Does Trump Want Us All To Die? Why Else Would Have He Put Pence In Charge Of The Coronavirus Pandemic?

Trump wants to prove he was right all along by banning travel into the U.S. from Mexico (to prevent coronavirus). As I was writing this the U.S.-- the world's example of how not to deal with a pandemic-- has 72 confirmed cases (probably closer to 72,000) while Mexico has 4 confirmed cases.

A group of 11 Republicans in the U.S. House of Representatives led by Chip Roy of Texas sent a letter on Friday to top Trump administration officials that pressed for details on the plan to contain the coronavirus at the border with Mexico.

“Given the porous nature of our border, and the continued lack of operational control due to the influence of dangerous cartels, it is foreseeable, indeed predictable, that any outbreak in Central America or Mexico could cause a rush to our border,” the lawmakers said.

A group of three Republican senators led by Martha McSally, of Arizona, sent a similar letter on Friday to the head of U.S. Customs and Border Protection.

...The discussions over possible border restrictions remain in the preliminary phase, but the DHS has considered increased screening of people from certain countries based on that country’s medical capacity and volume of travelers to the United States, according to one of the officials.

“The issue of it in our hemisphere is something we are exploring,” said one of the officials. “We are all a little worried now that Mexico has its first cases.”

Sharon Lerner, writing for The Intercept over the weekend reminded everyone that Trump's Secretary of Health and Human Services, Alex Azar, admitted that "a vaccine for the coronavirus might not be affordable for all Americans. 'We can’t control that price,' Azar told Rep. Jan Schakowsky (D-IL) during a congressional hearing about the virus... Azar, who served as the top lobbyist for Eli Lilly before becoming president of the drug company’s U.S. operations in 2012 and the secretary of Health and Human Services in 2018, knows of what he unthinkingly speaks. Exorbitant drug pricing often leaves life-saving treatment out of reach for the poorest Americans. And to the extent that Azar and the other businessmen who make up the majority of the president’s task force on the coronavirus have any experience with pharmaceuticals, one of the most profitable sectors of the economy, it’s been making money off the system that keeps them out of reach." If I didn't know better, I'd say Azar was doing a campaign ad for Bernie and his Medicare-for-All proposal.

Last week, writing for ProPublica, Caroline Chen, Marshall Allen, Lexi Chirchill and Issac Arnsdorf reported on the flawed coronavirus test designed by the the CDC. They wrote that "As the highly infectious coronavirus jumped from China to country after country in January and February, the U.S. Centers for Disease Control and Prevention lost valuable weeks that could have been used to track its possible spread in the United States because it insisted upon devising its own test... 'We’re weeks behind because we had this problem,' said Scott Becker, chief executive officer of the Association of Public Health Laboratories, which represents 100 state and local public laboratories. 'We’re usually up-front and center and ready.'"

The federal agency shunned the World Health Organization test guidelines used by other countries and set out to create a more complicated test of its own that could identify a range of similar viruses. But when it was sent to labs across the country in the first week of February, it didn’t work as expected. The CDC test correctly identified COVID-19, the disease caused by the virus. But in all but a handful of state labs, it falsely flagged the presence of the other viruses in harmless samples.

As a result, until Wednesday the CDC and the Food and Drug Administration only allowed those state labs to use the test-- a decision with potentially significant consequences. The lack of a reliable test prevented local officials from taking a crucial first step in coping with a possible outbreak-- “surveillance testing” of hundreds of people in possible hotspots. Epidemiologists in other countries have used this sort of testing to track the spread of the disease before large numbers of people turn up at hospitals.

...The CDC announced on Feb. 14 that surveillance testing would begin in five key cities, New York, Chicago, Los Angeles, San Francisco and Seattle. That effort has not yet begun.

On Wednesday, under pressure from health experts and public officials, the CDC and the FDA told labs they no longer had to worry about the portion of the test intended “for the universal detection of SARS-like coronaviruses.” After three weeks of struggle, they could now use the test purely to check for the presence of COVID-19.

It remains unclear whether the CDC’s move on Wednesday will resolve all of the problems around the test. Some local labs have raised concerns about whether the CDC’s test is fully reliable for detecting COVID-19.

