May 15, 2019: Scion of Greed, Kleptocracy At Work, The Jolly Roger

When it comes to naming the scion of greed the countenance of one snot-nosed little son-of-a-bitch named Martin Shkreli leaps immediately to mind. One may recall that in 2015 as head of Turing Pharmaceuticals he acquired Daraprim. “The drug's most prominent use as of late 2015 was as an anti-malarial and antiparasitic, in conjunction with leucovorin and sulfadiazine to treat patients with AIDS-related and AIDS-unrelated toxoplasmosis...The price of a dose of the drug in the U.S. market increased from US $13.50 to US $750. per pill, overnight, a factor of 56” (1)

This outraged followed previous behaviors.

“In May 2014, Shkreli had difficulty accessing public markets for capital, but received a $4 million series A funding round and a PIPE deal valued at $10 million underwritten by Roth Capital Partners. After obtaining the financing, Shkreli was able to acquire rights to market tiopronin (brand name, Thiola) a drug used to treat the rare disease cystinuria and Chenodal and subsequently raise the price of each drug substantially, with Thiola subsequently being marked up about 20 fold, from $1.50 to $30 per pill (patients must take 10 to 15 pills a day), and Chenodal about five fold. Retrophin did not lower the price of these drugs after Shkreli's departure.” (2)

There are other examples. He was hauled before Congress but refused to answer any questions other than confirm his name.  After receiving a tongue-lashing from outraged Democrats (the ReSCUMlickans were in control of the body), Shkreli was released to quickly return to rapine and plunder.

The real outrage is that he was finally sent off to prison...but for securities fraud! Yes, you can pluner the public but by god the capitalist is sacrosanct. Shkreli had finally gone too far—committed the capital sin—ripping off the stockholders.  In America, you can put the health of millions at risk but by god you don't mess with shareholders.

This is the state of the American health care system. I bring this up because this week yet another outrage was brought to our attention the editors of The New York Times.

“At first blush,” wrote the editors, “the news that Gilead—the company that makes Truvada, the medication that prevents H.I.V. infection—will donate enough of the drug to treat 200,000 patients a year through 2030 seems like unequivocally good news. Some 40,000 Americans are newly infected with H.I.V. Every year. Reducing that transmission rate is the key to eradicating the virus in the United States...

“But, as drug policy experts regularly note, such donations have a long history of doing more for drug makers than for patients.” (3)

Indeed as the Times points out, the tax breaks for the donation will amount to an estimated $1 billion on a product that costs around $10 million to produce. (4) So much for enlightened self-interest or disinterested benevolence.

“A month's supply of Truvada costs roughly $6 to make and sells for more than $1,600 in the United States, according to the PrEP for All Collaboration, an advocacy group...Owing partly to those prices, only about 18 percent of the million or so at-risk Americans who need the drug have access to it, according to the Kaiser Family Foundation...

“...As the Washington Post has reported, Truvada was developed largely with taxpayer dollars. The Centers for Disease Control and Prevention holds a patent on the medication, and the Justice Department is investigating whether the company owes the federal government back royalties on the patent, which experts say could amount to as much as $1 billion...

“Officials at the Department of Health and Human Services have resisted calls to sue the company for those royalties, saying that such a lawsuit would be expensive and time-consuming and would ultimately not make much of a dent in the drug's price. They're probably right. But the prospect of such a lawsuit should have given the government considerable leverage in its negotiations with Gilead.

“Mr. Trump appears to have used that leverage poorly. Regardless of how much access to the drug is increased by the new donation, most Americans who need Truvada will still be charged thousands of dollars a year for the drug, which citizens of most other countries get for a small fraction of that price. Those other countries made no investment in the development of Truvada, but most have access to generic versions of it. Gilead has managed to keep its rivals from introducing generics to the American market through a combination of lawsuits and private deals with would-be competitors.” (5)

It is evidently lost on the Department of Justice that making deals with would-be competitors in order to restrict access is price-fixing and a violation of anti-trust laws.

Clearly Disgustus, who had pledged to eradicate H.I.V., is no negotiator. Not only did the administration fail to bring legal action on the patent rights, but the government has failed to prosecute Gilead on charges of price-fixing. Disgustus didn't even employ the threat of such action in order to bring compliance.

The whole system is outrageous. This is what happens when profit governs the nation's health care system.  This is what happens when the government fails to protect the people by not enforcing laws long on the books against price-fixing.  This is what happens when Capital is allowed to form cartels controlling the marketplaces in the pharmaceutical, insurance and medical industries.   Here is yet another example of a product developed at public universities, at public expense, the patent for which is somehow found under the control of Corporate America. Why the people, who paid for the creation of this product, are not reaping the rewards is a national outrage. Here is yet another example of how we allow corporate greed not only plunder the marketplace but the public domain as well. The Kleptocracy at work, with the great kleptocrat sitting on the throne, overseeing his den of thieves. The ship of state has taken down the Grand 'Ole Flag and has run up the Jolly Roger.

