Amgen Got $500,000 in tax breaks to cover illegal marketing convictions.

In a recent breaking story, Amgen received a tax break while the rest of America faces increased taxes.  In a story, The Raw Story reports that Republican Senators with help from Baucus (D) were able to coerce a gift of nearly $500 million by delaying Medicare rules during the negotiations.

Despite recently pleading guilty in a major Medicare fraud case and being fined $762 million in criminal and civil penalties (the single biggest fine in history) for illegal marketing, Amgen, the world’s largest bio-technology company, just received a major gift from Congress in its “fiscal cliff” bill—a delay in Medicare price restraints on a class of drugs that includes Amgen’s profitable Sensipar. This provision is expected to cost Medicare up to $500 million over the next two years. The result is that US taxpayers will effectively be paying the majority of Amgen's fines.

Amgen has a major lobbying force in Congress with 74 lobbyists, and has deep financial and political relationships with powerful Senators including Max Baucus, Mitch McConnell, and Orrin Hatch, the leaders of the Senate Finance Committee. Additionally, Amgen employees contributed $141,000 to President Obama’s presidential campaigns.

Senators should not be financing the illegal missteps of Amgen.  The American people should consider it collusion, rather than "politics as usual".  Shareholders of Amgen should address the moral and ethical actions of its Board of Directors, while the Board of Directors should be evaluating the CEO and his role in the illegal marketing and the fines that followed.  All should be punished appropriately, rather than celebrate this windfall.

And, Senators should be protecting Medicare for those who most likely need it.  Medical and Medicaid should be protected.  And, these slimy type of activities which Senators like Orrin Hatch and Max Baucus seem to endorse should be sent to the Ethics Committee of the Senate for review.  Would it surprise anyone that both Orrin Hatch (R) and Max Baucus (D) received huge contributions from Amgen?  Could it be that both Senators Hatch and Baucus have staff who now work at Amgen, and have former Amgen staff that work for them now?  Raw Story reports this very fact and that the access was developed by the staff.

Many in the LGBT community depend on Medicaid in San Diego and those in with Medicaid in other states for their access to doctors and health care services.  Yet, these same Senators endorsed covering the illegal fines of Amgen or at least 65% of it, and are willing to continue decimating necessary safety net services in our communities.   Kaiser Health News reports that Orrin Hatch has bi-partisan support to continue capping and destroying these safety nets.  

Currently a bi-partisan group (only two senators) are leading an effort to repeal this give away.   The LA Times Report provides only two senators supporting this draft legislation.

What will our Californian Senators do about this misguided section of the Fiscal Cliff Bill?  Will it affect their decision that Amgen resides in Thousand Oaks, CA?   Let's find out.

A Thank You Note, UCSD and the Nurses of the 6th Floor.

Over the last couple of months, I have had the experience of being a visitor at the UCSD Hospital.  Someone I care about deeply, as many of my connected family know, has been fighting cancer related issues, plus other disease related issues that occur when someone has an immune system that is depressed severely from disease, cancer or even radical treatments for those diagnoses.

On Thursday, January 17th, on the second return to the floor, I stood outside his hospital room, or as I call it, "the suite".  I had just spent two hours cajoling, comforting, caring, and going half crazy in efforts to maintain emotional balance, contain fear, while deal with the reality that no one loves to be in a hospital.  We had come in for one simple activity, and we now were facing ever changing tests, with results that were not positive, or at best, postponing strategic implementation of drug regimens that could reduce or eliminate medically threatening issues on his life.  To consider it an emotional roller coaster was to suggest a mountain was actually a mole hill.

I took a "time out" on the other side of his hospital room closing his door.  He needed me to find some soda to drink, but I knew we both needed to breathe.  For the next 20 minutes, just outside his closed door, with bright colored paper warning visitors to protect him from them, I was treated to a parade of patients that ranged from the hilarious to the extremely deranged in their reality.  Patients bodly owning their new surroundings as if it was their own living room, and dressing as sparingly and as accordingly.  While others mistook the head nurse as their soda delivery person, and another patient communicated his joy at being interrupted from his telivision by spitting in the nurse's face.

While I appreciate the opportunities always presented to me to meet some of God's most precious or entertaining creations, I generally appreciate them for having survived in our society to this point.  And, at times, I can't wait to make my escape depending how uncomfortable I may be, or rather, howembarrassed.

