In the News: Why prescription drugs are bankrupting us

Photo by Mark Pernice

Few dispute the notion that prices for pharmaceutical drugs in the U.S. are too high – especially when compared to those of other nations. An op-ed piece in today’s New York Times looks at that issue and finds several reasons.

Among the factors cited by the report, which is based in part on an article in the New England Journal of Medicine,  insurance companies’ coverage of drugs regardless of price or whether they are much better than existing, less costly drugs. Also cited: some pharmaceutical companies buying up the rights to cheap generic drugs so they can then jack up prices.

The high cost of pharmaceuticals – Amgen’s new leukemia drug Blincyto is expected to cost $64,000 a month – clearly needs attention if health care costs are to be prevented from soaking up more of the nation’s wealth, crowding out other essential spending.

The op-ed piece was written by Dr. Peter Boch, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center.

– Len Maniace

Written off by some, the natural world rebounds in NYC

By Len Maniace

To paraphrase Mark Twain –  the report of nature’s death in New York City is an exaggeration. And given some help, nature can thrive in our city. That’s what leading experts from government and nonprofit groups told a City Council committee this week.

Natural areas in the New York City park system include Alley Pond Park in Queens.

Of the 30,000 acres of city parkland, 10,000 acres are considered natural areas: forests, meadows, freshwater wetlands and salt marshes. Within those natural areas, 51 sites  are designated “forever wild” nature preserves.

“New York City is portrayed as a city of brick and concrete, commerce and culture, a place that is beyond nature. But that’s not true. It’s a city of wild nature and snaking waterways, too. A place like no other along the East Coast,” said Bram Gunther, city Park’s chief of forestry, horticulture, and its Natural Resources Group. He’s also  president of the Natural Areas Conservancy, a nonprofit that assists in studying and restoring the city’s natural areas.

There are few signs of the city in many of New York City’s natural areas. Photo credit: Natural Areas Conservancy

Those natural areas are accommodate 2,000 species of plants and 350 species of birds. Across the city’s five boroughs there are more than 220 species of native bees, Gunther told a hearing the City Council’s Park Committee Tuesday.

That natural bounty exists here despite centuries of neglect; 85 percent of the city’s saltwater marshes have been filled in since the arrival of Europeans. And the 10,000 acres of natural areas are not pristine. In cleaning up the Bronx River, an astonishing  77,000 tires were removed. The cost of restoring natural areas is high, about $1 million per acre, but those efforts are paying off. In 2009, the alewife, a type of herring, returned to the Bronx River for the first time since the late 1600s; beavers have been spotted there, too, in recent years.

Once the city’s natural areas were victims of widespread dumping; now the number-one threat to natural areas are invasive species, Gunther said. These are usually non-native plants that run rampant because they have no natural predators, crowding out native species, upon which a network of beneficial insects, birds and other animals depend.

Phragmites is an invasive species that dominates many salt marshes in New York City and along the East Coast.

To get a better handle on the health of its parks, the city just completed what officials are calling the world’s largest ecological and sociological assessment, a huge data set that will help with continuing restoration and also provide a baseline for studying the effects of climate change. The study provides insights on the prevalence of invasives versus native plants. In Van Cortland Park in the Bronx, 67 percent of the understory plants – shrubs and small plants – are native, while the figure is only 40 percent at Marine Park in Brooklyn, said Sarah Charlop-Powers, Executive Director of  the Natural Areas Conservancy.

Getting rid of invasives is not easy. Typically it takes two years of stripping invasive plants from a site before the area can be restored with native plants. That typically involves heavy equipment and human labor ,which are expensive. But not always. At Staten Island’s Freshkills Park a herd of goats are helping to keep invasives under control. “They eat an enormous amount of vegetation,” Gunther said.

Officials plan to release the entire study online in 2015.

 

 

Wiring a city park to monitor a changing Mother Nature

The U.S. Forest Service installed instruments in Alley Pond Park to precisely document weather conditions that could provide a window on how climate change is affecting nature. Photo by NY Times

Planet NYC visited Alley Pond Park in Queens this year, documenting the sights and sounds of the changing seasons. It was a fascinating series of visits that showed just how much nature exists in parks that some dismiss as too urban.

Though some are skeptical, the significance of Alley Pond Park and similar city parks is not lost on the U.S. Forest Service. In fact, through it’s Smart Forest program, the federal agency wired Alley Pond Park with instruments that record temperature, humidity, sun light and other weather conditions that go far beyond our casual observations since early spring.

Adding that data to Smart Forest images recorded in the park, researchers hope to have a window on how climate change is affecting park plants, as in when buds burst open, trees leaf out and then change colors, according to a New York Times story earlier this month.

The story, which is well worth checking out, comes at a time of greater appreciation for New York City’s natural areas, some 10,000 acres across all five boroughs. In fact, the city’s Department of Parks and Recreation discusses its ongoing research on these natural areas at a City Council Committee on Parks and Recreation hearing tomorrow. We hope to be there and fill you in on what we learn.

