Liberal College Kid

A study has shown that Zetia, one of the most widely prescribed cholesterol reducing drugs, does nothing to prevent heart attacks and strokes, and that in some cases it may make them even more likely, as it sometimes causes fatty plaque to develop more quickly in arteries.

This should be shocking news, and it is. But its not that unusual of a discovery. The past ten or fifteen years have seen drugs that have been heavily prescribed to millions of Americans turn out to be flawed, useless and potentially life threatening. Remember Vioxx?

The website DrugRecalls.com lists over a dozen prescription medicines that have been either recalled or deemed worthy of serious warnings, including:

• Avandia
• Ephedra
• Crestor
• Fen Phen
• Zelnorm
• Baycol
• Meridia
• Neurontin
• Prempro
• Celebrex
• Risperdal
• Pemoline
• Rezulin
• Vioxx
• Bextra
• Many Antidepressants

All of these drugs have been at one time, or still are being, ingested by Americans all across the country. Why, if they are so potentially dangerous, did they ever make it to the market in the first place?

While there is a growing amount of concern over the practices within the FDA (Food and Drug Administration), the government body that tests and approves or denies new drugs, it is my opinion that there are two serious problems that lead to the approval of dangerous drugs, and one of them may already be rectified.

First, the FDA has had a serious problem in the past. Members of the panels who give recommendations for, or against, the drug in question, have actually in many cases been receiving financial backing from the pharmaceutical companies that have developed the drug in the first place. Can there be a more egregious conflict of interest? An FDA employed researcher being paid, in any way, by the pharmaceutical industry should not, under any conceivable circumstances, be involved int he approval of a drug. In one case, probably the worst, every single member of the trial study panel had been paid by the company that manufactured and developed the drug. This is completely unacceptable. Even if they really do evaluate the merits of the drug objectively, the entire study will smell rotten. We are talking about the health of millions of American who are shelling out unreasonable portions of their income to be able to take these drugs. There should be absolutely zero chance that the integrity of trial study is betrayed because of a researcher or researchers’ nepotism and greed.

However, that said, this problem may already be solved. In March of last year, the FDA released new guidelines that would create more strict rules barring individuals who have financial conflicts of interest from participating in advisory committees. The press release announcing these changes said the following:

FDA would tighten its policy for considering eligibility for participation. If an individual has disqualifying financial interests whose combined value exceeds $50,000, after applying certain exemptions, the person would generally not be considered for participation in the meeting, regardless of the need for his or her expertise. If the financial interests are $50,000 or less, after applying certain exemptions, the individual might be recommended to participate as a non-voting member. Only individuals with no potential conflicts would be eligible to fully participate in meetings as voting members.Financial interest means the potential for gain or loss to a person (or their family and outside affiliations) as a result of the government’s action on a particular topic. Financial interests screened include, but are not limited to, stock ownership, related research and consulting arrangements.

Now, while this is definitely a move in the right direction, I do have a problem. $49,000 is a lot of money to most people. Under these new rules, a researcher with $49,999 dollars worth of “financial interest” in the approval of a new drug would still be allowed to take part in the committee’s, even though they cannot participate in the final vote. This set up still has a distinctly rotten smell. Imagine a situation like this:

• Researcher A participates on the advisory committee of one drug, but because he has a conflict of interest, he cannot participate in the vote.
• Researcher B does not have financial interest, and therefore is a full, voting member of the committee.
• In another unrelated study, A does not have financial interest (and therefore can vote), but B has more than $50,000 worth of interest, and therefore cannot participate at all.

Maybe I am being pessimistic about the character or dedication to science of members of the FDA, but it seems to me that in this situation it would be profitable for both researchers A and B to help each other get the drugs in question approved for the public. I’m not even saying that committee members in a situation such as this would make an explicit, spoken deal with each other. What I am suggesting, however, is that, say, researcher B might skew the numbers or omit certain data, having a feeling that researcher A will be grateful and do the same for him.

I think that in order to really prevent corrupt influence on the trials of drugs, the FDA should use only doctors and researchers that do not have any financial interests in the marketing of any drugs at all. However, I’m not sure how feasible this is or how many doctors are even available that do not have these conflicts (anyone that has more information on this should post a comment).

