Tag Archives for PhRMA

Health advocacy groups oppose groups against drug price negotiations

Published in RINewsToday on August 21, 2023

As supporters of President Biden’s Inflation Reduction Act (IRA) celebrate the one-year anniversary of the passage of this historic legislation, health advocacy groups gathered last week in Austin, Texas, Washington, D.C., Chicago and New York City to publicly oppose and call on the U.S. Chamber of Commerce, Pharmaceutical Research and Manufacturers of America (PhRMA) along with drugmakers to withdraw their lawsuits to block the IRA’s drug price negotiation provisions.  They instead called for the immediate lowering of the prices of brand-name pharmaceuticals.

At press time, Merck & Co., Bristol Myers Squibb Company, Janssen Pharmaceuticals, Astellas Pharma US, PhaRMA, and the U.S. Chamber of Commerce have filed lawsuits arguing that the price negotiation program is unconstitutional and violates the Constitution’s separation of powers clause by giving the U.S. Department of Health and Human Services (HHS) discretion over a maximum fair price for any given drug selected for negotiation.  These lawsuits charge that the Centers for Medicare & Medicaid Services’ (CMS) price controls would force drug manufacturers to pull back on developing new drugs, jeopardizing medical breakthroughs for individuals with life-threatening and chronic illnesses.

The filed legal suits come weeks before Sept. 1 when CMS is scheduled to publish a list of the first 10 drugs that will be subject to negotiations. By Oct. 1, the drug companies must declare whether they will participate in negotiations or face steep financial penalties for not negotiating. The lower negotiated prices will not take effect until 2026.

Public Citizen, a Washington, DC-based nonprofit consumer advocacy group along with other health care advocacy groups including Patients for Affordable Drugs Now, Protect Our Care, Families USA and Doctors for America and AARP and the AARP Foundation have filed amicus briefs supporting HHS’ position that the motion for a preliminary injunction requested by the Chamber and the other plaintiffs in that case should be denied.

At the Washington, D.C. press conference, Robert Weissman, president of Public Citizen delivered a petition signed by 150,000 individuals to the U.S. Chamber of Commerce demanding that all court suits be dropped. 

Public Citizen, Social Security Works, and more than 70 health and consumer organizations also sent letters to the prescription drug corporations, demanding those corporations drop their lawsuits and begin negotiating lower drug prices.  The letter cited how drug corporations routinely charge Medicare beneficiaries in the United States twice or more of what they charge patients in other large, wealthy countries – even in cases where U.S. taxpayers supported the drug’s development.

“It’s a disgrace that the U.S. Chamber of Commerce is fronting for Big Pharma [against the interests of the mom-and-pop businesses it purports to represent,” said Robert Weissman. “Patients, small businesses, large businesses, state and local governments, and the federal government all have a shared interest in curtailing Big Pharma price gouging, as the Inflation Reduction Act’s drug price negotiation provisions will do.”

“The lawsuits filed by the large pharmaceutical corporations to overturn Medicare drug price negotiation authority demonstrates that there is no bottom to big pharma’s greed, charges Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare. “It isn’t enough that revenue to U.S. drug corporations was over $1 trillion in 2022.  It isn’t enough that big pharma benefits from the $54 billion spent in taxpayer dollars per year on pharmaceutical research. It isn’t enough that the 2017 Trump tax cut bill lowered average tax rates of the big pharmaceutical companies by more than 40 percent. It isn’t enough that pharma’s profit margin is 15 percent to 20 percent while the average profits of the nation’s largest 500 corporations ranged between 4 percent to 9 percent,” he says.   

“Americans have had enough of big pharma’s greed – and while I am sure the price gougers won’t stop putting profits before people – we urge the industry to drop this unconscionable lawsuit against the authority to negotiate prescription drug prices,” he adds.

“Big drug companies and their allies are fighting furiously to stop Medicare from negotiating drug prices so they can keep charging Americans the highest prices in the world. Allowing these distractions to derail implementation of the law would not be in the public’s interest, especially for older adults who have waited far too long for affordable drug prices. Medicare drug price negotiation represents a historic opportunity to access lifesaving drugs for millions of Americans at a time when they need them the most,” said William Alvarado Rivera, Sr. VP for Litigation at AARP Foundation.

