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Guest Post: Predatory Pharma – An End to Too Big to Nail?

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By a retired physician who worked several years in the medical communications and pharmaceutical industry who writes as Francois T

Is the federal government really ready to punish those responsible of corporate malfeasance in the pharmaceutical industry?

Push hard enough and you are bound to get a push back, even from a slow, at times dimwitted, sluggish, but mighty juggernaut like the federal government.

According to Fortune, this is the plight that could await executives at pharmaceutical companies. The Feds are, ahem, fed up, and ready to strike back.

The federal government is fed up with the amount of fraud, especially recurring fraud from the same companies, happening in the pharmaceutical industry. Therefore, regulators have decided that when it comes to punishments, it is time to get personal.

From now on, individual executives risk being ejected from their jobs — and perhaps even barred from the industry — for fraud their companies commit, even if they did not participate or even know about the crimes.

All that’s required for the government to flex this remarkably broad authority — embedded in the Responsible Corporate Officers Doctrine — is that the executives were in a position to have stopped the fraud that resulted in a criminal conviction or plea.

The new approach, emerging from the unusually powerful Inspector General’s office in the Department of Health and Human Services, reflects frustration with corporate recidivism even in the face of ramped-up fines, penalties and disgorgements.

FT here: Corporate recidivism? If this sounds bad, it is, and then some. Scroll through this extensive series of cases to get an idea of the magnitude of the problem, as well as some rather juicy details.

One could reasonably ask why wouldn’t federal prosecutors sue and get a conviction of the corporation in court. Alas, there are rather thorny legal and practical problems involving a serial recidivist:

…when it came to prosecuting Pfizer for its fraudulent marketing, (of Bextra, Pfizer’s answer to Vioxx) the pharmaceutical giant had a trump card: Just as the giant banks on Wall Street were deemed too big to fail, Pfizer was considered too big to nail.

Why? Because any company convicted of a major health care fraud is automatically excluded from Medicare and Medicaid. Convicting Pfizer on Bextra would prevent the company from billing federal health programs for any of its products. It would be a corporate death sentence.

Prosecutors said that excluding Pfizer would most likely lead to Pfizer’s collapse, with collateral consequences: disrupting the flow of Pfizer products to Medicare and Medicaid recipients, causing the loss of jobs including those of Pfizer employees who were not involved in the fraud, and causing significant losses for Pfizer shareholders.

“We have to ask whether by excluding the company [from Medicare and Medicaid], are we harming our patients,” said Lewis Morris of the Department of Health and Human Services.

So, Pfizer and the feds cut a deal. Instead of charging Pfizer with a crime, prosecutors would charge a Pfizer subsidiary, Pharmacia & Upjohn Co. Inc.

Quite a conundrum, isn’t it? Convicting the corporation can be very disruptive to innocent third parties, most especially patients and innocent employees; yet, ever-increasing fines, penalties and disgorgements are ineffective to change behavior. However, the monetary penalty strategy has been the modus operandi of the feds for a long time. So, what could explain the change among the HHS honchos?

There were two likely catalysts at play here. First, the “in-your-face” behavior of pharmaceutical companies is getting beyond outrageous. As per the Fortune story:

In the government’s most recent major settlement — in which AstraZeneca agreed to pay $520 million — the fine represented 16.5% of the $8.6 billion income (between 2001-2006) from U.S. sales of Seroquel, a powerful anti-psychotic. AstraZeneca turned this narrowly approved drug into a cash cow by marketing it for much wider use, including by the elderly and children, even though they are particularly vulnerable to “serious and debilitating side effects.”

A personal story: a teenaged relative was put on Seroquel. The poor kid gained 50 pounds (!!) in 2 months, had trouble waking up during the morning, and couldn’t focus in class while mercilessly taunted by the other students. His distraught parents finally called me and I sent them straight to the pediatrician. He was pre-diabetic (at 15 y/o) with a disastrous lipid profile. Needless to say AZ brass were well aware of these kind of side effects, yet, they tailored their marketing to minimize, when not withholding entire studies that were unfavorable to their product.

This took place while AstraZeneca was operating under a corporate integrity agreement (CIA) with the Inspector General, imposed after a 2003 off-label marketing case.

To get a true measure of the chutzpah on display here, consider this; the OIG had an office within Astra-Zeneca headquarters where OIG employees were in charge of the monitoring compliance of the agreement. The people from AZ I interacted with at the time, were very aware of that and toed the line. No one wanted to be caught in the vise grip of the OIG people.

