Maryland / Regional
---
National /
International
Calif. medical marijuana advocates encouraged with policy shift
by feds (Baltimore Sun)
Opinion
A Tumor at the Heart
of Medicare
(New York Times)
Maryland / Regional
---
National / International
Calif. medical marijuana advocates encouraged with policy shift
by feds
Associated Press Writer
By Greg Risling
Baltimore Sun
Saturday, March 21, 2009
LOS ANGELES (AP) — Medical marijuana users and dispensary owners
in California have held their breath for years — fearful they
would be targeted for prosecution by the federal government.
They finally exhaled this past week when U.S. Attorney General
Eric Holder said federal agents will now target marijuana
distributors only when they violate both federal and state laws,
a departure from the policy of the Bush administration.
It's not seen by many as a move by the Obama administration
toward the legalization of marijuana.
However, it could end much of the confusion among state and
federal authorities dealing with the mishmash of laws in which
cultivating, using and selling pot for medical purposes is
allowed by states but outlawed by the federal government.
"This signals, in my mind, a true kind of federalism," said Jody
Armour, a law professor at the University of Southern
California. "The federal government is allowing states to take
chances, to take experiments and see what happens."
California is one of 13 states that allows medical use of
marijuana.
Over the past 2½ years, the federal Drug Enforcement
Administration has raided at least 80 dispensaries in
California, the majority in the Central District that extends
from the Central Coast down to Orange County and includes Los
Angeles.
Yet criminal charges have only been filed in several of those
cases against the biggest distributors accused of breaking both
federal and state laws, said Thom Mrozek, spokesman for the U.S.
attorney's office in the Central District of California.
"What we have done in all of our narcotic cases is to focus on
large-scale traffickers," Mrozek said. "In terms of what happens
in the future, the federal government will continue to enforce
federal narcotics law."
The confusion was reflected in a case against Charles Lynch, who
ran a marijuana dispensary in Morro Bay. Federal prosecutors
said he should have known his employees sold marijuana outside
his store.
Lynch, 47, was convicted in August of distributing more than 100
kilograms of marijuana. His sentencing is set for Monday;
guidelines allow up to 85 years but prosecutors recommended a
five-year prison sentence.
Lynch's attorneys will try to persuade Department of Justice
officials to drop the case.
"The feds picked the wrong guy," federal public defender Reuven
Cohen said. "It's pure fiction that somehow Charlie was not in
compliance with state law."
Two of the jurors who convicted Lynch also took issue with the
federal prosecution. They wrote letters to U.S. District Judge
George Wu asking for leniency, saying they felt they were forced
to find him guilty under federal guidelines.
"Because of the instructions we were given regarding that we
were to disregard state law, I felt we had no other option but
to convict Mr. Lynch," juror Andy Gordon wrote.
Fellow panelist Reza Iranpour called the verdict a "miscarriage
of justice" and said Lynch was a victim of "bureaucratic
conflict."
Lynch "faces the prospect of being severely punished for
trusting misleading laws and regulations," Iranpour wrote.
Medical marijuana advocates say the change in federal policy
announced by Holder mirrors the spirit of the 1996 California
ballot initiative that made it legal to sell the drug to people
with a prescription.
"I think that if nothing else it gives people a sense of
optimism that the federal government is going to back off," said
James Shaw, director of the Union of Medical Marijuana Patients.
"But it's not entirely clear to me if they are going to do
that."
Holder didn't specify who would be exempt from future DEA raids.
And one federal prosecutor said cases will still be filed
against people who violate the law by selling marijuana for
non-medicinal purposes and other actions.
"From the type of dispensaries we have seen over the years, it
may be anticipated this does not signal an end to federal
enforcement actions but instead a refinement," said acting U.S.
Attorney Lawrence Brown in Sacramento.
Times have changed, agreed Elliot Katz, a senior member of a Los
Angeles-based marijuana collective, but not necessarily for the
better.
He recalled walking into a dispensary when he was first issued a
medical marijuana card in the mid-1990s and finding that
everyone was visibly sick.
These days, marijuana users who have no medical reason to obtain
the drug are taking advantage of the system, he said.
"It's up to the doctor or dispensary operator to weed out those
people," said Katz, 46, who has AIDS. "The government can do all
they want to regulate, but it's up to us to regulate ourselves."