“Pharmaceutical corporations have long shown that they care about nothing but profits. So, it is not surprising that they are attempting to use the courts to subvert the will of the people and block Medicare from using its bulk purchasing power to get better prices,” said Alex Lawson, executive director of Social Security Works. “The law is incredibly clear, as is the will of the American people: Medicare drug price negotiations are legal and incredibly popular. Everybody wins except the greedy CEOs who see their drug price extortion rackets shut down.”

Protests Call for the Immediate Dropping of Court Suits 

On Aug. 16, 2023, in Washington, D.C., the “Drop Your Suits, Drop Your Prices,” a press conference/rally was held outside the headquarters of the U.S. Chamber of Commerce in Washington, D.C., and in New York City outside of the offices of Jones Day, and outside the Federal Courthouse in Austin where some of the drug makers are launching their legal attacks on Medicare, and at the offices of Astellas in Chicago.

At the Washington, DC press conference, a digital billboard advertising on a parked box truck set the stage for the event. In big bold red and gold letters the message read: “The Chamber of Commerce and Big Pharma are suing to keep your drug prices high.  They must drop their lawsuits and lower drug prices.”

Public Citizen’s Weissman kicked off the noon time press conference, stating, the U.S. Chamber of Commerce claims to represent small businesses but these businesses are bearing the brunt of paying for the high price of drugs.  Because of this, 3 in 10 Americans are rationing their drugs, he says. 

Weissman asked why is the U. S Chamber of commerce opposing the interests of small and large businesses? He charges that the nation’s largest lobbying group for the nation’s businesses is “is shamefully fronting for Big Pharma and companies that have an interest in overturning this law” that requires Big Pharma to negotiate with Medicare on drug prices. “But we are here today to tell Big Pharma were not going to let you get away with it,” he says.

“We’re going to win. We’re going to win the in the courts. We’re going to win on the streets. This price negotiation is going to go forward. It’s the beginning not the end in getting big Pharma price gouging under control, making sure medicines are affordable for everyone who needs in this country,” predicts Weissman.

Like all the speakers, 22-year-old Jacqueline Garibay called on the U.S. Chamber of Commerce, PhaRMA, and the other pharmaceutical companies to immediately drop their lawsuits to lower drug prices.  She was diagnosed with Ankylosing Spondylitis, an autoimmune disorder that primarily affects her spine and has spread to most of her major joints. Without expensive biologic medications, Garibay’s spine could fuse and leave her unable to walk by the time she graduates from George Washington University.  

In the last four years since her diagnosis, doctors have put her on four biologic drugs, each one with a price tag ranging from $5,000 to $13,000 every month, trying to find one that will work for her.  There have been times when Garibay has had to forego refilling her prescriptions because of financial difficulties resulting from having to pay for her rent, groceries, and tuition at the same time. “It’s “absolutely terrifying,” she says, fearing that without taking these medications she will risk losing the ability to walk.  

“The new drug price reforms are projected to save patients like her tens of billions of dollars. “It will help me have a future I can afford, a future where I can pursue all my dreams without being financially undermined for the sake of my health condition,” she says.

Laura Marston, a 41-year-old diagnosed with Type 1 Diabetes over 27 years ago at age 14, has seen the price of her insulin soar from the price of a vial for $ 21 to over $300.  “No vial costs Eli Lilly less than $5 to make,” says the resident of Washington, D.C. 

Marston picked up her insulin prescription from the pharmacy a week ago. The price for a three-month supply of seven vials that will enable her to live was $ 2,267.99. “That’s immoral, that’s inhuman and that’s flat out wrong,” she said.

“My message to Eli Lilly, Novo Nordisk, Sanofi and the Chamber of Commerce is lower your insulin prices, or we will do it for you in the form of federal price caps legislation. The 7 million Americans who rely on insulin to level not-stop raising our voices until we no longer have to choose our money or our lives,” she says.

Arthur Blair, a patient advocate for Spaces in Action, described how a debilitating disease forced him to quick his job. What do you do when you don’t have money, not even enough to pay for high cost of drugs,” he asked. 

