February 27, 2025 • 29 mins
Birmingham Attorney Scott Morro and state legislator Allen Treadaway talk about the crime epidemic in Alabama’s largest cities and offer suggestions on how to fix it. Then health care expert David Poole talks about a drug discount program that benefits rural, working-class people in Alabama.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
On Tuesday, twenty two year old Damian McDaniel of Fairfield
was charged in three separate homicides dating back to twenty
twenty three. These charges are in addition to the days
of eleven people that has already been charged with following
the hush hook around shootings last year, and other shootings
are likely connected as well. Hello, I'm John Mounts and
this is Viewpoint Alabama on the Alabama Radio Network. In
(00:23):
spite of this announcement, Birmingham still has a real crime problem.
Joining me now in our Viewpoint Alabama studios is Birmingham
attorney Scott Morrow. Scott, Welcome to Viewpoint Alabama.
Speaker 2 (00:32):
Thank you, John. Glad to be here with y'all.
Speaker 1 (00:34):
Now, of course it's not on the best circumstances because
we're here to talk about the situation going on in
Birmingham with the crime.
Speaker 2 (00:40):
And it's not good.
Speaker 3 (00:41):
You know.
Speaker 4 (00:41):
We hear the mayor talk about what he's doing, but
really I see no action action at all.
Speaker 1 (00:47):
He does say he's trying to do something about it.
He says he's trying to hire more officers, but I'm
not seeing those numbers.
Speaker 5 (00:53):
We feel confident based on the response as we've been
getting with the high attendance and the physical agility tests,
we'll wish that number in the next year.
Speaker 1 (01:01):
He's purporting that we're bringing in people, but he hasn't
really come forward with the exact number of officers hired
and how they're being trained and what they're going to
do once they are trained.
Speaker 3 (01:09):
Right.
Speaker 4 (01:09):
That was part of the Crime Commission report where they
said they needed to prioritize hiring officers. But they can
talk all day long and have studies and assessments, but
unless they ask you to get the boots on the ground.
I heard them yesterday talking about one person cannot make
a difference in crime and Birmingham, you know, insinuating that
you need the community and all this other stuff. You
(01:32):
need beat cops to work hard. I've said it before.
Reasonable suspicion and probable cause beat cops.
Speaker 2 (01:39):
It starts there, ends there.
Speaker 1 (01:41):
And also we need to untie the hands of a
lot of these officers because you can have officers, but
if they're not able to, you know, effectively enforce the law,
then what are we really doing?
Speaker 4 (01:52):
And thank you John, because that's exactly what you're going
to see Thursday at the Personnel Board of Jefferson County.
I represent an officer who made an arrest for disorderly
conduct at three o'clock in the morning, and his initial
supervisors thought it was a great arrest, good arrest, But
then you got some other people in the precinct the
day shift woke idiots that thought it was a false
(02:14):
arrest and ended up terminating the man. So come to
the Personnel Board this Friday at nine o'clock. There's going
to be a hearing. It's open to the public. Michael
Pickett will be testifying, and we're going to expose them
for their foolishness of not giving the officers the benefit
of the doubt. Exactly what you're talking about, John, tie
in the hands of these officers that when they do
(02:36):
something in good faith to enforce the law, they end
up getting disciplined, suspended, or terminated.
Speaker 2 (02:42):
It's ridiculous.
Speaker 1 (02:43):
It's always the same thing, it seems whenever you if
you've ever watched the video, like a long form video
of a bad guy doing something stupid, cop comes up
to him and says, hey, quit doing something stupid, and
he doesn't want to quit doing something stupid, and then
an argument ensues and sooner or later, the CoP's got
to take that guy down. What happens is that's like
say a twenty minute long video. But what they do
is they pull out like a three second clip of
(03:05):
the officer taking the guy by the neck and take
him to the ground and say, oh look, it's it's
police brutality. What it is is you just saw one
little snippet of a very long interaction where the officer
was acting responsibly and following his training, and you're on purpose.
You're zooming in a little tiny thing to make a
mountain of a mole hill so you can make a
point that doesn't need to be made.
Speaker 4 (03:24):
It's called manipulating the truth to a desired outcome, John,
I see it all the time, you know. Alan Treadaway
Hopefully we'll be calling in later. He's got some legislation
that he's furthering on giving the officers more authority when
they're having these idiots interfere with what law enforcement is doing.
And until the leaders like Woodfinn, a police chief, a
(03:47):
captain internal affairs, until they give the benefit of the
doubt to the officers, you're going to have bad crime
in Birmingham. And that's just the way.
Speaker 1 (03:54):
It is and all of us, the citizens, the ones
who don't commit the crime are the ones who are
going to pay for it. And now joining us on
his way down to Montgomery to work on some legislation
along the same lines, is Alan Treadaway. Alan, welcome to
the show. Good morning, Good morning. So what is this
legislation that you're working on.
Speaker 5 (04:10):
Well, there's a number of pieces of legislation of Montgomery
dealing with violent crime in Alabama. A lot of folks
don't realize that we got four hundred and forty plus municipalities,
sixty seven counties and two cities are responsible for almost
fifty percent of the violent crime occurring.
Speaker 3 (04:29):
In the state of Alabama.
Speaker 5 (04:29):
That's Montgoment and Birmingham, with Birmingham.
Speaker 2 (04:31):
Leading by far.
Speaker 5 (04:33):
So the issue with me has been the last couple
of years has been transparency, the critical staffing levels in
both of these departments, especially Birmingham, and I hear from
officers on the street every day they need help, they
need relief. We can move money, and we can come
up with all the type of different ideals we want,
(04:54):
but unless we go out there and implement them, bring
folks onto the street, put these officers out there protecting
the public. You're just going to see more and more
of what we're getting, which is just out of control
violent crime.
Speaker 1 (05:08):
Well, Scott Marrow, why is it that it's so hard
to find officers who want to be This is kind
of a I realize socratic question here. Why is it
so hard to get officers to join the Birmingham Police Force?
Speaker 4 (05:19):
Well, Allen and I both know this as members of
the FOP one and being involved in disciplinary matters and training.
It seems like lately they've turned a lot of the
training issues into disciplinary issues and that's bad for morale.
They're terminating people, they're suspending people instead of giving a
mentor and training. And nobody really just wants to come
(05:39):
to Birmingham and these big cities to police because they're
not getting support from their leadership. You're getting great results
in the outlying areas because some of the great leaders
Birmingham had have gone to Leeds, have gone to pel City,
have gone to Mountain Brook. These police departments are flourishing.
They have plenty of police there, for example, with Nick Dervis,
(06:01):
Jersey's great leadership. So it's leadership, John, and the lack
thereof and the mentoring Alan, Yeah, you touched on.
Speaker 5 (06:09):
A very important component of what's causing all this and
the revolving door leadership in the City of Birmingham over
the seven years. The last seven years has caused a
great instability there. The National Chief of Police Association last
year came out and said the number one reason officers
leave the department is not pay, it's leadership. When you
look at approximately twenty three these officers are currently there,
(06:33):
have been there seven eight years, have had twenty three
chiefs and deputy chiefs over the last seven and a
half years, that is an issue that must be addressed.