In New York, scientists at both the city’s and state’s laboratories have seen false positives even when following the CDC’s latest directions, according to a person familiar with their discussions.

“Testing for coronavirus is not available yet in New York City,” city Department of Health spokeswoman Stephanie Buhle said in an email late Thursday. “The kits that were sent to us have demonstrated performance issues and cannot be relied upon to provide an accurate result.”

Until the middle of this week, only the CDC and the six state labs-- in Illinois, Idaho, Tennessee, California, Nevada and Nebraska-- were testing patients for the virus, according to Peter Kyriacopoulos, APHL’s senior director of public policy. Now, as many more state and local labs are in the process of setting up the testing kits, this capacity is expected to increase rapidly.

So far, the United States has had only 15 confirmed cases, a dozen of them travel-related, according to the CDC. An additional 45 confirmed cases involve people returning to the U.S. having gotten sick abroad. But many public health experts and officials believe that without wider testing the true number of infected Americans remains hidden.

“The basic tenet of public health is to know the situation so you can deal with it appropriately,” said Marc Lipsitch, professor of epidemiology at the Harvard T. H. Chan School of Public Health. He noted that Guangdong, a province in China, conducted surveillance testing of 300,000 people in fever clinics to find about 420 positive cases. Overall, Guangdong has more than 1,000 confirmed cases. “If you don’t look, you won’t find cases,” he said.

Janet Hamilton, senior director of Policy and Science at Council of State and Territorial Epidemiologists, said that with the virus spreading through multiple countries, “now is the time” for widespread surveillance testing.

“The disease,” she said, “is moving faster than the data.”

It remains to be seen what effect the delay in producing a working test will have on the health of Americans. If the United States dodges the rapidly spreading outbreaks now seen in Iran and South Korea, the impact will be negligible. But if it emerges that the disease is already circulating undetected in communities across the country, health officials will have missed a valuable chance to lessen the harm.

The need to have testing capacity distributed across local health departments became even more apparent Wednesday, when the CDC said it was investigating a case in California in which the patient may be the first infected in the United States without traveling to affected areas or known exposure to someone with the illness.

Doctors at the University of California, Davis Medical Center, where the patient is being treated, said testing was delayed for nearly a week because the patient didn’t fit restrictive federal criteria, which limits tests only to symptomatic patients who recently traveled to China.

“Upon admission, our team asked public health officials if this case could be COVID-19,” UC Davis said in a statement. UC Davis officials said because neither the California Department of Public Health nor Sacramento County could test for the virus, they asked the CDC to do so. But, the officials said, “since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered.”

After this case, and under pressure from public officials, the CDC broadened its guidelines Thursday for identifying suspected patients to include people who had traveled to Iran, Italy, Japan or South Korea.

The debate over whether federal, state and local officials should have already been engaged in widespread surveillance testing has become more heated as the virus has spread globally. The CDC had said the purpose of its five-city surveillance program was to provide the U.S. with an “early warning signal” to help direct its response. The cities were selected based on the likelihood that infection would be present, Hamilton said.

But Mark Pandori, director of the Nevada State Public Health Laboratory, which began offering testing on Feb.11, said surveillance testing may not be the best use of resources right now. “A lot of people look at lab tests like they are magic,” Pandori said. “But when you run lab tests, the more chances you have for getting false answers.”

Steve McIntosh is president of the Colorado-based Institute for Cultural Evolution think tank, which focuses on the cultural roots of America's political problems. A couple of weeks ago he wrote a piece for RealClearPolitics, Progressives Can Show Evangelicals They Don't Need Trump. It doesn't factor in what's headed in the direction of the hard core Trumpists who believe him when he says coronavirus is just a hoax and that he 's got it all under control. A quarter of the population identify as evangelicals. They are Trump's base and over 70% still support him! "The disparity between Christian morality and Trump’s evident lack of personal virtue," he wrote, "has led to charges of hypocrisy from the larger culture. Feeling the sting of these charges, the minority of evangelicals who oppose Trump are increasingly worried that populist evangelical support for the president will discredit Christianity’s 'moral witness' in American society. This growing division among evangelicals has recently been brought to a head by Christianity Today’s forceful call to remove President Trump from office. Progressive media coverage of this cultural divide within evangelicalism has focused primarily on what can be done to encourage the further liberalization of Christian culture. But an unexamined piece of this puzzle is how progressives themselves can evolve their own culture to reduce evangelicals’ enthusiasm for the Trump presidency. According to poll analysis by FiveThirtyEight, many evangelical Christians feel alienated from the Democratic Party because of its perceived hostility toward religion."

