Will The Inexorable Movement Of A Changing Climate Finally Force Us To Change With It?

September 1st, 2023 by Tom Lynch

Climate change is all around us, creeping in from every side, making itself known more and more in ever more problematic ways. This has been happening since the dawn of time; it’s ecologically normal. What’s not ecologically normal is our helping it along.

I thought about this a couple of nights ago as I stood at the glass doors overlooking the gorgeous forest that borders our land here in the Berkshire mountains of western Massachusetts. I was watching raindrops fall, just a few drops snaking through the lights on the deck. Falling so thinly, they seemed furtive, like the recon scout I once was, checking out the landscape for the armies to follow. Then, they slackened and died away. A minute later, they were back with billions of their buddies in tow to pound the roof and deck below.

That’s what it’s been like here this summer, the wettest on record. Is it just a blip in history, or something more, a portent of the future?

Climate has been changing repeatedly, over and over, since earth was first formed four and a half billion years ago. Humanity first blossomed in Africa about two million years ago (we are all Africans), Homo Sapiens two to three hundred thousand years ago, and for most of the time we’ve been here we have not seen climate change coming. Like my furtive raindrops, it snuck in when no one was looking and changed everything. But now, advances in science allow us to understand what’s happening, what’s happened before, and what’s just now coming over the horizon. And whatever’s coming, it seems to be gathering momentum. The question being debated is how much are we contributing to the process and, if we are, how can we slow it down?

Looking at the decline and fall of the Roman Empire is instructive, and historian Kyle Harper’s magnificent, The Fate of Rome: Climate, Disease & the End of an Empire¹, particularly so. Why? Because climate change played a significant role in the slowly disappearing Roman Empire.

We are now in the Holocene geological epoch. It began about 11,700 years ago after the last major ice age. The Holocene has seen a warmer climate, yet one that wobbles between warmer and cooler. As Harper points out, the apex of the Roman Empire, the Roman Climate Optimum (RCO), was one of the most geologically and agriculturally fruitful periods in the entire Holocene. The perfect weather of the RCO, which lasted from around 150 BCE to 200 CE, allowed Rome to provide all the food its citizens would need to grow and prosper. The height of Romans increased, as did their life expectancy. With Egypt as its breadbasket, Rome was able to conquer the entire known western world and reign supreme for more than 500 years. But climate changed and three plagues arrived, and the hegemony elevator began to take everyone back down. At the end of the seventh century, the Roman Empire was a long gone thing.

The year 536 was a pivotal year. Two major volcanic eruptions blotted out the sky, and the year came to be known as “the year without summer,” which began the coldest decade in the last two thousand years and a more prolonged cold snap lasting 125 years. By this time, earth’s warming had stopped, rain happened less often, and the planet entered the Late Antique Little Ice Age, which was accompanied, unfortunately for the Empire, by two decimating plagues. There had been an earlier one, the Antonine Plague of 165 to 180, but under Marcus Aurelius the Empire bounced back from that to be stronger than ever.

When the apocalyptic Plague of Justinian struck in 541, Rome was a tired nation. The plague was a devastating pandemic, and we now know it to have been Europe’s first bubonic plague. The emperor Justinian was one of the ablest emperors Rome ever had, but he was faced with an  insurmountable confluence of bad news: a decline in solar output, as well as spreading aridification in North Africa and frequent flooding in Anatolia and Mesopotamia. The Egyptian breadbasket was a thing of the past. But Justinian tried, and tried mightily, embarking on a series of environmental engineering projects, building cisterns and aqueducts, moving riverbeds and reclaiming floodplains, all in an effort to safeguard his civilization. He failed.

Harper estimates the mortality rate of the Justinianic Plague at around 50 percent, and notes that bubonic plague continued to attack the empire for two more centuries after 541, riding on the backs of the empire’s rats and recurring in humans whenever environmental conditions conspired: some 38 times over the next 200 years. The halving of the population in 541, followed by these periodic aftershocks, sent every sphere of public life into disarray, notably decimating the army and wreaking economic chaos. Harper writes, “There is a relatively uncomplicated line from demographic collapse to the failure of the eastern empire.”

We do not face bubonic plague, but we have the ever-mutating Coronavirus staring us in the face, and what it will do in the future is anyone’s guess. Just yesterday, the Massachusetts Department of Public Health reported 2,179 new cases in the Commonwealth, with 359 hospitalizations and 12 deaths.

And, as has been demonstrated vividly in recent times, the climate times are changing. Wildfires, floods, warmer seas breeding bigger storms, ungodly heat in places that never experienced it before write our story now. The hottest years since records have been kept are happening now, right now, and the best minds studying this predict more is coming. Rising seas will put our coastal cities in danger whether we like it or not.

The degree to which mankind is contributing to this disaster-in-the-making is immaterial, because the fact is, it is happening. We should stop arguing, agree about the problem and then, like Justinian, do what we can for the good of humanity. We have a lot more weapons than he did.

We can never address this successfully if every country is doing its own thing and if governments are not empowered to generate collective action. What we need is a collaborative human endeavor, one in which humanity as a whole works together with common purpose and sacrifice. And there really isn’t time to waste.

The fate of Rome does not have to be our fate. But I can’t say I’m optimistic.

 

_________________________

¹ Harper, Kyle, 2017, The Fate of Rome: Climate, Disease & the End of an Empire, Princeton University Press.

Medicare Drug Negotiation Moves Forward With Announcement Of First Ten Most Expensive Drugs

August 31st, 2023 by Tom Lynch

At a Washington press conference on Tuesday, President Joe Biden announced the first ten drugs whose prices Medicare is now required to negotiate following passage of last year’s Inflation Reduction Act (IRA). The pharmaceutical industry is outraged.

