Gun Violence: A Uniquely American Disease Devouring Our Soul

January 26th, 2023 by Tom Lynch

America suffered through 647 mass shootings in 2022, which is just a little better than the worst year on record, 2021, a year in which we saw 692 of them. In the last nine days, three mass shootings happened in California, killing 18 people. Thus far, in the first 26 days of 2023 there have been 40, which is more than any other January on record.

The 40 mass shootings in the the first 26 days of January resulted in 86 deaths. Although any death from gun violence is tragic, deaths from mass shootings make up a small percentage of all gun violence deaths. In 2022, there were more than 44,000 of them, 20,138 if you exclude suicides.  Through the first 26 days of January, there have already been 3,030 gun violence deaths nationally.   Here’s a map from the Gun Violence Archive* showing where all those deaths happened. Remember: It’s only 26 days.

If you extrapolate this for the full year, you’ll project more than 45,000 deaths. Now, mass shootings are not proxies for overall gun violence, but it could be instructive (and scary) to realize January is an historically low mass shooting month (relatively speaking).

How does America react to this continuing carnage? It yawns.

Oh, we hear from the politicians with their “thoughts and prayers” routine and go through the required few hours of television coverage (TV’s Mantra: “If it bleeds, it leads”), but after that we slip back into our desensitized cocoons. Most of the mass shootings go unnoticed. At 1.77 per day, who can keep up?

Beginning in 1959, and as it has every year since, the Gallup organization polled Americans with this question: “Do you think there should or should not be a law that would ban the possession of handguns, except by the police and other authorized persons?”  When Gallup asked that question in 1959, 60% of Americans said “Yes, there should be such a law.” Thirty-two years later, in 1991, the “Yes” group had decreased to 43%, and thirty years after that, in 2021, only 19% of Americans were still saying “Yes.” A whopping 80% now said “No.” Credit the NRA. It has done a magnificent marketing job.

Since 1959, when Gallup also reported 78% of Americans believed laws covering the sale of firearms should be made more strict, the decline in support for banning guns has been inversely proportional to the 63-year steady, linear rise in gun ownership and violence. The result is what we have today. Forty-five percent of all households now own at least one handgun. US gun owners possess 393.3 million weapons, according to a 2018 report by the Small Arms Survey, a Geneva-based organization. That is at least 60 million more guns than there are people. It is no surprise gun deaths routinely exceed the number of deaths due to auto accidents.

And it only got worse after Americans went on a gun buying spree beginning in 2020. The National Instant Criminal Background Check System, which the FBI collects, is a significant indicator of firearms purchases. It is noteworthy that background checks jumped 40% in 2020 from the previous year to 39.7 million checks. The frenzy only cooled slightly to 38.9 million checks in 2021.

Where do all those guns come from? Why, from the 71,600 federally licensed gun dealers operating nationwide, of course. That’s more than 1,400 per state.

It may interest you to know that the proposition reflected in Gallup’s question precisely mirrors the law in the UK. No one is allowed to own a gun except “police and other authorized persons.” Exceptions are made for hunting and target shooting, but these are highly regulated and controlled by government. There is very little handgun violence in the UK. To this, you may say, “Without guns, people will just find another way to kill.” To which I reply, “I’d rather try to outrun a knife than a bullet.”

I, like many others smarter than I, have written about this often. It almost seems as if it’s an annual requirement in which we fulfill Albert Einstein’s (possibly misattributed) definition of insanity: “Doing the same thing over and over again expecting different results.”

A University of Washington 2015 study found three million Americans carried a loaded handgun daily; nine million did so at least once a month. Since then, 19 states have passed permitless carry laws, which allow residents to carry concealed handguns in public without a license. There are now 25 states that allow this. If all this weren’t bad enough, only 18 states require “live-fire training” for people carrying concealed firearms.

Is gun violence evenly distributed around the country? Actually, no. It is far more prevalent in red states. These are the states with “stand your ground” statutes and permitless concealed carry laws. Once again, Mississippi leads the way with 28.6 gun violence deaths per 100,000 persons.

Firearm Mortality by State

Compared to the rest of the developed world, every one of our firearm statistics are staggeringly out of whack. As I reported in May of 2022, the US dwarfs the 28 most economically developed countries in the 38-member OECD** in deaths by firearms. Not only is our firearm death rate nearly 25 times higher than our OECD companions, our total homicide rate is eight times higher. Can’t get away from it. We are a violent society.

It’s not much, but there is one ever so tiny glimmer of light invading the darkness of firearm carnage in America. That would be the Bipartisan Safer Communities Act, signed into law by President Biden in June, 2022. This is the first major gun reform law in three decades. It includes $750 million in funding for states to improve or enact red flag laws and other crisis intervention programs, $250 million for community-based violence intervention initiatives, and $200 million for improving the national background check system. Millions more will go to school safety, police, and mental health programs.

Gun violence is a cancer eating away the heart and soul of America. It is amazing to realize that, despite the never-ending bloodbath, the country has managed to survive, prosper, thrive, and lead the world in so many areas.

Amazing, indeed.

_________________________________

*The Gun Violence Archive is a nonprofit research group that tracks shootings and their characteristics in the United States. It defines a mass shooting as an incident in which four or more people, excluding the perpetrator(s), are shot in one location at roughly the same time.

**The Organization for Economic Co-operation and Development, founded by the US and it allies shortly after the close of the Second World War. Its members are the most economically developed countries.

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Posted in Gun Violence, Law, Research

Florida’s Governor Ron DeSantis Builds His Educational Petrie Dish

January 24th, 2023 by Tom Lynch

I know it’s masochistic, but I couldn’t help it. I found myself thinking about Florida Governor Ron DeSantis and his all-out assault on education, specifically education about racism, Wokism (if that’s a word), the LGBTQ+ community, and anything else he doesn’t agree with.

I began my long and winding journey down the DeSantis rabbit hole when I learned that yesterday was the day in 1964 when South Dakota became the deciding and 38th state to ratify the 24th amendment to the US Constitution.

The 24th Amendment prohibits making the right to vote conditional on paying a poll tax, or any other kind of tax. It reads:

Section 1. The right of citizens of the United States to vote in any primary or other election for President or Vice President, for electors for President or Vice President, or for Senator or Representative in Congress, shall not be denied or abridged by the United States or any State by reason of failure to pay any poll tax or other tax.

Section 2. The Congress shall have power to enforce this article by appropriate legislation.

The 24th Amendment applied to Presidential and Congressional elections. Two years later, in 1966, the U.S. Supreme Court ruled 6–3 in Harper v. Virginia Board of Elections that poll taxes for any level of elections were unconstitutional. It said these violated the Equal Protection Clause of the Fourteenth Amendment.

Seven states never held a vote to ratify the Amendment. They are Wyoming, Arizona, Arkansas, Oklahoma, Louisiana, South Carolina and Georgia. One state voted to reject the Amendment’s approval altogether. That was Mississippi. Mississippi again. The state seems to rejoice in being the bottom of the country’s bird cage.

Four states, Virginia, North Carolina, Alabama and Texas, waited years to ratify the Amendment, with Texas being the last, in 2009.

If you don’t count Virginia, which enacted a poll tax in 1876, but repealed it six years later in 1882, Florida was the first state to make a poll tax a condition of voting, enacting the legislation in 1885. It became effective in 1889. In 1941, 52 years later, Florida repealed its poll tax.

