Well at least the Drug Companies will be in good shape. But as for the rest of us?
Hey, in Capitalism we trust, long live Capitalism!
____________________________________________________________
Rick Santorum lecturing sick people about the market:
http://susiemadrak.com/2012/02/02/the-free-hand-of-the-market/
“Republican presidential candidate Rick Santorum told the mother of a child with a rare genetic disorder on Tuesday that she shouldn’t have a problem paying $1 million a year for drugs because Apple’s iPad can cost around $900.
Speaking to more than 400 people at Woodland Park, Colorado, the former Pennsylvania senator said that demand should set prices for drugs.”
“People have no problem paying $900 for an iPad,” the candidate explained. “But paying $900 for a drug they have a problem with — it keeps you alive. Why? Because you’ve been conditioned to think health care is something you can get without having to pay for it.”
The mother replied that she could not afford her son’s medication, Abilify, which can cost as much as $1 million a year without health insurance.
“Look, I want your son and everybody to have the opportunity to stay alive on much-needed drugs,” Santorum insisted. “But the bottom line is, we have to give companies the incentive to make those drugs. And if they don’t have the incentive to make those drugs, your son won’t be alive and lots of other people in this country won’t be alive.”
“He’s alive today because drug companies provide care,” the candidate continued. “And if they didn’t think they could make money providing that drug, that drug wouldn’t be here. I sympathize with these compassionate cases. … I want your son to stay alive on much-needed drugs. Fact is, we need companies to have incentives to make drugs. If they don’t have incentives, they won’t make those drugs. We either believe in markets or we don’t.”
Merlin
Democratic Republic of the Congo (the)
16 Feb 2012
Programme: Democratic Republic of Congo, N Kivu Responsible To: Provincial Director (PD) Responsible For: All Provincial Finance Team Works With: Country Support Director in Goma, Financial Advisor in London, Operations Manager (N Kivu) Location: Goma, DRC with extensive travel to field sites in N Kivu Start Date: ASAP Duration: 4 months Salary and Benefits: ?33,480 - ?34,230 per annum per annum (dependant on relevant experience), inclusive of annual Cost of Living Allowance Benefits: Insurance cover, accommodation, annual leave entitlement of 24 days per annum rising to 30 days at the completion of 12 months of continuous employment with Merlin.
Only short-listed applicants will be contacted. Due to the urgency of this position, applications will be short-listed on a regular basis and we may offer this post before the closing date.
Please note that an assessment will need to be carried out to confirm if this position can be accompanied.
Merlin Undaunted and determined, Merlin saves lives. We deliver medical expertise to the toughest places. And we stay to help build lasting health care.
Our mission is to end the needless loss of life in the poorest countries caused by a lack of effective health care. We help communities set up medical services for the long term including hospitals, clinics, surgeries and training for nurses and other health workers.
We do whatever it takes and we stay for as long as it takes.
Context and Background The Democratic Republic of Congo is the second largest country in Africa and one of the poorest. Decades of dictatorship and civil war have left much of the national infrastructure destroyed.
Merlin has been operational in DRC since 1997. Merlin teams have provided emergency medical care to the most vulnerable populations in Maniema, Kasai Oriental , North Kivu and Orientale Provinces. Activities have included emergency response, support to primary and secondary health care facilities (including supervision, supply of drugs, and the payment of incentives), reproductive health, institutional capacity building, immunisation campaigns, nutrition, WASH, and the rehabilitation of health facilities.
From 1 January 2012 Maniema and North Kivu will operate as autonomous programmes, each reporting direct to head office in London; they will be supported by country offices in Goma and Kinshasa.
In North Kivu Merlin currently works in Rutshuru/Binza, Kayna, and Birambizu health zones, providing essential health care services to DPs and host populations; and will provide the health component of the rapid response to movements of population (RRMP) mechanism throughout the province.
Main purpose of the role As a Provincial Finance Director, you will provide leadership and financial management to the multi-programme and multi-site operation in N Kivu province.