Yet, the higher-ups felt so far above the unwashed masses that they were busy calculating the business cost (to their shareholders, of course, not themselves) of violating the law once again.

Please note that the AZ case falls under the “suitable for all audiences” label. For those connoisseurs who truly appreciate the hard-core stuff, (fatalities included) take a look (deep bow of appreciation to Dr. Roy M. Poses at Healthcare Renewal blog) at this saga (several links at post) and its sequel. The short of it is that Boston Scientific and its subsidiary Guidant Corp. kept selling potentially defective implantable cardiac defibrillators (the type that is surgically placed in the thorax) despite being cognizant of the problems for several years. The way prosecutors handled the settlement is the sequel, and it gives moral depravity a bad name. Even though prosecutors specifically stated in the complaint that Guidant had knowingly sold potentially flawed defibrillators, the plea agreement only contained a guilty plea for two misdemeanor chargesregarding the completeness and accuracy of its filings with the Food and Drug Administration! Fortunately, the judge assigned to monitor the settlement refused to approve it.

The second likely catalyst is more fundamental in nature. If calls to honor, pride or moral rectitude fails, try shame. What the officials at the Health and Human Services would not do to a pharmaceutical executive, the SEC did in a recent case involving Sequenom Corp. A former senior executive, Elizabeth Dragon manipulated data to make a Down syndrome test sold by the company “appear more accurate than it was”. The SEC also accused her of lying to investors. A as result, she is barred from serving as an officer or director of a public company.

Can the contrast between the Sequenom and Boston Scientific cases be starker? A former senior vice president of research and development is excluded from the pharmaceutical industry (by the SEC, not HHS) for lying to investors about a diagnostic test, while no one at Boston Scientific or Guidant has received civil, let alone criminal charges for knowingly selling defective cardiac defibrillators that can (and did!) cost lives. Compromising wealth get harsher punishment than compromising health? How could the enforcers at HHS explain this one to the family of the victims (or their bosses) without utter embarrassment?

Between getting sick and tired of the rank insolence of the executives, the blatant inadequacy of their settlements to curb bad behavior (let’s not forget the Obama administration commitment to deter health care fraud — yes! they’re serious about that.), it is fair to venture that the feds have had enough:

“We are going to start to use that authority in the appropriate circumstances to get high level executives out of companies, so that the company has a better shot at changing its behavior, so that it does not become a recidivist,” explains Lewis Morris, chief counsel to the Inspector General.

“It’s our expectation that in the next several months you will begin to see the fruits of that new strategy,” he adds. His targets include anyone going on corporate retreats, from VP of sales up to and including CEOs.

It remains to be seen if said bureaucrats will have the cojones to follow through while resisting the pressure that is sure to come from some corners of Capitol Hill. Even more speculative is the thought that this “get tough” attitude could spread across the different regulating agencies of the federal government. It sure would be a welcome change that we could believe in.

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32 comments

  1. attempter

    If anything, the worst stories aren’t only suitable for all audiences but should be required. (Don’t get me started on what Marlowe says at the end of Heart of Darkness.)

    The Feds are, ahem, fed up, and ready to strike back.

    The federal government is fed up with the amount of fraud, especially recurring fraud from the same companies, happening in the pharmaceutical industry. Therefore, regulators have decided that when it comes to punishments, it is time to get personal.

    They certainly must have had a change of heart indeed if those are the same feds who, at the beginning of the Bailout, even as their whole propaganda blitz was that they were doing it all for Main Street, they were at the same moment encouraging the banks to broker Big Drug M&As which would serve no real economic purpose but destroy thousands of jobs.

    All that’s required for the government to flex this remarkably broad authority — embedded in the Responsible Corporate Officers Doctrine — is that the executives were in a position to have stopped the fraud that resulted in a criminal conviction or plea.

    Well, the government almost always already has all the “authority” it needs. What’s really required is the willingness to use it. That, of course, is what’s lacking. The government has abdicated. That’s why it no longer has any true authority, but only power, as the people should recognize.

    …when it came to prosecuting Pfizer for its fraudulent marketing, (of Bextra, Pfizer’s answer to Vioxx) the pharmaceutical giant had a trump card: Just as the giant banks on Wall Street were deemed too big to fail, Pfizer was considered too big to nail.

    Why? Because any company convicted of a major health care fraud is automatically excluded from Medicare and Medicaid. Convicting Pfizer on Bextra would prevent the company from billing federal health programs for any of its products. It would be a corporate death sentence.

    They sure have things wrapped up in a nice little extortion-racket package, don’t they. Same with pensions invested in the stock market.

