LAYTON — Using a patented audio-introduction for job seekers, a Ogden-based business and its partners hope to lower the state’s unemployment rate.
The Davis Community Job Fair will be held Tuesday from 1 p.m. to 4 p.m. at the Davis Conference Center in Layton, 1641 N. 700 West.
The career fair, sponsored by Compass Career Fairs LLC of Ogden, is open to all job seekers and will feature Xentique’s patented live-recording audio-introduction -- about 2 to 3 minutes in length -- for all job candidates to ensure their paper resumes do not get lost in the interviewing process.
“We have 91 attending employers. It’s a big day,” said Shane Lyon, chief executive officer of Compass Career Fairs LLC.
Those jobs that will be available will range from entry level manufacturing to high-end technical careers, Lyon said, who is anticipating between 1,500 to 2,000 job seekers.
Lyon said his company sponsors career fairs about twice a year in each county along the Wasatch Front.
Despite the state’s 3.5 percent unemployment rate, and Davis County’s 2.9 percent unemployment rate, according to Lyon the career fairs continue to draw an increasing number of job seekers, not only looking for employment, but possibly looking to upgrade on their current job situation.
“All job seekers are welcome,” Lyon said of the fair that is inclusive.
Utah has about 50,800 workers who are unemployed.
Most of those who attend the career fair have no job, “but there are those who are under-employed and under-paid” for the work they do, Lyon said.
“We go for quality. We are trying to connect a quality workforce with quality employers,” Lyon said. There are many who are unemployed that just have not found the right opportunity, he said of those who utilize the fair.
The last time his company hosted a job fair was in Weber County at HUB 801, back in March, in which 79 employers attended and about 1,500 job seekers.
What will make Tuesday’s career fair different is that it will be the first time job seekers will produce an on-site recorded audio message promoting themselves in which will be shared with each employer there, said Nancy Lee, Xentique spokeswoman.
The goal of the partnership group is to provide the job seeker with a job that is a better fit for a better life, said Chris Bijou, a partner with iDealHiring, a software company.
Contact reporter Bryon Saxton at 801-625-4244 or email@example.com. Follow him on Twitter at @BryonSaxton.
LAS VEGAS — It took $817 million, two starts, more than six years and one worker’s life to drill a so-called “Third Straw” to make sure glittery casinos and sprawling suburbs of Las Vegas can keep getting drinking water from near the bottom of drought-stricken Lake Mead.
The pipeline, however, won’t drain the largest Colorado River reservoir any faster. It’s designed to ensure that Las Vegas can still get water if the lake surface drops below two existing supply intakes.
“You turn on the tap, you don’t think about it,” said Noah Hoefs, a pipeline project manager for the Las Vegas-based Southern Nevada Water Authority. “These are the things being done in order to live the lifestyle we want in the places we want to live.”
It’s the latest example of ways the parched West is scrambling to deal with 15 years of unprecedented drought.
California is encouraging homeowners to rip out thirsty lawns and asking farmers to turn off spigots. And in New Mexico, a $550 million pipeline project would supply drinking water to several communities that run the risk of having wells go dry within a decade.
Las Vegas started in 1999 to conserve, reuse and replenish supplies. When Lake Mead water levels plummeted in 2002, regional water officials began drawing up plans for the pipeline.
“Unlike California and our other partners on the river, we are almost entirely reliant on Lake Mead,” said John Entsminger, water authority general manager. “We couldn’t afford to wait.”
Sin City gets about 90 percent of its drinking water from the lake behind Hoover Dam, itself an engineering marvel that cost the lives of about 100 workers during five years of construction before it was completed in 1936.
The need for the new pipeline can be seen in the wide white mineral band marking rock canyon walls where lake water has receded and the sun-bleached docks at abandoned marinas, left high and dry.
The water level has dropped almost the equivalent of a 20-story building since Lake Mead last topped the dam’s spillways in 1983.
The pipeline resembles a subway tunnel 55 stories below Lake Mead’s Saddle Island, reinforced with more than 2,400 6-foot jigsaw sections of concrete. A $25 million drilling rig the length of two football fields ground nearly 3 miles through solid rock to reach the intake structure a minute before noon last Dec. 10.
Jim Nickerson, project manager for Vegas Tunnel Constructors, a subsidiary of Italy-based Impregilo, peered during a recent tour into the circular intake, which is designed somewhat like a big bathtub drain. The 100-foot structure was lowered in March 2012 into what once was a Colorado River canyon and cemented into place with the equivalent of 1,200 truckloads of concrete.
Its dome roof was capped by a 1,900-pound stainless steel ball.
Above that was about 300 feet of water. The lake is about 37 percent of capacity, but still contains trillions of gallons of water — mostly snowmelt from the Rocky Mountains in Colorado, New Mexico, Utah and Wyoming.
When the intake is flooded, water pressure in the tunnel will approximate water pressure in the lake. Nickerson said the ball plug will become buoyant enough for a crane on a barge to lift it.