The second problem is that the FDA itself has a conflict of interest once drugs are released to the public. Since they are the institutional that both approves the drugs in the first place, and also the ones that monitor their effectiveness or potential problems amongst the public, that have serious incentive to overlook early signs of danger once the drugs have hit the market. If a prescription that they approved turns out to be problematic or even life threatening to those taking it, it reflects very poorly on the FDA.

The drug Troglitazone, which was used to treat diabetes, was not pulled from US markets for three full years after it had been in the UK. This most definitely resulted in the injury or death of thousands of Americans (David Graham’s congressional testimony can be found here). The FDA was slow to react for fear of backlash.

The only useful solution to this very serious problem is to create an independent agency to follow a drug’s effect on the public after it has already been released. This group should have nothing to do with FDA so that if there is any sign that a drug should be recalled from the market, it can be done quickly and without concern over the FDA’s image. Many would resist the formation of an agency like this, especially proponents of small government at any cost. But in this case, I think it is vitally important.

Of course, there are other, even more insidious problems with the marketing of prescription drugs to the public. In 2004, the pharmaceutical industry spent more than 4 billion dollars for drug advertising. In addition to making drugs vastly more expensive for the patient, all this advertising has created a nation of hypochondriacs that are constantly self diagnosing themselves and then begging their doctors for the prescriptions they think that they need. But in many cases, they do not need them, and studies have found that most television ads don’t fully explain the risks associated with the drugs they are promoting. If you are going to convince people that they need a drug which they most likely do not, at least be completely honest and don’t mislead them as to the potential side effects. There are many groups that are speaking up and attempting to get prescription television ads banned entirely. If cigarettes can’t be advertised on television, and liquor is excluded from many times slots, why not limit or ban the marketing of often-dangerous drugs? This study nicely breaks down the misleading nature of prescription commercials. The following is a portion of the study’s abstract:

Most ads (82%) made some factual claims and made rational arguments (86%) for product use, but few described condition causes (26%), risk factors (26%), or prevalence (25%). Emotional appeals were almost universal (95%). No ads mentioned lifestyle change as an alternative to products, though some (19%) portrayed it as an adjunct to medication. Some ads (18%) portrayed lifestyle changes as insufficient for controlling a condition. The ads often framed medication use in terms of losing (58%) and regaining control (85%) over some aspect of life and as engendering social approval (78%). Products were frequently (58%) portrayed as a medical breakthrough. CONCLUSIONS Despite claims that ads serve an educational purpose, they provide limited information about the causes of a disease or who may be at risk; they show characters that have lost control over their social, emotional, or physical lives without the medication; and they minimize the value of health promotion through lifestyle changes. The ads have limited educational value and may oversell the benefits of drugs in ways that might conflict with promoting population health.

I’ve had the television on next to my desk as I work on this post. While I’ve written, I’ve been shown a total of 17 prescription commercials (note: some are the same ones repeated). I think I should go to the doctor now: I’m pretty sure that I have restless leg syndrome, anxiety, depression, high cholesterol and an enlarged prostate.

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I hear it over and over again, from political rallies to neighborhood bbq’s, “I just can’t support Hillary Clinton.”  This is customarily followed up by someone who is now instantly supporting her who makes the case for, “What’s not to like?  She was for universal health care in ‘94?”   And thus the divide is created and the several liberals convened have something to debate.  This is troubling to me, and I’m worried the Democrats aren’t worried enough about what’s happening in the party.

<! Kind of looks like a Fight Night poster!>

I want to first put in my own thoughts about Hillary.  First the positives, she has a long history of supporting progressive measures; most notably, her support for universal health care in the 90’s.  Since this time she has continued to support gay rights, a woman’s right to choose, stem cell research, combatting global warming, universal pre-K education, and a whole host of other domestic issues close to the hearts of Democrats.  In short, there is a reason she has been elected as Senator from New York twice, and it’s not just on name recognition.  I have jokingly said of Hillary that while she may not have the right stance now, once the majority of the party views things a certain way she will adapt her position to reflect that of the party.  The more I think about this statement, however, the more I think I’m being absolutly serious.

