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Rant 685: The Exorbitant Cost of Prescription Drugs

4/30/2022

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U.S. consumers pay far more for prescription drugs than the citizens of any of the other 32 member nations of the Organization for Economic Cooperation and Development (OECD), a.k.a., the developed countries. For example, of America’s almost 40 million diabetics, around 10 million are insulin-dependent. They pay 10 times what people in other OECD countries pay for insulin. The average cost of a vial of insulin is $98.70 in the U.S., compared with $8.81 in the other 32 OECD countries, according to the U.S. Department of Health & Human Services. A diabetic may need up to 6 vials a month. It costs only $2 to manufacture a vial.
 
Around 30 percent of seniors (over 65 years old) have diabetes. However, Medicare is expressly barred by law from negotiating with pharmaceutical companies with respect to prescription drug prices. The U.S. is the only developed country with such a prohibition.
 
Congress has resisted regulating prescription drug prices since time immemorial. Last month the House of Representatives voted to cap the out-of-pocket costs for insulin users at $35 a month. Only 12 Republicans (out of 209) voted for the bill. Despite overwhelming public support for lowering prescription drug prices (83 percent in one recent poll), the bill’s prospects in the Senate are poor.
 
Since even the most modest price controls are lacking here, pharmaceutical companies can raise the cost of their medications at will. Some have taken advantage of this to boost prices by orders of magnitude from one day to the next. When Sen. Joe Manchin’s daughter, Heather, was CEO of pharmaceutical company, Mylan, NV, she abruptly and arbitrarily raised the price of epipens by 461 percent.
 
How has it come to this?
 
The answer lies in the immense amount of money pharmaceutical companies contribute to members of Congress. They are among the biggest spenders on federal campaign contributions and lobbying. Pharma’s political contributions skyrocketed after Congress’ passage in 2003 of a Medicare prescription drug benefit and escalated even more following passage of the Affordable Care Act (“Obamacare”) in 2010 and the Supreme Court’s decision in Citizens United v FEC that same year that opened the floodgates to corporate campaign contributions. Contributions from the pharmaceutical and health products industry reached more than $89 million in 2020, a 3,000 percent increase since 1990. Roughly equal amounts have been doled out to Democrats and Republicans. The top recipients are the members of the key congressional oversight committees that have the most to say about regulating the pharmaceutical and health products industry.
 
These are not charitable contributions for which donors expect nothing in return. Thus, it is no surprise that something as universally popular as making prescription drugs more affordable consistently fails to become law.
 
What we have here is nothing less than legalized corruption, blessed by all three branches of government. And it is hardly restricted to this particular industry. This goes on in other countries too. However, few foreign corruption schemes are as sophisticated as the one that has taken hold in the U.S.
 
I’m not suggesting that your vote for or against a candidate turn solely on this issue. However, when you attend your congressional representative’s next town meeting, ask him or her two questions:
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  1. Did you vote for or against the Affordable Insulin Now Act?
  2. How much money have you received from the pharmaceutical and health products industry since you first ran for Congress?
 
The answers to these questions—and any efforts by a candidate to avoid answering--will tell you much about their character as well as their concern for their constituents’ well-being.

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Rant 684: The Criminality Just Keeps on Coming

4/23/2022

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While our eyes are directed at the unfolding horror of what is going on in Ukraine, it is critically important that we don’t ignore the nefarious assault on our democracy here at home. Ukraine’s heroic defense of democratic ideals should be an inspiration to us.
 
Instead of behaving like a mature adult, ex-president Donald Trump keeps bombasting his BS and acting like a petulant, starved-for-attention child. He could, like so many of his predecessors, do good works and refrain from criticizing his successor. Alas, human decency and restraint are not exactly Trump’s strong suits, so he must comport himself in the same shameless, irritating fashion we came to know during his four-year vandalizing of the presidency.
 
His most recent plea to his hero and role model, Vladimir Putin, to release whatever dirt he might have on Hunter Biden, comes in the midst of a brutal invasion of Ukraine in which millions of Ukrainian civilians suffer untold horrors at Putin’s hands. Trump of course is not focused on this tragedy, but instead is singularly fixated on his petty grievances.
 
