Friday, April 30, 2010

The Medical Industrial Complex: Sick People Required

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Living life with a chronic illness such as Multiple Sclerosis gives one an inside view of the medical establishment, a view that healthy people rarely glimpse. In the blissful ignorance of good health, modern medicine appears to be bright and shiny, a miracle machine complete with magical elixirs, futuristic technology, and a sophisticated understanding of the maladies that strike human beings. Headlines and television news anchors shout about the latest medical breakthroughs, and a stream of television commercials assure us that there are pharmaceutical remedies for everything from cancer to osteoporosis to erectile dysfunction. Once sick and thrust into the belly of the beast, though, this illusion starts to fall away, and a different reality emerges.

Although there have been some incredible advances made in our efforts to heal sick humans over the last 50 years, there are still vast swathes of patient populations whose illnesses remain poorly understood, insufficiently and ineffectively treated, and ultimately incurable. Problematically, many of these patient populations generate billions and billions of dollars for the modern medical hierarchy, a situation that sets up a paradox within our profit driven medical establishment. Cure these patients, and vast sums of money and an elaborate infrastructure would simply evaporate; keep them perpetually reliant on hyper expensive medicines and medical procedures, and reap the fruits of an unending money machine.

Before I am accused of being a conspiracy nut, let me state outright that I do not believe that there is a cabal of evil, mustache twisting, demonic connivers assembled around a huge flaming conference table, snacking on deep-fried baby’s arms while plotting to keep cures and remedies hidden and out of reach from the desperately ill. If this were the case, the solution would be fairly straightforward; simply "out" the conspirators, and the walls would come tumbling down. Rather, the problem has become incorporated into the system itself, insidious and inherent, the logical outcome of the evolution of a medical industrial establishment that has come to view sick people as consumers and horrendous illnesses as opportunities for tremendous financial gain. This system does not require people with malicious intent to keep it functioning; it only needs decent people doing their appointed jobs to the best of their abilities to keep the gears turning.

As previously stated, the past 40 or 50 years have seen some incredible medical advances, most of them in the fields of surgery and in the treatment of traumatic injuries and infectious illnesses. Organ transplants, less invasive surgical techniques, and an ever increasing understanding of human physiology have combined to put a shine on many facets of modern medicine. A patient's chances of surviving a heart attack, or avoiding having one in the first place, are much better now than in 1950. Knee injuries that in decades past would have necessitated complex and sometimes crippling surgery can now be done using arthroscopic techniques requiring only tiny incisions, with recovery times measured in a few short weeks rather than many grueling months.

The treatment of some of our most dreadful illnesses, though, have not seen such advances. Ask the average person about the chances of surviving cancer today vs. 1950, and I would expect that most would tell you that your odds of beating the disease are much better now than they were 60 years ago, a belief driven largely by the almost relentless marketing done on behalf of the medical profession. The New York Times, though, reports that "the death rate for cancer, adjusted for the size and age of the population, dropped only 5 percent from 1950 to 2005." (Click here for article). Headlines blaring about the latest advance in cancer drugs rarely mention that the studies cited often declare a cancer drug "effective" even if it increases the lifespan of the patients taking it by only a handful of weeks. The fight against some forms of cancer has indeed benefited from modern medical advances, but for many cancers, little real headway has been made.

Since the vaccine for polio was found in the mid-1950s, very few if any diseases have actually been eradicated. Instead, the trend is towards turning diseases such as diabetes, AIDS, some cancers, and multiple sclerosis into treatable chronic illnesses, their patients heavily reliant on fantastically expensive medications and interventions. The reason for this lies largely in the fact that over 70% of our medical research is carried out by pharmaceutical companies, whose primary mandate is to generate financial profit.

The job of a publicly traded pharmaceutical company CEO is to constantly drive up the price of his company's stock, not to facilitate the creation of drugs that would be of the most benefit to the patients taking them. This isn't a question of morality, but of economics. The drug companies, and those who manage them, are merely doing what every other business endeavors to do in our free-market capitalist system, to constantly increase profit. I'm all for free-market capitalism; in recorded history there has been no better economic driver and creator of wealth. Unfortunately, when applied to healthcare, in many cases good economics has led to very bad medicine. The corroding influence of big money, in addition to an environment of lax regulation, has led to some shocking abuses of the system, such as the marketing of drugs that are known to be dangerous (click here for info), and the suppression of studies whose results are unfavorable to the drug being tested (click here for info).