Florida did not repeal the poll tax because its legislators were conscience-stricken and knew they had to do the right thing. No. The state repealed the tax because too many white legislative candidates (they were all white) were buying votes by paying the tax for poor black and white constituents (disproportionately black, of course) who couldn’t afford it themselves. In essence, the tax was no longer doing what it was intended to do: suppress black votes.

Florida had two other legislatively approved ways to suppress black voting. The first was the Literacy test. According to the Tampa Bay Times:

In 1915, the Legislature enacted a literacy test along with a companion grandfather clause. The clause, common throughout the South, declared that any person who had a relative who voted prior to a certain date did not have to take the test.

According to the proposed Florida law, if you had a relative who was eligible to vote on Jan. 1, 1867, you were exempt from taking the test. Since no black Floridian was voting prior to that date, all of them had to pass the test.

Blacks were frequently asked more technical and legal questions than whites. When one black applicant was asked what “habeas corpus” meant, he responded: “Habeas corpus means this black man ain’t gonna register today.”

The final way the legislature held down, disenfranchised, the black vote in Florida was by means of the Criminal Disenfranchisement Law. This law, first enacted in 1868, reenacted in 1968, and in effect even today, bars anyone with a felony conviction from ever voting. Florida is one of seven states that still retain this disenfranchisement statute, which disproportionately affects blacks.*

Disproportionate imprisonment of blacks is not something peculiar to Florida. Nationwide, according to Bureau of Justice data, 18 and 19-year-old black men are 12.4 times more likely to be imprisoned than their white peers. And it doesn’t get much better as blacks age, as the chart below shows.

With this as background (and here are 24 more charts showing pervasive racism directed at blacks), Governor DeSantis insists there is no such thing as institutional racism, especially in Florida. And he’s gone to great lengths to make sure anyone in Florida who suggests otherwise will require divine intervention to escape punishment.

Ask Andrew Warren. Last August, DeSantis suspended Warren, the twice-elected Hillsborough County State Attorney, saying he violated his oath of office and has been soft on crime (Remarkably, Florida’s Governor has the legislative authority to do this). What had Warren done? Nothing, except for signing a group statement with other prosecutors saying “we decline to use our offices’ resources to criminalize reproductive health decisions.” In other words, Warren was suspended, not for something he did, but for something he said he might do at some time in the future.

Warren sued to get his job back. Yesterday, a federal judge ruled that, although DeSantis violated the Florida Constitution and the First Amendment, he lacked the power to reinstate Warren. In his 53-page ruling, U.S. District Judge Robert Hinkle, while grudgingly dismissing the case, excoriated DeSantis and his staff for attacking Warren for purely political reasons. Nonetheless, DeSantis won, which is usually the way things work in Florida.

And now, as we are smack dab in the second day of “Florida Literacy Week,” comes the Florida Department of Education’s new rules to enforce the Governor’s Parental Rights In Education Act, known by critics as “Don’t Say Gay” or the Stop WOKE Act and Florida law 1467, the Curriculum Transparency Law, which requires school districts to be transparent in the selection of instructional materials and library and reading materials.

Taken together, these two statutes limit what teachers can teach and what their students can read.

The two statutes are supposed to apply to what goes on in the classroom. Consequently, in federal court filings, lawyers representing DeSantis insist  the statutes do not apply to library books. In practice the opposite is true. A recent 23-slide librarian training program, approved by the Florida Department of Education, asserts: “There is some overlap between the selection criteria for instructional and library materials.” One slide says that library books and teacher instructional materials cannot include “unsolicited theories that may lead to student indoctrination.”

Good luck trying to understand what an “unsolicited theory” is, or what “student indoctrination” means. Indoctrination into what?

The rules are confusing for librarians, but they’re even murkier for classroom teachers, many of whom have created little classroom libraries over the years of their teaching. The Department of Education’s new rules require “media specialists” to vet every one of the non-curriculum  books teachers may have in their classrooms, as well as all the books in the school libraries. In Florida, some school librarians earn “media specialist certificates.” These are the “media specialists” tasked with vetting all the books in Florida’s 4,202 K-12 public schools. In Popular Information, Judd Legum reports that Kevin Chapman, the Chief of Staff for the Manatee County School District, told him that County principals told teachers last week they are subject to a third-class felony charge if unvetted books in their classrooms are deemed to violate the prohibitions contained in either of the two statutes.

Needless to say, those little classroom libraries are disappearing faster than the small piece of meat I dropped on the kitchen floor this morning right in front of my 80-pound dog, Lancelot (so named because he’s not Lance-a-little).

Florida law 1467 on Curriculum Transparency is particularly pernicious, because it prohibits teachers from exercising their own educated judgement regarding what is appropriate for their particular students. For Florida’s teachers, this is scary stuff. They are going to have to be very careful with what they say, or even suggest, in their classrooms.

Some teachers, perhaps many, will refuse to give up their intellectual freedom. It will be interesting to see how that plays out. As George Orwell said, “In a time of universal deceit, telling the truth becomes a revolutionary act.”

Nevertheless, it seems Governor Ron DeSantis has achieved in Florida what all autocrats crave. He has brazenly fastened iron bonds on what the next and future generations of Floridians are allowed to know. To my mind, he has also underestimated the youth of his state whose intelligence, curiosity, global involvement, and just plain desire to know and learn cannot and will not be inhibited by anything an autocratic governor, whose overarching goal in life is to rule the world, will ever do.

My money’s on the kids.

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*Angela Behrens, Christopher Uggen, and Jeff Manza, Ballot Manipulation and the “Menace of Negro Domination”: Racial Threat and Felon Disenfranchisement in the United States, 1850-2002, 109 AMERICAN JOURNAL OF SOCIOLOGY 559 (2003).

 

 

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Posted in Discrimination, Education, History, Incarceration, Law, Public policy, Racism, Research, State News

Martin Luther King—Sharing The Spotlight With Confederate “Heroes”

January 17th, 2023 by Tom Lynch

Yesterday, the city of Boston celebrated Martin Luther King day as no other city in the nation could. On Boston Common, the oldest public park in America, Mayor Michelle Wu and other leaders unveiled The Embrace, Hank Willis Thomas’s five-years-in-the-making monument to Martin Luther King and Coretta Scott King.* 

The huge bronze hug is 38,000 pounds and sits 22 feet high and 40 feet wide. Boston’s newest monument is inspired by a photo of the Kings hugging after Martin won the Nobel Peace Prize in 1964. The monument sits in an open circle with bench seating in the middle of Boston Common within another memorial, the new 1965 Freedom Plaza, which honors Boston civil rights activists.

The Kings had met as students in Boston and were married there in 1953. Among other things, the monument signifies the linkage between them in the civil rights struggles to which they each committed their lives. Coretta Scott King, in addition to being the wife of MLK, was also an artist, an activist, and a driving force who was by his side  doing the work with him, which she carried on after he was assassinated. She founded the King Memorial Center and never gave up fighting for a federal holiday honoring King’s legacy. Mrs. King’s efforts resulted in the federal holiday we now celebrate, when President Ronald Reagan signed the holiday into law in 1983; it was first observed three years later on January 20, 1986. In 1995, Congress designated Martin Luther King Jr. Day as the first and only federal holiday observed as a National Day of Service. Congress charged the Corporation for National and Community Service with leading this national effort.

All 50 states now recognize Martin Luther King day as a state holiday, South Carolina being the last in 2000. But when that happened, the South Carolina legislature also voted to create Confederate Memorial Day, which would be celebrated on the same day we honor King. And South Carolina is not alone. As Shoshana Gordon, Jacque Schrag and Russell Contreras report in AXIOS, “Ten states — all in the South — observe Martin Luther King Jr. Day plus at least one Confederate holiday.” This from the AXIOS report:

Arkansas, Georgia, Florida, Kentucky, North Carolina, South Carolina, Tennessee and Texas all have at least one day commemorating the Confederacy on other days of the year.

