Sue ’em! Albany County Comptroller Mike Conners. Photo: John Whipple

Health Gouging

Albany County is being screwed by pharmaceutical companies, county comptroller says

Albany County Comptroller Mike Conners has instituted an audit of prescription drug costs to the county for patients on Medicaid, and if early results are any indication, Albany County is being gouged by pharmaceutical companies.

Conners began his investigation due to a very noticeable 25 percent increase in the county’s Medicaid prescription drug costs from 2002 to 2003. For the first 20 drugs audited, Conners has found overcharges of about $2.2 million.

So far, the audit has looked into purchases from 2002, but Conners predicts that, because of the 25 percent increase in costs from 2002 to 2003, it is likely the overcharges in 2003 will dwarf those of 2002.

Before Conners began his audit, he invited 44 drug companies to take part in a forum on the potential cost discrepancies. Of the 44 invited companies, none attended the meeting.

“I was contacted by their law firms,” said Conners. “They all said the day was inconvenient or had some [other] excuse.” Conners was later told by two drug company lobbyists that the companies feared Conners was looking for publicity for his Congressional run. Conners points to the fact that he invited the companies to take part in a meeting before he began the audit and the fact that he did not bring the matter up during his campaign as proof that his intentions were pure.

But now that the audit has begun, Conners has dispensed with pleasantries and said “We’re going to have to sue the bastards!” Conners’ frustration and adamance stems not only from the overcharges the audit has revealed—only two of the first 28 drugs looked at so far have not been overcharged for—but from the difficulty he encountered in trying to find out what the companies should be charging in the first place.

After several unsuccessful attempts to obtain accurate data on what the county had actually purchased and what it had been charged, Conners finally received a disk from the Department of Health with figures showing what was purchased, what was charged, and what should have been charged. “We should be charged 80 percent of the lowest wholesale price. Instead, the companies institute a policy that creates artificial wholesale prices, which amounts to a mechanism to enrich reimbursement for drugs that assist the poor,” Conners states.

Albany County’s audit was inspired by a lawsuit the City of New York filed against the same 44 drug companies for overcharging its Medicaid program. Conners made it clear that the law firm in charge of New York City’s law suit is very willing to take on more litigants. Conners has officially recommended that Albany County join the NYC lawsuit. “It’s up to the Legislature now. I want to see them sue the bastards!” Conners repeats.

According to County Legislator Shawn Morse (District 18), if Conners’ audit pans out, the legislature will take action. “I can assure you that with all the financial problems Albany County faces, if Albany has the chance to go after people who are robbing our taxpayers, we will.”

According to Conners, while the gouging by pharmaceutical companies is a huge problem, it is “only another proof that Medicaid is irrevocably broken. We’re giving the poor low-quality care and the county is paying for it at a Rolls Royce price.” Again, Morse agrees, adding, “We need to create solutions. We can’t just complain. I am familiar with Mike’s proposals and I support him wholeheartedly.”

Conners’ proposals include passing legislation that will allow the county to buy drugs at a group, wholesale rate and then pass on the savings to the county’s taypayers. He also proposes “hiring the young and senior poor for community outreach to help care for the elderly in their homes. Keeping the elderly from being shoved into a nursing home for even a year can save $7,800.”

John McDonald, mayor of the city of Cohoes, who is also a pharmacist, says that Conners’ efforts are admirable, but he insists there is a larger issue at play here and that issue is the power of pharmaceutical companies. “Getting drugs from Canada isn’t the answer,” said McDonald. “The drug companies can control their shipments and pricing in Canada as well as they can here.” McDonald also sees the need for a limit on advertising; he points to the pharmaceutical industry’s ability to convince consumers through advertising that a new more expensive drug is more effective than the cheap, older one that they are also manufacturing.

As it stands now, Albany County’s audit has focused on 200 out of 6,000 drugs purchased by Medicaid in 2002. Conners expects that as the audit progresses and more years of expenditures are covered, things will look much worse. And he points to the techniques pharmaceutical companies use to keep their patents, techniques such as slightly tweaking a drug before the patent runs out to make it new, preventing it from coming up for grabs by generic drug manufacturers who can sell it at a lower price.

Conners states it is estimated that “By 2013 our nation’s prescription drug bill will jump from $250 billion to $520 billion. This increase is not sustainable. Something must be done.”

—David King

Robots R People 2 Photo:Alicia Solsman

Even the robot contingent got in on last weekend’s “Blue State Speaks Out” rally, as a pair of angry sign-toting bots shuffled downtown to announce that they too were mad at “something.” What they were actually mad at, we’re not quite sure—although one of their human helpers from UAlbany mentioned something about a “wave of robot inequality” overtaking the nation. We’re not so sure that they were really the cybernetic organisms they claimed to be, but here’s hoping they’re able to stem that pesky tide of robot prejudice.

Give peace a chance: participants in last weekend’s rally. Photo:Alicia Solsman

Refocused for Peace

Latest protest against the Iraq war draws large and spirited crowd

Like a football team that fell a few points short of the championship, the local peace movement turned out last weekend to refocus their efforts and kick off a new season of social action with the “Blue State Speaks Out” rally in downtown Albany.

