Credit: Tech Crunch; July 10, 2017
Credit: Tech Crunch; July 10, 2017
Gosh, even the famous NY mobsters appearing long ago in the 1950’s before the brave and superb dogged Senatorial investigator, the Honorable and too much forgotten Senator Estes Kefauver of Tennessee, knew to keep their big yaps shut and take the fifth amendment under Kefauver’s relentless pointed grilling about their criminal activities.
Taking the Fifth has come to occupy a hallowed and familiar place in American popular, media and legal culture. Everyone has accepted the right of the poor wretch under the microscope of such investigative grueling questioning to protect themselves with its constitutional protection, though it would often do little to convince most observers of that person’s innocence. Still it showed at least some prudent judgement on the part of the person in the Hot Seat.
Our Dear Leader, I think I will call our nation’s leader, our President, has set a new tone whether he realizes it or not in approaching such trials and tribulations [pun intended]. Rather than invoke the fifth whether in actuality which he has not been placed in the position of having to consider its use, or indirectly, he certainly has invoked lots of probably unwise defensive maneuvers, threatening he had tapes to try to intimate James Comey [which proved to another of his untrue made up on the spot dumb and untrue deflections], praising to the hilltops his dubious henchmen right up until he canned them abruptly, manufacturing his ‘maybe’ stories that have to run down and checked out no matter how absurb they appear to a sensible non-blinded to the ideology fanboys he surrounds himself [they used to be called sycophants or in the 1950’s “yes men”].
But in a present day [today] post derived from the AP, entitled, “Pharma Bro: Martin Skreli Refuses Attorney’s Advice to Stay Low and Keep Quiet,” [URL: https://wordpress.com/read/feeds/1235237/posts/1507667218] (Sorry, for some glitchy reason I could not get the usual link paste in mechanism to work…so you will have to manually copy and paste in another browser window’s search URL bar this URL to access the original article–again my apologies)
Mr. Shkreli made headlines last year after being grilled by members of Congress on his blatant price gouging of the drug Daraprim used to treat the not very frequent fungus infection often of lungs, which can be life threatening if not treated. Its previous price had been $13.50 per dose and was raised to $750.00 per dose. This disease is endemic to the Southwest where it can be caught by workers who stir up the dusty soil in which it resides ordinarily [like heavy machine operators preparing sites for building of all kinds], or in other desert climes, i.,e. the Middle East. Mr. Shkreli called members of Congress “imbeciles” on Twitter and regaled his opposition royally, not in the regal sense, but in the slanderous meaning of the word left and right. He impugned the legal process.
His lawyers and handlers rightly feared he has poisoned his own prospective jury pool and may have even impressed his judge given the wide spread local coverage by the press of his impulsive shoot his mouth off shenanigans.
All the brings to mind Our Own Dear Leader who could easily be viewed as [gasp] a role model for this pharmaceutical _ _ _ _ _ _ _ _ [fill in the blanks with your own epithets that you are think are appropriate to your private heart’s content as I do wish to be sued…
Our Dear Leader has done all this and more. He can not stop insulting and slandering persons he does not like or by whom he feels legally threatened. He keeps tweeting to his own detriment almost nightly. He has millions of “followers,” half of whom I suspect actually adore and love his wild alternative fact universe 140 character assertions, and the other half who see them as their daily “unbelievable” modern day political theater of the Absurd. “Honey read what he said today. You’re not going to believe this one!!!” must be heard in millions of households ‘who want to know.’
This leads me as a psychiatrist to add to the popular list of definitions of a certain personality disorder that has been hinted at being relevant since the Presidential election and that is the inability for this kind of personality style not to be able to follow the then seemingly abusive verbal harassing of his wife, the now sage advice of the infamous Phineas T. Bluster puppet character of long ago Howdy Doody fame, our late Archie Bunker who would tell his hapless wife to “Stifle It.” This character trait I think now could be regarded as part and parcel of the blowhard subcategory of this personality style and type. We have already seen the constant impulsiveness, personal insecurity when not be adored by the audience, the recurring near weekly to go campaign some more, even though the Election is long over, and to be cheered by hundreds and thousands of fans, the constant tearing down of the usual checks and balances of the other branches of government especially the Intelligence Community and press, the pathetic demands for loyalty, the reported rages and off again, on again anger at his staffers, reminiscient of the Kremlin Watching of the Cold War, trying to keep track of who is in favor of Khrushchev or Breslin, who’s up and who’s down, etc.At least we are not having heads chopped off like in North Korea where a fall from political grace is a death sentence.
