A Larger View

a commentary on how current events reflect— or not—our search for higher values

  • Volume XXII
  • No. 6
  • November/December 2017
  • Bulletin of The Inner/Outer Partnership

The pieces are reposted from some of the entries in InnerLifeDirections.com

in this issue:

  • Cancer Drugs Prices
  • Private Prisons Boom
  • The Deaf In Prisons
  • Cancer Drugs In Africa
  • Donations From Inmates
  • Kids And Robots
  • To Ponder On

Cancer Drugs Prices

To most of us it’s hardly surprising!! A new analysis found that the claim by drug companies justifying the high price of drugs by the expenses of research and development cannot be proven. In an article published in JAMA Internal Medicine, the researchers found that the cost of developing a new drug is around $650 million. The drug companies put that cost at $ 2.7 billion or several times the actual cost established by the researchers. On top of the $650 million the researchers add another $100 million to cover the cost of what the companies would have gained by investing the money instead of using it in R and D.  Of the 10 companies the researchers looked at, the drugs earned 7 times what they cost to be brought to market and of course the profits will continue in the years to come. One argument the pharmaceutical companies make is that for each drug that succeeds, there are those that fail. The new study says they took this into account.  The drug companies also claim that their costs are much more complex than those claimed by the analysis. To that the 2 researchers respond that drug companies are opaque about their costs and need to be more transparent. JAMA Internal Medicine invited Merrill Goozner, editor emeritus of the magazine Modern Healthcare, for a comment. He writes that pharmaceutical companies have higher profit margins than any other US industries. He argues that the patent protections far outweigh the risk of developing new drugs. He agrees with the study’s authors that “Policy makers can safely take steps to rein in prices without fear of jeopardizing innovation.” That puts it succinctly, and whether or not our policy makers choose to do something about drug prices, we need to remember that thought.

Private Prisons Boom

I found a small article in der Spiegel magazine disturbing although I know there are those who will find in it a good tip, or a good move. I had already read that the Trump administration, in this case the Justice Department under Jeff Sessions, was undoing the phasing out of private prisons begun under the Obama administration.  But this article went further. It took notice of this action because Deutsche Bank issued a report saying that under Trump the stock market had done well, hitting the 22,000 mark, that how long it will last was debatable since there were already signs of a crash–the word used by the article. However the bank’s report advised there were two “buy” recommendation the analyst was bullish on. They are CoreCivic and Geo Group, the two largest operators of private prisons in the US. Deutsche Bank analyst Kevin McVeigh’s report pointed to the  Federal Bureau of Prisons and the US Immigration and Customs Enforcement (FBP and ICE) estimate that  for the 2018 budget 12000 additional beds will be needed , an estimate that is bound to benefit these 2 companies.

Private prisons are a blight on the moral fiber of both the US and humanity. It’s distressing that there are those who think the companies that operate them make good investments.

The Deaf In Prisons

Every so often a neglected group comes to our attention, a group that deserves our compassion. Imagine being deaf and incarcerated. How would you communicate? Being disabled in prison is difficult and each disability has its own challenges, I was so touched by the challenges of deaf prisoners in this article. Some are essentially condemned to communication solitary confinement.  The TTD system is 50 years old and if the prison has it, the family of the inmate may have switched to a more modern video system, hence they cannot communicate since both the devices of the caller and the receiver must match.  If they can use the TTD system and go through an operator, then there isn’t much that can be said in a 15minutes call, since everything has to be related through the operator. While manufacturers give the devices free, and the calls are paid for by the FCC through a tax on phone bills, they do use the Internet. Prisons officials are concerned not only about the cost of that, but also about security. Say people give each other secret messages during a call, or have non verbal cues such as wearing a bandana? These calls they say must also be monitored. It’s one reason why deaf prisoners are often isolated since prison officials are afraid that if they congregate and even  if one other person can use sign language, they could organize a riot or  some sort of disturbance.  As a result of lengthy litigation some prisons are installing videophones in Virginia, Idaho, Florida, Maryland and Kentucky.  Lawsuits are pending in Michigan, Illinois and Massachusetts. Louisiana however was persuaded to install the phones without going to court. It is not known exactly how many inmates are deaf or hard of hearing, it is  estimated to be about 6%.  Making the technology available however is not enough, technology does not solve the problem of attitudes. Advocates for the deaf say that what matters most is the attitude of correction officials, of guards and other personnel. Without that hardware will not matter enough to make the needed difference.

