The US healthcare plan shunts billions into R&D in stem cells and neuroscience
by Steve Homan
[ opinion - october 12 ]
Chalk one up for the pharmaceutical lobby. The US drug industry fended off price curbs and other hefty restrictions when President Barack Obama's healthcare law passed, even as the industry prepared for plenty of new business when an estimated 40 million uninsured Americans eventually gain health coverage.
To be sure, the law also levies taxes and imposes other costs on pharmaceutical companies, leaving its final impact on the industry's bottom line uncertain. A recent analysis by Goldman Sachs, the Wall Street firm, suggests the overhaul could mean "a manageable hit" of tens of billions of dollars over the coming decade while bolstering the value of drug company stocks. Others expect profits, not losses, of the same magnitude.
Either way, pharmaceutical lobbyists won new federal policies they coveted and set a trajectory for long-term industry growth. Privately, several of them say their biggest triumph was heading off Democrats led by Rep Henry Waxman, DCalif, who wanted even more money from their industry to finance the healthcare system's expansion.
"Pharma came out of this better than anyone else," said Ramsey Baghdadi, a Washington health policy analyst who projects a $30 billion, 10-year net gain for the industry. "I don't see how they could have done much better."
Costly brand-name biotech drugs won 12 years of protection against cheaper generic competitors, a boon for products that comprise 15 per cent of pharmaceutical sales. The industry will have to provide 50 per cent discounts to Medicare beneficiaries in the "doughnut hole" gap in pharmaceutical coverage, but those price cuts plus gradually rising federal subsidies will mean more elderly people will purchase more drugs.
Lobbyists beat back proposals to allow the importation of low-cost medicines and to have Medicare negotiate drug prices with companies. They also defeated efforts to require more industry rebates for the nine million beneficiaries of both Medicare and Medicaid, and to bar brand-name drug makers' payments to generic companies to delay the marketing of competitor products.
The impressive list of wins is testament to a carefully planned and well-financed lobbying strategy, led by Pharmaceutical Research and Manufacturers of America, the industry's deep-pocketed trade group.
The financial services firm Morgan Stanley estimated a $95 billion, 10-year price tag, offset by tens of billions the companies would gain from extra customers and other provisions. Industry critics say the cost will be lower because of firms' control of prices, and will be more than outweighed by added sales.
Yet even the worst-case scenario - a net cost of tens of billions - would be small for a US drug industry that IMS Health, a medical data firm, calculates earns more than $300 billion a year.
"Let's put it this way: They can afford it," said Tim Chiang, a pharmaceutical analyst in Stamford, Conn.
Drug makers gained a win when lawmakers decided against expanding drug discounts to some hospitals serving low-income patients, a proposal some feared could cost tens of billions. The overhaul law that Obama signed would have broadened those discounts to inpatients, but the companion bill revising the earlier measure largely pulled that back.
Pharmaceutical interests spent $188 million lobbying, more than all but a handful of industry sectors, according to the nonpartisan Center for Responsive Politics. They employed an army of 1,105 lobbyists.
Thomas Jefferson, in his brilliance, knew that times were likely to change; life would not be like it was in 1789 forever, and, thus, the following quote found on his Memorial in DC:
"I am not an advocate for frequent changes in laws and constitutions, but laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths discovered and manners and opinions change, with the change of circumstances, institutions must advance also to keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy as civilized society to remain ever under the regimen of their barbarous ancestors."
- Thomas Jefferson, Panel Four within the Jefferson Memorial in Washington, DC
And, so, the continued gigantic profits for Big Pharma and Big Bio because weapons have changed since Jefferson’s day, as have communications, as has the possible infiltration of enemies within the actual homeland of the United States. In Jefferson’s day, the US was virtually a fortress, impossible to attack because of the two oceans on either side.
Now, weapon-wise, we have within easy reach the ability to attack and conquer entire countries with drugs; we can nearly map each area of the brain and determine what its function is; and we are in stiff competition, even with Britain, to build biological weapons, using stem-cell technology that also could wipe out entire populations - millions or even billions of people within days. This would be worse than a nuclear war during the heyday of the Cold War. Yes, worse.
Unfortunately, human beings have remained immersed in self-loving tribalistic blindness laced with a pathological refusal to accept responsibility for one’s actions. Thus, the latest fairytale, mainly since 9/11, that sees human history as a war between Islam on one side and Christianity and Judaism on the other. This causes participants to think of others as not fully human. They start to believe that others outside their tribe can be mangled, tortured, and killed blamelessly and that it is admirable to do so.