But the worrisome thing is that the new environment of BLOWHARDISM as I think I will lable it from now on, is setting a new low in national discourse. It encourages other and likely much less well controlled extremist home grown blowhards to feel emboldened to sounnd of in hateful ways, incite themselves and others to hateful and perhaps even violent acts in numbers we have never seen before in this country. And Radical Islam may very well not be blamed in the rise of our own homegrown blowhardist terrorism, who will be just be following the examples of what they see portrayed all around them in far more concentrated and frequent doses than ever before without the maturity to see any of it.
Even before his federal securities fraud trial began Monday, Martin Shkreli blatantly defied his attorneys’ advice to lay low. The former pharmaceutical CEO, who became a pariah after raising the cost of a life-saving drug 5,000 percent, has been preening for cameras and trolling on social media, potentially complicating his defense.
“I’m excited,” Shkreli said of the trial in a brief phone call last week to The Associated Press. “I can’t wait.”
Jury selection got underway Monday, and opening statements could occur as early as Tuesday.
Since his high-profile arrest in late 2015 when he was led into court in a gray hoodie, Shkreli has been free on bail and free to speak his mind. He went on Twitter to label members of Congress “imbeciles” for demanding to know why his company, Turing Pharmaceuticals, raised the price of Daraprim, a drug used to treat toxoplasmosis and HIV, from $13.50 to $750 per pill.
He took to YouTube for a series of lessons on chemistry and stock market analysis. His Twitter posts mocking a freelance journalist turned so creepy – one showed a fake photo of him canoodling with her – that his account was shut down. And on Facebook, he mused about the possibility of being “unjustly imprisoned.”
The 34-year-old Shkreli “travels to the beat of a very unique drummer,” exasperated-sounding defense attorney Benjamin Brafman said at a pretrial hearing this month.
Legal experts say there are obvious reasons lawyers want clients facing serious criminal charges to keep quiet.
“It’s twofold: You don’t want to antagonize the judge and you don’t want to get the attention of the jury in a way that hurts your case,” said veteran New York City defense attorney Gerald Lefcourt.
Columbia law professor John Coffee compared the situation to President Donald Trump’s unruly tweeting habits. “A lawyer can caution him,” he said. “But just like Trump, he doesn’t have to listen.”
Though Shkreli’s notoriety came from Daraprim, the federal securities fraud case is unrelated. Prosecutors say that after Shkreli lost millions of dollars through bad trades through his side business hedge fund, he looted a second pharmaceutical company for $11 million to pay them back. The defense has argued that he had good intentions.
“Everybody got paid back in this case,” his lawyer said. “Whatever else he did wrong, he ultimately made them whole.”
The defense has floated the possibility that it would put Shkreli on the witness stand to try to highlight how he grew up in a working-class Albanian family in Brooklyn, taught himself chemistry, interned at a financial firm founded by CNBC’s Jim Cramer and struck out on his own to become a rising star in biotechnology startups. He wanted to develop new life-saving drugs after seeing “several classmates and other children he knew struck down by debilitating disease,” court papers say.
Prosecutors call it a ploy to portray the boyish-looking Shkreli as “a Horatio Alger-like figure who, through hard work and intelligence, is in a position to do great things if only the jury would ignore the evidence and base its verdict on sympathy.” The real Shkreli was a con man often undone by his own mouth, they say.
The government has cited claims by one of Shkreli’s former employees that Shkreli harassed his family in a dispute over shares of stock.
“I hope to see you and your four children homeless and will do whatever I can to assure this,” Shkreli wrote the employee’s wife, according to court filings.
Prosecutors also used his boasts about some of his purchases of eccentric collectibles to undermine efforts to reduce his bail from $5 million to $2 million. If he needed to raise cash to pay legal fees and back taxes, they argued, why not sell the one-of-a-kind Wu-Tang Clan album that he brought for $2 million or his Nazi-era Engima code-breaking machine?