“End of the year, we’re done,” he said.
Pumping will mark completion of a perilous project.
The tunnel flooded in July 2010, when a drilling machine hit a geologic fault, and flooded again five months later. Project engineers abandoned and capped the first tunnel and started a new one in a different direction.
In June 2012, tunnel worker Thomas Albert Turner died. He was a married, 44-year-old father of two from Henderson whose brother also worked on the pipeline.
Pulling the plug won’t hasten creation of the “bathtub ring” around the lake. Blame drought for that — and exponential growth in a desert area that averages just over 4 inches of rain per year.
Las Vegas had about 126,000 residents when it began drawing water from Lake Mead in 1971. It now has 2 million residents and 40 million tourists a year.
The top of the new intake structure is at 860 feet. That’s 40 feet below so-called “dead pool” at which Hoover Dam electricity turbines would be idled and no water would flow downstream.
Water managers let the Lake Mead level fall to a new record low late Tuesday, at 1,074.98 feet. They say the lake level will rise by the end of the year to about 1,081 feet. That’s 6 feet above the trigger point that would require a percentage cut in water supplies to Arizona and Nevada.
Officials are currently giving Lake Mead a nearly 50-50 chance of ending 2016 below the 1,075-foot trigger point — unless the drought is broken.
Associated Press writer Susan Montoya Bryan in Albuquerque, N.M., contributed to this report.
NEW YORK — Pete Meegan had every intention of going back to college, but then he got a summer job in the Chicago trading pits and fell in love with the “roar” of the floor, the excitement of “4,000 people yelling, ‘Buy! Buy! Buy!‘” and decided no more classroom for him.
That roar will soon go silent. On Monday, most futures pits in Chicago and New York, where frenzied buying and selling once helped set prices on cattle and corn, palladium and gold, and dozens of other commodities, are expected to close for good. Traders yelled and shoved and flashed hand signals, just as they did in the movie “Trading Places.” But now the computer — faster, cheaper and not nearly as noisy — has taken over.
It will be a sad day for Meegan, still in the pits 34 years after dropping out of college, donning a trading jacket and mustering the courage to tell his dad.
“I thought he was gonna kill me, but he was like, ‘I don’t care if you pick up garbage or you’re a dog groomer. If you are happy doing what you are doing, you’re ahead of 99 percent of the people in the world,‘” recalls Meegan, now 54.
The few dozen jobs that will be lost when the pits shut down is just part of it, veterans say. What’s also disappearing is a rich culture of brazen bets, flashy trading jackets and kids just out of high school getting a shot at making it big. The pits were a ruthless place, but they were also a proving ground where education and connections counted for nothing next to drive and, occasionally, muscle.
“If people came to your spot, you shoved them out of it. ‘This is my two-foot space ... so get out of it,‘” says Dan Sullivan, a broker who’s been working in the pits since 1981. The competition, he adds, also bred camaraderie. “These guys knew me better than my wife.”
Dan Grant, 53, traces his love affair with the pits to a $150-a-week job as a “runner” ferrying messages between clerks taking phone orders from customers and brokers executing them.
Six years into his career, on Oct. 19, 1987, stocks were plunging around the world and he was a clerk taking orders from the head traders at Chemical Bank and Drexel Burnham Lambert desperate to buy anything to protect themselves. Grant still marvels that, just 24 years old and with no college degree, he wielded such power in the crash, later known as Black Monday.
“They were buying Treasurys and currencies, and watching their stock portfolios go to zero,” he recalls. “It was a lot of fun.”
The pits that are closing deal in futures, or contracts to buy or sell something at a later date at a set price. They’re used by farmers to lock in prices for their crops before harvest, for instance, and investors as a way to bet that prices will go up or down.
Not all futures pits are going away. In its February announcement about the closings, the owner of the exchanges said the pits where Standard and Poor’s 500 stock futures and options on futures are traded will remain open. Floor trading of stocks on the New York Stock Exchange, which is owned by a different company, won’t end, either.
But the few remaining pits are a small, perhaps fleeting, victory for the dwindling number of traders who still use hand signals to buy and sell.
Where once futures on everything from pork bellies and wheat to Treasurys and Eurodollars were only traded in this “open outcry” system, now just 1 percent are. Where once thousands of futures traders stood shoulder to shoulder, now just a few dozen show up on a typical day.
“There were five (people) in the wheat pit today,” laments broker Virginia McGathey after the closing bell in Chicago last Wednesday. “Back in the day, there were 400.”
Scott Shellady, a broker standing nearby, worries that fewer humans could mean more violent swings in food prices. He fears turbulence could be triggered by an unusually large offer from a stranger in India or another far off place to buy or sell a futures contract.
“That pit, with 500 guys, you can’t have a flash crash because ... there are 499 people that know he doesn’t normally trade that big,” says Shellady, who wears a black-and-white cow print jacket, a reminder of a time when brokers needed to stand out on the floor.