    The unfortunate fact is that until the people are willing to undergo “blood, sweat, and tears” for the short run, as Taleb called for, by smashing and breaking free of the protection rackets once and for all, whatever the short-term disruptions, they’ll forever be slaves.

    Ironically, as the crash, mass unemployment, the incipient Second Great Depression, and the “austerity” auto da fe are demonstrating, the long term blood, sweat, and tears will be vastly worse if we don’t smash them.

  2. i on the ball patriot

    Ha! Ha! Ha!
    Ha! Ha! Ha! Ha!
    Ha! Ha! Ha! Ha! Ha! Ha! Ha!…

    The corrupt Feds — the bought and paid for Feds — the creator of the scam rule of law Feds — are fed up with its bread and butter fraud in the pharmaceutical industry?

    Surely you jest?

    What you read as the Feds regulators being fed up and deciding to “get personal” is just a variant justification of the intimidation of selective enforcement in a brand new PR suit. The corporations own the scam rule of law. Under the guise of righteousness and too big to fail they now use the Feds regulators to chew each other up and do a little PR for the corrupt Feds on the side. Is that the smell of Lehman in the air?

    Too big to fail should be called, “Gotcha by the balls!” Its economic fraud with the economic ransom of innocents.

    But keep banging your head against that wall of hope, and faith, and ‘change you can believe in’, in crooked government, its going to feel great when you stop!

    Election boycotts as a ‘vote of no confidence’ in this crooked government are in order.

    No balls! No brains! No freedom!

    Deception is the strongest political force on the planet

    1. Francois T

      What you read as the Feds regulators being fed up and deciding to “get personal” is just a variant justification of the intimidation of selective enforcement in a brand new PR suit.

      You’re assuming the Fed regulators harbor the same level of cynicism and sociopathy than those who inhabit the corner office. I have my doubts about that. The simple fact is…they don’t have a choice, because something much bigger is at stake here.

      I mention the manipulation and withholding of data/studies. This practice has become generalized in the industry. Let’s also remember the industry fund around 70% of all medical drug research in the US, the other 30% being government funded. This is a complete reversal of the situation prevailing until 1980. Finally, research results get published into medical journals. Which begs the question: How reliable is the published research?

      Without delving into the details of this complex topic, one has to wonder how much trust readers of a medical journal can put into what is in front on them.

      Should the answer become a generalized “Not much”, then you don’t have meaningful pharmaceutical/medical research anymore. With a health care sector that is 16% of our total economy, the potential implications are obvious.

      1. David C.

        Dr. T, I read different conclusions regarding the value of state-run or funded research. Currently it is impossible to get funding to research hypotheses that challenge current orthodoxy in AIDS and, until quite recently, cancer. These are but two examples of what happens when science is co-opted by politics, and politics is synonymous with government these days.

        1. Francois T

          Oh! Hypotheses that challenge current orthodoxy always had troubles getting funds. That’s human nature for ya. Some researchers are very attached to their theories. Even some articles are refused publication for motives that have nothing to do with legitimate scientific disagreements.

          As for the politics of it, the US government is playing with napalm fire. More and more research projects are directly funded by –are you ready for this? — congressional earmarks!

          http://www.the-scientist.com/2010/6/1/32/1/

          I don’t think it is necessary to elaborate ad vitam aeternam about the sheer idiocy of this process. If a pair of trial lawyers were responsible for the Andrew Wakefield’s “autism is caused by vaccines saga” by funding his “research”, imagine politically motivehatred congress critters diverting millions upon millions of precious research dollars on the effects of video games, abstinence, naturopathy, reflexofuckology and what have you.

      2. i on the ball patriot

        Francois T says: “You’re assuming the Fed regulators harbor the same level of cynicism and sociopathy than those who inhabit the corner office. I have my doubts about that. The simple fact is…they don’t have a choice, because something much bigger is at stake here.”

        No. I’m assuming they are as pliable and subject to intimidation themselves as all law enforcement personnel are by their sociopath controllers. It goes beyond simple peer and paycheck pressure with a well publicized program of intimidation of those who dare speak out and make waves. Something much bigger IS at stake here …

        ht.://www.google.com/webhp?rls=ig#rls=ig&hl=en&source=hp&q=fate+of+whistleblowers&aq=f&aqi=&aql=&oq=&gs_rfai=ClVss-xcQTPXdApuIzQSkqOHgBgAAAKoEBU_QHLNd&fp=b8a3d25e1efe4b25

        Put me a few notches below your generalized “Not much” category when it comes to trust in government.