This story has been 17 years in the making. It’s a story of government-enabled corporate greed. It centers on the Pharmaceutical industry, an industry that has done Olympian good while achieving Titanic profit, profit which has been surgically excised from the hides of American taxpayers who never felt the touch. Here’s how we got here.

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. It also explicitly prohibited the government from negotiating with the pharmaceutical industry the drug prices it pays for its beneficiaries. Since then, Washington politicians have been arguing over whether this prohibition is appropriate and should continue. 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?

  • study published in October of 2022 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 a 2019 Kaiser Family Foundation report, the total we in the US spent on prescription drugs in 2017 was $333 billion; and,
  • In 2019, 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.” Interestingly, while the Rand study found brand name drugs were 344% higher than prices in the other 32 countries, “For unbranded generics, U.S. prices were lower than those of other countries—specifically, 84 percent of prices in the comparison countries combined.” However, pharmaceutical companies have gone to great lengths to delay brand name drugs from making the tortuous journey to generics.

But now with Tuesday’s announcement, the gravy train will begin to slow and might even be forced over the next few years to stop. Why? Because of the Inflation Reduction Act.

Why hasn’t Medicare been able to negotiate drug prices for its beneficiaries like the Department of Veterans Affairs can for the veterans it serves? VA negotiations have resulted in the cost of its drugs being half what Medicare pays, or smack dab at the average OECD countries pay.

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, the 2006 law forbade Medicare from trying to get a decent deal for its 64 million members.

Now, pursuant to the Inflation Reduction Act’s new Drug Price Negotiation Program, in 2024 Medicare is to negotiate the price of 10 Part D drugs, with new prices to be effective in 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.

And on Tuesday, Biden announced the first ten drugs to be price-negotiated. As required by the IRA, they are blockbusters. The top three drugs in the list are:

  • Eliquis, jointly made by Bristol-Myers Squibb and Pfizer, which treats blood clots and cost Medicare $16.5 billion in the one year period from June, 2022, through May, 2023;
  • Jardiance, a drug to treat Type 2 diabetes, which is hyper-advertised on television and brought in $7.1 billion for its makers, Eli Lilly and Boehringer Ingelheim; and,
  • Xarelto, another blood clot drug jointly developed by Bayer and Janssen Pharmaceuticals, a unit of Johnson & Johnson. Xarelto cost Medicare $6 billion in the last year.

In July of this year, knowing Tuesday was coming, the pharmaceutical industry and its allies filed four lawsuits in four different court venues, amounting to a legal blitz in the span of just over two weeks. The complaints include a range of legal arguments, some of which overlap.

The lawsuit filed by PhRMA (Pharmaceutical Research and Manufacturers of America) and two other plaintiffs alleges the drug negotiation program is unconstitutional for three main reasons. First, the groups contend Congress shouldn’t have delegated such broad authority to the Department of Health and Human Services (HHS); second, the program denies manufacturers their due process rights; and third, it imposes a “staggering” tax for noncompliance.

Another lawsuit from the U.S. Chamber of Commerce and local business groups made similar arguments, though they also included other claims in their quest to bring down the program.

Finally, the Jones Day law firm has brought suit on behalf of drug manufacturers Bristol Myers Squibb and Merck. Their arguments assert that the rules force the drugmakers to agree to the price HHS sets and thus violate their free speech rights.

“Force the drugmakers to agree to the price HHS sets…” Except — What the Inflation Reduction Act imposed on drugmakers was a negotiation, not a drug price mandate.

This seems destined to wind up on the docket of the Supreme Court.

As might be expected, AARP loves the idea of lower prices for its members, most of whom are Medicare beneficiaries. That’s a powerful voting bloc, and you can expect both President Biden and everyone else in the Democratic Party to look all 64 million of them squarely in the eyes and trumpet the lower Medicare drug prices due to the Administration’s negotiations, the results of which the IRA requires HHS to publicly disclose on 1 September 2024, just two months before the election. And you can be sure mention will be made repeatedly that not a single Republican voted in favor of the law that made it all possible.

One other change mandated by the IRA regarding drug costs for Medicare beneficiaries involves out-of-pocket costs, which can be considerable. In 2022, the average out-of-pocket costs for this group was $6,497. In 2025, the IRA requires those costs to be capped at $2,000.

The Medicare drug provisions of the IRA are wildly popular with both Democrats and Republicans. In a survey taken by the Kaiser Family Foundation late last year, 89% of Democrats and 77% of Republicans said they favored the plank of the Inflation Reduction Act that authorizes negotiations.

Notwithstanding what the public thinks, Republican members of Congress have been sharply critical of allowing Medicare to negotiate the prices it pays for drugs, calling the measure tantamount to imposing government price controls.

I’m curious to see how the Republican presidential candidates handle this issue. Although every single one of them has vowed, if elected, to repeal the Inflation Reduction Act, thus far, with the exception of Mike Pence, who called it “bad policy,” they’ve all  been silent about Medicare negotiating the price of drugs.

Are they all, blissfully ignorant, swimming against the tide of public opinion, or do they know something the rest of us don’t?

What do you think?

Another Penny Drops. This Makes Four.

August 16th, 2023 by Tom Lynch

“This was an overt act in furtherance of the conspiracy.”

The ten words in the above sentence appear at the end of every one of the 161 criminal acts listed in the first of 41 Counts of this week’s expansive indictment of Donald Trump for his attempts to overturn the 2020 presidential election results in Georgia and promulgate his voter fraud lies.

