Letters to the Editors

Physician care isn't swayed by drug companies

Re: Drug companies cozy up to doctors, May 4.

As a physician, I found the opinion piece by Sebastian Mallaby to be personally insulting and demeaning. Mallaby suggests that physicians can be paid off to do our job improperly. Physicians are supposed to help people, and we do.

I personally have never had a drug-company representative offer me anything that required I prescribe more of their product. I would ask him or her to leave my office if that occurred, and I am sure most of my colleagues would do the same.

Mallaby cites the drugs Vioxx and Celebrex. These are new anti-inflammatory pain relievers. They are similar to ibuprophen but with fewer side effects. Ibuprofen causes a significant amount of stomach pain and ulcers, so a number of people can't take it. It costs drug companies literally billions of dollars to develop new drugs. Why would they spend that money to develop new pain medications if there wasn't a market or need for them? And where is Mallaby's indignation over the fact that a large percentage of drug development costs are incurred because of needless federal government regulations?

Mallaby cites politics and hospital mergers as further reasons for an increase in health care costs and a coalition of businesses and state governments as a way to combat these increases. Please tell me how this relates to physicians. If doctors had any political clout, do you think we would be working for reimbursement that is literally one-third of what we received 15 years ago? If Teamsters had to work under the Medicare rules that we have, I guarantee you there would not be a truck rolling today. Physician reimbursement is less than 20 percent of the total health care expenditure.

Where is Mallaby's indignation when Medicare balances the federal budget on the backs of physicians by decreasing Medicare reimbursement by 5.4 percent this year and probably for the next few years? Where is the indignation when large insurers like Aetna cut my reimbursement by 10 percent this year and refuse to negotiate? If doctors had the power Mallaby implies, why would we accept this? We are powerless because we cannot negotiate as a group because of federal laws and regulations that resulted from a coalition of businesses and state governments.

Health care costs are going up because expensive technology is keeping people alive longer. Be careful of coalitions to reduce costs. To save money, doctors may be forced by coalitions to put heart-attack victims on bed rest as we did 60 years ago instead of using expensive clot-busting drugs developed by the "greedy" drug companies just so they could make money. What a coincidence that those expensive drugs reduce suffering and save lives, too.
-- Jesse A. Kane, M.D., Palm Harbor

Patients come first

Re: Drug companies cozy up to doctors, by Sebastian Mallaby.

Mallaby has obviously never been "in the trenches" of the delivery of medical care and must not have talked to many who are. He, and your readers, should know that most doctors think of their patients' well-being first and foremost. I have lectured for two major drug manufacturers and have never been given a gift or anything for my services other than my usual fee for lecturing. In fact, one company doesn't ask me to mention their products in any different light than their competitors. It was not Vioxx or Celebrex I was lecturing on but the nonsteriodals in general.

You should also know that the most inexpensive medicines do not always work, although managed care would like us to believe so. The point that politicians, managed care and Sebastian Mallaby seem to miss is that each patient is different and there is no scale or book to look into to tell what is right and cost effective for everyone. Based on my nearly 29 years in practice, I can also give you examples of generic drugs producing adverse and/or allergic reactions in individuals that have taken the brand name of the same drug without such a reaction. So thank God for new drugs and thank God for old drugs and thank God for some generics, but most of all thank God for physicians who have the guts to stand up for their patients and do what is best for them!
-- Dr. John Kauzlarich, Largo

A pitiful health care scenario

Re: Stalling for profits, May 5.

With taxpayer money, our government discovered Taxol, a drug to treat breast and ovarian cancer. In turn, this successful drug was given to Bristol Myers Squibb Co. which is enjoying astronomical profits (as much as $5-million a day) selling it back to the taxpayer.

The taxpayer loses at both ends. A generic form of this drug was delayed for years because Bristol Myers had the clout and money to initiate court battles that allowed it to retain exclusive rights to Taxol, and patients continued to pay as much as $1,435 for a vial of Taxol (Moffitt-Cancer Center, Tampa). What a pitiful scenario this article depicts of government and big business coercion. What a travesty to American people.

I don't know how our legislators, pharmaceutical/insurance CEOs along with stockholders can face themselves in the mirror or sleep at night knowing there is a positive drug available that can save thousands of lives but is not obtainable to all because of greed by big business and the hypocrisy of government. Either pay the price or die!