        As for medical journals and their veracity, this parallels the hijacking of the government. The perniciously greedy have rained on the vanilla greed parade and destroyed the playing field.

        In my viewpoint it all comes back to a now totally corrupt government that is non responsive to the will of the people. We have unfettered cannibalism everywhere you look.

        Deception is the strongest political force on the planet.

  3. Vinny

    Seeing the mess this president made of his so-called health care reform, I’m not holding my breath that he would stand up to the too big to nail pharma criminals.

    Regrettably, the abuse of the American people at the hands of gangster banks and insurance companies, a murderous drug industry, a beyond corrupt medical system, and an illegitimate government, will continue… Until the people will have enough, bring out the guillotines, and take care of business, at last.

    Vinny

  4. Debra

    I seem to remember a book that came out in the States at least five years ago about the medicalization of the human condition. With reference to the DSM diagnostic tool, and prescription oriented psychiatry. No link, I’ve got a hole in my head, and I’m lazy, but the book made a stir.
    I tend to be the kind of person who thinks that making a difference means traveling as far as possible UP the chain of events/causes to see where things need to be taken care of…
    The U.S. (and Western Europe..) are made up of pill popping consumers who believe that those pills handed out by the medical establishment are going to solve ALL their “problems”. (Or who would desperately like to believe this, at any rate…)
    And that all their “problems” can be interpreted in terms of the normalcy vs sickness paradigm.
    Those beliefs.. cost a lot of money, and they GENERATE a lot of business on an INDUSTRIAL scale.
    The industrial paradigm induces a major loss of consciousness of individual RESPONSIBILITY at all levels.
    You wanna have your cake ? You can’t eat it too.
    I know I keep hammering away at this but… regulation, prosecution and punishment only serve to camouflage the roots of this problem.
    They do not take care of the problem itself.
    Which is… the WAY we are doing business these days.
    Nothing short of that, my friends.

    1. Francois T

      There is a very good serie of video modules about the practices of the pharmaceutical industry here:

      http://www.perxinfo.org/perx/educationalModules.html

      One of these modules discuss the topic of medicalization of ordinary conditions, the so-called “disease creation” (Generalized Anxiety Disorder, GERD, Excessive Daytime Sleepiness, Restless Leg Syndrome for example) by the industry.

      Be sure to listen to NPR’s fantastic piece about osteopenia and bone density here:
      http://www.npr.org/templates/story/story.php?storyId=121609815

      and “Selling Sickness” here:
      http://www.npr.org/templates/story/story.php?storyId=113675737&ps=rs

  5. Petri Dish

    Decent, effective medical care is a BENEFIT of a vibrant economy. It cannot BE the economy, because if it is, what is the product? Human life is the product and, while this may sound harsh, human life is not in high demand right now–we have more than we need.

    Americans have unquestioningly accepted the idea that healthcare is a “business.” Why do they express such shock that fiduciary responsibility of corporations takes precedence over ethical healthcare?

    If medical treatment can be withheld for lack of money, and that practice is not only accepted but endorsed as the miracle of the “free market,” what’s wrong with a few defective devices or devastatingly harmful drugs? Think toys with lead paint, Chinese drywall or Toyota.

  6. Paul Tioxon

    Well, better late than never. Although some particular pharma problems are self limiting. Take the former Rorer Pharmaceutical Company, which during the 1970′s produced a cash cow call the Quallude. One of the most easily available and cheap pills you would ever find, with no real known medical demand, other than in college dorms and Discos, aka Disco Biscuits, and never found until near its fall in popularity in any other form than the high grade FDA approved lab manufactured quality, directly from Rorer. Of course, it was prescribed in amounts that can only be described as tonnage and redistributed for about 50 cents retail. James Mills, in his classic study of DEA enforcement, “THE UNDERGROUND EMPIRE” mentions the 2 Senators who were waiting to cut down any Department of Justice move against Rorer, a perfectly respectable business, later sold to Rhone Poulenc, then Aventis, then well you know how that goes. It was very hard to stop what was widely known to be a legally produced but massively abused drug, that while it’s illegal distribution could not be blamed on Rorer, if they stopped making it, no medical harm would be befall the public, only the gusher of profits generated from the enormous demand through its narcotic dealer channels. Now of course, expanded demand can be fabricated along with new diseases and marketed to the public through the redefinition of maladies into the proper channels, the paid for doctor/promoters. Another example of goosed economic expansion due to deregulation and letting the market do what it does best, when allowed to push product unimpeded.

  7. Timmy

    about pharma.

