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Perfect your plank, exercise to banish back pain

Planks are God’s gift to people with low back pain, which is the third most expensive medical condition in the United States. More than $57 billion a year is spent on low back pain, behind only diabetes and heart conditions.

The key to planks is they strengthen the core muscles — the muscles in the front, the six-pack that everyone wants — and the back at the same time.

If you don’t do them right, planks can actually hurt. Here’s how to do planks better:

  • Stay firm. The idea of a plank is like a plank of wood. You don’t want to be a wilting flower.
  • Don’t sag. You should feel some lift in your butt as you contract your core muscles.
  • But don’t pike, either! Keep your hips in line with your shoulders.
  • Relax your shoulders. People tend to be too tense in the shoulders and scrunch up. Be sure your shoulder blades are wide on your back.
  • Keep your hands and forearms aligned with your shoulders.
  • Relax your hands. Don’t grip your fingers.
  • Put your forearms on the ground for a somewhat easier plank. Do a full push-up position to increase difficulty.

 

I recommend 3 minutes of planks a day to give yourself a better life: One minute center, one minute on each side. But you can start with 30 seconds, and you can try it with bent knees like an assisted push-up.

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A Better Plank 0:27

Ligand, Amgen expand Captisol license, supply pact

Ligand Pharmaceuticals Incorporated (NASDAQ: LGND) today announced that it has entered into a commercial license and supply agreement with Amgen, granting rights to use Ligand’s Captisol technology in the formulation of AMG 330. Captisol is a patent protected, chemically modified cyclodextrin with a structure designed to optimize the solubility and stability of drugs. AMG 330 is an anti-CD33 x anti-CD3 (BiTE®) bispecific antibody construct. It is being investigated as a treatment for acute myeloid leukemia by Amgen.

This license agreement replaces the prior research agreement which allowed Amgen to evaluate AMG 330 with Captisol in preclinical and early clinical studies. Under this new commercial license agreement, Amgen receives exclusive worldwide rights to combine Captisol with AMG 330 for use in humans for a wide variety of therapeutic indications. In addition to an upfront payment, Ligand is entitled to potential milestone payments, royalties and revenue from future sales of AMG 330 formulated using Captisol.

“This agreement expands our license relationship with Amgen on AMG 330,” said John Higgins, Chief Executive Officer of Ligand Pharmaceuticals. “Ligand’s portfolio of fully-funded shots on goal continues to grow and contains a large number of Captisol-enabled drugs targeted to a number of serious diseases with unmet medical needs.”

 

AMG 330 is an anti-CD33 x anti-CD3 (BiTE®) bispecific antibody construct. It is being investigated as a treatment for acute myeloid leukemia by Amgen.

 

Ligand is a biopharmaceutical company focused on developing or acquiring technologies that help pharmaceutical companies discover and develop medicines. Our business model creates value for stockholders by providing a diversified portfolio of biotech and pharmaceutical product revenue streams that are supported by an efficient and low corporate cost structure. Our goal is to offer investors an opportunity to participate in the promise of the biotech industry in a profitable, diversified and lower-risk business than a typical biotech company. Our business model is based on doing what we do best: drug discovery, early-stage drug development, product reformulation and partnering. We partner with other pharmaceutical companies to leverage what they do best (late-stage development, regulatory management and commercialization) to ultimately generate our revenue. Ligand’s Captisol® platform technology is a patent-protected, chemically modified cyclodextrin with a structure designed to optimize the solubility and stability of drugs. OmniAb® is a patent-protected transgenic animal platform used in the discovery of fully human mono-and bispecific therapeutic antibodies. Ligand has established multiple alliances, licenses and other business relationships with the world’s leading pharmaceutical companies including Novartis, Amgen, Merck, Pfizer, Celgene, Gilead, Janssen, Baxter International and Eli Lilly.

http://bit.ly/2eG5i4Q

Straitjacket thinking on health insurance

Republicans are approaching health insurance as if they were the better managers of socialism.  Why not take this opportunity to express the core principles of conservatism for better solutions?