As if this disgusting behavior weren’t enough, he is calling on his devotees to "lay down their very lives" to defend the United States against…critical race theory. "Getting critical race theory out of our schools is not just a matter of values, it's also a matter of national survival," the disgraced loser told the MAGAverse. No matter that critical race theory is a non-issue, nowhere taught in K-12 grades. "We have no choice," blathered the blowhard. "The fate of any nation depends upon the willingness of its citizens to lay down – and they must do this – lay down their very lives to defend their country. If we allow the Marxists and communists and socialists to teach our children to hate America there will be no one left to defend our flag or to protect our great country or its freedom."
 
That this is utter hogwash is irrelevant. The concern lies in his once again inciting his followers to violence, unconcerned with the carnage he unleashed on January 6, 2021. That was not enough, so now he calls for a race war. If this is not the classic definition of fascism, I don’t know what is.
 
Two essential questions arising out of Trump’s despicable conduct demand answers:

  1. How is it possible that Republicans continue to defend this reprehensible behavior? Ask them straight up and they bob, weave and run away from the interrogator. Their terror of Trump and his adherents’ electoral wrath totally overpowers what little care, if any, they have for the nation’s well-being and future. Instead, they line up behind the biggest traitor AND greatest treason ever perpetrated against this country. Tragically, Republicans, a now contemptible excuse for a political party, may well prevail in the midterm elections.
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  2. How is it possible that Trump has thus far escaped accountability for his treason? What more evidence do the authorities need? They have an audio recording of his telephone call to the Georgia Secretary of State where he expressly attempts to rig the presidential election. That is more than sufficient to put him behind bars and bar him from ever running for office again. Why is he still at large? Allowing him to continue to undermine American democracy and thumb his nose at the rule of law is unconscionable. The longer he is allowed to continue to destabilize our society, the greater the danger.
 
Dick Hermann
April 22, 2022

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Rant 683: Squeezing Russia

4/16/2022

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​Now that we have a better grasp on Russia’s naked aggression towards Ukraine and evidence of the stunning ineptitude of the Russian forces, we need to reassess what more we and our NATO allies can do to aid Ukraine and punish Vladimir Putin and his brutal henchmen. We have supplied Ukraine with billions of dollars of defensive weapons. We are only now changing tack and beginning to send a few offensive weapons, mainly artillery. We need to go further and equip Ukraine with adequate offensive weapons that could cause Russia some of the same pain Putin is inflicting on this front-line democracy.
 
The concern to date that has prevented us from doing this are (1) fear of provoking Putin into expanding the war beyond Ukraine, and (2) that he might resort to using nuclear weapons.
 
Both fears appear to be unwarranted. Russia can barely manage its Ukraine adventure, much less assemble the wherewithal to expand its aggression elsewhere. So far, its war has been a military debacle and logistical nightmare despite its supply depots proximity to the front. Moreover, Russian troop morale is rock-bottom and its retreat from the Northern front (Kyiv, Chernihiv, Samy) signifies that Russia vastly overestimated its capabilities while grievously underestimating its enemy.
 
Looming over every Western assessment of what to do and how far to go in Ukraine is the unavoidable fact that Russia is the world’s number two nuclear power. While even Putin is not reckless enough to risk Armageddon, the possibility of him deploying low-yield tactical nukes makes NATO hesitate. Admittedly, bolstering Ukraine’s military capabilities is a calculated risk, but one I believe is worth taking. It looks like Putin is bluffing, trying to scare the West with bluster.
 
Front-line NATO nations have 56 MIG-29s in their arsenals that they plan on phasing out, “leftovers” from their Warsaw Pact days. This is about the same number that Ukraine inherited from the Soviet Union. The U.S. should strongly encourage our allies to send their MIG-29s to Ukraine immediately in order to double its jet fighter fleet. Ukrainian air force pilots and flight mechanics are conversant with MIG-29 fighter jets. There is no learning curve.
 
Additionally, the U.S. maintains an arsenal of around 4,000 Tomahawk cruise missiles. The U.S. Navy, which has most of them, plans to phase them out. Instead, many of them should go to Ukraine. The Tomahawk is an accurate long-range missile that would be able to hit targets within Russia. There is every reason for Ukraine to have the capacity to give the Russians a taste of the devastation they have wreaked in Ukraine. To date, the only Ukrainian offensive thrust into Russia has been the blowing up of a fuel depot in Belgorod, 25 miles from the border. Tomahawks would enable Ukraine to do serious damage to Russia’s military supply chains and perhaps give Putin pause.
 