Overall Objectives (scope) • Directly manage the Provincial Finance Team to ensure effective and proactive financial leadership, support and guidance is provided to managers in the province
• Ensure that mechanisms are in place to prepare and report field finances to head office • Ensure that budget preparation, financial reporting and amendment planning for donors is implemented in a timely manner and approved by head office before submission
• Ensure appropriate systems and procedures, support and guidance for country programmes • Be a member of the Province Management Team and take the lead role on financial planning, forecasting, budgeting and developing financial management capacity throughout the country
Responsibilities
Leadership Responsibilities • Responsible for all the Province programmes financial matters; ensuring that sound financial practices, rigorous budgetary and financial management controls are implemented and imbedded. • Ensure that Merlin's minimum standards of financial procedures, policies and guidelines are understood and adhered to throughout the Province programme, briefing and training all relevant staff as required. • As part of the Province Management Team (CMT) you will influence the strategic financial direction of the whole programme. Assisting the programmes teams in developing the financial elements of their project/programme plans. • Develop and implement the annual financial strategy and support cost budgets. Monitoring and reviewing its progress on a regular basis. • Work in close collaboration with members of the CMT; sharing information on the assessments and proposed interventions, providing overviews of financial requirements for the development of project proposals and subsequent projects. • Manage staff effectively, including appropriate and systematic delegation
Financial Management • Assist project staff in developing proposals (including budgets and activity plans) and subsequent revisions in accordance with external donor requirements. • Monitor, supervise and assist in preparing all interim financial and final reports to donors, in a timely manner, to ensure compliance with contractual and legal requirements. • Ensure the timely preparation and communication of monthly financial reports for the Province Director, Project Coordinators and Head Office, providing them with meaningful and accurate financial information to enable them to manage project and core budgets effectively. This should include advising on significant variances against budget, and making recommendations for corrective actions to ensure expenditure is in line with budgets. • Conduct regular field trips to project sites to monitor compliance with financial procedures, review activity progress and assist managers in identifying the financial implications of changes in proposed activities and revising budget lines as required. • Ensure a set of complete and accurate financial records is maintained, including all relevant supporting documentation for each project. • Facilitate visits by, and meet the requirements of, external auditors. • Ensure compliance with local regulations in respect of financial and other matters (e.g. Registration, Foreign Exchange, taxation, Province audits and labour laws). • Overall responsibility for managing and maintaining the Province balance sheets including salary advance accounts • Overall responsibility of treasury management for the entire Province programme. • Induct and regularly advise/capacity build on finance systems and controls for finance and non finance staff. • Develop the financial aspects of the programme emergency preparedness plan, in co-ordination with the CMT, and train finance staff in managing the financial aspects of in emergencies. • Work with the Finance Department in London to support head office initiatives and specific requirements.
Human Resource Management • Undertake expatriate staff appraisals for provincial finance team in accordance with Merlin’s Human Resources procedures • Maintain good team communication, engender positive team dynamics and take remedial action as soon as problems occur as advised by the Provincial HR/Admin Manager • Support team members professionally and monitor and support stress management • Provide support to in the recruitment process for provincial finance staff
Person Specification Essential Qualifications, experience and competences
• Accounting qualification (Degree or professional equivalent). • Strong communication skills with written and spoken French & English. • Experience of donor reporting requirements. • Experience of implementing financial control systems. • In depth knowledge of financial systems, financial/administrative management and reporting. • Strong communication skills including strong EXCEL skills (worksheet functions, data functions, pivot tables). • Good decision making skills on financial aspects of information management. • Good training/capacity building and management skills. • Focussed individual with capacity to plan and manage in a multiple deadline-working environment. • Pro-active financial manager with risk assessment aptitude. • Willingness to work in an insecure environment. • Understanding of security issues and guidelines. • Ability to work on own initiative. • Experience of establishing strong working relationships with colleagues from different functions and cultures • Experience of a flexible approach to managing and prioritising a high workload and multiple tasks in a fast paced environment with tight deadlines • Experience of proactively identifying and addressing issues • An understanding of and commitment to Merlin’s mission and values
Desirable Qualifications, experience and competences
• Previous experience of working in field financial management. • Experience of working in NGO sector organizations. • Experience of field administrative/HR management. • Previous experience of working in Central/West Africa
To apply for this position To apply for this job, please go to
www.merlin.org.uk/jobs and apply using our online recruitment system. In order to apply for a job with Merlin online you will need to complete a short registration process and create an account – the online recruitment system explains how to do this. Once your account has been created, you will be able to save the information that you have entered in your application and re-visit it at any time before you submit it.
