Articles tagged with: culture

We Can Have Our Medicines and Afford Them Too

Rethinking Wall Street capitalism for producing medicines

We Can Have Our Medicines and Afford Them Too

After earning a Ph.D. in human genetics in 1987, I chose to enter the nascent biotechnology industry rather than pursue conventional academic science. Venture capitalists in Cambridge, Mass, and elsewhere had caught wind of revolutionary genetic discoveries in university labs and academic medical centers. They saw a new gold rush opportunity.

The credo, then and now, is to bet big money on ten startup biotech companies, and if just one develops a high valuation in a buy out or IPO, presto! Instant millionaires! While saving patient lives too!

I joined a small army of scientists, engineers, patent attorneys, and young CEOs who set out to radically redefine human disease and treatment from the DNA on up. We knew that once we delineated the molecular pathway of any disease, we could prevent it with early detection and target treatment right at the root cause; ‘targeted therapeutics’ like the “Silver Bullet” for cancer, remember? All this transformation was enabled by loads of venture capital. Those were heady days. We intended to bring medicinal chemistry (pharmaceuticals) out of the dark ages. I contributed to early game-changing products and technological innovations. Some of the early companies and products are still impacting people’s lives today.

Most public life science companies back then and today have zero revenue. That’s right, companies trading on NASDAQ value their stocks based on intellectual property (patent applications) and potential revenue. These are high risk investments. It seems only right that those early investors in life-saving technologies would or should expect high returns on these investments. Some of the early investors became, and are still becoming, very rich from IPOs and acquisitions.

My colleagues and I asked, so what is wrong with that? In fact, as scientists, we felt that we should be well-rewarded for our role in inventing life-changing medicines, as some of us did.

There’s a but…

This 35 year-old biotechnology funding model should no longer be exalted because it’s now working against our collective interests.

Despite a tsunami of molecular knowledge generated by academicians and industry researchers concerning human diseases, we have developed drugs for only 10 percent of the roughly 6500 human diseases we know about — and at increasingly stratospheric prices.

I attribute this to two significant and important facts:

  1. About 90 percent of human diseases are not addressed with medicines today.
  2. any medicines that are developed are made available only because they can be priced for profit, not for the larger human needs they address.

We perverted the purpose of biotech companies by how we financed them. As is true in life, so it is in industry. You get the behavior you reward. And the process is addictive. It starts with a new company accepting high-cost early venture capital funds, followed by private equity and bankers doing IPOs and mergers and acquisitions, and finally the intoxicating experience of arriving in public markets. Everyone is financially rewarded. Except the patient.

High-cost capitalization

The behaviors incentivized by what I call “high-cost capitalization” include:

  • Maximize prices, especially if the drug is novel or rare. David Axelrod saw something upside down in that thinking as he tweeted, “Your money or your life is a hell of a choice that people shouldn’t have to make.”
  • Patient populations are framed as “markets” to entice the discovery of costly blockbuster drugs.
  • Ignoring prevention and early detection technologies because they are not blockbusters.
  • Trade secrets and price preservation are pillars of the industry
  • Development and purchase of potential cures can be shelved to protect companies and shareholders if the profit potential is inadequate.
  • Generated profits are used contrary to the purpose of furthering healthcare research. Only 7-15 percent of profits are reinvested in R&D for new products; the rest goes to executive pay, stock buybacks, marketing and sales.
  • Lean efficiency is not a standard. As of 2022, it takes 10-15 years and about $1-3 billion to commercialize a new drug, positioning pharma in the top three most profitable industries on the planet.

Wake up!

In 2019, some colleagues and I said, “Wait! Are our labs in the business of forming companies so that we can ring the bell on Wall Street, or in the business of creating medicines that heal people? And if we want to work on any opportunity for improving lives such as repurposing old drugs for new disease targets (frowned upon) or any preventive or early detection test (no money in that), how could we ever get financed?

Sometimes events collide with ideas.

COVID happened. We saw what our industry could do when it addressed an urgent need, as opposed to targeting a “market.”