And, while I wanted to go visit patient "know it all" next door who for at least an hour, had confusedly and completely confidently exoriated successful economic policies that the US was using to recover.  I was quickly stunned by patient "beauty" who was wearing half of her green gown suggestively open on one side, so that everyone in the hall could see her, the five or eight layers of alibaster jello as she walked to a nurse to ask for a glass of orange juice.  And, it was at that moment, I wished that vision of God's creation could be purged from my memory, every wisp of gown, and what was underneath.

And, through every incident, and there were many, the nurses on the floor were professional, patient, and prepared.  The patients on this floor did not want to be on the floor.  I am sure every one of them wanted to be somewhere else.  They did not want to be there for another diagnosis, another health strategy, another drug regimen, and they did not want the pain, and most of them certainly didn't have the purse strings to afford the professional care they were receiving.   And, these nurses understood the reality.

I have been to UCSD too many times to be the health advocate for someone who was there with a terrible sickness or disease.  Yet, this was the moment, and the weeks on the 6th floor, where I learned to appreciate and decided to thank the nurses on the floor who didn't only help the ones who were facing their health and mortalities, but they helped me.

I was at the nurses station asking a question when I saw the business card for the assistant manager of the Sixth Floor.  I took it home with me.  And, I will share, while eliminating personal names of patients, the e-mail I sent to Kyle, Assistant Nurse Manager of the Sixth Floor.

January 17, 2013

Kyle:

This week, I have been with the patient on your floor in room 602 the last few days.  I have had ample opportunity to see the diverse population your nurses serve, the patients who are frustrated, those who are scared, and those, like my room's patient, who are hurting, sick, scared, and simply want to go home.  The doctors who have come in with news both startling and distressing have been candid and tempered.  While the nurses and staff have been so importantly tender and considerate.

I want to thank the nurses who, for the last few days, have so quickly responded to me, to the room patient, and to his pain.  It has increased daily, while doctors come in, with health obstacles, observation, honesty, and strategy.  No matter the outcome for us, before life becomes crazier, or saner, I simply wanted to say Thank You to the staff you manage and assist.

When I have asked for water, they have asked how much?  When I have asked for soda for the patient, they have asked what kind?  When I have asked for heating pads to reduce the pain, they have asked “where can we place them and can we show you how to use them?”  And, when I simply needed directions, they were quite willing to tell me where to go, but did it with a smile.  And, to be honest, when I cried for help to figure out that crazy gown thing, it was obvious I was out of my element.  Yet, they smiled, as if they had been in the same place once.

 I cannot imagine serving as a nurse or in any of the capacities where you serve.  I simply care for those I meet.  I can only comfort those I know.  Your staff comforts us and ours.  And, today, no matter the outcomes for us, whether miracles occur or the cycle concludes, I wanted to thank you all for your care for us.  It is frightening in the thick of disease and worry.  Your staff has been most responsive, despite the competition of contrary patient demands.  And, when a worried partner ventures out to the hall to seek assistance, I have not been ignored, put off, or maligned. 

I thank you for your efforts, one and all.  In fact, some of the nurses have engaged us, cajoled us, encouraged us, and even made us laugh.  And, perhaps, in those particularly dark moments those skills may be the only medicine that can truly sustain us.

In the future, when my partner’s emergency is done, when your staff should need me, I will be there for them.  Thank you, from me and mine.  I appreciate the Sixth Floor.

 

Regards,

Eric

 

I sent th e-mail at 230am.  At 8am Kyle called me and at 830a, the Nurse Manager of the floor called to ask permission to share the e-mail with staff.  I learned that often notes of rage, grief, and frustration are sent to the nurses station, but apparently a thank you specifically documenting their actions and achievements is rare.

 

Clearly, they were moved, and as we escaped for the weekend, on the hopes of never returning, a nurse stopped me.  He was retiring in three months but wanted me to know how moved everyone on the floor was.  And, as soon as he knew I wrote it, he thanked me.  And, I was moved.  Here the caregiver was thanking the one they were helping. 

 

Unfortunately, this week, my favorite patient went back on Monday for one simply action to occur, but ultimately stayed the week for tests, results, new tests, concerning results, additional tests, with relieving results, confirmations, a new drug regimen and hopes of the original treatment can start in a month.  The nurses managing the concerns of my favorite patient sternly commanded compliance with his drug regimen, while making him laugh at their conversations.

 

The day I picked him up as he was discharged from the hospital this week, two nurses came in and let Carleton know they were the head nurses at the hospital and the floor.  They thanked him for the e-mail.  And, they asked him what they could do to improve the care.

