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Rx for Savings |
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Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=24357"><span class="small">The Washington Post | Editorial</span></a>
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Tuesday, 29 March 2016 08:41 |
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Excerpt: "Invoking new authority under the Affordable Care Act, the Department of Health and Human Services (HHS) plans a pilot program under which doctors would get reimbursed in a new way for medications they administer directly to patients, as opposed to those distributed through pharmacies or hospitals."
A pharmacist fills a prescription. (photo: CNBC)
Rx for Savings
The Washington Post | Editorial Board
29 March 16
 f you had to reduce economic science to a single phrase, it might be this one: Incentives influence behavior. Now the federal government is about to test that proposition in an effort to curb Medicare spending on prescription drugs dispensed by physicians, which grew from $9.5 billion in 2005 to $22 billion in 2015.
Invoking new authority under the Affordable Care Act, the Department of Health and Human Services (HHS) plans a pilot program under which doctors — mainly oncologists, ophthalmologists and arthritis specialists — would get reimbursed in a new way for medications they administer directly to patients, as opposed to those distributed through pharmacies or hospitals. Under current rules, the doctor gets the average price of a particular drug plus 6 percent. This may encourage doctors to use higher-priced drugs instead of lower-priced equivalents, since, well, 6 percent of $1,000 is more than 6?percent of $10. To the extent this artificially increases demand for higher-priced drugs, it enables manufacturers to charge everyone more.
HHS wants to test a system under which physicians would get 2.5 percent of the drug’s cost, plus a flat fee. Importantly, doctors would still be fully reimbursed for the drug’s cost to them; they would just make more for prescribing cheaper drugs than they do now, and a bit less for prescribing expensive ones. Over time, Medicare officials say, this shift in incentives should enable the system to deliver the same level of care at a lower cost. If it doesn’t, Medicare can revert to its previous payment formula after the five-year experiment has run its course.
Opponents, led by private-practice oncologists, protest that their current prescribing decisions are driven purely by medical considerations, so Medicare’s plan is a solution in search of a problem. In the short run, they argue, it will inflict economic damage on small, independent practitioners who tend to pay higher prices for drugs because they lack the bargaining power of large hospitals. The ultimate losers could be these doctors’ patients, it is argued.
No doubt the proposal, like any change to the status quo, would create winners and losers among health-care providers; that’s another basic teaching of economics. Heaven knows Medicare’s current policy is hardly the only source of distortion in health care: a new study by cancer researchers at Memorial Sloan Kettering Cancer Center estimated that the U.S. wastes $3 billion every year on cancer medicines that are thrown out because regulators allow them to be distributed in vials that hold too much for most patients.
It seems plausible, however, that the plan could level the playing field between medically equivalent but differentially priced drugs, eliminating an unfair advantage expensive products now enjoy. Given the potential efficiency gains to Medicare, and the ripple effects on health-care spending generally, the benefits of the HHS plan may justify the risks. Government statistics show that 30 percent of the increase in prescription drug spending from 2010 to 2014 was due to price increases and prescribers’ shifts to higher price products. Anything that pushes against that trend while preserving patient access to necessary treatments is worth a shot.
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How the New York Times Gets It Wrong on Latin America |
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Tuesday, 29 March 2016 08:39 |
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Emersberger writes: "The 'authoritarian abuses' denounced in newspapers like the New York Times were, in reality, mostly justifiable measures taken to prevent coups and protect democracy."
Ecuadorean president Rafael Correa greets supporters during a rally. (photo: CPCML)
How the New York Times Gets It Wrong on Latin America
By Joe Emersberger, teleSUR
29 March 16
The “authoritarian abuses“ denounced in newspapers like the New York Times were, in reality, mostly justifiable measures taken to prevent coups and protect democracy.
n a New York Times op-ed, Jorge Castañeda, Mexico’s foreign minister from 2000 to 2003, offered a few broad “lessons” to Latin America’s left governments. He accused them of not saving enough during good times and of failing to address corruption. Implicitly, he accused Ecuador and of course Venezuela, one of the international media’s favourite targets for vilification, of succumbing to “authoritarian temptations.” He says they “muzzled the press, stacked the judiciary, harassed opposition leaders and tampered with electoral systems.”
