The United States Supreme Court, in a unanimous opinion written Justice Sotomayor, overturned an Eleventh Circuit Court of Appeals and Georgia District Court finding “state action” antitrust immunity in the case of FTC v. Phoebe Putney Health System, Inc. et al, No. 11-1160. Had they ruled otherwise there would have opened a huge whole in the FTC’s ability to regulate anticompetitive conduct by state sub-entities under a general grant of state authority. Georgia like many states has a hospital authorities law that permits counties and or municipalities to create quasi governmental entities with broad grants of powers to operate health care facilities.
The Obama Administration recently announced the formation of the “Brain Activity Map Project” to be funded by the National Institutes of Health and other public and private foundations and organizations to undertake a ten year study of the human brain. The effort, which is similar to the organized effort to map the human genome is expected to cost at least 300 million dollars a year over the ten years. It is anticipated by scientists that it will be much for complex and difficult to undertake than the genome project. The hope is to develop a complete model of brain activity and the process of neuron firings that lead to cognition.
The United States Supreme Court will decide the question of whether genes are patentable in the coming term. The decisions has broad implications for the biotechnology industry, for researchers and for patients. The case at hand is Association for Molecular Pathology v. Myriad Genetics, Inc. originally filed in the U.S. District Court for the Southern District of New York by the ACLU and the Public Patent Foundation. The object of the case is to challenge a number of patents granted to Myriad, a Utah biotechnology company, by the U.S. Patent and Trademark Office. The patents granted were on DNA isolated from two human genes that increase the risk to women for breast and ovarian cancer.
The Institute of Medicine and the National Research Counsel announced the pre-publication release of their report on their recent comparison of health care data between the U.S. and 16 other countries which crosses all age categories. The other countries include Canada, Japan, Australia, Germany, Austria, Denmark, Finland, Norway, Portugal, Sweden, Switzerland, the Netherlands, the United Kingdom and Spain. This is a fascinating read entitled U.S. Health in International Perspective: Shorter Lives, Poorer Health is currently available to read on line for free at the National Academies Press website. The U.S. generally finished near the bottom in most categories for the population under the age of 75. Our post 75 population, outscores their peers elsewhere.
160 Common U.S. Food and Drug Administration (“FDA”) approved drugs which are used for “off label” purposes represent approximately 21 percent of all prescriptions in the United states. Physicians may prescribe FDA approved drugs for any therapeutic use that is appropriate in their medical judgment. The FDA, however, prohibits pharmaceutical companies and their employees from promoting the use of FDA approved drugs for “off label” use. Although there is no express prohibition in the Food Drug and Cosmetic Act or its regulations prohibiting the promotion of drugs for off label use, the government uses a criminal statute which prohibits the introduction of “misbranded” drugs into interstate commerce ( 21 U.S.C. 331(a) and 333(a)(1) to prosecute pharmaceutical companies, their employees and sometimes physicians who are “promoting” the off-label use of drugs.
On November 26, 2012 the Supreme Court of the United States will hear an important antitrust case where an admittedly anticompetitive merger between two hospitals in Georgia was immunized against FTC action by the application of the “state action” defense first promulgated under the precedent of Parker v. Brown, 317 U.S. 341 (1943)(the Sherman Act does not subject states to liability for anticompetitive conduct within their jurisdiction). Political subdivisions of the a state are not automatically protected by the Parker doctrine, but may under some circumstances be granted immunity if the state generally authorizes the challenged action and the state has a “clearly articulated policy authorizing anticompetitive conduct.
Wendell Potter is a former health care PR Director for Cigna who quit in disgust following CIGNA’s refusal to timely agree to provide a liver transplant for a 17 year old girl in 2007, Nataline Sarkisyan, who died without the procedure. He now works for the Center for Public Integrity as an analyst. Yesterday, in his blog, he called out the objection by one of the shareholders of CIGNA to the company’s increasing his compensation by 25% to an annual total compensation of about $20,000. The 46 year old, David Cordani, who looks a lot like the Russian New Jersey Nets owner Mikhail Prokhorov, is frequently sought out on the speaking circuit including Davos, Switzerland where he rails against rising health care costs as being unsustainable. On his departure earlier in the year the Hartford Courant quoted him as saying “ when you take the cost of sickness, its at an elevated level and its growing.”
If the Supreme Court decides to tank the Affordable Care Act and returns us to the past system, James Carville may just be right that it will be a long term boon for Democrats. Health Care costs rose from 12% to 17% of GNP from the 1970s to the present. An estimated 45,000 uninsured die each year over inadequate health care. The uninsured population is approaching 50,000,000. People with pre-existing conditions will continue to be uninsurable. Insurance companies will continue to make money but denying coverage to keep their medical loss ratios low and their stock prices and bonuses high.
Cost shifting will continue to be the major financing vehicle for hospitals and physicians to cover deficits in service shortfalls in funding from Medicare, Medicaid and the uninsured care. Medical bankruptcy’s will continue to grow from the current 60% of bankruptcy’s. The cost of private insurance will continue to climb as the consolidation of hospitals exercise increasing leverage to cover their costs and gain a tidy profit. The number of uninsured will continue to rise as employers continue their effort to shift the cost increases to individual employees.
Jennie Linn McCormack of Pocatello, Idaho has a messy life. She is the single mother of three children living on a $250.00 per month child support payment for one of her children. She is unemployed, poverty stricken and desperate. Adding to her troubles she became pregnant again and the father is now serving time in prison for robbery.