Since at least 1870, when the first octagonal pits were installed in Chicago, traders have been reading the “tone” of the crowd to sense where prices might be heading and feeling the “rush” when placing a big bet.
After more than 40 years of trading, George Gero knows all about the feel and thrill of the pits. But he is also familiar with wrenching change, and learning to adapt to it.
After fleeing from the Nazi’s in wartime Hungary, he came to New York, and found a home in the commodities pits downtown. And at 79, he’s still at it, marveling at how the computer allows him to find prices for gold and currencies around the world, no matter the time of day.
But Gero, a strategist at RBC Capital Markets, is not a complete fan of the new way. “It’s very cold ... strictly numbers,” he says.
Grant, the runner turned clerk who now oversees his own trading firm, says he has embraced change, too. But he mourns the loss of the kind of entry-level positions that gave kids without much education a chance to prove themselves, just as he did.
“The customer doesn’t have to call anyone to execute a trade,” he says.
Sullivan, the broker, puts it bleakly.
“It’s kind of a slow death for people,” he says. “Maybe I am holding on to something that needs to go.”
There are job expenses that can be deducted for job assignments that are temporary assignments that take the taxpayer away from the taxpayer’s home.
However, in order for job expenses such as housing, food and travel to be taken as a deduction, the taxpayer must determine whether the assignment is truly temporary.
A temporary assignment in a single location is one that is realistically expected to last (and does in fact last) for one year or less.
If the job assignment meets the criteria then the taxpayer’s home does not change in relationship to job expenses. The taxpayer is considered to be away from home for the whole period he/she is away from the main place of work.
If the job is initially temporary and then becomes indefinite due to a change in the circumstances, the taxpayer may no longer deduct job related expenses.
A misconception is that the taxpayer can take a break or leave for a period of time to keep the job assignment under the one year mark. The IRS considers a series of assignments to the same location, all for short periods but that together cover a long period to be considered an indefinite assignment. If the assignment is considered indefinite the location is considered to be the taxpayer’s new home and expenses cannot be taken.
Temporary job assignments often occur with traveling nurses and construction workers. Amounts paid for food, lodging, mileage, and other expenses necessary to maintain a temporary home may be deductible.
A taxpayer must be able to show that the assignment is indeed temporary and was not expected to turn into an indefinite assignment.
If the taxpayer receives an allowance for living expenses and the assignment becomes indefinite, the taxpayer must include in income any amounts received from the employer for living expenses. This is true even if the amounts are called travel allowances and the taxpayer accounts to the employer for them.
The taxpayer may be able to deduct the cost of relocating to the new tax home as a moving expense. Expenses for moving have some limitation to what is deductible.
Tracy Bunner is an enrolled agent and tax preparer with an office in Harrisville. She can be reached at 801-686-1995 or at firstname.lastname@example.org.
If you pay for good health insurance, shouldn’t you be able to afford the medicine you need?
For Kristin Agar, a 63-year-old social worker in Little Rock, Arkansas, this has not been the case.
In 2008, Agar began experiencing strange symptoms. Her feet swelled, her joints ached, a rash appeared on her face, and every night she would get a fever that would disappear in the morning.
Her doctor diagnosed her with lupus, a disease in which the body’s immune system mistakenly attacks healthy tissue, including the skin, joints, brain or kidneys. Agar’s doctor prescribed Benlysta, the only treatment on the market specifically for lupus.
But Agar says that, although she works hard and makes decent money, she isn’t able to afford Benlysta. Agar’s insurance policy pays for 80 percent of the drug’s price, or about $2,500 per dose. But Benlysta is so expensive that Agar would still have to pay $450 once or twice a month for the medicine — on top of a $770 monthly insurance premium, and her other medical costs.
“I make too much money to qualify for assistance, but I don’t make enough to pay the bills,” she says.
Around the U.S., people with serious diseases like Agar’s are falling through the cracks, unable to afford the medication they need even if they have good jobs and good insurance. Patients with HIV, cancer, lupus, leukemia, hepatitis C, multiple sclerosis and other serious conditions are paying huge out-of-pocket sums for necessary medication. These costs are putting heavy mental and financial stress on some of America’s most vulnerable people.
And the trend is getting worse. According to Truveris, a drug pricing research firm, the combined prices for brand, generic and specialty drugs rose 10.9 percent in 2014 compared with the previous year.
These rising prices are forcing some patients to take on huge amounts of debt. Others, like Kristin Agar, are forgoing medications altogether — increasing the risk that they will have more serious health complications down the road.
The reasons for these trends are complex: Drug companies blame insurers, insurers blame drug companies, and researchers blame both, as well as government regulations. But the implications are clear. Patients who can’t get medications will get sicker, and when they do, families, insurance companies and the government will bear the cost.
The Supreme Court ruled on Jun. 25 that the federal subsidies that help people purchase Affordable Care Act health plans are legal, ensuring that the system will survive for now, and that patients with pre-existing conditions can continue to get insurance. However, patient advocates say that much work still needs to be done to make certain that patients can afford the treatment they need.