So, here we are again. Another week, another indictment. This time it’s Fulton County, Georgia. This latest one contains qualities that are both different from and similar to the ones that came before it. Different in that:

  1. He’s been charged with leading a racketeering conspiracy under the state’s Racketeer Influenced and Corrupt Organizations Act (RICO). District Attorney Fani Willis brought the charges, with their 41 counts of criminal felonies.
  2. Unlike his previous three indictments, this one alleges a conspiracy and also charges 18 other people. Some have become almost household names over the last couple of years: Meadows, Giuliani, Powell, Eastman. But the majority of those charged are only now having their moment under the arc light of infamy. The indictment alleges that all 19, led by Trump, comprise the members of the “criminal organization” that sought to overthrow the election of Joe Biden.
  3. And there are others—unindicted, co-conspirator “individuals whose names are known by the grand jury.” These folks comprise the current mob of deer in the headlights who participated in the organized conspiracy and now wait to see if their cooperation with Willis’s team will keep them free.
  4. Willis wants to try all 19 together at the same time beginning in approximately six months. This is hugely ambitious. Herding nineteen defendants with nineteen attorneys into the same corral-like courtroom will be quite a trick. Moreover, as Meadows is already attempting, the defendants, especially Trump, are going to try to move the case from the state of Georgia to the federal system. Why? For two reasons: first, doing so may get them a more sympathetic judge, perhaps one Trump appointed; second, if Trump is successful and wins the 2024 election he could pardon everyone at the stroke of his Flair pen. The optics would be terrible, but when has that ever bothered Donald Trump? He’s the odds on favorite to win the Republican nomination regardless of how much legal baggage he’s dragging behind him, and in the general election, as he already proved once before, anything can happen. But he can’t pardon himself or anyone else if he’s convicted in a state court.

Despite the completely new and different set of charges Trump is facing, there are some things that don’t change:

  1. The Republican Party, on the whole, is four square behind the former President. Its leaders are, predictably, reacting as they have to every previous charge: the Democratic Party, the White House, the Department of Justice and the FBI are engaged in full scale weaponization of the country’s justice system to get Donald Trump. I thought the reaction of Jim Jordan (R-OH) was particularly rich: “Today’s indictment is just the latest political attack in the Democrats’ WITCH HUNT against President Trump,” Jordan, who heads the House Judiciary Committee wrote on X. “He did nothing wrong!”
  2. Although new poll numbers aren’t out since the Georgia indictment, there is no indication that Trump’s MAGA universe, his Cult of Trump, which makes up 42% of the Party, is inclined to desert their hero and move to someone else.
  3. In what I find to be the most bewildering news to emerge from the latest indictment, even Republican leaders who condemn what Trump did in trying to steal the election say they will vote for him if he’s the Party’s nominee. Even Georgia’s Attorney General Brad Raffensperger, he of the infamous and recorded phone call with Trump, the one during which Trump asked, no, demanded he find 11,780 votes to put him over the top in Georgia, the one in which Trump threatened the AG with criminal prosecution if he didn’t do “the right thing,” the one which is central to Fani Willis’s RICO case against Trump, even Raffensperger said he would vote for Trump if his is the name on the Presidential ballot. It is obvious that the addiction to power, power in the hands of the Republican Party, is the real Trump card in this political game. This is the very definition of commitment. Circling the wagons is what politicians do best. And this is not to say Democratic leaders might not act in precisely the same way if Joe Biden were the one being charged, but that is almost impossible to imagine, because the country has never seen political corruption of this magnitude, at least, not in our lifetimes. Whatever Hunter Biden did, it pales into insignificance beside this cabal.

A hundred years from now, when most of these people are nothing more than obscure footnotes in an obscure Wikipedia entry, will our descendants have learned anything from this descent into politically chaotic hell? Will they have recognized what happened to us for the immorality it is? Will their “better angels” have prevailed?

It would be so interesting to be able to stick around to see how history treats this sorry time.

Two Campaign Updates From…Where else? The Florida Of Ron DeSantis

August 12th, 2023 by Tom Lynch

Governor Ron DeSantis miscalculated badly

Writing in the Cook Political Report yesterday morning, Amy Walter reported on her conversation with Sarah Longwell, publisher of The Bulwark and a leader in the Republican Accountability Project. Over the last couple of years, Longwell has been conducting interviews and focus groups with Republican Primary voters to learn how they view their party, their candidates and the political climate. Longwell and Walter discussed the DeSantis campaign on this week’s episode of the Cook Political Report’s podcast, The Odd Years. Longwell told Walter voters believe DeSantis has made four critical mistakes in his run for the White House.

First, he entered the race too late and did it badly when he did jump in (Remember his technology-plagued announcement on Twitter sans video, sans sound?).

His propitious moment was the end of 2022 when he had a lot of wind at his back nationally. Longwell said, “There was the big Ron DeSantis boomlet. In the focus groups, we would have whole groups all the time who wanted Ron DeSantis to be the nominee. In fact, it was so complete and total, the interest in Ron DeSantis, that we actually started screening for sort of high favorability of Trump to find the Trump voters.” At that point, DeSantis was polling very close to Trump.

But DeSantis waited—until after Trump was indicted, which energized the Trump MAGA universe, and the Florida Governor has never recovered.

Second, nearly all of the likely voters reported their main concern in the upcoming election was law and order, not a war on Woke culture. They want a candidate who will focus hard on criminal justice and not get lost in battles about gender identity or LGBTQ+ issues. But DeSantis has based his entire campaign on becoming the anti-Woke candidate, and that is not selling.