Over the past three decades, pharmaceutical companies have discovered that the best way to increase profit is to market "blockbuster" drugs that patients must stay on for the rest of their lives. In the case of multiple sclerosis, this has led almost all research to concentrate on compounds that alter or suppress the human immune system, based on the "autoimmune model" of the disease, which states that MS is the result of an immune system gone awry. In reality, it's becoming more and more clear that the aberrant immune response seen in MS patients is more a symptom than a cause of the disease. Some unknown agent is driving the immune system to attack the central nervous system, the latest and hottest theory being that the vascular abnormalities collectively known as CCSVI (click here for info) might be the cause.

Since the mission of pharmaceutical companies is to generate the most bang for their research bucks, they direct their research dollars to projects that have the best possibility of leading to substantial profit. This, in turn, influences the behavior of even the most well-meaning medical researchers, who, just like everybody else, need to feed their families and pay their bills, and who naturally seek to advance their careers. Thus, they are drawn to investigations that will most likely win hotly contested research dollars. That funding, the vast majority of which comes from the big pharmaceutical companies, goes almost exclusively into researching novel compounds that can be patented and remain the sole property of the company that discovers them for many profitable years.

This same dynamic inherently underfunds research seeking to eradicate diseases that have each, in effect, become multibillion dollar a year industries. This is not because of evil or malicious intent, but instead is the result of the economic engine that drives what can be called the "medical industrial complex", the misguided marriage between profit-seeking corporations and the healthcare industry, which requires a perpetual supply of sick people to keep the money flowing. This need for patients is so intense that it can sometimes lead previously untreated and relatively benign conditions to be deemed diseases that require pharmaceutical intervention, as in the case of osteopenia (click here for details).

This same drive also leaves many potentially effective but unprofitable remedies untested and relatively ignored. Drugs such as Low Dose Naltrexone (LDN) and the effects of diet and natural remedies have barely been studied for their impact on MS, simply because there is no profit to be made from them. Recently, a cheap blood pressure medication, Lisinopril, has been shown to have some promise as an MS drug. This discovery wasn't made by any run-of-the-mill research scientist, but by Dr. Jim Steinman, one of the inventors of Tysabri, a very expensive and controversial MS medication that is very effective but also carries with it the possibilities of very serious side effects. Dr. Steinman would like to see a full scale human study of the effects of Lisinopril, but says that "Lisinopril is as inexpensive as any prescription drug at this time, so pharmaceutical companies won't see any profits from financing a study" (click here for article). Thus, the drug remains unstudied in its effectiveness against MS, for now and probably forever.

It's hard to see a solution to this disheartening status quo, other than a significant increase in the government funding of medical research. Unfortunately, the trends are heading in the opposite direction, with more and more funding coming from the private sector, as public dollars become scarcer and scarcer in this age of soaring deficits and cries for smaller government.

As a patient suffering from MS, the situation is incredibly frustrating, as it's clear to me that much of the research now being done on the disease is not conducted with patient benefit as its primary underlying goal, but rather with the profit potential and market share that each patient represents as the target. The recent CCSVI controversy has brought this situation into focus for thousands of MS patients, because if relatively simple vascular surgery can indeed treat MS effectively, the multibillion dollar a year treasure chest that is MS will be wrested from the grasp of the pharmaceutical companies, whose financial influence within the medical and political sectors cannot be overstated. The medical industrial complex is a self-perpetuating entity that will not easily be shut down, the sheer force of its financial weight creating an almost irresistible momentum.

I'll let my final words on the subject be these: As a just and honorable society, please, view me first as a patient, not as a consumer. Human suffering should never be treated as a commodity, regardless of the considerable economic incentives to do so.

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  1. brilliant post, very well said, thank you

  2. Bang-on, excellent analysis. When I see myself referred to as a "market" and that there are "bright opportunities" for investment because of my diagnosis, I absolutely see RED.

