Now we know the real reason Aetna bailed on the Affordable Care Act

By Bob Bryan

On Monday night, news broke that one of the five largest insurers in the US, Aetna, was leaving 70% of the counties in which it offers insurance through the Affordable Care Act's public healthcare exchanges.

The move was seen as a huge blow to the future of the act, making Aetna the third large insurer, after United Healthcare and Humana, to significantly reduce its Obamacare business.

Aetna cited the large losses that the company has incurred from the exchange business — $200 million in the second quarter alone — when explaining its decision to roll back its business.

These statements, however, appeared to be a dramatic turnaround from the company's first-quarter earnings call in April, when CEO Mark Bertolini said the firm planned to stay in the exchanges and that the company was "in a very good place to make this a sustainable program."

Now, however, it appears a large reason for the shift in tone was the Department of Justice's lawsuit to block Aetna's merger with rival Humana.

A July letter, acquired by Huffington Post reporters Jonathan Cohn and Jeffrey Young, outlined Aetna's thinking on the public exchanges if the deal with Humana were blocked. The letter from Bertolini to the DOJ outlined the effect of a possible merger on its Affordable Care Act business.

For one thing, Bertolini notes that the cost savings from the Humana deal would allow the companies to further expand coverage into parts of the US.

"As we add new territories, given the additional startup costs of each new territory, we will incur additional losses," the letter said. "Our ability to withstand these losses is dependent on our achieving anticipated synergies in the Humana acquisition."

Additionally, the letter seemed to foretell the move on Monday. Here's the key passage (emphasis added):

"Our analysis to date makes clear that if the deal were challenged and/or blocked we would need to take immediate actions to mitigate public exchange and ACA small group losses. Specifically, if the DOJ sues to enjoin the transaction, we will immediately take action to reduce our 2017 exchange footprint.

 

"We currently plan, as part of our strategy following the acquisition, to expand from 15 states in 2016 to 20 states in 2017. However, if we are in the midst of litigation over the Humana transaction, given the risks described above, we will not be able to expand to the five additional states. 

"In addition, we would also withdraw from at least five additional states where generating a market return would take too long for us to justify, given the costs associated with a potential breakup of the transaction. In other words, instead of expanding to 20 states next year, we would reduce our presence to no more than 10 states."

 

In other words, the cost of fighting the DOJ would make Aetna unable to sustain the losses incurred from the public exchanges.

According to a letter from the DOJ provided by Aetna, the DOJ asked the company what the effect would be on the firm's Affordable Care Act business if the merger were not completed. Thus, Aetna responded with its letter.

A spokesperson for Aetna said the decision to roll back the coverage was not because of the DOJ's lawsuit, but rather realizing the full details of the losses. The statement from the spokesperson reads, in part:

"In the time since we submitted our written response to DOJ and provided a courtesy copy to [the Department of Health and Human Services], we gained full visibility into our second quarter individual public exchange results, which — similar to other participants on the public exchanges — showed a significant deterioration. That deterioration, and not the DOJ challenge to our Humana transaction, is ultimately what drove us to announce the narrowing of our public exchange presence for the 2017 plan year. 

"If the Humana transaction is eventually blocked, which we don't believe it will be, the underlying logic of our written response to DOJ would still apply with regard to the public exchanges where we will participate in 2017." 

In the original letter from Aetna to the DOJ, Bertolini said that if the company lost the lawsuit and the deal were eventually scuttled, Aetna would drop its remaining Affordable Care Act business and leave the public exchanges entirely.

The DOJ declined to comment.

The DOJ blocked the merger between Aetna and Humana, along with the merger of fellow big-five insurers Anthem and Cigna, on the grounds that consolidating the industry would lead to lower competition and higher costs for consumers.

"They would leave much of the multi-trillion health insurance industry in the hands of just three mammoth companies, restricting competition in key markets," Attorney General Loretta Lynch said when announcing the lawsuit to block the mergers.

Typically the number of independent options available to consumers is correlated with lower costs.
"If the big five were to become the big three, not only would the bank accounts of the American people suffer, but the American people themselves," Lynch said.

The companies countered that the merger would not affect consumers and would allow the combined firms to be more cost-efficient and sustainable.

Read the full letter from Bertolini, via The Huffington Post, here »

Brazilian Doctor’s Chilling Warning To Olympic Visitors: ‘Don’t Get Sick’

By Joe DePaolo 

Add a public healthcare crisis to the ever-growing list of problems plaguing this summer’s Olympics in Rio.

As part of an episode of HBO’s Real Sports set to air Tuesday at 10:00 p.m. ET/PT, the network examined the condition of Brazil’s public hospitals. What they found wasn’t pretty.

Denied permission to tour a hospital by Brazilian officials, HBO managed to sneak a hidden camera inside for their investigation. Watch the disturbing footage below of patients lined up along hospital walls, with some even forced to lay on the floor.