An Br'er Putin, he jus' laugh and laugh

Impeach and Imprison.

_________________

1. See: https://en.wikipedia.org/wiki/Martin_Shkreli
2. Ibid
3. Editors. “Gilead's Gift Horse” The New York Times. Tuesday, May 14, 2019. Page A22
4. Ibid
5. Ibid

February 11, 2019: Health Care Confusions, Wrong-Of-Center, What Works and What Doesn't

“The health care debate isn't a question of Left vs. Right, it is a question of Forward vs Backward, or Up vs. Down.

                    ----from The Quotations of Chairman Joe

The New York Times featured an essay today written by Peter Suderman, the features editor at Reason, a libertarian rag trafficking in the fevered fictions of Aynn Rand and company. Suderman is here lamenting the G.O.P's foggy response to Obamacare and the recent Democratic shift toward universal health care, usually put in the form of Medicare for all.

From the mantra repeal and replace used in 2016 to mislead the public to today's patient centered and preserving the doctor-patient relationship, today's slogans ring as hollow and separated from the real world as defeated senatorial candidate Susan Lowden's suggestion, in the 2010 Nevada Senate Republican Primary that patients bring chickens to the doctor's office and barter them for medical attention. Of course, no one asked her what would happen if the patient's doctor were already stuffed with feathers and the poor soul had nothing left with which to barter. Carrying the argument to these extremes is to plumb libertarian fictions to the depths at which one encounters the likes of Suderman and his unhinged Reason. It's at these depths, according to these lights, where real freedom lies. 

But the fact is, in this post-medieval society, that one cannot achieve real freedom by chaining the health of your very being to the rapacious caprice of the marketplace, any more than you can purchase medical care with chickens. It simply doesn't work.

It isn't simply that the Republicans have given us fluff in place of substance; slogans instead of policy, vacuous platitudes instead of relief. It's that they had no intention of replacing Obamacare in the first place. They had no intention of doing anything.

Oh, but Suderman would have us believe otherwise. “It's not a shortage of ideas: Conservative think tanks have health policy white papers to spare, and have for years.” (1) Suderman assures us with a straight face. “All the way back in 2012, for example, you could find the right-of-center health policy scholars James Capretta and Robert E. Moffit outling principles for an Obamacare replacement in the journal National Affairs. Their plan called for limiting the tax break employers would get for offering health coverage, converting existing public coverage programs to premium support (essentially a subsidy) while promoting competittion among private plans, protecting people who maintain continuous coverage from spikes in premiums, and allowing states more flexibility to opt in or out of national health care initiatives”. (2)

Alright, lets analyze this word salad. First, let's begin with our nomenclature. This is not “right-of-center”, it is wrong-of-center. Obamacare, let us never forget, was first forged in the conservative stink tank Heritage Foundation, and has served as the most salient form of “let's never keep our corporate paymasters out of the mix”, initiative. First put in place of Mitt Romney in Massachusetts, Obamacare was written and implemented by the very same architects of Romneycare. And, accordingly, corporate America has its fingerprints all over it. Yes, Obamacare leaves too many people without coverage and is proving too expensive. It's failures are not that it has gone too far, but that it hasn't gone far enough—corporate profit-making is still an egregious feature and one look no further than big Pharma as an illustration of the problem. We remain with the developed world's most expensive system which in too many places delivers third world service.

But let's continue. Secondly, limiting tax breaks for employers, does not alleviate the problem; it would only exacerbate it. Under the all-too-transparent figleaf of 'principles', this 'reform' would only give corporate America yet another exit from the stage and, since most would still be depending on employer-sponsored health care, this further erodes security. Over time, as sure as the morning sun rise, the trend toward corporate shedding of this responsibility on to the backs of it's labor force would accelerate. The goal here, disguised as “priniciple” is to render the laborer at the mercy of the market-place, armed only with inadequate subsidy in the face of rapacious greed. Imagine, if you will, taking your health token to the drug store to get medications for a serious or rare disease. Of course, conservatives will bolt, as they do with the minimum wage, at any suggestion that these subsidies be annually adjusted for inflation. In a very short time, the public will be left not with health care, but health coupons.

And, point number two, this is the problem with converting existing public coverage to premium support. Government subsidy as used here is long on underwriting corporate profitability and short on health care delivery. Can we say campaign contributions here?