  3. Brilliant! You are eloquent, wise & a joy to follow!

  4. Very informative. Thank you. In support of your position, I worked in a general hospital for 18 years in Toronto. At the beginning of my time there, individuals using our care were called "patients." As time went on, we were encouraged to use the term "clients" and then it became "customers." Service to our "customers" was plastered all over the walls of the Human Resources Dept.

  5. I agree with you 100%. Thanks.

  6. I'm having visions of doctor evil with his bucket of deep fried baby arms. Amazingly insightful.


  7. Right on! And, until we can get doctors to resist the pharmaceutical company philosophy of drugs always, cure never, nothing will change. The revolution will have to come from the patients, as it is with CCSVI, and look at the dirt flying with that discovery.

  8. Marc,
    I am almost certain your blog never reaches the inquisitive eyes of the CEO’s of big Phar. It is however food for my soul. Sharing your view of our current Medical industry I have left the FIGHT and moved my energy and passion to a location that is out of the reach of the ABC & R companies. I made a leap of faith phone call to my local Universities Radiology department, fishing for help with CCSVI as my bait. When the administrative asst. rerouted my call to the nurses’ station and the Director of Radiology answered the phone, my fishing line went taught and I began to reel in. Little did I know I hooked a passionate, patient, hungry man of medicine? When his answer to my CCSVI question were as follows: never heard of a possible venous involvement, that’s interesting, yes I would like you to email me some info, I was floored. I used Judo in my last post; perhaps I should be thinking more along the lines of a dance analogy. I don’t want to dance with someone that wants to treat me and hopes they can slow my progression. Why not look for a partner that works with a cure mindset, the new girl with passion and enthusiasm based in Medicine. Not sure how this will work out, but man that is one mean beat.

  9. I was also pleasantly surprised when my neurologist stated he beleives the CCSVI needs to be studies more and is a valid piece of information in the MS puzzle. I was also shocked when I told him I was not quite ready for the Tysabri wagon. But could I try LDN? He said he'd get a perscription sent to a compounding pharmacy for me.

    It will be intersting too, as the healthcare changes take effect, if cheaper medications will be pushed. And since the taxpayers will be footing all the bills, maybe cures will be more researched than new therapies.

  10. Well put, Marc. When information about drug development appears on the financial pages rather than in the health/living section, it tells you something about what's driving this juggernaut.

  11. saw on tv news last night of a new breakthru (cure, perhaps?) in the treatment of advanced prostate cancer, and also read that 80% of "depressed people" did just fine on placebo. the antidepressant industry is more than likely a complete sham, but there is now great hope for (rich) men with advanced prostate cancer. the pharma-god works in strange ways.

  12. Marc, you have a silk (digital) pen, you have the talent to translate your thoughts onto paper in a very eloquent way.

    That the pharma industry put their money into the research to enhance their market for their pills is more or less understandable. That is part of the system that we all endorse in some way or another.
    But I find the ethic line is way overstepped by their bashing and undermining activities with regard to CCSVI.

  13. Thanks, Marc, for stating so eloquently some facts that I have been arguing for quite some time. Hopefully, your words may one day reach beyond Big Pharma and our days of suffering might come to an end!

  14. I'm with you, but you left out the all important link between "campaign donations" - read, bribes - by the medical industry and the refusal of government of any stripe to take any action.

  15. Sadly, accurately put.
    You need to publish your entries!
    best wishes!

  16. Great post Marc. Very well researched too! Man that's a good read.

  17. "..... the research now being done on the disease is not conducted with patient benefit as its primary underlying goal, but rather with the profit potential and market share that each patient represents as the target...." That being said, who would most benefit financially from CCSVI? My placed my bet on the radiologists. After requesting imaging from 2 neurologist and getting no where, I contacted a private, for profit national imaging center to see if I could self refer (the answer is no, you need a doctors order)and they had not heard of CCSVI. Coming from a large family, full of successful salesmen, my next call was to the head of the corporations sales and marketing department as I know that they would be very interested in this new theory. I was right. As they set off to research everything they could find regarding this new theory, including the proper imaging protocols, it was my job to get the order for the imaging. My next bet was on the Vascular Docs and that also paid off. Unfortunately, the MRV and MRA came back normal (the nurse that called with my results was shocked at my disappointment as she thought this would be good news)but I plan to go back when they have done more research on the screening process.