He says nothing about several violent coup attempts against left governments over the past fifteen years in Venezuela (2002), Haiti (2004), Bolivia (2008), Honduras (2009), and Ecuador (2010). The coups in Honduras and Haiti were successful and the consequences continue to plague those countries. Haiti’s coup was actually perpetrated by U.S. troops who kidnapped President Jean Bertrand Aristide. The coup in Honduras succeeded in no small part due the perfidy of Hillary Clinton. A right-wing “parliamentary coup” that ousted President Fernando Lugo in Paraguay in 2012 was also successful. The coup in Venezuela succeeded for two days before it was defeated. The coup attempt in Ecuador nearly took the life of President Rafael Correa.
The “authoritarian abuses“ denounced in newspapers like the New York Times were, in reality, mostly justifiable measures taken to prevent coups and protect democracy. For example, a powerful weapon in the hands of right-wing putschists in Latin America has always been the private media. That is being dramatically illustrated in Brazil at the moment. Blunting that weapon by expanding state media and using regulatory measures (which all governments have) is decried as “muzzling the press”. The allegation will seem valid if you accept the right of unelected billionaires to dominate public debate and incite coups against elected governments. Even if you don’t accept such a vile premise, you might still believe the allegation if you “inform” yourself about Latin America by casually reading the corporate press at any end of the political spectrum.
It is always worth recalling that the liberal New York Times editors cheered the 2002 coup in Venezuela with even more enthusiasm than the Bush administration (which was also openly pleased and had funded many of the perpetrators). Very recently, in a widely circulated interview with Obama in the Atlantic, Jeffrey Goldberg casually referred to Hugo Chavez as “the late anti-American Venezuelan dictator.”
Thanks to years of wretched one-sided journalism, most readers will not know enough to gasp at the ignorance or willful dishonesty of Goldberg’s remark. Before assessing the lessons that Castañeda offered the Latin American left, let’s mention a few crucial lessons for people outside the region. First, don’t trust the establishment media to get the most basic facts right. Second, any serious discussion of left governments in Latin America must account for the relentless efforts of the United States and its allies to get rid of those governments.
Arguably, Ecuador’s example best refutes Castañeda’s claim that “no one saved up for the inevitable rainy day” and especially his contention that left governments were “lucky” to have benefitted from a commodity boom. He doesn’t explain why voters gave so many left governments the chance to benefit from the allegedly transformative commodity boom. The chart below explains why voters gave them that chance.
Beginning in about 1980, a shift to what are called neoliberal economic policies brought a very prolonged economic disaster to the region. Neoliberalism is a menu of policies such as privatizing state owned companies, cutting taxes on the rich, slashing public spending among other policies known to stuff the pockets of the wealthy. The policies have also been known as the “Washington Consensus” because the United States used its muscle to impose them. They proved so harmful that they eventually caused Washington and its local allies to lose considerable influence in many countries. An updated chart above would show Latin America’s per capita growth rate to be 1.8 percent in the 2000-2014 period. Clearly, moving away from neoliberalism brought recovery.
So how “lucky” was Ecuadorian president Rafael Correa when he first took office in 2007? In 2008 the price of oil, which provided about 60 percent of Ecuador’s export earnings, collapsed by 75 percent thanks to a global recession whose epicenter was the United States where a massive housing bubble burst. The global recession and its aftermath also cut remittances from Ecuadoreans living and working abroad – millions of refugees from the neoliberal era who ended up throwing a lifeline to families back home. Remittances accounted for 6.6 percent of Ecuador’s GDP in 2007 but plummeted to 2.4 percent by 2014 as economies abroad went through deep recessions followed by weak recoveries.
The costs of production in Ecuador’s oil fields have also risen significantly since 1971 when its oil industry first took off. The population is now almost three times larger. So even during a few years when oil prices were over $100 per barrel, before a second huge and sustained price collapse hit Correa’s government in 2014, the government’s inflation adjusted oil revenue per capita - accounting for production costs - was lower than it was in the 1970s and mid-1980s. The average price of oil during Correa’s time in office, accounting for these factors, is actually a bit below the average for the 1971-2014 period.