Third, Suderman assures us that the conservatives are all about promoting competition. This is pure balderdash. If that were true, conservatives would be pounding the drums—as Teddy Roosevelt did—to enforce anti-trust legislation and break up the medical, insurance and pharmaceutical cartels. Again, one must always take the conservative use of the word principle with a grain of salt, for it is always a fig leaf designed to mask greed.

Fourth, the idea that they would protect people who maintain continuous coverage, as opposed to others whose coverage is interrupted, favors those who have steady, long-term employment. It also favors those who still have employer-based health insurance. Market trends, in case the conservatives haven't noticed—and by god, being the architects of these trends they know—are running in the opposite direction as corporations have been shedding these responsibilities long before Obamacare was crafted. Indeed, even during the best of times, employer-based health insurance never covered half the work force. This, 'protection' is yet another disingenuous overture designed to cover greed with yet another fig leaf; another principle masking greed.

Fifth, Suderman presents us with the old canard that allowing states more 'flexibility' to participate or not in whatever hodge-podge they would gag up is yet another attempt to sabotage any meaningful improvement of our health system under the age-old stratagem of giving the problem to the states. Again, like the Clinton-era welfare reforms which made welfare not needs but budget based, over time inflation will reduce the value of these 'block grants', further reducing the delivery of services to mere coupons. At some point, the public will grow disgusted with the delivery for the dollars spent and move to reject the whole enterprise as unworkable. This is entirely the point. At some point the public will lose confidence and want to dismantle it. That's the reality lurking behind the mask of these high-fallutin libertarian 'principles'.

Then, of course, there are always the shopworn suggestions that we adopt some kind of Health Savings Accounts, so dear to conservatives. Besides the fact that those living on the margins, those who, while working at Walmart, have no money with which to put into these accounts,--and there are tens of millions—those that do will have the opportunity to put that money into investments. Investments which, incidentally, will go into the pockets of stock jobbers and other financial parasites well before they make their way back into the emergency or the delivery room. It's strange how every conservative idea somehow benefits first, and perhaps foremost, the capitalist benefactor.

There are reasons these dog-eared proposals, taking short-lived flight in the 2016 campaign of Marco Rubio, and in the proposals of Lindsay Graham and Bill Cassidy in 2017, as the GOP struggled to come up with something—anything--to counter Democratic calls for universal health care. The reasons are that they have not worked and are now universally known to be-- unworkable.

And that is the criterion that conservatives, blinded by the ideological imperatives laid down by a writers of pulp fiction, (3) cannot wrap their arms around. This is not, from an ideological point of view a question of 'left-of-center' vs 'wrong-of-center' debate; and it would be a mistake to make it one. It is a question of what works and what doesn't .

The verdict is in. The game is up. But conservatives, whom experience is powerless to instruct, cling to their greed armed only with their all-too-transparent principles, and billions of dollars of Cartel money. It is with fig leaves and money that they cover their aging backsides and cling to power.

“An Br'er Putin, he jus' laugh and laugh'

Impeach and Imprison

__________

1. Suderman, Peter. “The G.O.P.'s Health Care Confusion.” The New York Times. Monday, February 11, 2019. Page A19.
2. Ibid.
3. I'm referring here to Aynn Rand and her accolytes.

August 13, 2015: Where is the Justice Department, a matter of Anti-Trust, Cabals and Cartels

 

In the wake of the decision handed down last month by the Supreme Court that the Federal Government has the constitutional authority to establish public insurance exchanges, thereby driving the final nail into the conservative arguments concerning the validity of the Affordable Health Care Act, the insurance industry immediately began an orgy of mergers.  Economist and former Secretary of Labor Robert Reich had this to say:

“Now that insurers know the Affordable Care Act is here to stay, they’re merging like mad. Today Aetna announced it will spend $37 billion to buy rival Humana in a deal that will create the nation's second-largest health insurer. Yesterday, Centene announced a $6.3-billion deal to acquire Health Net. Blue Cross-Blue Shield carrier Anthem just made a $47-billion offer for giant insurer Cigna.

We’re rapidly on the way to having a handful of giant health insurers. The only difference between this outcome and a government-run single payer, such as Medicare for all, is that revenues will go into executive salaries, dividends, and advertising and marketing rather than into lower premiums and health care.

