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My generation -- Boomers -- has seen a sea-change in our lifetime: the triumph of greed over good sense. During our lives, fundamental change has been the constant, perhaps more than at any time in history. Born and raised in communities with neighborhoods, we now look for our communities online. Television was the first, and arguably the most damaging, innovation. Calculators, faxes, computers, cell phones, the internet ... in quick succession, the onslaught of technology bowled us over.

These superficial changes mask a more basic change: the way we value ourselves. Where once we were valued on our participation in our communities, our good works, our dedication to improving the lot of our neighbors along with our own, these values have slipped away. Finding our value is so much simpler now: it's expressed in a single number (the larger, the better): our net worth.

We may see evidence of this almost everywhere we look, but somehow we overlook the larger picture: while we have become securely comfortable, our betters -- a designation we Americans loathe -- have won all the marbles. While we, as a people, struggle to keep our heads above water, to sustain what we have come to consider an acceptable lifestyle, the top of the heap, a tiny minority of the wealthy, capture more and more of the income and property. And, for the most part, we haven't noticed.

If you don't believe me, let me suggest a slide show for you, called The Great Divergence: A Visual Guide to Income Inequality.

Another way of looking at how
Reaganomics Killed the American Dream

Economists Thomas Piketty and Emmanuel Saez as cited by Politifact

posted 4 February 2011

Trickle Down ... how that's working for us

We suspected, but we weren't quite able to visualize, what a thorough hosing down we of the working class have gotten at the hands of Reaganomic's famous "Trickle Down Theory." Remember, that was the idea that if we really enabled the rich to get rich, they would be so grateful to the little people on whose shoulders they were standing that they'd pay better, but more of our goods, and otherwise make sure that all boats rose on the tide of prosperity.

Of course, the tide didn't come. The trickle never trickled down, only sideways, offshore to Caribbean islands and Swiss bank accounts, luxury German cars, multiple houses, private jets. Meanwhile, the American traditionof one-income households and the stay-at-home moms disappeared, and working people found themselves working much, much harder.

The financial industry Big Lie being widely circulated since Reagan was that America's economy was healthy and growing rapidly. And there did seem to be more money, although it never quite kept up with rising prices for essentials. So while we were being TOLD we were doing better, our experience suggested we were actually doing worse. Many of us assumed this was a personal failure, kept it to ourselves, and maxxed out our credit cards.

But here's the true picture, as revealed recently by the Economic Policy Institute (EPI):

Let's try to put that in the perspective of a Boomer's lifetime. Between the end of the second world war, in 1947, and the accession to national power of Reagan and his greed-whores, real family income grew dramatically and reassuringly right across the economic spectrum. If anything, the wealthy enjoyed the smallest gains (as they should.) During this halcyon period, family income doubled in all but the richest quintile (20%).

Then there was Reagan. Since 1979, the lowest 20% has seen a 7+% decrease in family income -- Oh, well, they're poor; they don't need it -- while the richest quintile have enjoyed a 50% increase -- being ridiculously wealthy is costing more these days, and they need the raise.

In real terms, that means that 99.5% of us -- all but the crème de la crème of American wage earners, have taken a 10% PAY CUT over the last 35 years, thank you very much. Here's the EPI's chart and analysis of this startling fact:

This chart represents the amount of overall national income the bottom 99.5% of the population has to share. All but the top one-half of one percent (0.5%) of the U.S. population receives 83.1% of all household income, an amount that has shrunk over 10% since 1973. In essence, it is like the bottom 99.5% of the population had incomes cut by 10%, simply as a result of the growth in inequality over that time.

So here's my question: how long are we going to stand for this? Diss a richie today!

posted 24 January 2011

borrowed with apologies but without permission from the Washington Post

How drug companies get rich: drug everyone!

The above was posted by Tom Naughton as borrowed from FAT HEAD (You've been fed a load of bologna.) The italic bits are pieced together from stories in the UK Telegraph (two), TIME's online version, the Los Angeles Times, Miller McCune, and Reuter's Health, among others, reporting on a meta-study by the Cochrane Collaboration, a highly-respected organization whose work is considered both thorough and unbiased.

Back in 1975, Henry Gadsden, the chief executive of the drug company Merck, expressed his frustration that the market for his company's products was limited to those with some treatable illness. Ideally, he said, he would like to "sell to everyone".

Three decades later, his dream would seem to have come true - epitomised by the most profitable class of drugs ever discovered, the cholesterol-lowering statins that are taken by an estimated seven million people in Britain, and tens of millions worldwide.

Yup, Merck and the other pharmaceuticals wanted to sell drugs to healthy people, and by gosh, they finally figured out how to do it.

The story starts with the arrival of "cholesterol consciousness": the thesis that those indulging in (for example) bacon and eggs for breakfast boosted the cholesterol level in the blood, causing the arteries to become narrow, and making a heart attack more likely.

Although this idea has its critics, there is no doubt that the small proportion of the population with a genetic predisposition towards high cholesterol levels are at greater risk of circulatory disorders. Encouraging them to switch to a healthy diet had failed to lower that risk - so the idea gained ground that cholesterol-lowering drugs might be the answer.

The small proportion of the population with a genetic predisposition are those with familial hyperlipidemia. Their LDL is extraordinarily high because their LDL receptors don't work and therefore don't remove LDL from the bloodstream. Cholesterol-lowering drugs were shown to reduce their rate of heart disease by a teeny, tiny bit. From that result, the medical community decided cholesterol is a killer and we should all stop eating bacon and eggs even though low-fat diets didn't do diddly for the people with hyperlipidemia. Go figure.