    We all know that life is not fair (and some are reminded daily if they are in the midst of raising teenagers) but if we look at CCSVI as "... profit potential and market share..." and find the solution from the group that can make the most money, I'm all for it. I'm throwing my support and energy into cheering for the radiologists. It's way less stressful and much more fun.

    Team Radiology! Go Team Go!

  18. I like your blogs and sharp insight. And I agree with Miss Kate that we should go for the other angel (is this correct english?): Concentrate on the vasculour doctors and radiologists. And there is also a market for the componies that produce stents and ballons etc for them. Dr Drake said: don't se it as a pharmaceutical issue anymore.

  19. Marc, How do you keep from getting depressed about this? Rather, DO you keep from getting depressed from this?

  20. Marc,

    You've gone and done it again, writing an excellent post and making your point crystal clear.

    I don't mind having my "local" farmer's market, or "Co-op" think of me as a consumer & customer, but I draw the line at being looked at that way by my physician and medical industry in general. But that is just what patients have become.

    Foe the folks reading Marc's blog who aren't that familiar yet with CCSVI, you can go to TIMS and get great information.

    Especially how to get darn near 100% of your charitable donation money going directly to the research you desire. Not just a pittance of your dollar finally filtering down after the "Charitable Organization" pays it's staff, advertising, overhead, etc. Go to:

    and read how!

  21. hi marc! your blog remains one of my two favorites in the MS community - your writing is excellent and your points are right on. coincidentally, i have had my attention on this exact issue of late and just wrote about it on my blog. i examined how we got to this shameful moment in western medicine based on some of Bruce Lipton's thoughts in his new book:
    Anyway it was great to read your take on it. Being diagnosed with a chronic illness and navigating our medical system well means needing to be aware of the motivations and incentives of the system we're inside of. And unfortunately it's mostly disheartening. But being aware of the context we're functioning in makes it so that we can make good decisions about our own treatment. Your spirit is inspiring. Keep on!

  22. Thanks, Marc - well-presented and balanced. I'm so glad you can think straight despite your physical challenges...The underfunding of medical research for inexpensive remedies is rampant. All you have to do is examine malaria cures, etc. Or ask why more studies about Vitamin D aren't being done. Or why diabetics languish for years on medications that cause their bodies to develop additional illnesses - the solutions aren't big profit, so not worth funding for the drug companies. I remember trying to get funding for a study on breastfeeding from the College of dietitians here in Canada - they wouldn't touch it because it might annoy their formula company sponsors.
    The lines are deep and wide. And we are all somewhat to blame - by buying funds from these companies, having them in our pensions, our retirement savings (those of us who have some). We demand returns on the dollar that are out of proportion to actual growth, and shred companies who don't measure up. The whole economy is founded on increasing revenues from companies, with no losses at any time. Is it any wonder that we suffer the consequences?
    My personal bugaboo is cancer research, which seems not to have progressed much in the past 20 years despite billions of dollars raised. By comparison, MS research is flying by, perhaps not all encompassing, but certainly world changing discoveries arriving every year. I agree it's important to stay on top of them, demanding results. i just wish SOMEONE was supervising cancer and diabetes research the way the MS community supervises MS research.

  23. This comment has been removed by the author.

  24. Marc, Thank you for this provocative essay. You catch the nuances just right.

    regarding, Dr (Lawrence, not James) Steinman and lisinopril,

    A few months ago he had an interesting story up on this page where he started googling lisinopril because his Dr put him on it for High Blood pressure (HBP). As he looked into it's supposed mechanism online for action google search engine kept bringing up "lisinopril multiple sclerosis". being an MS-EAE model researcher himself, he did a test on mice (or rats?) using EAE of lisinopril and found it helped them recover. I can't explain this with CCSVI in mind, but...
    I have a personal anecdote that I think about a lot.: I am on lisinopril for HBP and have MS, I do feel better on lisinopril than I did on HCTZ to treat the HBP. My theory why is that HCTZ works on the kidneys to lower blood pressure(BP), but lisinopril works as a vaso-relaxer, it opens up the vessels, to lower BP. I figure that with CCSVI you can get a bit of relief if your blood vessels are relaxed.
    I know just enough to be dangerous.