When will we learn?” (1)

 

It is a poignant question and one that should be troubling to every Progressive Democrat in America.  When will we learn?  The answer, as it pertains to the elites in this country, is that—like the Commanding Generals on the Western Front a century ago—they will never learn.  But the question runs deeper, when will we—we the people—learn?  Not since George W. ‘Ol Two-Cows’ Bush upon assuming the presidency dropped the anti-trust suit against Microsoft, a case that the government was incidentally winning, this government has not brought a significant anti-trust action. For nearly a generation there has been a veritable orgy of mergers and acquisitions as the banks, the oil companies, the pharmaceuticals and other major players have merged and joined forces in an erstwhile effort to further concentrate economic and political power.  Now, with the ACA firmly in place the major players in the Health Insurance industry are wasting no time in going about the business of strangling competition. 

The consequences cannot be good, for the concentrations of economic power into fewer hands, and the concentrations of the political power that follows will mean that the long anticipated benefits resulting from the creation of public insurance exchanges as well as the requirement that all participate in the system will be strangled at birth by the attempts of the industry to further eliminate competition.  Whatever ‘savings’ anticipated by the Act will soon be undone as the industry morphs into a cartel with less than a handful of companies commanding the markets.



Economists have long recognized that the behavior of Capital is to concentrate itself into fewer and fewer hands.  Economist John Kenneth Galbraith once observed that however the capitalist lauds competition, the fact is that he hates competition and will do whatever it takes to rid himself of it.  The classic example of this, dating back to the nineteenth century heyday of the modern capitalist experiment, was the railroads.  Financiers like Gould and Fiske would buy up railroads, like the old Erie Railroad, not to invest in them and improve them, but to close them down and eliminate the competitor.  Similarly, General Motors famously bought the old trolley companies in Los Angeles in order to close them and render the population dependent on the automobile.  Surveying the American experience Professor Galbraith observed that when confronted with competition the Capitalist will soon scurry for cover, seeking government protections by way of tariff restrictions, favor by way of government contracts, and the manipulation of the marketplace by the elimination of competition by way of restricting or eliminating government oversight and regulations. 
 

Governments also have long recognized this behavior and began immediately after the Civil War, with the passage of the Sherman and Clayton Anti-Trust Acts to address these unwelcome tendencies.  But it has, historically, fallen upon the People to insist on a remedy.  In fact, by 1905 Anti-Trust laws were being applied by the courts not to Capital but Labor.  After having decided in “United States v. E.C. Knight Co… that the Sherman Act could not be applied to a virtual monopoly of the sugar industry because the manufacture of sugar was not in interstate commerce”, the court had “(f)or all practical purposes…virtually set aside the Sherman Act”.  This action by the court was soon followed in the 1905 decision in Swift and Co. v. United States in which “the Court held that a combination of meat packers (union) was an illegal monopoly under the Sherman Act on the ground that its activities were transactions in interstate commerce”(2)  By the early years of the last century Capital, ensconced in power, had co-opted government and, with the aid of an ideologically compliant Court, set about making a mockery of not only free enterprise but the will of the people.

It took a ‘revolt of the masses’ in the form of a ‘prairie fire’ of grass-roots protest in the form of the Greenback and Progressive movements to right the ship.  With the election of Teddy Roosevelt and later Woodrow Wilson the Progressives, able to influence first the Republican and then the Democratic Party would compel government to not only protect the people from the worst ravishes that Capital is prone but to empower workers to improve not only pay but working conditions as well.   Finally, with the coming of the New Deal and the passage of the Wager Act, Fair Labor Standards Act the enforcement of Anti-Trust laws and the institution of a long overdue regimen of Federal Regulation, the People, acting through government, were able to not only establish a system of relative economic justice but a large and thriving Middle Class as well.

There has been a great unravelling of this in the last 40 years, the greatest example of which is the destruction of the Labor Movement as well as the inability of this government to enforce the laws on the books, particularly Anti-Trust laws.  Trends that increasingly see no improvement with the election of Democratic Administrations, leaving one to ask: Where are you Mr. President?  Where is the Justice Department?

As Goldman-Sachs staffs the Treasury, no matter who which party assumes power; as Paul Volker advises a Democratic Administration on economic Policy; as the likes of Alan Greenspan would be found commendable by both a Jimmy Carter and a Ronald Reagan, a George Bush and a Bill Clinton; and as no administration since Carter has lifted a finger to aid and protect the workers on the shop floor; and as no recent administration has seriously enforced anti-trust, it is clear that cabal having seized the levers of power now owe their allegiance not to the people, but to the cartels they have empowered.

As the Middle Class writhes in agony, Hillary Clinton and Jeb Bush wait in the wings.  Nothing more need be said.  No matter who wins, we lose.  The Calvary isn’t coming.  When will we learn?  Good question Dr. Reich, it’s been nearly half a century now.  One thing is certain though, our ancestors were never such fools.