As the Senate grapples with the Gordian Knot of universal and affordable health insurance, senators have fallen into the script that publicly funded health insurance is tantamount to a constitutional right.  It isn’t, and through the collective fog of “government money,” they’re obscuring the reality that, in effect, one neighbor is knocking on the door of another, demanding that he pay up for a “human right.”  Blindness to this reality is leading the Senate to irreconcilable conflicts within the majority party because personal responsibility and true conservative values are being ignored here.  What the Senate is left doing are back-room shell games to devise clever ways of disguising the redistribution of health insurance costs.  It won’t work.

Let’s first clarify a few points.  Health care is the treatment of a medical condition.  Health insurance is how that treatment is paid for.  You cannot call it “insurance” for pre-existing conditions.  Insurance deals with the probabilities determined from actuarial tables, not an existing event.  Paying for an existing condition is cost-sharing, pure and simple.  Calling it insurance is deceitful.  Furthermore, buying insurance is (and should be) a voluntary act; compelling people to pay for the needs of others is not.

The other point concerns the term “affordable.”  Affordable to whom and for what amounts?  If a healthy, low-risk 26-year-old male is forced to buy health insurance coverage for unlikely probabilities, does that fall within the definition of “affordable”?  If a family of four has to pay $1,000 per month for health insurance while another, who makes perhaps $5,000 less per year and falls within a subsidy income limit, would pay much less, is that a definition of “affordability”?  Are we conservatives in effect embracing a social scheme that would make people pay for things they don’t need or penalize upward mobility?  Can we at least get the definitions clear from the outset?

On the topic of affordability, where is the responsibility of the general public?  Current statistics show that two thirds of Americans are overweight, which spawns a whole spectrum of disabilities and ailments.  And we’re gulping down medications – particularly opioids – as though they were Tic-Tacs.  Too few of us exercise regularly, but we do find five hours a day (on average) to watch television or play videogames.  And our diets are horrendous.  Look: no politician would ever dare say this, but if the general public is going to live as if there’s no tomorrow, why shouldn’t it be charged as if there’s no tomorrow?

Clearly, rising demand for medical treatment for preventable causes must be a component of our national dialogue on this issue.  Otherwise, any solutions ignore an economic truth: that rising demand results in rising costs.  This rising demand siphons money and resources away from those whose afflictions are not the result of lifestyle choices – and those are precisely the people most deserving of any public cost-sharing scheme.

Is there really a heartlessness to demanding that if someone receives a public subsidy for his health insurance, he should at least show progress on becoming a healthier person?  Perhaps require a quarterly weigh-in for continued benefits or show us an attendance log at the local gym?  After all, aren’t the declining rolls of food stamp recipients – where work requirements are placed on able-bodied individuals – a shining beacon of how the conservative value of personal responsibility can help resolve this health insurance problem?

So why aren’t we using our conservative values in thoughtful and creative ways to address our health insurance issues?  Why not make it a prerequisite that in order to receive any government benefits, you must have at least catastrophic health insurance coverage and show regular contributions to an established Health Savings Account (HSA)?  That would include government-backed school loans or grants.  If you receive a tax return or an Earned Income Tax Credit, a portion of that should be a separate check made payable only to the recipient’s HSA account.  If you are a full-time student and working part-time, you will not have to pay taxes on your tips if you fund a certain percentage of your imputed income to an HSA account as well as maintain a catastrophic health insurance policy.  One might even go so far as to make it a requirement to obtain a passport.

These are just a few ideas, and, workable or not, they illustrate how an individual mandate is unnecessary if obtaining health insurance and funding an HSA account can be constructed to align with a person’s self-interest.

Congress is also looking to pass some measure of tax relief and to somehow couple that with funding health insurance benefits.  With a $20-trillion debt, that’s simply not plausible even with an increase in economic growth.  So here’s some more creative thinking:

U.S. corporations have an estimated $2-plus trillion in overseas income they keep offshore to avoid U.S. corporate taxes.  Prior efforts to bring that money home were ineffective.  But let’s suppose that we created a National Health Care Trust.  Initially, a U.S. corporation can deposit its overseas income into this trust and be solely responsible for the prudent investment of the funds it deposits.  A percentage of those investment earnings – say, half – is payable directly to health insurance companies as a direct subsidy for insurance coverage for those who need it.  Each following year, the corporation makes a percentage contribution to stay active in the fund, and in return, the balance of its overseas earnings can be repatriated tax-free.  So here you would have meaningful tax reform, a mechanism for profit for otherwise taxable earnings, a growing source of funding for domestic interests, and a bridge of health insurance coverage for those who lose their benefits from job loss or other circumstances.