    1. This sector is in urgent need to be reformed. It’s dangerous for public safety.

    2. We have reached a technological level that a) all bacterial disease are largely curable. b) within next decade we will cure majority of viral disease After that, what’s left is difficult problem like cancer or psychological, etc. The advance are primarily due to genetic technology. Whereby we start cataloging more and more, plus understanding how those little critter do their damage)

    3. This means, only ONE discovery/medicine is need to eliminate one disease. Once problem is solved. That’s it. The rest is simply marketing, distribution, manufacturing. These are the markup, the actual physical cost is very small.

    4. You cannot operate a business where after spending 80% of cost, suddenly the product will destroy 95% of potential market within very short time.

    This is why “flu vaccine” + government propaganda/public scare is so profitable.

    You can’t make large sums of money curing polio, TB, etc. It’s one time deal.

    5. India has some of the best fine chemical manufacture in the world. (read: pharma manufacturing without the overhead) they have 100:1 cost advantage.

    ——–

    You can’t run business like that…
    So in this time of great technological change, pharmas are defending itself with a lot of dirty tricks that has nothing to do with actually curing disease.

    There is no money in curing disease, they are in the business of selling product. Their business model is 18th century merchandising, not 21st century medical achievement.

    1. Petri Dish

      EXACTLY. Curing a disease destroys the customer base. The holy grail for drug pushers (and the rest of the medical- industrial complex) is MAINTENANCE of the disease(repeat customers) and increasing the number of diagnoses (customer base) through earlier detection (pre-conditions) and periodic redefinition of the condition to include more individuals. (Redefinition of high BP, for example, from 120/80 to 100/70.)

      Disease equals profits, health equals the destruction of corporate medicine.

      Remind you of any other industry? Military-industrial, perhaps, where peace equals corporate death?

      1. LAS

        “Curing a disease destroys the customer base.”
        Not the way it’s played, no. Rather it creates a new customer base for the side effects from the first drug. Drug consumers are driven to cure side effects by taking a second and third drug. For example, ever notice how people taking 1 or 2 drugs also get prescribed Nexium and some kind of “anti-anxiety” medication? Whereas hitherto there was no need of Nexium or “anti-anxiety” meds. By the time people are consuming 3 to 4 drugs, they lose track of what causes an undesireable sensation; it can’t be isolated and they’re captive to a regime.

      2. Dirk

        Reminds me of the Mr. Boffo comic. The patient is sitting on examination table in the MD’s office. The MD says to him: “Don’t expect any quick cures. I’m in this for the long run.”

    2. Vinny

      “We have reached a technological level that a) all bacterial disease are largely curable. b) within next decade we will cure majority of viral disease After that, what’s left is difficult problem like cancer or psychological, etc. The advance are primarily due to genetic technology. Whereby we start cataloging more and more, plus understanding how those little critter do their damage)”

      Actually, the opposite is true. Genetic drugs have produced true miracles for things like cancer (i.e., Rituximab, ipilimumab, etc). As far as bacteria and viruses go, we are sorely losing the war. Most antibiotics barely work anymore, we really have no defense against most viruses (except our own immune system), and formerly “eliminated” microorganisms (i.e., TB) are now coming back with a vengeance and we are simply helpless against them.

      May God help us against these viruses and germs.

      Vinny

      1. Timmy

        antibiotic is low tech. It’s enzyme and peptide. Very hard to do but will make today’s antibiotic as effective as candy.

        The recent gain of knowledge is huge, compared to cancer.

        http://www.sciencedaily.com/releases/2009/08/090827131830.htm

        Researchers at Burnham Institute for Medical Research (Burnham), University of Texas Southwestern Medical Center and University of Maryland have demonstrated that an enzyme that is essential to many bacteria can be targeted to kill dangerous pathogens. In addition, investigators discovered chemical compounds that can inhibit this enzyme and suppress the growth of pathogenic bacteria. These findings are essential to develop new broad-spectrum antibacterial agents to overcome multidrug resistance.

        http://www.sciencedaily.com/releases/2010/05/100527170957.htm

        http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VS2-4D8W0WV-4&_user=10&_coverDate=10%2F01%2F2004&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=79fc681b8176d33ade4396bd41f99662

      2. David C.

        Vinny, really?
        “Actually, the opposite is true. Genetic drugs have produced true miracles for things like cancer (i.e., Rituximab, ipilimumab, etc). As far as bacteria and viruses go, we are sorely losing the war. Most antibiotics barely work anymore, we really have no defense against most viruses (except our own immune system), and formerly “eliminated” microorganisms (i.e., TB) are now coming back with a vengeance and we are simply helpless against them.”