By contrast, Correa’s government increased tax revenues from 27 percent of GDP in 2006 (the year he was first elected) to 40 percent by 2012, mainly by clamping down on various forms of evasion by the rich. In real per capita terms, tax revenues have more than doubled over that period. Discarding neoliberal policies was way more important than any “commodity boom.” Incidentally, clamping down on tax evasion was also a major victory against corruption of both the legalized and illegal variety.
Correa’s government has made unprecedented investments in roads, education, and health care. It is finalizing the construction of eight hydroelectric plants and it has built multi-purpose dams to prevent the flooding of agricultural lands. Poverty has been cut in half since Correa was elected and the investments mentioned above lay the foundation for long term development. Investments improve the country’s productive capacity – its ability to generate wealth and diversify in the long term. The hydroelectric plants, which are already entering into operation, will make Ecuador a net exporter of electricity. That alone is a significant step towards diversification away from extractive industries that has been made in a very short time.
To use an analogy, a person who invests in obtaining a trade or academic credentials will generally have better long term economic prospects than somebody who decides to “save for a rainy day” by not investing in any kind of post-secondary education or training. Of course people can make unwise – even disastrous – decisions about which trade or academic credentials to pursue. Others – with exceptional luck or ability - can do very well without any kind of formal training or credentials. However, it is obvious which general approach is the most sensible.
Castañeda’s “save for a rainy day advice” offers a path toward continued under development. Dressed up as prudence, it’s an attempt to revive the ruinous orthodoxies from which the region has largely rid itself in recent years. Powerful interests work very hard to promote those orthodoxies, not only in Latin America but within developed countries. People everywhere can benefit from learning the real lessons of Latin America’s recent history.
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Big Food Says They Will Label GMOs, but Is There More to the Story? |
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Tuesday, 29 March 2016 08:37 |
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Excerpt: "With the July 1 deadline for complying with Vermont's GMO labeling law on the horizon, a handful of the largest multinational food corporations have announced they will now label GMOs - not solely because they will be forced to, but because as General Mills claims, they believe 'you should know what's in your food and how we make ours.'"
A woman shopping for cereal. (photo: Getty Images)
Big Food Says They Will Label GMOs, but Is There More to the Story?
By Katherine Paul and Ronnie Cummins, EcoWatch
29 March 16
 he world’s largest food corporations have spent hundreds of millions of dollars (some of it illegally) to avoid being required to label the genetically engineered (GMOs) ingredients in their products.
But with the July 1 deadline for complying with Vermont’s GMO labeling law on the horizon, a handful of the largest multinational food corporations have announced they will now label GMOs—not solely because they will be forced to, but because as General Mills claims, they believe “you should know what’s in your food and how we make ours.”
Have consumers won the GMO labeling battle? Have these food companies that so fiercely fought to keep labels off their products really split with the Grocery Manufacturers Association (GMA), the multi-billion-dollar lobbying group that is still trying to overturn Vermont’s law in the courts, and preempt it in Congress?
To be sure, consumer pressure has had an impact on brands’ decisions to label. We should celebrate that. But before we break out the champagne, it’s worth noting that not all of the food companies that announced plans to label have taken a strong position on labeling. Equally important, four out of the five companies announced plans to label after a Senate bill to preempt Vermont’s labeling law failed, but before the Senate has a chance to come back with an amended version of the bill after Congress returns on April 4 from Easter recess.
Is there something more to these recent announcements than just the need to comply with Vermont’s law? As in, a strategy to lull consumers into complacency, while at the same time forcing Congress to give food companies what they’ve wanted all along—a free pass on labeling?
It’s also worth noting that all of the companies that have revealed plans to label adamantly defend the “safety” of GMOs—without once mentioning the fact that the vast majority of GMO crops, from which GMO food ingredients are derived, are sprayed with glyphosate, classified last year by the World Health Organization as “a probable human carcinogen.” Clearly, we have a long way to go before food corporations acknowledge the devastating consequences of the GMO monoculture model on the environment, human health and global warming.
Who’s labeling, and why?
Campbell’s Soup Co. CPB (NYSE), General Mills (NYSE:GIS), Mars and Kellogg’s (NYSE: K) and ConAgra Foods(NYSE CAG) have all declared they will label GMOs in time to comply with Vermont’s July 1 deadline, and in accordance with the Vermont law’s standards. The companies say that any costs associated with labeling won’t be passed on to consumers—a claim that deflates one of the industry’s long-standing, albeit routinely debunked, arguments that GMO labeling will lead to higher food prices for consumers.
