Aug. 14, 2020
Permission to republish original opeds and cartoons granted.
Price controls for Medicare prescription drugs will just pass along costs of drug innovation to non-Medicare patients, could lead to socialized medicine
President Donald
Trump is currently considering an executive order that will direct the Center
for Medicare & Medicaid Services (CMS) to implement a proposed 2018 rule
instituting an International Pricing Index for Medicare Part B prescription drugs.
The intent is to reduce drug costs for seniors. However, it will come at a
significant cost to non-Medicare patients, who will be compelled to shoulder
the costs of drug innovation. How do we know that? Because the U.S. is already
bearing the costs of drug innovation for the rest of the world, which uses
similar price controls, in turn passing along the costs to the American people,
which pays far more than the rest of the world. Politically, this could also
create an opening for Democrats to exploit the disparity by calling for more
price controls or even for socialized medicine. House Democrats have proposed
Medicare for All, while Speaker Nancy Pelosi (D-Calif.) and former Vice
President Joe Biden are similarly offering Biden’s public option. Either way,
Democrats can bill socialized medicine as a means of reducing out-of-pocket
prescription costs that non-Medicare patients will be burdened with under the
CMS rule. Ultimately, the question that remains is who pays for the price of
drug innovation?
Cartoon: No-Brainer
The choice in 2020
could not be clearer.
Video: Biden's VP pick Kamala Harris supported cutting $150 million from LAPD & reducing force to under 10k
Former Vice
President Joe Biden’s choice of running mate in Sen. Kamala Harris (D-Calif.)
supported cutting $150 million from the Los Angeles Police Department budget
and reducing the number of officers to under 10,000 for the first time in over
a decade.
Rapid economic recovery Trump predicted continues as unemployment claims drop|
Americans for Limited
Government President Rick Manning: “President Donald Trump predicted a fast
recovery from the COVID-19, and now it is continuing at a rapid clip with fewer
than 1 million new jobless claims for the first time since March, and another
624,000 came off continued claims the week of Aug. 1. As a reminder, in Feb.
2020, unemployment was at a 50-year low with fewer than 6 million Americans
unemployed and it was the unleashing of the Chinese coronavirus that drove
those numbers through the roof. Now, the President's balanced approach to
reopening America while continuing to battle the virus has led to an
unprecedented recovery, with 9 million to 10 million jobs recovered in the past
three months. No President has been as focused on private sector job creation
in generations, and it stands in stark contrast to the Obama-Biden so-called
shovel-ready jobs promise that paid off public employee unions but did little
for Americans who were actually out of work.”
Byron York: Resistance sees military removing Trump from office
“With 80 days left
before the presidential election, a new and dangerous rhetoric has emerged from
some corners of the Resistance. A number of President Trump's most implacable
critics are fantasizing about deploying the U.S. military to remove him from
the White House on Jan. 20, 2021, based on their assumption that a.) he will
lose the election, and b.) he will refuse to leave office on his own. Recently,
two retired Army officers speculated about deploying a brigade from the 82nd
Airborne Division to overpower Trump's ‘private army’ that they believe the
defeated president will use to try to cling to office. Another retired officer,
a former chief of staff to Secretary of State Colin Powell, imagined the
military in battle with armed Trump supporters, the result being that ‘all bets
are off as to how much blood might flow.’ In addition, a group of former
government officials, political operatives, and journalists concocted a
scenario in which Trump actually won reelection but Democrat Joe Biden refused
to accept the result in hopes that the military would side with him against the
president.What is going on? Why have seemingly responsible people taken to
embracing fantastical visions of tanks in the streets of Washington, D.C.?”
Price controls for Medicare prescription drugs will just pass along costs of drug innovation to non-Medicare patients, could lead to socialized medicine
By Robert Romano
President Donald Trump is currently considering an executive order that will direct the Center for Medicare & Medicaid Services (CMS) to implement a proposed 2018 rule instituting an International Pricing Index for Medicare Part B prescription drugs. The intent is to reduce drug costs for seniors. However, it will come at a significant cost to non-Medicare patients, who will be compelled to shoulder the costs of drug innovation.