  25. Marc:

    What an exceptional dissertation! I've re-read it a few times to go deeper into the links you include within the text, and appreciated it each time. Would you consider publishing a collection of many (or all) of your posts?


  26. There is a lot to take in here. It does feel quite often to me that monies for research are often spent "barking up the wrong tree" as it were. And it does seem to always come down to money and profit opposed to real people and their families who are suffering. This would be a great piece to post in the NY Times and the Washington Post, don't you think? You should forward it to the Presidents care reform is focused on the wrong things...well at least, not enough of the right things. Keep writing. Keep giving voice and speaking eloquently for those of us suffering. You have so many valuable things to say Marc. I hope that you are able to get out and about and enjoy the spring air...unless it's yucky and rainy in NYC today.

  27. Marc,

    You've outdone yourself with this essay. Spot on!


  28. Good article except for your solution to the status quo. That's a terrible and immoral solution. People not interested in funding MS research should not be forced to. Instead, the cause for this status quo comes from two distinct sources: intellectual property and federal regulation over the creation and marketing of drugs. If intellectual property laws were done away with(copyright, patents, etc.) and the FDA and other regulatory bodies were abolished, the status quo would end overnight.

  29. Hi Marc,
    Expensive medicines is so far the only thing we´ve got for ms and we got to buy them. But if CCSVI would come to the surface, wouldn´t that be a huge saving - or profit if one so likes - for those who pay for it? In our case here in Sweden it would be the government and so it is in many countries.
    Roughly and very roughly a complete CCSVI examinition/surgery represents less than the cost for a full years consumption of ms-medicines.
    So,why don´t we see more action from our governments?

  30. Very good situational summary Marc, a valuable ability of yours. I do agree with Anonymous above though, the situation regarding our medical industry must be shared with our political system (“the best money can buy”), which has moved over and over to expand protection of the status quo. Change the laws and we could change the medical system. Get rid of the protection from competition and replace it with greater public interest, one of the government’s real jobs. If these things could be done in an intelligent manner, we would see a radically altered medical system evolve, hopefully for the better. It’s a stretch, I know.

    If our country learned anything from the recent financial crisis it's that our government’s actions in conjunction with the interests of large private sector entities can result in disastrous consequences to our country, its citizens and the world as a whole. Let us hope our illustrious leaders can avert a similar situation when all of the baby boomers come of social security and Medicare age, else I'm afraid we will see wheel chairs with arm mounted rifles instead of cameras rolling on Washington.


  31. "That's a terrible and immoral solution. People not interested in funding MS research should not be forced to."

    What dou you want to carry? MS or funding MS research?

    Don't forget that MSer's are carrying a disease that they didn't want to. They are carrying the share that bad luck inflicted upon them. And it is a certainty that someone will suffer from something at some time.

    So MSer's carry that burden for you my friend.

  32. Well done Marc. What a great post!

  33. Thanks everybody for such an enthusiastic response to this post. I'd like to respond to each of you individually, but there have been so many comments that it would take me hours. I hope you'll all accept a big blanket "thank you", because your comments and words of encouragement truly mean the world to me.

    I would like to say a few words about some of the political comments that have been made. I welcome people of all political stripes to air their views on this blog. As long as everybody respects each other's right to their own opinions, and doesn't denigrate any of the other commenters, I'd like everyone to feel free to openly voice their points of view here.

    Having said that, I'll take this chance to voice some of my own. It is not "immoral" to have taxpayer money fund research on any disease. Simply because each individual taxpayer may not benefit personally from such research, the society as a whole certainly does. I do not have children, but I don't resent the fact that some of my taxes go to funding public education, without which our nation could never have achieved the great heights it has reached. Likewise, I've never experienced a house fire, but I'm happy to pay taxes that fund my local fire department, as I easily recognize its value to my fellow citizens. As John Donne wrote many centuries ago, "No man is an island, entire of itself; every man is a piece of the continent, a part of the main... Therefore, never send to know for whom the bell tolls, it tolls for thee".

    The idea of eliminating patents and intellectual property laws, in addition to dismantling the FDA and other regulatory agencies, is simply a recipe for unmitigated disaster. Without the legal ability to protect an invention or idea, there would be no motivation to innovate. Without the oversight of the FDA and other regulatory agencies, pharmaceutical companies, medical device makers, and physicians could market whatever snake oil they conjured up, without having to prove efficacy or safety whatsoever. The FDA may not be an ideal organization, but the role it plays in protecting the public good is vital.