“Pharma has proven with this latest action [attempting to block the negotiation of drug prices] that they put unreasonable profits before the people. They don’t mind knowing that people are done because they are unable to obtain prescription drugs that would easily save their life and eliminate easier suffering,” charges Blair.

According to HHS, as of June 2021, about 48 million Medicare beneficiaries are currently enrolled in plans that provide the Medicare Part D drug benefit. Last year, Congress came together begin putting the brakes on spiraling drug costs by passing legislation that allows Medicare to negotiate for lower prices.  

Currently drug prices are higher in the U.S. than other countries because Medicare doesn’t negotiate prices with drug makers like other countries do. Because the practice of negotiating drug prices was banned in 2003 under the law that created the Medicare Part D prescription drug benefit, 77 percent of all Medicare beneficiaries pay more for prescription drugs than these nine countries — Austria, Australia, Belgium, Canada, Germany, Japan, Sweden, Switzerland and the United Kingdom (This was documented by a 2021 study of the Rand Corporation.) 

Although the “Drop Your Suits, Drop Your Prices” press conferences held around the nation drew small crowds, the importance of these gatherings is the message they sent to the nation, that is “It’s time to stop blocking a law that puts money into the pockets of seniors instead of the bank account of drug makers.”

To watch the https://www.youtube.com/watch?v=w_8WHFv7oL4

To read why the U.S. Chamber of Commerce is suing the U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services to challenge drug price negotiations, go to https://www.uschamber.com/lawsuits/why-were-suing-hhs-and-cms-to-challenge-illegal-price-controls.

To read an amicus brief submitted by Public Citizen, Patients for Affordable Drugs Now, Protect Our Care, Families U.S.A and Doctors for American, supporting HHS’s position that the motion for a  preliminary injunction requested by the Chamber and the other plaintiffs in that case should be denied, go to https://www.citizen.org/wp-content/uploads/35-1-Proposed-amicus-brief.pdf.

To read AARP and AARP Foundation’s full amicus brief, go to https://www.aarp.org/content/dam/aarp/aarp_foundation/2023/dayton-area-cha mber-of-commerce-v-becerra-brief.pdf.

Wake up call on spiraling brand-name drug prices 

Published in RINewsToday on August 14, 2023

By Herb Weiss

A new pharmaceutical drug price report that is both timely and overdue has been released by AARP’s Public Policy Institute, following on the heels of the Centers for Medicare & Medicaid Services (CMS) releasing in June, which revised guidance for the historic Medicare Drug Price Negotiation Program.  

This report details the list prices for the 25 brand-name drugs with the highest total Medicare Part D spending in 2021, noting that prices have increased by an average of 226%—or more than tripled—since they first entered the market. Those 25 drugs were responsible for $80.9 billion in total Medicare Part D spending in 2021, about 37% of the total spending, and were used by more than 10 million Part D enrollees.  It noted that, on average, nearly 60% of their current list price was due to price increases after the product entered the market.

The price of Enbrel, used to treat rheumatoid arthritis and psoriatic arthritis, has increased by 701% since coming to market in 1998, and the price of Januvia, used to treat diabetes, has increased by 275% since entering the market in 2006.

Overall, the lifetime price increases ranged from 20% to 739%, and all but one of the drugs’ lifetime price increases greatly exceeded the annual rate of inflation over the same period of time. 

Brand-name drug prices increase faster than inflation has – for decades

“Brand-name drug prices have increased dramatically faster than inflation for decades,” said Leigh Purvis, Prescription Drug Policy Principal, AARP Public Policy Institute, and author of the report.  “The median price of a new brand-name prescription drug is now approximately $200,000 per year, so even relatively small percentage price increases can translate into thousands of dollars and put life-saving medications out of reach of the patients who need them,” she said. 

“We know that there is lot of media attention on individual drug prices that take place year after year.  However, a lot less attention is paid to how those price increases are often building on top of a long line of price increases and how those relentless price increases add up over time,” says Purvis, during a press call to journalists scheduled on the day of the report’s release.

“These findings have huge implications for the people that AARP represents, many of whom need prescription drugs to help them stay well,” Purvis said. “People on Medicare prescription drug plans take on average of between 4 and 5 prescription drugs per month and their drugs are increasing covered using coinsurance where you pay a percentage of the drugs price instead of a flat co-pay.  In fact, across the country more and more people are facing cost sharing directly affected by drug price increases, whether it is by coinsurance or simply before they meet their deductible.  Millions of other people don’t have health coverage and are having to absorb the cost associated with growing drug prices on their own,” she said.