Again, just creative thinking and an exploration of possibilities rooted in conservative principles.  Yes, there are plenty of details to cover, and I can already imagine the cacophony of “it can’t done” comments.  But this isn’t a comprehensive legislative proposal; it’s a policy argument.  The health insurance script we have today is compelling us to speak lines that belie our core beliefs – that we believe in a hand up and not a hand-out, that elevating our national character is best achieved by holding individuals responsible and accountable for the benefits they receive, and that government can best serve the public by guiding its producers to explore free-market solutions to elevate the general welfare.

That’s what’s we need to untie this knot.

http://bit.ly/2tRRLZF

Fixing Medicaid and the ObamaCare subsidy program

On July 5, the Cato Institute ran “The Uninspiring Medicaid Debate” by Michael Tanner, whose big concern is Medicaid’s sustainability. He’s a numbers guy, and the numbers don’t look good for Medicaid, even without ObamaCare’s expansion of the program. Tanner lists five salient points, the second of which is: “The Medicaid expansion had nothing to do with women and children”:

While pregnant women and children make sympathetic victims in Democratic campaign commercials, changes to Obamacare’s Medicaid expansion don’t apply to them, because the expansion didn’t apply to them in the first place. It dealt almost exclusively with childless adults. Eligibility for pregnant women and children was raised to 138 percent of poverty as far back as the 1970s and ’80s. You could eliminate the entire expansion without necessarily hitting a single child or pregnant woman.

On July 1, the New York Times ran “Going Small on Health Care,” by Ross Douthat. Douthat thinks Republicans are in the same situation that the Democrats were in seven years ago when they enacted ObamaCare. He prescribes legislation that he thinks would help the GOP avoid the errors of the Dems in 2010, and proposes “a per-capita cap on future Medicaid spending.”

My idea of “going small” is cutting the number of statutes in the U.S. Code. Douthat’s fixes would add to the Code. But if employees of the failing New York Times who are neither insurance actuaries nor medical doctors can chime in on what America’s healthcare system should be, then I suppose I can too:

THE REPEALS: (Notice, it’s plural.) Either in whole or in part, ObamaCare and the McCarran-Ferguson Act both need to be struck down. I’d start with repeal of McCarran, and in a separate stand-alone bill. Why? Because if Democrats won’t support a repeal of the relevant parts of McCarran that have resulted in some of America’s counties having no insurers, then we’ll know they’re dug-in and won’t cooperate on anything, no matter how superior the GOP’s legislation might be. At that point Republicans will know they’re on their own, and will need to consider ending the legislative filibuster.

The repeal of McCarran should also contain a ban on the States interfering in the private insurance market. We’ve recently seen this out west, where the state of Oregon is mandating insurance companies to pay for abortions. In the health insurance market created by the repeal of McCarran, such interference couldn’t be allowed. The McCarran repeal should also ensure that insurance companies offer a variety of plans, including “catastrophic” plans for those who take assiduous care of their health. With the repeal of McCarran we should see a host of new insurance companies sprouting up in the newly-created national market.

Perhaps the worst thing the ACA did was to mix the public and the private; they need to be kept separate. Which means the subsidy program must not be duplicated in a replacement. Yet, we’ve seen a tax credit subsidy scheme emerge out of the House bill and the Senate is doing the same. Enough with the subsidies; the subsidy program, with all its very ill enrollees, is what has caused premiums to skyrocket in the individual market (i.e. the exchanges). Also, the subsidies cover those making four times the official poverty rate; that’s insane.

So here’s what we do: we put the neediest subsidy enrollees into Medicaid. By putting the patients with “preexisting conditions” into Medicaid, we’d socialize their costs, rather than heaping the costs onto the backs of those in the individual market, as ObamaCare has done. In trying to help a very small group of Americans, Democrats hurt another small group of Americans: those already in the individual market. In 2013, the year before the ACA went into effect, the individual market made up only 4 percent of the population. ObamaCare’s shunting of the very, very ill into the individual market, the smallest of the non-military groups, was sheer lunacy. The subsidy program needs to end.

