The world's largest drug maker -- Pfizer Inc. -- announced Monday it will cut 10,000 jobs and close at least five facilities due to fierce competition from generic drug makers. The goal, says Pfizer spokespeople, is to whittle away annual costs by $2 billion by the end of the year -- to combat the prediction that the company will lose 41 percent of its sales to generic drugs between 2010 and 2012.

Pfizer's other obstacles include expiring drug patents -- costing Pfizer about $14 billion in revenues between 2005 and 2007 -- as well as demands for lower prices by insurers and large purchasers, and repeated requests for evidence of products' worth.

The 10,000 layoffs amount to 10 percent of the company's global workforce and will take jobs from 2,200 United States employees. The company will cut 20 percent of its European sales force, will close three research sites in Michigan and two manufacturing plants in New York and Nebraska, and is considering selling a manufacturing site in Germany and closing two research sites in Japan and France. In the midst of all of this, the company will focus its efforts on transforming the way they do business.

"I believe we must transform the way we've done business in the past in order to be more successful in the future," said Jeffrey Kindler, CEO and chairman of Pfizer. " Incremental evolution is not enough. Fundamental change is imperative -- and it must happen now."

Pfizer's Monday announcement is the second declaration of budget cuts. A previous announcement has the company -- the maker of cancer drugs Aromasin, Ellence, Camptosar, and Sutent -- slashing costs by $4 billion a year until 2008.

Horizon Blue Cross and Blue Shield of New Jersey announced plans to launch a test program where they will be implanting an ID microchip in people who suffer from chronic diseases. The radio frequency identification device (RFID) microchip will include family contact information and medical history. The purpose is to give emergency room medical staff the ability to access a patient's information if they are brought to the emergency room and are unable to speak on their own.

According to the test program team, Horizon will start sending letters to patients with chronic diseases explaining the new program and inviting them to participate. The program will be cost-free and voluntary for those who wish to participate.

RFID implanted microchips in surgical sponges is one thing -- in people? I don't know.

I am taking an informal poll. Would you consent to having a microchip implanted in your right arm for the purpose of information retrieval?

Few would disagree that the health care system in this country is breaking down. If you are one of the 45 million without health insurance you already know how difficult it is to get health care, and if you have medical insurance you continue to watch as your insurance premiums and deductibles go up year after year. Medicine has become more about money and less about patient care. We are told we spend more because we have the best health care system in the world.

But as Maggie Mahar points out in her new book, Money-Driven Medicine: The Real Reason Health Care Costs So Much, "We spend twice as much as Japan on health care -- yet few would argue that our health care system is twice as good." Mahar, a seasoned financial journalist, takes an in depth look at what she calls America's complicated and increasingly dysfunctional health care system, and what she finds is disturbing. Frankly, from a patient's perspective, it's reprehensible.

Doctors aren't allowed to function as doctors in putting a patient's needs first -- no -- medicine is business and corporations decide on a patient's treatment. To put it bluntly, medicine is a market-driven $2 trillion industry rife with competition. To cite just one example of what is taking place, and to illustrate how medicine truly sees itself  -- Milwaukee hospitals spent more in one year on advertising than fast food business did. Reviewers are calling Mahar's book a thoroughly researched and carefully reasoned study. I call it gutsy because she takes no prisoners and she isn't keeping any secrets. Until the day comes when doctors are allowed to practice medicine once again, with the priority on the patient and not corporate profit, the wheels on this buggy are going to keep falling off one by one until the axle completely splits in two. A must read for anyone who wants to understand how the system works and what motivates the players. The patients aren't even in the game. And that is what is truly appalling.