I'm looking at legislation to put some of these appointments
back into the merit system and when you hire somebody
or terminate somebody, this legislation for transparency. Who will make
you go before the full body city council for the
(06:55):
reasons why you want to hire and the reasons why
you want to terminate, because I think far too all
often folks are hired and they've got great crime fighting
strategy plans and great retention recruitment plans, but if not
given the authority to implement or the funding, they just
sit on the table and you get more of the same.
Speaker 1 (07:14):
And so that's the reason Alan, why you have some
of the legislation you're proposing. If enacted, how soon could
we see something change.
Speaker 6 (07:22):
Well, provided we get it past, it could happen within
the next sixty to one hundred and twenty days given
what the legislation actually says on implementation, So pretty.
Speaker 1 (07:33):
Soon, Alan cred Away, I know you got to run
because you're on your way to Montgomery to do some
of the people's work down there. I appreciate you joining us.
You know a lot has been done. I've lived in
this area since nineteen eighty seven, and I remember when
I was younger. Birmingham used to be a place where
you only went downtown to two things, maybe to work,
but you left by the time some went down, or
(07:54):
you bought your drugs and got shot and that was it.
And so everyone's stay new to stay away from Birmingham.
And we've made a lot of improvements downtown from in
terms of we've got the Barons downtown now they are
building the new stadium, They've got another the new Amphitheater,
they got the stadium down there. They've got a lot
of great stuff in downtown. But yet there's a lot
of people who don't want to come in from over
the mountain. And there's the question of why. And I
(08:17):
tossed that to you, Scott Morrow, thank you for joining us.
Why don't people want to come downtown?
Speaker 2 (08:21):
John?
Speaker 4 (08:21):
Just for context, I started policing in eighty six South Precinct.
I walked South south Side five points south. I've policed
in West precinc And I've been practicing los since two
thousand and seven, been involved in the police issues ever
since almost thirty years. Why don't people want to come
downtown because they're afraid. They're afraid they're going to be accosted.
(08:43):
They don't see that beat cop stopping the individual that
is hanging around the corner, the bum, whatever you want
to call it, the person that looks suspicious. We need
the beat cop to stop the suspicious people. And when
you're trained right and you're mentald, you're not violating people's
constitutional rights. There was a caller wanted to talk about
(09:06):
qualified immunity and the different things that protect police. But
you have to show the police that when they do
approach somebody and they're looking at reasonable suspicion, probable cause,
why are you here at three o'clock in the morning,
just standing here doing nothing. Why are you milling around
these businesses that are closed, Why are you getting in
(09:27):
the street and look like you're stopping cars or whatever.
Speaker 2 (09:30):
The reason is, we.
Speaker 4 (09:32):
Have to have the officers approach these individuals, be able
to figure out what they're doing, and if they find
out they're doing something illegal, to arrest them and support
them when they take them down when they don't want
to be arrested. And it's not excessive for us. It's policing.
Speaker 1 (09:48):
You know, you said something interesting that piqued my interest.
A while back. I was on University and University I
think it was like nineteenth maybe twentieth, and this lady,
she was a very large lady, and I believe she
had pulled looked like maybe a nurse's outfit out of
a dumpster or something like that. She was worrying, and
she walks into traffic, into the middle of the intersection, right,
(10:08):
and she walks in the Millionaire and she just starts
stopping cars like you said, stop. She starts holding her
hand up, stopping all four directions, stopping all the cars.
And then she starts going up to cars, banging on
the windows and yelling at the people inside the cars
and no, he knows what to do. And I was like,
I don't know, so I just kind of slowly started
to pull out. And then she comes running up to
my car, so so I can, you know, kind of
go for it. She runs towards my car, hits the car,
(10:29):
bounces off, lands on the ground, and then and then
I see her rolling around on the ground. I'm thinking,
oh boy, she's gonna complain I hit her or something.
But I imagine this happens more more times than I realized.
That somebody comes up into harasses people in car.
Speaker 2 (10:40):
Right, And the answer to that, John is you got
the beat cop. If you're fully staffed.
Speaker 4 (10:44):
They're riding around and they would probably see that before
it even happened, and they would approach that individual and say.
Speaker 2 (10:50):
What's going on? Is there's something I could do to
help you?
Speaker 3 (10:52):
You know?
Speaker 4 (10:52):
It sounds like somebody had a mental probably yeah, And
you know, so that's the answer is to have enough
police in your city that are properly trained, that are
going to be assertive, not be afraid to be assertive,
go up to these individuals and find out what's going on.
If there's a crime being committed or about to be committed.
They detain them and figure it out. But you have
(11:14):
to have the officers the will. Don Lupo and I
used to talk all the time. Everybody knows who Don
Lupo is, but we used to say, you have to
have the will to do it, and if you don't
have the will to do it, then it's not going
to be done. So let these officers who want to
be assertive get out there do their job.
Speaker 2 (11:33):
You know, Randall, we're talking right to you. Man.
Speaker 4 (11:36):
Hire these police officers. Mentor these police officers. Stop disciplining
them when they're trying to do and fight crime. It's
not about discipline, it's about training.
Speaker 1 (11:48):
Let's do that and how they're back. You know, when
something happens, don't assume that the purp is the good guy.
Speaker 4 (11:55):
No, you have to give the officer the benefit of
the doubt. You know, those of us that have been
involved in police for so long, when we review these
individual cases, we know when there's somebody who's doing something
maliciously or you know, out of meanness, or is it
a tactical error or whatever, you got to give the
officers a benefit of the doubt, and you have to
have warriors out there.
Speaker 2 (12:15):
You have to have warriors.
Speaker 4 (12:16):
You can't have well, I'm not going to say females
shouldn't be police officers, because there's some fine female police officers.
Speaker 2 (12:25):
But you have to be able to fight.
Speaker 4 (12:26):
You have to be able to take these individuals into custody,
and if you can't be afraid to do it, and
so you know, as a team, if we all get together,
Randall's right, it does take more than one. But you
got to start with that beat cop randal. You got
to start with that beat cop and support that beat
cop that'll do it.
Speaker 1 (12:46):
And I think also you need to enforce even the
simple laws, the little laws about littering, the little laws
like loitering, all the little laws that just go unpunished,
because what happens is when you don't, when you don't
get people for doing the little stuff, then they feel
like in bold and they can do more. They can
hassle people, and then they can break into cars and
eventually shoot people. It escalates.
Speaker 4 (13:05):
And right now, John, they just don't have the numbers
to do all that, you know, because it takes time
to arrest people take them to jail. So they're kind
of letting all that stuff slide, and it's just not
good for Birmingham. Birmingham can be better, Montgomery, all of
these bigger cities if they just support the police. All
the incentives they've given on hiring are great, but hire
the right ones, mentor them, don't discipline them.
Speaker 1 (13:27):
Would you want to be a police officer in the
Birmingham if you could, if you were younger, and would
you want to go be a police officer?
Speaker 2 (13:32):
Yeah?
Speaker 4 (13:32):
Birmingham's a great place to work as a police officer
because you have all the resources, you have all the
backup that you needed. When I worked, we had sixteen
to twenty officers on a shift at eight hour shift
overnight eleven to seven, and we were tight. We were
like a family and work together.
Speaker 1 (13:48):
Not them. But now would you want.
Speaker 4 (13:49):
To be well, yeah, because I want a change. I
would want to be part of the change. You need
people like me to get in there and help the change.
So yeah, but it's difficult. It's a lot different now.