    The idea of "small government" sounds great in theory, but in practice has proven to be quite flawed. Between the start of the New Deal in 1932 and the beginning of its dismantling in 1980, there were absolutely no major financial crises or banking scandals in the USA. Once the deregulatory craze set in, things started to fly apart. In the 1980s we had the savings and loan fiasco, and the repeal of the Glass-Steagall act, along with a willful disregard of whatever remaining regulations were on the books from 2000 to 2008, resulted in the recent near collapse of our entire financial system. We averted being plunged into another Great Depression by a whisker.

    The bogus premise of "trickle-down economics", with its emphasis on tremendous tax cuts for the rich and slashing of the regulatory system that had worked so well for half a century, has succeeded only in creating the largest disparity of wealth since the "Gilded Age" (nearly 90% of the wealth in this country is now concentrated in the hands of the wealthiest 2% of the population), and ultimately led us to the brink of an economic abyss.

    I've personally experienced "government-funded medicine", with my many dealings with the National Institutes of Health. The difference between the care given at the NIH and at any other facility I've ever been involved with is astronomical, and if it weren't for the NIH, many of our modern medical miracles would never have been discovered.

    Unfettered, unregulated capitalism was given free hand in the early part of the 20th century. It led to child labor, company towns, tragedies such as the Triangle Shirt Waist Company fire, and ultimately to the Great Depression.

    Those who do not learn from history are doomed to repeat it.

  34. Marc,
    As you know I have been following your posts for some time now and reading yours and everyone else's comments. Being a non-MSer and a happy go lucky guy I have usually abstained from adding my own comments especially on the heavier, more thought provoking topics. However, I have seen something in your writing as of late that I must state publicly at this time. Although many readers have mentioned that you should publish your thoughts, I honestly believe that you should do more, something that would provide a greater benefit to the handicapped community. As huge as your readership is your intelligent, level headed, eloquence deserves a broader audience and perhaps an audience that has more political clout. Perhaps as the head of some nonprofit or government committee you could better effect change for us afflicted. I can only imagine that this is 100% against your core instincts but let's face it my friend, this is where you are headed. Thank you so much for all that you do for us. Please keep it up.


  35. A minor correction: there is no "cure" for polio. In the 1950s a vaccine was developed that creates immunity to the disease, but if you've got it, you're stuck with it. And its effects do not go away--as those who got it some years ago have learned.

    And (consistent with your argument) there is little research on post-polio and few MDs who want to make it their specialty. Why? Because the number of patients with PPS keeps getting smaller. The process is market driven.

  36. A cure is bad for business..simple as that!

  37. I have believed your theory for years. A lot of people would be out of work if they cured diabetes, let alone a lot of Big Pharma multimillionaires having to clip coupons like the rest of us. If "high cholesterol" wasn't an illness, which it is not, think of all the meds tht would not be sold.
    The newest MS med, Ampyra, is over $1000 a bottle for a one month supply. Before the FDA approval, it was between $100 and $200 for the compound.

  38. Great read. Now if you could just get it into a mainstream media outlet.....But I guess you would have to find one that doesn't take money for running drug company ads.

  39. Hi Marc,

    first off I am delighted that the Wheelchair Kamikaze is an actual person, I thought that the figure was being used metaphorically by other writers, "The WK would never stand for that intolerance (no pun intended), so I have always tried my best to be open-minded."

    That's not "metaphorically?" Well, looky, here is my primary reason for posting this comment - a complete shock to me to find it here, or anywhere, ever again:

    My ability to stay focused on the fairly complex issues in your post, AND THE RELATED MATERIAL LINKED TO....

    ... okay, lost again, how to I rephrase that to avoid "to boldly go" where no reasonably educated writer would ever want to go? Linked to "therein?" AGH!

    What? Yes, that is a Trek reference, oops. WTF was I getting at...

    >>> OH! right, right. My ability to read your fascinating blog is a testament to your fine writing! I can't generally hold ideas in my head this long. Ha ha, you thought I had wandered off!