Hillary’s support for the war is one that is personally troubling for me.  That said, I honestly feel as though she has no choice in the matter and had to respond the way she did.  Here’s why:  Hillary is a woman playing in a man’s game.  She needs to everything in her power to not come off as weak or feminine, and there’s nothing more nurturing or motherly than not wanting Americans to die in a phony war, right?  Regardless of where she was personally on the matter, she had to vote the way she did on the war because of the political reality in this country facing women.  Namely, in order to play with the boys, Hillary had to support the boy’s war.  She is also responding to the fact that the Democrats are perceived as being more lax on terrorism than the Republicans, something I truly don’t understand.  Having a city attacked while someone was mayor does not make them an expert on terror.  Especially when more lives were lost to rescue workers working in horrendous conditions at ground zero then were lost in the actual attacks from the planes.  Oh, and the fact that Giuliani spent more time at Yankee stadium in September 2001 after 9/11 then he did at ground zero.  I’ll buy that he’s a Yankee expert, no question.

However,  the media and it’s right wing message paint Giuliani, Bush, and the Republican idiots running this country as if they were the foremost experts on terror.  Even though the average 20 year old history major could tell you more about the Middle East than the Decider could, this is the reality we live in.  Because of this, Hillary must come out as strong against terror to the point that she’s a downright hawk! As unfortunate as this is, it truly may be what is best for her campaign, only time will tell.

Many Democrats also feel as though the race is over, that Hillary is already going to get the nomination and that the other candidates are just wasting their time.  This brings me to my only fear about a Hillary canidacy: she’s worth voting against.  The religious right in this country, especially the evangelicals don’t have a clear candidate.  To be frank, no one on the Republican side comes close to the crazy required of him to get real support from evangelical voters.  You have to say stuff like, “God wants me to be President.”  However, if there’s one thing the religious right hates more than Roe v Wade its the Clinton’s and their adulterous liberal ways.  All jokes aside, I do think the Republicans could mobilize to the point that they aren’t voting for someone, as much as they are voting against Hillary.  In this regard, I think she’s the only candidate for the Dems that this is the case.  Is this enough to not give her the nomination?  I don’t know.

We often forget just how progressive Hillary is, because she tries not to show it.  She also comes off as not having a guiding philosophy.  By this I mean something like Hope from Barack Obama, Peace from Dennis Kucinich, the transformative power of the American Dream from Edwards.  However, I will make the case that Hillary does have a guiding philosophy that she can’t talk about because of the political consequences.  That philosophy is this:  what should she do as a woman?  Hillary has taken a progressive stance on nearly every social issue, why?  Because she has a deep ceded belief in human rights, civil rights, and the ability for government to make the lives of the people it represents better.  She is a politician to her core, but I do see a universal theme to her, something I didn’t see from Kerry in 2004 and something Gore kept hidden (Global Warming) in 2000.  There’s more to Hillary than many of us think, and more toughness than I think any of us will ever know.  And so my fellow liberal America bashers (wink at Bill O), take a long hard look at the issues and then decide just how anti-Hillary you are.  I think most will find, as I have, that she may just be the right person for the job, and the time has long passed that our nation’s highest office should be run by a woman.

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We’ve all seen the signs at this point… At least in the western half of this country. “Ron Paul Revolution!” The signs look more like some kind of underground punk band and not an advertisement for a Texan in a suit. Then again, the Ron Paul campaign is not involved in the “revolution” movement. Here is the sign, if you’ve not seen one yet:

Some on the left have applauded Ron Paul for some of his positions. I would like to echo these statements and add that the Democrats should be brave enough to stand up and say some of the things Dr. Paul has said. Here are some examples of what I’m talking about.

Ron Paul wants to get the US military out of Iraq, but he also wants to get the US military out of every foreign nation. I couldn’t agree with him more. We are wasting money keeping troops in Korea for 50 years, keeping troops in Europe for 60. Troops in those countries are not protecting our national security. And we do not have a mandate that says we must police the world. If anything the radical groups of the Middle East’s message has been clear: get out of the Middle East and Palestine. Rather than accept this we go on with the rhetoric of “they hate us for our freedom.” (Giuliani et al) What nonsense! It’s refreshing to hear anyone, let alone a Republican stand up and say we need our troops out of these countries.