But people don’t like Medicaid; it’s a crumby system; many healthcare providers don’t even accept Medicaid patients. And over the last 50 years, Medicaid has cost taxpayers hundreds of billions in fraud. These things need to be fixed, but in future legislation after we repeal ObamaCare. For the time being, though, the ObamaCare expansion of Medicaid could be retained, but with the promise to immediately reengineer that broken system.

There you have proposals for “going big” on replacing ObamaCare. We erase state lines to create a truly private national insurance market, we separate the public from the private, and we take care of preexisting conditions.

On July 8, National Review ran “Why Senator Toomey’s Medicaid Measure Must Be Preserved” by George Will. Toomey’s provision is “a gradually arriving, but meaningful, cap on the rate of growth of per-beneficiary Medicaid spending.” Like Tanner, Will is also a numbers guy, and he reports on the runaway spending of Medicaid, and how it affects not only the federal deficit, but the States, too. The main reason to read the Tanner and Will articles are because of their focus on numbers: i.e. costs. Fixing our healthcare system is a necessary part of getting control of the federal budget. Will reports (link and italics added):

On June 29, with the health-care debate raging, the Congressional Budget Office revised $134 billion upward, to $693 billion, its projection for the 2017 budget deficit. […] The main reason for the revisions is the CBO’s expectation of interest-rate increases by the Federal Reserve. These will raise the cost of servicing the national debt, which itself is becoming a major driver of its own expansion. Medicaid, however, is another important driver.

The federal deficit got down to -$438B (page 29) in fiscal 2015, lower than it had been since before Nancy Pelosi took over the budget in 2008, but now the deficit is headed upward again, and by an additional $255B. We’re at the mercy of numbers now. We can’t afford the open-ended, unlimited, off-budget, runaway entitlements that the Democrats have promised. We must get control of spending, and not in five or ten years, but now.

On July 12, Human Events ran “GOP Rallies Behind Idiotic Bill,” another witty and perceptive article by Ann Coulter:

Republicans would be better off doing nothing. They can survive the ridicule for running against Obamacare through four election cycles and then not repealing it. They cannot survive a bill that does nothing to fix the actual problems with Obamacare. […] The whole key to fixing Obamacare is not to repeal it, but to allow the rest of us to buy insurance on the free market.

But Republicans may want to repeal ObamaCare regardless of whether they have a replacement or not. Because if they don’t repeal ObamaCare, later this year they’ll be expected to prop it up and bail it out and spend yet more money on it and give it mouth-to-mouth resuscitation. And regardless of what they do they’ll be blamed, which will be on top of the usual accusations of not being ready to govern.

http://bit.ly/2vNCpXI

Charlie Gard is the face of single-payer health insurance

I woke up very early this morning with the tortured picture of an infant running through my mind.

Charlie Gard has a tube through his nose into his lungs, connected to a machine that breathes for him.  He has all the latest electronics monitoring his status.  But he is unable to provide any indication of his pleasure or pain at the process.  He is dying from a horrendous genetic disease that robs his body of the ability to move, breathe, or respond.

Next I saw his parents.  Their expression conveyed the pain that Charlie cannot.  But their pain is not physical; it is emotional.  That is understandable, since their child is dying.  And their anguish is magnified by an emotionless megalith against which they flail to no avail.  Single-payer “health care” has taken their child from them, even while he is still alive.

Such pictures are not new to me.  During my time in critical care medicine, I saw many hopeless cases.  Their diseases had reached a stage where there was no medical reason to continue treatment.  They had no material chance to recover to a point where they would have any meaningful life away from extensive (and expensive) medical support.  And because these medical circumstances were not rare, I helped write my hospital’s policy on Futility of Care.  But Charlie Gard’s case is different from the ones I was involved with.

When Charlie Gard entered Great Ormond Street Hospital in London, England’s single-payer health system, the National Health Service, took over.  At first, it seemed that this was a good thing, since his parents didn’t have to pay extra for his care.  But they didn’t have a choice.  They weren’t in the small minority who are either wealthy enough or favorably employed to access private insurance.  So Charlie was swallowed by the Blob.

