Category Archives: General Cynicism

American Health Care: Your Money or Your Life

Cancer drug pricing started, as I recall, to accelerate in the 90’s with the advent of Taxol (paclitaxel). This drug used mainly for breast cancer was priced at what now seems a “reasonable” $1000 for a dose. Prior to this “advance” the maximum cost for a drug was in the range of a few hundred dollars.

With better understanding of DNA and the genetic basis of cancer “targeted therapies arrived on the scene and prices rapidly spiraled. The first of targeted treatments, i.e. those that block a genetic defect, was Imatinib (Gleevac). A revolutionary advance, it was initially priced at between $26,000-and $40,000 (I recall the latter) for a year of treatment. A very big escalation. Now, FYI, that very same drug is sold at about 5 times the initial high price, $120,000 per year.

What’s amazing is that our so-called healthcare system paid up. Since then costs have spiraled. And todays example is just one of the extreme ultra-high priced medical “advances.”

Approved by the FDA in January 2022 as the “first and only” treatment for metastatic uveal melanoma, Kimmtrak has kept his tumors stable, according to Davis. His oncologist told him he should stay on the drug “until it stops working.” Its manufacturer markets the drug’s power to deliver “6-month improvement in median overall survival.””

Medicynical Note: In cancer therapy the drug prices only partially reflect the actual cost of development. Companies price medication to maximize profits not to assure affordability or access. They consider the frequency of the disease as well as what any other drug for that disease will cost. When there is no other “effective” drug and the disease is severe and rare, the sky’s the limit.

The question remains who can afford it? How much can we afford to pay for 6 months of survival? Can insurers absorb the costs or is this the proverbial bridge too far?

DeSantis and Cultural Genocide

From Wikipedia on Nazi book burnings:

“The Nazi book burnings were a campaign conducted by the German Student Union (German: Deutsche Studentenschaft, DSt) to ceremonially burn books in Nazi Germany and Austria in the 1930s. The books targeted for burning were those viewed as being subversive or as representing ideologies opposed to Nazism. These included books written by Jewish, half-Jewish, communist, socialist, anarchist, liberal, pacifist, and sexologistauthors among others.[1] The initial books burned were those of Karl Marx and Karl Kautsky,[2] but came to include very many authors, including Albert Einstein, Helen Keller, writers in French and English, and effectively any book incompatible with Nazi ideology. In a campaign of cultural genocide, books were also burned en masse by the Nazis in occupied territories, such as in Poland.[3]”

And now in Florida and other states with republican governors:

PEN America found that 176 titles had already been banned, including at least one Berenstain Bears book; biographies of Henry Aaron, Harriet Tubman, Celia Cruz, Rosa Parks, and Malala; a preponderance of books about non-white children and families; as well as those dealing with sexual themes. Weirdly, many focus on stories centered around ethnic foods: Dim Sum, Dim Sum For Everyone!, Dumpling Soup, and Fry Bread: A Native American Family Story are all verboten in Duval.”

Medicynical Note: Both the Nazis’ and DeSantis’ goal is cultural genocide and marginalization of groups of citizens of different cultural origins, political and religious beliefs. DeSantis is just getting started but we all know all too well where the Nazi efforts led. America is on the cusp and the 2024 election will be very important.

LIV Golf and the Saudis: Sportswashing

I’m not a golfer and could care less whether LIV golf is successful. But I do think we should understand the motivation of the Saudi government sponsor. In the case of LIV, the Saudis are paying hundreds of millions of dollars to buy, I’m told, top golfers and to sponsor golf tournaments. Yes, the same government involved in the murder of journalist Jamal Khashoggi at the embassy of Saudi Arabia in Turkey is bringing us LIV. (a bit ironic to say the least)

“Saudi officials said the journalist was killed in a “rogue operation” by a team of agents sent to persuade him to return to the kingdom, while Turkish officials said the agents acted on orders from the highest levels of the Saudi government.”