Mississippi and Alabama each celebrate a total of three Confederate holidays every year — Robert E. Lee Day, Confederate Memorial Day and Jefferson Davis’ Birthday — all paid holidays for state employees.

Many lawmakers in the ten states believe it is wrong to celebrate the confederate holidays, but nobody seems to want to propose legislation to repeal any of them. Now why would that be? Here is a map showing the states honoring the confederacy:

Of particular note is Tennessee with its three days honoring the confederacy. Why? Because one of them is Nathan Bedford Forrest Day (first observed in 1921). In honoring the confederate general and first Grand Wizard of the Ku Klux Klan, Tennessee Gov. Bill Lee’s (R) 2019 proclamation saluted a “recognized military figure in American history” and a “native Tennessean.”

In these ten states Martin Luther King is lumped in with slaveholders, secessionists and murderers. The whole thing just oozes a terrible irony, especially when you consider how King’s life ended―and where―Memphis, Tennessee.

Those states aren’t the only places where Dr. King gets little respect. J. Edgar Hoover’s FBI considered King “the most dangerous man in America” and conducted decades-long surveillance of him, surveillance encompassing more than 300,000 pages of documents.

Film director Sam Pollard chronicles Hoover’s efforts in his 2020 documentary, MLK/FBI. According to Pollard’s research and as reported on NPR:

The FBI campaign against King began with wiretaps, but quickly ballooned. When wiretaps revealed that King was having extramarital affairs, the FBI shifted their focus to uncover all evidence of his infidelity by bugging and taping him in his hotel rooms and by paying informants to spy on him. Eventually, the FBI penned and sent King an anonymous letter, along with some of their tapes, suggesting that he should kill himself.

Yes, like all of us walking God’s green earth, Martin Luther King had feet of clay. But he also had a heart as big as Texas and a passionate, life-long commitment to freeing his people from the chains of racism, a struggle that continues to this day, 163 years after the civil war’s first shot.

Were he alive today, King would probably be the first to acknowledge the tremendous strides made in the long journey for true equality in civil rights. He would also be the first to acknowledge how far away the last mile really is.

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*The Embrace has not won instant acclaim from everyone. In fact, there has been quite a bit of snarky criticism, some even calling the artwork “obscene.” It all reminds me of another monument, a memorial dedicated in late 1982—Maya Lin‘s minimalist Vietnam Veterans Memorial in Washington, D.C. When it first opened to the public, politicians, celebrities, regular citizens and, most important, Vietnam Veterans, lined up to criticize it. It became known as “the black gash of shame.” Well, 42 years later, veterans go to the Wall and weep as they see the names of their fallen comrades. It is embraced by all, as will The Embrace be more and more as time goes by.

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Posted in Public policy, Racism, State News

Big Oil’s 50-Year Deception Revealed. It Is “Breathtaking.”

January 13th, 2023 by Tom Lynch

On 4 February 1996, Mike Wallace’s whistleblower interview of Dr. Jeffrey Wigand, former Director of Research for tobacco company Brown & Williamson, aired on CBS’s 60 Minutes. That interview began the destruction of what had been the myth of the invincibility of big tobacco’s power. Out of its fear of the epic lawsuit big tobacco could bring, CBS  refused to air the interview for several months. When it did air in February, the House of Tobacco began to crumble. Three years later, Russell Crowe, Al Pacino and Christopher Plummer would star in the Academy Award-winning movie that told the tale, The Insider, with Crowe, as Wigand, winning Best Actor.

Wigand suffered mightily  for his outing of big tobacco’s big secret: That nicotine is addictive, and a cigarette is, in his words, “a nicotine delivery device.” Of course, many people were decrying the evils of cigarettes during the 1990s, but they did not have Dr. Wigand’s inside knowledge. At the time of his 60 Minutes interview, 45.8 million Americans, nearly 26% of the US population, smoked, according to the CDC; today, the percentage has dropped to 12.5%.  Between 10% and 20% of smokers develop lung cancer. Jeffrey Wigand’s heroism has saved a lot of lives.

The current big worldwide battle is over Climate Change, and the science is finally winning. But, although scientists have been working in a Herculean effort to educate the countries of the world to get them to move collectively before time runs out on reversing the warming, there’s no Jeffrey Wigand in this fight.  This battle is not with Big Tobacco, but rather with Big Oil, and today, researchers from Harvard University and the Potsdam Institute for Climate Impact Research, writing in Science, catalogue in exquisite detail oil giant Exxon Mobile’s monumental 50-year coverup of its knowledge that human-induced climate change has been making the world warmer all along.

The new research has found Exxon privately “predicted global warming correctly and skilfully” only to then spend decades publicly attacking such science in order to protect its core business.

This story comes in three parts. First, in 2015, investigative journalists discovered internal company documents and research papers that established Exxon knew of the dangers of global warming from at least the 1970s. Additional documents then emerged showing that the industry’s largest trade association, the American Petroleum Institute, along with other oil industry companies knew of the risk even earlier, from around the 1950s. However, the industry forcefully and with great skill mobilized to attack the science to prevent action to reduce the use of fossil fuels.

But today’s publication in Science discloses and makes clear that Exxon’s scientists, not only knew about their industry’s contributions to global warming, but also were uncannily accurate in their projections from the 1970s onwards, predicting an upward curve of global temperatures and carbon dioxide emissions that is close to matching what actually occurred as the world heated up at a pace not seen in millions of years.

Lest you doubt the thoroughness of the researchers, here’s how they did it:

We analyzed 32 internal documents produced in-house by ExxonMobil scientists and managers between 1977 and 2002, and 72 peer-reviewed scientific publications authored or coauthored by ExxonMobil scientists between 1982 and 2014. The internal documents were collated from public archives provided by ExxonMobil Corp (28), InsideClimate News (29), and Climate Investigations Center (30). The peer-reviewed publications were obtained by identifying all peer-reviewed documents among ExxonMobil Corp’s lists of “Contributed Publications,” except for three articles discovered independently during our research (31) [see supplementary materials (SM) section S2 for details on the assembly of the corpus]. These constitute all publicly available internal ExxonMobil documents concerning anthropogenic global warming of which we are aware, and all ExxonMobil peer-reviewed publications concerning global warming disclosed by the company.

Lead author Geoffrey Supran, who characterized the team’s findings as “breathtaking,” said, “This really does sum up what Exxon knew, years before many of us were born.”

Chapter three of this saga began relatively recently and is ongoing. In it, the fossil fuel industry acknowledges publicly the now undeniable (even by it) dangers of global warming and vows to do all in its power to reverse what is rapidly becoming irreversible.

Here are three pieces of data to show the depth of the hole we’ve dug:

  • Burning fossil fuels accounted for 74 percent of U.S. greenhouse gas emissions in 2019.
  • The fossil fuel industry receives at least $20 billion in direct federal subsidies.
  • In 2020, renewable energy accounted for about 20 percent of U.S. electricity generation, and that share is expected to continue to grow. Seventy-four percent versus 20%. We have a long way to go.

In a telling irony, a gentleman by the name of Rex Tillerson was Exxon Mobil’s CEO from 2006 until 2017, when he retired to become Donald Trump’s first Secretary of State. I doubt we’ll have an academy award-winning film showing Tillerson’s heroic efforts to unleash the truth of global warming.

