Here is a compelling and thoughtful piece by a Vet who both passionately articulates his understanding and basis for opposing Prop 61:

I am pasting my comments to his posted video here:

Thank you for your ‘skin in the game’ passion and service. I hear you! You have every right and in my view a duty to go on the record for a vitally important issue. I take the opposing view and offer the following post to back up my rationale: https://yesonprop61.wordpress.com/2016/10/17/yes-on-proposition-61-the-california-drug-price-relief-act/

I’ve been in the healthcare administration, managed care, global risk including Pharma percent of premium download world since the mid 70s. We’ve created a ecosystem nightmare of epic proportions that is in the process of implosion, and I assure you Prop 61 is an incremental step in the right direction.

First up, if the drug manufacturing industry (PhRMA) choses to raise prices for VA beneficiaries to maintain their profits, it will be their and only their choice and to their long term detriment. My guess is they will back down and not risk the public blowback that will be fast, furious and justifiably extensive. They will be publically shamed in an unprecedented manner for putting profits above people and not just any ‘people’, but our prized ‘Vets to be specific.

This is an industry who more often than not will raise price before finding ways to grow share of the market or add therapeutic value to those in need. Some are beginning to go ‘at risk’ for outcomes vs. pushing pills (units), but this is a wholly new zeigeist that will take time to take hold.

This too often default aka ‘lazy‘ formula is as follows:

units (drugs) x price = revenue – expense (cost of sales, R&D and overhead allocations) = profit.

As evidenced by Turing Pharma (the pathethic and dis-graced bad boy of pharma Martin Shkreli), Valeant and most recently Mylan (EpiPen) we’ve seen price increases at magnitudes beyond comprehension (5000%) for life saving drugs. screen-shot-2016-10-17-at-12-21-23-pm

This is an industry that spends multiples of dollars on marketing vs. pipeline nurturing and research, see: ‘Big pharmaceutical companies are spending far more on marketing than research‘. Further their standards for efficacy before commercialization = a very low bar, see; ‘imprecision medicine‘.

screen-shot-2016-10-17-at-11-40-32-am

Granted there are long development cycles from bench-to-beside so to speak, and many failures before a blockbuster drug is revealed and successfully positioned into the market whether via ‘DTC’ (direct to consumer) or physician outreach nurturing. Yet, this is their duty – no one else’s.

You are well intended and in my view reasonably buying into the weapon of mass oversimplified deception here. Not to worry your are in ‘good company’ the California Medical Association (CMA), select major newspapers, certain ‘Veteran’ organizations State chapters are listed as supporters of the No on Prop 61 campaign. Yet, the premise of their collective opposition rests principally on the assessment –  which you eloquently outline – from the legislative analyst’s on the ‘unknown‘ impact (due to likely PhRMA responses) to Prop 61 if passed. In my view, they’ve all have been duped into buying the ‘potential downside scenario’ rationale for the ad’s claims. There is no past as precedent here, so the ‘insanity is doing the same thing over and over again while expecting different results‘ metaphor – whether 12 steps sourced or attributed to Albert Einstein – just doesn’t apply here.

The law of large numbers is common practice in pooling for best price purchasing. Yet there seems to be a double standard, i.e., one for the private sector and one for the Government. The VA is one example and an exception since it is empowered to leverage their purchasing power. While Medicare can NOT buy on behalf of its 54 million plus beneficiaries and thus drive the price for drugs substantially lower. I suspect, this is precisely what PhRMA fears. California is a big and progressive state (one reason Shkreli calls us ‘trash’) and while Prop 61 carves out only a fraction of the universe of who could and should benefit from group purchasing leverage, they fear the precedent of what this could mean for their business nationally.

Make no mistake, read the fine print of who sponsors the No on Prop 61 campaign. This is all you need to know. Do you honestly think PhRMA has your interests at heart vs. their next EPS (earnings per share) conference call? I seriously doubt it. BTW, VoteVets says ‘Yes’ to Prop 61 and there are plenty of Vets trying to clarify this important bottom line narrative as well.

On the other issues of your experience in VA healthcare, this is a separate concern and one that MUST be remedied. It is wholly INDEFENSIBLE, though decades of ill-advised and nonstop wars do take their tool on infrastructure that was apparently built under different assumptions of supply and demand to meet need.

Finally, have you tried a traditional osteopathic (DO) physician? They often resolve orthopedic issues without surgery. I am a raving fan, and happy to recommend one or more practitioners.

Thanks again for speaking up on this issue. I welcome your thinking in the comments section on the blog above. My intent is to feature both pro and con narratives and will be embedding your video in the ‘con’ tab.

Best,
Gregg
@2healthguru