Now, just a few years later the oil-wealthy Saudi’s are attempting to distract the world from it’s past by sponsoring sports events, and golf is not their only target.

Saudi Arabia has proved to be an alluring hub for sports events over the past few years, having signed a 10-year, $650m deal for a Formula One motor racing event, having invested millions in a Saudi International golf event, and hosted some of the biggest boxing showdowns in recent memory. The kingdom has also hired the Boston Consulting Group to help lobby its interest in hosting a World Cup event in the not-so-distant future.”

But the assassination of Khashoggi was not an isolated killing for the Saudis. It’s more the tip of an iceberg of killings and disappearances within Saudi Arabia.

Medicynical Note: it’s depressing. Sports icons such as Messi and Ronaldo and the prominent golf pros sell themselves and participate in events sponsored by an amoral and murderous regime. We watch and participate. We think nothing of going to the World Cup in Russia or Qatar. If we have no conscience we might even watch an obscure LIV golf event. We watch as the icons of world sport sell themselves and while they’re playing, people die.

Metal Detectors For Kindergardeners….. the Real America?

Reaping what the Supreme Court has sowed. The United States of America is the only place on earth where T.S.A.-like guards subject kindergarteners to daily security screening. Is this the “real” America? Is this what conservative America thinks is “freedom.”

Medicynical note: Our conservative Supreme Court majority has decreed that literally any attempt to control access to or the actual carrying of guns on our streets and malls is a threat to “freedom” and unconstitutional. Meanwhile the justices sit at home shaking in fear and complaining about the threat of people in front of their homes who might be carrying a gun. Ironic? Or just sicko?

Meanwhile the rest of us, including our children and grandchildren are subjected to mass shootings, threats of bodily harm, shooting incidents and now the daily screening for weapons as they go to school. “Freedom” in America has become a sick joke.

More Massacres: America Reaps what it has Sowed

America’s cavalier gun policies move toward their natural endpoint. Killings blossom out of nowhere, collateral damage (death) abounds. It’s no nightmare, it’s America’s self-inflicted hell on earth.

“Broadened out to include all deaths from gun violence, not including suicides, 1,214 people have been killed before the end of the first month of this year, including 120 children. That is likely to increase to tens of thousands by the end of 2023 – the figure for 2022 is 20,200.”

“In comparison, the latest data from the UK showed that in the course of an entire year ending in March 2022, 31 people were killed by firearms. The UK’s population is 67 million to the US’s 333 million.”

Medicynical Note: Ah can you feel the freedom! It’s an almost daily gift from the thoughts and prayers folks. From the conservative members of the Supreme Court who made this all possible and quake in fear of people with……. guns; to the feckless Republican Party who thinks this is just another sign of “freedom” to the emergency responders who must be exhausted by the mayhem. It’s deja vous all over again. It’s “Groundhog Day” until we get it right…….

We’ve become a parody of ourselves. This is not at all like the good old days. It’s a self inflicted purgatory— and speaking of the afterlife, wonder what all those gun carrying evangelicals think? Is this their idea of heaven?

Boring…….. You Can Smell the Musk………

It takes a real visionary to make the 1927 Holland Tunnel look like a modern, functional people mover in 2023. But that’s just what the (very) Boring company project,the Las Vegas slow transit tunnels, has done.

A true visionary Musk has delivered an auto tunnel in which vehicle and driver carries just 3-4 people at less than 30 mph over a limited (very) Boring company loop tunnel. A (very) resistible concept.

Medicynical note: Ignore the hype in the above video. This is a farce. One can only watch with anticipation as this failed concept dies it’s well deserved natural death.

Trump Tax Cuts and our National Debt: A Shell Game for Suckers

As Republican Trumpist radicals posture about our national debt remember their early actions during Trump’s first year in office that is constantly increasing our debt to the tune of over a trillion dollars over 5 years.

Medicynical Note: This is not rocket science nor advanced economics. The game plan is to play up the debt and try to pay for it by cutting Medicare, Medicaid, Social Security and other necessary domestic programs. Defense of course will be exempted from significant cuts.

