Recent news of note:
and a shout out to an excellent source of news and analysis with a focus on Oregon and the broader context:
Posted in Conflicts of Interest, Consumer Protection, Economics of Health Care, Ethics, Generics, Health Care Marketing, Health Insurance, Lobbying, Pharmacists, Prescription drugs, Promotions on 10 May 2012 | Leave a Comment »
Recent news of note:
and a shout out to an excellent source of news and analysis with a focus on Oregon and the broader context:
Posted in Access to Medicines, Cancer, Economics of Health Care, Ethics, Generics, Global Health, Health Care Marketing, Health Insurance, Lobbying, Prescription drugs on 9 May 2012 | Leave a Comment »
Those who have been following the saga of the leukemia wonder drug imatinib mesylate or Glivec (spelled Gleevec in North America to standardize pronunciation) may recall that it was said to be the first medicine for which a global price was set. At the time of its 2001 FDA approval, the worldwide price was US$2400/month, for a base dosage of a 30 day supply of 400mg caps. Indeed, Novartis CEO Daniel Vasella went to great lengths to discuss and justify both the high price and the pricing decision in his subsequent infomercial-type book Magic Cancer Bullet: How a Tiny Orange Pill Is Rewriting Medical History. The Gleevec story is notable too in that the typical pharma claim that the price is justified by R & D costs, was refuted by researcher Brian Druker MD, who detailed how most of the initial work on imatinib was publicly funded and he had to convince Novartis to produce enough of it to begin clinical trials with CML patients. Dr. Druker has also gone on record to criticize the price being charged for Glivec.
Since then patients in wealthy countries mostly have been clamoring for their public or private insurance to cover the drug (and its second-line successors) not that something be done about the price that is exorbitant even in their economies. Novartis invested heavily in worldwide patient relationship marketing for Glivec , which has contributed to this phenomenon, a topic explored previously in this blog. In recent years, it has become much more common to hear complaints from US patients and even some of the big-box disease associations, about the escalating price of drugs like Glivec and especially for new biologics. But it has been rare to to hear demands that something be done about drug prices.
So the recent posting of a patient petition on change.org calling for action to reduce the price of Gleevec is notable: Novartis and US Representatives in Congress: Reduce to patients the cost of the drug, Gleevec.
The introduction of the petition reads:
Novartis developed this drug in the 1990s. In the years since then the price of the drug has increased astronomically. Novartis must have paid their research costs long ago, but the price just keeps rising. Patients with CML leukemia are dependent on the drug to keep them alive. Our US representatives should work with FDA to pressure Novartis to reduce the cost
Setting aside the issue of misunderstanding that there are no price controls on prescription drugs in the US open market and that the FDA does not regulate drug prices, the petition is significant as a reflection of the increasing desperation of middle-class privately insured patients. They are among the majority here whose insurance status and/or income levels typically disqualify them for the patient assistance programs much touted by Novartis, whose global Gleevec sales generated $4.7B in 2011. Many US patients are now finding that the Gleevec price has skyrocketed at the same time that insurers are requiring them to pay a much larger share of its hefty price tag. The situation is quite simply unsustainable.
One person who signed the online petition shared:
I started taking Gleevec June 1, 2001, when it was first approved by the FDA. It cost $2400 for 30 pills. Now, these same pills cost $7367 per month. I pay $1035 per month for insurance to cover this cost. My insurance Co. gets billed for the drug. Why has Novartis raised the price so much? …
A look at Costco’s online pharmacy, which has a reputation, anecdotal at least, for offering “good value” retail prices on Rx meds in the US, found the following cash price for a month’s supply of an average dose (dosage is individualized) of 30 tabs : GLEEVEC 400 MG TABLET $6,264.59
While Novartis is continuing its drag on its patent fight to combat the imatinib generics already on the market in India, these cannot yet be exported to the US. The original US patent for Glivec expires in 2015. In 2009, Sun Pharma filed for and received tentative FDA approval for a generic imatinib for when that day comes.
Given the power of the pharma lobby the future remains very uncertain for any relief on the price of Gleevec , but the clamor of voices from the grassroots is a healthy development.
Posted in Access to Medicines, Advocacy, Assistance, Consumer Protection, Economics of Health Care, Environmental Health, Ethics, Generics, Health Care Marketing, Health Insurance, Lobbying, Pharmacists, Prescription drugs on 20 March 2012 | Leave a Comment »
Recent developments in Washington and neighboring Oregon are reminders of the clout and lobbying power of Big Pharma on the local level.