“Our analysis shows that drugs that have been on the market for twenty years or more have seen an average lifetime price increase of 592 percent.  In real terms this can be the difference of thousands of dollars for one person and enough to force the trade-offs that we often hear about, like choosing to put food on the table or being able to pay for gas,” notes Purvis.

“There is no justification for drug companies to engage in these type of price increases every year they are on the market, particularly increases that are so much higher than the price increases for other goods and services,”  adds Purvis. 

CMS releases revised guidance for negotiating with drug manufacturers 

Congress recently passed the Inflation Reduction Act (IFA), a federal law requiring drug companies to pay a penalty to Medicare if their drug’s price increases faster than the rate of inflation. The law will also give Medicare the ability to negotiate lower drug prices with drug companies for the first time. CMS is expected to announce the first 10 drugs selected for negotiation by September 1st, and the negotiated prices will become available in 2026.

“This historic law cracks down on the big drug companies and [will bring] real relief to millions of seniors who have been struggling with out-of-control prescription drug prices,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy and Engagement Officer. “American families simply can’t afford to keep paying the highest prices in the world for the medications they need.”

Last March, CMS issued initial guidance to seek comments on its historic Medicare Drug Negotiation Program.  The agency received over 7,500 comments from consumer, patient groups, drug companies and pharmacies.  In June, CMS released its revised guidelines detailing the requirements and parameters of how the agency will oversee the new program.

“Issuing final guidance for the Medicare Drug Price Negotiation Program is an important “next step” in controlling spiraling high drug prices, says AARP’s LeaMond, noting that Medicare’s new buying power will get a better price for Medicare beneficiaries, saving the program billions of dollars and making prescription drugs more affordable.

Opposition, of course

At press time, the Pharmaceutical Research and Manufacturers of America (PhRMA), the leading industry lobby group for pharmaceutical companies, along with a group of pharmaceutical companies and trade groups, are suing the U.S. Health and Human Services to block the implementation of the Medicare Drug Price Negotiation Program established by the Inflation Reduction Act enacted by President Biden last August. The U.S. Chamber of Commerce has also filed a lawsuit in a U.S. District Court in Ohio to ask for an injunction to keep the negotiations from going forward. The trade group is challenging the constitutionality of the IFA’s drug price negotiation program.   

It’s a very high lift and big burden to meet the standard to stop the law from being implemented,” noted Kelly Bagby, AARP’s Vice President at AARP Foundation Litigation, before AARP’s press call ended.

“It is entirely appropriate and is necessary and the public interest is so enormous in balancing of the government’s interest verses the pharmaceutical companies and Chamber’s interest in this case,” says Bagby,” stressing that beneficiaries have to win this case. “It’s so obvious that pharmaceutical companies are not the victims they are painting themselves to be, she adds, affirming her belief that beneficiaries and Medicare have the strongest argument.  

Bagby noted, “AARP is working to protect the integrity of whole Medicare program for everybody and to allow for older people to not have to make horrible choices about do I pay my rent or do I get to take my life saving drugs.” 

Reports a Wake-Up Call

Although PhRMA,  pharmaceutical companies and trade groups along with the U.S. Chamber are strongly opposed to CMS’s new program to negotiation drug prices, polls show that people aged 50 and over, view the lowering of the price of costly prescription drugs to be a very important policy issue to them. Purvis hopes that the recently released AARP report will serve as a wake-up call for every American who is skeptical about the importance of lowering prescription drug prices. “Higher government spending driven by drug price increases will affect all Americans in the form of higher taxes, cuts to public programs, or both,” she predicts.  

For a copy of AARP’s Medicare Part D Drug Price report, go to https://www.aarp.org/pri/topics/health/prescription-drugs/prices-top-medicare-part-d-drugs-tripled-since-entering-market.html.