But suppose someone had done that, say one of the scientists who correctly predicted the coming debacle. Imagine what would have happened if Big Oils’ Big Lie had been outed a la Wigand 30 years earlier. Imagine if the US and the rest of the world had had a chance to begin reducing fossil fuels and going green so much earlier. Imagine if we heeded Carl Sagan’s warning in his 1985 testimony to the US Congress that climate change and human-induced global warming was a “real phenomenon.” And he had data to prove it.

If that had happened, poor Kermit the Frog would never have had to sing, “It’s not easy being green.” 

___________________

For those interested in diving into the weeds, here are three graphs from the Science paper illustrating how closely Exxon’s predictions matched reality. In the third one, global temperatures are charted over the last 150,000 years. I’ve highlighted where we are today.

Historically observed temperature change (red) and atmospheric carbon dioxide concentration (blue) over time, compared against global warming projections reported by ExxonMobil

(A) “Proprietary” 1982 Exxon-modeled projections.
(B) Summary of projections in seven internal company memos and five peer-reviewed publications between 1977 and 2003 (gray lines).
(C) A 1977 internally reported graph of the global warming “effect of CO2 on an interglacial scale.” (A) and (B) display averaged historical temperature observations, whereas the historical temperature record in (C) is a smoothed-Earth system model simulation of the last 150,000 years.

Posted in Misc.

Mike Pence And His Book Deal Shenanigans

January 11th, 2023 by Tom Lynch

There are so many compelling and thought provoking things happening every day that it’s ridiculously easy to miss a few you’d rather have known about. Today, I see my job as helping you avoid that unfortunate circumstance. Read on and be enlightened.

Question: How many books must an author sell in order to make the New York Times Bestseller List?

Answer: A minimum of 5000 book sales in a single week across diverse retailers and from multiple geographic locations.

There are ways to manipulate sales, chief among them bulk sales and authors buying their own books. Wikipedia has a nice synopsis of sales manipulation:

Manipulation by authors and publishers. In 1956, author Jean Shepherd created the fake novel I, Libertine to illustrate how easy it was to manipulate the best-seller lists based on demand, as well as sales. Fans of Shepherd’s radio show planted references to the book and author so widely that demand for the book led to claims of it being on the Times list. Author Jacqueline Susann (Valley of the Dolls) attempted to “butter-up” Times-reporting booksellers and personally bought large quantities of her own book. Author Wayne Dyer (Your Erroneous Zones) purchased thousands of copies of his own book. Al Neuharth (Confessions of an S. O. B.), former head of Gannett Company, had his Gannett Foundation buy two thousand copies of his own autobiography. In 1995, authors Michael Treacy and Fred Wiersema spent $200,000 to buy ten thousand copies of The Discipline of Market Leaders from dozens of bookstores. Although they denied any wrongdoing, the book spent 15 weeks on the list. As a result of this scandal the Times began placing a dagger symbol next to any title for which bookstores reported bulk orders. However, daggers do not always appear; for example Tony Hsieh‘s Delivering Happiness was known to have been manipulated with bulk orders but didn’t have a dagger.

Enter stage right former Vice President Mike Pence. In 2021, CNN reported the ex-VP had signed a two-book deal with Simon & Schuster worth $3 million to $4 million, a pay day few, if any, Trump alums will get, especially if they did not resign immediately after the 6 January insurrection. Also not getting book deals are members of Congress who voted not to certify the 2020 presidential elections. All these people are damaged goods in the publishing world. Nothing personal; publishing is a business.

To fulfill the first half of his deal, Pence recently released So Help Me God. Now, it is assumed by everyone masochistic enough to follow the political scene that Pence aspires to run for President in 2024 (he also aspires to win) and that his book lays a marker down, a sort of sword in the sand. But how to get people to read it (Another question: How to get them to believe it?)? Although Pence is known to be deeply religious (in his own way) his book isn’t exactly as captivating as Dan Brown’s The Da Vinci Code, which spent 136 weeks on the Times Bestseller List.

The way out of this dilemma is to join the manipulators. And that’s what Mr. Pence did. As reported by Zach Everson, writing for Forbes, on 9 November 2022, Pence’s PAC, the Great America Committee, paid Books on Call NYC $91,000 for what the PAC described as “collateral materials,” according to a report the PAC filed in December with the Federal Election Commission. A spokesperson for Pence confirmed the money went to buy the book at $21.78 per copy, 4,178 of them to be precise, leaving friends and family only having to buy another 822 to make the Bestseller list. Sort of reminds me of Donald Trump in the early 1990s masquerading as fictional publicist John Miller (sometimes John Barron) and calling reporters to let them know what a brilliant and wonderful person his employer Donald Trump was.

Because Pence was not yet an official candidate for the 2024 election, it was legal for his PAC to do this.

So Help Me God debuted at No. 2 on the New York Times’ best-seller list for hardcover nonfiction and remained there for six weeks. The Times says when retailers report bulk orders of a book a dagger marking is supposed to appear beside the book’s name on the List. Inexplicably, no dagger ever appeared next to So Help Me God.

If you’re interested in being able to talk about So Help Me God without having to actually read it, you can find a number of reviews all in one place. The general verdict from all of them: Although the book is “well-written and well-paced,” (so says the Wall Street Journal), once again Pence is all things to all people. Whenever he writes something in So Help Me God, you can be sure it will be followed by, “On the other hand…”

I know it’s not charitable, but Mr. Pence has always reminded me of a cross between the David Copperfield’s unctuous Uriah Heep and a mortician describing his casket collection to the relatives of the dearly departed.

“Autobiography,” George Orwell once wrote, “is only to be trusted when it reveals something disgraceful…since any life when viewed from the inside is simply a series of defeats.” The defeats Pence documents in So Help Me God are the ones that make him look good.

One thing Pence doesn’t talk about in the book is his brother Greg, a member of the House of Representatives from Indiana’s 6th congressional district since 2019. That’s the seat brother Mike held for 12 years. On the day of the insurrection, after the madding crowd had erected a gallows outside the Capitol Building and were now marching through the halls looking for brother Mike and screaming, “Hang Mike Pence,” Greg was with his brother and family. The Secret Service evacuated him with the Vice President.

Hours after emerging from a secure location, Mike Pence gaveled the joint session of Congress back in session and presided over the certification of the election, despite Trump’s demands. His finest hour. The one the history books will mention.

Greg Pence, meanwhile, joined 146 other Republican election-denying members of Congress who sided with Trump and cast a vote rejecting the outcome in Pennsylvania, the state that clinched the election for Biden.

You won’t find any of that in So Help Me God.

 

 

 

 

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Posted in Politics, Publishing

Once More Unto The Mayhem

January 9th, 2023 by Tom Lynch

I don’t know how you welcomed in the month of December, 2022, the month ending a year most were happy to put behind them, but I spent the early morning hours of the 1st of December undergoing a total anatomical replacement of my right shoulder. Since then, I’ve been living 24/7 in the Donjoy super-duper Ultra-Pro Sling (except for showering, thank you very much). Tennis did this to me. Specifically, hitting nearly one million various forms of overheads. Serves, put-aways, you name it. Then there’s the Rafael Nadal buggy-whip topspin forehand. That certainly didn’t help. What we sow, we reap.

But now, nearly six weeks later, although I’m still not allowed to lift even a coffee cup, I do seem able to traverse a computer keyboard (as long as it’s in my lap). So, time to return to the fray.