Seattle City Councilmember Tom Rasmussen announced that he was working to implement a discounted prescription drug program for Seattlites , a program of the National League of Cities. At first glance this might seem like a boon most of us, cash-strapped and increasingly uninsured and underinsured, but in reality the plan is not needed, won’t offer much in the way of bargains, and is linked to a questionable PBM. With all due respect to Rasmussen, who undoubtedly has good intentions , he seems unaware that we already have a drug discount program available at no charge to all state residents, the Washington Prescription Drug Program , which offers discounts up to 60% on generics and 20% on branded drugs, while the NLC program offers maximum discounts up to 23% of full retail prices. Another concern is that the NLC card is an offering of CVS Caremark, the mega-PBM which has earned itself notoriety for unethical business practices, including overcharging government employee health plans ( including the federal plan) for Rx medicines and drug-switching on scripts. The Seattle-only program is due to start next month, so now is a good time to weigh in with Rasmussen and his fellow City Councilmembers , as well as with Mayor Mike McGinn on the issue. In addition to helping to increase awareness of the WPDP, our city elected officials could really offer a public service by creating a drug price comparison tool that surveys Seattle pharmacies.
And in the Washington Legislature, among several bills dealing with prescription drugs ( look for my comments in the future), for the third year in a row we saw Drug Companies Fight Take-Back Program for Unused Medicine. They claim that take-back programs, which they would be required to help pay for, would do little to stop abuse of prescription drugs and that environmental concerns about trashing meds are essentially bogus. Take Back Your Meds, a group of over 260 health organizations, police, drugstores, local governments, environmental groups and concerned individuals vows to keep up the fight.
In Oregon, a legislative defeat with direct negative impact there and for partner WA in the Northwest Drug Purchasing Consortium , pharma and insurance industry muscle united to make sure that Oregon Prescription Drug Program Bill Dies a Second Death. SB 1577 would have required all state agencies to purchase medicines for beneficiaries through the Oregon Prescription Drug Program, reversing the current optional status. When the OPDP and the WPDP were created in 2005, they formed the Northwest Prescription Drug Purchasing Consortium to achieve better prices through pooled volume purchasing but left participation optional for state agencies. In both states, for example, the Dept. of Corrections does not participate. And with efforts to control Rx costs stymied, we are seeing scenarios such as this year’s state budget proposal in Washington to eliminate completely prescription drug coverage for adults in the Medicaid program, only now with some hope of possible mitigation if competitive bidding for generic drugs is approved by the Legislature now in Special Session.
Posted in Access to Medicines, Advocacy, Cause Marketing, Consumer Protection, Economics of Health Care, Ethics, Generics, Global Health, Health Care Marketing, Health Care Reform, Lobbying on 30 July 2011 | Leave a Comment »
Recent news and commentary of note on US and global issues related to health and well-being:
Posted in Advocacy, Discrimination, DSHS budget, Economics of Health Care, Ethics, Health Disparities, Healthcare Inequalities, Language Access, Language Services, Lobbying, State of Washington on 15 February 2011 | Leave a Comment »
Things are still beyond grim as the work on Washington State’s budget continues. However, on February 4, there was a more hopeful sign when the Senate approved its version of the Supplemental Budget, including a provision to continue the Basic Health Program, although in reduced scope, by drawing on the Life Sciences Discovery Fund. The LSDF was established in 2005 from WA’s share of national tobacco settlement funds. Both the Governor’s budget and the one previously approved by the House had cut BHP, along with the DSHS long-standing interpreter services program for Medicaid and CHIP patients These potentially promising developments however have garnered less attention than another set of proposals in HB 1847 ,which would to sustain funding for BHP by eliminating tax exemptions for Big Banking, and sales taxes on elective cosmetic surgery and private jets.
While advocates regard these developments as positive, the struggle is far from over. The Supplemental budget is now undergoing the reconciliation process by both houses and will needs the Governor’s approval; the Biennial budget will have its turn next. Both contain deep cuts in virtually every area of life affecting Washingtonians, with the worst cuts affecting the most vulnerable populations, especially immigrants and refugees. WA Budget cuts 2011.