How do we know that? Because the U.S. is already bearing the costs of drug innovation for the rest of the world, which uses similar price controls, in turn passing along the costs to the American people, who pay far more than the rest of the world.
According to a 2017 Commonwealth Fund study on international price comparisons for drug pricing, “Unlike the U.S., many other countries employ centralized price negotiations, national formularies, and comparative and cost-effectiveness research for determining price ceilings. In the U.S., health care delivery and payment are fragmented, with numerous, separate negotiations between drug manufacturers and payers and complex arrangements for various federal and state health programs.”
But because of global price controls, as drug prices are artificially kept down overseas, market forces shift the costs elsewhere, as noted in a 2019 study by Joseph Fuhr, Liam Sigaud and Steve Pociask, “How International Reference Pricing for Prescription Drugs Would Hurt American Consumers”.
This helps lead to higher prices here. As Fuhr, Liam and Pociask write, “One reason that pharmaceutical prices are so high in the U.S. is that the U.S. is subsidizing the rest of the world in the development of drugs… [D]rug development is costly and other developed countries should pay their fair share of these costs. Indexing U.S. prices to those in other developed countries will not solve this problem, since other countries will not increase their prices to pay their fair share and the result will be less pharmaceutical innovation, including for American consumers.”
What CMS proposes to do is to switch from the Average Sales Price (ASP) under the current system to the International Pricing Index for Medicare Part B patients, including using the prices of Austria, Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Netherlands, and the UK — all countries that already use price controls.
This aims to keep the costs of the Medicare program down, both to patients and taxpayers. CMS estimates the proposed rule cuts federal Medicare spending $16.3 billion over 5 years and federal and state spending $1.6 billion for Medicare-Medicaid dual beneficiaries.
That works out to a $3.6 billion annual cost to pharmaceutical companies’ compensation from taxpayers under the proposed regulation. But even if the purpose is to reduce senior of out of pocket costs or the federal spending burden on taxpayers, by importing foreign price controls, that money will still have to come out of somewhere as the costs for life-saving medicines will simply be passed on to non-Medicare patients in the form of higher prices.
Politically, this could also create an opening for Democrats to exploit the disparity by calling for more price controls or even for socialized medicine, further stifling innovation. House Democrats have proposed Medicare for All, while Speaker Nancy Pelosi (D-Calif.) and former Vice President Joe Biden are similarly offering Biden’s public option.
Either way, Democrats can bill socialized medicine as a means of reducing out-of-pocket prescription costs that non-Medicare patients will be burdened with under the CMS rule.
Ultimately, the question that remains is who pays for the price of drug innovation?
According to a revised 2016 study by Joseph A. DiMasi, Henry G. Grabowski and Ronald W. Hansen, “Innovation in the pharmaceutical industry: New estimates of R&D costs,” it costs $2.6 billion to get a new prescription drug developed and through FDA approval. The cost rises to $2.87 billion when post-approval research and development costs are factored in.
What the federal government via CMS is saying is that the costs of research and development will no longer be subsidized by Medicare, the program that arguably needs those drugs the most for seniors.
The understated impact of price controls, unfortunately, is when the rest of the developed world uses them, not only are they not paying their fair share, they are passing the costs along to us. This is not unlike the situation that the U.S. finds itself vis a vis NATO, where the U.S. is expected to shoulder a disproportionate share of national defense spending, something President Trump has been savvy to and has sought to rectify among our allies.
In a similar vein, instead of passing higher costs for prescription drug costs onto non-Medicare patients, a more equitable solution would be to negotiate a G20 accord for cost-sharing on drug innovation, whether as a treaty, a trade agreement or even a high-level executive agreement. Why is the U.S. expected to spend the lion’s share of money on research and development?