 Cancer Drugs In Africa

Two drug companies, Pfizer based in New York and Cipla based in Mumbai have promised to provide cancer drugs for several African countries at rock bottom prices, meaning prices where the companies would not be making any money, but would not be losing money either. There are only 16 drugs involved and 6 countries so far, but the deal is seen as one that will save many lives. Cancer in Africa has been growing, and 450,000 die every year for lack of care. By 2030 this number is projected to be one million. The agreement also includes top American oncologists devising treatment program guidelines for unequipped African facilities, essentially refining and adapting existing protocols.  A team of IBM programmers will then build a program so that those guidelines can become an online tool available to any African oncologist with an Internet connection. The agreement is being brokered by the cancer society and the Clinton Health Access Initiative, IBM, The National Comprehensive Cancer Network, which is a group of American oncologists, and the African Cancer Coalition, a group of 32 African oncologists from 11 nations. Not only are hospitals ill equipped and underfunded, there is a shortage of them.  African nations usually also have a shortage of oncologists and trained personnel to diagnose. Many Africans have come to assume a diagnosis of cancer is doom. American health experts say this program has a good chance of working and is reminiscent of the efforts in Africa which saved many with AIDS.

The US has untold problems with its health care system, not the least of which is access, but at least the facilities and the personnel exist. As to drug pricing and the difference a similar approach would make, perhaps this will inspire appropriate groups to forge a similar alliance. Regardless we can all feel some gratification that some lives in Africa will be saved.

Donations From Inmates

I first In Texas, inmates got together and donated almost $54,000 towards the relief of hurricane Harvey. That is not the first time. After Katrina and Rita inmates collected $44,000. What makes these donations truly laudable is that they come from the trust funds of the inmates, money used for them to buy snacks or things they may otherwise not have.  In about one month 6,663 inmates donated $53,863, all the more impressive since most of the inmates had $5 or less in their account.  It may sound commendable when a celebrity donates millions, but these donations seen as a percentage of total assets stand out far more. These are small donations, and in some instances the larger ones the person emptied their savings accounts. In California, inmates are fighting the fires right alongside regular fireman and as a group comprise something like 15% of the firemen. And often inmates volunteer to test drugs, even when the side effects may be suspected to be dangerous. “lifers” have been known to say that this gave their lives some meaning. These are all people our society has labeled criminals and therefore assumes they are substandard, sub normal and do not deserve the same respect and consideration as those who we say are not criminals. And yet corporate executives who make anti-environment decisions, something increasingly legal in this administration, engage in what may be far more criminal behavior because their actions hurt far more people than the actions of those who have officially been found guilty.   Let’s hope the inmates’ donations and volunteer work challenges our labels, stereotypes and erroneous notions.  Hopefully it can and will also work towards helping us understand that people are more than their worst deeds.

Kids And Robots

Young I was in the car this morning with a seven year-old when a text announced the prospect of a play date. “Give me the phone,” the child asked, and she proceeded to use the Voice feature to answer the text using language she understood but was still beyond her capacity to spell out and write. Children are now growing up with technology, a lot of them with Alexa, Echo and other robotics aides. Researchers at the Personal Robots Group at MIT Media Lab are now looking at the consequences of their growing up relying on digital assistants. There’s of course the privacy issue—that the more one uses them, the more one needs to be connected and the more our privacy is compromised. But leaving aside the privacy issue, can these manifestations of AI help or hurt this new generation?  They play games and interact with it in all sorts of ways including how to control the use of the technology around their homes. It looks like it may be creating a form of social skills. For example, with Alexa, there is a need to preface a request with Alexa, something not needed with a parent or other non-robotic person.  Also if a parent interacts with Alexa, the child has to learn to be silent while it answers, something he or she is not likely to do when the parent addresses an adult. That’s why some researchers posit children are developing skills of communication when they use these devices. But critics wonder if those digital butlers are interfering with the child ability to think or to do things for themselves. All they have to do is ask for what they want. And all the while the robots are becoming more sophisticated and children can ask for more things.

Digital assistants it’s safe to say are here to say. Using them will increase and our reliance on this type of AI will deepen. But since as all of technology AI comes with consequences, now is indeed the time to assess and address them.

To Ponder On

“Be kind to everyone you meet for everyone is fighting a hard battle.”



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