Speaker 1 (14:01):
Yeah, I absolutely hear you, and I feel for these
officers because they have a lot ahead of them to
try and overcome in the city. Want to thank you
so much for joining me. Attorney Scott Morrow. This is Viewpoint,
Alabama on the Alabama Radio Network. In America, we have
an enormous healthcare industry that we believe works to keep
us healthy, but some say not everyone is well on
(14:23):
the up and up. Today, I'll let you decide. Hello,
I'm John Mount and this is Viewpoint, Alabama on the
Alabama Radio Network, and today we'll be speaking with David Pool.
He is with the AIDS Healthcare Foundation where he works
in the area of public policy and legislative efforts for
the Southern Bureau. David, Welcome to Viewpoint.
Speaker 3 (14:40):
Thank you, David.
Speaker 1 (14:41):
There's a great many afflictions that we've dealt with throughout
the years, and AIDS is one of them that in
the early eighties it was like a death sentence. But
through a lot of research and so forth, over the
last forty years, it's gotten a lot better and there
is a lot of great treatments out there. I'll let
you take it from there. What are some of the
treatments that are now available for people that didn't used
(15:03):
to be around?
Speaker 7 (15:04):
Really, from nineteen eighty one to nineteen ninety six, there
were no treatments that were considered viable. So we did
what we could as a community as a nation to
try to address the epidemic. But in ninety six things
changed greatly. With some research and development with some major companies,
they brought forth what became known as the cocktail, and
(15:25):
the cocktail was simply several drugs combined as anti retrovirals
that would actually bring people hope for a better future,
for a life. Now jump another twenty plus years, we
have single tablet regimens and we also have injectables that
don't even have to be taken daily, and for the
most part, people living with HIV will live a long life,
(15:49):
just as anyone else would.
Speaker 1 (15:50):
And David, these drugs are made available to these people,
but they're not free. Somebody has to pay for them.
So what's the cost of one of these regiments. And
it's not just like it's a pill, it's a pill
every day or every other it's a treatment ongoing for
the rest of your life.
Speaker 7 (16:05):
Right, But that's correct at this point, either every day
or as I mentioned, there's a new regiment and injectable
that's not as frequent as daily.
Speaker 1 (16:14):
But it's still something else that has a significant cost associated.
Speaker 7 (16:19):
Absolutely, the costs are in the thousands and thousands of dollars.
There's and especially when a company brings a new drug
to market, you'll see you know, prices. I mean an
example would be something somewhat related. When the hepatitis Secure
was brought to market in twenty thirteen, the costs, the
wholesale acquisition costs was in the like ninety to one
(16:41):
hundred thousand dollars for an eight week treatment.
Speaker 1 (16:43):
And that's a lot of money. But somebody has to
and you can't put a price on a life, of course,
but somebody does have to still pay for it. So
a lot of times that goes to the insurance company,
if somebody has insurance, if they don't have insurance. Sometimes
there's government programs, and there's a lot of there's a
lot of pharmacies and pharmaceutical manufacturers who they have programs
(17:03):
that help support people who are on one of these regimens.
Speaker 7 (17:06):
Right, Pharmaceutical companies often have what they call a patient
as systems program.
Speaker 1 (17:10):
Is there just one in particular that makes the aids
drugs or are there a multitude of them?
Speaker 7 (17:15):
I would say the leader is probably Gillyad Science. It's
either of Foster City, California.
Speaker 1 (17:21):
And these drugs are they still on patent or are
their generic equivalents These days, they're off.
Speaker 7 (17:26):
There are off patent drugs. But as with you know,
so many things in the pharmaceutical industry, generally speaking, the
newest drugs are the ones that have the least side
you know, the best side effect profile, the least side effects,
and are the most efficacious, the most effective and treating
the condition you're you know that you are treating. So
(17:46):
but there are generics, and that goes with all chronic
diseases and infectious diseases. And your generics sometimes are very
proven and you can take them, But then there are
also other circumstances where the side effect profiles are much
worse and if adherence is better with the more expensive drug,
you'll also want to go with the more expensive drug,
the newer drug.
Speaker 1 (18:06):
One of the other things that can be cost prohbitive
for people is even when there is a generic, the
generic is still pretty expensive. Like, okay, the name brand
might cost let's say ten thousand dollars a month, Well,
the generic might only cost three thousand dollars a month month,
which is a lot cheaper, but still for most people
that's out of reach. But the name brand made by
(18:28):
a manufacturer, let's say Gillia. Gillia will offer some sort
of copay assistance program to work with their insurance. However,
when if you try and use the generic, well, there's
no copay assistance for that, so you're on the hook
for the entire three thousand dollars. So a lot of
times there's a shell game that's sort of played between
the insurance company and the drug manufacturer and the patient
(18:50):
in terms of how are you going to pay for
this very expensive medication?
Speaker 7 (18:53):
Right, that's right, John, And what the group of people
that you just described, I think are all from the
world working class, especially here in the South and rural
working class people often either underinsured or uninsured completely. And
that's where our public health safety nets come in to
help with exactly what we're describing, which are the very
(19:14):
expensive medications and care that has to go alongside with
those treatments. So if it weren't for that safety net
that's been intact since the very beginning of the HIV
epidemic and all the other conditions that are covered, we'd
have a lot more people just simply dying for lack
of care. Completely. That healthcare safety net in the United
(19:34):
States is critically important.
Speaker 1 (19:36):
And that the reason why I have you on is
not just to talk about AIDS, although that is the
area where you have the most experienced currently, It's a
wider thing because there are a large number of drugs
that treat any number of chronic dises life threatening diseases
in some cases, and every one of these cases there's
a drug manufacturer involved, and then there's the patient. There's
(19:57):
the insurance company in the middle, and you're always kind
of stuck if you're the patient kind of dealing with
this situation. And most of these patients, David, don't They
have a they've got a full time job, or they
have other things going on in the world. They can't
make their entire life about chasing down the insurance company
to pay to pay for the drug or figure out
what the copay assistance program is like. And yet they're
(20:19):
left kind of in need of an advocate.
Speaker 2 (20:22):
Yeah.
Speaker 7 (20:22):
Absolutely, and in the excuse me, in the HIV universe
for sure. But this again goes for chronic conditions and
other infectious diseases. Is that you often have a case
manager that will be assigned to you either by the
care provider that you're seeing or with the insurance company,
or a combination of both. So you do have that
from the social work perspective, which is critically important oftentimes
(20:45):
with a population like we're discussing right now. Another thing
I'd like to introduce and mention that's critically important to
the cost issue is a program called the three forty
B Drug Discount Program that was introduced in nineteen ninety
two under the Veterans Care Act, and it actually is
(21:05):
a critical, critical aspect of that safety net. I keep
referencing the public hospitals, but federally qualified community health centers,
the nonprofit clinics that see folks that are under insured
or uninsured that will oftentimes be able to write off
that expensive copay or the drug itself can be covered
(21:27):
under that three forty B program. The three forty B program,
and I'll allude to you if you want me to
get into greater detail, basically provides a mechanism by which
all of these entities that we're talking about that safety
net can actually reinvest money that they get from the
drug savings that comes through the three forty B drug program,
(21:49):
and that takes that pressure you describing off of the
patients that might otherwise be or have to pay those
expensive copays or outlite for the entire price.
Speaker 1 (22:00):
At the drug And a lot of these rural hospitals especially,
they depend on these three forty B programs.
