Monday, October 26, 2009

Health Reform - Part I

Health Reform was one of the campaign promises of President Obama. The issue was started during Clinton's time and got buried also. During Bush era of 8 years, everything got screwed up and all the money in billions of dollars was spent on unwanted wars. And now they say that Mr President should slow down and do it on a bi-partisan way. Hell with the republicans. When one wants to achieve something lofty for the public, one can't start at compromising position. So Mr President, lets move on and get it done with or without the support of republicans. The President needs to take the cue from Mahatma Gandhi who was stubborn and wouldn't budge until he got what he wanted. Its so sad that a Governor with the Indian name, Bobby Jindal, talks nonsense and a voice for the party of "NO to everything". Its high time Bobby Jindal educates himself and his backward state.

So much debate and bickering on Health Reform is going on and on in this country. Its mind blowing to see many people in this "so called" developed nation still ignorant of the prevailing ruined health system. Health industry is in a complete mess. Health industry is dictated by the Insurance companies, Pharmaceutical companies, and not forget Hospitals and then Doctors. Its a BIG BUCK game. Medical bill is number one cause for bankruptcy in this country. It needs a complete overhaul otherwise its going to die. There is no point in just polishing and covering the cracks.

The health industry here is basically a "sickness" industry. They want people to be sick so they can make the most out of them. Insurance companies dictate who get covered for what and how the premium is set up. They are like mad, greedy dogs that let loose on the road. With no oversight and regulations on them, these dogs will enjoy milking and killing people by denying coverage. Greediness & true Consciousness never go hand in hand! The latest sad story is about a 38 year old man, who lost a job and hence the health insurance an year ago and whose wife is diagnosed of ovarian cancer, wants to join the army just for the sake of health insurance. There can not be a sickening story than this. The insurance company, even if its not confirmed and only a suspicion, raises an individuals rates, if the individual had requested a diagnostic test for some pre-existing conditions.

Drug companies are screwed up on a different scale. Here in US, patenting is absurd. Blind patenting without knowing what the gene does, is a drag on research and innovation. It only implies greediness. The patent laws have to be reformed too. Otherwise, the treatment let alone the cure for ghastly "single-gene" genetic diseases(mutation in a single gene causes havoc) like Huntington Disease(HD), Early-Onset Alzheimer Disease(EOAD), Duchenne Muscular Dystrophy(DMD), Tay-Sach(TS), Cystic Fibrosis(CF which is different from CFS-Chronic Fatigue Syndrome!) and so on will not be possible in the near future. The patenting in Europe is atleast slightly better than the one in US. Don't forget that unlike EOAD, LOAD(Late-Onset Alzheimers Disease) is not "inherited".

Diseases like Cancer, Congenital heart disease, asthma, schizophrenia, diabetes etc come under "polygenic or complex disorders" meaning they are caused by the interaction of several genes. Next to heart disease, cancer is the second leading cause of death worldwide. Lets take a look at the pathetic patenting and the commercial exploitation of the breast/ovarian cancer gene. Also insurance companies discriminate women. For the same doctor's visit, a woman's premium is way higher than a man's. I hope President Obama puts an end to this damn practice(like the Bill he passed into law "equal pay for equal work"). In fact more women than men supported the President for the simple reason that many women see in this President a brighter future for them. He has plenty of issues to deal with on his plate. Lets see how cool Mr President handles them.

Mary-Claire King, who first identified the gene(located at 17q21-means at location 21 on the long arm of chromosome 17) responsible for raising a woman's risk of developing breast/ovarian cancer, teamed up with the former director of NIH, Francis Collins to isolate the gene itself. Its called BRCA1. The three players in this gene were Myriad Genetics, NIH and the Utah University. Everyone involved in the gene applied for a patent. Myriad's application was approved. At the moment BRCA1 was being cloned, second group of scientists from Myriad and the Institute for Cancer Research in England, reported that they found a second breast cancer gene located on Chromosome 13 and then the gene BRCA2 was isolated. The dog race had begun! Both the institutes filed patent claims.

Myriad company enjoys a global monopoly on these genes and worldwide control over how they are used. Yes the company should make some profit from testing for BRCA1 & BRCA2 for having invested a great deal of money in developing the test. The question is how much should it make? The commercially available testing from Myriad Genetics, as of today, costs about $3000. Myriad restricts academic researchers from using the BRCA gene sequences to develop alternative tests. Also the same gene may play a multiple role, meaning it may play a role in some other disease. This blind patenting sucks. The most outrageous thing is: any information about BRCA mutations gleaned from DNA sequencing among patients enrolled in academic research projects is withheld even from the patients themselves. But Myriad has struck a government deal: those who do NIH funded research can avail the test at a cut rate $ 1400. Remember BRCA2 gene has European partners involved. So the french partners were incensed about Myriad's BRCA2 patent and they filed a joint complaint to the European patent Office. Finally the BRCA2 gene is free for academic researchers.