We saw companies choosing to make low-profit vaccines, and doing it within a single year. Not for $3B! We saw how testing companies were immediately funded to create PCR and home tests to meet a healthcare need, not a marketing plan. They found ways to capitalize that effort — for the public good. We can now see that placing health above profit is achievable – and desirable.

We saw an effort to share all data and technical know-how globally. Government and private industry worked together to meet this emergency. COVID vaccines and therapeutics have remained private intellectual property, not placed in the public domain as were the polio vaccines in the 1950s. Nevertheless, with taxpayer support we now can have all the medicines America needs. And we can afford them too.

Is this socialized medicine?

If you are talking about the industry sector in which my company is located, then no. It’s “conscious capitalism.” Audacity Therapeutics does not need charity, nor government programs, nor social or public services. We believe that private industry can and should be delivering on the public’s need for medicine.

But we do need some rethinking to bring that about.

We need more biotech and pharma companies, like ours, that are organized to operate differently. Companies that are financially able to say “No Thanks!” to high-cost capital.

Audacity Therapeutics is so-named because we had the temerity to ask what if there were biomedical and pharmaceutical companies with a healthier primary purpose and duty that could:

  • Develop effective therapies for untreated or under-treated human diseases, as many as possible.
  • Demand capital efficiency and a culture of deliverables, not promises
  • Focus on disease solutions opportunities rather than 10X return market opportunities
  • Prioritize medically valuable products for patients rather than capital value to financial markets
  • Guarantee that drugs are produced at prices affordable/accessible to all patients worldwide.
  • Provide fulfilling jobs and contribute to a balanced and just healthcare economy

From this ethical framework, we aim to prove that quality healthcare can be both profitable and affordable.

For more details, visit

Rethinking the VA's "Discretionary" Authority

Rethinking the VA's

Cary Harrison interviews Jerry Ashton about how our military veterans are burdened by medical debt.
Jerry discusses the problem with how Veterans Affairs processes claims, veteran homelessness, and veteran suicide.
Hear the solutions to the VA's discretionary authority and how veteran medical debt could be forgiven. #EndVetMedDebt

Open Your Heart - Close the Sky - "Crypto-Caring for Ukraine"

Open Your Heart - Close the Sky -

What do you do in the 21st century when war breaks out and you are not a soldier? If you “rethink your role as a citizen” as did Mark Nezvisky, you go to the virtual front-line.

“Not everyone can carry a gun,” explained Mark. “We didn’t want to simply head for shelter when the alarms started – we decided to use our connections in the cypto and NFT world. At least we could raise money for the war, for hospitals or other humanitarian needs.” He continues:

“It’s our way of contributing to the future of our country. It’s our digital front. We want to live in a free, independent country called Ukraine. We want to make our own decisions on what our country would be like. It’s our fight for democracy.”

The Result – and the Result-Makers

Mark’s “team” initially comprised himself, his wife, a sister and her husband to create a beautiful NFT collection available for purchase by people wanting to materially contribute to the Ukrainian army, their hospitals and much-needed help with essentials such as food and health goods.

At the moment, they have a telegram group with more than ten designers, some who have already contributed their artwork for the NFT collection while others have just started and are deep in that process.

“We also have a marketing specialist, Nazar Stepanyuk who joined us recently and we need many more with his skills to help us promote the collection. Although we did consult with 2 more marketing specialists on the best marketing strategies,” Mark explained, adding:

Everyone who’s contributing, whether designer, marketer or those spreading the word throughout the cyber community are highly motivated individuals and are true patriots of Ukraine.” He added for emphasis:

“We are all doing this on a pro bono basis.”

Where does this money go?

The group has raised over $911 USD so far by selling 9 NFTs from our CloseTheSky OpenSea account. Anyone with a cryptowallet such as Metamask can go to the activity tab of our collection on OpenSea and filter out by sales to see exactly which NFTs were sold.

That entire amount has been donated to which is a foundation datikng back to 2014 in response to that earlier Russian invasion started.