In addition, given the high costs of bringing drugs to market, and the situation we now find ourselves in with the Chinese coronavirus, a thorough reform of Food and Drug Administration (FDA) approval process is long overdue. We need to speed up that process as was done to combat the AIDS epidemic in the 1980s and reduce costs along the way.
The last thing we want to do, in the age of COVID-19, is stifle innovation among prescription drug developers — when we need it the most.
Robert Romano is the Vice President of Public Policy at Americans for Limited Government.
Cartoon: No-Brainer
By A.F. Branco
Click here for a higher level resolution version.
Video: Biden's VP pick Kamala Harris supported cutting $150 million from LAPD & reducing force to under 10k
To view online: https://www.youtube.com/watch?v=qUUgdlaq-yA
Rapid economic recovery Trump predicted continues as unemployment claims drop
Aug. 13, 2020, Fairfax, Va.—Americans for Limited Government President Rick Manning today issued the following statement on the latest unemployment insurance claims published by the Department of Labor:
“President Donald Trump predicted a fast recovery from the COVID-19, and now it is continuing at a rapid clip with fewer than 1 million new jobless claims for the first time since March, and another 624,000 came off continued claims the week of Aug. 1.
“As a reminder, in Feb. 2020, unemployment was at a 50-year low with fewer than 6 million Americans unemployed and it was the unleashing of the Chinese coronavirus that drove those numbers through the roof. Now, the President's balanced approach to reopening America while continuing to battle the virus has led to an unprecedented recovery, with 9 million to 10 million jobs recovered in the past three months.
“No President has been as focused on private sector job creation in generations, and it stands in stark contrast to the Obama-Biden so-called shovel-ready jobs promise that paid off public employee unions but did little for Americans who were actually out of work.”
To view online: https://getliberty.org/2020/08/rapid-economic-recovery-trump-predicted-continues-as-unemployment-claims-drop/
ALG Editor’s Note: In the following featured column from the Washington Examiner’s Byron York, talk of using the military to remove President Donald Trump from office is becoming all too commonplace:
Resistance sees military removing Trump from office
By Byron York
With 80 days left before the presidential election, a new and dangerous rhetoric has emerged from some corners of the Resistance. A number of President Trump's most implacable critics are fantasizing about deploying the U.S. military to remove him from the White House on Jan. 20, 2021, based on their assumption that a.) he will lose the election, and b.) he will refuse to leave office on his own.
Recently, two retired Army officers speculated about deploying a brigade from the 82nd Airborne Division to overpower Trump's "private army" that they believe the defeated president will use to try to cling to office. Another retired officer, a former chief of staff to Secretary of State Colin Powell, imagined the military in battle with armed Trump supporters, the result being that "all bets are off as to how much blood might flow." In addition, a group of former government officials, political operatives, and journalists concocted a scenario in which Trump actually won reelection but Democrat Joe Biden refused to accept the result in hopes that the military would side with him against the president.
What is going on? Why have seemingly responsible people taken to embracing fantastical visions of tanks in the streets of Washington, D.C.?
They, of course, would blame Trump. In a July 19 appearance on Fox News Sunday, the president was asked, "Can you give a direct answer you will accept the election?" Trump's answer was, "I have to see. I have to see. No, I'm not going to just say yes. I'm not going to say no, and I didn't last time, either."
Trump's response, similar to the answers he gave in 2016 when he was asked whether he would accept the results of that election, set off the usual firestorm. Trump will ignore the will of the voters! He'll set off a constitutional crisis! He'll destroy American democracy!
The speculation might have been less fevered had anyone actually noted how Trump has behaved in office. For example, what has Trump, as president, done when a judge tells him to stop doing something? He stops doing it. Starting with his travel ban and going on through his plan to end DACA and his move to impose new rules on asylum, his effort to revoke a reporter's White House credential and his effort to detain families at the U.S.-Mexico border and his move to stop former national security adviser John Bolton's book and his action to end sanctuary cities and his plan to impose a "public charge" test on immigrants and his multiple attempts to change various environmental policies and his plan to streamline the deportation process and his plan to liberalize energy restrictions and much, much more, Trump has done what judges tell him to do. No, he doesn't deserve a medal for simply respecting the rule of law. But his conduct in office suggests he will not defy the legally certified result of an election.
