Saturday, July 26, 2014

My View

Random ruminations from your resident curmudgeon...

The Center for Disease Control (CDC) estimates that 3.2 million people are infected with hepatitis C, and that this disease kills more than 15,000 people annually, more than succumb to HIV disease. Hepatitis C is most commonly spread by sharing needles, and if left untreated, can lead to chronic liver disease, cirrhosis, or liver cancer.

Patients that suffer with hepatitis C are costly to treat and require long term treatment, typically with Interferon, which has numerous serious side effects. Treatment requires taking a combination of drugs on a daily basis as well as a 48 week regimen of Interferon shots. The cure rate for these treatments is around 50%.

Now, bio-pharma company Gilead has developed a new treatment that has been very effective in treating and in many instances curing hepatitis C. their drug, marketed under the name Sovaldi. Sovaldi only requires 12 weeks of treatment, and although long term results are not available since it is such a new drug, initial reports are that its efficacy is significantly higher than current treatment protocols.

So a new drug has been developed that is more effective at curing a debilitating, chronic disease and will get people out of the healthcare system much more quickly than current protocols.

What's not to like?

Well, there is the matter of the cost of this wonder drug.

A 12 week course of treatment of Sovaldi cost $84,000.

Expensive drugs aren't new, but Sovaldi stands out because it is an effective treatment for a long term disease that costs the healthcare system millions of dollars annually. A number of those that suffer from hepatitis C are low income and qualify for Medicaid or are now covered under Obamacare. These government programs have mandates to provide the best coverage that is available and affordable for treatment of diseases and medical conditions.

And there is the dilemma.

New treatments and drugs like Sovaldi are not affordable for most state budgets.

While Sovaldi may cost $84,000 for a 12 week regimen, a liver transplant will cost on average $577,000. Long term treatment using Interferon and other protocols has shown to be marginally effective and more costly over the long term than using Sovaldi.

So while it may cost more on the front end, it would seem to make sense to spend the money now for a more effective treatment rather than more money over the lifetime of the patient.

But a drug like Sovaldi, that is effective but costly, will break the healthcare budget of most states. For example, Oregon currently spends $277 million to provide healthcare for its residents. Oregon Medicaid official Tom Burns estimates that if Sovaldi becomes the routine treatment for hepatitis C, it could cost the state $360 million to treat the state's enrollees that have that disease.

The cost of a wonder drug like Sovaldi has unleashed a massive debate about healthcare costs. State Medicaid programs are required to cover FDA approved drugs regardless of cost, unless there are comparable options available. It is estimated that treating hepatitis C patients in state programs could cost the states $55 billion per year.

And this could blow up state healthcare budgets.

And states are responding by limiting access to this drug, reserving it only for the very sickest patients.

This is the dilemma faced by federal and state government in providing healthcare. Costs are exploding as more people are forced into government programs. Irrespective of the effectiveness of the treatment, government agencies are beginning to limit some treatments because of the cost.

And this should be a warning to all of us.

As government continues to try to take control of the healthcare system, decisions will more an more be made on the basis of cost to the system, not what is best for the patient.

Incidents like this are going to continue to occur as states and the federal government look to control healthcare costs at the expense of the best treatment for the patient.

And you and I will suffer for it.

And that, my friends, is my view.

*Gilead justifies the cost of Sovaldi by saying that it took years of expensive research to develop the drug and that the price of the treatment is justified for the long term savings to the healthcare system.

Sunday, July 20, 2014

My View

Random ruminations from your resident curmudgeon...

Remember when John Edwards was campaigning for President and stated that there were "two Americas?" Edwards was stating that there were "haves" and "have nots" and that we needed more equality in this country.

That theme was picked up by President Obama, who after his re-election vowed to fight income inequality. His premise was based on the fact that some people make more money than others, and that is just not fair.

At its core, the fight against income inequality amounts to a rationale for thievery. Someone has more than someone else, so you have the government take it and re-distribute it to those that have less.

Never mind that those who have more may have worked harder, got a better education, or engaged in specialized training to get what they have. They have more, that's not "fair" and it should be taken away for no other reason than it doesn't satisfy someone's notion of fairness.

