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Celerity
Celerity's Journal
Celerity's Journal
March 21, 2024
https://www.nytimes.com/2024/03/20/opinion/trump-lost-cause.html
https://archive.is/dUJg8
At an Ohio rally this month, Donald Trump saluted the insurrectionists who stormed the Capitol on Jan. 6, 2021, calling them unbelievable patriots and referring to those whove been locked up for their involvement on that terrible day as hostages. This was a continuation of Trumps Lost Cause mythmaking that began during his successful presidential campaign in 2016 and was ramped up in service of his efforts to remain in power despite his 2020 loss and the deadly riot that those efforts stoked.
More than 1,200 people have been charged related to Jan. 6. And though it shouldnt have to be said, lets be clear: Those whove been tried, convicted and imprisoned for storming the Capitol arent hostages, theyre criminals. But Lost Cause narratives arent about truth. Theyre about negating the truth. Which is what happened when the Lost Cause mythology was constructed after the Civil War. The cause of the war was framed as Northern aggression rather than slavery. A lore about happy slaves and benevolent enslavers proliferated. The narrative valorized those who seceded from and fought against the United States.
And it has survived to some degree for over 150 years, tucked into the cracks of our body politic. It still surfaces in ways that may seem remote from the Confederate Lost Cause myth, but that definitely promote it. It manifested itself last year when Florida changed its African American history standards to say that the enslaved in some instances benefited from their enslavement, and in Nikki Haleys hesitance on the campaign trail to state the obvious, that slavery was the cause of the Civil War. It manifested itself in the infamous torchlight march in Charlottesville and in the bitter resistance to removing Confederate monuments.
Trump has his own version of the Lost Cause, one thats not completely untethered from the old one, but one thats miniaturized, personal and petty. The Confederate Lost Cause narrative came after enormous loss: Hundreds of thousands of soldiers had died, the South was decimated and its economy was hobbled. Trumps Lost Cause, on the other hand, is about the grievances he promotes, his inability to accept losing to Joe Biden and his utter disregard for democratic norms.
snip
The Potency of Trump's 'Lost Cause' Mythmaking
https://www.nytimes.com/2024/03/20/opinion/trump-lost-cause.html
https://archive.is/dUJg8
At an Ohio rally this month, Donald Trump saluted the insurrectionists who stormed the Capitol on Jan. 6, 2021, calling them unbelievable patriots and referring to those whove been locked up for their involvement on that terrible day as hostages. This was a continuation of Trumps Lost Cause mythmaking that began during his successful presidential campaign in 2016 and was ramped up in service of his efforts to remain in power despite his 2020 loss and the deadly riot that those efforts stoked.
More than 1,200 people have been charged related to Jan. 6. And though it shouldnt have to be said, lets be clear: Those whove been tried, convicted and imprisoned for storming the Capitol arent hostages, theyre criminals. But Lost Cause narratives arent about truth. Theyre about negating the truth. Which is what happened when the Lost Cause mythology was constructed after the Civil War. The cause of the war was framed as Northern aggression rather than slavery. A lore about happy slaves and benevolent enslavers proliferated. The narrative valorized those who seceded from and fought against the United States.
And it has survived to some degree for over 150 years, tucked into the cracks of our body politic. It still surfaces in ways that may seem remote from the Confederate Lost Cause myth, but that definitely promote it. It manifested itself last year when Florida changed its African American history standards to say that the enslaved in some instances benefited from their enslavement, and in Nikki Haleys hesitance on the campaign trail to state the obvious, that slavery was the cause of the Civil War. It manifested itself in the infamous torchlight march in Charlottesville and in the bitter resistance to removing Confederate monuments.
Trump has his own version of the Lost Cause, one thats not completely untethered from the old one, but one thats miniaturized, personal and petty. The Confederate Lost Cause narrative came after enormous loss: Hundreds of thousands of soldiers had died, the South was decimated and its economy was hobbled. Trumps Lost Cause, on the other hand, is about the grievances he promotes, his inability to accept losing to Joe Biden and his utter disregard for democratic norms.
snip
March 21, 2024
Leo Varadkar, whose Fine Gael party has struggled in the polls, said he would step down as leader of the country and of his party, citing personal and political reasons.
https://www.nytimes.com/2024/03/20/world/europe/ireland-varadkar-taoiseach-resign.html
https://archive.is/GSngq
Prime Minister Leo Varadkar of Ireland before announcing his resignation on Wednesday in Dublin.Credit...Damien Eagers/Reuters
Leo Varadkar, Irelands barrier-breaking leader, said on Wednesday that he would resign, days after a double referendum in which voters rejected constitutional changes his government had championed, and after years of waning public support for his political party, Fine Gael. Mr. Varadkar, the son of an Irish nurse and a doctor who was born in Mumbai, became the countrys youngest-ever leader when he was named prime minister in 2017 at the age of 38. He was also the countrys first gay taoiseach, or Irish prime minister, and the first person of South Asian heritage to hold the position. In many ways, he personified the rapidly changing identity of the modern Irish state.