Of course, that result might not be known on the night of Nov. 3, and if it is not, Trump might not immediately concede defeat, even if he is the ultimate loser. There might be litigation. But what is wrong with that? We have been hearing for a long time that, given heavy voting by mail, the voters' verdict might not be known for weeks. Does anyone believe that Biden, if he were trailing by a small margin, would concede prematurely with the counting still underway?
Given the chances of widespread dysfunction in vote tabulation, there is certainly the possibility of a crisis after Nov. 3. But if it happens, it would likely involve the chaos brought on by a deeply divided nation going weeks or months without knowing who the next president will be — not a losing Trump refusing to leave the White House.
Nevertheless, hysterical scenarios are coming from some sources in the Resistance — a phenomenon that is particularly troubling when it comes from men with ties to the military. Start with the two retired Army officers, Paul Yingling and John Nagl. Yingling is a retired lieutenant colonel with several combat tours, including serving as Gen. H.R. McMaster's deputy in the first Iraq war. Nagl, also a retired lieutenant colonel, is currently headmaster of the Haverford School in Pennsylvania. This week, the two men published, in the mainstream publication Defense One, an article entitled, "'...All Enemies, Foreign and Domestic': An Open Letter to Gen. Milley." The addressee is Gen. Mark Milley, the chairman of the Joint Chiefs of Staff.
Relying on MSNBC-style talking points, the two argue that the president is facing "near certain electoral defeat" and after losing would face "not merely political ignominy, but also criminal charges." Nagl and Yingling say an ex-President Trump will face prosecution by the Manhattan District Attorney and the U.S. Attorney for the Southern District of New York for bank fraud, insurance fraud, and "many examples of self-dealing."
This, Yingling and Nagl allege, has made Trump a desperate man. And he has already begun taking desperate measures. "Given this dizzying array of threats not merely to his political prospects, but also his liberty and wealth," they write, "Mr. Trump is following the playbook of dictators throughout history: he is building a private army answerable only to him."
By "private army," Nagl and Yingling appear to be referring to the president's decision to send Department of Homeland Security officers to Portland, Oregon, to protect the federal courthouse there from rioters. "The members of this private army, often lacking police insignia or other identification, exist not to enforce the law but to intimidate the president's political opponents," Nagl and Yingling write.
That is where Milley comes in. Because Trump is a desperate man with a private army at his command, they argue, the Joint Chiefs chairman must order troops into the streets on Inauguration Day. "The clock will strike 12:01 PM, January 20, 2021, and Donald Trump will be sitting in the Oval Office," Yingling and Nagl write. "The street protests will inevitably swell outside the White House, and the ranks of Trump's private army will grow inside its grounds. The Speaker of the House will declare the Trump presidency at an end, and direct the Secret Service and Federal Marshals to remove Trump from the premises. These agents will realize that they are outmanned and outgunned by Trump's private army, and the moment of decision will arrive. At this moment of constitutional crisis, only two options remain. Under the first, U.S. military forces escort the former president from the White House grounds. Trump's little green men, so intimidating to lightly armed federal law enforcement agents, step aside and fade away, realizing they would not constitute a good morning's work for a brigade of the 82nd Airborne. Under the second, the U.S. military remains inert while the Constitution dies. The succession of government is determined by extralegal violence between Trump's private army and street protesters; Black Lives Matter Plaza becomes Tahrir Square."
What is one to make of such a hallucinatory vision? "It's bananas," said one Republican lawmaker who has been following the talk. But it is more than just crazy, although it is crazy. It is chilling that retired military men are discussing military intervention in the transfer of political power based on Maddow-esque theorizing about the president's imagined motivations and actions.