This premise that you can reduce income inequality by debasing the successful denies the consequences of their efforts and spares the unsuccessful the consequences of their choices.

Economic success generally follows the choices that individuals make. As mentioned, those that have worked hard, sacrificed, and maximized their education are more often than not the beneficiaries of higher incomes than those that did not do those things.

And what is unfair about that?

There are those that decry the inequality of income while ignoring the inequality of effort.

My orthopedic surgeon makes more than I do. I do not begrudge that fact. He spent many more years getting an education and in specialized training than I did.

Should I be angry that he makes more than I do?

Absolutely not.

His years of study and training have enabled him to earn the income he enjoys, and he should be rewarded for his efforts.

Yet there are those in this country that would punish him because he makes more than most. Rather than award those who achieve through their efforts, they would seek to negate his efforts and take away his income.

A free society allows people to make choices and to succeed or fail based on those choices. That freedom can and does lead to different outcomes. As a society, we need to realize that there is no real option for success if there is no real option for failure.

It is a lie to say that one man's success happens because of the victimization of another man. That philosophy foments division, class warfare, and saps the productivity of those that put forth the effort to succeed. it pits one group of Americans against another for political purposes.

John Edwards was right: there are two Americas.

It is an America divided not by differences in outcomes, but in efforts.

Equalizing income is not a solution. It is Marxist class warfare cloaked in flowery language.

As a country, we must unequivocally be a nation that provides equality in opportunity. Our educational system must be one that equips ALL to function in the modern global economy. Laws and their application must be equal. The workplace must equally honor the efforts of both men and women.

But in no way should outcomes be equalized or guaranteed.

That denigrates the efforts of those that choose to work harder than those that do not.

Right now, the two Americas are pitted against each other.

And we as a nation run the risk of proving the truth spoken over a century ago by Abraham Lincoln.

"A house divided against itself cannot stand."

And that my friends, is my view.

Tuesday, July 15, 2014

Predators Sign Roy, Ribeiro to One Year Deals

The Nashville Predators have added to their depth at center by signing Derek Roy and Mike Ribeiro to one year contracts. Roy was signed for $1 million and Ribeiro was signed for $1.05 million.

Here is the Predators press release on the signing of Roy:

Nashville Predators President of Hockey Operations/General Manager David Poile announced today that the club has signed free-agent forward Derek Roy to a one-year, $1 million contract.
“Derek brings us added depth, playmaking ability and experience at center, helping complement our young, developing wingers,” Poile said. “He has played in a number of roles, averaging about 19 minutes of ice time throughout his career, and is effective on the power play. He provides our coaching staff with some added skill and maturity down the middle when putting together our lineup for the coming season.”
            Roy, 31 (5/4/83), has recorded 492 points (177g-315a) in 666 career NHL regular-season games with Buffalo, Dallas, Vancouver and St. Louis since 2003-04. The Ottawa native is a four-time 60-point, 20-goal scorer including a 32-goal, 81-point campaign in 2007-08 and a 28-goal, 70-point season in 2008-09, both with the Buffalo Sabres. In 2013-14, the 5-9, 184-pound center posted 37 points (9g-28a) in 75 games with the Blues.
            An alternate captain for three seasons playing alongside current Predator Paul Gaustad in Buffalo from 2007-09, Roy captained the Kitchener Rangers to Memorial Cup and OHL titles in 2003, earning both Stafford Smythe Trophy and Wayne Gretzky 99 Award as MVP of both tournaments. Buffalo's second selection, 32nd overall (second round), in the 2001 Entry Draft is a three-time silver medalist for Canada, representing his country at the 2003 World Junior Championship, and both the 2008 and 2009 World Championship.
And here is what they had to say about Ribeiro:
Nashville Predators President of Hockey Operations/General Manager David Poile announced today that the club has signed free-agent forward Mike Ribeiro to a one-year, $1.05 million contract.
Mike is a talented veteran center who has produced offensively everywhere he has played,” Poile said. “We have done our due diligence and believe Mike has a lot to offer to our team, improves us at our center ice position and will fit in with our group and contribute.”
            Ribeiro, 34 (2/10/80), has amassed 656 points (202g-454a) in 865 career NHL games since the 1999-2000 season with Montreal, Dallas (with James Neal and Eric Nystrom), Washington and Phoenix. In 2013-14, the 6-0, 179-pound center registered 47 points (16g-31a) and he is just one season removed from producing at a point-per-game clip with Washington, posting 49 points (13g-36a) in 48 games in 2012-13.
            Since the 2003-04 campaign – his first full NHL season – Ribeiro has played the 10th-most games of any NHL forward, averaging 62 points a season and posting the eighth-highest assist total (431). An NHL All-Star in 2007-08 when he set career highs in goals (27), assists (56) and points (83), Ribeiro has missed just 10 games his last four seasons.
            Montreal’s second selection, 45th overall (second round), in the 1998 Entry Draft, Ribeiro enjoyed a decorated QMJHL career with Rouyn Noranda and Quebec from 1997-2000, being named league rookie of the year and recipient of the Paul Dumont Trophy as personality of the year in 1998, and winning the Jean Beliveau Trophy as the league's top point producer the following campaign after amassing 167 points (67g-100a) in 69 games. He also helped Canada to a bronze medal at the 2000 World Junior Championship.
The Predators now have a glut of players that can play center. Mike Fisher is injured and will be out of the line up for 4-6 months. Even so, Calle Jarnkrok, Colin Wilson, Olli Jokinen, Paul Gaustad, Matt Cullen, and Craig Smith can play the center position. Colton Sissons and Austin Watson are also at Milwaukee, with Sissons seeing the most playing time with the Predators.
The addition of Roy and Ribeiro mean that Wilson and Smith will play on the wings and will only be pressed into duty as centers in an emergency. This could also mean that Jarnkrok and Sissons will probably be assigned to Milwaukee.
Frankly, I hope Jarnkrok can impress enough that he can stick with the Predators, who desperately need his play making skills.
Roy is a steady player that can produce. He should be able to step in and immediately help the Predators down the middle. He should see his ice time increase in Nashville, and hopefully that will allow him to increase his production. Last season, with the St. Louis Blues, 37 points (9G-28A) in 75 games while averaging around 13 minutes TOI.
Roy will also be a good locker room presence and will be helpful in mentoring some of the younger players on the roster. His transition to Nashville will be assisted by former team mate Paul Gaustad, both of whom were alternate captains for Buffalo.
Ribeiro comes to the Predators as damaged goods, having been bought out by the Arizona Coyotes because of off ice issues. Ribeiro has had domestic problems as well as missing team meetings and the team bus for a game.
Ribeiro had 47 points (16G-31A) for the Coyotes last season in 80 games. He has shown that he can be a consistent producer, his off ice issues notwithstanding. If- and this is a big if- he can be more stable in his off ice life, he could wind up being a steal for the Predators.
Ribeiro will have a fresh start here on the one year deal and will be presented with every opportunity to prove he can be a quality team mate and continue to produce. I believe that Ribeiro will look at the Predators as his last chance to stick on a roster at the NHL level and that he will respond.
Frankly, Ribeiro is a low risk signing by the Predators that could yield good results. Given his past history, I believe that he will be given a short leash by Head Coach Peter Laviolette, and if he is a disruption to the team, he will no longer be on the roster.
If however, he returns to form, he could be a great add for the Predators. I would look for him to paired on a line with Neal to begin the season.
These additions give the Predators some veteran depth with some upside as well as options once Fisher returns.
Now it is up to these guys to show they can still produce and be integral parts of this team.

Sunday, July 13, 2014

Some Thoughts From Development Camp

The Predators capped off their Development Camp with their Blue vs. Silver scrimmage yesterday. Here are some thoughts from the contest.

  • The boys have some wheels. Most everyone that was on the ice can fly, and those that stood out to me were Brendan Leipsic, Kevin Fiala, and Filip Forsberg. Those three especially used their speed to create some space and some opportunities around the net.

  • Speaking of Forsberg, he plays with a "casual virtuosity". He is adept at finding the soft spots in the offensive zone and has a deceptively good shot. Forsberg seems stronger and skating better than last season (which wasn't bad) and possesses a very good hockey sense. His ability to handle the puck in traffic was very good. I would expect to see him make the roster this season for the NHL club.