The history of these two programs is of particular note at this critical time. The original intent of the Master Tobacco Settlement Agreement was to fund health services in the states for those affected by smoking. At the time, Gov. Gregoire, aware that the state would come into additional funds from that source by 2009, planned a move to combine them with private monies to develop a biotech sector. In a 2005 commentary prescient of current threat of extinction for the Basic Health Program (which began as a 1987 pilot project and became permanent in 1993) the Seattle Weekly had reported:
It will be controversial because originally the tobacco settlement money was supposed to be used to help states offset the health care costs associated with smoking. In 2003, when Gary Locke floated an idea similar to the Life Science Discovery Fund—he called it Bio21—Senate Majority Leader Brown told Seattle Weekly she didn’t like the idea of using tobacco money for biotechnology. “We are one of the few states that has remained true to using that money for health care,” she said at the time. Expect the debate over the best use of the tobacco money to continue.
As I had written previously, in late October 2010, after the Governor had issued her call for “across the board budget cuts” from every state agency, the LSDF awarded $5 million to a private company engaged in personalized medicine research. Last week, LSDF awarded $600,000 in commercialization grants to four research projects.
The Interpreter Services program also was created as a result of federal litigation, in this case as a result of a 1991 Consent Decree negotiated with the Office of Civil Rights in response to lawsuits and civil rights complaints filed against DSHS for failing to provide equal access to services for clients with limited English proficiency By law, in this case the Civil Rights Act of 1964, title VI, recipients of federal funds must not discriminate against program beneficiaries on the basis of race, color, or national origin. Courts have defined lack of language access as a form of discrimination based on national origin. However, the responsibility to fund language services is ultimately that of providers. Since techncially Washington funded the DSHS program voluntarily, it is now able to seek to de-fund it, unlike other mandatory programs. But in doing so, the state would also forgo specific federal funds that it has been receiving that have covered 50-75% of the total costs, as the Washington State Coalition for Language Access explains in a fact sheet: WASCLA DSHS Interpreter Services Talking Points January 2011
Posted in Advocacy, Discrimination, DSHS budget, Economics of Health Care, Ethics, Health Disparities, Health Insurance, Healthcare Inequalities, Language Access, Lobbying, Recession, Responsible journalism, State of Washington on 4 February 2011 | Leave a Comment »
A front-page article published on February 1 by The Seattle Times, now the Emerald City’s sole remaining daily newspaper, purporting to describe new state demographic trends, is causing outrage at a very critical time. At this very moment the draconian cuts proposed by the Governor to balance the budget, are the subject of contention in the Legislature as advocates struggle to convince lawmakers to preserve at least the semblance of a safety net . The program cuts would disproportionately affect poor immigrants and refugees and communities of color, as the planned terminations cut deeply into a range of services from state food assistance, citizenship programs, Medicaid medical interpreter services, to health insurance plans which now cover noncitizen adults and some 27,000 children enrolled in the Children’s Health program of Apple Health for Kids, among other vital services. In addition, other bills being considered would promote racial/ethnic profiling of state residents, including requiring citizenship checks of applicants for drivers’ licenses to those targeting youth for incarceration on the basis of presumed but not proven gang affiliations.
So it seems like more than a coincidence that the Times story Illegal-immigrant numbers in state jump 35% in 3 years was published the day before the Senate Ways & Means Committee was to hold a hearing on the 2011 Supplemental Budget bill which encompasses all of the cuts. The Times article discussed a just-released report from the Pew Hispanic Center entitled Unauthorized Immigrant Population:
National and State Trends, 2010, about results of the Census Bureau’s Current Population Survey. Beyond just the damage that the inflammatory and dehumanizing language of the article’s title can cause in the court of public opinion , it turns out that reporter Lornet Turnbull got his facts wrong too. Subsequently Jeff Passel, one of the authors of the Pew report, was interviewed by a reporter for local radio station. Passel said that based on the Census data, there was no evidence that Washington’s undocumented population had increased, pointing to the high margin of error in the data analysis and its very small sample size, and more pointedly, that the Seattle Times had not done fact-checking with Pew. The Feb. 3 interview Dispute About Growth Of Undocumented Immigrants In Wash. can be heard in its entirety on the KUOW website.
In these desperate economic times, articles like this one in the Seattle Times serve only to scapegoat all immigrants for the economic woes of the state (and the nation) instead of focusing on the genuine causes of the recession. Over 400 comments have been posted in response so far, most of them of a hate-mongering nature. Recognition that Washington’s regressive tax structure means that all of us contribute at the same (sales tax) rate to state coffers, regardless of immigration status or income, is handily overlooked by the ranters. Interestingly, the Times has posted a partial correction to the article, explaining that undocumented people constitute a small fraction of the state’s population
A previous version of this story incorrectly stated that illegal immigrants accounted for nearly 5 percent of the state’s population, giving Washington the seventh highest rate of illegal immigrants in the nation. A Pew Hispanic Center report, on which the story was based, incorrectly attributed the percentage and ranking to Washington state rather than to the District of Columbia. The center has corrected the information in its online report to reflect that illegal immigrants comprise 3.4 percent of Washington state’s population, a rate that does not rank it among the top 10 states.