        Helpless? If I venture over to the CDC’s MMWR stats I’m not finding a huge surge in pneumonia deaths (nor of infections with TB). Most antibiotics work just fine, and much of the hype about a “post-antibiotic era” are just that. I am in a position to know, and to know where to look for actual data.

        Bacterial resistance is primarily a concern for the very old, the very young and the immunocompromised. Simply observing good hygiene and staying the hell away from hospitals is a good idea. After all, most docs don’t even know the story of Ignaz Semmelweis.

        1. Francois T

          “Bacterial resistance is primarily a concern for the very old, the very young and the immunocompromised.”

          I would add “for now” at the end of your statement. I don’t think we can allow ourselves to get complacent.

          For instance, I find the rise of extreme resistance MRSA and Acetynobacter Baumanii rather disturbing. Furthermore, the ease of international travel from and to countries with less than optimal epidemiological monitoring isn’t reassuring.

          We sure got to be on our toes when it comes to bacteria and viruses. They were here before us and they’ll be here after we’re history.

  8. sherparick1

    The post seems to confirm the thesis of this article on “Alternet:”

    “….In my humble opinion, it’s the sociopath part.

    CEOs of community-based businesses are typically responsive to their communities and decent people. But the CEOs of most of the world’s largest corporations daily make decisions that destroy the lives of many other human beings.

    Only about 1 to 3 percent of us are sociopaths — people who don’t have normal human feelings and can easily go to sleep at night after having done horrific things. And of that 1 percent of sociopaths, there’s probably only a fraction of a percent with a college education. And of that tiny fraction, there’s an even tinier fraction that understands how business works, particularly within any specific industry.

    Thus there is such a shortage of people who can run modern monopolistic, destructive corporations that stockholders have to pay millions to get them to work. And being sociopaths, they gladly take the money without any thought to its social consequences.

    Today’s modern transnational corporate CEOs — who live in a private-jet-and-limousine world entirely apart from the rest of us — are remnants from the times of kings, queens, and lords. They reflect the dysfunctional cultural (and Calvinist/Darwinian) belief that wealth is proof of goodness, and that that goodness then justifies taking more of the wealth….”

    http://www.alternet.org/economy/141615/it's_not_hard_to_be_a_job-slashing,_pension-grabbing_ceo_–_if_you're_a_sociopath/?page=entire

    1. NOTaREALmerican

      I think this is sampling bias. Liberal intellectuals tend to underestimate “badness” in humans because they hang around with each other and test each other. In bucolic college towns it’s really hard to find conservatives and libertarians.

      However, based on my experience with driving on the freeway I’d put the number closer to 80%.

      1. anonymous

        Evolution has shaped humans to be centered on family and friends, seeing everything else in the universe — including other people — as an external resource to be used and abused. The problem as I see it is finding ways for technology to bring us all together. Otherwise I think humans will destroy themselves, along with most of the ecosystem — an event that will be recorded as just another layer of geology and oil deposits.

        The technology that will be developed in the 21st century will make MAD appear sane in comparison: molecular nanotechnology (e.g. the ability to disassemble a target, molecule by molecule); genetic engineering (e.g. the ability to target a deadly virus on a specific genotype linked largely to one ethnic group); self-replicating armies of robots with artificial intelligence (Despite all the cautionary tales, nothing seems to stop engineers. Maybe they think that no one would ever be dumb enough to put it all together in one unstoppable killing machine… yeah right); or the obvious next step of weaponized space platforms with high-powered lasers and missiles that can track and kill a single human target with deadly accuracy at the push of a button (combined with military robots there’s no need for a complicated conspiracy with potential whistle blowers and politics; it’s just one man — perhaps a hacker — and one button and legions of machines that act without conscience).

        What makes these technologies worse than the mutually assured destruction of nuclear weapons is people will actually use them, including small bands of terrorists and even individuals. This will ramp up a Red Queen arms race with increasingly destructive technology and repressive regimes until possibly something like the “grey goo” apocalypse becomes inevitable.

        This is the never-ending “war on terror” served up by the combination of advanced technology with primitive, selfish human egos and ignorance. Something has to give. Either we revert to primitivism or commit to a program of social and cultural evolution that brings our hearts and minds up to date with our technology. We can’t embrace evolution half-heartedly. If we want to wield the power of gods, we need to develop the conscience of angels, or else we’ll be damned by our own creations.

  9. Vinny

    This is in response to Debra’s post, but I thought others may be interested in this information as well.

