We’re stuck with a huge tab

A couple quick facts to add to your “Pharmaceutical Companies Are Ripping Off Americans” article Aug. 15. 

First, pharmaceutical companies have the second biggest lobby in Washington, D.C. Second, pharmaceutical companies spend more on marketing than they do on research and development. 

What are the implications of these two facts?

Laws benefiting and protecting pharmaceutical companies will likely not change. Direct-to-consumer ads (you know the ones: “not feeling right, drug X can change all of that, ask your doctor to get you drug X”) have created an illusion of wonder drugs that has rocketed demand and sales to new heights. 

Skeptical? I’ll give you one more fact.

Before it went generic, Lipitor (the top-selling cholesterol drug) was making its pharmaceutical company $1 billion in sales per month (a billion is a thousand times a million, and yes I said month). It was a $12 billion a year drug (just one drug). Guess who was paying that tab?

— Steve Dang, Honolulu

Med prices must go down

Loved your article on pharma ripping off Americans. You got it exactly correct.

I am an internal medicine physician in private practice. I talk about what you succinctly summarized in your article all the time. I am so happy you wrote about it.

I wish more Americans would understand this problem we are facing. Pharma will not change and politicians are affected by their lobbyists so won’t change either. Insurance companies don’t suffer in the end because they balance their books and just increase premiums.

Unless patients start to all realize this and start a movement against pharma, health care will bankrupt the U.S.

I always give this example to my patients when we happen to discuss drug prices.

For example, a branded drug (sometimes we are forced to use it because there is no generic or in many cases, the patient is already on maybe two generics and their diabetes is still out of control) can cost $300 one month.  That is paid by the insurance company. A patient has co-pay card to bring it to zero, so he or she doesn’t care.

I see this patient maybe three times, a year and the insurance company pays me about $75 per visit so it comes out to $225 for one year. And I am responsible for everything for this patient in that one year and answering all phone calls from the patient as well for that $225.

Then I ask the patient, so did you know I as your physician am worth even less than one month of that one drug you are taking? Of course, they all say I am worth more. 

Insulin in Medicare patients is another problem. No generics.

California is trying to pass a law where co-pay cards won’t be allowed.

I do not think doctors need to get paid more. But meds must go down in price.

I even thought of on many occasions making a YouTube video about this and see how many hits I would garner because most patients don’t understand this at all.

Thanks for reading and thank you for writing about this problem. Have you watched the episode about Valeant on the Netflix show “Dirty Money”?

— Emily Diep, Honolulu

Mail-In Voting

It actually leads to higher turnout

First, congratulations on calling this out as you did. There really is no need to wait for Kauai in 2020 as the model is not only working in Hawaii (via absentee) but in many other locales, as you noted (“Forget The Pilot Program And Switch To All-Mail Voting Statewide,” Aug. 15).

I just wanted to make two points for you to consider as you cover this topic in the future.

1. The 2017 U.S. Election Assistance Commission report is now very out of date based on more recent research. The results are no longer “mixed.” The data they cite are largely from a 2002 study, while we now have more substantive data from the 2014 experience in Colorado and the 2016 general election in Utah. Those two studies are linked for your reference. They show a very clear correlation between the mailed-out ballot model and higher turnout.

2. Oregon’s success with automatic voter registration, which we fully applaud (and I’m an Oregon resident) actually hurts reported turnout percent, if one is measuring turnout as percentage of registered voters. It helps percent of all eligible voters, of course. But those newly AVR voters are, by definition, lower propensity voters or they would have registered already. In the 2016 election, Oregon saw an 80 percent overall turnout, but a turnout of about 44 percent of the newly registered AVR voters. Now, 44 percent is far better than 0 percent (or thereabouts) that would have happened if those folks were not registered via AVR. But it does depress the reported turnout percentage the way most report that. Hopefully, we’ll get many more data points on this as the new AVR states vote for the first time this fall.

Finally, you’ll note we’ve linked your editorial on our web site.

— Gerry Langeler, director of communications, National Vote at Home Institute

Too many paid holidays?

We retired and moved to Oregon five years and enjoy voting by mail.

The Hawaii Legislature opposes statewide mail-in voting, because there would be no need for city and state employees to have a paid holiday for Election Day on the first Tuesday in November.

The unions will get involved to obtain a new paid holiday for Hawaii’s city and county workers. Too many paid holidays in Hawaii is one reason Hawaii is always short of money.

— Larry Langley, Beaverton, Oregon

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