Dr. Jorge Darze, President of the Rio De Janiero Doctor’s Union, called the images “revolting.” He alleges criminal negligence on the part of Brazilian officials who’ve allowed the healthcare crisis to escalate by wasting money on Olympic-related projects unlikely to provide much benefit to residents after the Games conclude.

“I would say it’s a criminal situation,” Darze told Vice News earlier this year. “One that breaches basic human rights.”

His chilling advice for Olympic visitors?

“Don’t get sick.”

Health Providers Spill Patient Secrets On Yelp

The vast majority of reviews on Yelp are positive. But in trying to respond to critical ones, some doctors, dentists and chiropractors appear to be violating the federal patient privacy law known as HIPAA.

 https://www.propublica.org/article/stung-by-yelp-reviews-health-providers-spill-patient-secrets

Monsanto's Cancer Linked Pesticide Is Being Sprayed In New York City Parks

By Reynard Loki

 

Over 2,000 locations across NYC have been sprayed.

 

New Yorkers who visit their local parks have likely been exposed to glyphosate, the controversial, cancer-linked main ingredient in Monsanto's popular herbicide Roundup. But the data about herbicide and pesticide spraying projects across the city isn’t adding up.

In May 2015, in response to the concerns of community activists and public health advocates, the city government released a report, “Pesticide Use by New York City Agencies in 2014,” detailing the use of pesticides by city agencies in 2014. According to that report, the city applied glyphosate 2,748 times.

However, according to data procured by a Freedom of Information Law request, the city has revealed only 2,000 locations of glyphosate use in 2014. Pesticide information related to Central Park and other areas that are managed not by the city government, but by nonprofit conservancies has not been made public.

Several environmental and community activist groups, including Reverend Billy and the Stop Shopping Choir, Stop the Spray, and members of the Coalition Against Poison Parks, are pursuing legal action to “force the City to reveal all locations where it has been used."

According to the parks report, the city applied pesticides 162,584 times in 2014. Various city agencies used nearly 8,000 gallons ans more than 100,000 pounds of pesticides. Compared to 2013 levels, there was a 21 percent increase in insecticides by volume in 2014. What is of particular concern is the fact that, as the report states, "there was a 16 percent increase in herbicide use by volume, reversing a declining trend. Much of the change was due to a 9 percent increase in glyphosate products used.”

In March 2015, the World Health Organization, the U.N.'s public health agency, said glyphosate, which is widely used on genetically modified crops such as corn and soybeans, likely causes cancer. 

In its report, the International Agency for Research on Cancer, WHO’s cancer arm, classified glyphosate as "probably carcinogenic to humans." IARC scientists found that the chemical "induced DNA and chromosomal damage in mammals, and in human and animal cells in vitro."

They concluded that there was "sufficient evidence" that the herbicide causes cancer in non-human animals and "limited evidence" that it also causes non-Hodgkin lymphoma in humans. They said that the primary exposure to glyphosate comes through diet, home use—Roundup is a popular consumer gardening spray for people who are not informed about effective nontoxic methods—and living near sprayed areas.

A study published in February in the journal Environmental Health found that glyphosate persists in soil and water longer than previously thought, and that human exposure to the chemical is rising. The chemical also has harmful effects on birds, fish, and other wildlife.

While there was an increase in glyphosate use in New York City in 2014 as compared to 2013, the amount is much lower than it was in 2009, when, according to the Parks Department, it was used "to control invasive species in remote, often wooded, parkland.” The increase in glyphosate spraying in 2014 may have been due to “forest restoration work [which] was again done by Parks and their contractors, accounting for a substantial proportion of the city’s glyphosate use."

(Above: graphic from “Pesticide Use by New York City Agencies in 2014,” report by New York City Parks Department.)

To help residents steer clear of the toxic areas, Reverend Billy and the Stop Shopping Choir, a performance-based activist group based in New York City, created a map charting the parks and public areas across the city that have been sprayed with glyphosate. The map was created using data provided by the New York City Parks Department.

New York isn't the only major U.S. city that sprays glyphosate. San Francisco, Oakland, Portland, Seattle and Philadelphia also use the controversial herbicide. Some big cities, like Chicago and Boulder, as well as smaller cities like Richmond, California, and Takoma Park, Maryland, have instituted glyphosate bans.

The NYC Parks Department notes in its report that the NYC Department of Health and Mental Hygiene “encourages the pursuit of alternative weed control methods that would reduce the need for these herbicides.” The city should follow its own advice and protect its citizens from this cancer-linked chemical.

Related Stories

• Glyphosate, Monsanto's Widespread 'Probable Carcinogen' Weedkiller Is in More Food Than You'd Care to Know
• Monsanto's Highly Controversial Herbicide Is Currently Being Sprayed in Five of America's Largest Urban Areas
• Monsanto's Controversial Glyphosate Herbicide Is Being Sprayed in New York, Philadelphia, Los Angeles, San Francisco, Seattle and Portland

Conservative Plan To Fix The VA Has Vets Hopping Mad

Why is a commission charged with fixing the problems hoping to close down its hospitals?