Democratic House Passes Landmark Legislation to Drive Down Spiraling Prescription Drug Costs

Published in the Woonsocket Call on December 16, 2019

Just days ago, the Democratic House leadership successfully pushed for passage of landmark legislation, the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), that would give Medicare the power to negotiate directly with drug companies to bring down pharmaceutical prices and make those savings available to seniors.

House Democrats passed Speaker Nancy Pelosi’s sweeping legislation on Dec. 12 to lower the cost of prescription drugs on a largely party-line vote. The bill, which passed 230 to 192 with unanimous Democratic support and the backing of two Republicans, Reps Brian Fitzpatrick (R-Penn) and Jamie Herrera Beutler (R-Wash), is considered “dead on arrival” in the Senate. The White House has indicated President Trump would veto H.R. 3 it if it came to his desk.

The House Republicans fought to block passage of H.R. 3 by releasing their own legislative proposal, H.R. 19, to lower drug costs. The bill, consisting of bipartisan legislative provisions to lower drug costs that had already been adopted, would have achieved lower drug prices without imposing government price controls that House Republicans believed would decrease research and development spending for new drug cures.

Although House Republican Whip Steve Scalise called on the Democratic leadership to bring H.R. 19, with 135 sponsors and no Democrats, to the House Floor, the GOP proposal did not receive a vote on its own. It was offered by Rep. Greg Walden (R-Ore.) as an amendment to H.R. 3 and failed by a vote of 201 to 223, getting eight Democrat votes.

The Nuts and Bolts

H.R. 3 would put the brakes of spiraling drug cost by giving power to the Secretary of the Department of Health and Human Services to negotiate directly with drug companies to force real price reductions while also ensuring that seniors never lose access to the medicines they need. The legislation also expands access to the lower, negotiated drug prices to persons with private insurance, not just Medicare beneficiaries.

The 320-page House bill also prevents pharmaceutical companies from price gouging patients by capping the maximum price for a negotiated drug at the average price people in countries similar to the U.S. pay. It would create a brand new, $2,000 out-of-pocket limit on prescription drug costs for Medicare beneficiaries and even delivers vision, dental, and hearing benefits to Medicare beneficiaries for the first time.

H.R. 3 also increases the number of low-income seniors eligible for assistance with their drug costs and cost sharing for hospital and doctor visits. By extending guaranteed issue protections to disabled beneficiaries and to individuals who want to switch from Medicare Advantage to traditional Medicare, the legislation improves access to private supplemental coverage that helps fill in Medicare’s gaps for beneficiaries in traditional Medicare.

“The U.S. House of Representatives resoundingly defied Big Pharma today by-passing historic legislation to lower prescription drug prices for America’s seniors and their families. The Lower Drug Costs Now Act (H.R. 3) accomplishes what we and other advocates have long demanded — that Medicare be empowered to negotiate prices with pharmaceutical companies, which the CBO says will save more than $450 billion in drug costs. It also caps Medicare beneficiaries’ out-of-pocket prescription drug costs at $2,000 per year, says Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, in a statement.

The Pros and Cons of H.R. 3

Richtman says that it is time for the Senate Chamber to act. Drug pricing legislation that passed by the Senate Finance Committee has not been brought up for a vote on the Senate floor. “We insist that the Senate follow the House’s lead and act now to lift the burden of crushing prescription drug prices. Seniors who have been rationing pills or foregoing other necessities in order to afford crucial medications have waited long enough,” he says.

In a statement released following House passage of H.R. 3, AARP Executive Vice President and Chief Advocacy and Engagement Officer Nancy LeaMond, called the legislation” a bold step toward lowering prescription drug prices and high out-of-pocket costs for millions of older Americans.”
“High drug prices disproportionately hurt older Americans, particularly Medicare Part D enrollees, who take between four and five prescription medications each month and have an average annual income of just over $26,000 a year. The average annual price of a specialty drug used on a chronic basis is now $79,000. Medications cannot work if they are unaffordable, says LeaMond.

Adds AARP Rhode Island State Director Kathleen Connell, “Drug companies are price-gouging older Americans and taxpayers– who pay the highest drug costs in the world,” noting that “AARP is proud to support H.R. 3, which would allow Medicare to negotiate drug prices and cap out-of-pocket costs for Part D enrollees. The bill also enhances Medicare by improving access and adding needed dental, hearing, and vision coverage.”