Here’s the tricky part - the part where you may leave this article and never return: I believe Pelosi, Obama, the complicit Democrats and those abhorrent Republicans, behind the scenes (which is quite easy given today’s fawning corporate media) agreed with the Bush-Cheney analysis that billions should go into Big Pharma and Big Bio offensive and defensive R&D as fast as possible - not into healthcare which, in its current and near-future form, kills about 40,000 people a year via sins of omission. But, because of the possibility of another tribe/nation getting its hands on the new weapons.
This windfall to insurance and Big Pharma is different than the one to Wall Street. After all, we never hear derogatory remarks about all that money from Main Street going toward bonuses for health insurance or pharma executives, as we do about the millions for Wall Street bonuses.
This is more like the fantastical area in Nevada where the federal government supposedly stores and does research on UFOs. It’s something that Obama, Pelosi and the feds can’t tell us, or we, the “teeming, unschooled masses,” will panic. And society would end. As if it isn’t hanging by a thread anyway.
How can I back up such fantastical statements? Am I a kooky conspiracy junkie? Maybe. But I don’t think so.
It is well addressed in two new books that in easy-reading-styles describe the coming power of stem-cell and neuroscience weapons.
One book is called The Stem Cell Dilemma: Beacons of Hope or Harbingers of Doom? by Leo Furcht and William Hoffman (Arcade Publishing 2009). It shows how the world of science, including biomedical science, is racing ahead of the world of law.
It also is racing ahead of good-old economics. However, the man or woman on the street has no idea of this ongoing and accelerating “arms race.” The connection of research to economic growth is not as well appreciated as its connection to public health and national defense.
Science involving deadly pathogens, stem cells and cloning has disturbed deeply embedded core beliefs. The “culture of life” championed by religious conservatives can be a formidable barrier to research. But the US’s prudishness may not last long as it loses money. England not only permits but also promotes embryonic stem cell research and research cloning.
To put this in perspective, the global market for just one drug that makes more red blood cells from blood-forming stem cells - erythropoietin - is approximately $4 billion annually. Imagine the value of a drug that could regenerate heart muscle for people who have had heart attacks?
The era of bioterrorism also leaves no room for apathy or ignorance, the authors write.
Big Pharma is connected with Defense, which is where all money goes. No new healthcare system will be devised that lowers the amount of money that can be channeled into Big Pharma because of the weapons (both offensive and defensive) it will have to produce regarding the human mind and stem cells in the very near future.
The US economy depends on continual warfare now, which means money goes to any kind of weapon production - in this case, drugs or stem cell-related products that could be more devastating than nuclear weapons. That is why we will not have single-payor or "government-payor" care anytime soon. This is a hot area because of recent discoveries in neuroscience. Check out the other new book mentioned above, Thomas Metzinger's The Ego Tunnel: The Science of the Mind and the Myth of the Self, (Basic Books 2009):
When neuroscience discovers the sufficient neural correlates for willing, desiring, and executing an action, we will be able to cause, amplify and modulate the conscious experience of will. It will become clear that the ACTUAL causes of our actions will be proved to often have very little to do with what the conscious self tells us.
We now have an information jungle that is increasing each day. It already is reconfiguring our brain. Perhaps our body perception will change as we learn to control multiple avatars in multiple virtual realities, embedding our conscious self into entirely new kinds of sensorimotor loops. A growing number of social interactions may be avatar-to-avatar and we already know that social interactions in cyberspace increase the sense of presence more strongly than higher-resolution graphics ever could. We may finally come to understand that a lot of our conscious social life has been all along--an interaction between images, a highly mediated process in which mental MODELS of persons begin to causally influence one another.
We already use the the Internet as part of our self-model. We use it for external memory storage , as a cognitive prosthesis and for emotional autoregulation. We are learning to multitask, our attention span is shorter and our social relationships have a disembodied character.
A related problem is management of our attention span--the ability to attend to our environment, to our own feelings and to those of others as a naturally evolved feature of the human brain. Attention is a finite commodity. Our brains can generate only a limited amount of attention each day.
The advertisement and entertainment industries are attacking our foundations for experience and trying to rob us of our scarce attention.