—By AJ Vicens

Veterans commemorate the 50th anniversary of the Vietnam War on March 29 in West Palm Beach, Florida. Bruce R. Bennett/Zuma

 

Some members of the commission established by Congress to evaluate the Department of Veterans Health Administration have proposed drastically reducing the size of the VHA by closing its health facilities and transferring the care of the nation's millions of military veterans to the private sector.

But in a letter sent to the chair of the Commission on Care, leaders of eight of the country's most prominent veterans' advocacy organizations blasted the proposal.

"We are greatly alarmed by the content of [the proposal] that was developed and drafted outside the open Commission process by seven of the Commission's fifteen members—without the input or even knowledge of the other Commissioners," they wrote in a letter signed by senior leaders of the Disabled American Veterans, the American Legion, the Military Order of the Purple Heart, the Vietnam Veterans of America, the Veterans of Foreign Wars, the Paralyzed Veterans of America, AMVETS, and the Iraq and Afghanistan Veterans of America.

The plan—known as the "Strawman Document"—was floated in March by seven members of the 15-member Commission on Care, an oversight group that was established by Congress in 2014 in the wake of the national scandal surrounding the lengthy wait times for healthcare at VA facilities. The commission is charged with evaluating veterans' access to health care and with offering proposals for how the Veterans Health Administration should be organized over the next 20 years.

The "Strawman" report, which echoes VA privatization efforts that have been backed by the Koch brothers, says "bold transformation" is needed for the VA to address the needs of its enrolled veterans, and that the system is "seriously broken" with "no efficient path to repair it." The plan calls for closing many "obsolete" VA facilities and moving toward a model where veterans can seek taxpayer-funded care at private health care facilities. A process similar to the Base Realignment and Closure system—used by the military since the end of the Cold War to decide which bases to close—would be used to evaluate which VA medical facilities would close. Under the plan, there would be no new facilities or major renovations of the existing VA facilities.

The plan also called for private doctors to be reimbursed at 5 to 10 percent higher than the Medicare rate, so they would have a greater incentive to participate.

The authors wrote that eventually the VA would become a broad-based payer system, "though it will continue to pay for the veteran care provided by the community system."

Those who opposed the plan agree the VA needs to be improved, but they argue that essentially privatizing it would force veterans to search for care at private facilities that might not be trained or equipped to serve veterans suffering from the long-range effects of combat, such as spinal cord injuries "and the Polytrauma System of Care." The authors add that the proposal ignores recent research, some commissioned by Congress itself, that found that VA care is often better than care in the private sector.

Louis Celli, the national director of veterans affairs and rehabilitation for the American Legion, told the Arizona Republic that he was "angered and insulted" by the "strawman" plan, and that the commission is now "absolutely divided" between those who want to privatize VA care and those who don't.

The plan lines up with ideas from Concerned Veterans for America, a group that's backed by the Koch brothers. The group has called for more choice for veterans seeking health care and for the VA and its health functions to be partly privatized. Suzanne Gordon, a health care writer who has covered the VA, notes in her personal blog and in the American Prospect that the supporters and drafters of the "strawman" proposal include conservatives and several hospital executives "who stand to benefit financially from [VA medical] privatization."

Dan Caldwell, a spokesman for the Koch-backed group, told the Arizona Republic that the "Strawman" proposal has been "completely distorted by opponents," and that there is no call to abolish the VA health care system. "We are not proposing to abolish the [VA health care system] or to end government funding of veterans' health care," Caldwell said.

According to the Arizona Republic, the commission will have two public meetings before issuing a report on its proposal June 30. The report was due in February, but the commission asked for and received an extension.

Single Payer Universal Health Care Explained

There’s been a lot of fear mongering about the cost of Bernie Sanders’s health care plan. Time to set the record straight. Cenk Uygur, host of the The Young Turks, breaks it down. Tell us what you think in the comment section below.

"Single-payer national health insurance, also known as “Medicare for all,” is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents of the U.S. would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs.

The program would be funded by the savings obtained from replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money. Patients would no longer face financial barriers to care such as co-pays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care.”

http://www.pnhp.org/facts/what-is-single-payer

Flint Residents Told That Their Children Could Be Taken Away If They Don’t Pay For City's Poison Water

By John Vibes, The Free Thought Project

Not only is the Michigan government poisoning residents, but now they are threatening to take their children for not paying for it. 

 

Flint, MI – As the water crisis in Flint deepens, it is becoming apparent that the effects of the lead-infested water are not just a health hazard, but the situation has the potential of ruining many more lives outside of the poison issue. There is no denying that the water in Flint is undrinkable and that it is contaminated with lead and other substances, and it is clear that the government of Flint is responsible for the problem.

However, the city’s government continues to charge people for the poison water and then threatening to foreclose their home or take their children if they refuse to pay. Michigan law states that parents are neglectful if they do not have running water in their home, and if they chose not to pay for water they can’t drink anyway, then they could be guilty of child endangerment. Activists in Flint say that some residents have already received similar threats from the government if they refuse to pay their bills.