Speaker 2 (22:06):
Right.
Speaker 3 (22:07):
It's a huge source of revenue.
Speaker 7 (22:09):
And the good news is it not doesn't fall on
the US taxpayer. It actually is really a product of
that law that was passed in ninety two that required
negotiations between the drug manufacturers and the federal government. And
then those savings are passed along to the covered entities.
And there are about thirteen covered entities that are part
(22:31):
of that safety that I keep referencing, and they all
receive that pricing. And then if they build insurance and
the insurance is paying them based on a usual and
customary price that was contracted between them and the provider,
then that revenue comes back to the nonprofit hospital or
community health center or clinic and they can then reinvest
(22:52):
it back in the care and treatment of those patients.
Speaker 1 (22:54):
And this is something that affects US here in Alabama
as well.
Speaker 3 (22:57):
Right, Yeah, absolutely true.
Speaker 7 (23:00):
Again, the three forty B program has helped to keep
those hospitals and community health centers open.
Speaker 3 (23:05):
If you do not have that.
Speaker 7 (23:07):
Once you end up with that as a last case
or a last resort, you'll have a patient, as you say,
drives a great distance to an emergency room. And we
know when this country hands down the single most expensive
care delivered as in an emergency room, and that is
not where you want people seeking care. So yeah, it's
(23:27):
a great case for the three forty B drug program.
Speaker 1 (23:29):
Not to mention the fact that while people are at
the er basically getting treated for the common flu, do
you have people in there who also desperately need urgent
medical care, like say, injured in a car accident, and
now their care is kind of they have to kind
of triage nurses to figure out who is then most
need of care where it would be much better handled
by a physician in an outpatient setting if it's an ongoing,
(23:52):
you know, chronic disease that you're just having to treat
every you know, say month or something like that.
Speaker 7 (23:57):
Exactly, if you're a Royal Alabama and you're having a
heart attack, you want to be able to go into
that emergency room and get immediate care, and your main
goal is going to be you know, saving your life,
being alive and then getting better afterwards, and again the
program that I keep referencing, the three forty B program
helps make that happen in these rural settings.
Speaker 1 (24:17):
Now is this program, so it's a national program. The
federal government funds this.
Speaker 7 (24:22):
That is well, it's funded by the pharmaceutical industry, quite frankly,
the industry that has robust profit margins. And so I
might say that's again going back to my comment about
it's not on the backs of the taxpayers. The only
expense that really is a tax this program related to
government is the administration, which is a minuscule portion of
(24:44):
the revenue that actually goes back to these safety net providers.
Speaker 1 (24:48):
So then who has a problem with it? So it
sounds like the government shouldn't have a problem because they're
not having to pay very much other than this administration,
and they love administration at the government. So who is
it who has a problem with this? Is it the
pharmaceutical companies?
Speaker 7 (25:00):
As we know in this great country, we're a capitalist country,
and we have stockholders, and they're stockholders that own stock
in these pharmaceutical companies, and of course they want to
see those stockholders get great returns. That being said, this
is a minuscule erosion of their margin. But it's an
easy it's low hanging fruit for the pharmaceutical industry. So
(25:22):
I would say they're the number one, you know, con
against the.
Speaker 3 (25:25):
Three forty B programs.
Speaker 7 (25:27):
They bring new drugs to market, there's R and D,
but they also have a nice habit of doing what
they call evergreening. They don't always bring the newest product
to market, you know, get it out there until the
older drug has ever greened and the seventeen year patent
life has expired. And that's very unfortunate.
Speaker 1 (25:48):
I know. One of the things a game that the
manufacturers will play is they will come out with a
molecule that treats the disease, and they know that there's
a permentation on that molecule that is not much different,
but different enough for a new patent, and so what
they will do is they will hold on to the
other permittation and when we hit seventeen years, then they
patent to the next version and so the drug gets
(26:10):
new life. So now the old version that's off patent,
that there's a generic for that they no longer that
the insuranceys, well, now you have to take the generic.
Oh no, look we've got a brand new one. It's
got one more you know, it's got one more little uh,
you know, carbon molecule here, and this one is the
one you have to take. You should take now, and
then we go back over again with the whole Okay, well,
now insurance has to pay for the the full freight
(26:33):
because there's no there's no generic for this brand new
just slightly different in the way that's metabolized and liver
or whatever version of the molecule.
Speaker 3 (26:41):
Correct.
Speaker 7 (26:42):
These companies we're talking about, they bring a wonderful service
to our you know, our nation with treatments. But the product,
the process you just described or not referenced, is what
is flawed. And I just don't want it to be
overlooked that you know, we're making good medication, making life
saving medications. We don't want that loss in the shuffle.
(27:03):
But at the same time, we think there's root ample
room on the pharmaceutical industry's part to be able to
continue with the three P forty B program as it is,
and uh and be a you know, be a good citizen,
be it. We need to be working together on this
and do right by the patient. Ultimately, it still should
be about the patient.
Speaker 1 (27:22):
So David, what is the long term solution that you
recommend in order to make sure the patients cared for
the pharmacytaceutical companies can still get those profits so they're
able to pay the not only the shareholders, but also
for more R and D to make new, great and
wonderful medicines in the future, and you know, keep our
medical system functional.
Speaker 3 (27:42):
Yeah, and it sounds really simple.
Speaker 7 (27:44):
I mean, I think every every business entity, not for
profit and for profit needs to be in a constant
state of disruption and quality control and looking at things
better things. But that being said quite frankly, and I
may have I have, because I've worked with the three
forty B program for thirty something years, have a major bias.
(28:05):
But I think it's one of those things if it
ain't broke, you know, there's nothing to fix. So let's
try to fix something that ain't broke. And if you
go back to the original legislation, I'll make mention that
one of the major co sponsors on this was former
Speaker Newt Gingrich. I mean, you have major leadership back
in ninety two that rallied around this legislation that included
(28:27):
the three forty B drug program and you can say.
Quite frankly, I think eleven or twelve of the states
that were sponsoring this legislation that was passed, eight or
nine of them were Southern states. So I think that
speaks volume.
Speaker 1 (28:41):
So, David, what do people need to do if they
want to keep the three forty B program around? Do
they need to write through their legislators? So they need
to write to the who who needs to take action here.
Speaker 7 (28:49):
Your local congressman. It's ultimately this is absolutely a federal program.
In recent in the last few years, there has been
legislation introduced at the state level, but ultimately the program
that we've been discussing, this three forty big program, is
federal law, and it's your federal congressman, your senators, your congressmen.
But certainly I wouldn't discount your legislators hearing about it
(29:11):
as well.
Speaker 3 (29:12):
Well.
Speaker 1 (29:12):
David Pool, you've opened my eyes to a lot of
interesting nuances in how the system works and how we're
able to get funding for the things that keep us healthy,
keep us living longer. And at the same time, you know,
like you said, they're for profit industry, so how they're
able to you know, continue to fund our four one
ks all those sound like good things, and I think
they can all exist at the same time.
Speaker 3 (29:32):
Absolutely, I couldn't agree more.
Speaker 1 (29:34):
John David Pool, thank you for being my guest today
on Viewpoint Alabama.
Speaker 3 (29:37):
Thank you very much for having me.