“The first challenge for the peace movement now is to put ourselves forward as the real ‘values voters,’” announced Steve Breyman of Veterans for Peace, one of the many groups whose members endured the cold Saturday morning to protest local politicians’ continuing support for the war in Iraq.

While many attendees argued that Saturday’s rally was simply a continuation of the same activism that preceded the presidential election, the content of speeches and signs—and there were many of both at Saturday’s rally—reflected a more post-election-revival mood. “Is this what you mean by moral values, Mr. Bush?” asked one sign, while another simply stated, “We’re not going away.”

And they certainly don’t seem to be. If last weekend’s rally was any indication of the election’s effect upon the peace movement, Bush’s reelection would appear to have only increased the numbers of those willing to voice their opposition to his policies.

An energetic crowd of more than 70 teachers, church workers, parents, children, veterans and other assorted activists gathered outside the Leo W. O’Brien Federal Building to remind everyone that it was the votes—and continuing support—of New York state’s elected officials that have made the war in Iraq possible. Sens. Charles Schumer and Hillary Clinton, along with Rep. Michael McNulty, all have offices in the O’Brien building and have cast supporting votes for much of the legislation leading to American military involvement in Iraq.

“It’s time for the senators and representatives to take a stand against this war,” said Alison Guernsey, a member of Women Against War and one of the organizers of the rally. “[New York’s elected officials] need to stop looking at the politics of the war, and start looking at the humanitarian aspects of it.”

Geralyn McDowell, a Catholic worker with Troy’s Rosa House Peace Community, questioned elected officials’ use of religion in justifying the war, saying that if they truly wanted to act upon their faith, they would “perform works of mercy.”

“Feeding the hungry, sheltering the homeless—these are acts of faith. I am not going to allow [elected officials] to say that Christianity is this,” said McDowell, gesturing in the direction of a sign with the words “100,000 Dead. Enough?”

Along with offering up a list of the challenges facing the peace movement, Breyman also made a few predictions about the future of politicians’ response to the peace-minded constituents. According to Breyman, Americans can expect to see a non-binding resolution against the war come across the desks of their senators and representatives in the near future.

“But we can’t support something like that,” said Breyman, arguing that such legislation is simply a way of appeasing the peace movement without actually taking any action against the war. “If it’s not binding, it’s not the answer. It will only sidetrack us and cause us to focus our energy to no valuable end.”

—Rick Marshall

rmarshall@metroland.net

Time to speak out: Moonhawk River Stone. Photo: Teri Currie

Who Gets Rights?

Right-wing activists target Albany county proposal to extend human rights to transgender people

To supporters, Albany County’s proposed Local Law B guarantees basic rights to those being denied them. Opponents feel it would force nontraditional values down their throats and support “destructive behavior.”

Local Law B would add three classes to the anti-discrimination provisions of the county’s 2000 human-rights law: active-duty military personnel, victims of domestic violence, and transgendered persons. The law includes transgendered people by listing “gender” as a protected category and then later defining gender as “actual or perceived sex and shall include a person’s gender identity, self-image, appearance, behavior or expression, whether or not that gender identity, self-image, appearance, behavior or expression is different from that traditionally associated with the legal sex assigned to that person at birth.”

Local Law B was introduced on Oct. 12 by John Frederick (District 6), and is co-sponsored by five other legislators. Although a similar provision passed the city of Albany with no opposition in April, the transgender portion of the county’s proposal has come in for some fierce resistance. (Frederick has been out of town this month and was unavailable for comment for this article.)

“It’s important for people going through [a gender] transition, or who have gone through one, to be protected from being fired from their jobs, thown out of housing, denied credit,” said Libby Post, president of Communication Services and founding chair of the Empire State Pride Agenda. “They’re taxpayers too.”

“Transgender people are chronically unemployed or underemployed, not because of their skills, but because of fear and discrimination,” added James Ross, executive director of In Our Own Voices, an organization that serves lesbian, gay, bisexual, and transgender people of color. “At a very basic level, [passing anti- discrimination provisions] suggests that people have value,” he said. When discrimination is legitimized, says Ross, it encourages anti-transgender violence, which some have estimated claims the life of one to two people per month in this country.

The county law would have a more direct effect on the lives of many transgender people than the city one did, because most social services are provided at the county level. Harry Davis, who works with people with HIV/AIDS at the Whitney Young Health Center and also with Gay Men of Color Alliance and the Colored American Transgender Society, has seen discrimination directly affect his clients. “There were almost no services for them,” he said. “Nowhere would accept them, such as the shelters. I had transgender clients who had to go to the City Mission; they were afraid, one of them had physical problems.”

A major problem often occurs with substance-abuse in-patient treatment centers, which are gender-segregated. Davis has worked with several local institutions to come up with separate transgender units, or to appropriately accommodate those who are comfortable in the general population. “It’s getting better,” he said, but more needs to be done.