Flint residents have recently filed two class action lawsuits calling for all water bills since April of 2014 to be considered null and void because of the fact that the water was poisonous.

“We are seeking for the court to declare that all the bills that have been issued for usage of water invalid because the water has not been fit for its intended purpose,” said Trachelle Young, one of the attorneys bringing the lawsuit said in court.

“Essentially, the residents have been getting billed for water that they cannot use. Because of that, we do not feel that is a fair way to treat the residents,” Young added.

Recent estimates have indicated that it could take up to 15 years and over $60 million to fix the problem, and the residents will be essentially forced to live there until the problem is solved. Despite the fact that the issue is obviously the government’s responsibility, they have made it illegal for people to sell their homes because of the fact that they are known to carry contaminated water.

Meanwhile, residents are still left to purchase bottled water on their own, in addition to paying their water bill.

Although this problem is finally getting national media attention in Flint, they aren’t the only city with contaminated water supplies. In fact, a recent report published by The Guardian showed that public water supplies across the country were experiencing similar issues.

This crisis highlights the many dangers of allowing the government to maintain a monopoly on the water supply and calls attention to the fact that decentralized solutions to water distribution should be a goal that we start working towards.

Federal charges for 'Pharma Bro'

Alex Wagner looks at the downfall of Martin Shkreli, the fool who jacked up the price of a life-saving AIDS drug by 5,000%.

5 vitamins and minerals that are actually worth your money

Science tells us that taking most vitamins is worthless - but here's a few that buck the trend

By Joseph Stromberg

(Credit: R_Szatkowski via Shutterstock)

Recently, a number of studies published in the Annals of Internal Medicine underscored a fact that scientists have become increasingly sure of: The vast majority of vitamins and mineral supplements are simply not worth taking. “Enough is enough: stop wasting money on vitamin and mineral supplements,” declared an editorial that was published in the issue.

This goes for a tremendous range of supplements that you might imagine to be beneficial. Multivitamins don’t reduce the chance of cancer or cardiovascular disease. Controlled, randomized studies—where one group of people take supplements and another takes placebos, and the groups are compared—have produced little evidence that antioxidants protect against cancer. Study after study has shown that vitamin C does nothing to prevent common cold, a misbelief that dates to a theoretical suggestion made by a scientist in the 1970’s.

Of course, our bodies do need these vitamins to live—it’s just that the diet of most people who live in developed countries in the 21st century already includes them in abundance. In many cases, taking high amounts of them in a refined form (especially vitamins A, C and E and beta carotene) can actually be harmful, increasing the risk of cancer and other diseases by excessively inflating the concentration of antioxidants in the body.

Nevertheless, there are a handful of vitamins and supplements that, studies suggest, are actually worth taking for people with specific conditions. Information is Beautiful, a data visualization website, has a thought-provoking interactive that shows supplements charted by the strength of evidence that indicates they’re beneficial. Here’s our rundown of some of the most promising.

​Vitamin D

Of all the “classic” vitamins—the vital organic compounds discovered between 1913 and 1941 and termed vitamin A, B, C, etc.—vitamin D is by far the most beneficial to take in supplement form.

A 2008 meta-analysis (a review of a number of studies conducted on the same topic) of 17 randomized controlled trials concluded that it decreased overall mortality in adults. A 2013 meta-analysis of 42 randomized controlled trials came to the same conclusion. In other words, by randomly deciding which participants took the supplement and which didn’t and tightly controlling other variables (thereby reducing the effect of confounding factors), the researchers found that adults who took vitamin D supplements daily lived longer than those who didn’t.

Other research has found that in kids, taking vitamin D supplements can reduce the chance of catching the flu, and that in older adults, it can improve bone health and reduce the incidence of fractures.

Of course, even though they’re widely recognized as the best way to test a treatment’s effectiveness, randomized controlled trials have limitations. In this case, the biggest one is that these studies can’t tell us much about the mechanism by which vitamin D seems to reduce mortality or provide other health benefits. Still, given the demonstrated benefits and the fact that it hasn’t been shown to cause any harm, vitamin D might be worth taking as a supplement on a consistent basis.

Probiotics

A mounting pile of research is showing how crucial the trillions of bacterial cells that live inside us are in regulating hour health, and how harmful it can be to suddenly wipe them out with an antibiotic. Thus, it shouldn’t come as a huge surprise that if you do go through a course of antibiotics, taking a probiotic (either a supplement or a food naturally rich in bacteria, such as yogurt) to replace the bacteria colonies in your gut is a good idea.

In 2012, a meta-analysis of 82 randomized controlled trials found that use of probiotics (most of which contained bacteria from the Lactobacillus genus, naturally present in the gastrointestinal tract) significantly reduced the incidence of diarrhea after a course of antibiotics.