Third, one has to account for DeSantis’s insularity (in the beginning he would only talk with friendly reporters from Fox News) and inexperience on the big stage. As Amy Walter writes, “I am a big believer that every campaign is ultimately a reflection of the candidate. In this case, DeSantis’ campaign reflected his wariness and discomfort with bringing new voices into his very small and parochial circle of loyalists — including his campaign manager, who had no experience in doing a job this big.” The result is embarrassing for him—in his short time as a candidate he has already had two campaign staff shakeups. His new nickname among the press—one Donald Trump did not invent—is Trainwreck Ron.

Fourth, when voters got to see him, “they found out he was weird,” according to Sarah Longwell. The man is an uncomfortable candidate. He has a weird laugh. He doesn’t know how to make small talk. And he’s bad at retail politics. A losing combination, if there ever was one. Financial Times columnist Janan Ganesh notes that DeSantis, who speaks “in a sort of monotone nag,” could “illuminate a stage by getting off it.”

Candidates who are losing, and losing badly, react. DeSantis is now nearly 40 points behind Trump, and this week he reacted to the perception he’s all about the culture wars and light on law and order by once again removing from office a prosecutor elected to the office. This makes two. Last year’s victim was Hillsborough’s State Attorney, Andrew Warren. Florida law allows the Governor to do this (hard to understand, but there it is), and this time he did it to State Attorney Monique Worrell, duly elected by the citizens of Orange-Osceola county. Why did he do this? In his executive order removing her, he accused her of policies “allowing violent offenders, drug traffickers, serious juvenile offenders, and pedophiles to evade incarceration.”

WOW! That sounds bad. How did she ever get elected? When pressed by reporters from the Tampa Bay Times, though, neither the Governor nor his staff could or would provide any credible evidence of Worrell actually acting in this way. No cases of pedophiles, or drug traffickers, or any other convicted criminals evading incarceration.

But now the Governor has checked a box in the law and order column. He’s on his way.

High School kids in Florida will now take AP Psychology

After serious blowback from more than 30,000 parents of high school seniors who had been  deprived the opportunity to take the College Board’s Advanced Placement (AP) Psychology course in the Sunshine State because, as part of its curriculum, the course covered gender identity and sexual orientation, Commissioner of Education Manny Diaz informed school boards yesterday that the students actually could take the course, because doing so would no longer violate new state law prohibiting such instruction. That is the definition of pretzel logic.

The problem now is that most school boards, having been told teaching the course would violate the law, either removed it from the year’s curriculum, or contracted with another company to offer another version of AP Psychology. Unfortunately, this is not the course certified by the College Board, the organization that certifies AP courses for inclusion on a student’s transcript.

A bigger problem, of course, is that the Florida school year began two days ago, and courses have been pretty much curing in educational cement for the last week, or so. Wonderful timing, Commissioner Diaz.

This culture war stuff has turned Florida into an upside down state led by a man becoming more clueless every day. Perhaps the Governor should rethink his current career objectives, go home, lick his considerable wounds, and ponder 2028 when Donald Trump will be 82 years old and either spending his days in Leavenworth Federal Prison, or, having been exiled to Scotland, residing at his “very fine” golf course in an apartment built purely for the purpose of housing him in his dotage.

One can hope, anyway.

Israel: On The Cliff At The Edge Of Democracy

August 10th, 2023 by Tom Lynch

For the last eight months, Israel, America’s foremost ally in the cauldron of the middle east, has been an ally controlled by far-right extremists. This was driven home again this week in another episode of its government doing everything it can to antagonize its Arab citizens and the permanent residents of East Jerusalem.¹

Israel’s previous government had allocated Arab municipalities $85.5 million for educational programs in East Jerusalem. Moreover, additional funding was allocated for higher education preparatory programs for young Palestinians, designed to enable students from East Jerusalem to study in preparatory programs at Israeli academic institutions. Some 500 Palestinians have studied in them in recent years.

Although, given Israel’s precarious relationship with Palestinians, this educational funding may seem like one drop in a great big barrel of rain, it is at least a step toward the integration of East Jerusalem’s Arab population into academia that holds social, economic, and security importance for the long-term good of the country.

But now, defying stark warnings from Israel’s Shin Bet security service, as well as her international allies, the new government has frozen the funding and refuses to release it for the legislated purpose. The funding freeze can be laid at the door of Finance Minister Bezalel Smotrich, the leader of the Religious Zionist Party noted for his far right extremist views, especially with respect to Palestinians. He told Arab Israeli lawmakers in October 2021, “It’s a mistake that Ben-Gurion didn’t finish the job and didn’t throw you out in 1948.”

Smotrich is also a settler in the Israeli-occupied West Bank. The UN Security Council, its General Assembly, the International Red Cross, and others have all agreed settlements on the West Bank and the Golan Heights violate Article 49 of the Fourth Geneva Convention. Doesn’t matter to Smotrich and his colleagues now leading Israel. They just keep building new ones.

This is all just more fuel thrown on the burning Israeli blaze opponents now call the Judicial Coup of 2023, which began less than one week after Prime Minister Benjamin Netanyahu cobbled together a coalition government in late 2022 after two previous elections that year had failed.

The coalition government consists of six political parties—Likud, United Torah Judaism, Shas, Religious Zionist Party, Otzma Yehudit, and Noam—and is led by Likud’s Netanyahu, who has taken office as the Prime Minister of Israel for the sixth time. With the exception of Likud, the other five parties are right-wing and religiously conservative, hugely influenced, perhaps dominated, by Israel’s ultra-Orthodox community, known as the Haredim.

