The Case of the Autumn Crocus

I know this sounds like a Conan Doyle or Agatha Christie title but it’s not. For a start it’s a sneaky way to explain the absence of many posts since my return from Europe because I’ve been sick and I’m still not close to 100%.

It’s also a way to get into a topic that presents a graphic example of Government’s involvement in the healthcare business.

Over the years I’ve been supportive of and sympathetic to the pharmaceutical industry’s much criticized pricing policies. The companies spend years trying to develop new medications and treatments. Sometimes that research does result in a product but more often than not it doesn’t because it doesn’t work as hoped or because it’s too toxic or because some competitor has beaten them to it.

Which brings me to the main topic which was forcibly thrust down my throat as an all too graphic example of government involvement in healthcare. Since the first century of the Common Era, practitioners have used an extract from a plant called Colchicum Autumnale, the Autumn Crocus for the treatment of conditions as varied as gout and familial Mediterranean fever.

Now those early practitioners may not have understood the chemistry or the pharmacology of the product we know today as colchicine but they knew it worked and they knew all about dosages, side effects and possible toxicity. In our time it was produced by several manufacturers at an average cost per pill of 9 cents. I know because I’ve been prescribed it in the past.

Because of its long history, it was one of a substantial list of so-called “orphan drugs” and now we come to the part which can be paraphrased by the oft-used phrase, “I’m from the Government and I'm here to help.”

As a drug predating the FDA, colchicine was sold as a generic in the United States for many years. Then in 2009, the FDA approved a brand name called Colcrys and awarded its manufacturer a three-year term of market exclusivity in return for government-approved testing. Now some people might think that being handed a 3 year monopoly might be enough but they’d be wrong for, in addition to exclusivity, the FDA prohibited existing manufacturers from continuing generic sales.

And to top it all, the sole anointed company gained approval to up the price from 9 cents to $4.85 per pill, a 54-fold increase. 54-fold note, not 54%.

Thus it was that my co-pay went from $5 to $106. And that's after Government approved prescription insurance.

Now, yesterday, while everyone else was focused on Obama bashing Paul Ryan, I was still concentrating on government healthcare and I noticed that he took full ownership of death panels yesterday. Naturally, Obama did not call them death panels. He called them “an independent commission of doctors, nurses, medical experts and consumers.” But his description hits dead on with what his death panels will do.

According to Obama yesterday, the death panels “will look at all the evidence and recommend the best ways to reduce unnecessary spending while protecting access to the services seniors need.”

We already know what they’ll recommend as “the best ways to reduce unnecessary spending”. Obama’s own advisers have told us. They will prioritize giving health care to healthier people and let sicker people die. At end of life, they will deny people life sustaining treatment because, after all, they’re going to die anyway. Note his phrasing: “protecting access to the services seniors need.” 


Dying people, according to Obama’s advisers, need hospice not hope. They certainly do not need expensive treatments that may buy them time to see the birth of a new grandchild or other reasons.

“We will change the way we pay for health care – not by procedure or the number of days spent in a hospital, but with new incentives for doctors and hospitals to prevent injuries and improve results. . . . If we’re wrong, and Medicare costs rise faster than we expect, this approach will give the independent commission the authority to make additional savings by further improving Medicare,” Obama said. At a time Democrats are saying Republicans want to starve old people to death, Democrats are intent on embracing a cost savings model for Medicare that incentivizes doctors to encourage people to die and, when all else fails, gives a death panel “the authority to make additional savings by” ensuring the dying elderly die quickly.

“Our approach lowers the government’s health care bills by reducing the cost of health care itself,” Obama said. Really? The only way that will happen is by rationing. You may not like the use of the phrase “death panel,” but make no mistake about it — at the end of your life, in Obama’s America, his death panel will throw you under the bus in a way much closer to reality than metaphor.

My travelling companion in the UK was appalled to hear a BBC radio report that a woman local to where we were had been denied a treatment for her terminal cancer. Even more poignant was the revelation that if she’d lived 15 miles away in the jurisdiction of another “death panel”, the treatment would have been approved. It seems that once we simply had to choose to live in an area that afforded us the best schools. 


Now we have to factor in the benevolence of the local "death panel."

Me? I’m going to tend my crocuses!