And what a fray it’s been, culminating in House Republicans sending white smoke up the chimney early Saturday morning after 15 Freedom Caucus-driven votes over four tumultuous days to elect a Speaker for the 118th Congress. Let’s begin there.

Habemus Ducem! Sed infirmus est.
We have a Leader, but he’s wounded.

Throughout history, Populist political movements have appeared with regularity, most often in times of economic hardship when, at the instigation of fire and brimstone rabble rousers, people perceive their government working against them rather than for them.  America has been no exception. Consider the proto-populist Greenback and Granger movements in the 1860s and ’70s, William Jennings Bryan’s Populist Party in the 1890s and Louisiana politician Huey Long’s Share Our Wealth program during the Great Depression of the 1930s. Then there were the Anarchist and Socialist movements of the late 19th and early 20th century. Historically, there’s nothing new about the Freedom Caucus; it’s just new to us.

That said, how did we get to this political moment, the ascendency of the Republican Party’s Freedom Caucus, a 54-member disruptive group within the House of Representatives? Did it begin in the early 1970s with the corruption of the Nixon Administration’s Watergate scandal? Or maybe it began in 1992 with Newt Gingrich and his Contract With America? Or perhaps they spawned on 19 February 2009, when Rick Santelli, a commentator on the business-news network CNBC, referenced the Boston Tea Party (1773) in his response to President Barack Obama’s mortgage relief plan during the Great Recession?

More likely, the Freedom Caucus gradually grew out of all those things and found its apotheosis in the bile falling from the mouth of Donald Trump, who continues to cling, as skin clings to a grape, to his hatred for anything or anyone not sufficiently worshipful.

However it began, they’re here now, and 20 of them held government hostage last week while they extorted concession after concession from now-Speaker Kevin McCarthy, who ultimately prevailed when he had nothing more to give. After it was all over, one of their ringleaders, Florida’s Matt Gaetz, told the Washington Post’s Dana Milbank, “I ran out of things I could even imagine to ask for.”

Speaker McCarthy, after he had finished selling what remained of his soul, took the gavel from Minority Leader Hakeem Jeffreys, and proudly announced to the world he had proven he would “never give up.” Maybe not give up, but sure as shootin’ give in. He’s now the quintessential hollow man.

And what about these House Disruptors? What they seem to want, crave even, is power, but to what end? They’re long on cutting spending, but short on good governance.  It looks as if they’ve come to Washington, a place they deride, for the sole purpose of feeding red meat to their base back in Wherever, USA. The Republican Party created the Freedom Caucus, an animal with four back feet, each pointed in a different direction. What we sow, we reap.

Look closely at the Freedom Caucus. Try to find one coherent, let alone intelligent, proposal to do anything vaguely related to public service. You’ll be looking a long time. Every one of these characters is a one-trick pony, and the pony limps. They deftly avoid offering up their own proposals, as a helmsman avoids rocks. Why? Because if they did, they’d have to defend them.

They’re Kevin McCarthy’s problem now. Will he still wield the gavel six months from now? Or will the US House more closely resemble Animal House, food fights and all? Tonight’s vote on the Rules Package McCarthy and this Mephistopheles agreed to will provide the first opportunity to see whether adults have entered the room.

Government will certainly be difficult for a while, but, as has happened so many times in our nation’s journey, these people and their corrosive vitriol will someday fade into history’s dust when better people with good ideas emerge, as surely they will.

However, it’s hard to imagine that happening in this 118th Congress.

What we sow, we reap.

 

Posted in Misc.

A Few Items To Ponder, Two Of Them Important

November 30th, 2022 by Tom Lynch

Type 1 Diabetics get good news

As I have written before, Type 1 diabetes (T1D) is a horrific disease. It is a leading cause of stroke, heart disease, blindness, kidney disease and non-traumatic amputations. It also costs a lot to manage. The media has been full of stories of unfortunate people who have had to choose between taking insulin or food. The Inflation Reduction Act, passed in August, caps the cost of a vial of insulin at $35 for Medicare beneficiaries, but does nothing for diabetics not on Medicare. About 70% of the nation’s 1.9 million Type 1 diabetics are on Medicare.

Research has proven Type 1 diabetics contract the disease in three stages over time. According to a 2015 study on the presymptomatic stages of Type 1 diabetes:

Insights from prospective, longitudinal studies of individuals at risk for developing type 1 diabetes have demonstrated that the disease is a continuum that progresses sequentially at variable but predictable rates through distinct identifiable stages prior to the onset of symptoms. Stage 1 is defined as the presence of β-cell autoimmunity as evidenced by the presence of two or more islet autoantibodies with normoglycemia and is presymptomatic, stage 2 as the presence of β-cell autoimmunity with dysglycemia and is presymptomatic, and stage 3 as onset of symptomatic disease.

Type 1 diabetics go through two stages of disease development before full-blown diabetes appears in Stage 3. Imagine a platform diver. Stage 1 is climbing to the platform and standing at the edge. Stage 2 is lifting off and moving through the air. Stage 3 is hitting the water and getting very wet. Diabetics don’t know they have the disease until they hit the water. But what if they did, and what if the time in the air between the platform to the water could be extended, say by 25 months?

On 17 November, the FDA approved a biologic therapy that delays the onset of Stage 3 by about that much.

The monoclonal antibody teplizumab, which will be marketed under the brand name Tzield, from ProventionBio and Sanofi is given daily through intravenous infusion over two weeks. And it works. Patients who take it extend Stage 2 by a little more than two years.

But there’s a catch, two, in fact. First, PreventionBio announced last week it is pricing Tzield at $193,900, which is considerably higher than insurers anticipated. Second, how does a person know they’re in Stage 2 and, therefore, should be taking the drug? The answer is screening for autoantibodes that are markers for diabetes. This will also incur a cost. More about that below.

The question to be answered is will insurers cover the considerable cost for screening and drug infusion?

In 2014, the FDA approved Harvoni as treatment for Hepatitis C, which is the leading cause of liver failure. Hep C is a life-threatening disease. Harvoni cured it. Completely. Its maker, Gilead, priced the pill at $95,000 for a twelve-week course of treatment. At the time, I was a Director at a Boston HMO. We wrestled with the cost issue. In the end, because Harvoni cured what was a horrific and terrifically costly disease, we gladly decided to provide it for our members.

Tzieild is different. It does not cure diabetes. Rather, it delays its onset. The American Diabetes Association and the Juvenile Diabetes Research Foundation (JDRF) are ecstatic about the arrival of Tzield. They point out this is the first time a successful treatment for diabetes has appeared on the scene, although it’s not really a treatment. However, they’re concerned about the screening issue.

Aaron Kowalski, CEO of JDRF, says the main challenge in prescribing Tzield will be finding people who need it. The drug is approved for people who don’t have any symptoms of the disease and may not know they’re on the road to getting it.

“Screening becomes a really big issue, because what we know is, about 85% of type 1 diagnoses today are in families that don’t have a known family history,” Kowalski said. “Our goal is to do general population screening” with blood tests to look for markers of the disease.

It will be interesting to learn how insurers and health plans react to Tzield. According to the JDRF, 64,000 people a year are diagnosed with Type 1 diabetes. If every one of them received the drug the total cost would be about $12.5 billion. But if you were one of the 64,000, my guess is you’d happily stand in line for it. So would I.

Donald Trump and the Mar-A-Lago fiasco

By now, every sentient person in America knows ex-president Donald Trump dined last week with Nick Fuentes, the poster child for anti-Semitic white nationalism, and Kanye West, who now calls himself Ye and has also spouted anti-Semitic whinge. Afterwards, when social media lit up like the Rockefeller Center Christmas tree, Trump claimed he didn’t know Fuentes was going to be there; West just brought him along.

