck with the bills.

      We’ve created a secure, prosperous island in an economy that is suffering under the weight of the riches those on the island extract.

      And we’ve allowed those on the island and their lobbyists and allies to control the debate, diverting us from what Gerard Anderson, a health care economist at the Johns Hopkins Bloomberg School of Public Health, says is the obvious and only issue: “All the prices are too damn high.”

      #pavé #must_read


  • RTV6 - CEO group wants U.S. retirement age bumped up to 70 - US/World Story
    http://www.theindychannel.com/news/u-s-world/ceo-group-wants-us-retirement-age-bumped-up-to-70

    The Business Roundtable, an association of CEOs from the some of the largest U.S. companies, thinks the retirement age should be raised to 70.

    The group wants to gradually raise the full retirement age to 70 for both Social Security and Medicare and to partially privatize the health insurance for older Americans. 

    Todd Roberson from the Indiana University Kelley School of Business said a move like this is inevitable.

    Ben oui, faut passer l’âge de la retraite à 70 ans, on peut pas s’en sortir autrement.

    Les propositions sont là (p. 4 du Scribd) http://businessroundtable.org/studies-and-reports/social-security-reform-and-medicare-modernization-proposals

    WP indique : http://en.wikipedia.org/wiki/Business_Roundtable

    The Business Roundtable (BRT) is a politically conservative group of chief executive officers of major U.S. corporations formed to promote pro-business public policy.

    Et je vous invite à jeter un coup d’œil sur la composition du comité exécutif…

    http://en.wikipedia.org/wiki/Business_Roundtable#Executive_Committee


  • The Definitive Story of How President Obama Mined Voter Data to Win A Second Term | MIT Technology Review
    http://www.technologyreview.com/featuredstory/509026/how-obamas-team-used-big-data-to-rally-voters

    they had identified a three-step process they called “Wood’s Triangle.”

    Within three or four days of a new entity’s entry into the conversation, either through paid ads or through the news cycle, it was possible to make a well-informed hypothesis about whether the topic was likely to win media attention by tracking whether it generated Twitter chatter. That informal conversation among political-class elites typically led to traditional print or broadcast press coverage one to two days later, and that, in turn, might have an impact on the horse race. “We saw this process over and over again,” says Lundry.

    They began to think of ads as a “shock to the system”—a way to either introduce a new topic or restore focus on an area in which elite interest had faded.

    #marketing #politique #etats-unis #data-mining


  • Obama proposes Social Security cuts - World Socialist Web Site

    http://www.wsws.org/en/articles/2012/12/20/pers-d20.html
    20 December 2012

    Fiscal cliff talks get down to business

    The cuts in Social Security and other critical social programs proposed Tuesday by the Obama White House as part of negotiations with House Speaker John Boehner over the so-called “fiscal cliff” mark a watershed in US social policy.

    Obama has publicly proposed to cut future benefits for Social Security recipients, underlining the bipartisan agreement that the working class and the elderly, not Wall Street or the super-rich, must pay for the crisis of American capitalism.


  • Extremely Rich Wall Street CEO Wants Americans to Work Longer « MasterAdrian’s Weblog
    http://masteradrian.com/2012/11/21/extremely-rich-wall-street-ceo-wants-americans-to-work-longer

    Extremely Rich Wall Street CEO Wants Americans to Work Longer
    Pat Garofalo
    Think Progress / News Report
    Tuesday 20 November 2012

    Lloyd Blankfein — evidently taking a break from doing “god’s work” as the CEO of Wall Street behemoth Goldman Sachs — told CBS News’ Scott Pelley that he believes the retirement age needs to be raised because “in general, entitlements have to be slowed down and contained”:

    BLANKFEIN: You’re going to have to undoubtedly do something to lower people’s expectations — the entitlements and what people think that they’re going to get, because it’s not going to — they’re not going to get it.

    PELLEY: Social Security, Medicare, Medicaid?

    BLANKFEIN: You can look at history of these things, and Social Security wasn’t devised to be a system that supported you for a 30-year retirement after a 25-year career. … So there will be things that, you know, the retirement age has to be changed, maybe some of the benefits have to be affected, maybe some of the inflation adjustments have to be revised. But in general, entitlements have to be slowed down and contained.

    PELLEY: Because we can’t afford them going forward?

    BLANKFEIN: Because we can’t afford them.

    Maybe working until a later age is fine for a Wall Street CEO whose net worth is $450 million. But it’s simply nonsense to assert that the retirement age needs to go up because Social Security is no longer affordable.

    For starters, Social Security can pay full benefits for decades without any changes at all. (Imagine the accolades that would received if any other federal program had guaranteed funding for that stretch of time.) One simple change, raising the cap on the payroll tax, can guarantee that the program will pay nearly full benefits for three-quarters of a century. In the meantime, Social Security is statutorily barred from adding one dime to the federal deficit, so cutting it doesn’t change the nation’s deficit or debt picture.

    Raising the retirement age, meanwhile, adversely impacts those workers most in need of a robust social safety net. While a year or two of extra work may not seem like much to a Wall Street CEO with his cushy corner office, for a factory worker or janitor, it can mean real problems. Life expectancy is only increasing for wealthier workers in non-physical jobs. Poorer workers doing physical labor have not seen the same gains. Overall, raising the retirement age to 70 would “cut benefits for the average retiree by 19 percent.”

    Pat Garofalo is Economic Policy Editor for ThinkProgress.org at the Center for American Progress Action Fund. Pat’s work has also appeared in The Nation, U.S. News & World Report, The Guardian, the Washington Examiner, and In These Times. He has been a guest on MSNBC and Al-Jazeera television, as well as many radio shows. Pat graduated from Brandeis University, where he was the editor-in-chief of The Brandeis Hoot, Brandeis’ community newspaper, and worked for the International Center for Ethics, Justice, and Public Life.


