Politics: A new beginning

[sgtclub]

http://news.yahoo.com/news?tmpl=stor...dc_3&printer=1

[Only coalition countries permitted to bid on Iraq reconstruction contracts]

[Not Me]

Originally posted by Atticus Grinch
You're getting slightly funnier. I'm howling at the thought that all Minnesota doctors who end pregnancies in trimesters one and two are somehow squicked out by D&E. I guess MN medical schools produce graduates who are extremely sensitive and can't stand gruesome medical procedures.

You really don't understand the differences in the procedures if you think that. First of all, not any old doctor can safely perform a 3rd trimester abortion. They are performed by OBs who have trained in this procedure. And they are surgical operations performed in the OR under anesthesia, not in a clinic as a first trimester abortion is.

A first trimester abortion usually consists of placing a canula in the uterus and turning on suction. Then some tissue and blood gets deposited in a tank and disposed of. By the third trimester, the baby has bones and a skull and cannot be sucked out. There are various ways of performing late-term abortions and you can read about them for a small fee here:

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

Then ask yourself if you would like to perform one if you were an OB. It is one thing to remove a tumor from someone's body. It is another thing to remove a baby that you participated in ending its life. When it is just a mass of tissue and blood that gets sucked out, it doesn't even look like a baby. But when you remove an actual baby, albeit a dead one that is chopped into pieces, it is quite a different experience. Lots of doctors and nurses see this distinction and don't want to participate in late-term abortions. That doesn't mean that they are anti-abortion, although it can mean that. Some of the people are pro-choice but just choose not to be involved with providing late-term abortion.

If you don't believe me about this, call around and see yourself how many OBs there are that will do a 3rd trimester abortion. And ask the doctors and nursees who do them or assist how traumatic it is or is not. Just because someone will perform these procedures doesn't mean that they don't feel emotional trauma from them. They just believe that the ends justify the means. In the case of an anencephalic baby, I agree with them. But just because I agree with them doesn't mean that I would do one and many OBs feel the same way and choose not to do them.

Anyhow, it would be unconstitutional for Minnesota to outlaw all late-term abortions. So the reason that there are no late-term abortion providers in Minnesota isn't because of the law. It is because there aren't that many docs that will do them.

Originally posted by Atticus Grinch
Another possible explanation is that your side can't control its radicals, and no one wants a bullet in the brain for such a remote principle. I think we should even the score by making all anti-abortion radicals who are willing to kill for the cause take out Yellow Pages ads, so my side's radicals can even the score a little bit. Fair fighting is a midwestern value, after all.

Nice. I am not taking sides in this debate. Just stating the facts.

FYI - intact dilatation and extraction is the medical term for a partial-brith abortion. Late term abortions can also be performed by dilatation and evacuation.

[bilmore]

Originally posted by Atticus Grinch
Another possible explanation is that your side can't control its radicals, and no one wants a bullet in the brain for such a remote principle. I think we should even the score by making all anti-abortion radicals who are willing to kill for the cause take out Yellow Pages ads, so my side's radicals can even the score a little bit. Fair fighting is a midwestern value, after all.

You're getting funnier as you age.

Let me preface this by saying that I ain't pro-life, I ain't pro-choice, and I really don't much feel like even getting involved in the debate.

Then let me mention that I suspect the law was written to make a difference in the thousands and thousands of other cases that are slightly more "normal" (you know, the dead babies 'cuz someone was inconvenienced), and that I bet I can find horrific stories that have resulted from the granting of civil rights and liberties, (Dru, anyone?), or from liberal taxation-of-the-rich-'cuz-they-can-afford-it (remember the american boat industry?) or . . . pretty much any initiative taken for any cause, forever.

Somewhere, I'm sure, someone died a horrible, innocent death because a food shelf was established. Let's make our arguments on that kind of basis, shall we?

Oh, wait, that would be ignorant and overtheatrical.

[Not Me]

This legal case acurately discusses the differences between an intact dilation and extraction (partial birth abortion) and a dilatation and evacuation:

http://www.law.emory.edu/4circuit/ju...81930or.p.html

Here are the excerpts. Read these descriptions and you tell me if you want to do that for a living? That doesn't mean that the OBs who won't do these are anti-abortion. Most aren't. They just don't want that to be part of their practice. There really aren't many who do these procedures.

This is the typical D&E (which is not a partial birth abortion)

In the conventional dilatation and evacuation procedure, the abortion provider, in addition to using suction, typically dismembers the fetus with a pair of forceps and then removes the fetus from the uterus in pieces.

