Friday, February 12, 2010

Stenting competition 

Michelle Malkin notices that the stents received by President Bill Clinton are from Boston Scientific. She links to an October 2009 story in which Boston Scientific warns that Obamacare would lead to job losses at the company.

Actually, it's already happening. Announced earlier in the week, the company is cutting 1,300 jobs, with many likely to come from the Twin Cities.
Boston Scientific has been facing a lot of headwinds lately. They recently had to make a $1.7 billion payment to their competitor Johnson and Johnson over patent disputes and sales of key products are down. They include drug-coated stents, mesh tubes that prop open clogged arteries, and cardiac rhythm devices, which treat irregularly beating hearts.

CEO Ray Eliot joined the company last summer and said during a conference call Thursday that investors should be patient with his efforts to improve the company's results.

"This is a big ship," Eliot said. "I don't care how smart you are, you don't turn this around in a quarter or two, and it...has had some underlying issues that I think we've addressed well. "
It's not a great example for Malkin's narrow point about the company and stents, but in the broader sense it makes a very good point. These companies that produce valuable, life-extending medical devices -- just ask President Clinton, or my dad who has a few of those in him -- live in a profit-and-loss system, one that is quite competitive. The company does not run on a very large profit margin with competition from places like JNJ and Medtronics and St. Jude Medical, etc. To the extent that government regulation damages these firms we could see a loss of competition and higher prices for devices, leading to government price controls and non-price rationing. Not that ex-Presidents will ever go wanting for a stent, but for you and me that's not a pleasant prospect.

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Thursday, January 07, 2010

Stop the Health Control Legislation 

It's not "care" and it's not "insurance" it's "CONTROL" of 1/6 of our economy, period. If you are so sure we have problems, check out waiting times, MRI availability, etc. in other nations. It's not pretty.

How to stop it? This article on Scott Brown, taking on the Kennedy/Democrat/control machine in MA describes the best chance Republicans have had in a very long time, to get some balance in the MA representation group in DC. In addition, Scott's election could derail the health hurricane that will affect all of us, including those of you who are so enamored with central control.

If you can possible make a contribution to Scott, please do. Info is here - yes, I sent a check yesterday.

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Monday, November 02, 2009

But I have a right! 

Philip Greenspun:
Health insurance is a basic human right ... which is why Congress proposes to leave 18 million people still uninsured in the year 2019 (source). I�m getting more and more confused by our politicians. A lot of them have offered beautiful speeches about how it is both a tragedy and a violation of basic human rights for a person to live in the U.S. without health insurance. At present, millions of Americans are not customers of health insurance companies. After the proposed $1 trillion health care reform has had six years to work, we�ll be left with� millions of Americans who have no insurance. If this is indeed a moral issue, how can it be moral to leave millions in the same supposedly inhuman situation that they�re in right now?
I am trying to remember who said this first -- maybe it was Philip Howard? -- but you get in arguments with people about costs and benefits and what should be paid for by whom, and then someone stands up and says "but this is a right." And argument stops, because if something is a right you can't demand that it be limited by feasibility or cost-benefit studies. It just ends debate.

And while they end debate, they add 111 new bureaucracies.

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Friday, October 23, 2009

Tomorrow on the King Banaian Show 

The newly-constituted King Banaian Show (this still feels awkward and unnatural) continues tomorrow on KYCR, AM 1570, 9-11am with a replay Sunday 5-7pm. Please note that from the station's main page you can stream the show by clicking on the "Business1570 Listen Live" link on the right hand side of the page. I know a couple of people are saying they can't stream -- I know I can. (We're working on the podcasting part.)

This week we will visit with Ken Doyle, communications professor at the University of Minnesota, about his new book To Tax or To Ration: Medicare, Medicaid, and Our Long-Term Healthcare Crisis. The book's focus is on long-term care, and in particular its impact on senior citizens. While I've known Ken for awhile, I note his new bio refers to his profession as a financial psychologist. I am fascinated by what that could mean. He'll be on in the 10 o'clock hour.

We will also discuss the current economic and financial news from last week, what's coming up next week, and the impact of losing one's airline connection on a local community (following up on yesterday's Delta news, which was the headline in the St. Cloud Times this AM.)

Missed this last week: the new show gets some speculation from Saint Paul at Nihilist in Golf Pants. Regarding reason #1 for the real reasons I'm now on Business1570 -- the station expects to be at the State Fair with its own separate studio. Nothing keeps me from the State Fair. Not even buffalo.

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Monday, October 12, 2009

Hands off the food, MN doctors! 


I saw this picture yesterday on Business Insider and wondered, what is it that Minnesota does differently that forces a drug manufacturer to write a sign saying "hands off the food, Minnesota doctors!" Here's your answer:

Two years after Minnesota officials forbade drug makers to give doctors more than $50 worth of food or other gifts per year, drug company sales representatives there are having a far harder time marketing to doctors. The rule change was small and almost accidental � a state official decided to interpret a 1993 law differently from his predecessor. But the effect on drug makers has been profound.

The year after the change, the number of visits that Minnesota primary care doctors accepted from drug sales representatives decreased at about twice the rate of the decline reported by primary care doctors nationwide, according to a survey by ImpactRx, a New Jersey firm that tracks pharmaceutical marketing. A growing number of Minnesota hospitals and clinics have banned routine visits from them.

�We have an extended hallway, and the sales reps sit there now without anything except maybe Styrofoam cups filled with M&Ms. The 30 pizzas are gone,� said Dr. Michael Severson, a pediatrician in Brainerd, Minn. �It�s made the doctors think about whether to ban them.�

A 1997 study found that medical students saw gift-bearing drug sales representatives as helpful while viewing with suspicion those without gifts. This experiment is now being played out statewide in Minnesota.

Leslie Pott, a spokeswoman for AstraZeneca, said the company provided �modest meals� to doctors because �given a physician�s demanding clinical schedule, the most efficient time for doctors and medical staff to meet with representatives is often during lunch hour.�

... Minnesota also requires drug makers to report all consulting payments made to doctors. Maine, Vermont and West Virginia have passed similar registry requirements, at least a dozen other states are considering them and Congress is considering a national one.
It's that last paragraph that tells the tale. If a MN doctor picked up a food item they'd have to report it. Rather than screen who eats what, they post this sign. It's a transactions cost story that inter alia Oliver Williamson might have told. Most remarkable -- this isn't an explicit law, it's just a state official's interpretation of the law. But we're "vile and stupid" to worry about increasing regulation of health care, right Prof. Krugman?

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Thursday, October 08, 2009

The whole Baucus debate in one question 

Everybody knows that the US spends much more on health care than anyone else, without getting better results. Everyone also knows that health spending has outpaced GDP growth everywhere, thanks to medical progress. What I didn�t realize was just how clearly the evidence shows that the rising trend is steepest in the US. We have the biggest increase as well as the highest level. We�re #1!
Paul Krugman, 3/28/08.

So here's the question: If we pass Baucuscare, what would happen to the share of GDP devoted to health care? I thought the whole idea was to "bend the curve downward." You won't find that in the CBO report -- that's not their job. How else can we get the unfunded mandates included in the conversation?

Martin Feldstein thinks that the share of health care in income should be no more than 15%; I don't know why that's the right number, but if what we want is a cap on spending that is a more direct way to do it.

Megan McArdle shows that's not the case for Massachusetts. John Lott could add the question "what will this proposal do to cancer survival rates"?

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