The story’s problematc title and other content inaccuracies however remain the same, its damage done. Use of attention-grabbing headlines is a journalistic technique of course; likewise fewer readers ever bother to go back to read corrections.
Posted in Access to Medicines, Advocacy, Assistance, Cause Marketing, Consumer Protection, Economics of Health Care, Health Care Marketing, Health Care Reform, Health Insurance, Lobbying, Patient groups, Promotions on 17 January 2011 | Leave a Comment »
The article Efforts to Undermine Public Health: Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis of Disclosure Practices in the Jan.13 issue of American Journal of Public Health focuses some much-needed attention on a serious and growing problem , which directly impacts the creation of rational health policy. It’s also good to see the wide media attention being given to the study, which has been flagged by venues across the spectrum, including healthcare sector analysis and investigative reporting blogs to mainstream business media and news reports.
It’s been interesting too,but not surprising to see, that a number of people are also sending identical comments to multiple venues which covered the story, some to decry the findings of the study, or to make off-topic remarks. The comments from the National Health Council , for example emphasized that it has a policy of requiring member groups to have internal disclosure policies regarding industry support received. The NHC itself has a listing of funding received in 2009 from its many “Corporate Partners.” However, just like with payments to physicians, merely acknowledging industry funding doesn’t mean that it does not influence the actions of the recipient, nor not create conflicts of interest. Unlike the significant body of research on the topic of influences on the prescribing practices of doctors (which have found that while many state that they themselves are not influenced by pharma gifts and perks, they believe that their colleagues are) , much less attention has been paid in the US to the phenomenon of industry support of HAGs and its impact on public policy.
Based on personal observations both as patient and a healthcare professional , I believe that the “don’t bite the hand that feeds you” phenomenon relating to HAGs, contributes to the present inaction on getting states and federal government to do something about the exorbitant and escalating price of medicines as a public health measure. Until the electorate actively protests what is going on, the lobbying power of the biopharma industry on Congress will remain in effect. While it is becoming more common to find media pieces highlighting complaints by provider and disease groups about the price of Rx drugs, along with the unaffordable co-pays for those insured, almost never do we hear patient advocacy groups demand that something be done about the situation. The only logical conclusions that seemingly can be made about the scenario is either that the public is incredibility naive about how the pharmaceutical and insurance industries function, or else HAGs have been so influenced by their pharma benefactors that recipients actually believe that the prices are justified by R & D costs, and that patient assistance programs ( PAPs) are a genuine access solution. Likely it’s some combination of factors. More about this later.
Since a requirement that HAGs disclose industry funding was dropped from Sunshine Act provisions incorporated in the ACA, it’s time start to address the problem by pressing the IRS to require that all 501(c)3 charities disclose their funders and amounts received from each. At the same time, much more public education is needed about “the ties that bind”, to paraphrase the title of a 1999 report on the topic by Health Action International.
In the meantime, those interested in starting to research industry links to patient and disease groups will find the following resources of independent organizations helpful:
Knowledge Ecology International
Medical professional and patient group funding by drug and medical device companies
I’m catching up on my reading now, so passing on links to a number of important studies , some ongoing , published in late 2010, including:
MSF/Doctors Without Borders
Access to Essential Medicines: Ten Stories That Mattered in 2010
American Medical Students Association
AMSA PharmFree Scorecard 2010 : Conflict of Interest Policies at Academic Medical Centers
and in the news Supreme Court Reviews Data Mining & Free Speech
Also of note, the upcoming conference of the National Legislative Association for Prescription Drug Prices :NLARx Meeting on Drug Pricing & Affordability, Friday, January 21, 2011, Washington D.C.