The tragedy is Myriad's monopoly is not good for patients. The company's test fails to detect all possible cancer causing changes affecting the gene, so people who test negative may still be at risk. On top of this Myriad has the person sign a waiver that a negative result does not necessarily indicate a clean bill of health. Then why the heck, one should  go for testing that costs $3K in the first place? Does it make any sense? As of today, there are roughly 1100 genetic tests available but they are under utilized.

It is estimated that one hundred million people are chronically ill in this country. That means they are on the prescription bandwagon. Look at the plethora of OTC drugs and prescription drugs. An average senior citizen may be taking upwards of 10 different prescribed medications, many of which interfere with each other and there are very few studies on such interactions. Prescription drugs are the third leading cause of death in the US.

For every physical ailment(mental is even more hilarious), people are given antibiotics. Even for cold, prescription is antibiotic. Antibiotics work specifically on bacteria and not for viruses which cause the common cold. First, there is a prescription drug for X. Then another drug is prescribed for the side effect of that X and it is cyclic. Look at this way: everybody knows what beta blockers, calcium channel blockers are...All these can interfere with a neurotransmitter responsible for erection. When the neurotransmitter no longer functions properly, it becomes very difficult for a man to have an erection. So what's next? He is then prescribed the wonder/blue pill "viagra(sildenafil is the generic name)" or its cousin weekender "cialis(tadalafil)". When a person takes this many medications, its a toxic load on liver and kidneys and also it can compromise a person's immune system. When you come out of the doctor's office, drugs are the first order of business.

Now that we have had some glimpses of the insurance and drug industry, lets see how the hospitals are run and then "with all due respect for" doctors in the next article...

Friday, October 9, 2009

Criteria for winning the Nobel Prize

I thought I will start my blog on health care reform. But I changed my mind after listening to the morning news that President Obama has been conferred the 2009 Nobel Peace Prize award. Right from day 1, when he announced that he is running for Presidency, i had my trumpet cards on him that he would surely win and i was a local volunteer during the campaign. It was a great moment and triumph for many especially Africans to witness this young, charismatic, Harvard educated lawyer to become the youngest President of the United States. Positive thinking has the power to unite the world and the campaign used the power of language to impact the minds of people. President used to quote Martin Luther King's words and Martin Luther King used to quote Gandhi.

Mr President has been into the office for approximately 8 and 1/2 months and some people have insane expectations on him to accomplish all the things he promised during the election campaign. They forget that he is a human being too and he alone doesn't decide to implement policies. But one thing Mr President has not deviated from is, his constant message of world peace, nuclear disarmament, global warming and other issues that affect the entire world. Its a clear shift from the mentality of Bush era.

Now that the Nobel committee has awarded him the Peace Prize, the right wings have yet another topic to slaughter "whether President deserves or not". Many people are surprised by the committee's decision because President Obama is yet to deliver the goods he promised.

Initially only science was included in the Nobel Prize. Later on, subjects like Literature, Peace, and Economics were all added to the list. The criteria in the strict sense was "it should have positive impact on humankind". The world is like an extended family and in this global economy, Obama Presidency has opened the eyes and minds of the majority to see things in different perspectives. It is not one country that can do everything for the rest of the world. President has been doing his part since day one he entered the office. He has the potential to deliver what he promised. He has been consistently a unifying force in trying to get certain bills pass through senate, house and the congress. We are yet to see certain results like health care bill, gay rights and immigration.

War always saps a Nation's economy. Eight years of Bush's non-sensical war mentality has dragged down this country to a mess. Republican government(there could be exceptions!) is mainly for the riches. It will take some time to recuperate from the current mess. President Obama is undoing some of the Bush's policies that cost US some damage on the International stage. During Bush times, not much investment was spent on education and research. Any country that doesn't take care of the educational system will soon go down the drain. Its my hope that President Obama, who has very good intentions, succeeds in achieving his goals. This country became a superpower because it recognized brain power. Every great act/accomplishment starts with good/noble thoughts. There is a positive reaction now from many countries around the world towards the United States. In Science, it may take years to prove/disprove a theory and hence may take years to award the scientists. Examples are Quantum Physicist Wolfgang Pauli(it took two decades for the Nobel committee to realize the work of Pauli), Astrophysicist Chandrasekhar(it took almost 5 decades). Peace doesn't have to take years to see some of the changes already taking place. When we change our mind, the world automatically changes. So, from this standpoint, President Obama definitely deserves the Peace Prize. I hope people around the world, wake up, get educated so that any political leader doesn't abuse powers and should remember that he is answerable to the public. Because its the people who have the power to select/throw any Government.

Wish Mr President good luck in everything.