The Drug Industry, Again

One of the bloggers at The New York Times, Judith Warner, writes that one Louise Claire Clark was a supporter of national health care while living in Australia in the 1980s. Living in the U.S.A. in the early 1990s as a single mother, she was eager to see health care reform and campaigned for Bill Clinton for president. She needed work and auditioned for the job of "Louise" in a commercial directed by political consultant Ben Goddard, who told Clark he was a Democrat and

the insurance lobby’s goal was merely to “open communications with the White House, to bring everyone in,” she recalls.

“He said, ‘It’s just one ad, and everybody knows there’s going to be health reform.”



She says that she was "very upset" when health care reform was eviscerated in 1993. Then in 1997 she married Goddard, a highly successful political consultant who, Jeffrey Birnbaum noted in 2004

created the first political advertising in the former Soviet Union to preserve Boris Yeltsin's free-market reforms. In the United States, he's worked for politicians including President Jimmy Carter, Sen. Gary Hart (D-Colo.), Rep. Morris K. Udall (D-Ariz.), former interior secretary Bruce Babbitt and Jesse Jackson.

And whose "clients are a Who's Who ofcorporate America- including life insurers and utility giants."

Fast forward sixteen years from the failure of President Clinton's health reform and 12 years since Clark's marriage. We now have the pharmaceutical industry willing to spend up to $150 million advocating generic health care reform in ads such as this:



As vanilla as this spot is, it would still be difficulut to understand why the health insurance industry, which dominates a health care system which desperately needs an overhaul, would be supporting any deviation from the status quo. Except, as Robert Reich explained on his blog Tuesday

Last week, after being reported in the Los Angeles Times, the White House confirmed it has promised Big Pharma that any healthcare legislation will bar the government from using its huge purchasing power to negotiate lower drug prices. That's basically the same deal George W. Bush struck in getting the Medicare drug benefit, and it's proven a bonanza for the drug industry. A continuation will be an even larger bonanza, given all the Boomers who will be enrolling in Medicare over the next decade. And it will be a gold mine if the deal extends to Medicaid, which will be expanded under most versions of the healthcare bills now emerging from Congress, and to any public option that might be included. (We don't know how far the deal extends beyond Medicare because its details haven't been made public.)

So health "reform" may be to the industry's liking, especially if final legislation includes a mandate with no public option. As Daniel DeGroot details in his post at openleft.com, conservatives have attacked virtually everything proposed in reform legislation, and much of what hasn't been proposed but only imagined. Except: there has been a stunning (near) silence about mandates. That's hardly surprising, given that a mandate for health insurance would increase demand for care- which then would be met by a health insurance industry only too happy to increase its rates in the face of greater demand, and no public option to increase supply.

Some things, and people, have changed in the sixteen years since the last effort to provide a health care system befitting a great country. There is now Barack Obama instead of Bill Clinton and Billy Tauzin heading up Big Pharma instead of doing its bidding in Congress. But there still are Louise Clark, Ben Goddard, and an insatiable greed in the pharmaceutical industry.

Politics Trumps Family: Thy Name Is Sarah

The exploitation of the children of Sarah Palin by their mother for political gain continues.

It began, as far as we know, on convention night in St. Paul, Minnesota. And it continues to this day on Facebook:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats....."

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s 'death panel' so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care."

Really, was it necessary to use her daughter's disability to make things up about a "death panel," to imagine "subjective judgement(s)," blindly to attack nameless government "bureaucrats," and to try to scare individuals into believing that the President of the United States wishes them dead? Apparently it is, if your name is Sarah Palin.

That Little Matter Of Drug Prices

Once a Democratic U.S. Representative from Louisiana, Billy Tauzin was instrumental in forming the Blue Dog caucus. When it became clear the Democratic label had become anathema to white Southerners, Billy Tauzin in 1995 became a Republican member of the House of Representatives. As chairman of the Commerce and Energy Committee, in 2003 he shepherded through the House the Medicare Modernization Act, creating Medicare Part D in 2006, in the process prohibiting Medicare from negotiating prices with drug companies.