Posted in Access to Medicines, Consumer Protection, Economics of Health Care, Ethics, Generics, Global Health, Health Care Marketing, Health Care Reform, Health Insurance, Lobbying on 10 January 2011 | Leave a Comment »
Beyond the challenges planned to overturn the Affordable Care Act in the US, we need to keep abreast of news from around the world affecting access to care , such as these headline stories:
Darcy Malard-Johnson, a pharmacist at the University of Minnesota’s cancer clinic, said 13 of the 150 drugs on the current shortage list are cancer drugs. Most have been around for years, she said, and that may be one of the problems. Because they’re generic, they’re not as profitable to make or sell as newer drugs. And there’s no way of knowing when a company will simply decide to stop making it.
The shortage of oncology drugs in particular was also highlighted in NCI Cancer Bulletin in an article entitled Continued Shortage of Chemotherapy Drugs Causing Concern.
The FDA’s Drug Shortages website includes current shortages, status updates, and a list of drugs to be discontinued, per the following terms:
Companies are required under 21 CFR 314.81(b)(3)(iii) to provide FDA with a six month advance notice of the discontinuation of sole source products that are life-supporting, life-sustaining or for use in the prevention of a debilitating disease or condition. From time to time, FDA also receives notification for other products. These discontinuations are provided below for informational purposes only.
Health Canada currently does not conduct such monitoring or provide information on drug shortages, actions that the Canadian Pharmacists Association has urged the government to take on quickly to address the serious and growing problem.
Posted in Access to Medicines, Assistance, DSHS budget, Economics of Health Care, Ethics, Global Health, Health Disparities, Healthcare Inequalities, Language Access, Lobbying, Recession, State of Washington on 3 January 2011 | Leave a Comment »
The end of the year with its annual holidays found many of us here in Washington State feeling anything but in a festive mood, given the imminent decimation of core health and human services, as part of the Governor’s proposal for balancing of the state’s budget in the new year and for the biennium. On September 13th, Governor Gregoire’s Executive Order 10-04 instructed all state agencies to make reductions in their allotments from the State General fund in order to meet the requirement for a balanced budget. On September 29, DSHS issued its initial plan of how the 6.3% across-the-board budget cuts would be applied to Department programs to meet this mandate. The proposed cuts were aimed at every program and service (included some entirely state-funded and other linked to Medicaid) not technically defined as “mandatory,” affecting the state’s most vulnerable populations in all age-groups from pre-cradle to grave, and including primary care delivered at community health centers.
By December, a supplemental budget proposal with even worse news was issued, containing further proposals for achieving the needed $4 billion in savings to balance the budget. The drastic cuts to almost every aspect of civic life, was driven by outcomes of ballot measures from the November elections, which dashed any hopes even of short-term new revenue generation from snack sales, rejection of a first-ever state income tax to have been levied only on the wealthiest among us, and hamstrung future legislative efforts to raise taxes with the 2/3 majority approval stipulation. By December 30, the Governor released the latest list of planned budget cuts,and the timeline for their elimination. While some of the worst of the cuts have been staved off or delayed temporarily, it still remains to be seen whether the remaining services will be funded, even in vastly reduced mode, and how many human beings affected by the cuts will even survive.
While at this stage in my life nothing surprises me any more, the discrepancy between what is happening to these most basic of services and the treatment of the high-profile, socially attractive high tech sector by state government should be a wake up call to all of us who value a decent society. While the majority of Washingtonians have not misbehaved, it seems like the most vulnerable among us are being singled out for punishment.
State Dollars > Private Venture
During exactly same time period that the budget cuts were first announced in October, another state agency, the Life Sciences Discovery Fund, gave a grant of $5 million to a private, for-profit business, the Omeros Corporation, a Seattle biopharmaceutical company, for research into speculative personalized medicines. The grant to Omeros was rolled into a package deal for the firm, that included $25M from Paul Allen’s Vulcan Capital. Even Xconomy: Seattle‘s biotech reporter Luke Timmerman expressed great surprise at this development in his Dec. 14 article entitled Life Sciences Discovery Fund Debunks Perceptions with Omeros Deal, Shows State Can Bankroll Companies. If the research ever pans out, then there is the possibility of financial returns to the state at some unknown time in the future.
A bit of background: Washington’s Life Sciences Discovery Fund was established by the Legislature in 2005 to disburse the tobacco settlement funds allocated to the state. While the the fund originally had been allocated $350M for a 10-year period, when the State’s budget crisis threatened to shut down the program in 2009, it survived with a budget cut of 41% or $39M in funds for FYs 2009-2011. The LSDF’s stated mission is as follows:
The Life Sciences Discovery Fund supports innovative research in Washington state to promote life sciences competitiveness, enhance economic vitality, and improve health and health care.
which the program website further explains as intending to “foster growth of the state’s life sciences sector and improve the health and economic wellbeing of its residents.”