Not busy Thursday and Friday? Why not plan NYC’s future

By Len Maniace

A legendary basketball coach may be this nation’s foremost advocate for planning.  Though others have been credited with saying it first, UCLA basketball coach John Wooden is the one most often associated with the sage advice: Failing to plan is planning to fail. Though the coach was talking about the need for his Bruins to prepare for their games, the words apply to environmental and urban planning.

Last year’s Municipal Art Society Summit for New York City overlooked Columbus Circle in Jazz at Lincoln Center overlooking Columbus Circle. This year’s will feature 140 speakers at the New York Times headquarters.

Some might say that lack of planning is why we are in the mess we’re in when it comes to our environment, sustainable transportation, climate change and health issues.

One major nonprofit organization is wrestling with the issue. Thursday and Friday of this week the Municipal Art Society holds another of its Summit for New York City conferences, this time at the headquarters of The New York Times, at 242 West 41st St, off 8th Avenue.

Among roughly 40 scheduled programs are sessions on making our communities more resilient in the face of emergencies such Hurricanes Katrina and Sandy; the value in preserving old buildings, including architecturally significant post offices; the competitiveness of cities, and what it means to be both a just and a green city.

Though the Municipal Art Society is no longer selling tickets on its website a limited number of tickets are available at the door.

 

Ebola – and the new era of infectious disease

By Len Maniace

Unlike other world-changing events, the first reports of the current Ebola epidemic are not stamped into memories. For the record, the World Health Organization issued its first public announcement on March 23rd of this year, reporting that a total of 49 people were stricken with Ebola virus disease in Guinea and 29 had died. That was months before the outbreak registered with many in the U.S.

A colorized image of an Ebola virus particle (green) taken by a scanning electron. (National Institute of Allergy and Infectious Diseases)

Even more muted was the public introduction of an earlier and profoundly world-changing disease that has killed 36 million people. AIDS was first reported on June 5, 1981, in a publication of federal Centers for Disease Control and Prevention. It described five previously healthy young men in Los Angeles who were mysteriously stricken with Pneumocystis carinii pneumonia, an ailment that occurs almost exclusively in people with severely suppressed immune systems. Two had died.

That is the nature of such outbreaks. They start small, sometimes in far away places. Most times they are brought under control before threatening people too far from where they started. Ebola outbreaks were like that once. The first killed 280 people during a 1976 outbreak in the Democratic Republic of Congo. The toll taken in any of the next 23 never matched that figure number. The current outbreak is different though. By mid-October it killed nearly 4,500, according to WHO, and the epidemic shows no sign of abating.

We all hope that mobilization of more doctors, nurses, equipment and expertise, will turn the tide against Ebola soon. Even so, this outbreak is likely to finally confirm the notion that the nature of infectious disease has changed and that AIDS was not just a freak virus that evaded our capabilities. We no longer live in an era when antibiotics and distance were enough to protect us from most infectious disease.

Published 20 years ago The Coming Plague described the new era of infectious disease we face.

That was the thesis of Laurie Garrett’s 1994 book, The Coming Plague: Newly Emerging Diseases in a World Out of Balance. Global air travel, wars, changing social mores, and environmental destruction have allowed deadly viruses once confined to wild animals – and a few unlucky humans who came in contact with them – to reach a worldwide population.

No doubt preventive measures have improved since that book was published. But as the recent spread of Ebola to health workers in the U.S. and in Spain shows, these measures are likely not enough – or aren’t being strictly followed. The full extent of these shortcomings, we will learn soon. And beyond our borders is West Africa where, health officials agree, medical care will need to be greatly improved to defeat Ebola. Attention must be paid: When it comes to infectious disease, there is no such thing as Fortress America; we ignore these outbreaks in seemingly far away places at our own peril.

Watching and waiting for Ebola

By Len Maniace

Ebola is something happening over there – but in short order it could be happening here. This outbreak is far bigger than any before, and that makes one wonder, what’s different now? Is it happening in a part of Africa that’s more hospitable to its spread, or has the virus changed?

It’s not hard to imagine a traveler infected with Ebola arriving at a U.S. airport. The question then is how quickly can that person be identified and prevented from infecting others? The nation has an early warning system to detect infectious disease that’s become far more elaborate as a result of September 11,  probably the only thing good to come out of that event.

New York City possesses a particularly sophisticated early-warning system.  An important part of these detection system is the screening of symptoms of patients going to hospital emergency rooms. Some hospitals in New York are isolating patients with Ebola-like symptoms as a precaution. None are believed to be infected. Kennedy Airport, the city’s main arrival site for international travelers has isolation rooms for exactly this purpose.

Helping to make the city’s system even better was the 2003 SARS outbreak in which much was learned about how to handle international outbreaks with potential for rapid spread, New York City Health Commissioner Dr. Mary Travis Bassett told WNYC news.

No one has a crystal ball to see what happens next. By September we may have moved on to other concerns. On the other hand, Ebola could arrive, unidentified. And in that case we could have more immediate concerns than lawsuits against the President, young refugees crossing into the U.S., or even rockets being fired in Gaza and Israel.