“It’s a reputable organization that receives donations not only from Ukrainians but people all over the world, including celebrities and business people in the U.S.,” Mark says. “You can visit their website to learn more how they distribute the funds that are being donated. We plan to expand the list of organizations we contribute to as our sales from the NFTs grow.”

Your involvement – heart and wallet

Whether you are a crypto enthusiast or someone who wants to step up to answer this humanitarian need, you will be purchasing artwork created by a group of nine designers who have donated their efforts for the sake of Ukraine. The designers adding their skill to the CloseTheSkyUA NFT collection are Den Matliak, Vlad Kornyuk, Artem Koliadynskyj, Roman Mamchur, Karina Kuts, Asya Pyatnychko, Anna Fedora, Lena Afanasieva, and Julia Lipa.

All of You Medical-Debt-Inflicted Veterans Out There – Forward this Valentine’s Day Greeting to the VA! #EndVetMedDebt

Forward this Valentine’s Day Greeting to the VA! #EndVetMedDebt

All of You Medical-Debt-Inflicted Veterans Out There – Forward this Valentine’s Day Greeting to the VA!  #EndVetMedDebt

The VA will most certainly become your valentine – once they see to it that all of your unpaid and unpayable hospital bills are made available for legitimate and final debt forgiveness. Every. Single. Dollar. Forgiven.

Although differing in form, this wouldn’t be the first “modest proposal” made publicly for a cause that would benefit society. Jonathan Swift, in an essay by that title published in England in 1729. He made a strong argument that – since there the Irish at that time were painfully impoverished – that they should sell their youth to the English as food.

Our not-so-modest Valentine proposal is that a similar societal ill be addressed, the medical debt on the backs of current and former service members (our veterans). It is not so modest in that this debt has been estimated to be as high as $6 billion.

You weren’t aware that America’s warriors, who on joining the military, basically agreed to do whatever necessary to protect our country – up to and including loss of limb and life – would not be cared for by a grateful populace once that service is completed? Time to fetch the Smelling Salts.

OK – We’re Conscious – Tell Us More

To quote from my article in Physician Outlook that appeared on 2/10/22, “Whether you have a role in the VA delivery system or a civilian (physician) serving veterans at a public hospital, you are unwitting (unaware?) accomplices in bringing about the $6 billion in unpaid medical bills that the VA has refused to pay…or forgive…up to this point.”

You see, if someone has an injury or disability caused by military service, they are eligible to be treated by the VA for free. That same promise does not include treatment for a service-related disability outside of the system.

That’s not a typo, although it is difficult to know at this point how much debt is being and has been disallowed for payment by the VA for emergency services provided outside of their hospital system. As said earlier, at one point it was over $6 billion, but an appeals court ruling in 2019 contested that policy and is requiring the VA to reimburse vets. Is that happening? Has it happened? I don’t know. If you do, please let me know.

Being in debt is not even the worst part.

I can tell you that – whatever and however it is owed – the IRS would envy the collections apparatus for recovering those monies. Such as, reporting your past-due account to credit bureaus after exhausting months of their phone calls and dunning letters. 

Public blowback on this practice got so bad that, earlier this month, new rules were issued by the VA sharply to limit its credit reporting activities. As reported by Jim Rice of the CFPB (Consumer Financial Protection Bureau earlier this month, the VA is instituting “additional protections to the most financially vulnerable veterans” which will result in a 99% reduction in reporting. (Italics mine)

That doesn’t mean they will stop attempting to recover on a past-due balance. A veteran owing as little as $25 will still be pursued. Not even a commercial collection agency (and I come from that world) would go after a bill that small. Forget the morality, it just doesn’t make business sense. Spending $100 to collect $25…and failing?

Formally Launched : A Campaign Titled #EndVetMedDebt

Beginning with this Valentine’s Day announcement and continuing through Veterans Day which will take place on November 11, 2022, a coalition of military and civilian organizations and individuals are forming to devote themselves to the task of seeing that VA unpayable medical bills be forgiven. Legally, and in full.

There’s precedent.

