5.15.2007

At a recent discussion with area First Selectmen, Congressman Joe Courtney concluded that one of the most immediate concerns of government officials is the high cost of medical care, the inadequacy of insurance coverage, and the large percentage of people in our communities who have no health insurance. Highlighted were consumer frustrations with limited and confusing benefits provided by the new drug programs. Instead of funding the drug programs through Medicare and Medicaid and assuring consumers of cost benefits and increased access to prescriptions, the program rewards the pharmaceutical companies. Medicare is not able to negotiate for better prices with increased volume.

Jeffery Cassberg, the Director of Pharmacy services for ConnectiCare Inc., at a forum on health care sponsored by the Middlesex Chamber of Commerce in April, discussed the "Two Angle Attack" for controlling drug costs. Controlling unit costs, the first angle, was hardly discussed. In fact it is evident that politics and current marketing practices will abet soaring costs to the consumer. The second angle, utilization, puts the responsibility on the consumer by suggesting the consumer ask questions of the doctor and pharmacist, and request prescriptions for generic equivalents of medications. Cassberg indicated that drug utilization is proportionately lower in programs with a high co-pay which I suspect just deters patients from getting needed medication rather than controlling excessive usage. He also spoke of the development of newer more efficient medications.

Cassberg addressed the emergence of "Specialty Pharmaceuticals" for chronic illnesses which now include oncology. By the year 2009, it is anticipated that 28% of pharmacy expenditures will be for specialties which probably will be beyond the average person's reach.  
             
As Killingworth's First Selectman, I am naturally very concerned with the advent of an influenza pandemic. Drs. Jim Hite and R.A. Goodwin of Middlesex Hospital, at another meeting with area first selectmen, affirmed that it is not a question of whether or not we will experience a flu pandemic, but when. Dr. Richard Melchreit, Public Health Intervention Program Coordinator for Infectious Diseases, DPH, delineated four steps necessary for pandemic influenza control. First is social distancing, a strategy that includes avoiding crowds, closing schools, working at home, and quarantine. The severity of the outbreak would determine suitable levels of social distancing.

Wearing masks is an example of personal protective equipment advocated in Step Two. The third step is using antiviral drugs such as tamiflu for prophylaxis and early intervention. The development of vaccines, the fourth step, can be accomplished only when the strain of the infectious influenza virus is known. Vaccines may be unavailable at the onset of a pandemic. Stockpiling of public antiviral supplies should be complete by 2009, according to federal guidelines. Dr. Mechreit cited the Spanish Flu Pandemic of 1918 as an example of how the impact of a disease can be minimized with appropriate early intervention. In St. Louis, early intervention policies resulted in half the death rate experienced by Philadelphia, where mobilization against the disease was slower.

As your First Selectman, I want Killingworth residents to have access to everything needed to keep our population healthy. I, myself, intend to keep informed about more efficient medications and necessary strategy for disease management. If an outbreak of disease occurs, we will implement procedures to limit risk, as proposed by the State and Federal Departments of Public Health. I expect to keep you informed.

Sincerely,
Marty