Meanwhile the Republicans have moved in Congress to eviscerate the Pell Grants making higher education unaffordable to much of the Middle Class.  You see they don’t want us competing with their kids in school either, they fear the competition.

_____
(1). Robert Reich, Facebook post 7-15-15
(2). Tresolini, Rocco J. “American Constitutional Law” The Macmillan Company
                    New York, Collier-MacMillan Limited, London. Pg. 265

 

December 14,2014: Thank Lyndon Johnson, Measure in the Details, Because Liberalism Works

On Thursday morning, December 10, my wife suffered her second stroke in 7 years. The first occurred in October of 2007 while she was in the employ of the University of Georgia engaged as the administrative assistant to the Chief Information Officer. The stroke damaged 3 of the 12 main nerve bundles that make up the cerebral cortex, leaving her with some difficulty with motor skills, some weakness, and a propensity for scanning speech to return when fatigued. She soldiered on nonetheless, returning to work within a couple of months and working for an additional 4 years. As the stresses of employment became more and more obvious we were able for her to leave her employment fearing another stroke would surely result if some dramatic changes were not forthcoming. What followed was a period of unemployment and then, when it became obvious that she could no longer work, a claim for disability. In mid summer of 2012 she filed her claim and was speedily granted the benefit after a review of her medical records. Because, for some insane reason, health insurance does not become available for two years she was unable to seek medical care until she qualified for medicare under the social security disability act. Previously there had only been a one year wait but ‘Ol Two-Cows’ extended the waiting period doubling the time one has to wait until on qualifies for medical assistance. So the nation now poses the absurdity of denying medical treatment to disabled persons for two full years. Such is the logical consistency and the compassion as exemplified by political conservatives.

In any case she was able to first get health insurance when she became eligible nearly a year ago with the introduction of the Affordable Care Act, or ACA, or ObamaCare as it is widely known. This, in effect, reduced the two year wait to see a doctor by about four months. She then qualified for Medicare under the Disability Act. Having insurance she could now seek treatment. 

While it has been stressful dealing with the events of the last days, one would have to ponder what would have befallen us if this had happened a year or two earlier when we had no insurance and could get no insurance given her medical history of ‘prior conditions’? The answer is at once obvious: the resulting expense would have been financially devastating, reducing the household to poverty, facing trade offs between medical expenses and food.

I’ve had the misfortune of encountering many a swine and the larvae of the swine on the internet, as I have commented on various issues of the day. Often I will get some knuckle dragging bonehead who will tell me straight out that taxes are theft, and that no government is the best government. The fool, if pressed, would no doubt reveal that he is in his twenties or early 30's and doesn’t see why ‘he’ should pay for someone else’s benefits. Of course he can, afford this ignorance, or thinks he can, because he is presently covered by his employment or is in pristine health at the prime of his life. What he doesn’t understand, and will make no effort to understand is that we are what he will be. At some point he too will no longer be employed and will have to either insure himself or will have to rely on government insurance.

The experience of my wife is a text book case; a standing justification of Lyndon Johnson and the liberalism that he exemplified. She lost her job at the prime of her productive years not because of incompetence or failure but because she could no longer physically deal with the stresses and strains. Having suffered already a major brain injury (brought on by stress) she was forced from the labor market long before she reached her golden years. Did her employer step up and see to it that she would keep her insurance and, therefore, her medical security? No he did not. The institution did what every employer does in this country, viewing the employee as a commodity, an interchangeable part, much as any piece of office equipment. They simply let her go, and replaced her with someone else, leaving her to fend for herself. This is the situation millions of workers in this country face every day as they are downsized, let go, forced by medical issues to leave the workplace early, or the company simply declares bankruptcy and wiggles out of its obligation to its workforce.

The point should now be obvious. If you are relying on your employment to care for your medical needs you may be in for a rude awakening, especially if you develop a serious, chronic, or end of career illness. Some may step up and do what is right, but most will not and you will find yourself damn thankful that Lyndon Johnson and now Barack Obama have come to the rescue.

When Medicare was passed it cut poverty among seniors by nearly two thirds. There are reasons for that, given that most of what one will spend on medical care occurs in the late stages of life, at a time when one no longer works and is on a fixed income. For this reason Lyndon Johnson set up a government insurance program in which everyone is compelled to contribute through payroll taxes. The program works. It isn’t perfect, but it sure as hell beats the alternative. As someone who has faced the real prospect of an event like this happening with no insurance at all, it is of some great comfort that for the last year or so we have had a measure of security, secure enough to make that ambulance call last Thursday morning. For that I take a moment and thank my stars for Lyndon Baines Johnson.

Ask me why I’m a Liberal? Because liberalism works.