Americans of all parties now see the cost of drugs as a top concern, even more important than political aspects of the Affordable Care Act. In a poll by the Kaiser Family Foundation earlier this year, 76 percent of the public said the top priority for the president and Congress was making sure that those who need high-cost drugs for chronic conditions, such as HIV, hepatitis, mental illness and cancer, can afford them.
There is no quick fix to these problems. Meanwhile, the American population is aging, and many more expensive drugs are coming on the market. The problem is likely to get much worse before it gets better.
“It’s ironic: We’ve had fairly stable health care costs for a number of years, which is a truly historic achievement. We’ve saved billions and billions of dollars,” says John Rother, the president and CEO of the National Coalition on Health Care, which advocates for sustainable drug prices. “And now it looks like this one sector, pharma, is going to drive healthcare costs much more aggressively upward in the future.”
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The number of Americans taking expensive prescription drugs is rising quickly. In 2014, 576,000 Americans took at least $50,000 worth of prescription drugs, up from only 352,000 the year before, according to a recent report by Express Scripts, which manages pharmacy benefits for government agencies, labor unions, and other big employers.
Insurance companies paid the bulk of this cost, of course — more than 97 percent. Most insurance plans cap the amount that patients can pay out of pocket for drugs. After a patient reaches this maximum level — up to $6,600 for plans purchased on the federal exchange — the insurance company will pay 100 percent of drug costs.
But for many patients, the problem is in getting to that spending cap. Many Americans with chronic illnesses don’t have $6,000 or more to spend on prescriptions, especially after paying a monthly insurance premium, doctor visit co-pays, and other medical costs.
For many with serious illnesses, hitting that maximum annual out-of-pocket level has become inevitable. Many patients, Agar included, hit the cap within the first few months of the year. “I don’t have that money lying around to be able to do it,” she says.
“I’m not a stranger to hard work, I’ll work hard six days a week and people who know me will say that,” says Agar. “But there’s a limit to what anybody can do.”
For much of her career, Agar worked with cancer patients, and she saw them go through the struggle of trying to afford their medications first hand. But she never thought she would end up in the same situation.
Without the drug, Agar is vulnerable to a lupus flare that could damage her organs. “I feel like a sitting duck,” she says.
People living with HIV and AIDS describe similar challenges. For lower-income patients who get access to the system, federal funds will cover the cost of medical care and support services. Jaysen Foreman, a case manager who works with HIV positive youth in Charlotte, North Carolina, says patients making up to $34,000 in Charlotte can receive free HIV medication and care through the government’s Ryan White program.
But those who make more than that amount often struggle to afford their medications, too.
“That’s the portion that it’s really squeezing, individuals who are in the gap between what Ryan White will cover, and where people have the income to pay for the medication whatever the co-pays are,” says Jonathan Hammond, a clerk at an immigration law firm in Cincinnati who is HIV positive.
Considerations about insurance and HIV-related debt have changed the course of Hammond’s life.
Hammond was forced to take on a heavy debt load as a result of HIV. When he discovered that he was HIV positive in 2002, he was enrolled in a graduate school program that didn’t offer health insurance. Hammond dropped out of school and spent a decade as a manager at Starbucks, which provides health insurance to part-time employees.
Hammond started studying to become a lawyer in 2013 as a way to finally escape from what he calls “the debt of HIV.” He has around $50,000 in medical-related debt alone, including charges from multiple visits to the emergency room over a decade ago, when he was very sick but didn’t yet realize that the cause was HIV.
Despite Hammond’s efforts to pay that debt down, in most years his total debt grows rather than falls. Last year, Hammond paid close to $9,000 for medical care. This year, his law firm adopted a new insurance policy with a maximum out-of-pocket payment of $6,350. He met that maximum on March 7.
“Beyond the stress of living with HIV and having that, [there’s] knowing that every single year that goes on, your debt is just going to get larger,” he says.
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Nine out of 10 of the more than half a million Americans who consumed at least $50,000 in prescription drugs last year were taking what the medical industry calls “specialty medications.” These are drugs that treat complex and chronic conditions such as cancer, HIV and AIDS, rheumatoid arthritis, hepatitis, multiple sclerosis, kidney failure, and hypertension.
The growth is partly due to pharmaceutical innovation that is helping those with serious illnesses live longer and healthier lives. Drug companies are rolling out life-changing treatments for chronic conditions, including cancer and hepatitis C. And patients who are taking these drugs are living longer, meaning the number of people on high-cost drugs is increasing.
But the trend also has a lot to do with how pharmaceutical and insurance companies price their products, and how the government regulates them.
In the debate over who is responsible for high patient drug costs, insurers and pharmaceutical companies are almost totally at odds. The pharmaceutical industry says insurers bear most of the responsibility for passing on too much of the cost of prescription drugs to consumers.