To defeat Trump in November, and defeat Trumpism once and for all, progressives would do well to acknowledge their cultural victory and make peace with their Christian fellow citizens. Yet to become cultural peacemakers, progressives don’t need to move toward the middle, soften their political demands, or otherwise compromise their values. On the contrary, liberals and progressives can reduce the sense of alienation that drives support for Trump by extending their own inclusive values to encompass evangelicals, who are experiencing their own cultural marginalization. It is important to recognize that evangelicals feel “unsafe” and have elected Trump to serve as their cultural bodyguard. And when hiring a bodyguard, one may be inclined to overlook his arrest record.

Even as they oppose the politics of the religious right, progressives can make common cause with the many enduring values that traditional Christian culture continues to contribute to our society. These values include decency, loyalty, modesty, patriotism, and respect for rightful authority. The traditional reverence for family life can also be carried forward by progressives within their more inclusive understanding of family.

By tempering their self-sabotaging hostility toward Christianity in this way, progressives can atone for their own unwitting complicity in the rise of Trumpism. And by doing their part to make America’s political discourse more civil, and even welcoming, for ideologically diverse groups, progressives can sway the evangelical vote at the margins, which might be enough to prevent Trump’s reelection in November.

...Although evangelical support for Trump does constitute moral hypocrisy, progressives evince their own hypocrisy when it comes to their stated values of diversity and inclusivity. Progressives are keen to demonstrate cultural sensitivity toward Islamic traditionalists, for instance, despite Islamic homophobia and contempt for liberal freedoms. If progressives showed a similar degree of cultural sensitivity toward Christian traditionalists, even while opposing them politically, this would help ameliorate the hyper-polarization that led to the rise of Trumpism. Progressives may have won the culture war, but unless they are gracious in their victory, their cultural success will continue to result in their political defeat.

When it comes to American democracy, we’re all in this together. By simply acknowledging that conservative Christians “have a right to be who they are,” progressives can persuade a politically significant number of evangelical voters that they don’t need a cultural bodyguard.

Trump Is Pretending He Wants To Finally Help With Out-Of-Control Drug Prices

After my successful cancer treatment-- which included a full stem cell replacement operation-- I quickly realized I would be taking a lot of drugs for the rest of my life, including some very expensive ones. I was looking at-- even with insurance (Medicare Part D, the one part of Medicare-- written and passed strictly by Republicans-- that sucks) thousands of dollars a month. Prices have gone up since Trump entered the White House, despite his oft-repeated promises to lower them. I turned to Canada for one of the most expensive of the drugs, VIMPAT (lacosamide, around $1,093.78 a month). No Canadian pharmacy online will sell it to Americans through the mail. It's something like $90 in Thailand-- where I've been getting it-- and I'm hearing just as inexpensive in Mexico. Yesterday, Trumpanzee was bragging how he's waving his magic wand and making drug prices "for our great seniors" less expensive. Health and Human Services Secretary Alex Azar: "Today's announcement outlines the pathways the Administration intends to explore to allow safe importation of certain prescription drugs to lower prices and reduce out of pocket costs for American patients. This is the next important step in the Administration's work to end foreign freeloading and put American patients first."

The Washington Post seemed skeptical: "The Trump administration on Wednesday," wrote Yaseem Abutaleb and Laurie McGinley, "said it was taking steps that might eventually lead to the importation of some lower-cost prescription drugs from Canada, an idea supported by President Trump but long opposed by many Republicans, including some of his own aides."

This was from Azar's live presentation yesterday:

For too long, there’s been a lot of talk on drug prices and no action. Drug companies have insisted we can have new cures or affordable prices, but not both.

I’ve been a drug company executive-- I know the tired talking points: the idea that if one penny disappears from pharma profit margins, American innovation will grind to a halt.

I’m not interested in hearing those talking points anymore, and neither is the President.

High prescription drug prices... are a serious threat to the health and well-being of too many Americans. President Trump has told us at HHS to fix this problem, and we will.

