Substacks
August 29, 2023 Heather Cox Richardson
“For far too long, Americans have paid more for prescription drugs than any major economy. And while the pharmaceutical industry makes record profits, millions of Americans are forced to choose between paying for medications they need to live or paying for food, rent, and other basic necessities. Those days are ending,” President Joe Biden declared today.
The government announced the first ten drugs whose prices it will negotiate with pharmaceutical companies for about 65 million Medicare recipients. Until now, the United States has been virtually alone as the only country in which the government did not negotiate or regulate medicine prices, instead allowing companies to set whatever prices they believe the market will bear. Since their products often are the difference between life and death, it turns out the market will bear quite high prices, but—as Biden observed—those prices often force consumers to sacrifice in other ways to afford them.
A 2021 study by the RAND corporation found that drug prices average 2.56 times higher in the U.S. than in 32 other countries. For name brand drugs, U.S. prices were 3.44 times those in comparable nations.
As Amy Goldstein and Daniel Gilbert explained today in the Washington Post, when Congress created Medicare and Medicaid in 1965 as part of President Lyndon B. Johnson’s Great Society program, it covered drugs administered in a health care setting but excluded those a patient took at home. In 2003, after almost 40 years of medical innovation had significantly changed our management of chronic illnesses, Congress included those drugs under a separate Medicare plan—Part D—or as part of managed-care plans, but to get Republicans behind the bill, Congress explicitly prohibited the government from negotiating the prices of medications.
In 2021 a nearly three-year investigation by the House Committee on Oversight and Reform, then overseen by Democrats as they held the majority in the House of Representatives, concluded that “[d]rug companies have raised prices relentlessly for decades while manipulating the patent system and other laws to delay competition from lower-priced generics. These companies have specifically targeted the U.S. market for higher prices, even while cutting prices in other countries, because weaknesses in our health care system have allowed them to get away with outrageous prices and anticompetitive conduct.”
Republicans sided with the drug company executives who insisted that high prices were necessary to create an incentive for drug companies to innovate, as their investment in research and development depends on the revenue they expect from new drugs. But the committee’s report said their investigation concluded that “sky-high drug prices are not justified by the need to innovate. The largest drug companies spend more on payouts for investors and executives than on research and development. And many blockbuster drugs rely on scientific discoveries from research funded by taxpayers, while drug companies’ R&D spending often focuses on minor changes to extend patent protection and block lower-priced competitors.”
In 2022, Democrats passed the Inflation Reduction Act without a single Republican vote. That law permits the government to negotiate with pharmaceutical companies over drug prices the government will pay.
The ten drugs listed in today’s announcement are among those with the highest total spending in Medicare Part D, and today the Department of Health and Human Services released a report that 9 million seniors paid a total of $3.4 billion for these drugs in 2022. The Congressional Budget Office, the nonpartisan agency that provides budget and economic information to Congress, estimates that government negotiation over these drugs will save taxpayers about $98.5 billion over ten years. If a drug maker refuses to negotiate, it either will face a significant tax or must withdraw from Medicare and Medicaid.
This measure is extraordinarily popular. More than eighty percent of Americans want the government to be able to negotiate drug costs.
The new negotiated prices are scheduled to go into effect in 2026. Pharmaceutical companies are suing to stop the law, claiming it is unconstitutional, although when asked by reporters today about the lawsuits, domestic policy advisor Neera Tanden pointed out that the government “negotiates prices for every other element” Medicare covers of the health care system,, including rates for doctors, other providers, and hospitals. “The only reason why Medicare has not been negotiating drug prices is because Pharma got a sweetheart deal decades ago to basically prohibit negotiations,” she said. “Negotiations are part of [a] market system. It’s very normal for that to happen.”
“This plan is a key part of Bidenomics, my economic vision for growing the economy from the middle out and the bottom up—not the top down,” Biden said. “And it’s working.”
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Notes:
https://www.cbo.gov/publication/57126
https://www.kff.org/health-costs/poll-finding/public-weighs-in-on-medicare-drug-negotiations/
https://www.rand.org/news/press/2021/01/28.html
https://www.washingtonpost.com/health/2023/08/29/medicare-drug-price-negotiations/
https://www.pharmexec.com/view/astrazeneca-joins-legal-battle-against-ira
https://www.politico.com/news/2023/08/29/biden-drug-prices-gop-00113404
Yesterday, U.S. officials arrested Ismael Zambada García, or “El Mayo,” cofounder of the violent and powerful drug trafficking organization the Sinaloa Cartel, and Joaquín Guzmán López, a son of its other cofounder. That other cofounder, Joaquín Guzmán Loera, or “El Chapo,” is already incarcerated in the U.S., as are another of El Chapo’s sons, alleged cartel leader Ovidio Guzmán López, and the cartel’s alleged lead hitman, Néstor Isidro Pérez Salas, or “El Nini.”