A second scenario of military intervention came from another prominent former Army officer. Appearing on Bill Maher's Real Time, retired Col. Lawrence Wilkerson (a former chief of staff to Secretary of State Colin Powell) outlined a scene from the apocalypse on Inauguration Day. Wilkerson said he believed the military would stay in their barracks under most scenarios. But then: "I wonder what will happen if Trump calls his base to the streets with their guns. His base owns something like 60-70% of the 300, 400 million guns in America. If they answer that call and come to the streets with guns, then we probably are going to have a need for the military. And then, all bets are off as to how much blood might flow."
Wilkerson is part of an anti-Trump group called the Transition Integrity Project, which was founded to promote the notion that Trump "may seek to manipulate, ignore, undermine or disrupt the 2020 presidential election and transition process." The group recently made news by holding "war games" to explore some possible election scenarios. The project, which includes about 100 former government officials, political operatives, academics, and journalists, explored two Biden victory scenarios, one a blowout, the other a narrow win. In the blowout, Trump left office on Jan. 20, 2021, with little drama. In the narrow win, Trump did not concede defeat, there were street protests, and a signal from the Secret Service that it would escort Trump out of the White House when the time came. After what the group called an "uneasy and combative but ultimately successful" transition, Trump left office on Jan. 20, 2021. In both scenarios, a defeated Trump left the White House at the appointed time. Neither scenario involved the military.
The big problem came when the experts at the Transition Integrity Project gamed out a clear Trump victory. In that scenario, as in the 2016 election, Trump lost the popular vote but won the Electoral College — meaning he won the presidency. But Biden and his Democratic supporters would not accept the election verdict. The transition period was wild. Biden pushed the Democratic governors of states Trump won to reject the president's electors and substitute Biden electors instead. Democrats encouraged some states to secede from the United States to put pressure on Trump. Biden's campaign made wild demands in exchange for conceding, such as statehood for Washington, D.C., and Puerto Rico, and breaking up California to add new Democratic senators. A standoff ensued. Trump had without doubt won the presidency, but Democrats were willing to do virtually anything to keep the president from his second term. Finally, Inauguration Day came with the situation "unresolved." The group's report said: "It was unclear what the military would do in this situation." The suggestion, never made explicit, was that Democrats would seek the military's help in evicting the constitutionally elected president from the White House.
In June, Biden himself raised the possibility of the military removing Trump from office and praised retired generals and admirals who publicly condemned Trump's handling of rioting around the country. Asked by Comedy Central's Trevor Noah if he had considered the possibility of Trump losing and refusing to leave office, Biden quickly answered, "Yes, I have. And I was so damn proud — you have four chiefs of staff coming out and ripping the skin off of Trump. And you have so many rank-and-file military personnel saying, 'Whoa, we're not a military state. That is not who we are.' I promise you, I am absolutely convinced they will escort him from the White House with great dispatch."
We are not, in fact, a military state. But there have arisen, among some of Trump's angriest critics (especially those with military experience), disturbing imaginings about the military removing the president from office. Perhaps after three years of white-hot opposition to the president, there is an emotional gratification in contemplating soldiers grabbing Trump and taking him from the White House "with great dispatch."
But perhaps the theorizing about Trump refusing to leave, which in turn would justify military action, is the final product of a deep frustration among those in the Resistance. At this point, they have thrown everything they have at him. Years of investigations. Unprecedented leaks of U.S. intelligence. Media treatment that has been negative beyond measure. And then, they tried impeachment, the constitutionally prescribed means of removing him from office during his term. That, too, failed.
Now, in November, comes the final constitutionally prescribed means of removing the president. At the moment, the polls give Biden a substantial lead. If Biden wins (even if it comes after a vote-counting process that is long and rocky), a reasonable look at Trump's history suggests he will leave office like every other president. But for some, there could be something unsatisfying about a scenario in which a hated president simply loses and leaves. So, coup porn has appeared. Perhaps for some people, it fills a deep-seated need. But for others, it is a terrifying glimpse of the abandonment of basic constitutional principles.
To view online: https://www.washingtonexaminer.com/opinion/columnists/coup-porn-resistance-sees-military-removing-trump-from-office