This is the intact D&X (which is a partial birth abortion)

the late-term abortion procedure in which the physician pulls a lower extremity into the vagina and then uses his fingers to deliver the lower extremity and then the torso followed by the shoulders and the upper extremities. At that point, the skull is lodged at the internal cervical os. Usually the dilation is insufficient for the skull to pass through. At that point, the surgeon slides his or her fingers along the back of the fetus; uses a pair of blunt curved scissors to rupture the base of the skull; and uses a suction catheter to evacuate the contents of the skull and then applies traction to the fetus to remove it from the patient.

Those are the choices in late-term abortions. Either stick the forceps into the uterus and crush the skull and dismember the limbs or pull the fetus half way out of the uterus feet first and suck the brains out with a canula. Personally, I don't see where a D&E is any less gruesome than a D&X.


Do you think when you evacuate the contents of the uterus in a third trimester abortion, you don't see the little limbs or the crushed skull? Of course you do. And it is not a pleasant experience for those witnessing it. That doesn't mean that they don't believe what they are doing is right in the case of severe birth defects or life of the mother. They do. But it is also why so few docs will do these procedures.

Fetal Hand

[Tyrone Slothrop]

Originally posted by Hank Chinaski
Webster was a dem, or a whig maybe, but anyway......
you specifically seemed to say the government should have insisted/bought/regulated the production of more flu vacine. how the f does that come under this?

It sounds like we can't rely on free market incentives to ensure that we have enough vaccine, and that we should be subsidizing the manufacture of more in some way.

and the social sanity sciences shit...... are you saying I don't wipe correctly?

That's between you and your Underoos.

[Not Me]

Originally posted by Tyrone_Slothrop
It sounds like we can't rely on free market incentives to ensure that we have enough vaccine, and that we should be subsidizing the manufacture of more in some way.

The vaccine industry is not like the rest of the pharma market. It is hard to get companies interested in making vaccines because they are low margin products with potential for high liability.

[Tyrone Slothrop]

Originally posted by Not Me
The vaccine industry is not like the rest of the pharma market. It is hard to get companies interested in making vaccines because they are low margin products with potential for high liability.

And if people get sick because they didn't get the vaccine, the cost to the company is only the lost profit from the marginal dose.

[ltl/fb]

Originally posted by Not Me
The vaccine industry is not like the rest of the pharma market. It is hard to get companies interested in making vaccines because they are low margin products with potential for high liability.

I'm sorry, but I fail to see how this is totally unlike the rest of the pharmaceuticals market. It is unlike some high-end products that remain under patent, but it does not seem unlike older, but still effective, products for which there is actually competition. Perhaps we are far more aware of the newer, higher-margin products because those are the ones advertised to us and to our doctors.

The main way in which vaccines seem different from most pharmaceuticals is that they are for prevention, not treatment. Related to this is that the effect . . . fuck, I don't know how to express this without going to numbers, the cumulative effect of 95 out of 100 people having it is far more than 95 times the effect of one person out of a hundred having it.

I'm sure this is somehow conceptually related to easily monopolized situations -- situations where entry costs are so high that you rarely get duplicative services set up, and there has to be intervention to produce competition. You know, like railroads -- if company X builds the railroads and only allows its own trains to run on the tracks, it can set prices pretty much how it wants because, what, some other company is going to lay the same tracks? Yes, I know, there will be competition from road transportation and air transporation and people in buggies carting their goods to market, but those aren't perfect substitutes. But I'm not sure how. I will work it out later.

[Not Me]

Originally posted by Tyrone_Slothrop
And if people get sick because they didn't get the vaccine, the cost to the company is only the lost profit from the marginal dose.

I am not sure what you mean by "marginal dose." BTW - I wasn't disagreeing with you. I am agreeing with you.

Market forces aren't too likely to work to produce adequate vaccine supplies. This is because it is a low margin, high liability product and there aren't likely to be many or any new entrants into the market.

[Not Me]

Originally posted by ltl/fb
I'm sorry, but I fail to see how this is totally unlike the rest of the pharmaceuticals market.

The rest of the pharma market is high margin as long as patent protection exists. Very, very high margin. And in general, lower liability costs, too.

There has been much written on this topic and if you research it, I am sure that you will find the articles. These links can get you started in your research:

http://www.nap.edu/books/0309035449/html/index.html
http://www.gao.gov/new.items/d02987.pdf

[ltl/fb]

Originally posted by Not Me
The rest of the pharma market is high margin as long as patent protection exists. Very, very high margin. And in general, lower liability costs, too.

There has been much written on this topic and if you research it, I am sure that you will find the articles. These links can get you started in your research:

Wow, I wonder if that's why my post went on to talk about the high-end shit covered by patents having a big margin and how that differs from older drugs that are off-patent. Y'think?