If you are unable to apply online for any technical reason, please contact
applications@merlin.org.uk.
Please note that we do not accept CVs. Unfortunately due to the number of applications we receive, only shortlisted applicants will be contacted.
W
ASHINGTON - The federal government this week announced a rule change it says will save the federal-state Medicaid program $17.7 billion over the next five years. Called for in the 2010 federal health law, the new rules for prescription drug pricing are based in part on an innovation pioneered in Alabama.
Instead of paying for drugs based on drug company price lists, which are often inflated, Alabama decided a few years ago to start paying local pharmacies for prescriptions based on what they actually paid for the medicines. After getting permission in September 2010 from the U.S. Department of Health and Human Services, the state Medicaid program started collecting receipts from local pharmacies to create a new pricing benchmark.
The result was a 6 percent reduction in Alabama’s Medicaid pharmacy bill - a savings of $30 million in the first year. Since then, Oregon, Idaho and California have followed suit.
By John T. Aquino
A whistleblower's complaint from 2011 that was unsealed Jan. 20 in a federal district court alleged that Forest Pharmaceuticals paid the principal investigator of a federally funded antidepressant drug study to fix the results in favor of the company's drug Celexa (
United States ex rel. Pigott v. Forest Pharmaceuticals Inc
., D. Md., No. 1:11-cv-00717, unsealed 1/20/12).
The whistleblower litigation was filed in the U.S. District Court for the District of Maryland by H. Edmund Pigott, a psychologist who resides in Clarksville, Md. The alleged False Claims Act violations occurred during the company's management of the largest antidepressant drug trial ever conducted: the $35 million STAR*D (Sequenced Treatment to Relieve Depression) study, which was funded by the National Institute of Mental Health. The study enrolled 4,041 patients who were provided with 12 months of continuing antidepressant care.
In the article by J. Boren, A. Leventhal, and H.E. Pigott, “Just how effective are antidepressant medications? Results of a major new study,” Journal of Contemporary Psychotherapy, 39 (2), 93-100 (2009), Pigott had alleged there was bias in the STAR*D study in favor of Forest's drug Celexa. In the litigation, he alleged that the bias was the result of kickbacks, bribes, and other improper financial inducements that were paid by Forest to Dr. John Rush, the principal investigator of the study, and to one or more of the project's other investigators.
The complaint alleged that this conflict of interest not only caused the selection of Celexa as the only antidepressant employed in the first part of the study, but also led to falsification and overstatement of the effectiveness of Celexa in the study's published result.
The end result of the kickbacks and bribes, Pigott claimed, was a significant increase in the sales of Celexa and its second generation version, Lexapro, to patients covered by federal and state health care programs in violation of the FCA, 31 U.S.C. §378, and comparable state statutes, which impose liability on persons and federal contractors who defraud government programs.
Only Explanation for Study's Bias: Kickbacks
According to the complaint, the NIMH initially entered into a contract for the STAR*D study with the University of Texas in September 1999 with Rush as the P.I.
Celexa is a selective serotonin reuptake inhibitor or SSRI. SSRIs prevent the body's reuptake or removal of a naturally-occurring neurotransmitter that it is believed to have a positive impact on mood.
STAR*D was designed as a comparative effectiveness study of different treatment options for people with major depression and included 12 pre-specified research outcome measures and a detailed analytical plan for evaluation. According to the complaint, Celexa was selected for the study even though it was the least prescribed of all SSRIs. Pigott argued that the least-prescribed status was either because Celexa was less effective than other SSRIs or had a greater risk continuation syndrome or drug-to-drug reaction. Patients in the study were first given Celexa and, if they failed to get relief from Celexa, they received one of three other antidepressant treatments.