The employment problem, for example, is big enough that many transgender people are forced into prostitution, said Davis. “We need to look at this as a health issue. We’re cutting off our nose to spite our face if we’re not giving these people jobs, housing, substance-abuse treatment,” he said.

Both advocates and transgendered people spoke in favor of Local Law B at a public hearing on Oct. 26. A week before the hearing, Steve Kidder of the New York Family Policy Council, which is associated with the national group Focus on the Family, got a call from a legislator opposed to the bill. Kidder informed Bill Carlson, chairman of the local Association of Political Active Christians, who turned out five people to speak in opposition to the bill.

Carlson argues at different times that transgenderism is either a “choice” or a “mental illness” (gender identity disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders, as homosexuality used to be), and therefore not an “immutable characteristic” like race, deserving of civil rights protections.

“It’s effectively a government endorsement of transgender behavior,” said Carlson. When asked if that meant the Americans With Disabilities Act’s protections for people with mental illness was a government endorsement of mental illness, Carlson said he was unfamiliar with the ADA.

Active military duty, which APAC does not oppose being added to the law, is also choice, but Carlson says it’s different because joining the military “is not, shall I say, disruptive to society at large.”

Carlson also argues that the law is too vague, and said he was afraid it would lead to a disgruntled employee cross-dressing in order to be able to claim discrimination.

Chagrined by the quick passage of the city bill and their small turnout at the hearing, APAC organized people to show up at the regular county legislature meeting on Nov. 8. Though several supporters of the bill passed around an e-mail from APAC and urged supporters to show up, many people got the message too late or called and found out the issue wasn’t on the agenda, and so didn’t go. APAC turned out close to 75 people, who began arriving up to an hour before the comment period to sign up for slots, leaving several supporters who did show too late to get on the speakers’ list.

Though some bill opponents, like Carlson, tried to frame secular arguments, other speakers relied heavily on claims that transgenderism and homosexuality (sexual orientation is already a protected class in the bill) are “against God.”

Over a dozen emotionally charged speakers quoted from the Bible and warned that the bill would lead to gay marriage. (The bill includes an explicit provision saying it does not confer marriage rights.) The director of the Capital District Prayer and Healing Center asked the legislators not to do anything that would “further harm the family structure” in Arbor Hill, and a youth pastor claimed the bill would add to the confusion of teenagers who are questioning their own identities. “I urge this body not to be exploited by a larger gay agenda,” said one speaker.

“As a Christian myself, I find it really offensive that Christianity is used as a way to separate and divide people,” responded Ross. “I am thankful that I come from a tradition that’s about love, faith, tolerance, and grace.”

“Did they talk to God on the phone before the meeting? Did they get a telegram? Or, is God so tech-savvy that he has a blog on the web that only the righteous have the password for?” wrote Post in her weekly commentary for WAMC the week after the Oct. 26 hearing.

“My experience in the hearing is they seemed to use [this law] as a stepping stone for the whole anti-gay agenda,” said Moonhawk River Stone, a psychotherapist specializing in transgender issues. “People spoke in fear-mongering ways. One person threatened a lawsuit. They were really trying to place fear in legislators on something that should be a nonissue.”

The recent elections and the elevated profile of gay marriage have “really increased the conservative and religious right’s attention to our issues,” noted Keith Hornbrook, director of the Capital District Gay and Lesbian Community Center, who attended the original hearing. “No one in this community will be unaffected by what has happened.”

Bill supporters argued that the stigma against transgender expression should make it clear that transgender people are not acting capriciously. “This isn’t just a choice that someone decides to get up in the morning and put on a dress [or] cut their hair short. This is really about who you are,” said Hornbrook.

“Who would make this choice?” asked Post. “Clearly this is innate.”

One African-American woman who spoke against the bill on Nov. 8 shook her Bible at the legislators and said several times, “I dare you try to pass this law like a civil rights law.”

Ross admits that the religious right has often been “very effective in mobilizing certain segments of communities of color,” but he notes that just as they don’t speak for all Christians, nor do they speak for all people of color. “I think that there is no way that one can not draw parallels between this desire for civil rights and the historic African-American quest for rights,” he said. “Are there differences? Of course there are. But that doesn’t mean that the basic fundamentals are not the same. People are people and deserve to be treated with respect.”

Transgender anti-discrimination provisions are neither new nor particularly rare. In New York state they are in place in Albany, New York City, Ithaca, Buffalo, and Rochester, and Suffolk and Tompkins counties. Outside of New York, they have been instituted in four states and dozens of major cities. And in all those places, the scare stories of problems in the schools or people trying to take advantage of the laws to get back at an employer or secure a marriage license, simply haven’t happened, said Post, Hornbrook and others. Numerous large companies, including Aetna, IBM, Bank One, J.P. Morgan, and Lucent Technologies, also have transgender non- discrimination policies.

Transgender issues are complex, admitted Post. “I’m hopeful that the county legislature doesn’t rush to judgment and goes through the process of being educated,” she said. “It took me a while to come around. It took a lot of us a while.”

The measure is expected to be back on the agenda at the county’s next meeting on Dec. 6.

—Miriam Axel-Lute

maxel-lute@metroland.net

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