Dr. Paul is also right when he says that the over-spending must stop. The idea that we are relying on China to finance a failed war that the majority of Americans do not support is frightening. How can that even be happening? The truth of the matter, as Paul would agree, is that this Republican administration has over spent in record amounts and have run the national deficit into the trillions. These are the people that are “financially conservative?” Please, Paul’s suggestion for spending is to return to the Clinton era.  Ironic no?

Paul loses me on a critical issue, however, and that is his idea of abolishing income tax and with it 1/3 of the government’s budget. While I detest the way this government spends money abroad, both Democrats and Republicans are guilty here, I can’t let the government’s funding wane. Rather, I want a government that is investing in the lives of the people it represents, rather than monetary interests from big party donors abroad. Rather than abolishing taxes we should be reinvesting. We are already paying enough money to pay for everyone in this country to have universal health care, free college educations, free pre-K programs, social security that provides for people to live above the poverty line, the list could go on.  We’re simply spending the money on failed efforts at Americanizing the world.

Ron Paul has some great ideas, and his forthrightness is refreshing. Perhaps the best compliment I can give him, though, is that I can actually fathom how a Republican could support Ron Paul. His thinking makes sense, he’s consistent, he actually has a plan to do something in this country domestically unlike the rest of his field who either want to make abortion illegal or continuing a failing war for the rest of our lives. So, my Republican friends, I applaud your support for Dr. Paul, and if you really like his ideas I recommend you take a look at http://www.dennis4president.com/. Kucinich has all the same stances on foreign policy issues and yet also wants to make life better for every American at home rather than asking Americans to put out their own fires, build their own roads and bridges, and home school their children.  Yes I know this isn’t part of Paul’s campaign speeches but these are the things that taxes fund.

Does this make me part of the Revolution?  I hope not, I think.

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President George W. Bush today in his press conference said,

“Congress has work to do on health care. Tomorrow Congress will hold a vote attempting to override my veto of the S-CHIP bill. It’s unlikely that that override vote will succeed, which Congress knew when they sent me the bill.”

The Decider speaks truth!

Hang on, they shouldn’t have sent him the bill because they knew the decider would reject it? That’s not the way legislation works. There’s no requirement that the President must be ok with any legislation that comes to his desk. Of course it is his constitutional right to veto legislation, but the idea that congress should stop making legislation based on the will of the people they represent because the President disagrees is laughable.

This President has such a narrow view of what our government should look like that he can’t accept the fact that congress, for the most part, is now speaking for the American people while he is not. George W. Bush is out of touch with the American people, my fear however, is that congress is as well. The President requested legislation for funding of the federal government, renewing No Child Left Behind, to rework the Foreign Intelligence Surveillance Act legislation so that his fascist tendencies can continue to be realized, and to update veteran’s affairs. Of course all of this must be read as, “Do what I ask you to, how I ask you to do it or I’m not signing anything.”

But back to the out of touch comment. The President said something that is actually a very poignant and accurate critique of congress. He said,

“With all these pressing responsibilities, one thing Congress should not be doing is sorting out the historical record of the Ottoman Empire. The resolution on the mass killings of Armenians beginning in 1915 is counterproductive….Congress has more important work to do than antagonizing a democratic ally in the Muslim world, especially one that is providing vital support for our military every day.”

I couldn’t agree more Mr. President. It is not worth the American people’s time for congress to be debating a genocide (or just a horrific mass murdering?) when we have a failing healthcare system and a failed war on our hands. We need to be representing people in this country through legislation, not deciding what the official stance is of the US government of an atrocity that happened nearly 100 years ago. I’m sorry, but there is far more relevant conversations that need to be happening in our nation’s capital. And on this point, George W. Bush is right.

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The New York Times ran a story today spotlighting the slow march away from abstinence only education. The article reported that birthrates in American teenagers has been steadily falling since 1991 but that the state of Texas has seen the smallest decline despite receiving the most money for abstinence only education. This, in a nutshell, explains the absolute absurdity of abstinence only education.

If a teenager wants to wait to have sex before they get married, great. Good for them, it’s nice to see the youth of America having principles and sticking to their guns when these principles are called into question. Why on earth, though, would we want our federal government to have a policy stipulating that kids can’t have a real sex education class (I would challenge anyone to show me how abstinence only education can actually be considered educational) in school? Let’s face it most kids don’t want to go to their parents to talk about sex and most parents feel equally as awkward having the birds and the bees talk with junior.