“What we’re seeing in the marketplace is that insurers are requiring patients to pay an ever-growing share of their medicine costs,” says Robert Zirkelbach, a senior VP of communications at PhRMA, a trade group that represents the pharmaceutical industry. “In fact, patients are being asked to pay a far greater percentage of the price of medicine than they’re required to pay for physicians or other medical services that may cost significantly more.”
Some independent researchers agree. Allison Rice, a professor at Duke Law School who teaches a training program for law students who are working with HIV patients, cites a longer-term trend in past decades toward insurers, employers and government-sponsored programs like Medicaid shifting more costs onto patients in order to encourage them to make smarter decisions about health care and reduce health care expenses overall. But while this approach might work with everyday health care, Rice says it doesn’t apply to chronic diseases.
“The notion is that you can reduce health care costs by ‘putting skin in the game,‘ which I always find to be kind of hilarious when you’re dealing with people with cancer, multiple sclerosis or HIV. It’s not like they have a whole lot of choice in their meds,” Rice says. For HIV, for example, there are a limited number of drugs on the market, and each may provoke a different response in different patients.
Some researchers have also found evidence that insurers offering health plans through the new federal marketplace are purposefully passing on higher costs to those with chronic illnesses, in order to discourage the sickest, and therefore most expensive, people from joining their plans.
A study published in the New England Journal of Medicine in January by two researchers at Harvard argued that some insurers are discriminating against people with HIV by putting all medicines to treat the condition in the highest cost-sharing tier.
Normally, insurance companies place medicines in different cost tiers in order to guide patients toward lower-cost versions of the drug. That might be a generic, or it could be a drug for which the insurer has been able to negotiate a lower price. But the Harvard study showed that some plans put all HIV medications in the highest cost tier — a practice they call “adverse tiering.” While Affordable Care Act bars insurers from discriminating against patients with pre-existing conditions, researchers say adverse tiering is designed to discourage HIV patients from joining certain insurance plans.
Doug Jacobs, the lead author of the study, says they were surprised to find that adverse tiering was a widespread practice, going on in 12 of the 48 plans they looked at across the country. “The implications for people with HIV were tremendous. We estimated that if someone with HIV was in an adverse tiering plan, they would be spending more than $3,000 [a year] than if they weren’t.”
Those working with HIV positive people say they have seen this phenomenon in action. Rice of Duke University says that it has been one of the barriers to people with HIV enrolling in the federal exchange plans in North Carolina. “People who realized up front that they were going to face 25-50 percent coinsurance for HIV drugs didn’t even bother to sign up,” she says.
Another study by Avalere Health, a healthcare system advisory company, showed evidence of insurance companies engaging in similar practices for the high-cost medicines that treat cancer, diabetes, rheumatoid arthritis, multiple sclerosis, asthma, schizophrenia and bipolar disorder.
“After the Affordable Care Act, people kind of assumed that discrimination on the basis of pre-existing conditions was completely gone,” says Jacobs. “I think it has the potential to be gone in the future, but doing so would require some vigilant oversight.”
Another issue for many patients is pricing transparency. For the most expensive specialty drugs, many insurers have switched to charging patients coinsurance (a certain percentage of the drug’s total price, for example 20 percent) rather than a copay (a flat dollar fee, like $20). A study by Milliman Inc showed 41 percent of silver level plans on the federal exchange charged coinsurance greater than 30 percent for specialty medications in 2015, up from 27 percent of plans the year before.
This practice not only passes along more of the cost to patients, it also prevents them from knowing how much their medications will cost before they enroll in a plan. Insurance companies don’t disclose the total price of drugs to people who are shopping on Healthcare.gov. So patients may know that they have to pay 30 percent of the price of a drug, but they won’t know what that price is until they get to the pharmacy.
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Insurance companies claim that they are not using adverse tiering to discriminate against the sickest patients. Clare Krusing, the communications director for America’s Health Insurance Plans, an advocacy group that represents insurers, says that insurance companies are doing everything they can to provide affordable coverage. The real issue is exorbitant prices of prescription drugs, which drive up insurance premiums and increase cost sharing, says Krusing.
Insurers are on the hook for much more of the rising cost of prescription drugs than patients are, Krusing points out. For example, the report from Express Scripts shows that insured patients who used more than $100,000 worth of prescription medications in 2014 paid 1.7 percent of the total cost out of pocket, on average. Insurance companies picked up the rest, including 100 percent of the cost of drugs after patients hit their out-of-pocket maximums.
No matter how insurers try to ease the burden, some of those hefty drug costs have to be passed on to consumers through premiums and co-pays, says Krusing. “What patients are paying out of pocket is a direct reflection of that increase in cost.”
The pharmaceutical industry claims these high costs are necessary to recoup their investments, including in the many drugs that never make it out of the laboratory, and fund the high cost of getting prescription drugs approved by the FDA. But critics say high prices are more likely a product of lengthy patents and market consolidation that gives pharmaceutical companies monopolies over certain drugs.