The problem has multiple parts: high list prices, overpaying in government programs, high out-of-pocket costs, foreign-government freeloading. They are connected in a way that attempting to squeeze one end of the balloon won’t lead to lasting change.

But the complexity of the problem is no excuse for inaction or incrementalism. There are plenty of actions we can and will take administratively to shake up this system.

We do want to hear from industry, patients, and other stakeholders about what they think of the full range of changes we put out in our blueprint

. That’s because we’ve proposed a set of changes that are more sweeping than any drug-pricing initiative ever, more bold than any set of proposals set forth before.

I’m sure that pharmaceutical manufacturers took note on Friday when the President pointed out that they are one of the most aggressive industries when it comes to lobbying. Pharma spends more than $175 million a year trying to understand what the President and I are thinking.

So I’m going to save pharma some money and tell you what the President and I have planned. Pay attention, as there’s a lot on the way.

There are four strategies for reform set out in the administration’s drug-pricing blueprint: improved competition, lowering out-of-pocket costs, enhanced negotiation, and incentives for lower list prices. On each of them, we’re going to start taking action today.

I want to start with negotiation, because it’s so important-- and there’s been some confusion on it, for a while now.

You heard President Trump make it clear on Friday how important tougher negotiation is.

That is exactly what our plan brings to Medicare, in an effective and targeted fashion. We are going to make negotiation more effective than it is today in our retail drug program, Part D, and bring negotiation to where it doesn’t exist, in physician administered drugs, Part B.

In Part D, we’ll be giving Medicare plans the same negotiating power that private sector plans already have-- we know this approach works.

Let me briefly lay out how this will happen. We know right now that Medicare Part D is not getting the deals it should on some expensive, important drugs.

For instance, there are six types of drugs that are automatically put into Part D categories that are called “protected classes,” because they’re vital to treating some serious conditions.

Part D spends about $30 billion a year on these drugs. That’s almost 10 percent of what our entire country spends on drugs each year.

Yet Part D plans are hamstrung by current rules from really negotiating over drugs in these protected classes-- allowing Pharma to run up huge profits on patients who desperately need these often-expensive drugs.

For example, the company that makes one of the 10 most common drugs in these categories raised that drug’s price 20 percent in the last 12 months. That particular drug, in 2015, cost $11,500 per month. Under Medicare Part D, that means seniors using the drug will typically owe an extra $115 every month. They just went from paying $575 per month to $690 per month, at a time when the average Social Security check is $1,400.

Typical private-market discounts for these drugs are in the 20 to 30 percent range. The average discount across all of these protected drugs in Medicare Part D is just 6 percent, and for some of them it’s 0.

A 6 percent discount-- I’m sorry, that is not negotiating.

This administration has it within our authority to provide Part D plans with new tools to negotiate for these drugs.

For one-third of Medicare Part D spending, we can go from where plans effectively aren’t negotiating, to plans having real power to negotiate.

These are important drugs for patients with potentially debilitating conditions, so we will go about these reforms transparently. This process will not restrict patient access, but expand it through lower costs.

It’s important to understand that, because it isn’t true of the alternatives. You’ve probably heard before that Medicare could save tons of money by negotiating directly for drugs.

This just isn’t true, and you don’t have to take my word for it. The Congressional Budget Office, when it was run by Peter Orszag, who went on to work for President Obama, found that the idea of direct negotiation would generate almost no savings. The same conclusion was reached by President Obama’s Office of Management and Budget when it assessed the proposal in his budget.

The only way that direct negotiation saves money is by doing something this administration does not believe in: denying access to certain medicines for all Medicare beneficiaries, or setting prices for drugs by government fiat.

We don’t believe either of these proposals would put American patients first. They would move us toward the kind of socialized medicine systems that have such a notorious reputation for poor quality and access. This stacks right up there with the false promises of Obamacare: that if you like your plan, you can keep it, and if you like your doctor, you can keep seeing him.

But I don’t expect these ideas to go away, no matter how unlikely they are to work. If the pharmaceutical industry wants this idea off the table entirely, the only way is to come to the table with us, to engage in meaningful negotiation with Medicare Part D plans, and to stop the price hikes.