All the same, probiotics aren’t a digestive cure-all: they haven’t been found to be effective in treating irritable bowel syndrome, among other chronic ailments. Like most other supplements that are actually effective, they’re useful in very specific circumstances, but it’s not necessary to continually take them on a daily basis.

Zinc

Vitamin C might not do anything to prevent or treat the common cold, but the other widely-used cold supplement, zinc, is actually worth taking. A mineral that’s involved in many different aspects of your cellular metabolism, zinc appears to interfere with the replication of rhinoviruses, the microbes that cause the common cold.

This has been borne out in a number of studies. A 2011 review [PDF] that considered 13 therapeutic studies—in which patients who’d just come down with the common cold were given zinc supplements, and compared to those who’d been given a placebo—found that the mineral significantly reduced the duration of the cold, and also made symptoms less severe. So if you feel a cold coming on, avoid overdosing on vitamin C, but take a zinc lozenge or pill to get better sooner.

Niacin

Also known as vitamin B3, niacin is talked up as a cure for all sorts of conditions (including high cholesterol, Alzheimer’s, diabetes and headaches) but in most of these cases, a prescription-strength dose of niacin has been needed to show a clear result.

At over-the-counter strength, niacin supplements have only been proven to be effective in helping one group of people: those who have heart disease. A 2010 review found that taking the supplement daily reduced the chance of a stroke or heart attack in people with heart disease, thereby reducing their overall risk of death due to a cardiac event.

​Garlic

Garlic, of course, is a pungent herb. It also turns out to be an effective treatment for high blood pressure when taken as a concentrated supplement.

A 2008 meta-analysis of 11 randomized controlled trials (in which similar groups of participants were given either a garlic supplement or placebo, and the results were compared) found that, on the whole, taking garlic daily reduced blood pressure, with the most significant results coming in adults who had high blood pressure at the start of the trials.

On the other hand, there have also been claims that garlic supplements can prevent cancer, but the evidence is mixed. Observational studies (which rely on data collected from people already taking garlic supplements on their own) have found associations between garlic consumption and a reduced incidence of cancer, but that correlation could be the result of confounding factors. Controlled studies have failed to replicate that data.

Ben Carson's History As A Medical Malpractice Trainwreck

Republican presidential candidate Ben Carson isn’t as good of a doctor as he’s made himself out to be. Carson is actually a walking medical malpractice suit waiting to happen. Thom Hartmann and Ring of Fire host Mike Papantonio discussed Carson’s shady history of medical malpractice.

Watch.

About the Author

Joshua De Leon

Josh de Leon is a writer and researcher with Ring of Fire.

Deadly Anticoagulant Xarelto Continues To Get Celebrity Endorsements

As the number of Xarelto lawsuits approaches 2,000 and the drug’s connection to fatal bleeding becomes more widely known, manufacturer Janssen Pharmaceutica is pulling out all the stops on its marketing campaign – including a recent television ad featuring a quartet of prominent celebrities.

The four celebrities –  NBA player Chris Bosh, NASCAR driver Brian Vickers, golfing legend Arnold Palmer and Saturday Night Live alumnus Kevin Nealon – move in widely separated social and professional circles, and would be unlikely to meet for a casual luncheon under most circumstances. However, Janssen would have us believe they’re all old friends who decided to meet up for a friendly game of golf, then retire to the clubhouse to talk about how “treatment with XARELTO® was the right move” for them.

Vickers assures viewers about how Xarelto was “proven to treat and help reduce the risk of DVT (deep vein thrombosis) and PE (pulmonary embolism) blood clots,” while Nealon points out that “Xarelto was also proven to reduce the risk of stroke in people with ‘A-Fib’ (atrial fibrillation, or irregular heartbeat) not caused by a heart valve problem.”

Of course, there’s no mention of FDA concerns over aspects of the clinical tests (specifically, whether or not test subjects had been at the optimal level of blood clotting for a sufficient period of time), nor the fact that post-market studies were funded by the manufacturer and its marketing partners at Bayer.

During the after-game luncheon, in which viewers see the four celebrities chowing down on healthful salads, a voice-over acknowledges that “for people with ‘A-Fib’ currently well-managed on warfarin, there was limited information on how Xarelto and warfarin compare in reducing the risk of stroke.”

Nonetheless, Vickers shares his experience: “You know, I tried warfarin…but the blood testing and dietary restrictions…”  Nealon commiserates: “Don’t get me started on that.”

This has been the big selling point of Xarelto. Warfarin patients are at risk for some 500 interactions with other prescription drugs as well as various foods high in Vitamin K, such as spinach. Those drug interactions are of particular concern among elderly patients, many of whom take several different medications. Xarelto (also known as rivaroxaban) has fewer than 50 interactions and requires far less in the way of expensive, time-consuming patient testing. The ad acknowledges that patients on Xarelto “may bruise more easily, and it may take longer for bleeding to stop.”