Never let it be said that Billy Tauzin would fail to seize an opportunity. Mr. Tauzin resigned from Congress and that day became president of the Pharmaceutical Research and Manufacturers of America. And now Tauzin has seized the opportunity to negotiate with a President who desperately wants a health care reform bill, passage of which numerous pundits have suggested would put him on an upward spiral toward an historic presidency.

A few months ago, President Obama announced that the pharmaceutical industry had agreed to $80 billion of savings (over ten years) to help pay for a reform package. Unfortunately, as the Los Angeles Times reported

Tauzin said he had not only received the White House pledge to forswear Medicare drug price bargaining, but also a separate promise not to pursue another proposal Obama supported during the campaign: importing cheaper drugs from Canada or Europe. Both proposals could cost the industry billions, undermine its ability to develop new cures and, in the case of imports, possibly compromise safety, industry officials contend.

If Medicare were permitted to negotiate drug prices, according to a report by energy and commerce's investigations subcommittee, savings would approach $156 billion over the same ten-year period. However, the authors of a paper (pdf) prepared by the Institute for America's Future conclude that the savings would be nearly $35 billion a year.

That would amount to $350 billion over the ten-year period, substantially in excess of the $80 billion Obama procured from the drug industry. But even at the conservative estimate of $156 billion, the President has managed to negotiate away $76 billion, a not insubstantial sum of money.

Tauzin's pre-emptive strike was in response to action by the House Energy and Commerce Committee in reporting out a bill which would permit Medicare drug negotiation. Timothy Noah in slate.com describes the Administration's response. It is somewhat cryptic and hardly reassuring, and suggests that the Administration has cut a deal it is displeased has been interpreted as giving away the store.

If, as is probable, such a deal was cut, the obvious savings and benefit to Big Pharma are substantial and reasonably calculable. Aside from that, however, is a cogent objection leveled by one reader of Noah's article, who notes

it would be instructive to define the true cost/benefit to Pharma of the purported $80 billion they are "giving up" (putting aside the backdoor negotiation to prohibit any future risk). Assuming that health reform includes a drug benefit for an additional 45 million uninsured any reduction in drug charges will be compensated for by increased volume, thus at the least preserving current and future revenue (and very likely expanding it). In addition, the basis from which the $80 billion "savings" is derived needs to be defined - is it retail or wholesale pricing, are standard discounts acknowledged etc?

And a simpler objection need be raised: how enforceable is the industry's promise of $80 billion in savings? Clearly, in either case, President Obama needs to start one of his famous dialogues, this time with candidate Obama, who seemed in this video (below) to have no illusions about Billy Tauzin. He still does not, but apparently also wants a health care bill, representing a notch in his belt, at virtually any cost.

The Quitting Governor Sounds Off On Health Care

She has done it again!

Without being prompted by Democratic politicians or the "liberal media" to leave Alaska in favor of hobnobbing in the "lower 48," Sarah Palin has issued another entertaining statement.

In Facebook, the ex-Governor issued a "Statement on the Current Health Care Debate" in which she exclaimed

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

To give Mrs. Palin her due, that kind of society would be "downright evil," were such a thing being contemplated. (Although given the rationing of care practiced by the health insurance industry every hour of every day, the current system, does bear a small resemblance.)

Inasmuch as no health reform initiative proposes a "death panel," let alone one which would evaluate an individual's "level of productivity in society," no one can be sure what The Quitting Governor actually meant, not unlike her resignation speech. Perhaps we should give her the benefit of the doubt and assume that she was not referring to the noxious conservative tall tale that hordes of government workers are poised to descend on the homes of elderly Americans and encourage them to die. Maybe The Quitting Governor, ignorant though she sometimes appears (video below- you've seen it many times, but you can't stop looking, can you?), was referring to comparative effectiveness research. In the words of a federal government website

The American Recovery and Reinvestment Act of 2009 created the Federal Coordinating Council for Comparative Effectiveness Research to coordinate comparative effectiveness research across the Federal government. The Council will specifically make recommendations for the $400 million allocated to the Office of the Secretary for CER.