New insights into the human mind by cognitive and brain science “neuromarketing” is one of the ugly new buzzwords. The author writes, “If I am right that consciousness is the space of attentional agency and if it is also true that the experience of controlling and sustaining your focus of attention is one of the deeper layers of phenomenal (experience) selfhood, then we are witnessing not only an organized attack on the space of consciousness per se, but a form of depersonalization. New media may create a new form of waking consciousness that resembles weakly subjective states - a mixture of dreaming, dementia, intoxication and infantilization.”
The author continues: “Lives can be ruined because we have not done our homework. The price of denial may rise. Many new psychoactive substances of the hallucinogen-type - such as 2C-B (“Venus” or “Nexus”) or 2C-T-7 (Blue Mystic” or “T7”0 are out on the illegal market without any clinical testing; their numbers will continue to increase.
And that’s just the old homework we never did. In our ultrafast, ever more competitive and RUTHLESS modern societies, very few people are seeking deeper spiritual experiences. They want altered concentration, emotional stability, and charisma - things that lead to success. In the rich societies of the world, people are growing older than ever before - and they want not just quantity but QUALITY of life.
BIG PHARMA knows this, he writes. “Everybody has heard of modafinil, and perhaps that it is already with us in the Iraq war; but there are at least 40 new molecules in the pipeline. There is hope and alarmism is not the right attitude, but the technology is not going away.”
Big Pharma, circumventing the border between legal and illegal substances is quietly developing new compounds; they know that cognitive enhancers will reap them hefty future profits from “nonmedical use.” For instance, Cephalon, maker of modafinil has said that 90 percent of prescriptions currently are for off-label used. The spread of Internet pharmacies has given them new ways for distribution and new tools for mass testing potential long-term effects.
Modern neuroethics will have to create a new approach to drug policy: The key question is: Which brain states should be legal?
In “The Stem Cell Dilemma: Beacons of Hope or Harbingers of Doom?” the writers say that the fate of all societies in the face of bioterrorism and epidemic onslaughts will hinge on the health of the human immune system. Advances in stem cell technology, as well as biotechnology and nanotechnology have revealed both the strengths and the vulnerabilities of this system.
The human immune system is perhaps the greatest marvel of biological complexity ranking far ahead of our other physiology. Its workings have been described as “cognitive” - that is, having an ability to perceive, reason, decide, learn and remember.
Stem cell biology has accelerated our ability not only to follow the development of the immune system, but also to create a replica of the system in a three-dimensional matrix, such as a portable cell growth cassette or “laptop” system.
Stem cells wield undeniable potential in two fateful arenas: emerging microbial threats and biowarfare. That knowledge is putting humanity in an unprecedented position. Whoever possesses that knowledge possesses the power to destroy that is potentially more pervasive and more sinister than its 20th-century thermonuclear counterpart.
The concept of defense has pushed immunology into the forefront of today’s basic research and applied technology, according to the authors. Among the government agencies that fund applied research in immunology is the one that brought us the Internet, Stealth technology, and satellite-enabled global positioning systems. It’s the Department of Defense research arm know as DARPA. DARPA along with many, many centers around the world are eyeing stem cells for use in bioprotection through the construction of an artificial, yet interactive and functional, human immune system in the laboratory from “a common stem cell source” using tissue-engineering technologies. A main first usage would be to test new vaccines.
For these attempts and this genomics research to succeed, strange as it may seem, commercial inkjet printers have become a staple. They actually print LIVING cells. The printers can deposit cells in precise positions in a 3-D matrix of highly specialized bioactive materials that would convert the 3-D space into a bioreactor. A bioreactor can serve as an artificial organ that mimics what occurs in the body.
Researchers at Carnegie-Mellon University have printed a “bio-ink” of stem cells and growth factors that direct their differentiation into specialized cells.
All of this means that the behavior of these powerful tissue-forming cells is increasingly something that can be CONTROLLED for the first time in a 3-D artificial environment. The next step is to attempt to re-create the stem cell microenvironment, the wellspring of regenerative medicine, in bioreactors.
DARPA and academic collaborators have formed a consortium that is borrowing from the architectural genius of bees to build an artificial environment to foster the growth of cells and development of tissue. They used nanotechnology to create a honeycomb scaffold similar to the internal structure of bone marrow that supports stem cells. The scientists found the scaffold stimulated stem cell interactions and that they were able to control stem cell specialization into the different cells that make up the immune system.
The fate of all societies is very close at hand.