How forgiveness can be done while ensuring that there are no tax consequences to the recipient is a process that has been pioneered and perfected by the 501(c)(3) charity that I helped to co-found in 2014, RIP Medical Debt. It was a great ride, and after achieving all the goals I had set for myself and RIP I retired to its board in October 2020 to invent other channels by which to create positive social and economic impact. Out of this has come my present venture, Let’s Rethink This (LRT).

LRT will serve as a temporary platform until a formal #EndVetMedDebt website is revealed on March 1 – a scant two weeks from now.

To date, RIP has abolished over $5.5 billion in medical debt, positively affecting the lives of over 3 million Americans. It has published a seminal book on the need and reasons behind its work, put on first-ever summits on medical debt, enabled a major study of the costly impact of medical debt on our citizens and is now involving itself more deeply in influencing policy.

To be clear, this is not a fundraising campaign for RIP. This is a campaign that intends first to see that public awareness, federal legislation, VA policy changes – whatever works best – comes about so that this debt can be accessed and made available to organizations, such as RIP, which can step forward with their solutions.

Let’s Rethink This is only the originator of this campaign. Over the next eight-plus months we will be working shoulder-to-shoulder with scores of other organizations and individuals that share in this mission and its purpose. Are you one of them?

Please write us for more information at This email address is being protected from spambots. You need JavaScript enabled to view it.

A Call to Action #EndVetMedDebt

A Call to Action #EndVetMedDebt

This is what needs to be done if you want to bring about medical debt justice for our veterans. Now, THAT would be the best way to bring in – and end – 2022. You (yes, you) can help bring that about. We at Let’s Rethink This (LRT) are honored that Physician Outlook is making available its platform – and its audience – to learn more about America’s shame in allowing hundreds of thousands of active duty and veteran users of the VA system to be both financially and emotionally crippled and what to do about it.

And what better, singular group could better relate to the need for this broken system to be rethought than physicians, nurses, and concerned members of the healthcare community? Whether you have a role in the VA delivery system or a civilian serving veterans at a public hospital, you are unwitting (unaware?) accomplices in bringing about the $6 billion in unpaid medical bills that the VA has refused to pay…or forgive…up to this point.

Sorry, kid. You fixed ‘em. The VA broke ‘em. Who is responsible for the “do no harm” part?

By the numbers

Currently, there are fewer than 4,500 active-duty physicians tasked with overseeing the healthcare needs of America’s 1.4 million active-duty, 330,000 members in the reserves, and/or retired, along with a veteran population of approximately 18 million. This takes place at 1,293 healthcare facilities, including 171 VA Medical Centers and 1,112 outpatient sites. The annual budget is $50 billion.

According to USA Today, of those 18 million veterans, more than 5 million veterans have at least one disability, 1.2 million live in poverty, and 77% of veterans aged 18 to 64 are employed or looking for work. At the end of 2018, an estimated 37,878 veterans were homeless.

How can any of this be?

Military veterans, contrary to popular misconception, do not get free healthcare from the Dept. of Veterans Affairs. If a health issue isn’t related to military service or is not the result of their being more than 50 percent disabled – the vet can be held responsible for co-pays. 

If the veteran has the misfortune of requiring the services of a civilian hospital emergency ward for a non-service-related injury or illness, they are also on the hook as they might need to meet a deductible or pay co-insurance – or did not get a pre-authorization to get service in a non-VA setting. If as a civilian, you feel you are dealing with uncaring insurers – try jumping through military hoops!

For example, in 2019, a federal appeals court in Virginia ruled that the VA would be required to reimburse veterans for $6.5 billion in unpaid emergency medical bills. Good luck on that happening anytime soon. If ever.

What to do?

Lots, starting now. This is just the first shot across your consciousness prow. Visit Let’s Rethink This where in February we will have a revamped Our Newspaper to head to for the latest news, articles, and interviews. Want a free copy of my chapter titled “No Thank You for Your Service” in the recently released End Medical Debt: COVID Recovery Edition to deep dive into the problem? Write me personally: This email address is being protected from spambots. You need JavaScript enabled to view it.

Let's Rethink This is licensed under a Creative Commons (BY-NC) 4.0 License


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