Reflections From a Murky Pond

It’s a pretty good time in the fight against AIDS. A recent study showed that a daily pill, Gilead Science’s Truvada, which already on pharmacy shelves as a HIV treatment could actually help prevent new HIV infections.

The study, published in the New England Journal of Medicine was conducted on 2499 men at 11 sites in six countries: Peru, Ecuador, Brazil, South Africa, Thailand and the United States.

Diligent use of the medication (90%+ daily usage) resulted in a 73% reduction in infection rates over the course of the year-long study. Quite surprisingly, even lackadaisical usage ( 50% daily usage) resulted in a 50% drop in infection rates among the men in the study.

It’s a fact of life, however, that such treatments and potential prophylactics come at a cost.

Associated Press via Yahoo News:

Because Truvada is already on the market, the CDC is rushing to develop guidelines for doctors who want to use it to prevent HIV, and urged people to wait until those are ready.

As a practical matter, price could limit use. The pills cost $5,000 to $14,000 a year in the United States, but roughly $140 a year in some poor countries where they are sold in generic form.

Whether insurers or government health programs should pay for them is one of the tough issues to be sorted out, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

So there’s a median cost of $10,000 per annum in America and $140 per annum in the Third World. That’s approximately a 7,150% variance in price between what Americans must pay for drug and what Third Worlders and/or the various institutions helping them in their fight against HIV / AIDS must pay!

Hellfire! In Uganda where’s there’s a shortage of Truvada, there’s a black market for the drug and, even at black market prices, the cost is only approximately $720 per annum ($2 / dose).

Why is there such a discrepancy and inequality in pricing for this drug? Why is it that Americans with HIV already have to pay such comparatively high prices for Truvada as a treatment?

Big Pharma’s Greed

Is the inequality of costs based upon the greed of the pharmaceutical companies? That’s a seductively easy answer, and one that anyone who studied healthcare costs during the battles over ObamaCare would have to say is not totally without merit.

Yet that would fully explain the degree of inequality in pricing. Given US foreign aid and American based NGOs continued widespread assistance to the Third World’s struggle against HIV /AIDS, one would reasonably expect higher prices than what are being experienced. “Charge all that the market will bear” is an axiom but the market would not, in truth, be the Third World; it would still be America in the form of our federal government and our various charities.

Eating The Rich

An alternative theory would be that the inequality in pricing is based upon some form of ethnoguiltism- and/or oikophobia-driven class warfare which causes our own people to be charged what seems to exorbitant amounts of money in order to subsidize the nearly free care provided to the the Third World.

This is not as easy or pat an answer as corporate greed, but it’s not, in any way shape or form, without merit. We’ve seen this neo-Socialist mindset many times before – in the details of the AGW movement, in ObamaCare itself, in most things billed as “Social Justice,” and in just about anything involving “spreading the wealth.”

Intellectual Miscegenation

A third and, to my mind, more probable hypothesis is, “Why Chose?” I find it likely that the reasons for this disparity between what Americans must pay for treatment vs. what the populace of  the Third World must pay is based upon some misborn hybridization – mongrelization really – of the first two possibilities.

Gilead Science, the makers of Truvada, and the other pharmaceutical companies are private sector firms and, hence, profit-driven. Their investors and shareholders are expecting and demanding positive returns on their investments from these companies. When you factor in the broad use of health insurance, it would be – or should be – expected that they would maximize their returns by charging Americans as much as they could manage to do.

At the same time they well might feel the moral and/or – yes, it could be both – public relations need to provide very low-cost medicine for the rest of the world’s poor.

This would cause an intrinsic conflict with their investors and stockholders who want and/or need these companies to focus on profits and market cap so as to maximize the  investors’ returns. Charity and profits rarely go hand in hand after all.

Therefor, somebody has to pay for this charity, and who better to pay than the American people? After all, we’re all wealthy and we all owe restitution and reparations to the Third World for that fact – or so those of a common mindset keep claiming.

My Thoughts On The Matter

I care about the reason why there’s such a discrepancy and inequality in the pricing of Truvada only insofar as discovering those reasons would be the first step towards correcting what I see as a problem. I don’t even care that much in particular about Truvada or any other of the antiretroviral drug cocktails used to combat HIV / AIDS; the disease doesn’t, despite it’s being an ongoing cause celebre,  affect near as many people – by whole orders of magnitude – than other, less “popular” diseases.

Yet, Truvada’s pricing model is indicative of the entirety of current medical science and technology, especially pharmaceutical science. Americans, rich and poor alike, pay far higher costs than what is charged to the Third World and that just doesn’t seem right.

NOTE: Don’t bother coming here and ranting about how it’s the fault of America’s for-profit health insurance industry; I’ve little tolerance for foolishness and even less for the fools themselves.

The costs of the medicines and procedures are the costs the medicines and procedures. Health insurance, whether it be private, public, or single-payer only spreads out those costs among a pool of payers; it doesn’t positively change the costs themselves.

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On Monday, August 23, 2010 a US federal judge blocked the Obama administration from funding human embryonic stem cell research via the National Institutes of Health (NHS). The court ruled that the President Obama’s planned financial support Human Embryonic Stem Cell (HESC) research violates an existing  federal law barring the use of taxpayer money for experiments that destroy human embryos.

So much for President Obama March 9, 2009 Executive Order 13505, with which he supposedly tried to fund the practice with taxpayer money.

From the Washington Post:

U.S. District Judge Royce C. Lamberth issued a preliminary injunction that prohibits the National Institutes of Health from funding the research under the administration’s new guidelines, citing an appeals court’s ruling that the researchers who had challenged the less-restrictive policy have the legal standing to pursue their lawsuit.

The decision, a setback for one of the administration’s most high-profile scientific policies, was praised by opponents of the research.

The preliminary injunction will, if some vestige of the laws of America still exist, be followed with a final ruling that permanently blocks Obama’s directive. This is not because HESC research is wrong but because a President’s Executive Orders do not overrule the laws as created by the Congress and, therefor he cannot approve such funding when a law explicitly prohibits it.

That is a much more important point than whether or not Human Embryonic Stem Cell Research gets federal funding – unless one suddenly likes the idea of the “Imperial Presidency.”

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Assuming that ObamaCare is passed into law in America, people may in the future be calling the ObamaCare Line as the first step in receiving medical treatment. Here’s what such a phone call might sound like:

The ObamaCare Line – Enforcement Of Obama’s Policies

Well, as over-the-top and hyperbolic as this video by Concerned Women For America is, mandatory health insurance is part of the proposed ObamaCare. Enforcement capabilities have to be assumed, especially with the proposed sharing of health insurance information and medical records between different branches of the federal government, including the IRS.

All sarcasm and humor aside, this video speaks to a real fear among Americans. If the government controls our access to medical care, how can we dissent from anything that the government wants to do without risking our health and lives and that of our children?

On the other hand, if they’d have included that creepy Obama cult hold music, it might make one glad for the police to come to take you away.

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