Kids aren’t going to decide to have sex simply because they know how to do it safely. That’s the biggest flaw in the AO argument. It’s as if AO proponents fear that by telling kids how STD’s are contracted and how to use a condom correctly or what other means of birth control are available the students will run out and start shacking-up as soon as class gets out. Have a little more faith in your kids America. If a child is staying abstinent for moral reasons then telling he or she how to put on a condom shouldn’t change that. However by not teaching a child who has no intent on saving it until marriage how to have safe sex you’re not only doing huge disservice to the child but you’re also burdening your community with undue healthcare and social service costs which will come from the unplanned and unwanted pregnancies. A condom is a lot cheaper than maternity care for an uninsured woman.

I have no problem with including an abstinence portion included in a more rounded sex education. After all, the only 100% surefire way not to contract a sexually transmitted disease or to get pregnant is by not having sex in the first place and teens should know that condoms don’t work every single time. This mentality that if we only talk about abstinence with our children then they won’t have sex before marriage (or before they’re ready) is ridiculous. We need to stop being a nation of ostriches in give teenagers the information they need in order to be healthy.

After all this is NOT a moral issue, it’s a health issue and the government needs to realize this.

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Former U.S. Surgeon General Richard Carmona, along with former Surgeons General C. Everett Koop and David Satcher, testified yesterday that he felt his four year tenure as SG was wasted. Carmona, and the others, said he felt immense political pressure from those in the Bush administration and had his reports censored. Carmona also said that he was not allowed to speak on issues such as “stem cells, emergency contraception, sex education, or prison, mental and global health issues”. That’s just fantastic isn’t it? I mean I know that whenever I go to a doctor and he or she tells me what’s wrong with my body I like to totally disregard what they say and tell them what I think and then follow that up by telling them that they’d better agree with me or else. I mean, medical school. What’s that about? What, do these doctors think that just because they put years and years of education into learning about the human body and diseases that they actually know more than I do?

President Bush is the most powerful man in the world so obviously that makes him the smartest. If he says that abstinence only education is the only proper method of sex ed then I for one believe him. It’s not like we need to have our heads clouded by all this medical information anyway. Carmona and others who complain about the Surgeon General being censored need to calm down. If Bush thinks he needs to overrule a medical professional then he probably has good reason to do so, look how well all his other decisions have turned out.

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As I’m sure you all know by now I had a piece on Sicko, the new film from Michael Moore, appear on our Blogging Network’s main page: Pajamas Media (PJM). You can read the article here. The comments on the article, however, are far more interesting than my little reaction piece.

PJM has a very noticeable slant in most articles and the vast majority of their blogroll are conservative sites. So, I guess it really shouldn’t surprise anyone that my blatant pro-Moore reaction piece to Sicko was so poorly received. Personally, I think it’s great that it got so many of their reader’s upset. My favorite comment was:

“For the reviewer to accept this movie uncritically only shows his ignorance, prejudice, mental laziness, and utter foolishness. The only debate here is why PJM gave him this forum. Perhaps it’s just so we could point and laugh and teach him a lesson. Personally, I’m not laughing. This review, like Moore, is a disgrace.”

The right only wants to read things that validate their own opinions. I suppose we on the left are guilty of this as well but how can there ever be real dialog if only one side of an issue is ever presented. What’s more, of the 39 comments now up in response to the article, the only ones that support my position are my own. Everyone else, even the two or so who said they were progressives, still either didn’t like Michael Moore or think socialized medicine is the worst thing ever. We are so partisan in this country that people can get all of their news from one sole view point and be contented. We no longer value a dissenting view point and our political dialog is lacking because of it.

I hope we see more articles up on PJM from writers on this site. It’s kind of hard to be the only voice of dissent in a forum like that but at least the position has been presented. And so far only one person has brought up my age as being a negative thing, which is nice.

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Michael Moore’s latest film Sicko opens in theaters on June 29th in the U.S. His film has been causing people on both the left and right to react, but this time it’s very different than his past films. Fox (Fake/Faux etc.) News called it “brilliant and uplifting” and said that Moore displays a new sense of maturity. I can’t believe I just linked to Fox Noise…

The film has had this effect on the crazy right wing folks at FOX because it hits on something that is above party politics. We are the only Western Industrialized country without universal health care. While we are the richest country on earth, our health care system ranks 37th, right ahead of Slovenia. We should be ashamed of ourselves for this, as the people of this country deserve better and yet our government, from both sides of the aisle, have done virtually nothing to solve our health care crises.