Speaker 5 (29:38):
You've been listening to Viewpoint Alabama, a public affairs program
from the Alabama Radio Network. The opinions expressed on Viewpoint
Alabama are not necessarily those of the staff, management, or
advertisers of this station.
On Tuesday, twenty two year old Damian McDaniel of Fairfield
was charged in three separate homicides dating back to twenty
twenty three. These charges are in addition to the days
of eleven people that has already been charged with following
the hush hook around shootings last year, and other shootings
are likely connected as well. Hello, I'm John Mounts and
this is Viewpoint Alabama on the Alabama Radio Network. In
(00:23):
spite of this announcement, Birmingham still has a real crime problem.
Joining me now in our Viewpoint Alabama studios is Birmingham
attorney Scott Morrow. Scott, Welcome to Viewpoint Alabama.
Speaker 2 (00:32):
Thank you, John. Glad to be here with y'all.
Speaker 1 (00:34):
Now, of course it's not on the best circumstances because
we're here to talk about the situation going on in
Birmingham with the crime.
Speaker 2 (00:40):
And it's not good.
Speaker 3 (00:41):
You know.
Speaker 4 (00:41):
We hear the mayor talk about what he's doing, but
really I see no action action at all.
Speaker 1 (00:47):
He does say he's trying to do something about it.
He says he's trying to hire more officers, but I'm
not seeing those numbers.
Speaker 5 (00:53):
We feel confident based on the response as we've been
getting with the high attendance and the physical agility tests,
we'll wish that number in the next year.
Speaker 1 (01:01):
He's purporting that we're bringing in people, but he hasn't
really come forward with the exact number of officers hired
and how they're being trained and what they're going to
do once they are trained.
Speaker 3 (01:09):
Right.
Speaker 4 (01:09):
That was part of the Crime Commission report where they
said they needed to prioritize hiring officers. But they can
talk all day long and have studies and assessments, but
unless they ask you to get the boots on the ground.
I heard them yesterday talking about one person cannot make
a difference in crime and Birmingham, you know, insinuating that
you need the community and all this other stuff. You
(01:32):
need beat cops to work hard. I've said it before.
Reasonable suspicion and probable cause beat cops.
Speaker 2 (01:39):
It starts there, ends there.
Speaker 1 (01:41):
And also we need to untie the hands of a
lot of these officers because you can have officers, but
if they're not able to, you know, effectively enforce the law,
then what are we really doing?
Speaker 4 (01:52):
And thank you John, because that's exactly what you're going
to see Thursday at the Personnel Board of Jefferson County.
I represent an officer who made an arrest for disorderly
conduct at three o'clock in the morning, and his initial
supervisors thought it was a great arrest, good arrest, But
then you got some other people in the precinct the
day shift woke idiots that thought it was a false
(02:14):
arrest and ended up terminating the man. So come to
the Personnel Board this Friday at nine o'clock. There's going
to be a hearing. It's open to the public. Michael
Pickett will be testifying, and we're going to expose them
for their foolishness of not giving the officers the benefit
of the doubt. Exactly what you're talking about, John, tie
in the hands of these officers that when they do
(02:36):
something in good faith to enforce the law, they end
up getting disciplined, suspended, or terminated.
Speaker 2 (02:42):
It's ridiculous.
Speaker 1 (02:43):
It's always the same thing, it seems whenever you if
you've ever watched the video, like a long form video
of a bad guy doing something stupid, cop comes up
to him and says, hey, quit doing something stupid, and
he doesn't want to quit doing something stupid, and then
an argument ensues and sooner or later, the CoP's got
to take that guy down. What happens is that's like
say a twenty minute long video. But what they do
is they pull out like a three second clip of
(03:05):
the officer taking the guy by the neck and take
him to the ground and say, oh look, it's it's
police brutality. What it is is you just saw one
little snippet of a very long interaction where the officer
was acting responsibly and following his training, and you're on purpose.
You're zooming in a little tiny thing to make a
mountain of a mole hill so you can make a
point that doesn't need to be made.
Speaker 4 (03:24):
It's called manipulating the truth to a desired outcome, John,
I see it all the time, you know. Alan Treadaway
Hopefully we'll be calling in later. He's got some legislation
that he's furthering on giving the officers more authority when
they're having these idiots interfere with what law enforcement is doing.
And until the leaders like Woodfinn, a police chief, a
(03:47):
captain internal affairs, until they give the benefit of the
doubt to the officers, you're going to have bad crime
in Birmingham. And that's just the way.
Speaker 1 (03:54):
It is and all of us, the citizens, the ones
who don't commit the crime are the ones who are
going to pay for it. And now joining us on
his way down to Montgomery to work on some legislation
along the same lines, is Alan Treadaway. Alan, welcome to
the show. Good morning, Good morning. So what is this
legislation that you're working on.
Speaker 5 (04:10):
Well, there's a number of pieces of legislation of Montgomery
dealing with violent crime in Alabama. A lot of folks
don't realize that we got four hundred and forty plus municipalities,
sixty seven counties and two cities are responsible for almost
fifty percent of the violent crime occurring.
Speaker 3 (04:29):
In the state of Alabama.
Speaker 5 (04:29):
That's Montgoment and Birmingham, with Birmingham.
Speaker 2 (04:31):
Leading by far.
Speaker 5 (04:33):
So the issue with me has been the last couple
of years has been transparency, the critical staffing levels in
both of these departments, especially Birmingham, and I hear from
officers on the street every day they need help, they
need relief. We can move money, and we can come
up with all the type of different ideals we want,
(04:54):
but unless we go out there and implement them, bring
folks onto the street, put these officers out there protecting
the public. You're just going to see more and more
of what we're getting, which is just out of control
violent crime.
Speaker 1 (05:08):
Well, Scott Marrow, why is it that it's so hard
to find officers who want to be This is kind
of a I realize socratic question here. Why is it
so hard to get officers to join the Birmingham Police Force?
Speaker 4 (05:19):
Well, Allen and I both know this as members of
the FOP one and being involved in disciplinary matters and training.
It seems like lately they've turned a lot of the
training issues into disciplinary issues and that's bad for morale.
They're terminating people, they're suspending people instead of giving a
mentor and training. And nobody really just wants to come
(05:39):
to Birmingham and these big cities to police because they're
not getting support from their leadership. You're getting great results
in the outlying areas because some of the great leaders
Birmingham had have gone to Leeds, have gone to pel City,
have gone to Mountain Brook. These police departments are flourishing.
They have plenty of police there, for example, with Nick Dervis,
(06:01):
Jersey's great leadership. So it's leadership, John, and the lack
thereof and the mentoring Alan, Yeah, you touched on.
Speaker 5 (06:09):
A very important component of what's causing all this and
the revolving door leadership in the City of Birmingham over
the seven years. The last seven years has caused a
great instability there. The National Chief of Police Association last
year came out and said the number one reason officers
leave the department is not pay, it's leadership. When you
look at approximately twenty three these officers are currently there,
(06:33):
have been there seven eight years, have had twenty three
chiefs and deputy chiefs over the last seven and a
half years, that is an issue that must be addressed.
I'm looking at legislation to put some of these appointments
back into the merit system and when you hire somebody
or terminate somebody, this legislation for transparency. Who will make
you go before the full body city council for the
(06:55):
reasons why you want to hire and the reasons why
you want to terminate, because I think far too all
often folks are hired and they've got great crime fighting
strategy plans and great retention recruitment plans, but if not
given the authority to implement or the funding, they just
sit on the table and you get more of the same.