After marching in lock-step to increase the debt under Trump by cutting taxes on the wealthy our republican faux libertarian radicals want to place the burden of the debt that THEY created on middle and lower income earners. Are we so stupid as a country to fall for this? ………. maybe. Watch the posturing over the next few weeks and find out.

Only in America…..6 years old shooters

“In no way do I believe that we were fully prepared for a 6-year-old student to bring a gun to school … and shoot his teacher,” he said. “There is a lot to learn here and a lot to unpack.”

“On Monday, the chief called the investigation into the shooting “unprecedented.” He said the gun was taken from the child’s home. The boy’s mother had legally purchased the gun, Drew said.”

Medicynical Note: Is it any wonder that our conservative dominated Supreme Court, the facilitators of our gun culture, is fearful of people…….. with…….. guns.

We’ve become the America no one could have possibly anticipated or hoped for, except maybe gun manufacturers. We lead the industrialized world in guns/capita, gun homicides, gun suicides, mass shootings, school shootings, accidental gun deaths, police shootings (both of policemen and of citizens).

It’s our disgrace and yes, it’s the guns.

American Health Care…… isn’t

Understanding health care coverage and costs requires a PhD. The folks in today’s health care fiasco bought coverage from a company that for two years doesn’t cover “pre-existing” problems…. and got burned.

‘The plans are often faith-based, whatever that means, and have surged in popularity in recent years because they can be cheaper than traditional insurance — the Kings said their plan cost $534 a month, plus an additional $118 a month to join a direct primary care medical practice.”

“But the sharing plans offer fewer protections than insurance and come with provisos. The Kings said their plan did not fully cover preexisting conditions like Jeff’s heart condition for the first two years of coverage — and he needed the surgery after 16 months.”

In this case the couple found they were liable were for the entire $160,000 billing.

Medicynical Note: Healthcare has become worse than buying a used car, in part because the car purchase is discretionary while in health care one’s very existence may be involved……..and, in part because the amount of money involved in healthcare is so much more.

The article notes: “Hospital charges are generally understood by health economists to bear little resemblance to the actual prices that are typically paid. Instead, they are more of an opening salvo in the high-stakes negotiations between hospitals trying to get as much money as they can for providing care and insurance companies trying to pay as little as possible.”

In this case after billing $160,000 the hospital knocked off $107,000 from their original pricing. This for a non-surgical Cath-lab procedure that probably required only an overnight stay. And FYI the hospital involved had a net revenue of over 800 million dollars and net income (2020) of over 57 million dollars. Not bad for a “non-profit.”

It’s sadly true in America that in America healthcare companies are more interested in income than outcomes.

A Six Year Old Perp: Guns in America

Anyone think this is what the Supreme Court had in mind when they legalized guns everywhere for everyone?

Sadly this Onionesque headline is real.

“We did not have a situation where someone was going around the school shooting,” Newport News police chief Drew told reporters. “We have a situation in one particular location where a gunshot was fired.”

“He added that the shooting was not an accident.” (Emphasis Medicynic)

“The student has since been taken into custody, and the teacher, a woman in her 30s, was taken to a local hospital to be treated for injuries that were “believed to be life-threatening”, according to the police department. Drew told reporters the teacher’s condition had improved somewhat by late afternoon.”

Medicynical Note: This really happened…..in…..America. WTF happened to us?

On the same day it was reported that 323 police were shot and 60 died in 2022 while 1400 people were shot and killed by police in 2022 and that since 2014 over 8000 people have been shot and killed by police.

Ironically, the people who made the killings possible and common, the people who gave us the “freedom” to kill, our conservative Supreme Court members, say that are “afraid” of people carrying guns near their homes.

And our brave police who should be leading the fight against gun violence, continue as a group to support deregulating gun ownership. They do this to the point of often refusing to enforce gun laws (Connecticut is just one example).

And we all live in fear. Welcome to America in 2023.