In a statement, Attorney General Merrick Garland said: “Fentanyl is the deadliest drug threat our country has ever faced, and the Justice Department will not rest until every single cartel leader, member, and associate responsible for poisoning our communities is held accountable.” El Mayo has been charged with drug trafficking and money laundering.
U.S. officials exploited rifts in the cartel to get Guzmán López to bring El Mayo in. The successful and peaceful capture of the two Sinaloa Cartel leaders contrasts with Trump’s insistence that the U.S. must bomb or invade Mexico to damage the cartels, a position echoed by Republican vice presidential candidate J.D. Vance and increasingly popular in the Republican Party. Mexico, which is America’s biggest trade partner, staunchly opposes such an intervention. Opponents note that such military action would do nothing to decrease demand for illegal drugs in the U.S. and would increase the numbers of asylum-seekers at the border as their land became a battleground.
Trump seems to think that governance is about dominance, but that approach often runs afoul of the law. Today the Justice Department reached a $2 million settlement with former FBI counterintelligence agent Peter Strzok and former FBI lawyer Lisa Page, who became the butt of Trump’s attacks after their work on the FBI investigation into the ties between the 2016 Trump campaign and Russian operatives. Trump’s Department of Justice released text messages between the two journalists. Today’s settlement appears to reflect that the release likely violated the Privacy Act, which bars the government from disclosing personal information.
Tonight, speaking to Christians at the Turning Point Action Believers’ Summit in West Palm Beach, Florida, Trump made his plans to become a strongman clear: “Get out and vote. Just this time. You won’t have to do it anymore. Four more years, you know what: it’ll be fixed, it’ll be fine. You won’t have to vote anymore, my beautiful Christians…. Get out, you’ve got to get out and vote. In four years, you don’t have to vote again, we’ll have it fixed so good you’re not going to have to vote.”
This chilling statement comes after Trump praised autocratic Hungarian prime minister Viktor Orbán in his speech at the Republican National Convention last week and then publicly praised China’s president Xi Jinping for being “brilliant” because he “controls 1.4 billion people with an iron fist.” It should also be read against the backdrop of the Supreme Court’s decision in Donald J. Trump v. United States that a president cannot be prosecuted for crimes committed as part of his “official duties.”
The Harris campaign reacted to Trump’s dark statements by ridiculing them, and him: “Tonight, Donald Trump couldn’t pronounce words [he mispronounced “landslide” as “land slade], insulted the faith of Jewish and Catholic Americans, lied about the election (again), lied about other stuff, bragged about repealing Roe, proposed cutting billions in education funding, announced he would appoint more extremist judges, revealed he planned to fill a second Trump term with more criminals like himself, attacked lawful voting, went on and on and on, and generally sounded like someone you wouldn’t want to sit near at a restaurant—let alone be President of the United States.
“America can do better than the bitter, bizarre, and backward looking delusions of criminal Donald Trump. Vice President Kamala Harris offers a vision for America’s future focused on freedom, opportunity, and security.”
Harris continually refers to Trump as a criminal in her speeches, but her campaign has taken the approach of referring to him and J.D. Vance as weirdos. On Tuesday, Minnesota governor Tim Walz said, “These guys are just weird.” Senators Chris Murphy of Connecticut and Brian Schatz of Hawaii recorded a video together about Vance’s “super weird,” “bananas,” and “offensive” idea that people with children should be assigned additional votes for each child, making their wishes count more than people without children.
As J.D. Vance continues to step on rakes, the “weird” label seems correctly to label the MAGAs as outside the mainstream of American thought. Today, Vance doubled down on his denigration of women who have not given birth as “childless cat ladies” but assured voters he has nothing against cats. In addition, a video surfaced of Vance calling for the federal government to stop women in Republican-dominated states from crossing state lines to obtain abortions.
Mychael Schnell of The Hill reported today that while MAGA Republican lawmakers like Vance, a number of House Republicans are bashing his selection as the vice presidential candidate. “He was the worst choice of all the options,” one said. “It was so bad I didn’t even think it was possible.”
“The prevailing sentiment is if Trump loses, [it’s] because of this pick,” another said, a sentiment that suggests Vance will be a scapegoat if Trump loses. Considering what happened to Trump’s last vice president after Trump blamed him for an election loss, Vance might have reason to be concerned.
Last night’s “Answer the Call” Zoom has now raised more than $8.5 million for Harris; the organizers thanked Win With Black Women “for showing us how it’s done.” Today the Future Forward PAC, which had threatened to hold back $90 million in spending if Biden stayed at the head of the ticket, began large advertising purchases in swing states for Harris.
Carl Quintanilla of CNBC reported that a week ago, those on a phone call of more than 400 people from Bank of America’s Federal Government Relations Team believed that a Trump victory was a “foregone conclusion.” Now that conviction is gone. “[T]here’s been a palpable sentiment reversal.”