Putting aside the fact that Trump’s Secret Service detail would never in a month of Sundays allow just anyone to drop in to break bread with the big cheese without getting clearance from the big cheese himself, I’m more concerned with the response of the Republican Party’s leadership to this. Republicans who are likely to run for President, notably Mike Pence and Chris Christie, criticized their former leader, although it took them two or three days to do it. It took more than a week for anyone in Republican leadership to put their wet finger in the air and decide to say he shouldn’t have done it.

The stench wafting from the halls of Congress is remarkable, indeed.

A personal note

Starting tomorrow I shall be away from this, and any other, keyboard for a little bit.

Since I was eight years old, I have been an avid, competitive, pretty good, tennis player. I’ve calculated that in the intervening years I have hit somewhere around just under a million overhead smashes. That’s a lot of serves and put-aways. And they have taken their toll. So, at 7:00 AM tomorrow morning, a very good doctor (I hope) will be concentrating deeply (I hope) on the job of giving me a new shoulder. I’m told it will be a little painful for a while, but on the other side lies bliss, and more overheads.

I look forward to being back at the keyboard.

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Posted in Drugs, health care, Leadership, Medical Issues, Research

Today, We Thank Our Veterans ― Ninety Years Ago, We Did Something Else

November 11th, 2022 by Tom Lynch

Well, that was interesting. The midterm election, not yet over, showed once again experts and their predictions are worth about as much as a sneaker full of puppy poo. All the supposedly smart pundits who predicted the end of democracy as we know it are now doing their best to explain what happened, and why. They forgot, or ignored the fact, that, on the whole, Americans are decent, loyal citizens. Right now, regardless of how the election turns out, we can feel proud of most our neighbors around the nation thoughtfully exercised their right and duty to vote, regardless of how they voted and for whom.

It would be nice to think the Congress we are now still electing will be as thoughtful, decent and loyal to the oath it will collectively take in January. However, I can’t help fearing that in Ronald Reagan’s “shining city upon a hill,” internecine, malodorous warfare will remain on full display. Looking for all the world like a gussied-up version of the Hatfields and McCoys, Republicans and Democrats will once again assemble in a highly organized circular firing squad, seeming far more intent on annihilating each other than on devoting themselves to the moral imperative of governing.

But enough of that. This is Veterans Day, a day to give thanks to all the men and women who gave themselves to the defense of our country.

We’ve come a long way in that regard. It wasn’t always so. One hot summer, fourteen years after Johnny came marching home, he was persecuted, dehumanized and then cast into the darkness of the Great Depression. Here’s what happened.

1932 – Washington, D.C.

At the close of World War I, Congress decided to thank the war’s veterans for their service with some cash — $500, which, in today’s dollars, would be about $7,500. Quite a bonus. But there was a catch: The “bonus” authorized by the Adjusted Compensation Act of 1924 would not be paid until 1945. The veterans did not complain at the time. It was The Roaring Twenties. Everyone was flush.

But then along came the Great Depression. The economy descended from full employment in 1929, where the unemployment rate was 3.2 percent, into massive unemployment in 1933 when the unemployment rate reached 25 percent. From sitting on top of the world, plutocrats were suddenly seen jumping out of windows on Wall Street. Breadlines became the meal du jour. The word, “Hobo,” which had been around, but hardly used, since 1888, became a symbol for the forgotten man.

In the summer of 1932, 25,000 penniless, desperate veterans and their wives and children descended on Washington, D.C. They camped in District parks, dumps, abandoned warehouses and empty stores.  These aging warriors had come to the nation’s capital to ask Congress, admittedly 13 years early, for their $500. Newspapers christened them “the bonus Army,” or “the bonus marchers.” They called themselves the “Bonus Expeditionary Force,” the BEF.

The men drilled, sang war songs, and, once, led by a Medal of Honor winner and watched by a hundred thousand silent Washingtonians, marched up Pennsylvania Avenue bearing flags of faded cotton.

The BEF had pleaded in vain with Congress for the money. They were ignored and left to wither. As a last resort they appealed to President Hoover to meet with them. He sent word he was too busy. Then, confronted with 25,000 squatters he would later label “communists,” while asserting less than 10% of them were veterans*, he isolated himself from the city, canceled plans to visit the Senate, had police patrol the White House grounds day and night, chained the gates of the Executive Mansion, erected barricades around the White House and closed traffic for a distance of one block on all sides of the Mansion. A one-armed veteran, attempting to picket, was beaten and jailed.

Conditions for the veterans were pathetic. The summer heat was severe. Lacking shade or screens, the BEF was beaten down by the climate’s fury. Since the founding of the city, Washington was viewed as a place to be avoided in the summertime. In the words of an official guidebook, Washington was “a peculiarly interesting place for the study of insects.” The veteran men and their families had arrived at the height of Cherry Blossom season, but by July they were debilitated, ghostly, dehydrated and hot. Very hot. The columnist Drew Pearson called them “ragged, weary and apathetic with no hope on their faces.” Downtown businessmen complained through the Chamber of Commerce that “the sight of so many down-at-the-heel men has a depressing effect on business.”

And that was the extent of their crime, their threat to the country. They weren’t good for business.

General Douglas MacArthur, the Army’s only four star general who, even then, referred to himself in the third person, had met with some of the men and assured them if he had to evict them he would allow them to leave “with dignity.” But when the end came for the BEF at 10:00 A.M. on 28 July 1932 there was no dignity to be found. Hoover had had enough, and he ordered “Mac” to get rid of them. Trouble was, he didn’t tell the General “how” to get rid of them. MacArthur, who never did anything small in his life, was unleashed.

First, Police Commissioner Glassford, who had been sympathetic to the men, was sent to tell them they had to leave, orders of the President. They refused, which was when MacArthur sent the Army in, led by then Major George Patton and his 3rd Mounted Cavalry — with him prancing at the front atop his privately-owned horse (he had a stable-full; he was rich) — followed by infantry and a World War I vintage Tank Brigade. Bullets began to fly. BEF men were killed. Two babies were gassed to death. And Joseph Angelino suffered a deep wound from Patton’s sabre-wielding cavalry, the same Joseph Angelino, who, on 26 September 1918, had won the Distinguished Service Cross, the Army’s second highest medal, for saving the life of a young officer named George Patton.

By midnight that day, the Army had driven the BEF veterans, their wives and children across the Potomac and out of the city. But that wasn’t good enough for MacArthur and Hoover. The BEF was chased and harassed west and south, out past Ohio and all the way down to Georgia. Then, the veterans just folded into the vast transient population that roamed the land in 1932.

In 1936, overriding a veto by President Roosevelt, Congress voted to immediately pay World War I veterans their full $500 bonus specified in the Adjusted Compensation Act of 1924.

____________________________________________

*The Veterans Administration, which had the actual service records, would subsequently refute Hoover’s claim with an exhaustive study concluding that 94% of the  bonus marchers were veterans of World War I.

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Posted in History

A Midterm Reminder That Bears Repeating

November 7th, 2022 by Tom Lynch

The Midterms are tomorrow, and, if you’re like me, you can’t wait for the campaigning to be over. The constant emails, texts and television ads will stop―for about a week, after which we’ll begin getting bludgeoned by the 2024 campaign. God help us all.

According to Bloomberg, the two political parties and their candidates will have spent nearly $17 billion to get elected, by far the most for any Midterm election in history. That’s more than the budgets of 14 US states.