  • Tommy Veilleux showed that he is not afraid to go to the high traffic areas and scored twice from the slot with a good snap shot.

  • I liked the play of Leipsic and Fiala. Both used their speed to their advantage to create offensively and neither shies away from contact. Leipsic in particular used his speed and shiftiness to avoid the big hit but wasn't afraid to mix it up when necessary.

  • Fiala had a beautiful move in the shootout, faking left and dragging the puck back to the right side of the net for the score.

  • The goal of the shootout belonged to Viktor Arvidsson with a spin-o-rama back to the forehand and lifting it under the crossbar. That goal brought everyone to their feet.

  • Jonathan-Ismael Diaby is huge and skates fairly well for a big man (6'5", 223 pounds). I expect he will be in Milwaukee next season to continue to develop his game. Diaby showed that he has the ability to use his size well, especially down low and clearing the front of the net.

  • Pontus Aberg, the first pick of the 2012 draft, did not show me much. He possesses good speed and hands but did not show a desire to drive the net and get in the tough scoring areas.

  • Colton Sissons looks as if he is going to challenge for a spot on the opening night roster. he played with intensity and has a sound overall game. The door is certainly open for Sissons with the injury to Mike Fisher.

  • I thought Jaynen Rissling, acquired from the Capitals, looked good on the blue line. Again, I would expect him to be in Milwaukee to open the season, but he could be a call up if the Predators experience injuries on the blue line.

  • The Predators game ops experimented with a new goal song, the Black Keys "Gold on the Ceiling" I like the song as a goal song, but it is kinda clunky with the "I like It, I love It" lead in. perhaps it is time to retire Tim McGraw's part of the goal celebration.
There is a lot of talent with these young guys. But potential is just potential. It will be up to Scott Nichol, Director of Player Development and the coaching staff to continue to develop the talent and make it NHL ready. That is a formula for long term success, and it is good to see that the Predators have filled the pipeline with young players that have tons of potential.

Friday, July 11, 2014

My View

Random ruminations from your resident curmudgeon...

Last week, we heard from the Bureau of labor Statistics that hiring is on an upswing and that unemployment has fallen to 6.1%. That news was delivered and immediately hosannas were sung throughout the land about the strong "recovery" that was underway in our nation.

Yeah... about that.

Wal-Mart CEO Bill Simon says that we may want to take a second look at those numbers. In particular, Simon says that with so many people who have dropped out of the work force that those numbers are, for all intents and purposes, bogus.

According to Simon,

"The unemployment numbers have been particularly hard to read, especially with so many people dropping out of the work force," adding, "that middle class and lower class consumers are still economically challenged, only spending for the holidays and family occasions."

The fact remains that the unemployment numbers that we hear trumpeted in the news are grossly misleading. The 6.1% unemployment rate is the U-3 rate, and it counts those that have lost their jobs and are drawing unemployment and are searching for another job.

The more accurate U-6 unemployment rate counts those that are in the U-3 category AS WELL as those that have stopped looking (discouraged workers) and those that are no longer receiving unemployment benefits (even though they are still unemployed..

Care to guess that number?

Currently, the U-6 rate is closer to 13%.

And there are 92 million Americans of working age that do not have a job.

This situation is made worse by the fact that our economy, in response to overall weakness and the impact of Obamacare, is adding far more part time jobs that full time jobs. The June jobs report was heralded as good news with 276,000 jobs added. Look at the numbers and you find that we lost 592,000 full time jobs while adding 799,000 part time jobs.

Replacing full time jobs with part time jobs results in stagnant wage growth and makes it difficult for many families to make ends meet. Real income has fallen for seven consecutive years, mostly as a result of the loss of good paying full time jobs.

Many of the full time jobs that are now being created in our economy are in lower paying industries: food service; hospitality; and leisure. The industries that are hiring are food service (fast food and food preparation), hospitality (mainly cleaning jobs); and leisure (ticket takers, for example). All of them lower wage jobs.