Speaker 1 (07:14):
And so that's the reason Alan, why you have some
of the legislation you're proposing. If enacted, how soon could
we see something change.
Speaker 6 (07:22):
Well, provided we get it past, it could happen within
the next sixty to one hundred and twenty days given
what the legislation actually says on implementation, So pretty.
Speaker 1 (07:33):
Soon, Alan cred Away, I know you got to run
because you're on your way to Montgomery to do some
of the people's work down there. I appreciate you joining us.
You know a lot has been done. I've lived in
this area since nineteen eighty seven, and I remember when
I was younger. Birmingham used to be a place where
you only went downtown to two things, maybe to work,
but you left by the time some went down, or
(07:54):
you bought your drugs and got shot and that was it.
And so everyone's stay new to stay away from Birmingham.
And we've made a lot of improvements downtown from in
terms of we've got the Barons downtown now they are
building the new stadium, They've got another the new Amphitheater,
they got the stadium down there. They've got a lot
of great stuff in downtown. But yet there's a lot
of people who don't want to come in from over
the mountain. And there's the question of why. And I
(08:17):
tossed that to you, Scott Morrow, thank you for joining us.
Why don't people want to come downtown?
Speaker 2 (08:21):
John?
Speaker 4 (08:21):
Just for context, I started policing in eighty six South Precinct.
I walked South south Side five points south. I've policed
in West precinc And I've been practicing los since two
thousand and seven, been involved in the police issues ever
since almost thirty years. Why don't people want to come
downtown because they're afraid. They're afraid they're going to be accosted.
(08:43):
They don't see that beat cop stopping the individual that
is hanging around the corner, the bum, whatever you want
to call it, the person that looks suspicious. We need
the beat cop to stop the suspicious people. And when
you're trained right and you're mentald, you're not violating people's
constitutional rights. There was a caller wanted to talk about
(09:06):
qualified immunity and the different things that protect police. But
you have to show the police that when they do
approach somebody and they're looking at reasonable suspicion, probable cause,
why are you here at three o'clock in the morning,
just standing here doing nothing. Why are you milling around
these businesses that are closed, Why are you getting in
(09:27):
the street and look like you're stopping cars or whatever.
Speaker 2 (09:30):
The reason is, we.
Speaker 4 (09:32):
Have to have the officers approach these individuals, be able
to figure out what they're doing, and if they find
out they're doing something illegal, to arrest them and support
them when they take them down when they don't want
to be arrested. And it's not excessive for us. It's policing.
Speaker 1 (09:48):
You know, you said something interesting that piqued my interest.
A while back. I was on University and University I
think it was like nineteenth maybe twentieth, and this lady,
she was a very large lady, and I believe she
had pulled looked like maybe a nurse's outfit out of
a dumpster or something like that. She was worrying, and
she walks into traffic, into the middle of the intersection, right,
(10:08):
and she walks in the Millionaire and she just starts
stopping cars like you said, stop. She starts holding her
hand up, stopping all four directions, stopping all the cars.
And then she starts going up to cars, banging on
the windows and yelling at the people inside the cars
and no, he knows what to do. And I was like,
I don't know, so I just kind of slowly started
to pull out. And then she comes running up to
my car, so so I can, you know, kind of
go for it. She runs towards my car, hits the car,
(10:29):
bounces off, lands on the ground, and then and then
I see her rolling around on the ground. I'm thinking,
oh boy, she's gonna complain I hit her or something.
But I imagine this happens more more times than I realized.
That somebody comes up into harasses people in car.
Speaker 2 (10:40):
Right, And the answer to that, John is you got
the beat cop. If you're fully staffed.
Speaker 4 (10:44):
They're riding around and they would probably see that before
it even happened, and they would approach that individual and say.
Speaker 2 (10:50):
What's going on? Is there's something I could do to
help you?
Speaker 3 (10:52):
You know?
Speaker 4 (10:52):
It sounds like somebody had a mental probably yeah, And
you know, so that's the answer is to have enough
police in your city that are properly trained, that are
going to be assertive, not be afraid to be assertive,
go up to these individuals and find out what's going on.
If there's a crime being committed or about to be committed.
They detain them and figure it out. But you have
(11:14):
to have the officers the will. Don Lupo and I
used to talk all the time. Everybody knows who Don
Lupo is, but we used to say, you have to
have the will to do it, and if you don't
have the will to do it, then it's not going
to be done. So let these officers who want to
be assertive get out there do their job.
Speaker 2 (11:33):
You know, Randall, we're talking right to you. Man.
Speaker 4 (11:36):
Hire these police officers. Mentor these police officers. Stop disciplining
them when they're trying to do and fight crime. It's
not about discipline, it's about training.
Speaker 1 (11:48):
Let's do that and how they're back. You know, when
something happens, don't assume that the purp is the good guy.
Speaker 4 (11:55):
No, you have to give the officer the benefit of
the doubt. You know, those of us that have been
involved in police for so long, when we review these
individual cases, we know when there's somebody who's doing something
maliciously or you know, out of meanness, or is it
a tactical error or whatever, you got to give the
officers a benefit of the doubt, and you have to
have warriors out there.
Speaker 2 (12:15):
You have to have warriors.
Speaker 4 (12:16):
You can't have well, I'm not going to say females
shouldn't be police officers, because there's some fine female police officers.
Speaker 2 (12:25):
But you have to be able to fight.
Speaker 4 (12:26):
You have to be able to take these individuals into custody,
and if you can't be afraid to do it, and
so you know, as a team, if we all get together,
Randall's right, it does take more than one. But you
got to start with that beat cop randal. You got
to start with that beat cop and support that beat
cop that'll do it.
Speaker 1 (12:46):
And I think also you need to enforce even the
simple laws, the little laws about littering, the little laws
like loitering, all the little laws that just go unpunished,
because what happens is when you don't, when you don't
get people for doing the little stuff, then they feel
like in bold and they can do more. They can
hassle people, and then they can break into cars and
eventually shoot people. It escalates.
Speaker 4 (13:05):
And right now, John, they just don't have the numbers
to do all that, you know, because it takes time
to arrest people take them to jail. So they're kind
of letting all that stuff slide, and it's just not
good for Birmingham. Birmingham can be better, Montgomery, all of
these bigger cities if they just support the police. All
the incentives they've given on hiring are great, but hire
the right ones, mentor them, don't discipline them.
Speaker 1 (13:27):
Would you want to be a police officer in the
Birmingham if you could, if you were younger, and would
you want to go be a police officer?
Speaker 2 (13:32):
Yeah?
Speaker 4 (13:32):
Birmingham's a great place to work as a police officer
because you have all the resources, you have all the
backup that you needed. When I worked, we had sixteen
to twenty officers on a shift at eight hour shift
overnight eleven to seven, and we were tight. We were
like a family and work together.
Speaker 1 (13:48):
Not them. But now would you want.
Speaker 4 (13:49):
To be well, yeah, because I want a change. I
would want to be part of the change. You need
people like me to get in there and help the change.
So yeah, but it's difficult. It's a lot different now.
