Thursday, February 25, 2010

Health Policy Recommendations

Create a federally funded, universal, non-corrupt, insurance free, free to enroll health care system open to all US citizens, locally administered, employing medical workers receiving hourly wages, with strict state and federal oversight, charging $5.25 for prescriptions, $12 for physician appointments, $15 for tests, $40 per night for hospital stays, $180 for emergency room treatment, and $15 for most other medical treatments. Require healthy non-payers to perform one hour of community service per $8.10 owed. Permit those wanting to pay for other health care at private facilities that option. Eliminate Medicare, Medicaid, and the prescription drug so-called benefit. Fund comprehensive family planning, including free IUD installations. Legalize citizen re-importation of non-mood altering prescription drugs. Provide for $15 each: eye exams, hearing exams, dental exams, dental x-rays, fillings, and extractions. Permit teenagers access to birth control without parental or guardian approval. Give FDA approval to Plan B. Provide vaccines at no charge to patients.

Require children to receive all shots and vaccines recommended by the CDC for children, including hepatitis B vaccinations and vitamin K shots for newborns, except children with significant medical exemptions. Provide seasonal flu vaccines free to citizens. Require all foreign entrants to the US to have the same vaccines before entering the US.

Create a national registry on how individuals fare after surgeries and other treatments.

Per Larry Zaroff: Create a nationwide database of drugs prescribed to patients. Make the database available to working pharmacists and those permitted to write prescriptions.

Per Shannon Brownlee: Create "a new Institute for Effective Medicine. It would serve as a new, independent source of research dollars for medicine. It would provide independent evaluation of data generated by industry. And it would oversee the creation of clinical practice guidelines, a manual of proven best practices for physicians... without industry influence."

Increase Federal medical treatment research, development, and production by at least three percent plus the inflation rate each year for the next 40 years. Use the money to find and implement non-patentable treatments with the highest benefit-cost ratios, sometimes studying the effectiveness of substances lacking patents in new medical applications, comparing the cost effectiveness of all relevant treatments.

Cut the number of federally funded endarterectomies by at least 55 percent, back surgeries by at least 60 percent, and the number of chondroplasties by at least 99 percent.

Prohibit makers and distributors of drugs or medical devices from giving gifts to anyone in the medical industry, except first, second or third degree relatives.

Slash the number of evidence free medical procedures, for example, as proposed here.

Require anyone with a trivial, medically insignificant complaint, who demands an ambulance or emergency room treatment, to pay out  of pocket or perform 20 hours of community service or serve three days in jail (if they fail to pay or show for community service).

Increase non-patentable federal funding for pathogenic vaccine and addictive drug vaccine research, development, and production by at least 100 percent.

Increase federal funding for pain management research and education by 90 percent. Double the number of federally funded pain management clinical trials.

Implement a 70 percent negative externalities VAT on meat, except poultry, nutria, tilapia, feral swine, Asian carp, constrictor snakes, and other invasive, destructive animals. Implement a 20 percent VAT on poultry. Create a 40 percent VAT on non-meat food products that provide more than 25 percent of their calories from sugars and non-sugar refined carbs. Require food labels to list the masses in grams of trans fatty acids and fully hydrogenated fats to two decimal places. Ban the retail sale to children under 17 of foods having more than 14 percent of their calories from sugars.

Fully fund the Johns Hopkins Clinical Compound Screening Initiative to test existing drugs for efficacy against illnesses they were not developed to help.

Require drug makers to remove drugs from the market when follow up studies indicate harms outweigh benefits. End federal funding for treatments with overall harms outweighing overall benefits.

Prohibit rebates for pharmaceuticals and medical devices.

Amend relevant privacy laws to collect, analyze, and publish price and quality data on doctors. Pass the National Medical Error Disclosure and Compensation Bill, creating a national database of medical errors, along with researching injury prevention and implementing injury prevention programs.

Require medical field schools to increase the number of nursing school graduates by at least 85 percent, medical school graduates 78 percent, and other medical field graduates 68 percent to qualify for federal health care funds and financial aid. Continue changing numbers of medical field graduates in proportion to population changes. Create one national medical licensing board. 

Prohibit medical field workers from working more than 15 straight hours, except during medical emergencies. Require such workers to leave their work places for at least nine hours after shifts end.

Increase funding for Toxoplasma Gondii research.

Reinstate the US entry ban on HIV positive individuals and others testing positive for pathogens likely to cost citizens more than $1,000. 

End the ban on stem cell research. 

Increase funding on flu vaccine research and production by at least $200 million per year.

Stockpile 460 million doses of smallpox vaccine, enough for every citizen and for non-Americans at places of outbreaks.

Provide Federal funding to produce and distribute vaccines costing less than $40 each from production to patient delivery, leaving no purchase cost for recipients.

Legalize irradiation for all legal foods.

Separate prisoners with lethal contagious pathogens from the rest of the prison population. Prohibit prisons from hiring guards having lethal contagious diseases.

Permit pharmacists, phlebotomists, paramedics, pharmacy technicians, and emergency medical technicians to administer vaccines.

Require dietary supplements to comply with FDA drug laws, banning the sale of any not complying.