Funds for comparative effectiveness research enable medical and scientific professionals to compare strategies and treatments which can be used to improve the health of patients. No "bureaucrat" makes a "subjective judgement;" they are objective judgements and decisions would remain the responsibility of government officials. It's hard to imagine anyone objecting to this concept, unless the pandering politician is playing to pharmaceutical or medical device lobbyists. Or hostile to science. Or both. (For a thoughtful, balanced analysis of implementation of comparative effectiveness research, click here.)

Conservatives enjoy railing against what they claim is government efficiency. You might think that faced with a governmental intitiative aimed at increasing efficiency, they would applaud what they could trumpet (sincerely or otherwise) as somehow uncharacteristic of liberals, or of Democrats. But that is not how the Repub Party of No operates these days, and there may be no better example than Sarah Palin, her words at once ignorant and manipulative.

Obama Not A Man

At firedoglake.com, blue texan quoted her as writing "the health-care protesters have to make sure they don’t get too hot, or get out of hand. They haven’t so far, they’ve been burly and full of debate, with plenty of booing. This is democracy’s great barbaric yawp." He/she concludes

This is the first time I've seen racism and death threats described as 'great.'

Media Matters.org recognized that

she whole heartedly defends the mini-mobs and berates Democrats for having the nerve to push back rhetorically (and) ignores the death threats issued to at least one Congressman. She ignores that members of Congress now routinely have to be escorted to their cars by police after mini-mobs unleash their wrath (and) lectures the White House that nobody in the administration--nobody--should be using Nazi references in the context of the health care debate. Ever. This, of course, one day after Rush Limbaugh and Glenn Beck both accused the White House of acting like Nazi's (sic).

At his Daily Dish blog, the Atlantic's Andrew Sullivan noted

She is not terrified by massively escalating healthcare costs, which are bankrupting the government and the private sector. She doesn't mention these once in her know-nothing column. She just channels the "feelings" of others and wants that to guide public policy. She does not mention the crises on many people's lives because of our current healthcare system. In fact, there is not a scintilla of a constructive proposal in the column - just an amorphous sense that anything that costs money shouldn't happen now....

And who is the "she" they are referring to? None other than Wall Street Journal columnist and former President Reagan speechwriter Peggy Noonan, having penned an opinion piece on August 7, 2008, invoking all the usual villains to rationalize the angry mobs which have disrupted town hall meetings called by Democrats in their home districts last week. Nancy Pelosi (the favorite Repub target), the Democratic Party, the Democratic National Committee, the AFL-CIO, and even Noonan's favorite Democrat, Barack Obama.

Funny, though. Criticizing Pelosi for criticizing demonstrators for criticizing Obama, Noonan charges "for normal people, it's not all about Obama." Later, she upbraids the President, who should

should call in his troops and his Congress and announce a rethinking. There are too many different bills, they’re all a thousand pages long, no one has time to read them, no one knows what’s going to be in the final one, the public is agitated, the nation’s in crisis, the timing is wrong, we’ll turn to it again—but not now. We’ll take a little longer, ponder every aspect, and make clear every complication.

The President, she seems to be saying, is weak- he hasn't been able to "call in his troops" and order them to do as they should. There is a faint odor about this coming from Ms. Noonan.

From New York Magazine, "Looking For Mr. Right" is a compendium- as of mid-2004- of Peggy Noonan's Greatest Hits, and below a couple of quotes, the first in the longer version about President Reagan, the second about Reagan and President George W. Bush that didn't make the list.

But you know, that’s how I think a lot of people felt when Reagan was in the White House: Daddy’s home. A wise and brave and responsible man is running things. And that’s a good way to feel.

The charismatic figure Mr. Bush follows is the last big American president, the last who had the massive presence of a battleship, Ronald Reagan.

There is an obvious pattern in Noonan's elegant prose, including “Men are back. Manliness is once again being honored and celebrated in our country ... I am speaking of masculine men, men who push things and pull things and haul things and build things ... Manliness wins wars.”