Predictions are Republicans will win in the House, and perhaps the Senate, too. If they do, what will happen then?

In early April of this year I wrote about that when I analyzed Florida Senator Rick Scott’s Plan to Rescue America. Scott was the only Republican lawmaker willing to put a stake in the ground and tell America what the GOP would do when, at least in his mind, it inevitably came to power. At that time I thought his plan so outlandish and, to use a technical term, flat out wacky, it would die a quick death. I was wrong. By my count, the majority of Republican candidates, especially for the House, have been trumpeting, Trump-like, many of Scott’s prescriptions for “rescuing” America. And that’s not all. One of the things not in Scott’s manifesto is the myriad investigations the Republican-controlled House will begin immediately upon taking power to show the rest of America all the evil things done by President Biden and his fellow Democrats in the last two years. Impeachment will likely follow. This is not hyperbole, but it sure is scary.

Therefore, today I’m republishing the April analysis to give us all an idea of what might be in store for us over the next couple of years, and maybe beyond. Fasten your seatbelts.

Rick Scott Is Going To Rescue America!

Rick Scott is the junior U.S. Senator from Florida. Elected in 2018, Scott has now served in Congress for 39 months. In November, 2020, his Senate GOP colleagues elected him Chairman of the National Republican Senatorial Committee (NRSC). His job is to get Republicans elected and reelected to the Senate.

Prior to the Senate, Scott was a two-term governor of Florida, succeeded by Republican Ron DeSantis. Before that, he was a businessman. We’ll get back to that later.

You would think the Chairman of the NRSC would be lock-step with Republican leadership in the strategy to take the Senate from the tenuous hold of the Democrats in the upcoming mid-terms. But this does not appear to be the case. Senator Scott is marching to his own drummer.

On Thursday, after no consultation with or cooperation from Senate GOP elites, Scott officially unveiled and launched the Rick Scott, 31 page, 11 Point Plan to Rescue America. The Rescue Plan has 117 agenda items.

This is not a surprise to GOP Senate Leader Mitch McConnell. Scott’s Plan has been discussed for more than a month, and as far back as 1 March McConnell publicly rebuked Scott for it. McConnell is fixated on making the mid-terms a referendum on President Biden, not on laying out a Republican plan he and the GOP establishment would have to spend the entire mid-term campaign defending. He wants Biden playing defense. Scott, on the other hand, wants America to know what Republicans will do if given control of the Senate. Right at the beginning of his Rescue Plan he says, “Americans deserve to know what we will do if given the chance to govern.” If Scott gets his way, now they will. And you have to hand it to him; he certainly doesn’t tap dance around the many issues facing the country.

Before diving into his 11 point, 117 agenda item plan, Scott lays out what the future will look like if nothing changes:

The militant left now controls the entire federal government…Among the things they plan to change or destroy are: American history, patriotism, border security, the nuclear family, gender, traditional morality, capitalism, fiscal responsibility, opportunity, rugged individualism, Judeo-Christian values, dissent, free speech, color blindness, law enforcement, religious liberty, parental involvement in public schools, and private ownership of firearms.

Holy Militant Left, Batman! We need a plan to stop all that!

A few of Senator Scott’s 117 agenda items, guaranteed to be saliva-producing red meat for the trumpiest of trumpsters caught my eye.  For instance,

We will secure our border, finish building the wall, and name it after President Donald Trump.

Kids in public schools will say the Pledge of Allegiance, stand for the National Anthem, and honor the American Flag. We must foster national unity.

Teacher tenure at public schools must be eliminated

We will not allow political or social indoctrination in our schools. Teachers who refuse to comply will need to find new jobs.

We will close the federal Department of Education. Education is a state function.

Government will not ask American citizens to disclose their race, ethnicity, or skin color on any government form.

Our military will engage in ZERO diversity training, teachings on critical race theory, or any woke ideological indoctrination that divides our troops.

We will force prosecutors to prosecute. At present, many prosecutors in big cities are allowing criminals to go free with no justice, and they are doing it on purpose.

Immigrants will not be eligible to collect unemployment benefits or welfare for the first 7 years after arriving in the US.

No government assistance unless you are disabled or aggressively seeking work.

If Congress does not pass a budget, the members of Congress do not get paid. Full stop.

Other than disaster relief, the federal government must stop spending money on non-essential state and local projects until the budget is balanced.

All Americans should pay some income tax to have skin in the game, even if a small amount. Currently over half of Americans pay no income tax.

Enact term limits for the Washington ruling class – 12-year limits for Congress and government bureaucrats.

All federal legislation sunsets in 5 years. If a law is worth keeping, Congress can pass it again.

We will immediately cut the IRS funding and workforce by 50%.

Humans are born male and female, there are two genders, and to deny that is to deny science. No government forms will include questions about “gender identity” or “sexual preference.”

We will protect women’s sports by banning biological males from competing.

No tax dollars will be used to pay for any diversity training or other woke indoctrination that is hostile to faith.

We will not pay any dues to the United Nations or any international organization that undermines the national interests of the USA.

The weather is always changing. We take climate change seriously, but not hysterically. We will not adopt nutty policies that harm our economy or our jobs.

There are a few difficulties with a number of these policy tectonic changes. Ending Social Security, Medicare and Medicaid in five years being among the biggest. Also, Scott’s colleagues in Congress might have something to say about going without pay and getting sent home after 12 years. Increasing taxes on 50% of Americans may prove challenging for Republicans on the campaign trail. Pulling billions of dollars from the states until we have a balanced budget might irritate a few Republican governors. And reducing the IRS’s funding and currently understaffed workforce by 50% would have brought tears to the eyes of mobster Al Capone.*

Although Senator Scott’s plan is dead on arrival, the problem is it arrived in the first place. It’s not about getting Republican senators elected; it’s about Rick Scott.

And what about Rick Scott? As I mentioned above, before getting into government, Scott was a “businessman.” He co-founded Columbia Hospital Corporation in 1987. Columbia later merged with another corporation to form Columbia/HCA, which eventually became the nation’s largest private for-profit health care company with Scott as Chief Executive. According to The New York Times, “[in] less than a decade, Mr. Scott had built a company he founded with two small hospitals in El Paso into the world’s largest health care company – a $20 billion giant with about 350 hospitals, 550 home health care offices and scores of other medical businesses in 38 states.”

Sounds good, right? Quite the businessman.

But there were problems. In March of 1997, the FBI, the IRS, and the Department of Health and Human Services arrived with search warrants. Four months later, Scott was forced to resign by his Board. He didn’t leave willingly, but when he did, he left with a settlement of $9.88 million and 10 million shares of stock worth $350 million. Columbia/HCA pleaded guilty to 14 felonies and agreed to a $600+ million fine in what was at the time the largest health care fraud settlement in U.S. history.

The company admitted to systematically overcharging the government by claiming marketing costs as reimbursable, by striking illegal deals with home care agencies, and by filing false data about use of hospital space. It also admitted to fraudulently billing Medicare and other health programs by inflating the seriousness of diagnoses and to giving doctors partnerships in company hospitals as a kickback for the doctors referring patients to HCA. It filed false cost reports, fraudulently billing Medicare for home health care workers, and paid kickbacks in the sale of home health agencies and to doctors to refer patients. In addition, it gave doctors “loans” never intending to be repaid, free rent, free office furniture, and free drugs from hospital pharmacies.

And that’s not all. In 2002, HCA agreed to pay the federal government an additional $631 million, plus interest, and $17.5 million to state Medicaid agencies, in addition to $250 million paid up to that point to resolve outstanding Medicare expense claims. The entire fiasco cost the company $1.7 billion. Nobody went to jail.