Allow competent adults to sell their body parts and to sell their future cadavers. (Bruce Gottlieb: 2,300 people a year die waiting for kidney transplants. Kidneys from dead people last eight years. Kidneys donated from the living last 17 years. Dialysis costs $40,000 per year for those waiting for a transplant.)

Increase Federal community housing funding and placements for mentally ill homeless individuals.

Ban intellectual property claims on medical treatments developed in part with government funds.

Require vaccine researchers and manufacturers to create challenge studies, recruiting study participants at least 99 percent unlikely to suffer death or long-term disabling adverse events, during vaccine lacking viral pandemics at least 40 percent likely to kill at least 80,000 Americans. Incentivize vaccine manufacturers to produce pandemic relevant vaccines as soon as relevant phase II vaccine trials begin, even if some vaccines fail to gain eventual FDA approval and must be discarded.

Encourage national pandemic vaccine and medication distributions based on expected values when shortages exist, roughly infection fatality rates plus permanent disability rates, times probabilities of infections, times remaining life expectancies for subgroups, with age, work, gender, health histories, numbers of individuals living together among the factors used for classifying subgroups, putting mass destructive people last: billionaires, elected officials, lobbyists, national TV news people, financializers, college administrators, retired politicians, pro sports folks, oligopoly executives, and Hollywood executives.

Per David Manstein: "Government should offer to buy put-options for any vaccine production facilities... started now that they don't use... pay 102% of the cost, plus 1% per month, less than two years to completion... a functional facility, with inspections by an independent body."

Fund research on many mask types, various mask air gap closing devices, and masks dried after soaking in hydrophilic solutions.

Permit probate judges to require daily antipsychotic medications for mental illness caused psychosis, regardless whether such mentally ill individuals pose a threat to themselves or others.

Require new smart phones and computers to have important health information apps and extensions pre-installed, including personalizable pandemic information.

Require quarantine detainees to participate in ethical medical research.

Prohibit products from being advertised as health enhancing, except when having approval by the FDA and having suggestive evidence from replicated, independent, controlled clinical trials.

Require the FDA to approve or not approve treatments based on ethical expected values. Require the FDA and pharmaceutical manufacturers to recommend dose sizes with greatest known situational ethical expected values, not greatest profit values, not lawsuit avoidance values, not arbitrary rules.

Ban government entities from charging sales taxes, excise taxes, and value added taxes on FDA approved pharmaceuticals, except aspirin and acetaminophen. Prohibit government entities from charging sales taxes, excise taxes, and value added taxes on medical masks and pulse oximeters and nicotine gums and blood pressure machines and air filtration equipment sufficient to filter corona viruses and most other airborne virus particles.

Place organ donation stickers on all driving licenses and state ID cards. Require individuals to opt out if they do not wish to donate organs. Place opt out individuals lower on lists to receive organ donations.

Require 72-years-old and older drivers to pass written and road driving tests once every two years.

Prohibit the importation of medical use masks that fail to block at least 93 percent of virus-size particles.

Permit licensed pharmaceutical prescribers to prescribe mifepristone and misoprostol. Reasons: little danger, earlier abortions rather than more and later abortions.

Require all acetaminophen tablets to contain low doses of N-acetyleysteine to prevent overdoses. Create a 20 cents per 325 milligrams excise tax on aspirin.

Allocate at least $30 million annually for the study and development of 18-mc, noribogaine, and similar drugs.

Require all new mattresses and couches to have at least 16 point font visible advisory labels that side sleepers should sleep with their lower legs dangling off. Require all new mattresses to have at least 16 point font visible advisory labels that side sleeping on mattresses softer than extra firm harms backs.

Provide federal funds to make medical field faculty pay competitive with private sector pay.

Prohibit the addition of phosphorus to corporation manufactured processed foods.

Require post-secondary schools to increase the ratio of medical field students to faculty.

Implement these pathogen testing policies.

Require each new adult size bed sold in the US to have at least one open end, so legs may hang off.

Mail at least 14 reusable KF94 or N95 masks to each United States citizen above the age of eight.

Make 80 years hard labor the mandatory minimum sentence for individuals trying to creating new pandemic pathogens or reviving pandemic pathogens from the past.

Ban food advertising, except by food retailers owning or renting fewer than 14 buildings. Prohibit all radio and television food advertising.

Prohibit the importation of medical use masks from China.

Prohibit private and government funding for any virologist or related scientist and their research, who has made public claims supporting pathogen gain of function research or made public claims defending the so-called right of scientists to pursue research with negative ethical expected values.

Eli Dourado and Joanne Peng: "areas that the NIA could invest in include building tools for understanding molecular mechanisms of aging, establishing and validating aging biomarkers, and funding more early-stage clinical trials for promising drugs."

Ban human hospitals and medical clinics from being owned by for profit entities.

Ban alcohol and tobacco advertising. Prohibit the sale, manufacture, and importation of tobacco products containing more than 0.3 percent nicotine by mass.

Prohibit states and local governments from banning mask mandates of building owners and managers.

Test more cancer drugs on humans, including many that failed on mice.