The Haredim have long enjoyed benefits unavailable to other Israeli citizens: exemption from army service for Torah students, government stipends for those choosing full-time religious study over work and separate schools that receive state funds even though their curricula barely touch government-mandated subjects.

This new government, with dynamite in one hand and a flaming match in the other, is now in charge and, as I have written before, is doing its best to remake Israel’s judicial system by emasculating the country’s Supreme Court and consolidating all power in its own hands.

Israel does not have a constitution, It has 13 rather vague Basic Laws enacted at various times between 1958 and 2018. The 8th Basic Law, The Judiciary, enacted in 1984, lays out common sensible judicial requirements about honesty, transparency, judicial probity, process, and the like.

Unlike the United States, with two legislative bodies, an Executive, and a judicial system to provide tripartite balance, Israel has only its Knesset, controlled by the Prime Minster’s coalition, and its Supreme Court, which is the only check on government overreach.

The Basic Laws place a heavy burden on the country’s judiciary and its Supreme Court, the High Court of Justice, making it the final arbiter. By nature, the Court is always involved in a tense relationship with its sister institution, the Knesset, Israel’s parliament. In this regard, both are critical pillars in Israel’s foundational house of democracy.

Every one of Israel’s allies has strongly urged Netanyahu to pause his judicial “reforms.” But Netanyahu wants to stay in power, and if he loses the loyalty of his far-right coalition, he won’t. Simple as that. So, he and his colleagues, the ones who, to the bottom of their cores, believe deeply in what they are doing, are marching toward the cliff at the edge of democracy. Eyes wide shut.

Two weeks ago, they prevailed, despite country-wide protests, in the first of their attacks on the Supreme Court by passing a law prohibiting the Court from exercising one of its foremost functions: ruling on the “reasonableness” of laws passed by the Knesset, which is akin to our Supreme Court ruling on the constitutionality of any law. Now, in a judicial irony of the first order, the same Supreme Court will rule on the “reasonableness” of the “reasonableness” law just passed. What happens if, as expected, it rules the new “reasonableness” law is unreasonable, is anybody’s guess.

To give you an idea of just how ferociously this problem has torn at the country, consider this. Israel, being a small country with areas that often can pretty much resemble a war zone, is one of the world’s few countries with mandatory, two-year conscription for its armed forces. In addition, following their time on duty, many soldiers continue service as reservists. There are 400,000 of them right now, many of them Air Force pilots, and they are essential to Israel’s defense. However, many reservists and active duty soldiers have publicly vowed not to serve if the judicial coup continues. As you can imagine, this is tremendously concerning  to the country’s military leaders (who also oppose the judicial “reforms”), its security services, and, most important, its allies—us, in particular. But it does not appear, despite the best efforts of President Biden and Secretary of State Blinken, that Netanyahu and his coalition partners are prepared to budge one bit. At this moment, there is no resolution on the horizon for this impasse.

Hard to believe, but Israel is now standing at the edge of that democracy cliff and thinking about jumping. There’s not a parachute in sight.

¹ Although offered citizenship after the 1967 war, many Arabs refused. That is why, though comprising 20% of Israel’s population, many Arab’s living in East Jerusalem are designated as “permanent residents.”

A Witch’s Brew Florida

August 9th, 2023 by Tom Lynch

During the summer of my 15th year, my father walked into our very Roman Catholic home to find me reading a paperback book on the couch in our living room. “What are you reading, Tommy?” he asked. So, I showed him the book I was well into. It was The Tropic of Cancer. Whereupon, Dad became somewhat apoplectic, and rushed into the kitchen where my mother was starting to cook supper. “Mary, do you know what your son is reading?” he demanded. “Of course,” my mother replied. “I gave it to him.”

Tropic of Cancer is an autobiographical novel by Henry Miller, published in France in 1934 and, because of censorship, not published in the United States until 1961. And it is racy, indeed. It is also superbly well-written and compelling as it takes the reader on a tour of Miller’s mind as he lived a hedonistic life in the Paris of his youth. We should all be so lucky.

My mother knew a book would never hurt me. People could and would, but not books. And I’m happy to say she eventually convinced my father of the value of that proposition.

And it was my mother who introduced me to the works of William Shakespeare when I was 13. The play was Romeo and Juliet, the story of the star-crossed teenaged lovers from Verona. It’s a story of young love, but also a story of what hate can do when left to run amok. The writing was beautiful, especially to a new teenager whose hormones were flowing like Romeo’s.

Two years later, my sophomore class was assigned Julius Caesar. It was magnificent, and, to this day, is still my favorite Shakespeare play. I can quote large sections. Marc Antony was a part for the ages.

I bring this history up because of what’s happening right now in the Florida of Ron DeSantis where fair is made foul and foul becomes fair.

Like Donald Trump, Governor DeSantis has surrounded himself with sycophants, and the sycophant of the moment is his Education Commissioner Manny Diaz.

Diaz is an interesting character with an educational history that would cause neither Henry James, not his friend Edith Wharton, to sit up and take notice. He’s a politician first and an educator second. With a 1998 Master’s Degree in educational leadership from Nova Southeastern University in Fort Lauderdale, he became a teacher and baseball coach at Miami Springs High School. Following that, he taught social studies at Hialeah-Miami Lakes High School, where he spent eight years as an assistant principal. He filed for bankruptcy is 2012, citing $1.3 million in debts.

In the same year, he won a seat in the Florida House of Representatives. He became a champion of allowing students to go to private schools on state funding. He also became Chair of the Choice and Innovation and K-12 Appropriations committee during his tenure in the House. More important, he was a key member of Representative José R. Oliva’s team. Oliva rose to become Speaker of the House in Florida.