While understandable that the West is cautious about engaging Russia directly, it would be worth its NATO and EU strategtists’ time to read Andrew Cockburn’s 1983 book, The Threat: Inside the Soviet Military Machine. The author interviewed hundreds of former Soviet military members who had emigrated to the U.S. about their experiences in the Soviet army, navy, air force, marines and rocket forces. He discovered that our Cold War adversary’s military forces were a complete mess, a house of cards, a paper tiger much weaker than anyone thought. That has now been borne out in battle by Russia’s thus far dismal showing in Ukraine.
 
At the same time, we need to escalate sanctions on the aggressor. That includes Western Europe ceasing to buy Russian oil. Europe gets about 25 percent of its oil from Russia. However, cutting off Russian oil imports would have little effect on Europe because both the U.S., OPEC and other producers could make up the difference.
 
Gas is a different matter. Europe’s dependence on Russian gas is much greater and its ability to secure alternative supplies limited. Substituting U.S. gas, for example, would require both parties—the U.S. and Europe—to build new liquefied natural gas terminals, a multi-year undertaking.
 
Furthermore, the U.S. and EU should immediately sever all diplomatic relations with Russia and expel its diplomats (many of whom are spies masquerading as foreign service officers). This should also include the entire Russian United Nations delegation. Three possible justifications under international law exist for expelling UN diplomats: (1) for violating UN agreements, such as warring with another member state; (2) for national security reasons; and (3) for self-defense. Justifications (2) and (3) apply because Russia’s illegal action threatens NATO.
 
Finally, almost 5,000 Russian students are enrolled in U.S. universities and another estimated 50,000 in EU institutions. They should all be expelled and deported. While this may seem a harsh measure, the circumstances require that all Western ties with Russia be terminated. No exceptions.
 
Dick Hermann
April 16, 2022

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Rant 682: CBS-An Icon Tarnishes Itself

4/9/2022

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​“A balanced treatment of an unbalanced phenomenon distorts reality.”
     --Political Scientists Thomas Mann and Norm Ornstein
 
CBS, the network that produced and nurtured the finest news team in the history of broadcast journalism, has now descended into the muck where sham outfits like Fox News predominate. The hallowed ground previously trod by titans like Edward R. Murrow, Eric Sevareid, Bill Shirer, Walter Cronkite, Howard K. Smith and Charles Collingwood among other giants of the CBS broadcast news pantheon, is now going to give way to the likes of Mick Mulvaney, one of Donald Trump’s White House chiefs of staff.
 
Mulvaney was the execrable, loathsome Trump flunkey and “alternative facts” aficionado who lied incessantly for his boss. His greatest hit might have been when he told the press to “get over it” when Trump withheld $400 million in congressionally authorized and vital military assistance to Ukraine during his “perfect” phone call in which he pressured President Zelensky to dig up dirt on Joe Biden and his family. That led to Trump’s first impeachment.
 
Mulvaney is the hack that CBS apparently feels is the best it can do to provide what it perversely perceives as “balance” in its political analysis. The additional rationale provided by the network is that the Republicans will likely wrest control of Congress from the Democrats come November, which will mandate that it have “access” to the dark side. It is actually going to compensate this lying mouthpiece handsomely for his trenchant analyses of the political scene. It’s enough to make one vomit.
 
Sadly, fairness and balance are no longer relevant now that the Republican Party has abandoned democracy in favor of autocracy. There can be no “bothsidesism” or “whataboutism” in the current existential battle to preserve the rule of law. We are at the point where one party supports our almost two-and-a-half-century old democratic system while the other party wants to overthrow it by any means possible and replace it with a government of autocrats and oligarchs in the image of Vladimir Putin and Donald Trump. Seditionists do not deserve a place at the media table. However, by hiring a wretch like Mulvaney, CBS has decided to facilitate this corrupt design.
 
The network has fallen a long way from its early days when quality and integrity were its watchwords and it was the standard-setter for great news reporting and opining. Today it has chosen to abandon that lofty legacy and sink into the cesspool heretofore the domain of Fox, Newsmax, OANN, Alex Jones and their disgraceful ilk. It would be no surprise if its next hire were the QAnon Shaman.
 
Dick Hermann
April 9, 2022

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Rant 681: The GOP Sends In the Clowns

4/1/2022

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​Whenever you conclude that the Republican Party cannot possibly go any lower, it proves you wrong. The Senate hearings on the nomination of Judge Ketanji Brown Jackson to the Supreme Court were proof positive that the GOP can sink to depths matched only by the total darkness of the Mindanao Trench.
 