Copyright 2009 Associated Press. All rights reserved.
Opinion
A Tumor at the Heart
of Medicare
By Mark Lange
New York Times Commentary
Saturday, March 21, 2009
San Francisco - GENERATING efficiency in the health-care market
will be one of President Obama’s greatest challenges. To do
this, he will have to create meaningful competition between drug
companies, and between public and private plans. Congress’s
attempt at market-driven health care offers good instruction in
what not to do.
Medicare Part D, the prescription benefit that went into effect
three years ago, was supposed to let the elderly get their
medicines more cheaply by creating competition between private
insurers. Yes, the program has undeniably improved access to
prescriptions. But the cost to taxpayers has been 3.5 times the
market value of those prescriptions, according to a study in the
journal Health Affairs.
Part of the problem was that insurance analysts saw a chance to
double the size of the managed care industry. Drug companies
stood to collect $30 billion in windfalls over the coming
decade. So legislation was pushed, paid for and effectively
drafted by thousands of lobbyists.
Proposals requiring the government to use the buying power of 40
million Medicare patients to negotiate prescription prices were
defeated. Pharmaceutical lobbyists fought for direct federal
subsidy of drug benefits, knowing plans would be reimbursed no
matter how much prices were inflated. Lobbyists also prevented
identical but less expensive drugs from Canada and other
countries from coming here. After arm-twisting that reduced at
least one member of the House of Representatives to tears, the
bill to expand Medicare passed at 5:53 a.m. on a November
morning in 2003.
When the program went live in 2006, a fragmented market of 80
insurers - with 1,400 prescription drug plans - lacked the
purchasing power to negotiate drug prices. Nor did those
insurers have much reason to bargain, since Part D subsidized
the most costly patients at 80 percent. So prices under Medicare
private insurance plans for the top 10 medications shot up, and
in 2006 the five largest drug firms notched a 45 percent spike
in profits over the previous year. After insurers rushed to sign
as many retirees as possible at attractive rates, they raised
premiums 13 percent. Medicare patients in private plans cost
taxpayers about 15 percent more than those covered under
traditional government programs.
Then the story started to resemble a Dickens novel. State
insurance commissioners complained about a nationwide pattern of
aggressive, abusive and deceptive marketing practices by sales
agents. Free of basic oversight and enforcement, other insurance
agents and brokers manipulated the elderly by falsely claiming
that they worked for Medicare, selling unrelated and
inappropriate policies, bullying the elderly and even forging
signatures.
It doesn’t have to be this way. There are a few relatively
simple steps Congress could take quickly to redeem Part D, and
build momentum for effective, market-driven health care reform.
Congress should begin by requiring private insurers accepting
public money to offer a plan option equivalent to what the
Department of Veterans Affairs offers, at the same price.
Another important step would be mandating that the Department of
Health and Human Services negotiate drug prices on behalf of
Part D plans. Rather than reimburse private insurers for
pharmaceuticals through unlimited direct subsidy, Washington
could compare prices paid by Part D plans to Medicaid’s best
prices (today both price lists are confidential), and pay at
either market or Medicaid rates, whichever is cheaper. Deceptive
marketing could be combated by passing a bill to allow states to
regulate and police marketing. To further ease confusion,
Medicare should clearly outline plans with simple side-by-side
comparisons of costs and benefits.
The public can also play an important role. While the larger
health-care reform debate unfolds in Washington, the rest of us
can keep an eye on the members of Congress who may be the most
conflicted about bringing real competition to bear. At sites
like www.maplight.org you can see whose campaigns have
gotten the plushest contributions from pharmaceutical
manufacturing and managed care companies.
This year, total Medicare and Medicaid spending will probably
account for nearly a quarter of all federal spending, and by
2016 it could rise to almost a third. Enlisting real competition
will be crucial to containing costs. So before offering a new
universal benefit for the millions of Americans who lack health
insurance, Congress should put an end to manipulative
profiteering in Medicare. As challenging as the program’s
problems may be, they do not prove that a market-based approach
can’t work.
Mark Lange, a technology industry consultant, was a
presidential speechwriter from 1989 to 1991.
Copyright 2009 The New York Times Company.
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