There is absolutely nothing wrong with any of these jobs. But when this is the bulk of the full time jobs being created, one can see the problem with growing wages in the overall economy and with supporting a family specifically.

So while job creation is being lauded, one would be wise to take a closer look at the numbers. When you do, you can begin to understand why our economy is struggling and families cannot make ends meet.

Wal-Mart is the canary in the coal mine. They should serve as a warning to all of us that this economy is much weaker than the numbers suggest.

And that weakness is going to take a long time to overcome.

And that, my friends, is my view.

Tuesday, July 8, 2014

Thoughts on James Neal, Olli Jokinen, Anton Volchenkov, and Mike Fisher

The dust has settled on the James Neal trade and the Predators activity in free agency. So what are we to make of all this?

Neal, a second round draft choice by the Dallas Stars in the 2005 Entry Draft, made it to the NHL in the 2009 season, in which he played 78 games and notched 65 points (27G-38A). In subsequent years, he had 55 points (2010-11 22G-23A in 79 games); 81 points ( 2011-12 40G-41A in 80 games); 36 points (2012-13 21G-15A in 40 games); and 61 points last season (27G-34A in 59 games).

Neal has been productive playing with centers like Brad Richards and Evgeni Malkin, and the Predators lack that caliber of player at that position.

One of the questions that arose after the trade was who was going to center Neal's line and get him the puck? That is a valid question because the Predators have struggled to find an elite number one center. Colin Wilson was thought to be able to grow into that role when he was drafted, and although occasionally showing some flashes, has never developed into the consistent number one center the team had desired.

Could it be promising youngster Calle Jarnkrok? Craig Smith?

The lack of a definitive answer to that question has many wondering whether Neal can continue to be productive at the levels he has displayed so far in his career.

That question will not be answered until after the preseason, but I believe that the Predators will find a solution. Now, will it be a player currently on the roster or one acquired via trade?

I don't know, but I believe the Predators are still in the market for a center. It could be Vinnie Lecavalier from the Flyers or perhaps another player. Regardless, the Predators have the assets to make a deal.

Barring a trade, someone on the roster has to step up. To me, the most likely candidate is Jarnkrok, who has shown creativity and a nose for the net in his brief NHL appearance last season. Jarnkrok is adept at distributing the puck and creating space with his speed and puck handling and could be an exceptional fit with Neal.

The other question surrounding Neal is his sometimes stupid play that has resulted in several suspensions.

Time will tell if he has moved past his sometimes reckless play, but I believe the move to the Predators will be good for him. With the Penguins, Neal was not in a leadership role and with Sidney Crosby and Malkin in the line up, was not "the man" on the ice. He will be with the Predators, and I think this will lead to more responsible play.

The Predators also signed Olli Jokinen and Anton Volchenko to one year deals. Both were good signings for the team.

Jokinen brings a veteran and consistent presence to the Predators. Although he is in the twilight of his career, Jokinen has shown that he can be a proven scorer and is hungry to get back to the playoffs. He has 740 points (317G-423A) in 1169 games and his veteran presence will benefit the younger forwards on the roster.

Jokinen signed a favorable one year deal for $2.5 million and I would project him as centering the third line.

Anton Volchenkov was signed to a one year, $1 million deal. The 32 year old blueliner has played 650 NHL games for New Jersey and Ottawa and is a rugged, stay at home defenseman. He will probably slot in on the third pairing, and while not an offensive threat, can play a physical game.

The signing of Jokinen is particularly fortuitous with the announcement that Mike Fisher ruptured his Achilles tendon during off season work outs. He is expected to miss between 4-6 months while recovering, which could translate to as little as 10 games to possibly 40 games if he takes longer to recover.

This is a significant loss for the Predators as Fisher is a leader and strong locker room presence and was potentially slotted to be the number one center. While a loss, it does open the door for Wilson or Jarnkrok to step into an increased role. The problematic aspect of this injury for Fisher is that it is a difficult one from which to recover, especially late in his career. It remains to be seen how effective Fisher will be on his return.

There are questions surrounding this team. Which player on the current roster will step up, or will the Predators attempt to plug holes in their roster via trade?

How those questions are answered will determine the success of this team.