The complaint stated that even after the passage of four years since the publication of STAR*D's major summary article and the publication of over 70 peer-reviewed articles on the STAR*D findings, none of the articles published by the STAR*D authors have reported the outcomes of any of the 12 pre-specified measures of the study, nor have they reported any findings in a manner consistent with the study's analytical plan as presented in STAR*D's research protocol.
The authors' articles also did not discuss the main purpose of the study, which was to evaluate the cost-effectiveness of the various antidepressant treatments, Pigott claimed.
The article for which Pigott was coauthor, the complaint stated, documented that, in contrast to the positive results in STAR*D's published findings, only 108 of STAR*D's 4,041 patients (2.7 percent) had an acute-care remission and neither relapsed nor dropped out during the 12 months of continuing care that followed. The article also documented how STAR*D changed its research outcome measures and analyses, which resulted in an inflation of STAR*D's remission rates by 44.9 percent.
The complaint reported that 10 of STAR*D's authors, including Rush, have disclosed in journal articles that they had received money from Forest and that in the summer of 2008 Rush left the University of Texas, moved to Singapore, and was replaced as the STAR*D P.I.
The complaint stated, “The relator has concluded and therefore alleges that the only reasonable explanation for the false and biased reporting of the study results is that Dr. Rush received significant financial remuneration from Forest that Forest paid to him for the purpose of influencing his actions.”
Forest's 2010 Settlement
In September 2010, Forest Pharmaceuticals Inc. agreed to pay $313 million to resolve criminal and civil liability arising out of a guilty plea on obstruction of justice charges and to settle FCA allegations relating to three of its drugs including Celexa.
The Maryland district court complaint asserted 30 counts, including anti-kickback and false statement violations of federal and state false claims acts. Also asserted were violations of the Medicaid fraud false claims acts of Arkansas, California, Colorado, and Georgia; false claims acts of Connecticut, Delaware, Florida, Hawaii, Massachusetts, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New York, North Carolina, Rhode Island, Tennessee, and Texas; and statutes of the District of Columbia, Illinois, Indiana, Louisiana, Michigan, Oklahoma, Virginia, and Wisconsin.
For each count, the complaint asked that penalties be imposed on Forest for the maximum amount allowed by law for each claim presented to the court.
Frank J. Murdolo, vice president of investor relations of Forest Laboratories, of which Forest Pharmaceuticals is a subsidiary, told Bloomberg BNA in an e-mail that the company does not comment on matters of pending or threatened litigation.
The complaint was filed by George G. Tankard, of Waters & Kraus LLP, Baltimore, and William Paul Lawrence, of Waters & Kraus LLP, Middleburg, Va.
For More Information
The complaint from 2011 can be found at
http://op.bna.com/hl.nsf/r?Open=jaqo-8qvqcd.
Prosecutors alleged the owner submitted more than $1.2 million in claims to Medicaid, and received hundreds of thousands of dollars in payments from fraudulent claims
A statue of President Abraham Lincoln stands in front of the old Essex County Courthouse in Newark in this file photo.
NEWARK — The former owner of a now-defunct mental health and substance-abuse counseling center has been convicted of defrauding Medicaid through false claims totalling hundreds of thousands of dollars.
A Superior Court jury in Newark found Rostislav Vilshteyn guilty of health care claims and Medicaid fraud Friday, said the state Attorney General’s Office, which prosecuted the case.
Prosecutors alleged Vilshteyn, who owned the Bloomfield Health Pavilion on Bloomfield Avenue in Newark, submitted more than $1.2 million in claims to Medicaid, and received hundreds of thousands of dollars in payments from fraudulent claims.
Vilshteyn, 33, submitted or approved the claims although the services had either not been provided or had not been provided to the extent alleged in the claims, prosecutors said.