That is a gross understatement. In fact, the bleeding may not stop at all until the drug has been removed from the system, as there is no approved reversal agent. Patients taking rival medications Pradaxa (dabigitran) faced similar problems; however, that drug could sometimes be removed by putting the patient on emergency dialysis. Due to Xarelto’s particular mechanism of action, this is not an option for Xarelto patients. The ad goes on to state: “Xarelto may increase the risk of bleeding if you take certain medicines…Xarelto can cause serious, and in rare cases, fatal bleeding.” The voice-over advises patients to seek emergency help in the case of emergency bleeding – but again, there is no mention how such bleeding should be handled.

Meanwhile, our celebrity endorsers are seen as they continue to enjoy their post-luncheon round of golf, to the accompaniment of sprightly guitar music. As Vickers tells Nealon in a confidential tone as they watch Palmer sink a putt, “You know, Xarelto is the Number One prescribed blood thinner in its class,” to which Nealon responds, “That’s a big win.”

It wasn’t such a big win to those who allege that they been injured or killed by Xarelto, says Levin Papantonio attorney Ned McWilliams who is helping to head the national litigation against those involved in the manufacture and promotions of Xarelto. Executives at Janssen and its parent company Johnson & Johnson, which has been target in several liability lawsuits in recent years, know they’re facing some serious trouble, especially with recent studies published in major medical journals.

Although a small San Francisco biotech firm has come up with a promising reversal agent, that drug  – Annexa-R – is still undergoing clinical trials, with no indication as to when or if it will get FDA approval.  In the meantime, Janssen and Bayer are determined to wring as much revenue out of Xarelto as possible, taking advantage of America’s obsession with celebrities in order to manipulate consumers and boost sales.

Hopefully, all four of Xarelto’s celebrity cheerleaders will continue to live healthy, productive lives. However, if any of them wind up suffering uncontrolled bleeding like almost 2,000 other patients, it could put a serious damper on the drug maker’s current marketing ploy.

About the Author

KJ McElrath

K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues.

Bernie Sanders smacks down Martin Shkreli: Rejects meeting and donation from hated drug CEO

martin shkreli

Pharmaceutical CEO Martin Shkreli’s very public temper tantrum continues: “I would destroy Bernie Sanders in a debate”

The notorious CEO said he was going to start a Democratic Super PAC, but now he's leaning toward voting GOP
Scott Eric Kaufman Friday, Oct 23, 2015 11:49 AM EST 145
Elections Bernie Sanders, 2016 Elections

Don’t feed the Shkreli: The Turing Pharma CEO’s pathetic Twitter antics are about as funny as his price-gouging

The pharmaceutical exec is trolling on social media like a bored teen instead of lowering drug costs
Mary Elizabeth Williams Tuesday, Oct 20, 2015 03:19 PM EST 23
Life martin shkreli

“FML”: Martin Shkreli, the world’s most hated pharmaceutical CEO, is trying to win back hearts and minds by trolling

Just when you think it's not possible for him to be more despicable
Scott Eric Kaufman Tuesday, Oct 20, 2015 09:17 AM EST 12
Media Bernie Sanders, Elections 2016

Martin Shkreli, poor little rich bro: The most hated man in pharma is “furious” he couldn’t meet with Bernie Sanders

The controversial pharmaceutical CEO can't always get what he wants
Mary Elizabeth Williams Friday, Oct 16, 2015 11:12 AM EST 75
Life martin shkreli, Bernie Sanders

Bernie Sanders smacks down Martin Shkreli: Rejects meeting and donation from hated drug CEO

“We are not keeping the money from this poster boy for drug company greed"
Salon staff Friday, Oct 16, 2015 08:04 AM EST 25
Business martin shkreli, Bernie Sanders

Martin Shkreli is back: The “Donald Trump of drug development” is just as loathsome as ever

The Turing CEO unlocked his Twitter, but still hasn't touched his his jacked-up drug prices
Mary Elizabeth Williams Monday, Oct 12, 2015 03:32 PM EST 34
Life martin shkreli

Bill Maher smacks down GOP’s “supply-side Jesus”

"It exposed just how little the so-called Christians of the far right believe in what Jesus actually said." VIDEO
Sarah Burris Saturday, Oct 3, 2015 07:48 AM EST 263
Entertainment Bill Maher

The 9 most expensive medicines in the world — courtesy of Big Pharma

Martin Shkreli isn't the only executive shamelessly gouging consumers. Some of these drugs cost more than a house
Larry Schwartz, AlterNet Friday, Oct 2, 2015 04:00 AM EST
Politics AlterNet, martin shkreli

Martin Shkreli’s free-market fetish: How the drug profiteer’s pathetic excuses reveal a dangerous ideology

The Turing Pharmaceuticals CEO tried to jack up the price of an essential drug. This is shocking, but no surprise
Conor Lynch Saturday, Sep 26, 2015 09:29 AM EST 86
News martin shkreli, Health Care

Paul Krugman dismantles GOP candidates’ plans to rein in federal regulation of “demonic” corporations

""I’m not claiming that all businesspeople are demons, just that some of them aren’t angels," he wrote
Scott Eric Kaufman Friday, Sep 25, 2015 08:27 AM EST 68
Business Paul Krugman, Business