My shame to be a veteran serving this country continually grows as I see the paybacks from the people I took an oath to protect. It's too bad the pharmaceutical industry can't discover a drug to cure hypocrisy and greed.
-- Jack Burlakos, Kenneth City

Don't expect anything to change

Re: Stalling for profits.

Moral outrage over the Bristol Myers cancer drug? Sure, lots of it. Will something come of it? Not a chance. We might all agree that what that drug company did was wrong, but right and wrong no longer are issues of consequence in America. Only legal and illegal matter. In time Bristol Myers will be found to have done nothing "illegal," so what's the beef?

You want your congressman and senator to care about it? How naive. All of them are fully covered by taxpayer-paid health care programs that pay for drugs no matter what they cost. And the vast majority of them receive campaign donations from the drug companies, which help to re-elect them. Does anyone seriously expect them to care, much less do something about it?

Americans have no one to blame but themselves. A majority of us are too lazy to stay informed about our representatives much less, go to the polls and vote. Every First World, industrial country except America has universal health care for all. The programs include prescription drug coverage. The people of those countries live full and healthy lives and in many, they even live longer than Americans do. When their national health care systems fall short, the people have a voice through their elected representatives. When American HMOs fall short, only a lawyer can help. Maybe!

As long as shareholders are more important than the lives of Americans, nothing will change. Good luck to you few idealists who still believe your representatives give a hoot about you and your health. In Washington only one thing matters: Being re-elected! With no irate voters to worry about. Well you can figure it out.
-- Erik H. Thoreson, St. Petersburg

Yucca Mountain storage issues

Your recent editorial, No to Yucca Mountain (May 2) is fraught with error.

"It's a shame the decision has to be made that quickly." The work on Yucca -- and the decision to use it as a waste repository was made several decades ago. Funding for the project has been under way all during this period. Ergo, this is no quick decision.

"Highly radioactive waste from spent fuel is stacking up." The storage facility is to be used primarily -- perhaps exclusively -- for spent fuel. Spent fuel is not the same as highly radioactive waste. Safe storage requirements are very different.

"One of the most dangerous substances known to man." Well, yes, but it is very securely enclosed in metal containers. Have you ever heard of anthrax? Now that's a real threat.

"And an accident or act of terror that breached the waste container could have catastrophic consequences." Here's a twofer: Waste is not shipped -- spent fuel elements are. Exhaustive tests on shipping casks -- fire, explosion, collision by a locomotive -- have shown these casks (not "containers") have shown them to be darn near indestructable.

"Spent fuel would once again pile up at reactor sites . . . Yucca Mountain is at best a temporary solution." Of course, but the longest journey begins with the first step, so let's take this first, well thought-out step.

If your editorial writer would "study the project more thoroughly," he would be more assured of the safety thereof and would write a more accurate and insightful editorial.
-- Harold Stelling, Lecanto

Transportation isn't the problem

Re: No to Yucca Mountain, May 2.

Your editorial suggested that one of the main reasons not open Yucca Mountain for the storage of spent fuel was the hazard associated with the transport of the material. The facts are such that the transport of spent fuel by highway and rail has been taking place for some 50 years without incident.

Last summer I rode along with such a shipment from an East Coast port to a storage facility located in a Western state. The only hitch in the entire trip was when the governor of a Midwestern state made a last-minute political grandstand play trying to prevent the shipment from entering his state.

Everyone involved from the truckers to the state and local authorities are highly trained professionals. The shipping casks themselves are designed to withstand impact from trains, planes and automobiles.

You may have other valid points in opposing Yucca Mountain, but transportation safety should not be one of them.

Your opposition to Yucca Mountain also makes me ask: What do you propose as an alternative?
-- Rick Bodette, Tampa

Plug open-government loophole

Re: A career in dark, brought to light, May 4.

The indictment of W.D. Childers brings to public light the gaping loophole in open-government law that needs to be closed.

I plan to ask my state representative and state senator to sponsor a bill to apply the Sunshine Law (the public meetings law) to the state Legislature in Tallahassee. You should, too.
-- Martin Shelby, Largo

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