He was acquitted of kickback charges in the form of Pathmark gift certificates he gave to Medicaid beneficiaries to lure them to his office, and for submitting false claims related to those visits.
The Staten Island, N.Y., man faces up to 10 years in prison and $250,000 in fines when sentenced on March 16. His attorney, Don Savatta, did not return a telephone call seeking comment.
Let me start by doing something I failed to do in my last post and that is thank my colleague Laura. Thank you for taking me to NYC and thank you for letting me puke in your car. I don't know if you did it for a promotion, a raise or because you are a good person but either way.....thank you (you know I'm kidding about the promotion right and raises are coming anyway right?!)
And now...........on to our hospital stay in Chez Private Hospital Digs.
Once I was settled in to my comfy, cozy hospital bed Steve - exit Stage Left. He went back to work to pick up his car, drive to our house, get the cat settled for an overnight alone, pick up clothes for him and pajamas for me. No hospital gown for this chickadee!
While Steve did the whirlwind NJ tour, the faithful Jill got a babysitter and entered Stage Left. While I hung out and puked and cramped, Jill made sure the nurses were on top of my every need and that I was entertained as well.
The crazy thing about hospitals is you need to rest and get better. Yet they wake you every hour to check your vitals so you never realy get a good night's sleep. In my case we were also waiting for radiology to call and say LISA FRANK - COME ON DOWN! for my abdominal catscan.
In order to have a productive ab catscan I needed to drink a liquid that would make it easier to see what's going on down there. Ok, let's recap. I cannot keep anything down, even water and we now need me to drink an entire water pitcher of foul tasting fluid for a catscan. Something seems counterintuitive here - but hey - maybe it's just me. The good news is over the course of an hour and a half I was actually able to sip on this tasty beverage and drink it all in anticipation of my 11 p.m. catscan. Oh did I say 11 p.m. I'm sorry, my mistake. It was actually 2:30 a.m. when they wheeled my tired, sore and pukey ass to the ER catscan facility (only place open for scans at 2:30 a.m.) to take pictures of my intestines.
Let me tell you, a NYC ER at 2:30 a.m. is quite a sight. There are people on beds lining the halls and in every available nook and cranny. I realize once again how fortunate I am to have a bed to call my very own in this hospital. It made me sad to think that it's not that way for everyone. Definitely makes one think about access to healthcare and who gets what and how. But enough of that..............on to the fun stuff! The catscan.
After they took a few pics of my intestines my personal wheelchair attendant came back downstairs for me and took me to bed. Another added benefit of the room was they brought in a nice comfy cot for Steve so by the time I went up, Jill went home to her family and my beloved was in the room waiting for me to return.
And finally, sleep.............................UNTIL THEY COME IN TO CHECK MY VITALS AGAIN!!! Please I love that you want to make sure I'm okay but come on.............LET ME SLEEP!
I must mention however the incredible nurse Kristen, my night nurse who took such wonderful care of me. She truly was amazing. The nice thing about this floor was there are only 20 beds so each nurse had around 3 patients - great ratio.
Really all the nurses and the patient care folks were absolutely amazing. As much as I joke that I couldn't get any sleep the truth is they were all incredible and caring.
Tuesday morning rolls along and it is clear I'm spending another day in paradise. Welcome today's nurse for the day Matt visiting from his normal gig in ICU. Matt was excellent and very witty and intillegent. He started the day with the "News of the Day".................they need to figure out what's going on (or not) in my intestines and - oh yeah - YOUR BLOOD SUCKS! My hemaglobin is way low as is my white blood count. And so my next First - BLOOD TRANSFUSION!
Before that blood bonanza I was lucky enough to take a shower in my beautifully glass tiled huge bathroom with Molton Brown toiletries. The lovely and caring Dorota made sure I was all safe and sound in the shower and changed all my linens and towels while I made myself smell better - well just a bit. Nothing makes a girl ready for a blood tranfusion like a hot shower and clean hair!