Introducing more competition into the pharmaceutical market, both for brand name products and generic drugs, is the easiest way to slow the growth in drug prices. According to Truveris, while prices for brand-name drugs rose 14.8 percent and specialty drugs increased 9.7 percent last year, generics rose only 4.9 percent.
As an example of blatant profiteering by the pharmaceutical industry, many in the health care industry point to the case of Sovaldi, the breakthrough drug that, for the first time ever, cures rather than treats hepatitis C. Gilead acquired the drug by buying its maker, Pharmasset, for $11 billion in 2012. Gilead then rolled out the miracle drug at $84,000 for the full 12 weeks of therapy — more than twice as much as Pharmasset had forecast that the treatment would cost in a 2011 filing to the SEC.
Gilead took advantage of its position as the only provider of the drug at the time to charge extremely high prices, critics say -- and the market and its shareholders have richly rewarded the company for doing so. Gilead recouped the cost it paid to buy Pharmasset in just the first year of Sovaldi sales, and its stock price has doubled in the last two years.
Patents are necessary to encourage companies to innovate, but they also slow the progress of cheaper generic versions of drugs to market, and allow drug companies to charge much more in the interim than they could if they had more competition. Drug makers are also accused of “evergreening” patents, making slight tweaks to an old formula to win a new patent on a drug without substantively improving the product.
Rother of NCHC and others say the public needs more transparency into the opaque system of how drug companies price their products — whether prices are based on clinical studies, the value of the drug, or merely what drug makers think the market can bear.
Another major issue is that private insurance companies don’t have the clout to negotiate down these high drug prices, and the government has refused to play that role, says Rother.
Rother says Medicare is large enough to force drug makers to lower their prices, but the government once again decided not to negotiate for lower drug prices while crafting The Affordable Care Act — a decision Rother calls “the price of pharma’s acquiescence in the Affordable Care Act politically.” The U.S. is the only wealthy country that does not negotiate with the pharmaceutical industry over drug prices.
Rother says the lack of negotiation has left the insurance industry with only very crude tools to try to counter aggressive drug pricing. One is what he calls “step therapy,” or insurers’ requirements that patients try less expensive drugs first before they move on to more expensive drugs. The other is high out-of-pocket costs. “These are not happy tradeoffs,” he says. “These are not something that anyone designing an ideal system wants to see.”
In turn, the pharmaceutical industry has countered insurers’ high out-of-pocket costs with their own initiatives, called co-pay assistance. These programs help patients pay the co-insurance or co-pay costs on their prescriptions that their insurance plans require.
Foreman, the case manager who works with HIV patients in North Carolina, calls co-pay assistance “a saving grace” for patients with HIV. “The pharma companies have stepped up and noticed there is a huger gap between these plans than someone can afford.” He says that, as out-of-pocket costs have increased for patients, he’s also seen co-pay assistance soar in the last few years, from roughly $3,500 to $6,500 per patient.
Glen Stettin, M.D. and the senior vice president of clinical research and new solutions at Express Scripts, says that these co-pay programs perversely allow for higher health care costs. These programs help to shield many patients from the higher cost of drugs, meaning that only the insurance companies have to pay the full cost of the prescriptions. And that in turn forces insurers to raise premiums and coinsurance for people in their plans.
Allie Gutshall, a 24-year-old grad student who lives in Houston, gets the medicine she needs through one of these assistance programs. Gutshall has lupus and takes Benlysta, the same expensive drug that Kristin Agar has been prescribed but can’t afford. Gutshall says Benlysta has been a miracle drug for her, allowing her to work and live a normal life. A few years ago, her joints were so swollen she couldn’t even walk to the bathroom with help.
Allie says her family initially struggled to pay for Benlysta. After Allie resigned from her teaching job due to health complications, she was put on her mother’s insurance, which chose not to cover the drug. Allie’s dad had to put the $2,500 charge for a single dose of the drug on his credit card. Now, after extensive appeals to the drug maker, Allie is on their assistance program.
“I’m very lucky it’s worked out this way. If my insurance company had said they would cover it, I would be paying a 20 percent co-pay of $7,500,” she says. “Even if I had got covered, it would be very difficult to come by that money every month.”
But while she’s grateful for the assistance, Gutshall also recognizes the deep unfairness of these assistance programs. “My mom nearly had to take on a second-time job of being my advocate. . . Unfortunately, not everybody has a strong support system like that. They don’t have parents who are able to help out -- they might be parents themselves. It shouldn’t be that difficult to get the medications you need to be healthy and live a normal life.”
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Some new regulations and legislation are in the works to help slow the growth of drug prices. Even as the Supreme Court decided to uphold subsidies for The Affordable Care Act, its regulations continue to evolve. The Department of Health and Human Services is expected to issue new regulations in the next few months on discrimination in the Affordable Care Act. Those new rules could force insurance companies to stop adverse tiering, or potentially allow private parties to sue insurers for discrimination against those with preexisting conditions.