But given the crisis situation we now face–in context of course of the ongoing national recession–emergency measures are needed. It hardly seems the time for state government to be investing in private companies, purely ethical issues aside for the moment. Obviously, it’s going to take more than redirecting the “mere” $5M given by the LSDF to a private venture to save public health services in Washington State, but those funds certainly could have turned things around for a good number of the axed programs, such as the Basic Health Program insurance plan and so many Medicaid services. While research is important, without access to care, medical innovations are meaningless. What good is research, if there is no safety net? Given the LSDF’s mission, it should be part of the logical solution needed now: making sure that all Washingtonians can benefit from the medical knowledge available today. And the state government can take a leadership role too in education on the need for investment in our human capital. Despite laments over the election outcomes,and grim prognostics, the official ChooseWashington.com website continues to highlight the array of attractive tax incentives, some of which I had commented on previously, for certain types of companies to set up shop here, along with the absence of a personal income tax.
Another part of the Governor’s plan to balance the budget, announced December 14, is to eliminate Boards and Commissions. No mention was made in this announcement, however, about the status of a brand-new board, the Global Health Technologies Competitiveness Board established in July 2010, after SB 6675 Creating the Washington global health technologies and product development competitiveness program and allowing certain tax credits for program contributions, was approved by the Legislature and signed into law by Gov. Gregoire. Per RCW 43.374.010, among the Board’s charges are seeking funding from the private sector, foundations, and the federal government in order to issue grants to local enterprises …to stimulate our economy and foster job creation in the emerging field of global health while improving the health of people in our state and the world. The program is required to be administered by a 501(c)6 tax-exempt nonprofit organization, which contracts with the Dept. of Commerce for administrative services.
The Global Health Technologies Competitiveness Program (GHTCP) was awarded $1M by the Legislature (evidently not subject to the budget cuts) and issued its first RFP in mid-November, with awards expected to be announced early in the new year, along with a second RFP announcement, according to the Washington Global Health Alliance.
Think Globally, Act Locally ?
These new developments beg the question of just exactly what these specific state-funded programs are doing to improve the health of Washington residents in the here and now. I write these words from the perspective of understanding full well how domestic and international health are inextricably linked, whether regarding diseases rapidly transcending national borders or concerning the impact of international trade agreements on availability of medicines for US Medicaid programs, just to name a few examples. I myself am alive today partly as a result of medical advances developed here in Seattle, and I am also directly involved with both local and global health equity work, which makes me even more appalled at what is going on. Global health has been described as Seattle’s “next hot industry,” but few are the public voices applying critical thinking skills to analyze what this actually means for local folks. One of the exceptions is that of Seattle journalist Tom Paulson, who now offers insights on his Humanosphere blog. such as a November 2010 story on a still-vague, 5-year $1M Swedish Medical Center pilot project called Global to Local targeting two low-income communities in South King County. Tom pointed out the irony of this program being rolled out at the very same time that well-established and proven-effective, public health services are being slashed. According to the article, G2L is based on a concept that the “best practices” used by local actors in overseas health programs can be applied here at home too, while structural reasons for domestic health and healthcare inequalities are not addressed. And another observer, Steve Gloyd, MD of Health Alliance International and the UW Dept. of Global Health, has opined that there can be an upside to calling global health an “industry”:
“Maybe using the word will shock people into recognizing that when a local biotech firm says it is working on a vaccine to help people in Africa, some will see it is actually just trying to make a few people in Seattle rich.”
Next year, a new nonprofit called Global Health Nexus will commemorate the 50th anniversary of the Seattle World’s Fair with a major conference and exhibition showcasing the region’s global-health advancements. One has to wonder if anyone working to improve health at the local level will be invited to present, or if we’ll be able to afford the registration fees. Perhaps advocates can submit an abstract for a session there featuring real-life Washingtonians sharing first-hand accounts of the outcomes of state budget cuts on preventable health problems, such as a child who has been experiencing asthma attacks since elimination of the Children’s Health Program; an adult with diabetes who had to get their leg amputated due to lack of non-emergency podiatry care; or the relative of a patient who died due to a wrong diagnosis resulting from lack of a medical interpreter; or we could show videos of overflowing ERs full of patients bumped from the Basic Health Program and unable to be seen at community clinics. Then maybe we could pass the hat among the rich and famous to take to up a collection for local health.