Larry Wilmore demolishes Ayn Rand capitalism: “The more we leave things to unfettered markets, the more we have to clean up their sh*t”

Three of the worst examples of capitalist dung -- all in one week VIDEO
Sarah Burris Friday, Sep 25, 2015 08:02 AM EST 82
Entertainment pope francis, Larry Wilmore

“Morons,” “dumb,” “idiots”: Martin Shkreli and Donald Trump deserve each other

Separated at birth -- the price-gouging CEO and the leader of the GOP clown car
Aaron R. Hanlon Wednesday, Sep 23, 2015 02:10 PM EST 14
Life martin shkreli, Donald Trump

Drug profiteer Martin Shkerli relents: “There were mistakes made with respects to helping people understand” why we raised prices 5,455%

His passive-voice defense -- "mistakes were made" -- essentially confirms every awful thought you had about him
Scott Eric Kaufman Wednesday, Sep 23, 2015 10:46 AM EST 35
Business martin shkreli, Big Pharma

“Martin Shkreli is the Donald Trump of drug development”: Why even a biotech exec agrees Turing’s pill price-gouging is “even skeevier than you think”

Raising the price of a drug 5000 percent may be legal, but it's wrong
Mary Elizabeth Williams Tuesday, Sep 22, 2015 11:40 AM EST 128
Life martin shkreli

Martin Shkreli on his “altruistic” motives: “I’m a capitalist — I want to create a big drug company”

"There're a lot of altruistic properties" to raising cost of treating toxoplasmosis from $1,350 to $63,000, he said VIDEO
Scott Eric Kaufman Tuesday, Sep 22, 2015 10:26 AM EST 95
Business turing pharmaceuticals

CEO Martin Shkreli defends his company: Life-saving pill whose price was increased 5,455 percent is “still under-priced”

"I don't think you can find a drug company on the planet that can make money on $5 million of revenue," he said VIDEO
Scott Eric Kaufman Tuesday, Sep 22, 2015 08:16 AM EST 70
Business martin shkreli, Big Pharma, Video

Twitter shreds drug profiteer for increasing cost of common treatment of parasitic infections by 5,455 percent

“It really doesn’t make sense to get any criticism for this," Martin Shkreli said, unaware that it really does
Scott Eric Kaufman Monday, Sep 21, 2015 01:39 PM EST 355
Business martin shkreli, Big Pharma

Jeb Bush Is Flirting With Disaster: Why His Latest Anti-Medicare Fearmongering Could Sink His Campaign

Much of the GOP base loves medicare. Bush should tread lightly.

By Heather Digby Parton / Salon

 

It’s been a good week for economic reports. For example, we heard that the jobless claims for June were lower than they’ve been in 40 years. Take it from someone who remembers 1975 — it was a long time ago. The job market is finally looking up. And we also found out that Medicare is on stronger footing than anyone could have imagined just a few years ago. Kevin Drum at Mother Jones wrote it up:

Ten years ago, Medicare was a runaway freight train. Spending was projected to increase indefinitely, rising to 13 percent of GDP by 2080. This year, spending is projected to slow down around 2040, and reaches only 6 percent of GDP by 2090.

Six percent! That’s half what we thought a mere decade ago. If that isn’t spectacular, I don’t know what is.

Drum points out that this is largely being driven by the fact that medical costs overall have slowed dramatically. This is due to a number of factors, but one of the most significant has to be the Affordable Care Act’s cuts to provider payments, which you will certainly recall had the Republicans whirling like tops with claims that President Obama was planning to turn the elderly into Soylent Green — or submit them to ghoulish “death panels” at the very least. It was one of the primary motivating factors that drove the white elderly Republican base to invade town hall meetings by the hundreds and storm the voting booths in November of 2010 to decimate the Democratic congressional majority.

Ads like these ran all over the nation:

Republicans have run similar ads in every election since. Indeed, it’s their most potent argument against Obamacare. And there’s been every reason to believe that the Republicans would use this message again in 2016. After all, the Medicare constituency is their bread and butter, and they are, quite reasonably, protective of the program. They may selfishly not want anyone else to have health care but they damned sure want to make sure that seniors have the program. In case anyone hasn’t noticed, the elderly have a lot of health problems. It has always made perfect sense for the GOP to demagogue any and all changes to the program.

This represented a very dramatic change in the demographic make-up of the two parties. Since their inception in the New Deal and Great Societies, Social Security and Medicare had made loyal Democratic voters out of the elderly. They were fiercely protective of the programs and the Republicans were caught by the trap their ideology forced them into. Ronald Reagan’s GOP may have looked congenial to many older people — but they knew that he wanted to end the programs that made it possible for them to live with dignity in their old age. So when they heard his famous recording railing against Medicare — in which he said,”one of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project, most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it” — it sounded abstract and irrelevant to their very practical needs. (Not to mention obtuse; a medical program is a humanitarian project.) It’s likely that many of them were just as staunchly anti-communist and anti-statist as Reagan, but few were willing to die prematurely to make that particular political point.