Noonan loves masculinity. Hard, muscles ripplin' masculinity. And unless President Obama reins in those wimpish, liberal, renegade Democrats, he just doesn't cut it for her.

Obama is unlikely to demonstrate such manful manliness. He doesn't need to. He has Chief of Staff Rahm Emanuel to do that, as Jane Hamsher points out. And with Emanuel, the President aims to go 14-0 on legislation. Even if he has to sacrifice genuine health care reform to do it.

The Conservative Impulse, Circa 2009

The description of the town hall meeting of August 4 held by Rep. Todd Akin (R.-Mo.) comes from Steve Benen of The Washington Monthly:

"This particular meeting, in a way is a little bit unique," Akin said. "Different people from Washington, D.C., have come back to their districts and have town hall meetings, and they almost got lynched."

The conservative crowd thought this was great."I would assume you're not approving lynchings, because we don't want to do that," Akin said, generating more laughs as he put his hand to his neck.

The video of this remarkable exchange was highlighted by firedupmissouri.com:



Understandably, the first reaction is: this guy thinks it's amusing that Democratic legislators have been almost "lynched" when they've appeared recently at town-hall meetings in their district. And the second reaction is that Akins' easily amused constituents are mighty pleased these legislators have gotten yelled at, hung in effigy, and worse.

It's bad enough that Akins cavalierly invokes "lynching" as if that does not bring up thoughts of the worst manifestation of the greatest stain on the American character, slavery. Perhaps the right, or extremists generally, are characteristically insensitive to the historical implications of emotion-laden terms: the far-right, traditionally not enthralled with Jews, likes to refer to abortion as a "holocaust." Those who can't argue, trivialize suffering.

But there is something else going on here, as reported by The St. Louis Beacon. Julie Eckstein, described as a former director of the Missouri Department of Health and Senior Services and now a project director with Newt Gingrich's Center for Health Transformation, received an approving laugh from the audience when, ridiculing health care freform, she said

How many of you think the government can run your business better than you do?

And apparently Akin also was auditioning for a gig as a stand-up comedian:

On the cap-and-trade bill -- or cap-and-tax, as Akin and the presenters termed it -- Akin started out by saying, "I hope you've enjoyed the global warming we've had here in St. Louis lately."

What do these comments have in common, a characteristic of the modern conservative movement?

The boldest (such as it is) and, possibly, defining characteristic of the reform effort is the public option. Still, Eckstein slammed reform by sarcastically asking whether "government can run your business better than you do?"

But is a public, government-run option tantamount to government running the business? Or is it government offering an alternative? Clearly the latter, as implicitly acknowledged by the health insurance industry and its lackeys when they claim that a public option would run the private suppliers of health care out of business.

And Akin, belittling the notion of climate change, chose to remind his audience of the recent weather, hot and humid, in the St. Louis area. Most of us are familar with global warming-deniers jumping on a cold wave to proclaim triumphantly: "aha, there's your global-warming! You enjoying this cold weather?" Sure, they are unaware, or pretend to be unaware, that a few days of unusually cold weather in one part of a country in one part of the earth means virtually nothing. But at least cold runs counter to warming. However, Akin- who reportedly was a big hit with the crowd- pointed to heat ("I hope you've enjoyed this global warming") to undermine the idea of a warming trend.

This is not your Republican Party of William F. Buckley or George F. Will- or even of Barry Goldwater or William Kristol. This has become a party allergic to reasoning- with those you oppose or even those with whom you agree. A party which finds thinking overly exerting, apparently dominated by a whatever-pops-into-the-mind conservatism, whose more conservative adherents and heroes (e.g., Limbaugh, Beck, Hannity) often exhibit a kind of ideological attention deficit disorder.

This doesn't apply to all conservative Republicans, obviously. Libertarians, though acutely misguided in their philosophy, tend to be somewhat thoughtful. Still, what understandably strikes some liberals as stupidity or ignorance in the right-wing really gives them too little, or too much, credit. Some of these guys and gals still win elections, and some make a whole lot of money. Look closely- it is more often a convenient lack of focus, a resistance to disciplined thinking and analysis which is at play.