    - Lorraine

    PS, your photos look so much NYC, I love them like a squealing girl: OMG, these totally ROCK.

  40. oh NO NO - I meant to click Preview, not Post!

    I was turning over the phrase "like a squealing girl," and I realized I might have just said I love squealing girls, which WAS NOT my intention...

    But the photos are NY, right? And look at my tiny BloggerProfileAvatar PHOTO - many yrs ago on the roof of the St. Mark's Cinema! NO WC access up there, back then...

    Afraid to say, that all of these ideas /\ were occurring to me at about the same time,
    which is
    time for my Copax...


    and stop turning over squealing girls

  41. hm, if I wanted to put a link to "this part" of your blog, would I achieve the link by planting the link code here in my (visible) text?

    < name="after LK's comment"></a>

    nah, that couldn't work, could it? out there on the page?

    'scuse me, Marc! old thoughts popping up un-invited!

  42. WAH hoo! it works! the code vanishes on the blog page, but functions as HTML!

    This link LK's comment

    goes right to here!

  43. Thanks Marc,

    A brilliant piece of writing that says it as I'd like to.

    Best wishes to you

  44. Where’s the commom sense in America?

    If Pres. Obama wants real change from the business as usual drug
    and insurance companies, all he has to do is look at the money saving
    value added proposition of approving the CCSVI treatment for MS to
    move forward.

    Just think what he could accomplish, if he pushes the NIH to move
    forward with this?
    A group of people whose loyalty is demonstrated by the effort to
    fight the establishment, more working taxpayers and burdens on the
    system (this would ease some burden), actual family’s happy to have
    a meaningful life for themselves and loved ones, and give the Dr.'s
    a reason to practice the medicine they trainned for.
    Currently the drug companies make billions of dollars with disease
    modifying drugs at tremendous cost to insurance companies and soon
    the taxpayer. Is he really for overhauling the health care system
    without making more efficient, or just adding more costs to the
    American government with no goal of improvement?
    Why was the angioplasty procedure never tested ot trialed before
    this? The same DR.'s who question this, use this procedure
    regularly for the same reason.

    Nobody is saying the drug companies are not entitled to profits,
    but when profits come before the general public, the government
    supported business model seems a little out of touch with their
    customers. The fact is, this procedure cost about as much as a
    years supply of the drugs they sell, something is wrong. Either the
    drugs are too expensive, or the government allows and endorses this
    to continue.

    Why aren't lawmakers or the mainstream media supporting this
    initiative? Are the profits of the drug companies that influential?

    As a patient who is prescribed one of the disease modifying drugs,
    it funny how they push the re-fill of the drug prescription close
    to the end of each quarter. The pressure to make numbers is
    recognizable with the sales calls.

    It's also funny how Pharma provides free samples at first then
    slowly raises the cost.. Isn't this the way drug dealers on the
    streets introduce their merchandise to younger crowds. At least
    when the government warns of drug abuse, this is the example they
    use in the commercials. So whats the difference?? Why is legal to
    do it this way with the support of the goverment?

    If the medical community is all about solving problems and curing
    diseases, why do they continually subscribe to this paradigm?
    especially at the expense of people and the affected families that

    I know these questions are being IGNORED by the elected officials
    who are suppose to be guarding the best interest of their
    constituents, but why the silence?

    It's interesting to read about the politicians in Canada ignoring
    this disovery as well as the people voted into office in the US.
    While the time consuming research trials are pushed by the drug
    companies, more people get disabled and the market for these drugs
    that don't offer anything but a longer wait for the people to
    become fully disabled grows, and thus grows thier market. the
    profits become self perpetuating.Does anyone not see this?
    Especialy the people who say they represent us.

    The reality of this, is there are future elections and new people
    that will run for elected office that can have a positive affect on
    this,and listen to the people that voted them into office. Because,
    the same people will vote them out of office.

  45. Brilliant work. Here is some medical research I have put together on natural and complementary medical approaches to MS

  46. Hi Marc,
    This is an excellent post. You raise some very important points for those of us who work in the clinical trials "industry." I look forward to reading your blog on a regular basis.

  47. Looks like you are not alone the British Medical Association have just awarded this book first prise in their 2014 book awards in the category of '' The Basis of Medicine''