Also cited were his offers to pay a $100,000 bounty for finding the killer of a Democratic National Committee staffer and $40,000 in tuition for a Princeton student who solved a math problem he posed during a guest lecture at the school earlier this year.
Shkreli “is not the demon he’s been made out to be,” the student, Yuan Wang, told the AP.
Still, he added, “I haven’t received the money yet.”
Source: Associated Press
High costs, in point of fact the highest cost of pharmaceuticals, have been a given for the resident of the United States. Citizen/health care consumers of these drug prices have pretty much accepted this state of affairs since the late 1980’s when under the Reagan administration, in anthromorphorzing view of the human-like actions of the big drug companies, upped their periscopes from the national headquarters bunkers, looked around at the regulatory landscapes, and saw the lack of regulation creating a manna from Heaven business opportunity for their business model and industry. And that was the realization that they could jack up prices even more and not get their knuckles rapped by the feds, or any of its past oversight, regulatory agencies.
And so, in my ‘industry, “healthcare,” [a term I and most providers hate unless they are more business types and less health care devotees in practice to make a decent living but mostly to serve their patients and ‘do good,] became ‘business-ized at the upper, larger, company levels. Hospitals started buying up medical, surgical, and specialty practices at huge rates for the last 20 years. Providers found themselves being squeezed, pressured and commanded to evolve into a factory-like production model of seeing as many patients in as short an individual time as possible. Seeing patients does not lend itself easily to the Henry Ford conveyer belt mass production manufacturing model that has been the basis of modern production and business model that has dominated the industrial revolution since the early 1900’s. But the medicine behemoths have tried. And now they have reached the limits of that as patients and providers have typically 15 minutes or less for histories, physicals, treatment planning, execution and referral and whatever else is called from. Solo practices have disappeared as the economics of a single revenue generator cannot pay the overhead anymore, e.g., purchasing and maintaining a high-end mandated health information and record keeping system that is also used to monitor the quality of care issues and determine level of reimbursement for that poor shcmuch doctor living and practicing in the past. Groups have had to expand greatly, buy out other practices mirroring the wave of mergers in all industries who have had to adopt the same strategy to stay competitive for decades.
Now with limits of squeezing out more and more revenue of a system that cannot increase production beyond a certain limit, unless unscrupulous money making practices such as ordering procedures for larger numbers of patients that are not needed, medicine is turning to big data as its saviour to somehow point to population-wide ventures based on disease management through data that tells the data trend sifters and analysts what could need new attention and new ways of inventing new health care measure and generating reimbursements for preventive services to the ‘still well.’ Wellness program, weight loss programs, stop smoking campaigns, yoga classes, preventive back injury exercise programs (do you know any furniture movers or long distance truck drivers who need those, actually taking and paying for them? No, I didn’t think so.
Race, class, and a flawed perception of who gets or deserves “government assistance.”
As the current Presidential campaign/circus proceeds with unheard of antics on a daily basis, I have become reminded over and over again of the importance of the modern phenomenon of narcissism. As a tongue in cheek pictorial example to set the tone for this series of posts in the few weeks before the national election, I have chosen the famous but perhaps forgotten by many of our younger generations of the prototypical fashion dandy of Britain in the early 1800’s, Beau Brummel. In a way, he could be the male forerunner of the phenomenon of fame seekers such as the ubiquitous Kardashians.
In spite of the now rampant, free-wheeling, arm chair psychologizing and analyzing of the Republican nominee for the Presidency Donald Trump, there persists in the blather and smoke of the nondebate political exchanges among the candidates, an issue that still is important. This is the somewhat famous “Goldwater Rule,” formulated and made part of the American Medical Association’s section of Psychiatric Ethics in 1973. It basically stated that psychiatrists were being unethical if they held forth on diagnosing, attaching specific psychiatric labels and such to Senator Barry Goldwater of Arizona who was in 1964 the Republican nominee for the Presidency. A magazine published for approximately 3 years by Ralph Ginsburg, a prominent counter-culture writer in the 1960’s.
Section 7.3, which appeared if the first edition of the APA’s code of ethics in 1973 and is still in effect as of 2016, says:
On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement. [From Wikipedia