I'd bet that there are a lot more drugs not covered by patent than drugs covered by patent. You just don't hear about them as much because they aren't as interesting, I mean, they aren't as profitable so why advertise them? Not to say that a lot of newer drugs aren't better than older ones, but I've ended up taking sulfa drugs when the newfangled antibiotics didn't kill whatever I had -- and those are ancient. They may even have had them when Atticus and bilmore were kids.

Is Prilosec still on patent but just not prescription anymore? I had thought its patent had expired, but I'm not seeing that there are any different brands available, and that seems odd. But, maybe the current manufacturer is really selling it at a price that others can't beat. Odd.

[Tyrone Slothrop]

Originally posted by Not Me
BTW - I wasn't disagreeing with you. I am agreeing with you.

Likewise, I was agreeing with you. We were agreeing together.

Market forces aren't too likely to work to produce adequate vaccine supplies. This is because it is a low margin, high liability product and there aren't likely to be many or any new entrants into the market.

Yes. Inter alia.

[Not Me]

Originally posted by ltl/fb
I'd bet that there are a lot more drugs not covered by patent than drugs covered by patent. You just don't hear about them as much

Maybe YOU don't hear about them, but those in the know know.

Originally posted by ltl/fb
Is Prilosec still on patent but just not prescription anymore? I had thought its patent had expired, but I'm not seeing that there are any different brands available, and that seems odd. But, maybe the current manufacturer is really selling it at a price that others can't beat. Odd.

You are confused as usual. First of all, there are many different brands of proton-pump inhibitors available. Different patents cover different proton-pump inbitors. The difference is that only priolsec is OTC. The others are by prescription only. However, they are all proton-pump inhibitors that work by the exact same mechanism and have the same safety profiles so there is no reason for only prilosec to be OTC. But that is a different issue. It is like why is claritin OTC but allegra is not? I know the answer but I am not telling you. I prefer that you remain confused.

Even if the patent is still in force, for a variety of reasons, a company may license the patent to others. There are a few good examples of this, but again, I am not telling you about them. You can remain confused.

[Secret_Agent_Man]

Originally posted by Not Me
Maybe YOU don't hear about them, but those in the know know.

You are confused as usual. First of all, there are many different brands of proton-pump inhibitors available. Different patents cover different proton-pump inbitors. The difference is that only priolsec is OTC. The others are by prescription only. However, they are all proton-pump inhibitors that work by the exact same mechanism and have the same safety profiles so there is no reason for only prilosec to be OTC. But that is a different issue. It is like why is claritin OTC but allegra is not? I know the answer but I am not telling you. I prefer that you remain confused.

Don't be snotty.

Actually ltl -- there are (or soon will be) generic versions of omeprezole (Prilosec) available on the market.

Claritin and Prilosec are both available OTC because consumer groups and health insurers placed tremendous pressure on FDA to switch those very popular and very expensive drugs from Rx to OTC status -- arguing that they are essentially proven as safe as any OTC drug. FDA had never done this without the manufacturer's consent.

The manufacturers fought that effort at first -- because it would mean less $$, but then switched strategies and concented to the swith to OTC when it became fairly clear that they were soon to lose patent protection AND (most importantly) when they had their next generation versions (Clarinex and Nexium, respectively) ready to launch onto the Rx market.

Allegra (for example) and the proton-pump inhibitors competing with Prilosec probably _could_ also be switched to OTC -- but the manufacturers don't want it, and the market pressure isn't there -- because adequate OTC options exist.

With their consent to the switch to OTC and their marketing budgets, Schering and Astra were able to get their OTC versions well established before the generics could even hit the market (patent litigation). This strategy has not gone so well for Schering in terms of total dollars, however, because the availability of Claritin OTC has severely limited the insurers coverage of -- and thus the market for -- prescription Clarinex.

Originally posted by Not Me
Even if the patent is still in force, for a variety of reasons, a company may license the patent to others.

No duh. Yes -- but that esentially only happens with blockbuster prescription drugs if the big pharma fears loss of patent protection and wants to get its own Licensed "generic" on th market first.

S_A_M

[ltl/fb]

Originally posted by Secret_Agent_Man
Don't be snotty.

Actually ltl -- there are (or soon will be) generic versions of omeprezole (Prilosec) available on the market.

Not in my drugstore. I think the last couple times I got it prescription it was a generic so I was kind of surprised that there was no OTC generic. I just hope it will come out soon and be cheaper -- now, the OTC version is more expensive for me than getting a generic on my plan. But such is life.

The rest of the information you kindly provided and it snottily provided I already knew, oddly enough. Possibly because these things are important to employers who sponsor health plans that have prescription drug benefits, aka my clients.