The insulting and demeaning questions flung at the unflappable and unfailingly polite Judge Jackson by GOP Senators Ted Cruz, Josh Hawley, Lindsey Graham, Tom Cotton and Marsha Blackburn were examples of performance art designed only to reinforce their racist reactionary bona fides to the perpetually aggrieved, angry, fearful and fact-averse Trump base. The four White men who harassed and harangued Judge Jackson viewed it as an opportunity to abuse a Black woman as a reminder, especially to the base, of the days of Jim Crow when such mistreatment was commonplace. They competed to see who could punch hardest below the belt in a brazen attempt to attract followers and campaign money.
 
Take Ted Cruz (please!), he who slithered off to Cancun while his Texas constituents froze to death, then blamed his being AWOL on his daughters, proved once again that no amount of slime can deter him from diving in and wallowing in it. Immediately after asking Judge Jackson if she believes “babies are racist,” he checked his Twitter feed to see how his character assassination was playing with the Trump crowd. Pretty well, actually.
 
Hawley, he of the raised fist in support of the January 6 insurrectionists, and Cotton, like Terrible Ted also aspirants to the Republican presidential nomination should Trump find himself behind bars in an orange onesie matching his comb-over, auditioned for the top job in the same polluted sludge. Their impertinent interrogations ranged from Hawley’s accusations that Jackson is a champion of child pornographers to his smear that public defenders (Jackson was at one time a Federal Public Defender) were somehow tainted by representing individuals accused of crimes. The eternally clueless Cotton grilled her about policy matters that are the sole responsibility of Congress and not the courts, a not-so-subtle distinction that Jackson noted for him several times. Not to be outdone by her male colleagues, Ms. Blackburn chimed in by asking the judge for her definition of “woman,” a shameless attempt to imply that the nominee supports transgender rights, which are anathema to the base. What it really showed was that Blackburn was perfectly capable of getting down and dirty in the same sewer as her partners-in-slime. Oh, and did I mention that she confused the Constitution with the Declaration of Independence?
 
Lindsey Graham, the opportunistic changeling whose loyalties and positions shift with every slight breeze, probed Jackson’s faith, asking if as a Protestant she could fairly judge a Catholic. He was also unhinged that, in her public defender capacity, she had represented Guantanamo detainees. She politely reminded him of (1) the landmark Supreme Court case of Gideon v. Wainwright that established the constitutional right to counsel under the Sixth Amendment, and that (2) public defenders have no discretion about which cases they are assigned. His creative juices having dried up years ago, he went on to rehash Hawley’s anxieties about child porn. Demonstrating that Jackson’s responses were of no interest to him, Graham constantly interrupted her, a performative effort designed only to enable him to secure some face time on Fox News. Perhaps he exerted himself to such an embarrassing extent in order to justify his opposition to Jackson’s appointment this time, having voted to confirm her for federal court positions twice before.
 
Jackson had to endure 22 hours of this despicable Republican nonsense. The purpose of such hearings is to vet the qualifications of potential Supreme Court justices. Judge Jackson not only possesses those in great abundance; she also demonstrated that her judicial temperament, sorely tried by these five avatars of how much the GOP has mutated into a racist, anti-democratic corruption of conservatism, is second to none. The contrast with how Justice Brett Kavanaugh comported himself at his confirmation hearing was stark.
 
Supreme Court confirmation hearings at their best should be teachable moments, instructing Americans about the Constitution, federalism and judicial philosophy that would teach listeners something about the law, relationships among the three branches of government and judicial institutions. Unfortunately, the Fetid Five made this one a lesson in gutter-sniping. Instead of examining her judicial qualifications, their nonstop bullying established beyond any doubt their lack of qualifications for Senatorial service. The competition for the dishonor of being labeled the vilest of the vile ended in a toss-up.
 
Dick Hermann
April 1, 2022

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    Author

    Richard Hermann is the author of thirteen books, including Encounters: Ten Appointments with History and, most recently, Mother's Century: A Survivor, Her People and Her Times. Soon to be released is his upcoming Close Encounters with the Cold War, a personal reflection on growing up in the nuclear age. He is a former law professor and entrepreneur, and the founder and president of Federal Reports, Inc., a legal information and consulting firm that was sold in 2007. He has degrees from Yale University, the New School University, Cornell Law School and the U.S. Army Judge Advocate General’s School. He lives with his wife, Anne, and extraordinary dog, Barkley, in Arlington, Virginia and Canandaigua, New York.

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