The President is also going to bring smart negotiation to billions of dollars’ worth of drugs in a part of Medicare where there is currently no negotiation at all. That’s Medicare Part B drugs, those administered in a physician’s office.

Right now in Part B, essentially as soon as a drug is approved by the FDA, it’s covered. Medicare gets a bill for the drug, composed of the standard price plus a 6 percent markup, and we pay it.

Compare that with the negotiation in Part D: Plans determine whether a drug should be covered or whether an alternative is superior. Plans negotiate discounts, rather than just paying full price.

You can imagine what happens when you’re developing a drug: It’s often much more appealing for the drug to go into Part B than D. Perversely, some of these drug development decisions are being driven by government reimbursement systems, rather than what’s best for the patient.




In short order, we will be issuing a request for proposal to make new use of an alternative system for buying Part B drugs, a Competitive Acquisition Program. We believe there are more private sector entities equipped to negotiate these better deals in Part B, and we want to let them do it.

More broadly, the President has called on us to merge Medicare Part B into Part D, where negotiation has been so successful on so many drugs. This is how we follow through on his promise to do smart bidding and tough negotiating for our seniors.

Before closing on negotiation, I want to be clear: This is a topic the President and I have discussed at great length, and the idea of direct negotiation in Medicare has come up. He is tired of the government getting bad deals on the drugs seniors need, and I couldn’t agree more.

We formulated this plan with fixing that problem as the No. 1 priority, and the President is following through on his promise. What we came up with is the smart, effective approach to tougher negotiation, and a more aggressive approach than has ever been tried before in our programs.

Another key way to bring down costs using our market-based system is through more competition. Thanks to thriving generic drug competition, Americans get better prices on generics than most European countries, but we can go further.

FDA Commissioner Scott Gottlieb, who is here today, has made it a top priority to stop drug manufacturers from gaming our patent system to block generic competitors.

In one of the most notorious examples, pharma companies use FDA safety rules or commercial distribution restrictions to block generic drug manufacturers from having access to samples of the branded drug.  Those samples are needed to perform the testing that gets generic drugs approved, giving consumers safe and effective lower-cost medications.

We know that certain brand name manufacturers are abusing the system by blocking access to samples, and hiding behind FDA’s rules when they do it. FDA is going to begin publicly identifying drug companies suspected of engaging in these abusive practices. The agency has already received more than 150 inquiries from generic manufacturers about challenges with access-to-product samples from brand manufacturers.

It’s time to shed light on these practices and call out the manufacturers who may be abusing the rules that built our free market for drugs. They’re using laws intended to promote the public health to pad their profits instead.

I want to raise a final point in the context of competition: Many people may be familiar with proposals to give our seniors access to cheaper drugs by importing drugs from other countries, such as Canada. This, too, is a gimmick. It has been assessed multiple times by the Congressional Budget Office, and CBO has said it would have no meaningful effect.

One of the main reasons is that Canada’s drug market is simply too small to bring down prices here. They are a lovely neighbor to the north, but they’re a small one. Canada simply doesn’t have enough drugs to sell them to us for less money, and drug companies won’t sell Canada or Europe more just to have them imported here.

On top of that, the last four FDA commissioners have said there is no effective way to ensure drugs coming from Canada really are coming from Canada, rather than being routed from, say, a counterfeit factory in China. The United States has the safest regulatory system in the world. The last thing we need is open borders for unsafe drugs in search of savings that cannot be safely achieved.

You can’t improve competition and choice in our drug markets with gimmicks like these-- you have to boost competition and price transparency. That informs our third strategy, to reduce Americans’ out-of-pocket drug costs.

Today, some pharmacy benefit managers set contracts with pharmacies that prevent your neighborhood pharmacist from telling you when you could get a better deal on a drug by paying cash than by using insurance.

That’s because, when you use your insurance, the pharmacy benefit manager gets a cut of the deal-- when you pay cash, they don’t.

You ought to know how you can get the best deal possible, and your pharmacist should be able to tell you how. So this week, CMS [Centers for Medicare & Medicaid Services] will be sending a letter to all Medicare Part D plan sponsors saying that we consider such behavior unacceptable.

If pharmacy benefit managers really believe in doing right by the patients they work for, there’s no reason they can’t end this practice and release pharmacists from these gag clauses, right now.