The greatest amount of controversy in Moore’s new film comes from a scene where he takes several September 11th rescue workers to Guantanamo Bay, Cuba for health care treatment as it is the only part of American soil that has universal health care. Basically, the terrorist suspects being held there have better health care than we do, when they’re not being tortured. The workers Moore takes in the film have been abandoned by their own country as the need to make money supersedes the will to help people.

I, like many my age, have elderly grandparents. They are in their 80’s and I have been very fortunate that they have been a huge presence in my life growing up. They take $2500 worth of medicine a month. Plus doctor’s fees, expenses for surgeries they’ve had, appointments after cancer treatments, the list goes on. They have Medicare but it doesn’t cover all of their cost and they pay a ton of money on what their insurance doesn’t cover. There are people making money on the fact that my grandparents are sick. There are people making money on cancer victims. No one can be so heartless as to think that that is right.

Let’s play a hypothetical, as I know the right loves these days. Let’s say an American pharmaceutical company receiving government funding finds the cure for cancer, and turns it into a pill. They used tax payers’ dollars to fund it, but now it’s their’s to sell and they can make all kinds of money on the sale of the pills. Of course, they could make them so expensive only the wealthiest of Americans could afford them. This is simply wrong, and it’s past time that America changes its ways in terms of how we care for our people.

We have fallen behind the rest of the world in health care as country after country (Costa Rica for example) pass us by in the world health care rankings. If we are truly the greatest country in the world, why not have the greatest health care in the world? Why have a system in which 40 million people are uninsured and do not get the medical coverage they deserve? People talk about being “pro-life” in this country. It’s more like “pro-fetus” because being truly pro-life would include the entirety of a person’s life.

I hope Moore’s new film will get the ball rolling faster towards real change on the health care front. You can watch a great interview with Moore and Bill Maher here.

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jama-table.ppt

In addition to my frustrations with how the American media beast portrays political issues, I am also frustrated with the negative impact of the media and corporations on how we live, especially as it relates to what we eat and our sedentary lifestyles.

I recently listened to a pod cast reviewing an editorial piece in the Journal of the American Medical Association (Jan. 3, 2007, vol. 297) “Law as a Tool to Facilitate Healthier Lifestyles and Prevent Obesity.” [The online version of JAMA is restricted to subscribers, but most colleges and universities should provide access to this journal through their library holdings. If you can’t get to the article visit fitnessrocks.org and listen to the ‘Short Run 5’ pod cast, Dr. Monte Ladner provides a great 15 minute review.]

Some interesting facts from the article:
• “Obesity could shorten the average lifespan of an entire generation by 2 to 5 years, which, if true, would result in the first reversal in life expectancy since data were collected in 1900.”
• While health choices and obesity is usually assumed to be a personal issue, it has a significant socioeconomic impact. In 2003, “obesity-attributable medical expenditures reached $75 billion in the US….taxpayers finance about half of all medical costs through Medicare and Medicaid, and employers cover most of the rest”
• “Nonwhite and poor individuals experience substantial disproportionate burdens from obesity, with poor diet and sedentary lifestyles contributing to socioeconomic disparities.”
• “The food industry spends more than $11 billion annually on advertising to children and adolescents…America’s youth is exposed to approximately 40,000 food advertisements annually, the vast majority of which are candy, cereal, and fast foods.”

The author goes on to describe 8 legal interventions, their public health benefits and arguments for and against each. (see the attachment - it’s a table outlining these as a PowerPoint slide).

Of course, this is not a new concept to the Europeans who just adopted the European Charter on Counteracting Obesity (www.euro.who.int/obesity). Denmark was the first country to regulate trans fat in foods – America is implementing restrictions on trans fat foods served in restaurants as of July 2007.

I’m really putting this out there to generate dialogue… Is the food you put in your mouth a personal responsibility/right? While obesity is supposedly a “self-imposed” condition are the socio-economic implications worthy of government intervention?

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