In the late 1980's, when a virulent strain of deficit fever invaded the swamps around the nation’s capital, the government raised premiums on Medicare to provide some new coverage that many people didn’t need and which didn’t cover the one thing they need need, long term care. Seniors rebelled and they rebelled vociferously:

This summer’s bitter struggle over the Medicare Catastrophic Coverage Act of 1988 has damaged the credibility of one of the nation`s largest lobbies, both in Congress and among the 28 million members of the American Association of Retired Persons.
From his retirement home in Las Vegas, Daniel Hawley, a 64-year-old former airline pilot, has helped organize the stunning grass-roots protest that has shaken AARP and pushed this largest expansion of Medicare benefits to the brink of congressional repeal.
“They thought retired people were sitting around doing their ceramics and their little aerobics classes in senior centers and wouldn’t give any fight,” said Hawley. “Well, they found out differently.”

Indeed they did. This infamous (and hilarious) video of seniors chasing the powerful chairman of the House Ways and Means committee perfectly captures the power the medicare constituency has over the U.S. Government:

They repealed the law in November 1989.

For a lot of reasons, older people began to vote for Republicans over the ensuing couple of decades. But the “Mediscare” campaigns continued to have potency for the Democrats. It wasn’t until they came up with the Obamacare scare ads that the Republicans were able to turn the argument back on the Democrats. And it worked beautifully. It was a strong motivation for seniors to turn out in both recent mid-term elections, and while it wasn’t enough to offset the Obama coalition’s turn out in presidential years, it undoubtedly helped keep elderly white people in the Republican column. It’s a darned good strategy.

So, what in the world is Jeb Bush up to? Has he been asleep for the past three election cycles? Did somebody forget to tell him that old white people are the GOP’s most loyal voters and the new scheme is to say you’re saving Medicare? He must not have gotten the memo because he’s just spent the last couple of days telling audiences that Medicare is on its last legs and will have to be killed in favor of some new program, which will probably be along the lines of Paul Ryan’s “shop for health care ’til you drop” voucher proposal.

Get a load of this commentary he made at a Koch Brothers sponsored Americans for Prosperity event on Wednesday:

“The left needs to join the conversation, but they haven’t. I mean, when [Rep. Paul Ryan] came up with, one of his proposals as it relates to Medicare, the first thing I saw was a TV ad of a guy that looked just like Paul Ryan … that was pushing an elderly person off the cliff in a wheelchair. That’s their response.

“And I think we need to be vigilant about this and persuade people that our, when your volunteers go door to door, and they talk to people, people understand this. They know, and I think a lot of people recognize that we need to make sure we fulfill the commitment to people that have already received the benefits, that are receiving the benefits. But that we need to figure out a way to phase out this program for others and move to a new system that allows them to have something – because they’re not going to have anything.”

That’s the kind of braindead doofus “policy” talk you might expect from Donald Trump, not one of the front-runners for the Republican presidential nomination. Sure, he uses some weasel words about fulfilling the commitment to people “who’ve already received benefits, are receiving the benefits,” but he apparently didn’t get the other memo that says seniors don’t buy that line when Republicans say it about Social Security, and they aren’t going to buy it when they say it about Medicare.

The idea of telling anyone that the program “must be phased out” for something “new” because they’re not going to have anything is just daft. Even Paul Ryan’s privatization plans never said that he planned to phase out the most popular health care program in America (even though he did plan exactly that). Even more daft is the idea that Bush would say this at a time when the projections for Medicare solvency are, as Kevin Drum said, “spectacular.”

But Jeb didn’t misspeak. He meant it.  He actually doubled down on that claim in New Hampshire yesterday, saying “we have a Medicare program that’s not going to be around 30 years from now in form that is.” Apparently, the last time he looked at the numbers was back when  he was stumping for his brother in 2004. Somebody needs to fill him in on what’s been happening in the last decade.

Once again, you see the Republicans stuck in their ideological corner. Medicare costs are leveling out and there is no crisis in funding it. The people who have Medicare love it. In fact, they love it so much that they irrationally oppose anyone else having something like it to prevent their beloved program from somehow being diluted. Republicans have struggled with this problem for a long time: They just do not believe in government health care, no matter how well it works.

But they had, for a time, found a way to finesse that by saying the Democrats were threatening their program by giving similar health care to other people. It was a sweet obfuscation that played into everyone’s worst instincts. It was conservative perfection. Jeb, however, seems to be stuck in 2005, when George W. made his kamikaze attempt to destroy Social Security. And we know what happened in 2006. 

Has anyone told Jeb that when he left office his brother had a 25 percent approval rating?  It’s probably not a great idea to remind people of why that happened.

Heather Digby Parton, also known as "Digby," is a contributing writer to Salon. She was the winner of the 2014 Hillman Prize for Opinion and Analysis Journalism.