Ending gag clauses is part of a much broader effort CMS will be undertaking to bring more transparency to our drug markets. You ought to know how much a drug costs and how much it’s going to cost you, long before you get to the pharmacy counter or get the bill in the mail.

We want to consult with industry on how to get to that point, but [CMS] Administrator [Seema] Verma, whom we’re glad to have here today, is going to make it happen.

The final strategy we’re getting to work on, immediately, is a new set of incentives on list prices. Right now, our entire system-- both industry practices and government rules-- encourages higher and higher list prices. It’s time for drug prices to go down, not up.

One particular example is a deal that the Affordable Care Act contained for the pharmaceutical industry: Congress put a cap on the penalty that drug companies had been paying when they raised prices faster than inflation.

Yes, you heard that right: Congress put a limit on how much companies would have to pay when they jacked their prices up beyond inflation.

That means drug companies can keep raising their prices rapidly, soaking up new profits from private insurance without paying any penalty in the Medicaid program. And this isn’t just a few medications: There are now more than 2,500 drugs that have hit this cap.

President Trump and I are working with Congress to look at overturning this cap and restoring the brake on runaway price increases.

But we can take more action to create incentives for lower list prices, too.

Right now, Medicaid pays for drugs based on something called the Average Manufacturer Price, or AMP.

In calculating what Medicaid pays, we ignore that the private sector isn’t paying anything like the AMP-- they are actually paying the AMP minus a significant rebate.

If Medicaid is supposed to be getting a better deal than the private sector because it serves our most vulnerable, why not incorporate the private sector rebate into the AMP, lowering it significantly?

Just this change could drop what manufacturers get paid on many Medicaid drugs by 30 to 40 percent or more.

As big as such a change would be, believe it or not, it’s a relatively incremental step in our plan. We can go a lot bigger.

We believe that the entire system of pharmacy benefit managers negotiating rebates needs to be re-examined. Right now, we’re asking a pretty straightforward question: What if, instead of the current system where drug companies get paid rebates and middlemen take a cut, we just had fixed-price discounts?

This would fix the situation where even the pharmacy benefit manager, who is hired to help keep prices low, makes money from higher list prices.

Pharmacy benefit managers are also getting paid by both sides of a transaction: the insurance companies, who pay a fee as their customers, and the drug companies they’re supposed to be negotiating against, who give them a cut of the rebates they receive and other fees.

It is easily within our power to forbid remuneration from pharmaceutical companies-- to eliminate rebates, align interests, and end the corrupt bargain that keeps driving list prices skyward.

We’re also going to be looking at how pharmaceutical companies interact with the American public.

As of today, we have FDA and CMS working to examine how to require drug companies to post their list prices in direct-to-consumer advertising. When patients hear about a wonderful new drug, they should know whether it costs $100 or $50,000. A patient might even pay for a doctor’s appointment to discuss a drug, not knowing that the price puts it totally out of reach, and that’s unfair.

Drug companies don’t have to wait on us. Today, I am calling on America’s pharmaceutical manufacturers to level with the American public-- be honest about what you’re trying to charge us, put your list price in your ads.

We believe Americans should know which drug companies are gouging consumers and which ones are being good actors for our communities.

So we’ll go beyond direct-to-consumer advertising: This week, CMS will be unveiling updates to its drug-pricing dashboard, which will offer much more detail than ever before about which companies are raising prices.

On top of that, I will be having regular meetings with CMS Administrator Verma and others to examine where prices are rising, and why.

That, of course, complements every conversation I have with the President-- where, as I mentioned Friday, drug pricing tends to be the first thing we talk about, and the last.

He’s now laid down a marker about the need for reform. I can imagine he is going to be very interested in the next company that takes a price increase not justified by inflation or change in clinical benefit. I can tell you I wouldn’t have wanted to be the one to do that.

On the other hand, I expect the President will be interested in hearing which companies lowered their prices and took other actions to support the changes we want to make.

I should say that, because I have been in business-- in this business-- I understand that companies have systems that work and market positions that help them succeed.

But markets only work when they’re open to forces for change.

The American system works incredibly well in so many ways because we have a free market.

But right now, we have a drug pricing system that is protected from market forces-- that is set up to benefit the manufacturers and the middlemen, not the patients.