Speaker 1 (14:01):
Yeah, I absolutely hear you, and I feel for these
officers because they have a lot ahead of them to
try and overcome in the city. Want to thank you
so much for joining me. Attorney Scott Morrow. This is Viewpoint,
Alabama on the Alabama Radio Network. In America, we have
an enormous healthcare industry that we believe works to keep
us healthy, but some say not everyone is well on
(14:23):
the up and up. Today, I'll let you decide. Hello,
I'm John Mount and this is Viewpoint, Alabama on the
Alabama Radio Network, and today we'll be speaking with David Pool.
He is with the AIDS Healthcare Foundation where he works
in the area of public policy and legislative efforts for
the Southern Bureau. David, Welcome to Viewpoint.
Speaker 3 (14:40):
Thank you, David.
Speaker 1 (14:41):
There's a great many afflictions that we've dealt with throughout
the years, and AIDS is one of them that in
the early eighties it was like a death sentence. But
through a lot of research and so forth, over the
last forty years, it's gotten a lot better and there
is a lot of great treatments out there. I'll let
you take it from there. What are some of the
treatments that are now available for people that didn't used
(15:03):
to be around?
Speaker 7 (15:04):
Really, from nineteen eighty one to nineteen ninety six, there
were no treatments that were considered viable. So we did
what we could as a community as a nation to
try to address the epidemic. But in ninety six things
changed greatly. With some research and development with some major companies,
they brought forth what became known as the cocktail, and
(15:25):
the cocktail was simply several drugs combined as anti retrovirals
that would actually bring people hope for a better future,
for a life. Now jump another twenty plus years, we
have single tablet regimens and we also have injectables that
don't even have to be taken daily, and for the
most part, people living with HIV will live a long life,
(15:49):
just as anyone else would.
Speaker 1 (15:50):
And David, these drugs are made available to these people,
but they're not free. Somebody has to pay for them.
So what's the cost of one of these regiments. And
it's not just like it's a pill, it's a pill
every day or every other it's a treatment ongoing for
the rest of your life.
Speaker 7 (16:05):
Right, But that's correct at this point, either every day
or as I mentioned, there's a new regiment and injectable
that's not as frequent as daily.
Speaker 1 (16:14):
But it's still something else that has a significant cost associated.
Speaker 7 (16:19):
Absolutely, the costs are in the thousands and thousands of dollars.
There's and especially when a company brings a new drug
to market, you'll see you know, prices. I mean an
example would be something somewhat related. When the hepatitis Secure
was brought to market in twenty thirteen, the costs, the
wholesale acquisition costs was in the like ninety to one
(16:41):
hundred thousand dollars for an eight week treatment.
Speaker 1 (16:43):
And that's a lot of money. But somebody has to
and you can't put a price on a life, of course,
but somebody does have to still pay for it. So
a lot of times that goes to the insurance company,
if somebody has insurance, if they don't have insurance. Sometimes
there's government programs, and there's a lot of there's a
lot of pharmacies and pharmaceutical manufacturers who they have programs
(17:03):
that help support people who are on one of these regimens.
Speaker 7 (17:06):
Right, Pharmaceutical companies often have what they call a patient
as systems program.
Speaker 1 (17:10):
Is there just one in particular that makes the aids
drugs or are there a multitude of them?
Speaker 7 (17:15):
I would say the leader is probably Gillyad Science. It's
either of Foster City, California.
Speaker 1 (17:21):
And these drugs are they still on patent or are
their generic equivalents These days, they're off.
Speaker 7 (17:26):
There are off patent drugs. But as with you know,
so many things in the pharmaceutical industry, generally speaking, the
newest drugs are the ones that have the least side
you know, the best side effect profile, the least side effects,
and are the most efficacious, the most effective and treating
the condition you're you know that you are treating. So
(17:46):
but there are generics, and that goes with all chronic
diseases and infectious diseases. And your generics sometimes are very
proven and you can take them, But then there are
also other circumstances where the side effect profiles are much
worse and if adherence is better with the more expensive drug,
you'll also want to go with the more expensive drug,
the newer drug.
Speaker 1 (18:06):
One of the other things that can be cost prohbitive
for people is even when there is a generic, the
generic is still pretty expensive. Like, okay, the name brand
might cost let's say ten thousand dollars a month, Well,
the generic might only cost three thousand dollars a month month,
which is a lot cheaper, but still for most people
that's out of reach. But the name brand made by
(18:28):
a manufacturer, let's say Gillia. Gillia will offer some sort
of copay assistance program to work with their insurance. However,
when if you try and use the generic, well, there's
no copay assistance for that, so you're on the hook
for the entire three thousand dollars. So a lot of
times there's a shell game that's sort of played between
the insurance company and the drug manufacturer and the patient
(18:50):
in terms of how are you going to pay for
this very expensive medication?
Speaker 7 (18:53):
Right, that's right, John, And what the group of people
that you just described, I think are all from the
world working class, especially here in the South and rural
working class people often either underinsured or uninsured completely. And
that's where our public health safety nets come in to
help with exactly what we're describing, which are the very
(19:14):
expensive medications and care that has to go alongside with
those treatments. So if it weren't for that safety net
that's been intact since the very beginning of the HIV
epidemic and all the other conditions that are covered, we'd
have a lot more people just simply dying for lack
of care. Completely. That healthcare safety net in the United
(19:34):
States is critically important.
Speaker 1 (19:36):
And that the reason why I have you on is
not just to talk about AIDS, although that is the
area where you have the most experienced currently, It's a
wider thing because there are a large number of drugs
that treat any number of chronic dises life threatening diseases
in some cases, and every one of these cases there's
a drug manufacturer involved, and then there's the patient. There's
(19:57):
the insurance company in the middle, and you're always kind
of stuck if you're the patient kind of dealing with
this situation. And most of these patients, David, don't They
have a they've got a full time job, or they
have other things going on in the world. They can't
make their entire life about chasing down the insurance company
to pay to pay for the drug or figure out
what the copay assistance program is like. And yet they're
(20:19):
left kind of in need of an advocate.
Speaker 2 (20:22):
Yeah.
Speaker 7 (20:22):
Absolutely, and in the excuse me, in the HIV universe
for sure. But this again goes for chronic conditions and
other infectious diseases. Is that you often have a case
manager that will be assigned to you either by the
care provider that you're seeing or with the insurance company,
or a combination of both. So you do have that
from the social work perspective, which is critically important oftentimes
(20:45):
with a population like we're discussing right now. Another thing
I'd like to introduce and mention that's critically important to
the cost issue is a program called the three forty
B Drug Discount Program that was introduced in nineteen ninety
two under the Veterans Care Act, and it actually is
(21:05):
a critical, critical aspect of that safety net. I keep
referencing the public hospitals, but federally qualified community health centers,
the nonprofit clinics that see folks that are under insured
or uninsured that will oftentimes be able to write off
that expensive copay or the drug itself can be covered
(21:27):
under that three forty B program. The three forty B program,
and I'll allude to you if you want me to
get into greater detail, basically provides a mechanism by which
all of these entities that we're talking about that safety
net can actually reinvest money that they get from the
drug savings that comes through the three forty B drug program,
(21:49):
and that takes that pressure you describing off of the
patients that might otherwise be or have to pay those
expensive copays or outlite for the entire price.
Speaker 1 (22:00):
At the drug And a lot of these rural hospitals especially,
they depend on these three forty B programs.
Speaker 2 (22:06):
Right.
Speaker 3 (22:07):
It's a huge source of revenue.