 

Again, I was moved.  But, I wasn't surprised.  My parents provided some simply truths that over the years I have determined are helpful in day to day life.

 

The first rule is to say "please".

The second rule is to say "thank you".

The third rule is really a belief.  The core of who a person is will manifest itself under extreme stress.   I had been just observant enough to see this fact on an entire floor of a hospital.  

Now, I have a belief as well.  I believe that when I am the person advocating for someone I care recieves the best treatment, I learn to appreciate the challenges of those bringing the best care possible and when asking, offer to help as best as I am able. 

 

And, recently, I have determined that for me, at the end of the day, I have learned I do not want to be thanked for the fact that I was present for a period of time.  I want to be thanked for what you thought was valuable during that time.  What moved the nurses was not that I said thank you for what they were there to do, but that I recognized the value of what they did, and how priceless what they did for me while they did their jobs was to me.

 

Perhaps, leaders in organizations, managers of people, parents of children, and those who have the opportunity would consider the very value in identify what is priceless about what someone else does for them, we would have a more unified community, state and country.  But, for right now, I am clearly the biggest fan, and will continue to give a big thank you, to the nurses at UCSD, the Sixth Floor.  I would include all of your names, individually, but if I left out that fabulous woman who clorox's the walls to minimize MRSA, it would be a failure.  It is the team, the way they individually respond, and a culture of care.

 

Thank you, again, and let my tears show your value.

 

Phrases Women Say that Men Don't Understand

For 45 years, I have had a wonderfully amazing mother.  For over 40 years, my sister has been in my life.  For many years, I have enjoyed great friendships with girls and women.  Many of them shared secrets with me about boys/men they found interesting or fascinating.  For over 20 years, I have also served in LGBT organizations where women have been a significant part of the membership, leadership, or who benefited from the services of those organizations.  For years, certain words I would hear caused me great confusion until I identified that I had a different definition of these words than women did.  Now, 20 years after I started in my current practice, 70% of my clients are women, 20% are gay men, and the remaining clients are progressives who enjoy my perspective.

The words below are words I have provided current definitions when identifying the connotation of the word when spoken by many of the females I have met.  This is not an exhaustive list nor do the definitions mean exactly what I have written.  It is a suggested definition if you are male, you are in a conversation with a woman, in any type of relationship whether in business, at a restaurant, or in your private life.  It can make life a lot easier when you understand a connotation of word, rather than the definition you have foolishly applied.

Words and phrases to consider:

Whatever – You are wrong.  She is right.  She isn’t willing to discuss the topic any longer.

Fine - Women use “fine” to end an argument when they have already decided they are right. That one word means “shut up” as this conversation is over.

“I’m fine.”  - Translation: “I am anything but fine.” She may be upset, annoyed, anxious or hurt. Calmly ask what she needs of you rather than asking her what is wrong.

Nothing – This word means anything but “nothing”.

Have it Your Way – Immediately choose to not do it your way.

It Doesn’t Matter – Trust me, what you next do will matter.

Don’t worry about it – Worry, and worry a lot.  Likely you need to execute on whatever was discussed in the last two minutes and FAST.

Ok – Red alert.  Do not pass go.  Ok actually means that the discussion is over, she has made up her mind, you are wrong, but you will be addressed later.

Go Ahead - This is a dare, not permission. She is testing if you will really do something she most likely disapproves of.

You can do whatever you want – My mom used a similar term when I was younger.  You can do whatever you can afford.  This is a phrase that provides you an early warning system that you can not do whatever you want.  You might want to carefully consider any actions that you have been discussing.

Forget it – Consider yourself dismissed from the conversation.  You have lost any negotiation power in the conversation.  The only thing you might be able to do is engage in any activity that was recently shared and get it done now.

That’s okay – It is far from okay.

You’re Right – You aren’t.

The Decision is yours – Not really, just go ahead.

We need to talk – This doesn’t really mean there will be a conversation.  This means that you will be listening, your ears will burn, your eyes may boil out of your head, but you best not say anything during the conversation.

Enough - I have recently added this word.  It may be the only word that is truly clear.  Whatever was just said best not be executed, discussed, or identified in the future.  You are warned.

Silence – Stay busy.  Take out the trash.  Fill up the car with gas.  Clean the toilet.  Stay busy.  Do not engage until you have completed about 1,000 tasks that have been suggested you get accomplished.  And, at all costs, do not turn on the television.

Ladies, what words would you include?  Men, do you have anything to add?