In 2018, Diaz was elected to the Florida Senate and became closely aligned with Ron DeSantis. So much so, that, like DeSantis, he opposes CoVid 19 vaccine requirements and, as of 2022, was not vaccinated, himself.

He sponsored SB148/ HB7 in the Florida Senate, the “anti-woke” legislation much beloved by Governor DeSantis. This is the legislation called “positively dystopian” by Chief U.S. District Judge Mark E. Walker, as he blocked key provisions of it in his 139-page decision in November 2022. Following passage of the anti-woke act, DeSantis appointed Diaz to his current position as Commissioner of Education.

I dwell on Commissioner Diaz because yesterday Florida schools, in order to comply with the provisions of DeSantis’s “don’t say gay” and “anti-woke” legislation, announced high school students would no longer read any Shakespeare play, but would, rather, discuss “excerpts.” From now on, it’ll be Cliff Notes for Shakespeare.

As Joseph Cool, a reading teacher at Gaither High School told the Tampa Bay Times, “There’s some raunchiness in Shakespeare,” and staying with excerpts, schools can teach about Shakespeare while avoiding anything racy or sexual.

This is all part of Florida’s new Benchmarks for Excellent Student Thinking. Thinking, that is, of a non-prurient nature.

Shakespeare would have loved this Floridian witch’s brew, “The rankest compound of villainous smell that ever offended nostril.”¹

More “excellent student thinking” was on display last week, when Commissioner Diaz announced the cancellation of Florida’s Advanced Placement (AP) course in psychology, because the College Board, the administrator of the course, refused to take out any references to gender or sexual orientation.

This AP course has been taught in Florida high schools for the last 20 years without complaint from anyone. In 2022, 28,000 students took the course. However, in May, 2023, Commissioner Diaz’s Office of Articulation (whatever that is) “implored” the College Board to review all AP courses and remove any content that would violate Florida’s new law banning any instruction which may allude to gender identity or sexual orientation.

The College Board, to its credit, said “No.” Gender and sexual orientation, the College Board said, “must remain a required topic, just as it has been in Florida for many years.”

Now, Commissioner Diaz is scrambling to put the toothpaste back in the tube. He has turned to another course administrator, “pivoting to the college-level course offered by Cambridge International instead,” the Tampa Bay Times reports. Cambridge International says it will offer the course without the offending material. However, the College Board, which confirms student AP course completion for inclusion on student transcripts, says any course without the required content regarding gender or sexuality will not qualify.

All of this is now a certifiable mess, a full measure of “double, double, toil and trouble.”²

I wonder what Henry Miller would say? Probably something like (fill in the blank for extra credit):_________.

¹ The Merry Wives of Windsor (Act 3, Scene 5)

² Macbeth (Act 4, Scene 1)

Weekend Bits and Pieces

August 4th, 2023 by Tom Lynch

The Johnny Appleseed of Election Deniers

Douglas Frank was born and raised in Sonoma County, California, studied chemistry at Westmont College in Santa Barbara and earned a doctorate in surface analytical chemistry from the University of Cincinnati. He was Chair of the math and science department at a Cincinnati private school. Then, after the 2020 election, he quit his teaching job and, depending on whom you believe,  either went completely crazy, or became the Lord’s anointed, the Apostle bringing truth to the masses, the Johnny Appleseed of Election Deniers spreading the gospel of Donald Trump.

In contrast with other members of the congregation of election deniers who testify online and on conservative cable shows, Frank has proselytized at churches, bars, libraries and civic organizations throughout California over the last two and a half years. By going small, Douglas Frank got big.

He says he wants to eliminate electronic voting machines (the name Dominion comes to mind) and prohibit mail in voting¹, because these are the two liberal moves that allowed the 2020 election to be rigged for Joe Biden and stolen from Donald Trump.

And he’s having some success. Due in large part to his constant efforts, the Shasta County Board of Supervisors ended its contract with Dominion in January, and went a step further in March when it voted to stop using electronic machines at all to tabulate ballots. Only a small number of the roughly 10,000 election jurisdictions in the U.S. have stopped using electronic voting machines since 2020, but Frank says Shasta is a good start.

Frank speaks of Shasta County in biblical terms, holding it up to audiences as an inspiration and template.

“Once David slew Goliath, then the Hebrew children, the Israelites, chased the Philistines out of the land. They suddenly all got brave, right? Shasta just slew Goliath. Now you all need to get brave,” he said in Hemet, California.

Frank chuckled when told of his Johnny Appleseed epithet. “Instead of planting apple seeds, I think I’m going around starting little fires everywhere,” Frank said. “And then I come back and I throw gasoline on those fires.”

Frank has energized the faithful as he wanders around preaching to California choirs, who are fully on-board with his wacko theories.

Every charge Frank makes has been debunked. None of it’s true. But he’s a top-notch presenter making solid contact with his audiences.

A friend of My Pillow nutcase Mike Lindell, Frank has appeared in Lindell’s election conspiracy films, is a frequent guest on Lindell’s streaming show and has emceed Lindell’s election denial conferences. In June 2021, Frank spoke at a televised rally for Trump in Ohio.

This man is beginning to reach a wider swath of the population, and that is scary. His mission is to disrupt how elections are run, and that happens at the local level where Frank is at his best firing his rhetorical missiles.

Staying in California at the local level

The Republican Party learned long ago that former Speaker of the House Tip O’Neil was right: “All politics is local.” Taking Tip’s mantra to heart, it has perfected it into a winning strategy, which is why it has done so well winning state legislatures.