Thus far, there didn’t seem to be any difference between single-payer and private insurance.  Both start with the same level of medical care. But shortly, the differences became manifest.  When Charlie’s rare diagnosis became clear (only 16 known cases), the NHS refused to allow any sort of alternative approach.  Charlie had struck the iceberg, and the Carpathia was nowhere to be seen.

After first contact with a doctor who might be able to help, Charlie’s parents set up a crowdfunding page and raised £1.3 million (about $1.7 million).  That’s enough for any conceivable therapy.  They had become financially able to relieve the NHS of any need to care for Charlie.  All the NHS had to do was say, “Yes.”  Instead, the NHS asserted its ownership of Charlie, and multiple courts agreed.  The hospital got court orders to discontinue life support.

What would have happened in the U.S.?  When there is no reasonable probability of returning a critically ill patient to meaningful life, the situation is to be presented to the patient’s health care surrogate.  This “Legally Authorized Person” is encouraged to recognize that further care is futile and should not be undertaken.  With the LAP’s consent, it would become possible to withdraw futile care.

It is critically important to note that the LAP (typically close family) has the authority to tell the medical staff to continue care or not.  It is not up to the doctors or the hospital.  It does not matter that continuing futile care burns out staff and consumes resources.  The family is the final authority, because the family members are the ones who own all rights in this situation.  It would be unethical to proceed without their consent, because they are protecting the patient’s natural human rights, even if they conflict with the medical prognosis.

I know that speaking in terms of “ownership” sounds strange coming from a doctor.  But this is the key fact, based in natural law.  Charlie Gard’s parents “own” him.  They begot him.  They cared for him.  And when he became ill, they cared even more for him by seeking expert assistance.  They are primarily responsible for Charlie.  But single-payer NHS changes everything.

When Charlie Gard came through that Emergency Department door, the NHS took ownership of him.  It’s a classic case of the Golden Rule: “He who has the gold makes the rules.”  (Apologies to Saint Matthew.)  In essence, the NHS said that since it is paying the freight, Charlie is now the property of the State.  His parents were involuntarily dispossessed of their son.  The NHS stole him by force of law.  Parental rights inherent in natural law were “stripped away by strangers.”

The therapy proposed by Dr. Hirano from America supposedly has about a 10% chance of success.  That’s significantly better than the zero the courts have offered.  But let us suppose that it fails.  Is it a total loss?  Almost certainly not.  Knowledge will be gained.  It may not help kids with Charlie’s condition, but it may lead to help for others.  And Charlie’s parents are able to afford it now.  The NHS would incur no further expense.

Even at this late date, with doctors and world leaders lining up to volunteer help for Charlie, the NHS still acts on the basis that it owns the child.  His parents were not allowed to appeal.  Only the hospital had that right.

This conceit is at the center of the single-payer controversy, but no one is willing to actually argue it.  If it were debated, it would show that the “payment” idea is a diversion.  Instead, single-payer advocates have taken the position that the State owns its citizens.

Right now, I have been forced into Medicare.  I don’t like it, and I would happily take an alternative, but legally, I cannot.  Further, if Medicare declares that I can’t have a particular treatment, I can’t even buy it for myself.  That’s exactly the same situation Charlie Gard’s parents are in.  The federal government owns me through Medicare.

My only alternative is to go out of the country for unauthorized care, or to find a cash-only doctor who does not accept Medicare.  And how many of those are there?  I’ve saved enough to have such an option, but how many others can do that?  And suppose I’m in the hospital when the need arises.  I’d have to sign out AMA (Against Medical Advice).  Fortunately, I still have that small shred of personal ownership.

Every time someone proposes single-payer, throw Charlie Gard in his face.  He is single-payer – state ownership of the individual.  After single-payer is instituted, will it be possible that this “government of the people, by the people, and for the people, shall not perish from the earth”?

http://bit.ly/2gUcQSf

Improving health care with doc-in-a-box

The current debate over government-subsidized health care seems unsolvable — there is just not enough money to give everyone what they demand. Nevertheless, this circle can be squared, at least partially, and in a way that will satisfy both free market conservatives and champions of helping the poor. The solution depends on is how health care is viewed and what constitutes “accessibility.” Moreover, this could be accomplished quickly and, in fact, much of it already exists without budget-busting machinations. While admittedly far from perfect, it will certainly help millions of Americans gain better and more affordable health care.