    There were a number of books written on that topic. A few popular ones:

    Crazy: A Father’s Search Through America’s Mental Health Madness, ISBN: 0425213897
    Prozac Nation, ISBN: 1573229628
    Crazy in America: The Hidden Tragedy of Our Criminalized Mentally Ill, ISBN: 0786717459

    I worked as a shrink in various capacities, for the VA, the US DoJ, hospitals, clinics, and have been a psychology/psychiatry professor for many years. What is happening in the US with psychotropic medication is one of the greatest tragedies of our time, and it is entirely driven by profits. Not only these mental drugs do not work well or not at all, but the side effects of many are horrendous (and often permanent). Many of the conditions these drugs are administered for are psychological/developmental in nature, and could only be adequately resolved through (often long-term) psychotherapy, not medication. However, the (hidden) alliance between psychiatry, drug companies, and insurance companies makes that nearly impossible.

    Regarding the role of government in this, what is shocking is that over 30% of inmates in federal and state prisons are on some kind of (usually non-generic, thus expensive) psychotropic meds. Most of these people do not really need it, but it is encouraged/forced down from political levels. So, the federal and state governments have become little more than pill pushers for these criminal drug companies. And, in case you are wondering, yes, this is paid for by our taxes. It’s big business, my friends.

    Now, as far as that dreaded DSM, it is a diagnostic book designed primarily to make it easy to administer medication, not to accurately diagnose and treat a condition. If a certain medication does not work, just tweak the diagnosis a bit, and try another drug. Yes, unbelievably, most psychiatrists are so incompetent as diagnostiticians, they actually base their diagnosis on whether a drug works or not. Unbelievable!

    The DSM is now in version 4 (with revisions). Beware that version 5, which is due soon is going to prey on our children. The plan is to bring many conditions now reserved for adults to adolescents and children. Yes, they plan to diagnose your young kids with Bipolar Disorder I and put them on lithium. Or they plan to diagnose your children with schizophrenia, or schizoaffective disorder.

    Finally, keep in mind that the DSM is the creation of the American Psychiatric Association, and psychiatry is by far the most compromised branch of medicine, doomed to disappear in a few decades. The incompetence and arrogance of most psychiatrists is simply mind-boggling, as most think they can accurately diagnose your kid after a 5 minute observation, and then put him or her on some hard core medication. Ridiculous!

    Vinny

    1. Francois T

      Since you know the mental health care field, you will be interested to read this:

      http://brodyhooked.blogspot.com/2010/05/whitakers-anatomy-of-epidemic.html

      Thought provoking, to say the least. Here’s a sample:

      Whitaker starts off with an epidemiological question. If you go back about 60 years, you discover that relatively few people in the US were diagnosed with mental illness, and that they often recovered and went back to leading normal lives in the vast majority of cases. A tiny percentage made up the chronically mentally ill that were warehoused in state hospitals. Then came the psychopharmacology revolution and the discovery of all the modern classes of psychotropic drugs. We have been told that these drugs revolutionized psychiatry and allowed those “warehoused” people to come out of the hospital and into the community. But when we look at the numbers we see a surprising thing. Not only are many more times the old number of people being diagnosed today with mental illness, but their long term prognosis seems to be abysmal, with a great many ending up on disability. If these new drugs do such a great job, how come we have so many more mentally ill and they do so much worse?

      Whitaker then offers an answer, in terms of both basic biological mechanisms and actual patient outcome data. The mechanism answer is a great embarrassment to me personally because I never thought of it, despite having had what I thought was a good biology education in college and even writing papers about systems biology. The standard psychiatric theory, which seems correct, says that the new drugs alter the levels of neurotransmitters in the synapses between brain cells. Anyone with an ounce of knowledge of biology ought then to ask–and what happens next? Just about the fourth or fifth word we learned in biology class is homeostasis. If something comes along from the outside and disrupts any body system, the body almost always has a built-in regulator that seeks to restore the prior state of balance. And indeed, Whitaker tells us, scientists who have gone looking have found the homeostatic responses to these drugs. If the drug results in(say) an increase in dopamine in the synapse, the brain down-regulates its dopamine system, by putting out less dopamine from the first neuron, or by shutting down some of the dopamine receptor sites in the second neuron. In short, the drug, that was supposed to be correcting a disorder (which was actually not the cause of any mental illness anyway according to the best current evidence) has actually now induced a brain disorder.