Opposing the passage of H.R. 3, the White House says in a statement, “Heavy-handed government intervention may reduce drug prices in the short term, but these savings are not worth the long-term cost of American patients losing access to new lifesaving treatments.” Noting that lowering the price of prescription drugs is major concern for seniors, the White Houses warned that H.R. 3 is the wrong approach to address this issue, “especially when bipartisan legislative alternatives that encourage innovation while lowering prescription drug

During a briefing with reporters over two months ago, President and CEO Stephen Ubl, of the Pharmaceutical Research and Manufacturers of America (PhRMA), warned the passage of H.R.3 would trigger “nuclear winter” for biotech innovation. Fiercely opposing passage, PhRMA has called on the Senate to “stop H.R. 3 in its tracks.”

Putting the Brakes on Rising Drug Costs in Rhode Island

“We all know someone who has been forced to ration the medication they need to live so that they can afford to keep a roof over their family’s heads or put food on the table. In America, in 2019, this should never be the case,” said Congressman David N. Cicilline (D-RI), who voted to pass the measure. “Pharmaceutical companies have abused American patients and taxpayers to increase their profits hand over fist without recourse for too long. The Lower Drug Costs Now Act will put an end to the price gouging by big pharma that sees American patients and taxpayers paying more for their prescription drugs than people in other countries, says the Rhode Island Congressman representing the state’s first congressional district.

In his 2016 campaign, President Donald J. Trump supported the government to negotiate drug prices. Cicilline calls on the president to honor this promise and urges Republican Senate Majority Leader Mitch McConnell to bring a companion measure to the Senate floor for consideration. At press time more than 300 House passed bills are stuck in the Senate (about 275 are bipartisan).

According to Cicilline, the out-of-pocket savings to Rhode Islanders will be substantial. “This year alone, more than 1,000 women in the state will be diagnosed with breast cancer, 550 people will be told they have prostate cancer, and 190 folks will be diagnosed with leukemia. H.R. 3 will lower the average costs of many popular medications for these and other cancer treatments. The cost of Ibrance for treating breast cancer will be reduced by as much as 65 percent. Zytiga, a common prescription for people with prostate cancer, will be reduced by as much as 66 percent. And the cost of Tasigna, which is commonly prescribed to people with leukemia, will go down by as much as 71 percent,” says Cicilline, who serves as the Democratic Policy and Communication Committee Chair.

Earlier this year, the Rhode Island Congressman released information detailing how much more Rhode Islanders with diabetes pay for their insulin than people in other countries. Currently, 8.6 percent of Rhode Islanders, just over 83,000 people, have diabetes. They pay from $1,200 to $20,000 per year for the most commonly used insulin medications. Under the newly passed H.R. 3, the average total cost of NovoLOG Flexpen, a common insulin medicine, would decrease by as much as 76 percent. Under H.R. 3, Rhode Islanders could spend 3.5 times less on insulin, and some of the commonly used insulins could cost as little as $400 per year.

According to Cicilline, seniors in his Congressional District will see Medicare improvements if H.R. 3 becomes law. At this time, Medicare does not provide coverage for: oral exams for 71 percent of beneficiaries, eye exams for 66 percent of beneficiaries, hearing exams for 66 percent of beneficiaries, dental exams for 75 percent of beneficiaries, eye glasses for 75 percent of beneficiaries, and hearing aids for 86 percent beneficiaries.

Under H.R. 3’s Medicare expansion, 93 percent of beneficiaries (98,800 people) stand to gain from adding a dental benefit, 75 percent of beneficiaries stand to gain from adding a vision benefit, and 97 percent (102,700 people) of beneficiaries stand to gain from adding a hearing benefit.

On December 6, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) released an updated version of their bipartisan Prescription Drug Pricing Reduction Act of 201. Will McConnell, who controls its legislative fate, allow it to be considered on the Senate floor? Can a conference committee iron out the different between a Senate bill and H.R. 3, that can be pass both chambers and be signed by the president?

The legislative clock is ticking. It’s 324 days until the upcoming 2020 presidential election and the voters are demanding Congress to put aside philosophical policy differences and come up with a compromise that will truly put the brakes on rising drug costs. We’ll see.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.