“Health care” should be viewed as a consumer product comparable to food, housing, clothing and other marketplace commodities. So, just as some people of equal incomes daily patronize McDonald’s for cheap burgers, others will skimp for monthly steakhouse filet mignon. In medical terms, some with a medical problem will insist on costly physician at a university-based hospital for their upset stomach; others just buy Pepto-Bismol and pray. Yes, the latter choice might be ill-advised, but choice is choice and it’s the consumer, not a government bureaucrat, who ultimately decides, and this autonomy deserves respect. If there is to be a role for government in this marketplace, it ought to be educational, perhaps warning those with chronic stomach disorders to visit an MD.

Second, health insurance availability should not be conflated with improved quality of life (one might mistakenly gather from the mainstream media that legislators still enamored of ObamaCare believe that its repeal will deprive Americans of eternal life). Even single-payer Medicare-for-all, the Left’s disingenuous socialized medicine, will not improve the nation’s health if consumers disdain treatment. Put graphically, how many older Americans demand, and will actually use, free colonoscopies? One might predict that even generous “free” health care will not entice millions to no-cost annual check-ups. Again, subsidized health insurance does not automatically translated into better health.

Third, despite the heated rhetoric about how the cancer-stricken face certain death if the Affordable Care Act (“ObamaCare”) is repealed, most illnesses are far more humdrum and these should be an important element for government-assisted medical care, particularly for those on limited budgets. Yes, these maladies seldom kill and being generally exempt from government compilations of illnesses, rarely draw much attention, but they are the day-to-day conditions that can make life miserable. Just ask a parent whose child is suffering from a throbbing ear infection. Everybody is familiar with low-level injuries such as sprains, back pains and lacerations, minor burns, insect bites and rashes, allergic reactions, coughs and flu, nausea, diarrhea, asthma reactions, ear infections, severe headaches, urinary tract infections and multiple other “minor” illnesses whose numbers go unnoticed in congressional debates over government-subsidized health care.

Fortunately capitalism has come to the rescue with thousands of neighborhood min-clinics that handle those maladies, usually quickly and at a reasonable price. This is a rapidly growing industry with many of the firms organized into the Convenient Care Association (founded in 2006 but with the first businesses going back only to 2000). The Urgent Care mini-clinics are typically located in malls, stand-alone buildings on highways (often nicknamed “Doc-in-a-Box”) and in high-traffic stores such as Walmart and Target. The drugstore chain CVS is making convenient care central in its expansion.

According to 2015 data, there were some 6400 such facilities and they are growing at the rate of 700 per year. Regarding care quality, the tough-minded American College of Physicians (ACP) endorses the role of these mini-clinics though the ACP warns about over-relying on them.

They are truly the McDonald’s of health care, some even more so since they are available 24/7 and require no advance appointments. Moreover, their upfront price list is a godsend to patients unable to navigate complicated hospital bills where an itemized invoice continue for pages and the sum typically paid after negotiations may not reflect the initial charge. A 2014 PricewaterhouseCoopers study reported that the average urgent-care visit, for patients with or without insurance, averaged $121, and can include blood tests, urinalysis, X-rays, and basic metabolic analysis. An emergency room visit, by contrast, averaged $499, and this figure excluded the cost of lab work, which can run into the thousands. Many hospitals appreciate Doc-in-a-Box for this very reason — they free up already overburdened ERs.

As in the restaurant business, a wide range of quality exists. In some instances, the clinic is associated with a leading full-service hospital (and here) while more down-market facilities supply only a nurse practitioner who might refer you to a hospital if the illness is beyond his or her competency. Also as is true in the restaurant industry, clinics target the local clientele, for example, if lots of gays reside nearby, the available “menu” would features test for HIV/AIDS and shots for sexual transmitted diseases. And for good measure, urgent care facilities, like restaurants, are often rated by previous customers.

Such localism also facilitates decent care for populations (including those who avoid “government” facilities) all too often underserved by megahospitals or specialized MDs. In fact, many of these customers might be fearful of applying for insurance. A CVS facility in an Hispanic neighborhood will probably employ Spanish-speaking doctors better acquainted with illnesses that disproportionately afflict Hispanics, for example, asthma. These local CVS employees may also cultivate personal ties with their clientele and families not possible in impersonal hospitals with dozens of staff doctors.

