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.

A Bad Precedent

Bolivia has passed a law lowering the legal age for children to work to 10. It was 14. The authors of the law say they are acknowledging a reality since many children below the age of 14 are already working. For the children who work, it’s a necessity. Those families would not survive without their labor. While child labor is fought against by human rights advocates, there are those who believe that the necessity trumps the principle. And while there’s truth to that argument, it’s also short sighted, because too often child labor perpetuates conditions of poverty. To the credit of the Bolivian law, it stipulates that working children must attend school. To work under contract children must be 12, and they too must attend school. A 2008 study found 850,000 children age 5-17 working in Bolivia, and nearly nine in 10 were in the worst kinds of jobs which include harvesting sugar cane and underground mining, which have been proven to shorten lives. The UN says that since 2000, child labor is down a third and that Latin America accounts for 13 of the 168 millions working children worldwide. If children under 14 were working illegally, why then not enforce the law rather than enact a new one, particularly since the present law is bound to be difficult to enforce—will children working as miners really be able to attend school? Maybe Latin America does not have as many working children as other continents, still this law sets a bad precedent.

Children, Holocaust And Responsibility

Oyster Creek, Tex, Lawrenceville, Va and Murietta, Calif, are among the many localities that have strongly objected to having a shelter for the Central American children who need to be taken care of until their immigration status is clarified or they are deported. As past and future demonstrations remind us, possible locations in Connecticut, Iowa, North Carolina, New York along with several other states also have objected, some with extreme measures such as a demonstration complete with rifles. According to several reports including one by Sonia Nazario who has long studied the effects of illegal immigration on children, they are fleeing violence—usually from gangs—and most would be in harm’s way if they went back. I can’t help think that the more we take politics and ideology out of how we perceive this problem, the more we are able to see it as a humanitarian crisis, of minors trying to escape despair, poverty as well as violence. Maybe that’s why as I was reading about these shunned children, I remembered Holocaust survivors telling me about the instances of boats full of Jewish refugees who kept being denied access to port after port, until in at least one instance they went back to Germany where many of the passengers ended in concentration camps. I wasn’t surprised therefore when I read that Deval Patrick, the governor of Massachusetts, had the same idea when while speaking to the Boston Herald he made a comparison linking the children and the Holocaust. Yet, when asked by the White House if he could help with a location in his state, he did not say yes, but said he would be thinking through a practical solution. I was told by those same survivors that the Jewish refugees’ plight and fate eventually played a role in the establishment of the state of Israel, for many in the United States understood but too late that something had to be done. If Deval Patrick and I are correct and there is a link with what happened to Jewish refugees, then we need to ask ourselves, are we making the same mistake again? Will some of the children have to go back to harm and be killed in order for us to grasp our human responsibility?

Psychiatic Hospital on Death Row

California state officials are opening a 40-bed psychiatric hospital on death row at San Quentin. Judge Lawrence Karlton said they had to. He ordered a psychiatric evaluation of all 720 inmates on death row and 37 already qualified for admission to inpatient psychiatric care pointing to the fact that additional space will no doubt soon need to be found. Berkeley law professor Franklin Zimring commented that the order “was a measure of American greatness and American silliness….We are curing them to make them executable.” Courts have ruled that it is unconstitutional to execute people who are not aware they’re being killed. The peculiar situation created by the order points to the fact that underlying issues go even deeper than the death penalty. Justin Helzer’s suicide which started this whole process was diagnosed as schizophrenic and delusional. He had helped his brother kill 5 people and throw their dismembered bodies into the Sacramento River. In 2010, while on death row he blinded himself with a pen and in 2013 hung himself in his cell with a bed sheet.

It may be that mental illness is a contributing factor—or a cause—behind the inmates’ crimes, and if not it may be that incarceration may be a contributing factor—or a cause—of their mental illness. The implication then would be that the death penalty, the criminal justice system and the mental health delivery system ought to be seriously reviewed to take in those realities. A 40-bed psychiatric hospital is but a way station