Sovaldi, a new treatment for Hepatitis C, costs $1000 a pill. Members of Congress have begun an investigation as to how Gilead Sciences, its manufacturer, arrived at this price. Advocacy groups are also raising the problems of cost. We already know that for some of the drugs which cost as much or more that prices can’t always be justified. In this case, however, analysts and those reporting on the consequences of such pricing point to weaknesses in our health care delivery system. The drug can cure Hepatitis C with less side effects than previous ones. A whole course of treatment costs about $84,000. The number of people in the U.S. estimated to need this treatment is about 3.2-milllion. Since many of them are on Medicaid, it is feared that the costs to the States would be quite heavy. Some also fear that although those using Sovaldi would involve a small percentage of those insured by Medicare, that it could raise Medicare medical premiums by 2 to 3 points. But most interesting is the stance of the insurance companies. Since a whole course of Sovaldi is a cure, a problem arises due to the cost being born all at once over a period of weeks, not years like HIV/AIDS. Because people change jobs frequently and therefore are likely to also change medical insurance, it is feared that the insurance company which pays for the treatment would not be the insurance company that ends up benefiting from having borne the costs. The results are that Sovaldi has created an uproar in many circles—one that can be said to be a sad statement on our health care system. Yet, if we could solve some of the issues being raised, our health care delivery system would not only improve, it would be much cheaper.

Children Into Schools

Worldwide, 57 million children are not in school, many are working. That’s why The Emergency Coalition For Global Education Action recently launched a campaign using global leaders, celebrities and officials like UN Secretary-General Ban Ki-moon to ensure that the goal of having these 57 million children in school by the end of 2015 is met. The Countdown Summit was held in Washington, D.C. as a way to pressure the international community to take action on behalf of children everywhere. The effort is to ensure that that Millennium Development Goal is reached. If not, at the current rate, it would take until 2086 before all children who need to be in school are enrolled and learning. The Coalition includes people like singer and songwriter Shakira, actors Jude Law and Goldie Hawn and CNN International anchor Isha Sesay. All are willing to work even harder to accelerate the progress of ensuring all children who need to be are in school by the end of next year.

Since child labor must end and education has proven to be an anti-poverty tool, success seems a necessity.

Small Victory?

I periodically come across a group of people who make me stop to recognize what they represent. This time it is a group of migrants from Honduras, who take the train through Mexico on the way to the U.S. to find work. They find a way to hop on one of  the freight trains they call La Bestia (the beast) since it has maimed so many.  The group headquartered in Honduras  has 400  to 500 members, all disabled who have lost limbs traveling it. They are as illegal in Mexico as they would be in the U.S. and are then sent back to their countries, and there particularly given their disabilities are unable to work and endure sorrowful and very difficult lives. The wife of one migrant worker who returned without his right leg and right arm just left him. But the men, who feel their lives have become nightmares, also want to fight for the rights of other migrant workers, people who like them seek to escape desperate conditions and hope for something better in the U.S.  Norman Varela, the spokesman for the group who made it to a small city in Mexico, and who when he lost his leg was robbed of all his money by a Mexican policeman, said they wanted a meeting with President Enrique Pena Nieto. He was told by a local official it was impossible. “What’s impossible,” he said,” is re-growing a hand or an arm or a leg. It is not impossible to arrange a meeting with a fellow human being.” Short of meeting the President, the migrants want to deliver letters to him. In future, they want their fellow migrants to be assured safe passage to the United States, instead of being detained or repatriated for being illegals in Mexico.

Days after their story and their plight were made public, they received word that a representative of Mexico’s national immigration department would receive their letters and would deliver them.

Intelligent Budget Cutting

Increasingly police departments are arresting people who are mentally ill, people who do not understand commands, who think they are someone else, who get frightened and act belligerently. Some have been shot and killed in this manner. In Albuquerque 37 people have been shot since 2010, 23 fatally.  Because in some cases the shootings were caught on video, the issue is coming to the fore, not only in New Mexico, but also in other states. Most often officers aren’t trained to handle mental illness, and in most cities they have no back up. Exceptions are few. In Los Angeles, for example, there is a specialized mental health unit and in New York the department has adopted its own form of a crisis intervention model.

A consensus is forming that the underlying problem is related to be the lack of adequate mental health care. Mental health ever since the 60’s has been a budget item that is often cut. According to the NIH, about 6%of the population (one in 17) suffer from a serious mental illness, and while studies show that only 4% of them  are involved in violent crimes, when untreated severe mental illness can be associated with higher rate of violence. The director of policy and legal affairs at the National Alliance on Mental Illness, compared our current practice to what it would it be like to stop treating heart disease until people had heart attacks, except that in mental health treatment is more difficult to begin once people reach a point of crisis.

Cutting budgets is sometimes necessary, we must however cut budgets intelligently, that is with awareness of the consequences, of what happens when these cuts are put into effect.