      1. Vinny

        Indeed, this is very true. What this actually does is create permanent customers for these drugs. Not only that, but if the patient attempts to get off of a certain drug, often the disorder returns but with much worse symptoms. So, it plays right into the hands of these drug pushers. Sometimes, people resort to illegal drugs to self-medicate a mental condition, thus risking prison or other legal and lifestyle problems. And, by the way, these prescription mental drugs are also very common illicit drugs sold on the streets. It’s a very bad cycle that only the drug companies are profiting from.

        What I observed in my clinical work is that changing the patient’s environment would usually alleviate the mental illness. But of course, if you send the person back to the same crazy family or the same nasty neighborhood in South Chicago, guess what — their symptoms will remain.

        Psychotropic meds are big, big business in America. We really need a revolution in this country to get these vampires off of our jugular. The guillotines would be busy for many, many years.

        Vinny

        1. Francois T

          Psychotropic meds are big, big business in America.

          Big business in expansion mode

          http://www.reuters.com/article/idUSN1924289520100519?type=marketsNews

          By Bill Berkrot

          NEW YORK, May 19 (Reuters) – Children were the leading growth demographic for the pharmaceutical industry in 2009, with the increase of prescription drug use among youngsters nearly four times higher than in the overall population, according to a report by Medco Health Solutions Inc (MHS.N).

          More than one in four insured children in the United States and nearly 30 percent of adolescents aged 10 to 19 took at least one prescription medicine to treat a chronic condition in 2009, according to an analysis of pediatric medication use conducted as part of Medco’s drug trend study issued on Wednesday.

          [...]

          “Looking at children was the real shocker for us,” Dr Robert Epstein, Medco’s chief medical officer, said on a conference call from Medco’s drug trend symposium in Orlando, Florida.

          Over the past nine years, the most substantial increases in the medicating of children were seen in drugs for conditions not typically associated with them, such as for type 2 diabetes and antipsychotics, Medco said.

          There will come a time when we shall have to ask ourselves this very uncomfortable question: “What are we doing to our kids?”

          Unless some blithering idiot wants us to believe the kids did it to themselves…

    2. NOTaREALmerican

      Wow, can’t wait for the Great American centralize health-care system to get rolling with this one. As usual, liberals never get what they want or need.

      However, I’m sure making the government bigger will be a proposed solution.

      1. Francois T

        If you want to reduce this problem to a liberal v conservative issue, there are tons of blogs who specialized in that kind of BS.

        NC isn’t one of those.

    3. David C.

      Psychiatry, by some views, does not exist but as an arm of the state.
      http://www.bigeye.com/szasz.htm

      In this light, taking behaviors and terming them diseases meriting chemical treatment takes on a whole new light, as does the partnership between the People Controllers staffing the state and the folks staffing drug companies that produce behavior-modifying pills.

      There are already those who claim that various attitudes toward government, vaccines, and certain public policies constitute a form of mental illness in need of “Treatment.”

  10. Debra

    In my home town, we just scored a temporary victory over the politicians/businesses in power that wanted to build YET ANOTHER freeway loop and tunnel to speed up bypassing the town center…
    Yeah, this starts out off topic, but I’m working towards the topic, don’t worry…
    They got a lot of flack from the green associations who are very informed about public transport, and car transport too.
    The associations remarked that… when you build one of those new freeway loops to divert traffic to fluidify it, invariably within a very short time, IT TOO is as congested as all the other transportation arteries…
    Moral of story : we tend to invent things, and THEN look for applications for them, or ways to justify them. Also… demand does not create supply, supply creates demand. In many instances.
    This is true, to a certain extent (not totally) for the psychotropic drugs. (In all fairness, at the beginning they liberated the truly mentally ill patients from straitjackets, and chains, which is not such a bad thing, in my book.)
    The problem is our blind prejudice that… something that is GOOD for one thing must be good for lots of other things, too, and that… MORE OF A GOOD THING IS ALWAYS BETTER…
    Na. Not true. “We” seem to fall into this trap every time.
    That’s what we get for waiting for Santa Claus to show up behind every corner.

  11. yarro

    If they are worried about destroying the company, then go after the individuals responsible. They broke the law. The punishing of the company (and it’s share holders) for the actions of individuals at these companies has always done nothing other than give them the green light to do it again. If the people who orchestrated the unlawful activity, go to jail and lose all their ill gotten gains then this would stop. Instead, the govennment usually settles for taking money from shareholders and the company gets to not acknowledge wrong doing in return. Those running the company keep their compensation that came from the wrong doing. Use the RICO act on the executives and sieze everything they own. Any agreements should include the executives in question staying off of boards or being corporate officers at any publicly traded company.

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