The bipartisan 21st Century Cures initiative will seek to address the supply side, speeding up the FDA’s approval process for new drugs. The FDA also recently approved the sale of the first-ever biosimilars, “generic” versions of biological medicines that have been marketed in other countries for years. Another bipartisan bill introduced in the house, Patients’ Access to Treatments Act, is seeking to limit cost-sharing for medications in specialty drug tiers. And many new regulations are being put in place at the state level, with Maine, Vermont, Delaware, Maryland, Louisiana and others setting limits on out-of-pocket spending.
Consumer pressure is also a powerful force for change: In the past year, campaigns by patients and advocacy groups have pushed insurance companies to reexamine their plans and eliminate adverse tiering for HIV patients. A similar outcry by patients and advocates has pushed drug companies to expand co-pay assistance programs. Yet for both insurers and drug makers, the profit motive encourages them to raise prices and limit access to expensive drugs.
Overall, the problem of unaffordable prescription drug costs for people with illnesses seems likely to get worse before it gets better.
As Baby Boomers age, America’s population of people living with various chronic illnesses, including cancer, diabetes, high blood pressure and high cholesterol, will grow.
Many more expensive prescription drugs are slated to hit the market in the next few years, and some are approved to treat conditions with larger patient populations, such as high blood pressure. According to Express Scripts, 27 of the 51 new medications the FDA approved in 2014 were specialty drugs.
“Ultimately there are going to be more medications that come out that are incredibly innovative,” says Krusing of AHIP. “But if people can’t afford them, what good will they do?”
Trying to catch up on Reddit this holiday weekend? Good luck.
The “Ask Me Anything” subreddit and several other major portions of the site are inaccessible to the public, and it’s all because of the sudden apparent removal of Reddit’s popular director of communications, Victoria Taylor.
Taylor, known on the community by the username “chooter,” has been a key administrator for the site’s open Q-and-A subreddit “Ask Me Anything” — a prominent section of Reddit that has hosted conversations called “AMAs” with everyone from an unnamed McDonald’s employee to President Barack Obama. Several Reddit users have posted that Taylor was let go without warning — a story that has spread through the site like wildfire and caused widespread outcry on the site. Several moderators began locking down their sections of Reddit in solidarity starting Thursday night.
Users have started calling it the “AMAgeddon.”
Tensions have already been running high between the company and its longtime users. Interim chief executive Ellen Pao has made several rule changes, most notably to the site’s anti-harassment policies. That’s been part of an effort to clean up the site’s reputation, a change that could make Reddit more palatable to its current users, new users and advertisers. But Pao’s changes have drawn ire from those who want the company to remain the freewheeling forum for discussion — even highly offensive discussion — that it has always been.
Many Reddit users are blaming Pao for Taylor’s departure, piling on to widespread anti-Pao sentiment on the site.
Reddit declined to comment on the situation because it was a personnel matter. But Alexis Ohanian, Reddit co-founder and executive chairman, has posted comments to users on the site attempting to smooth things over.
Taylor has not commented publicly on the matter apart from saying on Reddit that she was “dazed” by the situation; she also thanked people for their support via Twitter:
“Thank you to everyone for their good wishes and support. Love you guys.”
NEW YORK — Chips made out of broccoli, chickpeas and kale. Wine-spiked ice cream. Popcorn that didn’t quite fulfill its destiny.
Those were some of the alternate-universe products at this week’s 61st annual Fancy Food Show. Many have limited distribution and aren’t easy to find, but could signal coming trends.
Buyers for places like supermarkets milled about the trade show at the sprawling Jacob Javits Center in New York City, tasting the treats on display and stuffing bags with free samples.
“It’s like a secret wonderland of food,” said Louise Kramer, a spokeswoman for the Specialty Food Association, the trade group that puts on the show. The expo, which featured more than 100,000 products, is not open to the public.
Here are five potential foods of the future exhibitors were showing off:
WINE ICE CREAM
Instead of a glass, this wine can be served in a cone.
Mercer’s, a dairy in upstate New York, was offering tastes of its “wine ice cream,” which has up to 5 percent alcohol. The ice creams come in eight flavors including “Strawberry Sparkling” and “Chocolate Cabernet.”
Roxaina Hurlburt, a co-owner of Mercer’s, said the dairy has been making traditional ice cream for 60 years and started packaging the wine ice cream in 2008. She said it’s sold online and in a couple of hundred locations around the country, including places like casinos and wineries.
Is maple water the next coconut water?
Drink Maple, based in Concord, Massachusetts, sells bottles of maple water it says is tapped from maple trees.
It’s the same stuff that’s boiled down into maple syrup, but don’t expect a thick and sticky drink. The clear liquid has the consistency of water and a lightly sweetened taste, with a 12-ounce bottle labeled as having 30 calories and 7 grams of sugar. The product also seems to hit on all the prevailing dietary trends: the company’s website notes maple water is “low calorie, gluten-free, dairy-free and non-GMO.”