The Harris campaign announced that it will launch 2,600 more volunteers into its ground game in Florida, a state where abortion rights will be on the ballot this fall, likely turning out voters for the Democratic ticket. The volunteers will write postcards, make phone calls, and knock on doors.
Today, Vice President Kamala Harris filled out the paperwork officially declaring her candidacy for president of the United States.
Notes:
https://www.cnn.com/2024/07/25/us/sinaloa-cartel-ismael-zambada-custody-report/index.html
https://www.texasstandard.org/stories/mexico-surpasses-china-us-biggest-trading-partner-exports/
https://www.politico.com/news/2023/04/10/gop-bomb-mexico-fentanyl-00091132
https://www.politico.com/news/2024/07/26/peter-strzok-lawsuit-settlement-00171498
https://www.vox.com/culture/363230/jd-vance-couch-sex-hillbilly-elegy-rumor-false
https://thehill.com/homenews/4793818-vance-vp-trump-house-republicans/
https://ballotpedia.org/Florida_Amendment_4,_Right_to_Abortion_Initiative_(2024)
X:
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Acyn/status/1816993825929461860
Victorshi2020/status/1817024584425619737
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EJDionne/status/1816923327048613906
shannonrwatts/status/1816882297595150756
JacobRubashkin/status/1816859976444338479
KamalaHarris/status/1816998711056052463
EdwardGLuce/status/1816814101823131803
carlquintanilla/status/1816848322050642373
ArtCandee/status/1816935834500657185
NewsHour/status/1816964874120974349
Oh, no, it’s the sister again, for another slow news week. Let’s get to it.
→ Biden dropped out: Six years ago emotionally, but technically this past Sunday, Joe Biden dropped out of the presidential race. He did it via X and promptly threw his support (and cash) behind Vice President Kamala Harris. Then he got Covid and hunkered down in Delaware—or depending on what hooch you’ve been drinking, died and was reanimated so he could appear before the cameras on Wednesday to address the nation. Joe’s family, including Hunter, sat along the wall of the Oval Office as he spoke. The president talked about the cancer moonshot, ending the war in Gaza, putting the party over himself, and Kamala’s tenacity, as Kamala’s pistol dug ever-so-slightly harder into his back. Right after, Jill, the First Lady of passive aggression, who apparently wanted to outdo her heart emoji, tweeted a handwritten note “to those who never wavered, to those who refused to doubt, to those who always believed.” I respect a First Lady who stands by her man and her energetic stepson. A First Lady who sees the high road way up there and says to herself, “If they want us out of here so bad, they can clean out the fridge and strip the beds themselves!”
→ Kamala is brat, Biden is boots, please God send the asteroid today: I’ve learned the hard way—and by that I mean my parents once asked me what “WAP” meant—that certain things should never be explained with words. It’s not that it’s impossible, it’s just that it embarrasses everyone.
That’s how I feel about the whole Kamala-is-brat thing. Brat is a good album about partying and getting older and having anxiety that was released earlier this summer by Charli XCX. But it’s since been adopted by too-online and very young people as a personality, and by Kamala Harris’s campaign as a mode to relate to those very young people. Her campaign is leaning into the whole green look of the album to try and win over Gen Z, and generally recasting her many viral moments—“You think you just fell out of a coconut tree?” “I love Venn diagrams” “What can be, unburdened but what has been”—as calling cards. It’s like when Hillary went on Broad City, only this time more cringe.
And now we have Jake Tapper and Greg Gutfeld grappling with the “essence” and the “aesthetic” and overall vibe of brat girl summer. We used to be a serious country. We used to make things.
Here’s the thing about Kamla: she is hilarious and campy, but unintentionally so. Any goodwill that her goofy dances or weird turns of phrase garner should be considered bonus points, not game play. Was there ever any doubt that Fire Island would go blue? We’ve been debating whether Kamala’s meme campaign is a good move for her prospects in the Free Press Slack, and here I’ll borrow from my older and wiser colleague Peter Savodnik: “There is nothing more pathetic than an older person who cares what a younger person thinks is cool.”
→ Boomer behavior: While Kamala’s campaign is being run by a 24-year-old twink with an Adderall prescription, J.D. Vance’s speechwriter seems to be a drunk Boomer who just got kicked out of a 7-11. Vance, appearing this week at a rally in Middletown, Ohio, riffed, “Democrats say that it is racist to believe. . . well, they say it’s racist to do anything. I had a Diet Mountain Dew yesterday and one today, and I’m sure they’re going to call that racist too.” Crickets. Horror. Major “Thanks, Obama” energy. There was also a bit on fried bologna sandwiches and a lot of “lemme tell you another story.” The guy is 39 but sounds older than Biden.
Fresher, 35-to-60-year-old blood is exactly what we’ve been begging for. Let the Boomers boom, let the Zoomers zoom. Kamala and J.D.: act your age.
July 26, 2024 Heather Cox Richardson
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