Speaker 7 (22:09):
And the good news is it not doesn't fall on
the US taxpayer. It actually is really a product of
that law that was passed in ninety two that required
negotiations between the drug manufacturers and the federal government. And
then those savings are passed along to the covered entities.
And there are about thirteen covered entities that are part
(22:31):
of that safety that I keep referencing, and they all
receive that pricing. And then if they build insurance and
the insurance is paying them based on a usual and
customary price that was contracted between them and the provider,
then that revenue comes back to the nonprofit hospital or
community health center or clinic and they can then reinvest
(22:52):
it back in the care and treatment of those patients.
Speaker 1 (22:54):
And this is something that affects US here in Alabama
as well.
Speaker 3 (22:57):
Right, Yeah, absolutely true.
Speaker 7 (23:00):
Again, the three forty B program has helped to keep
those hospitals and community health centers open.
Speaker 3 (23:05):
If you do not have that.
Speaker 7 (23:07):
Once you end up with that as a last case
or a last resort, you'll have a patient, as you say,
drives a great distance to an emergency room. And we
know when this country hands down the single most expensive
care delivered as in an emergency room, and that is
not where you want people seeking care. So yeah, it's
(23:27):
a great case for the three forty B drug program.
Speaker 1 (23:29):
Not to mention the fact that while people are at
the er basically getting treated for the common flu, do
you have people in there who also desperately need urgent
medical care, like say, injured in a car accident, and
now their care is kind of they have to kind
of triage nurses to figure out who is then most
need of care where it would be much better handled
by a physician in an outpatient setting if it's an ongoing,
(23:52):
you know, chronic disease that you're just having to treat
every you know, say month or something like that.
Speaker 7 (23:57):
Exactly, if you're a Royal Alabama and you're having a
heart attack, you want to be able to go into
that emergency room and get immediate care, and your main
goal is going to be you know, saving your life,
being alive and then getting better afterwards, and again the
program that I keep referencing, the three forty B program
helps make that happen in these rural settings.
Speaker 1 (24:17):
Now is this program, so it's a national program. The
federal government funds this.
Speaker 7 (24:22):
That is well, it's funded by the pharmaceutical industry, quite frankly,
the industry that has robust profit margins. And so I
might say that's again going back to my comment about
it's not on the backs of the taxpayers. The only
expense that really is a tax this program related to
government is the administration, which is a minuscule portion of
(24:44):
the revenue that actually goes back to these safety net providers.
Speaker 1 (24:48):
So then who has a problem with it? So it
sounds like the government shouldn't have a problem because they're
not having to pay very much other than this administration,
and they love administration at the government. So who is
it who has a problem with this? Is it the
pharmaceutical companies?
Speaker 7 (25:00):
As we know in this great country, we're a capitalist country,
and we have stockholders, and they're stockholders that own stock
in these pharmaceutical companies, and of course they want to
see those stockholders get great returns. That being said, this
is a minuscule erosion of their margin. But it's an
easy it's low hanging fruit for the pharmaceutical industry. So
(25:22):
I would say they're the number one, you know, con
against the.
Speaker 3 (25:25):
Three forty B programs.
Speaker 7 (25:27):
They bring new drugs to market, there's R and D,
but they also have a nice habit of doing what
they call evergreening. They don't always bring the newest product
to market, you know, get it out there until the
older drug has ever greened and the seventeen year patent
life has expired. And that's very unfortunate.
Speaker 1 (25:48):
I know. One of the things a game that the
manufacturers will play is they will come out with a
molecule that treats the disease, and they know that there's
a permentation on that molecule that is not much different,
but different enough for a new patent, and so what
they will do is they will hold on to the
other permittation and when we hit seventeen years, then they
patent to the next version and so the drug gets
(26:10):
new life. So now the old version that's off patent,
that there's a generic for that they no longer that
the insuranceys, well, now you have to take the generic.
Oh no, look we've got a brand new one. It's
got one more you know, it's got one more little uh,
you know, carbon molecule here, and this one is the
one you have to take. You should take now, and
then we go back over again with the whole Okay, well,
now insurance has to pay for the the full freight
(26:33):
because there's no there's no generic for this brand new
just slightly different in the way that's metabolized and liver
or whatever version of the molecule.
Speaker 3 (26:41):
Correct.
Speaker 7 (26:42):
These companies we're talking about, they bring a wonderful service
to our you know, our nation with treatments. But the product,
the process you just described or not referenced, is what
is flawed. And I just don't want it to be
overlooked that you know, we're making good medication, making life
saving medications. We don't want that loss in the shuffle.
(27:03):
But at the same time, we think there's root ample
room on the pharmaceutical industry's part to be able to
continue with the three P forty B program as it is,
and uh and be a you know, be a good citizen,
be it. We need to be working together on this
and do right by the patient. Ultimately, it still should
be about the patient.
Speaker 1 (27:22):
So David, what is the long term solution that you
recommend in order to make sure the patients cared for
the pharmacytaceutical companies can still get those profits so they're
able to pay the not only the shareholders, but also
for more R and D to make new, great and
wonderful medicines in the future, and you know, keep our
medical system functional.
Speaker 3 (27:42):
Yeah, and it sounds really simple.
Speaker 7 (27:44):
I mean, I think every every business entity, not for
profit and for profit needs to be in a constant
state of disruption and quality control and looking at things
better things. But that being said quite frankly, and I
may have I have, because I've worked with the three
forty B program for thirty something years, have a major bias.
(28:05):
But I think it's one of those things if it
ain't broke, you know, there's nothing to fix. So let's
try to fix something that ain't broke. And if you
go back to the original legislation, I'll make mention that
one of the major co sponsors on this was former
Speaker Newt Gingrich. I mean, you have major leadership back
in ninety two that rallied around this legislation that included
(28:27):
the three forty B drug program and you can say.
Quite frankly, I think eleven or twelve of the states
that were sponsoring this legislation that was passed, eight or
nine of them were Southern states. So I think that
speaks volume.
Speaker 1 (28:41):
So, David, what do people need to do if they
want to keep the three forty B program around? Do
they need to write through their legislators? So they need
to write to the who who needs to take action here.
Speaker 7 (28:49):
Your local congressman. It's ultimately this is absolutely a federal program.
In recent in the last few years, there has been
legislation introduced at the state level, but ultimately the program
that we've been discussing, this three forty big program, is
federal law, and it's your federal congressman, your senators, your congressmen.
But certainly I wouldn't discount your legislators hearing about it
(29:11):
as well.
Speaker 3 (29:12):
Well.
Speaker 1 (29:12):
David Pool, you've opened my eyes to a lot of
interesting nuances in how the system works and how we're
able to get funding for the things that keep us healthy,
keep us living longer. And at the same time, you know,
like you said, they're for profit industry, so how they're
able to you know, continue to fund our four one
ks all those sound like good things, and I think
they can all exist at the same time.
Speaker 3 (29:32):
Absolutely, I couldn't agree more.
Speaker 1 (29:34):
John David Pool, thank you for being my guest today
on Viewpoint Alabama.
Speaker 3 (29:37):
Thank you very much for having me.
Speaker 5 (29:38):
You've been listening to Viewpoint Alabama, a public affairs program
from the Alabama Radio Network. The opinions expressed on Viewpoint
Alabama are not necessarily those of the staff, management, or
advertisers of this station.
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