GOP Mistaken, Americans Don’t Want to Dismantle Obamacare

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The new Republican House majority coming to Washington next week is ready to dismantle the health care reform law.

Majority opinion is on their side, they say. The most recent evidence they point to comes from last week’s CNN Opinion poll, which showed public opposition to reform, while slipping slightly since its November high water mark, exceeded proponents by a 50-43 margin.

But a closer reading of the poll by U.S. News and World Report opinion editor Robert Schlesinger puts those results in a new light. One of every four people who said they were opposed to reform said it didn’t go far enough. If you add those people to those supporting reform, a clear majority of Americans – 56 percent – are opposed to Republican efforts to dismantle or defund the bill.

People forget that some of the most virulent opposition to health care reform came not from Tea Party activists making headlines with town hall meeting protests, but from frustrated health care reform activists who backed either a single-payer insurance system (“Medicare for all”) or a public option that would compete with private insurance companies. Conservative Democrats in the Senate refused to consider those options during the debate.

Yet between 2003 and 2009, no less than 17 different opinion polls, including ones taken by the New York Times, the Associated Press-Yahoo, Quinnipiac, the Washington Post/ABC News and Kaiser Family Foundation, showed either a majority or a plurality of Americans backing a single-payer system, according to Wikipedia. For many of the activists pushing single-payer, the public option was a compromise plan.

So it’s no wonder that when pollsters ask that segment of the public what they think about “reform,” they check the “opposed” box. But it hardly makes them supporters of “repeal and replace,” the slogan of in-coming Republicans.

Meanwhile, the front-loading strategy that the Democratic architects of the law employed will continue to undermine opposition to the law. Popular provisions like extending insurance to children living at home up to age 26 and non-discrimination for previous medical conditions have already gone into effect.

Starting January 1, insurance companies will be held to medical-loss ratio rules that limit overhead to 85 percent of premiums in the large-group market and 80 percent of premiums in the small group and individual market. The near-old population will have the option of buying low-cost, long-term care insurance from the government.

In Medicare, seniors will begin getting a 50 percent discount for brand name drug purchases while they’re in the so-called donut hole of non-coverage. Primary care physicians will get a 10 percent pay bump on their Medicare services, while all co-payments for prevention measures given a high rating by the U.S. Preventive Services Task Force – like colonoscopies – will be waived.

Of course, there is one element of reform that the latest polls continue to show most Americans are against. That’s the individual mandate, which requires people buy health care coverage.

But that’s heading for a Supreme Court challenge, and wouldn’t have become effective until 2015. The incoming House will be on strong ground with the public when they give that measure a thumbs-down vote. But when the leadership schedules the vote on the entire legislation, they might want to recheck the numbers in the latest polls.

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Eugene Goldwasser, the University of Chicago biochemist whose agonizingly long but ultimately successful search for a single protein helped launch the biotechnology industry, died Friday in Chicago. He was 88.

The immediate cause of death was renal failure associated with advancing prostate cancer, which he’d lived with for over 20 years. When his kidneys began to fail shortly after Thanksgiving, Goldwasser opted for hospice care instead of dialysis, a procedure revolutionized by his discovery.

Goldwasser, whose government-funded research began as a Cold War experiment to cure radiation sickness, found and purified erythropoietin, or EPO, which is a naturally-occurring hormone produced by the kidneys to stimulate new red blood cell production. Today, genetically-engineered versions of EPO cure anemia in dialysis and cancer patients and generate billions of dollars in sales for Amgen, Johnson & Johnson and Roche.

Unlike its discoverer, EPO has generated numerous headlines over the years. Its high price, which is mostly paid by the government, has generated anger and intense lobbying on Capitol Hill and at the Centers for Medicare and Medicaid Services. It has been used illegally by athletes like Tour de France bicyclists to provide more energy by expanding oxygen-carrying capacity. And, more recently, regulators have issued warnings against EPO overuse after clinical trials showed overdosing raises the risk of heart attacks and strokes in chronic kidney disease patients and premature death in cancer patients.

But none of that was foreseen by Goldwasser when he decided in 1980 to provide California-based Applied Molecular Genetics, later Amgen, with the world’s sole supply of purified EPO, which it had taken him nearly a quarter century to find. Though he disclosed his findings to the University of Chicago as required by his federal funders, the university never patented the discovery.

That decision allowed Amgen scientists to identify the gene that produced EPO, patent its use, and manufacture the protein using the then new technology of recombinant engineering. The company also financed the clinical trials in dialysis patients that led to Food and Drug Administration approval of the first EPO product – Epogen – in 1989.

But as far as Goldwasser’s long search for EPO that predated those efforts, “private companies rarely support that kind of research. It takes too long, and the odds of success are even longer,” I wrote in 2004 in “The $800 Million Pill,” whose first chapter documents the biochemist’s quest. “The Goldwasser-Amgen story provides an excellent opening snapshot of the complicated relationship between basic and applied research in the public and private sectors and shows how private firms rely on public research to come up with important new drugs.”

Born in 1922 in Brooklyn, New York, Goldwasser’s father moved the family to Kansas City during the depression after his clothing manufacturing business failed. Inspired by books like Sinclair Lewis’s “Arrowsmith” and Paul de Kruif’s “Microbe Hunters,” the teenager studied science at a local community college, which he attended for free, and won a scholarship to the University of Chicago, where he majored in biological sciences.

During World War II, he worked on top-secret programs to discover antidotes to chemical warfare agents and in 1944, moved to Fort Detrick, Maryland, to work on the army’s anthrax program. After the war, he returned to Chicago to get his doctorate in biochemistry, and went to work in Argonne Cancer Research Hospital, which was developing novel approaches to treating leukemia using derivatives of mustard gas, the chemical warfare agent that wiped out infection fighting white blood cells.

In 1955, the Atomic Energy Commission awarded Goldwasser a grant to identify and isolate the protein that stimulated red blood cell production. “This was a time when everyone was scared to death and children in the schools were taught to crouch under their desks,” he told me in an interview in 2002. “It was a time of foolish panic, but it gave me every young investigator’s dream. I had all the money and space I needed. And I didn’t have to write any reports. I thought it would take about three months.”

Instead, it took 22 years before he published his seminal paper documenting his discovery in the Journal of Biological Chemistry. His efforts to convince Midwestern firms like Parke-Davis in Michigan and Abbott Labs in North Chicago to work on commercializing his discovery fell on deaf ears, thus leading him to Amgen.

In subsequent years, Goldwasser’s research focused on the cells inside the kidney that produced EPO. He hoped to discover mechanisms for repairing damaged kidneys, which would make use of artificial EPO unnecessary. In 2003, he closed his lab and retired after the National Institutes of Health lost interest in his work.

Goldwasser is survived by his second wife Deone Jackman; two stepchildren, Tara and Tom; and three sons by his first marriage, Thomas, a rare book dealer in San Francisco, Matthew, an education consultant in Chicago, and James, a rare book dealer in New York. He also has five grandchildren. His first wife, Florence Cohen, died in 1981 of leukemia.

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