An even more important factor, especially in the US, was the drive to establish "clinical practice guidelines", under which panels would set the optimal treatment for any given condition. Successive guidelines have forced the "normal" level of cholesterol ever lower, resulting in leaps in the numbers deemed eligible for treatment. In the US, the figure went from 15 million to 40 million.

That's how you sell drugs to healthy people: redefine normal cholesterol levels as dangerous. Among the un-medicated population, average total cholesterol was around 220 a few decades ago. Doctors rarely warned patients about heart disease unless their cholesterol was 250 or higher. But if 220 was the average, how did the new "normal" end up being 200?

After it was pointed out that those responsible for the most recent guidelines had failed to declare any potential conflicts of interest, it subsequently emerged that most of them had received research grants or consultancy fees from the drug companies involved in manufacturing statins.

That's how. By declaring 200 to be the target level for cholesterol, the researchers (ahem, ahem) who wrote the guidelines guaranteed their paymasters millions of new customers.

Not surprisingly, quite a few clinical studies eventually concluded that statins prevent heart disease. I say "not surprisingly" because nearly all the studies were funded and conducted by the pharmaceutical companies. According to the Cochrane review, the studies might've been (surprise!) skewed to exaggerate the benefits and minimize the side effects:

In particular, while all the studies focused on benefits, only half provided information on the side effects of the drugs, said Dr. Shah Ebrahim, whose group's findings are published by the Cochrane Collaboration, an international organization that evaluates medical research.

"There is evidence that the reports cherry-picked the best outcomes for presentation," he added, "which will tend to inflate apparent benefits of treatment."

While there appeared to be no difference in side effects between trials participants taking dummy pills and statins, the researchers say those results aren't credible.

"Any appraisal we can make of adverse events is biased by failure to report these events," Ebrahim said in an e-mail to Reuters Health. "We believe that trial funders, investigators and journal editors have failed to provide adequate information to doctors and their patients to assess the benefits and harms of statins in primary prevention."

The good news is that while Merck and Pfizer may not report on negative side effects, more media outlets are:

Dr. Greg Burns (not his real name) is a 72-year-old retired radiologist living in Connecticut. Until early last year, he ran with his dog at canine agility meets, skied, ice skated and played 18 holes of golf. He is now unable to walk and is taking a course of medication that will postpone, by a few months, his death.

Burns' rapid decline began in December 2007 when he suffered a short-acting stroke from which he fully recovered. His cholesterol level was elevated and so as a preventative measure his doctor prescribed a 20mg daily dose of Crestor, a cholesterol-lowering drug in the "statin" class.

A few months after beginning Crestor, Burns developed muscle cramps. He was assured by his doctors that these were not serious side effects of taking the drug. But in December 2008 when tests showed that his creatine phosphokinase - an enzyme that is released into the blood stream when muscle cells are damaged - was elevated, Dr. Burns stopped taking Crestor. When his enzyme levels returned to normal, he began taking Pravachol, another statin drug. He quickly developed weakness in his lower legs and a right foot drop.

Mayo Clinic cardiologists acknowledge that the side effects of statin drugs can include muscle pain, extreme fatigue, liver damage, digestive problems and neurological damage including memory loss.

Of course, not everyone who takes statins will experience side effects, so it's a question of balancing benefits and risks, just like with any other drug. So let's look at the supposed benefits.

If you've seen Lipitor ads on TV (and if you haven't, it means you don't watch TV), you know Pfizer claims Lipitor reduces the rate of heart attacks by 36%. As I've explained in previous posts, that figure may sound impressive, but basically it means that during the clinical trials, three out of every 100 men who took a placebo had a heart attack, while slightly less than two out of every 100 men who took Lipitor had a heart attack. So for every 100 men treated for ten years, we're preventing (in theory) one heart attack. That's one heart attack, not necessarily one death.

But even those unimpressive results were found only among with men with existing heart disease or multiple risk factors for heart disease not among women, and not among otherwise healthy people who happen to have high cholesterol.

But of course, statins didn't become the most profitable drugs in history by being prescribed solely to men with existing heart disease. Nope, statins became a cash cow when doctors started prescribing them to pretty much everybody whose cholesterol is above 200. (In the UK, you can even buy your future muscle or memory problems over the counter yippee!)

The theory, of course, was that statins could prevent heart disease from developing in the first place, otherwise known as "primary prevention." The Cochrane report casts more than a little doubt on that theory, as several media articles pointed out:

An authoritative review shows there is little evidence that the cholesterol-lowering drugs protect people who are not already at a high risk of heart disease.

Experts who advocate the use of statins say they have helped prolong thousands of lives by preventing heart attacks and other cardiovascular events. But a wide-ranging review of previous studies, published today in the journal The Cochrane Library, urges "caution" among GPs who prescribe them. It concludes that there is no "strong evidence" to suggest that statins reduce coronary heart disease deaths among those who have not suffered a heart attack or other cardiovascular event in the past.

Shah Ebrahim, a professor of public health at the London School of Hygiene and Tropical Medicine, who co-wrote the report, called on doctors to stop giving patients the drugs unnecessarily.

Just one life is currently saved for every 1,000 people who take them each year, the report says.

Great ... so to prevent (in theory) one fatal heart attack among every 1,000 people who take statins, we've created lord-only-knows-how-many cases of muscle degeneration, memory loss, kidney failure, erectile dysfunction and liver damage. Of course, that works out well for Big Pharma they sell drugs to treat those conditions, too.

posted 21 January 2011

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