It also says “no trees are harmed” in the collection process.
The company says it’s sold in about 800 stores throughout the Northeast, including at select Whole Foods and small health food stores.
Holding a bag of chips with the word “Sexy” in big letters can cure shyness. At least that’s what Sexy snacks founder Robert Ehrlich told visitors to his booth.
“When you hold a bag, you are sort of empowering yourself,” he says.
The most notable aspects of the snacks may be the name and Ehrlich, whose claim to fame is his founding of Pirate’s Booty. Ehrlich says the snacks are a way for people to brand themselves, as they might with sneakers or handbags. The company, based in Sea Cliff, N.Y., says its products are sold in about 1,500 locations.
The popcorn comes in flavors like “Bangin’ Cheddar” and “Brazilian Coconut,” and the chips in flavors including “Spinach & Matcha Tea.”
Do you think those half-popped kernels at the bottom of the popcorn bag are the best part? Now two companies are selling bags of just those bits.
HalfPops and Pop’d Kerns offer the snacks in different flavors, with a one-ounce serving containing between 130 and 160 calories, depending on the flavor.
HalfPops, based in Bellevue, Washington, says it uses a proprietary process to cook the kernels. Six-ounce bags of HalfPops are available online and at about 2,000 locations, including some Whole Foods and Wegman’s, said Mike Watts, the company’s vice president of marketing.
A prevalent theme at the expo was snacks made from unusual ingredients; think bags of roasted chickpeas, cheese puffs made out of beans, and chips made out of seaweed.
Another example that fell into that category was Broccoli Bites from Rhythm Foods, which also makes kale chips. Before they’re dehydrated, the broccoli is tossed in a dressing made with seeds, herbs and spices to add flavor and prevent crumbling. Each 1.5-ounce bag has 150 calories.
Even though kale has surged in popularity in recent years, Rhythm Foods CEO Scott Jensen said he expects the broccoli snacks to be a lot easier to explain and sell to buyers.
And he’s already working the next vegetable snack: cauliflower.
We're in the grip of a heatwave with temperatures close to or exceeding 100 degrees now for about a week. That's about 10 degrees higher than average and more than enough to give your phone and other electronic devices their own kind of heat stroke. Just a few minutes in the sun can cause your phone to overheat, but there are steps you can take to protect your sensitive equipment and avoid interruptions and worse, permanent damage.
Most smartphones, including iPhones, are not designed to operate normally over 95 degrees. And if your phone starts to run hot, it will try to regulate its temperature. Signs that your phone's internal sensors have registered too much heat include a display that dims or goes black and shuts off altogether, the phone stops charging, the camera flash is disabled and, when using navigation, you'll see an alert that says your phone needs to cool down. If you notice any of these warning signs, turn your phone off and allow it to cool down.
But it's much better for your phone to keep it from overheating. First, keep your phone out of the sun as much as possible — if you're outside put it in the shade or in a loose bag. You may want to remove your phone's case too, which tends to insulate the device. And don't leave it in a car, where temperatures quickly soar.
Along with these simple physical measures, you can also limit your usage in very specific and perhaps surprising ways. Electronics generate heat and the harder they work, the more heat they will expel. This holds true for a full-size laptop as well as for your pint-size phone. Use just one app at a time, closing each as you finish. If you're like many users, you may not be in the habit of closing your apps, which is a fast way to run down your battery. To check, double-press your phone's start button and you will see a series of "screenshots", one for each open app. Simply swipe up to close.
Some processes produce a lot more heat than others. GPS turn-by-turn navigation and graphic-laden games are the biggest culprits, so avoid these activities when it's hot. You should also turn off background app refresh, location services and Wi-Fi. An easy way to do this is by putting your phone in airplane mode. (Worried about missing a call? You can easily toggle this mode on and off to briefly check your messages.) Turn your screen brightness down as low as possible.
Don't charge your phone if it's hot. Battery charging creates a lot of heat and is best left until you are back in cool conditions. And remember, drastic changes in temperature can damage sensitive electronics. When you're transitioning between hot and cool locations, turn your phone off and let it adjust to the new temperature before powering back up.
Many of these principles will work for your laptop, but you can do a bit more. Clean the air vents where dust and debris can block cooling airflow. Use a can of compressed air, just make sure you're blowing the dust out of the unit and not inside the case. Make sure you're not blocking any of your laptop's vents when you're using it.
Don't place your laptop directly on your lap — that's a sure way to build heat. Even a solid surface may trap heat, so consider an alternative. You can buy specialized "heat sink" mats that absorb heat from your device or stands that raise your laptop an inch or so above the work surface, which will allow air to flow. But if you're looking for an inexpensive (and likely free) way to achieve the same effect, try a slatted camping table or even a wire baking rack.
Leslie Meredith has been writing about and reviewing personal technology for the past six years. She has designed and manages several international websites. As a mom of four, value, usefulness and online safety take priority. Have a question? Email Leslie at email@example.com.