Prohibit snowboarding, Alpine skiing, mountain climbing, and rock climbing for individuals under age 18. 

Require approved helmet wearing by participants at snowboarding, Alpine skiing, mountain climbing, and rock climbing facilities.

Terminate FDA drug export license requirements. Prohibit patents on new medical treatments longer than two syllables and 13 letters.

Shift funding from failed dementia strategies to studying, preventing, and reversing cellular aging.

Prohibit medical providers from prescribing aspirin for arthritis and joint injuries.

Require landlords, by dates of move in, to provide properly working carbon monoxide alarms in rental properties containing landlord provided fuel burning appliances.

Pass the PASTEUR Act. Create a $100 million prize for each completely new antibiotic developed and manufactured in the US, approved by the FDA, medically successful for at least 5 years.

Prohibit current and former FTC, SEC, DOJ, FDA, and OSHA employees earning or previously earning annual government salaries greater than the median annual household income from receiving total remuneration greater than the median annual household income per year from all non-governmental entities combined. 

Prohibit former corporate executives and managers from being employed by the FTC, SEC, FDA, OSHA, and Antitrust Division.

Prohibit physical obstruction of legal health and other legal humanitarian services.

Treat deliberate, politically motivated misuse or overuse of legal health and other legal humanitarian services as terrorism.

Ban public funding of surgical treatments for TMD.

Require human hospitals to report causes of deaths statistics.

Require public school meals to provide at least 94 percent of their calories from plants, to deliver at least 2.8 grams of fiber per 100 calories, contain fewer than 30 percent of their calories from refined carbohydrates, and fewer than 2.1 grams of sugars per 100 calories.

Revoke FDA approval of Aducanumab. 

Goodman and Musgrave: Require cost estimates prior to any medical service over $160, except in cases where the patient or their representatives are not fit to respond and the patient needs immediate care.

Ban licensing of new US physicians having medical degrees from outside the United States, Japan, Taiwan, Grenada, Australia, South Korea, New Zealand, and NATO nations.

Ban government funded knee replacement surgeries in individuals above the age of 77.

Create a mandatory minimum $800 fine and 90 hours community service punishment for communicating a medical treatment related threat to a pet or human medical treatment provider.

Prohibit industry royalty payments to individual government employed researchers, including payments through friends and relatives, for government-sponsored research.

Require packages of N95 masks to include instructions for effective reuse.

Require elected officials and political appointees above age 61 to make their health records public or resign.

Ban pharmaceutical manufacturers and middlemen from charging more than 60 percent more than the costs of manufacturing, distributing, and insuring non-patent pharmaceuticals.

Ban limited liability protections for corporations selling alternative medicine products and or performing alternative medicine procedures, including non-vitamin, non-mineral supplements, for alternative medicine relevant harms caused.

Prohibit hospice care entities from having mean after-tax profit margins greater than 6.8 percent. Prohibit hospice care entities from giving anyone more than $180,000 per year in all remuneration. Prohibit any entity from owning more than one hospice care entity. Prohibit hospice care entities from receiving government funding if more than 13 percent of their patients over the past two years live more than six months. Prohibit physicians referring patients to hospice care from receiving more than $16 per year from hospice care entities. Prohibit family members from receiving remuneration from any hospice entity they have a first degree relative in. Create a lifetime hard labor mandatory minimum sentence for murdering hospice patients.

Require all businesses developing and or manufacturing pharmaceuticals to be sole proprietorships and or have the same legal liabilities as sole proprietorships, the same for businesses owning pharmaceutical intellectual properties.

Prohibit states and local governments from banning FDA approved vaccines.

In government funded studies having p-values and sample sizes, require sample sizes and p-values within the first three sentences of abstracts and introductions.

Require public publication of every drug prescribed to judges, generals, admirals, presidents, governors, and legislators.

Streamline processes for mental health treatments, for example, permit physicians assistants and nurse practitioners to prescribe same dose mental health medications to individuals successfully on medications for at least five months.

Prohibit manufacturer, wholesaler, and retailer pharmaceutical and medical device prices greater than 15 percent more than the mean of other NATO countries.

Pass the Over-the-Counter Hearing Aid Act of 2016. 

Prohibit the over-the-counter sale of phenylephrine.

Approve the over-the-counter sale of female oral contraceptives. Prohibit abortion parental consent laws.

Permit the over-the-counter sale of adjustable arch hard orthotics.

Prohibit cosmetic butt, breast, and penile implant procedures.

Gradually increase the percentage of well run phase II and phase III trials done by Federal entities having no medical conflicts of interests.

Prohibit medical and social science researchers and sponsors from hiding study procedures and results, except for House approved national security reasons.

Ban patents on treatment delivery methods.

Implement these pharmacy benefit manager reforms.

Conduct additional safety studies on Belviq, a weight loss drug removed from sale in the US.

Require random and stealthy inspections by the FDA, at least once per year, of all facilities where drugs for the US market are tested or manufactured. Ban facilities and their executives from United States medical markets for repeated or systemic fraud. Reject any private medical study from foreign facilities with rates of positive efficacy results higher than the 70th percentile of similar U.S. facilities.

JT Fournier, last updated January 29, 2024

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