Campbell’s was first out of the gate, and the first to break with the GMA on the lobbying group’s non-negotiable stance against mandatory labeling. After spending a half a million dollars to help defeat California’s Proposition 37 ballot initiative that would have mandated labels, Campbell’s now says the company supports a mandatory federal labeling solution. Following Campbell’s Jan. 1 announcement, we reached out to clarify what the soup company would do if Vermont’s law were preempted at the federal level. A Campbell’s spokesperson responded by saying that regardless of what happens in Congress, Campbell’s products will be labeled, with the words “partially produced with genetic engineering,” in all 50 states. On the surface, that’s good news. But let’s not forget that a federal labeling bill could forbid companies from printing those, or similar words on a label, in the interest of preventing food producers from “stigmatizing” biotechnology.
Similarly, we reached out to General Mills, Mars and Kellogg’s this week asking for clarification on their positions. Kellogg’s responded, but wouldn’t provide answers to our direct questions, referring us instead to the official statement (which doesn’t answer our questions). We haven’t yet heard back from ConAgra, but we did receive responses from General Mills and Mars.
When asked if General Mills now supports a mandatory federal labeling solution, Mike Siemienas, manager of brand media relations, told us in an email that the cereal giant is “supportive of a model similar to what is used for organic products.” In other words, voluntary, not mandatory. Asked if General Mills would label its GMO products according to Vermont standards even if Congress were to preempt Vermont, Siemienas wrote: “… we would comply with any law that Congress passes.” We took that as a no.
But General Mills appears (so far) to be alone in continuing to side with the GMA on opposing mandatory labeling laws. Jonathan Mudd, Mars’ global director of media relations, told us by email that Mars, like Campbell’s, supports “the establishment of a mandatory national labeling system.” Mudd also confirmed that Mars will label its products “consistent with Vermont” regardless of whether or not Vermont is preempted “because we believe in consumer transparency.” Mars pitched in $376,000 to defeat California’s Proposition 37. But after anti-labeling food corporations became boycott targets following the defeat of Prop 37, Mars sat out similar battles in Washington State (2013) and Oregon (2014).
Campbell’s and Mars both cited the “need to avoid a 50-state patchwork” of labeling laws as their reason for supporting a mandatory federal solution, as opposed to supporting states’ rights to pass GMO labeling laws. On the surface, the patchwork argument might sound rational—until you consider the fact that there are more than 100 state laws, governing food labeling, including a Vermont maple syrup labeling law, and a Minnesota law governing the labeling of wild rice. None of these laws ever created “chaos” in the marketplace, as U.S. Department of Agriculture Secretary Tom Vilsack has warned about Vermont’s GMO labeling law. And none were ever opposed with the same relentless determination, much less lavish spending, as GMO labeling laws. Maybe because none of them affected Monsanto’s bottom line?
Timing is everything
General Mills, Mars and Kellogg’s all revealed their labeling plans after the Senate failed to pass S. 2609, a bill intended to preempt Vermont. It’s possible that their announcements signal that these food giants have conceded defeat, especially as they all noted the need to comply with the Vermont July 1 deadline.
That’s the optimistic view. But the timing of these announcements, made before the Senate returns to try again to try to pass a preemption bill, could also be part of a calculated strategy to win over more Senators to a compromise bill, one that will delay or outright preempt enactment of Vermont’s Act 120.
Sen. Pat Roberts (R-Kan.), sponsor of the Monsanto- and GMA-funded S. 2609 (dubbed by opponents as the DARK Act—Deny Americans the Right to Know Act) is unwavering in his rejection of any legislation that requires labels on GMO ingredients. Though he is adamant about a “federal solution,” Roberts outright, and illogically, rejects the idea of a uniform mandatory federal solution.
Roberts’ rigid position on mandatory vs. voluntary cost him the support of Sen. Debbie Stabenow (D-Mich.), Ranking Member of the Senate Agriculture Committee and a key player in the GMO labeling drama. Stabenow says she would support a mandatory federal labeling law, though whether that support would include on-package labels, or some sort of QR barcode scheme or toll-free phone numbers, both of which have been floated as alternatives to on-package labels, remains unclear.
