Deborah Ray’s Blog, Practicing Medicine without a License

It has become a perennial political argument. Is it wise to involve government in health care? Does the government practicing medicine help people to live longer, live better, or make healthcare more efficient? The Medicare regulations alone, more profuse than those from the IRS, have caused many a physician to say “I wouldn’t choose this profession again.” There is a host of other issues including medical privacy but to name one that cause many of us to question the wisdom of government-run healthcare.

The union groups representing about 6 million workers (Change to Win) has charged the pharmacy benefits manager of CVS with sending a letter to doctors urging them to add Januvia, a new, expensive diabetes drug to specific patients’ treatment. The letter mentions that Merck paid for the letter but not the fact that Januvia is 8 times more expensive than other diabetic medications.
It is reminiscent of the Rezulin drug recall. Thanks to the collection of prescribing practices by pharmacy benefits manager firms, a local TV outlet called a Jacksonville, FL diabetic to inquire about their reaction to the Rezulin recall, only to be told “How did you know I am taking Rezulin? My doctor’s office has not even called me yet.” Doctors have these firms looking over their prescribing habits and this information is sold profiting pharmacies and benefiting pharmaceutical firms in the long-run. Patient privacy appears to go by the wayside.
While Change to Win has charged that the CVS pharmacy benefits management firm is putting its interests ahead of the businesses that pay CVS to manage employee prescription drug benefits, there is much more to discuss. Where are the privacy rights of the patient here? What about the patient’s right to choose? What about raising the standard of care for the treatment of diabetes? Lifestyle based techniques to address diabetes along with the use of the older, cheaper drugs only when absolutely necessary work 90% of the time or better treating type II diabetes. Why has 30-years of government funded research on chromium and its ability to address insulin sensitivity and blood sugar control been dismissed by diabetic educators as ‘sounds good but let’s wait for more studies’?
These issues are medical issues, economic issues, political issues and health freedom issues. They are key to the practice of medicine in the U.S. where wasting resources is no longer financially sustainable. This small issue tells us that healthcare is not sustainable as it is now practice in the U.S. It is time to protect the right of the practitioner to practice and the consumer to choose. It is time to support the legislative efforts of AAHF.
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