Now, California Republicans have used the tactic to, in their minds, insure that Donald Trump is the Party’s nominee for the 2020 presidential election. Let me explain.

Until now, when voters cast their ballots in a presidential state primary a candidate is awarded delegates based on the percentage of the vote they win. If they win 20% of the vote, they’ll win 20% of the state’s delegates to the Republican National Convention.

That is, until now. In early June, Michigan changed its rules for awarding delegates. Under a new rather byzantine process, one-fifth of the state’s 52 national convention delegates will be given to the presidential candidate who wins the state’s 27 February 2024 primary election. However, three-quarters of the delegates, 39, will be divvied up by 13 congressional district caucus meetings occurring on the following 2nd of March. Seems a bit bizarrely unfair to me in that a candidate could win more than 50% of the vote, yet end up with only 20% of the delegates. But who am I to question the motivation of the leading lights of the Grand Old Party?

Last Saturday, California went in the other direction. Under that state’s new Republican Party rule, adopted by its executive committee, if a candidate wins more than 50% of the vote, the Party will award that candidate 100% of the delegates.

In recent polling, Donald Trump is polling above 50% for the Republican primary in California, and, as can be expected, his campaign supports this change; in fact, the campaign pushed for it.

California awards more delegates than any other state—169 of them. Whoever, comes out of the primary with that bucket of delegates is well on his or her way to the Republican nomination, which will require securing 1,234 votes at the national convention.

However, if no candidate wins 50% of the primary votes, the delegates will be awarded proportionately based on each candidate’s share of the statewide vote.

California’s primary has historically come at the end of the primary campaign season, in June, but for the 2024 primary, Party leaders have moved it to 5 March, the same day as 14 other states.

The night of the 5th of March will be a long one.

How goes the listing ship of DeSantis?

Simple answer: not well.

This week’s release of a new New York Times/Sienna College poll throws more of the stinky fecal matter on the anti-woke candidate.

By a wide margin—34%—Donald trump leads the combative all-his-eggs-in-one-basket DeSantis.

Trump’s lead, nationwide, is so large that the New York Times’s Nate Cohn, who compiles The Tilt, this morning wondered if Iowa could be becoming a problem for the one-time president and three-time indicted Mr. Trump. Why? Because the poll margin in Iowa was only 24% in favor of the yellow-haired, teflon-baked DT.

DeSantis has a lot of hair. He must be tearing gobs of it out right now.

Finally, staying on DeSantis

The man can’t help himself. In trying to be the toughest creampuff on the block he keeps spilling the goo all over himself.

I know in presidential elections it is de rigueur for candidates to attack federal workers for being lazy, wasteful, and incompetent. The federal workers are used to it, not that they like it, of course. But in New Hampshire this week, Ron DeSantis decided to take the attacking to a new level, as only he can.

As reported by Eric Katz of Government Executive, DeSantis attended a campaign-stop barbecue, and said, “We’re going to have all these deep state people. We’re going to start slitting throats on day one.”

Now friends, that is not the way to win the votes of the 800,000 federal workers, to say you’re going to kill them on your first day in office. Can we agree the silver tongued governor was hyperbolizing a bit? Probably. But I’m beginning to wonder if winning the presidency were dependent on a few slit throats, would Mr. DeSantis be inquiring for the location of the nearest knife.

Hope you all have a nice weekend.

__________________________

¹ According to noted art historian and scholar Robert Hughes, the credit for creating mail in voting goes to Caesar Augustus who allowed it for Roman elections around the beginning of the common era (CE).

 

 

 

 

The Trials Of Donald Trump

August 2nd, 2023 by Tom Lynch

Having just concluded a marvelous vacation in the wonderful Alaskan wilderness searching for Moose and Black Bear in Denali National Park, sitting in the sea 75 yards from the great Northwestern Fjord Glacier as large hunks of it fall right in front of me, watching brown bears bulk up for the winter on deep-red Sockeye Salmon at Brooks Falls in the Katmai National Park, to what reality do I return in the beautiful Berkshires of the lower forty-eight? Why, of course, what else, another episode in the continuing saga of The Trials Of Donald Trump. What a way to come back to earth.

Hanging around the Ted Stevens International Airport in Anchorage waiting for the long flight home, I picked up a local newspaper to while away the time, only to learn from a New York Times/Sienna College poll that the Grifter in Charge now leads his closest rival, the out-of-his-league Ron DeSantis, by 34 percentage points in the race for the Republican nomination for the presidential contest of 2024. This, despite his two indictments and recent conviction for sexually harassing E. Jean Carroll.

Then, upon landing in Boston, I was greeted by the News Flash of yet another indictment, the second brought by Special Counsel Jack Smith. This one has four charges, three involving conspiracies, and the fourth for “obstructing, or attempting to obstruct an official proceeding.” And, despite his growing laundry list of charges, he continues to have the unwavering support and adulation of his MAGA cult following. In fact, the more indictments he faces, the stronger he seems to get. As the New Yorker’s brilliant Andy Borowitz so sharply pointed out, “The former President is but a few indictments away from clinching the Republican nomination.” And he wrote that before the latest.

If The Trials Of Donald Trump weren’t real, they would make wonderful television farce. But this is all real. So, how is it possible? In America?

I am painfully aware of our country’s political mistakes. You know, all the ones Governor DeSantis is doing his best to erase from history. But how has our orange-haired charlatan persuaded, no convinced, a significant chunk of the Grand Old Party, the one Abraham Lincoln made famous, that he is innocent as driven snow and is being persecuted by a corrupt Department of Justice and FBI, which, by the way, is led by a man he appointed?