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Here are links to some quick and easily readable information on Ebola:

WNYC: Commissioner’s five Ebola takeaways.
Daily News: Health Commissioner says NYC prepared to rapidly identify Ebola.
Popular Mechanics: Why this is the worst Ebola outbreak yet.
NYC Department of Health: Ebola basics.

Here’s a link to a series of stories on Ebola from The New York Times.

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Did state really OK Flushing Meadows shopping mall in 1961?

Developers cite a 1961 law as permission for building a shopping mall next to Citi Field on official city parkland.

Full disclosure: The author of this article is president of the Jackson Heights Beautification Group, a civic and environmental nonprofit that has contributed funding for the lawsuit opposing the shopping mall at Flushing Meadows-Corona Park.

By Len Maniace

The David and Goliath dispute over whether developers can build a mammoth shopping mall on city parkland that’s served as the New York Mets’ parking field finally got its day in court yesterday.

Arrayed on one side were New York City and the developers, Related Companies and Mets owner Sterling Equities. Three attorneys, including former Chief Judge of the New York State Court of Appeals Judith Kaye, presented that case. The other side ­– a group of nonprofit organizations, local businesses,  residents and state Senator Tony Avella – were represented by a single attorney.

No decision was reached yesterday, but the hearing provided a dramatic glimpse of a major New York City land-use battle at Flushing Meadows-Corona Park worth billions of dollars.

And based on the arguments heard by state Supreme Court Justice Manuel Mendez, the case could be decided on issues such as: whether shopping could be considered “recreation, entertainment, amusement,” and whether the state Legislature’s 1961 permission for a portion of the park to be used for a Mets’ stadium and parking, amounts to “direct and specific approval” for a 1.2 million square foot shopping mall.

The developers argued yes on both points, yesterday.

“People go to shopping centers and malls for entertainment and recreation and amusement,” contended attorney Jonathan Frank.

Attorneys for the city and the developers contended that their plan complied with seven uses cited in a 1961 state law allowing a portion of Flushing Meadows to be used to build a stadium and parking field while remaining official New York City parkland. The lawyers, however, focused not on the land remaining park space, but on a section of the law allowing for uses that:

Mall opponents talk to press after court hearing. Fom left: Harbachan Singh, Queens Civic Congress; Irene Prestigiacomo, Willets Point United; state Senator Tony Avella; Joseph Ardizzone, Willets Point United; Michael Gruen, City Club of New York; John Low-Beer, plaintiffs’ attorney; Ben Haber, activist/plaintiff; Copyright 2014 LoScalzo Media Design LLC.”

…provide for the benefit of the people of the city, recreation, entertainment, amusement, education, enlightenment, cultural development or betterment, and improvement of trade and commerce, including professional and amateur scholastic sports and athletic events, theatrical, musical or other entertainment presentations, and meetings, assemblages and conventions and exhibitions for any purpose…

The developers contend the phrase “improvement of trade and commerce,” also allows for construction of the mall.

The developers’ lawyers buttressed their case – and indeed spent much of their time – pointing to their redevelopment plan for a nearby site that contained several hundred small auto-related businesses. A mall on the Citi Field parking field would generate enough money to finance that otherwise separate housing and a hotel project on a site that’s long been targeted by the city for redevelopment.

The mall-opponents’ attorney John Low-Beer, however, was quick to point out the redevelopment of the auto-related businesses on Willets Point was not the issue before the court.

“This maybe the greatest project since sliced bread, but the city still has to follow the law,” said Low-Beer, referring to the housing and hotel project on Willets Point.

The mall-plan critics’ lawsuit boils down to three main points: that the city failed to get state Legislature approval for what’s known as alienation of parkland; that the land must be rezoned before any non-park use can take place; and that any city lease of the land or rezoning requires a city planning review known as the Uniform Land Use Review Procedure, which did not take place.

The intent of 1961 state law, Low-Beer maintained, was not to permit a shopping mall on the site, but to serve as a vehicle allowing for construction of the stadium and parking field. The land, he noted, remained as parkland.

“Shopping may be great fun, but it is not a public purpose,” Low-Beer said.

Low-Beer noted that converting parkland to a non-park purpose requires a special act by the state legislature. He pointed to a 2001 case requiring the city to go through that procedure in order to build a water treatment plant in Van Cortland Park in the Bronx, even though the land would eventually be returned for park purposes.

The decision in that case by the state’s highest court, the Court of Appeals, read in part:

Our law is well settled: dedicated park areas in New York are impressed with a public trust for the benefit of the people of the state. Their use for other than park purposes, either for a period of years or permanently, requires the direct and specific approval of the State Legislature, plainly conferred.

That decision was written by Kaye, then the court’s Chief Judge, and Low-Beer argued that it clearly upheld his position in this case. Kaye argued that the decision was not in conflict with the developers’ position because of the 1961 law.

The mall supporters have two weeks to submit further legal arguments on the lawsuit, after which Justice Mendez will issue a ruling.