Still, Stabenow and other Senators representing Big Ag states are under tremendous pressure (by corporations, not voters) to keep Vermont’s law from taking effect. The Big Food corporations know this. So is it possible that companies, by announcing, in quick succession that they will label voluntarily, hope to send the message that there’s no need to pass a mandatory labeling law, because they’ve already volunteered? And could those big companies, or at least some of them, pull the plug on their labeling plans if federal legislation preempts Vermont? (Again, Campbell’s and Mars have said they will proceed regardless of what happens in Congress—we know that’s not the case for General Mills; Kellogg’s and ConAgra haven’t confirmed one way or the other).
That’s one possibility. Here’s another. General Mills told Politco’s Jenny Hopkinson that while the company won’t pass on the cost of labeling to consumers, the Minnesota-based cereal giant will have to spend “millions of dollars” to comply with Vermont’s law. Could this “woe is me” message win enough sympathy votes from Senators who may still be on the fence (and who are being hounded by their corporate donors), that they’ll be persuaded to betray consumers in order to stave off what General Mills or other companies allege is a “huge” financial burden?
It’s also possible that this is just a public relations ploy by corporations that are banking on the fact that a federal law will pass before they have to label, and that that law will include restrictions that prohibit them from printing “produced with genetic engineering,” or similar wording, on their packages. That scenario would allow them to say, gee, we tried to give consumers what they want, but Congress wouldn’t allow it.
Whatever the new-and-improved version of the Senate bill morphs into, assuming the Senate passes a bill, it will have to go back to the U.S. House. There, members of a Republican-controlled Joint Standing Conference Committee will try to “reconcile” the Senate bill with the House version, H.R. 1599, which passed the House in July by a vote of 275 – 150. Guaranteed, the House won’t sign off on anything with the words “mandatory” or “on-package.” In fact, House Agriculture Committee Chairman Mike Conaway (R-Texas), according to Politico, “declared just this week that he won’t support on-package labeling, which he has said stigmatizes the technology.” Whatever ends up coming out of the committee will have to go back to the House and Senate for a full vote.
That leaves consumers no choice but to continue to hammer our Senators with this message: No compromise. Let Vermont’s law take effect. And if you really can’t tolerate supporting states’ rights to pass labeling laws, then pass a federal labeling law that meets, or preferably exceeds, the standards set by Vermont’s law.
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Media Unimpressed as Sanders Barely Gets Seventy Percent of Vote |
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Written by <a href="index.php?option=com_comprofiler&task=userProfile&user=9160"><span class="small">Andy Borowitz, The New Yorker</span></a>
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Monday, 28 March 2016 13:24 |
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Borowitz writes: "Bernie Sanders failed to impress major media outlets over the weekend as he barely managed to win seventy percent of the vote in three western primaries."
Democratic presidential candidate Bernie Sanders arrives for a rally at the Moda Center in Portland, Oregon on March 25, 2016. (photo: Steve Dykes/AP)
Media Unimpressed as Sanders Barely Gets Seventy Percent of Vote
By Andy Borowitz, The New Yorker
28 March 16
 The article below is satire. Andy Borowitz is an American comedian and New York Times-bestselling author who satirizes the news for his column, "The Borowitz Report." 
 ernie Sanders failed to impress major media outlets over the weekend as he barely managed to win seventy per cent of the vote in three western primaries.
The major cable networks briefly mentioned Sanders’s vote tallies in Washington, Alaska, and Hawaii but noted that he ran out of steam well shy of eighty per cent.
“There’s no point in sugarcoating it,” one analyst put it. “Rough night for Sanders.”
According to one cable executive, Sanders needs to “put up some big numbers fast” if he expects the networks to continue giving his campaign airtime.
“It’s going to be harder and harder to justify covering him while he’s stuck down in the seventy-per-cent range,” the executive said.
While Sanders campaign officials remain optimistic about the upcoming primary in Wisconsin, media outlets are calling it a “do or die” state after his sputtering finishes over the weekend.
“I think if he limps across the finish line with, say, seventy-five or seventy-nine per cent, it’s going to be time for him to reassess things,” one cable representative said. “That would have to be a wake-up call.”
A spokesperson for CNN could not be reached for comment, as the network was busy preparing a ninety-minute special on the birth of Donald Trump’s new grandchild.
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