This is kinda freaky to think about them putting someone else's blood in my veins. But if I rely on the info from the fabulous Stephanie, damn girl you will feel like new once they transfuse you. So I keep that in mind because as doc onc said, if it were not for my brightly colored eyeglasses I would have simply blended into the white sheets of the bed. That's how pale I was.
I am officially a VAMPIRE as I have feasted on the blood of another. But disappointingly I do not have Edward's super human strength and unlike Alice I cannot hear what others are thinking. Hmmmm....be careful what you wish for!
And.....................I completely understand why athletes blood dope. DAMN, I FEEL GOOD! MY CHEEKS ARE ROSY AND I'M STEPPING OUT FOR A NICE LONG WALK IN THE HALL. Seriously a little fresh healthy blood does wonders for a girl! 2 Pints of blood and I'm moving and grooving!
The last puzzle piece has arrived and the results of the catscan are in. Drum roll please....................................and the winner is:
SMALL BOWEL OBSTRUCTION! ANOTHER FIRST!!
What does this mean you ask? It means that all that lovely spinal radiation caused so much inflammation and irritation that my intestines closed up a teensy bit and the crap that normally flows through them created a little wedge and obstructed the flow. Thus, nothing moved anywhere except out the wrong way - PUKE and PAIN! The good news was it looked like the obstruction had started to dissipate by the time the scan was taken so I should be on the mend!
Did I say YEAH SIDE EFFECTS FROM FUCKING RADIATION? Medical community - we must come up with a better way to treat cancer patients that doesn't land them in the hospital from the side effects. Take note please!
I forgot to mention the coverage shift for the day. Steve went to work, Jill covered the midday "watch Lisa and keep the staff in line" shift and Ann Marie covered the later day into evening when Steve returned "watch Lisa and keep the staff in line" shift. I was well covered and protected at all times. And as an added bonus the always funny and sarcastic Stephanie dropped by with coloring book and crayons for me and Jack Daniels for Steve. Talk about making friends!
One interesting phenomenon was the number of doctors that "just stopped by to see how I was doing". In a way I felt like a bit of an oddity because these docs were sometimes related to my doc oncs and sometimes not but they knew of my parotid case and ensuing case history and wanted to see how I was doing. I guess it's not a bad thing to have a bit of notoriety when being treated at a large hospital with lots of great docs and resources.
Now the 24,000 dollar question..........what did I need to do to get sprung from this joint? As lush and lovely as the concierge floor was, I still wanted my home. Doc onc said we need to make sure you can tolerate food and go home basically without puking, pain and all that fun stuff. The good news now is, I get to try some solid food made by the private chef on the floor. It's now gourmet dinner time for me, Steve and AMC. Ok, so more gourmet for them than me.
Steve and AMC have monkfish with veggies and mushroom polenta. AMC has heirloom tomatoes with mozarella and Lisa has plain pasta with butter, mushroom polenta and chicken broth with little tortellinis/spinach and tomato chunks. Yeah food!
Unfortunately, this lovely gourmet meal does not sit so well with my intestines. I am now back to having pain in my gut to the point that I cannot sleep. My wonderful Kristen who is the same nurse as Monday night and truly an angel agrees I need a painkiller so it's DILAUDID time.
I now know how people can become drug addicts. In the past, I've had Dilaudid or Morphine through a pain pump post surgery. It's carefully measured how much you can get at any given time and it completely manages the pain. I honestly never felt "drug fucked up". Well let me tell you, a syringe full of Dilaudid into your IV in your port is a whole different puppy. That warm feeling overtakes your body and I seriously felt the most amazing rush of heaven from that drug. And boy did I get a good night's sleep. Next to the Propofol pre-colonoscopy, Dilaudid by IV is my new favorite drug!
I floated into a euphoric sleep dreaming of hopefully getting discharged the following day.
To be continued..................................
Category: Health News
Created: 2/2/2012 2:06:00 PM
Last Editorial Review: 2/3/2012
Category: Health News
Created: 2/2/2012 2:06:00 PM
Last Editorial Review: 2/3/2012
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