We are open to all potential solutions for fixing this problem-- assuming they are effective, safe for patients, and respect our seniors’ choice and access.

Industry leaders have an opportunity to get started on changing our system, today.

These have mostly been Democratic Party proposals and ideas but it's good that Trump is backing them a bit. Vermont, Colorado and Florida already have drug importation statutes on the books. Writing about Trump's plan's for the Washington Post yesterday, Yasmeen Abutaleb and Josh Dawsey had a different narrative: White House Races To Come Up With Health-Care Wins. "White House advisers," they wrote, "scrambling to create a health-care agenda for President Trump to promote on the campaign trail, are meeting at least daily with the aim of rolling out a measure every two to three weeks until the 2020 election. One of the initiatives would allow states to import lower-priced drugs from Canada and other countries and another would bar Medicare from paying more than any other country for prescription drugs, according to two senior administration officials and lobbyists-- controversial ideas in line with Democratic proposals. Yet it remains unclear the administration has the legal authority to execute some of these policies without Congress. The White House is already facing fierce pushback on some proposals from Republicans on Capitol Hill and the pharmaceutical industry, which will likely go to court to challenge any measure it opposes.

The furious push reflects the administration’s sense of vulnerability on an issue that Democrats successfully used in 2018 to win control of the House of Representatives. White House officials are eager to inoculate the president against a repeat of that strategy in 2020-- and reduce the GOP disadvantage on an issue that pollsters say plays to Democratic strengths. Most of the Democratic presidential candidates have made health-care proposals, including Medicare-for-all plans, key to their campaigns. Health care is already playing a starring role in the debates and Democrats are sure to assail Trump for his attempts to eliminate coverage for millions of people by challenging the Affordable Care Act in court.

“President Trump has said we will protect people with preexisting conditions, lower drug prices, end surprise medical bills, and make sure Americans get the highest quality of care they deserve,” said White House spokesman Judd Deere. “While the radical left has sweeping proposals for a total government takeover of the health system that will hurt seniors and eliminate private insurance for 180 million Americans, the Trump administration is working on real solutions.”

Some, however, are doubtful a flurry of executive orders and new regulations would have an immediate effect on consumers’ pocketbooks. What is clear is that the approach, which includes White House support for a bipartisan Senate bill to cap Medicare drug price increases to the rate of inflation, is putting congressional Republicans in a tough spot: Embrace Trump’s agenda and abandon conservative precepts about interference in the marketplace, or buck the president on one of his top priorities.

While Republicans have largely fallen in line with Trump on free trade and immigration even when he has blown up GOP orthodoxy, many rely heavily on donations from the pharmaceutical industry and are reluctant to sour those relationships.

One lobbyist, who spoke on the condition of anonymity, described being stunned at a recent White House meeting when Domestic Policy Council Director Joe Grogan said the administration would not let Democrats run to the president’s left on lowering the prices of prescription medicines.

In another tense meeting, top pharmaceutical executives were told bluntly “it wasn’t in the industry’s best interests” to block the bipartisan Senate bill backed by Trump. If it failed, they were told, they’d see “the president of the United States negotiating with Nancy Pelosi [on allowing the government to negotiate drug prices in Medicare],” said a person familiar with the meeting.

That looks pretty evenly corrupt doesn't it? That was just last cycle. Let's look at who-- currently in the House-- has been taking the biggest bribes from the drug companies since 1990. And, yes, the implication is that all of these men and women should be expelled from the House and tried and imprisoned. All share responsibility for high drug prices.

• Anna Eshoo (D-CA)- $1,664,131
• Fred Upton (R-MI)- $1,548,456
• Kevin McCarthy (R-CA)- $1,491,350
• Frank Pallone (D-NJ)- $1,399,417
• Greg Walden (R-OR)- $1,147,395
• John Shimkus (R-IL)- $1,092,215
• Steny Hoyer (D-MD)- $1,079,072
• Michael Burgess (R-TX)- $949,074
• Kevin Brady (R-TX)-$891,333
• Ron Kind (D-WI)- $872,129
• Jim Clyburn (D-SC)- $823,843
• Brett Guthrie (R-KY)- $802,513

What about the Senate? Sure these are the dozen worst crooks-- currently in the Senate-- in terms of taking bribes from drug makers. They should all also be in prison. The prices we pay for medicine would probably be far less than half. Keep that in mind when you go to the polls this cycle. MoscowMitch bears the greatest responsibility and he is up for reelection.