All on Senator Scott’s watch.

There’s one last twist. In a civil suit deposition connected to the case (there were a lot of civil lawsuits), Senator Scott invoked his 5th Amendment rights 75 times.

Somehow, all of that has been forgotten, and Scott has managed to be a governor, a Senator, and, I’m guessing, a man, a businessman, who has his eyes on the biggest prize of all, the one up for grabs in 2024.

Rescue Plan, indeed.

*Capone was a nationally famous, Chicago-based killer and crime boss who went to prison in 1931 for tax evasion.

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Posted in Politics, Public policy

The Earth Is Moving Under Medicare And The Price Of Drugs ― But Slowly.

November 4th, 2022 by Tom Lynch

Prologue

This is a story, 16 years in the making, of government-enabled corporate greed. It’s complicated and somewhat dense. It has to be to go on that long. It’s a story of how one industry, the Pharmaceutical industry, has done Olympian good while achieving Titanic profit, which has been surgically excised, Midas-like, from the hides of American taxpayers who never felt the touch. The story ends with a different way, a better way, but a way we common folk won’t likely see.

The story

Medicare Part D, a prescription drug benefit plan for Medicare beneficiaries, became law on 1 January 2006 under the George W. Bush administration and a Republican controlled Congress. The legislation was enacted with no funding provisions whatsoever. Since then, Washington politicians have been arguing over whether this government program should be allowed to negotiate with pharmaceutical companies the prices it pays for drugs its members need. Medicare beneficiaries, all 64 million of them, and the public at large, have overwhelmingly supported such a move. Over the years, pharmaceutical companies have spent a king’s ransom donating to politicians to secure―should we say “buy?”―their votes in opposition.

What’s been the result?

  • A study published recently in the Journal of the American Medical Association concluded more than a quarter (27.2%) of Medicare spending is now for prescription drugs;
  • That would be $180 billion, as reported by the Medicare Payment Advisory Commission for 2020;
  • According to the Kaiser Family Foundation, the total we in the US spent on prescription drugs in 2017 was $333 billion; and,
  • The Rand Corporation studied and compared US prices to 32 other OECD countries (The Organization for Economic Cooperation and Development – the most developed nations) and reported our prices are “nearly twice those of other countries after adjusting U.S. prices downward to account for rebates and other discounts paid by drug companies.”

And now, the gravy train may be slowing.

In August 2022, Congress finally passed―without a single Republican vote―and President Biden signed, the Inflation Reduction Act, which, among other things, allows Medicare to move forward with drug price negotiations―sort of. Right about now, you may be asking what prevented Medicare from doing that all along since 2006 as a normal part of its drug-purchasing process?

As the Kaiser Family Foundation explains:

Under the Medicare Part D program, which covers retail prescription drugs, Medicare contracts with private plan sponsors to provide a prescription drug benefit. The law that established the Part D benefit included a provision known as the “noninterference” clause, which stipulates that the HHS Secretary “may not interfere with the negotiations between drug manufacturers and pharmacies and PDP [prescription drug plan] sponsors, and may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs.”

In other words, although Medicare is buying drugs for its members, all 64 million of them, it has not been allowed to even hint that a lower price might be more fair and appropriate for the government to pay. That is the very definition of a “sweet deal” for drug manufacturers.

Giving the negotiation contrarians the benefit of a doubt they more than likely don’t deserve, their argument in opposition hangs on the slim thread that negotiations will lower the income of drug manufacturers, and that will, in turn, reduce the amount of money the companies invest in research and development to discover new life-saving drugs. My own opinion is that this argument is chock full of what makes the grass grow green and tall. And, by the way, the Congressional Budget Office agrees with me, although their analysists said it with a bit more eloquence.

And what does the aforementioned Inflation Reduction Act do, anyway?

It does a number of things, one of which is to lay down new rules for price negotiations. These are its major health care provisions, leaving out, for the moment, the negotiation issue. It will:

  • Require drug companies to pay rebates to Medicare if prices rise faster than inflation for drugs used by Medicare beneficiaries, beginning in 2023;
  • Cap out-of-pocket spending for Medicare Part D enrollees and make other Part D benefit design changes, beginning in 2024;
  • Limit monthly cost sharing for insulin to $35 for people with Medicare, beginning in 2023. This might be the most far reaching and important item in the entire legislation.
  • Eliminate cost sharing for adult vaccines covered under Medicare Part D and improve access to adult vaccines in Medicaid and CHIP, beginning in 2023;
  • Expand eligibility for full benefits under the Medicare Part D Low-Income Subsidy Program, beginning in 2024; and,
  • Further delay implementation of the Trump Administration’s drug rebate rule, beginning in 2027.

Notice the years in which these provisions take effect. In most cases, it’s 2023.

The negotiation provision of the Inflation Reduction Act:

  • Requires the federal government to negotiate prices for some drugs covered under Medicare Part D and Part B* with the highest total spending, beginning in 2026. Note the year.

This provision targets the most expensive drugs. Here’s how.

Under the new Drug Price Negotiation Program, Medicare will negotiate the price of 10 Part D drugs for 2026, another 15 for 2027, another 15 for 2028, and another 20 for 2029 and later years. The drugs to be chosen for negotiation will be selected from among the 50 drugs with the highest total Medicare spending. The number of drugs with negotiable prices  will accumulate over time.

So, beginning four years from now, the law goes after the most expensive Medicare drugs.

There are debatable reasons for delaying implementation until 2026, all dealing with operational processes. The period of negotiation between the Secretary of Health and Human Services and manufacturers of the selected drugs will occur between 1 October 2023 and 1 August 2024, and the negotiated “maximum fair prices” will be published no later than 1 September 2024 and will go into effect 1 January 2026.

This seems to me a rather long and drawn out negotiation process, but it is, after all, a political compromise.

The better way

And now for the better way.

There is another government health care organization that has never had a prohibition with respect to negotiating drug prices. It is the Department of Veterans Affairs. The VA.

In January, 2021, the Government Accountability Office released a study that concluded:

“the Department of Veterans Affairs (VA) paid, on average, 54 percent less per unit for a sample of 399 brand-name and generic prescription drugs in 2017 as did Medicare Part D, even after accounting for applicable rebates and price concessions in the Part D program.”

This means what the VA pays is in line with those other 32 OECD countries.

Moreover, the GAO found that 233 of the 399 drugs in the sample were at least 50% cheaper in the VA than in Medicare, and 106 drugs were at least 75% cheaper. Only 43 drugs were cheaper in Medicare than in the VA.

What are the operational differences between the two organizations?

For one thing, the programs pay for drugs differently. Medicare reimburses the Part D plan sponsors to pay pharmacies through the middlemen―Pharmacy benefit Managers, but the VA buys drugs directly from manufacturers. It cuts out the middlemen. The VA can get lower prices because it can:

  • Negotiate as a single health system with a unified list of covered drugs; and,
  • Use discounts defined by law that Medicare doesn’t have.

As in everything political, it all comes down to economics. The VA, with only nine million health care beneficiaries, as opposed to Medicare’s 64 million, could fly under the political radar and avoid congressional restraint. It was able to keep the congressional camel’s nose and, more to the point, its sticky fingers out of its tent.

Medicare is so big, it could never do that.

And here we are.

______________________

*Medicare will also negotiate in a similar manner the prices of Part B drugs. These are drugs administered in physicians’ offices or hospital outpatient departments.

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Posted in Drugs, Law, Politics, Public policy

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