Perhaps the answer has a lot to do with the illusory truth effect. As Aumyo Hassan and Sarah J. Barber point out in their May 2021 paper, The effects of repetition frequency on the illusory truth effect:

Repeated information is often perceived as more truthful than new information. This finding is known as the illusory truth effect, and it is typically thought to occur because repetition increases processing fluency. Because fluency and truth are frequently correlated in the real world, people learn to use processing fluency as a marker for truthfulness.

In other words, people tend to believe lies that are repeated over and over. And, as Hassan and Barber showed in their study, the more often they’re repeated, the deeper the belief becomes. Further, if someone wants to believe the lie, the more likely they are to do just that even faster. The lie becomes the belief, which becomes the deeply held belief, which becomes nearly impossible to correct. This has been proven throughout history time and time again. Donald Trump is just the latest competent practitioner.

Trump also knew it was not enough for him to be the only one spreading his lies. For them to take deep root in the consciousness of his followers he would have to dangle the pearls of power in front of fawning sycophants by giving them significant positions of governmental authority. Then, they could repeat and amplify his lies. Who can forget Trump’s Senior Counselor Kellyanne Conway and her “alternative facts” when defending her boss’s lies?

The real damage Donald Trump has done to the country is not measured by the indictments and trials to come. No, the real damage he has done lies in the path to power he has shown others, the Kevin McCarthys, Jim Jordans, and Marjorie Taylor Greenes of the world, who walk right behind, following his example as if it were a bright red rope in the snow.

It will be a long, hard slog to wash clean the stain Donald Trump has poured over the face of America.

 

How Medicare’s Drug Prices Could Have Been Half What They Are

July 20th, 2023 by Tom Lynch

In yesterday’s Letter I described the torturous path taken by the Biden Administration to get to the point where Medicare would be allowed to negotiate the prices it pays for the drugs it provides to its beneficiaries. I wrote that pharmaceuticals now cost Medicare about a quarter of its entire spend for the 64 million people it insures.

The Inflation Reduction Act was the vehicle that finally ushered in negotiations, which are scheduled to begin next month, negotiations that will center on ten of the highest cost drugs and should result in lower prices beginning in 2026. In succeeding years, more negotiations will focus on more and more drugs. Given the huge dollars Pharma contributes to Washington’s politicians, stretching everything out as far as possible was a necessary compromise the President’s team made.

But Pharma, the US Chamber of Commerce and two big drugmakers, Bristol Myers Squibb and Merck, haven’t given up, not by a long shot. Within the last two weeks they have filed four lawsuits. They’re throwing everything they have up against the wall to see if anything sticks. If they succeed in derailing the train to lower prices, they will, with great big smiles, sit comfortably back in plush seats on board the gravy train they’ve come to know so well.

But while all of that plays out, I want to suggest a better result that could have happened long ago if only lawmakers had treated drugmakers differently.

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 the other 32 OECD countries I mentioned yesterday whose cost are half those of the US for Medicare.

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 an aside, I’ve always thought that one of the primary causes of high costs in both Medicare and group health insurance is the presence of Pharmacy Benefit Managers, the middlemen. But that’s a topic for another day.

As in everything political, all of this 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 couldn’t do that.

And here we are.

Where Does The Medicare Drug Price Negotiation War Stand Now?

July 19th, 2023 by Tom Lynch

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?

  • 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, perhaps 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. Which is now.

The negotiation provision of the Inflation Reduction Act:

  • Requires the federal government to negotiate prices for some drugs (emphasis added) 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 three years from now, the law goes after the most expensive Medicare drugs — ever so slowly.

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 has always seemed to me a rather long and drawn out negotiation process, but it is, after all, a political compromise, and a rather elegant one, at that.

But now, into that elegant compromise has stepped the pharmaceutical industry and a bunch of high-powered allies. They lost in the fight that brought the compromise within the Inflation Reduction Act, but they’re now back with lawsuits to derail the process before it gets going this year.

Just this month, four lawsuits have been filed in four different court venues, amounting to a legal blitz in the span of just over two weeks. The complaints include a range of legal arguments, some of which overlap.

“If you find one judge or one panel, that’s all it takes. When you’re thinking of savvy and sophisticated litigants, that is the way that they try and challenge major policies at this stage,” said Zachary Baron, an associate director of the Health Policy and the Law Initiative at Georgetown’s O’Neill Institute.

The lawsuit filed by PhRMA (Pharmaceutical Research and Manufacturers of America) and two other plaintiffs alleges the drug negotiation program is unconstitutional for three main reasons. First, the groups contend Congress shouldn’t have delegated such broad authority to the federal health department; second, the program denies manufacturers their due process rights: and third, it imposes a “staggering” tax for noncompliance.

Another lawsuit from the U.S. Chamber of Commerce and local business groups made similar arguments, though they also included other claims in their quest to bring down the program.

Finally, the Jones Day law firm has brought suit on behalf of drug manufacturers Bristol Myers Squibb and Merck. Their arguments assert that the rules force the drugmakers to agree to the price HHS sets and thus violate their free speech rights.

“Force the drugmakers to agree to the price HHS sets…” Except — What the Inflation Reduction Act imposed on drugmakers was a negotiation, not a drug price mandate.

One person who spoke with a Washington Post reporter suggested the lawsuits were just the first move in a complicated chess match the drugmakers were hoping would wind up in a  sympathetically conservative Supreme Court.

No one ever said this was going to be easy.

Tomorrow — A better way to lower prescription drug costs for Americans.