  • Does the US health system work well ? 15% of US physicians agree: http://www.washingtonpost.com/blogs/wonkblog/wp/2012/11/15/six-out-of-every-seven-doctors-agree-our-health-care-system-doesnt-w - aggressive insurers, administrative overhead, lousy coordination, restricted patient access to care, uninsured patients... Horrible value for such an expensive system: http://www.washingtonpost.com/blogs/wonkblog/wp/2012/11/09/the-single-best-graph-on-whats-driving-our-deficits - yet another reason to choose France !



  • Attention, Sidi Romney a parlé : il faut que les Égyptiens comprennent quelles sont les règles. (En fait, il n’y a qu’une seule règle, et il semble que les Égyptiens l’avaient déjà assez bien comprise. Quant à savoir si ça va faire reculer « le sentiment anti-américain »…)
    http://www.foxnews.com/politics/2012/09/24/transcript-romney-on-60-minutes

    ROMNEY: Communicate to nations like Egypt, and Egypt is — if you will, the major player, eighty million people, the center of the Arab world. Egypt needs to understand what the — the rules are. That to remain an ally of the United States, to receive foreign aid from the United States, to receive foreign investment from ourselves and from our friends, I believe, around the world, that they must honor their peace agreement with Israel.


  • The US Medicare debate
    http://www.wsws.org/articles/2012/aug2012/pers-a25.shtml

    The US Medicare debate
    25 August 2012

    Much attention in the US presidential campaign has been focused of late on Medicare, the health care program relied upon by some 50 million elderly Americans. Democrat Barack Obama and his Republican opponent Mitt Romney are trading accusations about placing Medicare in jeopardy, while both parties and both candidates are in agreement that drastic cuts are required to “save” the government-run program.

    The discussion surrounding Medicare is a particularly cynical component of a highly manipulated, anti-democratic process through which the bourgeoisie is vetting its political representatives and deciding who it believes will best carry out its dictates over the next four years. The so-called Medicare debate is a façade behind which the two big business parties are preparing an unprecedented attack on not only Medicare, but Social Security and all that remains of the social welfare programs enacted since the New Deal.

    #Etats-Unis #Santé #Elections


  • Malade et ruinée par la médecine privée, à la fin de sa vie, Ayn Rand a demandé et obtenu la sécurité sociale.
    http://www.gorevidalnow.com/2011/06/gore-vidal-on-ayn-rand-in-1961-she-has-a-great-attraction-for-simple-p

    At the end of her life, suffering from lung cancer as a result of a two-pack-a-day nicotine addiction, Rand quietly renounced her philosophy of selfish self-reliance. According to the Oral History of Ayn Rand by Scott McConnell, founder of the media department at the Ayn Rand Institute, after the American capitalist medical system had wiped her out financially, she used her married name, Ann O’Connor, to apply for and receive Social Security and Medicare.

    Yes, in the end, when Ayn Rand found herself in the unfortunate position of those she’d built a philosophy, not to mention a career, castigating — when it was she who was elderly, broke and ill — she availed herself of the crown jewels of American socialism.


  • Anemia drugs made billions, but at what cost?
    http://www.washingtonpost.com/business/economy/anemia-drug-made-billions-but-at-what-cost/2012/07/19/gJQAX5yqwW_story.html

    The trouble, as a growing body of research has shown, is that for about two decades, the benefits of the drug — including “life satisfaction and happiness” according to the FDA-approved label — were wildly overstated, and potentially lethal side effects, such as cancer and strokes, were overlooked.

    #pharma #lobby


  • William Blum :: Anti-Empire Report, Number 106
    http://killinghope.org/bblum6/aer106.html#link-5

    I’m sure most Americans are mighty proud of the fact that Julian Assange is so frightened of falling into the custody of the United States that he had to seek sanctuary in the embassy of Ecuador, a tiny and poor Third World country, without any way of knowing how it would turn out. He might be forced to be there for years. “That’ll teach him to mess with the most powerful country in the world! All you other terrorists and anti-Americans out there — Take Note! When you fuck around with God’s country you pay a price!”


  • Evaluating medical treatments: Evidence, shmevidence | The Economist
    http://www.economist.com/node/21556928

    Mr Obama’s health law stipulates that insurers must cover the treatments the task-force recommends.

    Nevertheless, the power of both bodies is purposely dulled. A negative recommendation from the task-force does not mean that coverage will stop. PCORI is explicitly barred from studying cost-effectiveness. The health secretary may not use PCORI’s findings to deny coverage under Medicare, the federal health programme for the old. When the institute announced its agenda in May, it was vague in the extreme.

    Even neutered bodies, however, can provoke outrage. The task-force unleashed a torrent of fury in 2009, when it recommended against mammograms for women in their 40s. Last month the task force advised against routine prostate-specific antigen (PSA) tests to screen for prostate cancer. The panel explained that for every life that the tests save, the treatment inspired by those tests would cause one man to develop a serious blood clot, two to have heart attacks and at least 30 to become impotent or incontinent. This reasoning did not calm critics.

    #santé #états-unis #sécurité_sociale #rationalité


  • How Doctors Die
    http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus

    Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.”

    CPR : http://fr.wikipedia.org/wiki/R%C3%A9animation_cardio-pulmonaire

    #santé, #hôpital et acharnement thérapeutique en fin de vie ; article pas rigolo mais intelligent (via Nathan Geffen)