Ironically, the very existence of these readily available, low-cost facilities may well discourage buying insurance and such rationality undermines the coerced coverage characteristic of government-subsidized health care plans. After all, why pay hundreds per month in premiums and with large deductibles when an unexpected illness can be treated cheaply at the nearby Walmart? Yet again, capitalism defeats what is government run or mandated.

Lastly, if Washington wants to subsidize health care for the low-income, it can be accomplished quickly and cheaply — adjust Electronic Benefit Transfer (EBT) cards (the same cards that provide “food stamps”) to allow charges at government-certified convenient care facilities. This straightforward needs-based solution would be dramatically cheaper and less cumbersome than the current system of private, paperwork-heavy insurance and would be totally transparent. If you have a pesky rash, just Google for a local Doc-in-the Box (or use the Yellow pages), request open hours, if they treat this condition and for how much?  No worry about co-pay or if Cigna will eventually send the payment — cash or credit cards eliminates all the hassles and cuts waiting time to a minimum.

This does not, of course, provide solutions for catastrophic illnesses such as cancer or stroke. Those comparatively rare though fiendishly expensive illnesses are far beyond convenient care and must be addressed differently. In the meantime, however, the market-driven urgent care solution dramatically improves health care to those in need and at a reasonable cost with barely any costly bureaucracy and paperwork. Not even Rand Paul or Bernie Sanders can object to that.

http://bit.ly/2uVERyW

Walgreen Boots apologizes for reply to urgings to cut pill price

British pharmacy chain Boots has apologised for its response to a campaign calling for it to cut the price of one of its morning-after pills and said it was looking for cheaper alternatives.

Boots, part of U.S.-listed Walgreens Boots Alliance, was criticised by health campaigners and lawmakers after refusing to cut the cost of the emergency contraception pill, saying it could be accused of “incentivising inappropriate use”.

The British Pregnancy Advisory Service (BPAS) campaigned for Boots to cut the price for the Levonelle morning-after pill, saying it was more expensive in Britain than other parts of Europe. Its campaign was backed by lawmakers from Britain’s opposition Labour Party.

“Pharmacy and care for customers are at the heart of everything we do and as such we are truly sorry that our poor choice of words in describing our position on Emergency Hormonal Contraception (EHC) has caused offence and misunderstanding and we sincerely apologise,” Boots said in a statement late on Friday.

Boots said pricing EHC was determined by the cost of the medicine and the cost of pharmacy consultation.

“We are committed to looking at the sourcing of less expensive EHC medicines, for example generics, to enable us to continue to make a privately funded EHC service even more accessible in the future,” it said.

http://bit.ly/2uVAEuX

Teva to lay off 7,000 in Israel in reorg to drive competitiveness

Teva Pharmaceutical Industries said on Sunday it would lay off some of its 7,000 employees in Israel in the coming months as it reorganises in a drive to improve competitiveness.

Teva, Israel’s largest company, did not specify how many workers would leave, but a source close to the process told Reuters the number would be about 350, mainly in production.

Teva <TEVA.N> employs 4,000 workers in production in Israel. It has already begun consultations with unions at two of its productions sites, one in the central city of Kfar Saba and the other in the southern Negev desert.

“In light of the complex business reality the entire pharmaceutical industry and Teva in particular face, Teva has been implementing in recent years a global reorganisation,” it said in a statement. “Large parts of this plan have already been completed in most of the countries Teva operates.”

Teva’s acting chief executive, Yitzhak Peterburg, said the company was committed to do all it can to guarantee that its work sites in Israel were competitive, efficient and sustainable for the long term.

Teva was left without a permanent CEO in February after Erez Vigodman stepped down, leaving new management to try to restore confidence in the world’s biggest generic drugmaker after a series of missteps. Chief Financial Officer Eyal Desheh also resigned at the end of June.

The company’s stock price has been languishing since it acquired the Actavis generics drug business from Allergan last year for $40.5 billion (31.17 billion pounds).

http://bit.ly/2vNJM1b