Arlen Specter and Barack Obama: Perfect Together

Thanks to dailykos, here is video of Pennsylvania Senator Arlen Specter explaining on MSNBC's Hardball on Tuesday evening why he voted for McCain-Palin rather than Obama-Biden:



And thanks to the MSNBC website, we have the transcript to read the response of Republican-turned- Democrat Specter when Chris Matthews asked him for whom he had voted:

I thought that they were the better choice. And I was trying to work within the Republican party, and trying to bring moderation to the Republican party. The decisive step I took was when I heard President Obama early this year say we were on the verge of sliding into a 1929 Depression, and a new president with a new mandate. And I voted for the stimulus package.

And when Matthews wouldn't accept that answer at face value and asked him whether he was comfortable trying to place Sarah Palin "a heartbeat away from the presidency," Specter respnded:

Chris, I didn't exactly think my vote would be decisive. But when you're in a party and you work for a party and you're trying to work within the structure to moderate the party, I think that's the correct thing to do.

But parties change. Look here, Ronald Reagan changed parties. Winston Churchill changed parties. Phil Graham, Dick Shelby. It's not so unusual. And in my case, I think there was good provocation to do it, and I think it was the right thing.

Now, up until then, Biden and Rendell and a lot of people had been trying to get me to become a Democrat. When I voted for the stimulus package, I had more Republicans urging me to become a Democrat than the Democrats. And the effort to bring moderation to the Republican party was not successful. And I feel very comfortable as a Democrat.

It's hard to figure out why trying to "moderate" the party would entail voting for John McCain and, especially, Governor Palin, and Specter never explained. He does remind us that he voted for the stimulus package, though neglecting to remind us that he first (successfully) worked to weaken it. But he never concedes that he made a mistake voting for McCain-Palin- if in fact he thinks he does- or even that he finds Democratic/liberal ideology preferable to the reigning ideology of the Republican Party. Only that he "feel(s) very comfortable as a Democrat," which might mean only that he's more at ease when he actually has a chance to win re-election.

Pat Toomey, the former president of the right wing libertarian Club for Growth who very likely will be the Repub nominee for the Senate seat in 2010, had it right when he appeared immediately before Specter on Hardball and observed

Chris, Arlen Specter is whatever he thinks the political calculus suggests he should be at any moment in time.

Right now, that means liberal Democrat, because he's got a primary challenge from the left. If-if he manages to get by that, which I don't know that he will, but, if he does, he will be something else again. This is a guy who has made a career out of being on both sides of as many issues as he can.

It's not likely that Toomey, former chairman of the right-wing/libertarian Club for Growth, has seen the bar graph posted Wednesday by Moulitsas on his dailykos site. It seems hardly coincidental that Arlen Specter voted with the GOP most of the time when he belonged to that party, then voted primarily with the Democrats after his switch, then veered sharply left once it became clear he'd be challenged in the Democratic Party by Joe Sestak, who announced Tuesday that he would enter the race.

And the stance of President Obama, whom Specter apparently is still satisfied he voted against? As the New York Times reported, the day after Mr. Opportunistic announced his change of party

Mr. Obama pledged enthusiastic support for Mr. Specter’s candidacy as a Democrat in 2010, saying, "We are confident that Arlen Specter is going to get a sixth term."

No doubt the President has believed all along that Arlen Specter would be a valuable supporter as a Democrat of his agenda. And so he has been, and will be until, if planned, he is re-elected, at which time his political calculus will shift. Meanwhile, it will be interesting to view President Obama campaign for the incumbent against two-term U.S. Representative Sestak, the highest ranking former military officer in Congress. Sestak is a little different than Specter, having been a critic of the Iraq War, supporter of gun control, and an original co-sponsor of the pro-labor Employees Free Choice Act, which Senator Specter still opposes. And someone who has cast a vote for for Barack Obama.