• Mitt Romney (R-UT)- $2,739,142
• Richard Burr (R-NC)- $1,570,212
• MoscowMitch (R-KY)- $1,340,771
• Bob Casey (D-PA)- $1,225,195
• Roy Blunt (R-MO)- $1,081,856
• Patty Murray (D-WA)- $1,046,938
• Robert Menendez (D-NJ)- $976,534
• Chuck Schumer (D-NY)- $939,789
• Rob Portman (R-OH)- $936,580
• Marsha Blackburn (R-TN)- $915,381
• Chuck Grassley (R-IA)- $876,460
• John Cornyn (R-TX)- $827,415

Bad Medicine (For Us) From The Trump Regime-- Backed By Half A Dozen Conservative Democrats

This week 6 corporate Democrats voted to confirm Alex Azar to be Secretary of Health and Human Services:

• Tom Carper (D-DE)
• Chris Coons (D-DE)
• Joe Donnelly (D-IN)
• Heidi Heitkamp (D-ND)
• Doug Jones (D-AL)
• Joe Manchin (D-WV)

Maine independent Angus King also voted to confirm and Rand Paul was the only Republican to break with his party, cross the aisle in the other direction and vote NO. Paul said he voted against him because Azar opposes drug importation but Heitkamp said she was voting for him because he is "incredibly competent... I don’t share a lot of his philosophy," she said, "but he understands, as someone who has been in the administration, the importance of the rule of law and compliance. I believe I can work with him in the future, especially on Indian health." If she means by that, raising the cost of pharmaceuticals, she's right. He proved he can do that when he was the head of Eli Lilly’s U.S. operation ( 2012 to 2017).

Skyrocketing drug prices are the bain of many people's lives. I think I mentioned when I got back from Thailand a couple of weeks ago. I bought a couple of months worth of one drug I take that costs $3,000 a month here and less than a fifth of that there. I also bough several inhalers for $6 each in Thailand and $70-80 in the U.S. with insurance.

When Azar was running Eli Lilly he tripled the price of insulin for example. Is that what Heitkamp thinks is going to help her American Indian constituents back in North Dakota? Heitkamp and the Republicans are basically using the laughable argument that who's better to fight crime than criminals. That doesn't work with predators like Azar (or Trump or any of his cabinet appointments).

The only part of Medicare that sucks is Bush's Medicare Part D-- the part that insures (badly) drugs. Azar was a key Bush staffer on that. Bush's Health Secretary Mike Leavitt appointed Azar to oversee the department’s regulatory process. Remember when Trump, on the campaign trail, said that firms like Eli Lilly were "getting away with murder?" Now he's put one of the most brutal murderers in charge.

Senator Ron Wyden (D-OR), the top Democrat on the Senate Finance Committee: "Azar’s nomination is a perfect encapsulation of the president’s broken promises on prescription drugs and health care overall." Almost all the Democratic senators looked at Azars pledge to address rising drug prices in the light of what he did at Eli Lilly significantly raise prices. He opposes the Affordable Care Act and is an anti-Choice fanatic, which probably helps explain why other conservative Democratic women who often cross the aisle to vote for Trump's nominees left Heitkamp other own this time.

Kaylie Hanson Long, a spokeswoman for NARAL: "It is sad, but not surprising, that Donald Trump is so desperate to install another anti-choice ideologue at HHS, an agency that's critical for women's healthcare. HHS has a duty to protect the health, rights, and reproductive freedom of women all across America, and Azar's clear and consistent anti-choice record should disqualify him from such an influential position."

Jenny Marshall in the progressive candidate running for the House seat in northwest North Carolina-- the seat Virginia Foxx occupies. She explained that "It is the job of the Senate to confirm well qualified candidates who will serve the people of this country through their departments. So far President Trump has put forward nominees who despise the departments they would oversee, were completely incompetent and who would stand to make fortunes from the policies they enact. This is not best for the people of this country and it erodes the very fabric of our government. My fellow Democrats and I should be standing strong against these kinds of nominees. Our country deserves better."