But Fine Gael, which is ruling in coalition with two other parties, has struggled in recent years, and, before local and European elections in June, polls suggest public support for the party has flatlined. I know this will come as a surprise to many people and a disappointment to some, but I hope you will understand my decision, Mr. Varadkar told said at a news conference outside Leinster House in central Dublin. I know that others will how shall I put it? cope with the news just fine, he said. That is the great thing about living in a democracy.
Citing reasons both personal and political, Mr. Varadkar, 45, said he would step down from the party leadership effective immediately and would continue to serve as prime minister until Fine Gael elects a new leader before the Easter break. That post is expected to be in filled when the government returns on April 16. Mr. Varadkar made the unexpected announcement shortly after a cabinet meeting on Wednesday morning, his voice at times cracking with emotion.
There had been no indication of his decision just days earlier when he visited the White House and met with President Biden for St. Patricks Day. But Mr. Varadkar has been unable to revive the fortunes of Fine Gael since it came third in the 2020 election, when the most votes went to Sinn Fein the party that has historically called for uniting Northern Ireland, which remains part of the United Kingdom, with the Republic of Ireland. That result was damaging to the longstanding dominance of Fine Gael and Fianna Fáil, which went on to form a coalition government alongside the Green Party.
snip
Ireland's Prime Minister Resigns in Surprise Announcement
Leo Varadkar, whose Fine Gael party has struggled in the polls, said he would step down as leader of the country and of his party, citing personal and political reasons.
https://www.nytimes.com/2024/03/20/world/europe/ireland-varadkar-taoiseach-resign.html
https://archive.is/GSngq
Prime Minister Leo Varadkar of Ireland before announcing his resignation on Wednesday in Dublin.Credit...Damien Eagers/Reuters
Leo Varadkar, Irelands barrier-breaking leader, said on Wednesday that he would resign, days after a double referendum in which voters rejected constitutional changes his government had championed, and after years of waning public support for his political party, Fine Gael. Mr. Varadkar, the son of an Irish nurse and a doctor who was born in Mumbai, became the countrys youngest-ever leader when he was named prime minister in 2017 at the age of 38. He was also the countrys first gay taoiseach, or Irish prime minister, and the first person of South Asian heritage to hold the position. In many ways, he personified the rapidly changing identity of the modern Irish state.
But Fine Gael, which is ruling in coalition with two other parties, has struggled in recent years, and, before local and European elections in June, polls suggest public support for the party has flatlined. I know this will come as a surprise to many people and a disappointment to some, but I hope you will understand my decision, Mr. Varadkar told said at a news conference outside Leinster House in central Dublin. I know that others will how shall I put it? cope with the news just fine, he said. That is the great thing about living in a democracy.
Citing reasons both personal and political, Mr. Varadkar, 45, said he would step down from the party leadership effective immediately and would continue to serve as prime minister until Fine Gael elects a new leader before the Easter break. That post is expected to be in filled when the government returns on April 16. Mr. Varadkar made the unexpected announcement shortly after a cabinet meeting on Wednesday morning, his voice at times cracking with emotion.
There had been no indication of his decision just days earlier when he visited the White House and met with President Biden for St. Patricks Day. But Mr. Varadkar has been unable to revive the fortunes of Fine Gael since it came third in the 2020 election, when the most votes went to Sinn Fein the party that has historically called for uniting Northern Ireland, which remains part of the United Kingdom, with the Republic of Ireland. That result was damaging to the longstanding dominance of Fine Gael and Fianna Fáil, which went on to form a coalition government alongside the Green Party.
snip
March 21, 2024
Downgrading to a misdemeanour offence may allow WikiLeaks founder to reach a plea deal without going to the US, ending a 14-year legal saga
https://www.thetimes.co.uk/article/julian-assange-could-be-freed-as-us-prosecutors-consider-lesser-charges-pm50zb7c2
https://archive.is/dekgZ
American prosecutors are said to be considering downgrading charges against Julian Assange in a move that could end a 14-year-old legal battle and may see him freed from HMP Belmarsh. Assange, 52, was charged in May 2019 with conspiring with Chelsea Manning to obtain classified documents and publish them on his WikiLeaks platform.
Assanges actions risked serious harm to United States national security to the benefit of our adversaries and put the unredacted named human sources at a grave and imminent risk of serious physical harm and/or arbitrary detention, the Justice Department said. But sources have told The Wall Street Journal that the 18-count indictment for releasing classified information could be downgraded to mishandling classified information a misdemeanour offence.
The lesser charges could lead to the Australian-born Assange potentially entering his plea remotely, without setting foot in the US. He sought asylum in the Ecuadorean embassy in London in June 2012 and remained there until he was forced out in April 2019, having overstayed his welcome and exasperated officials.
Protesters and supporters gathered outside the building visitors included Pamela Anderson and Lady Gaga and he irritated staff with his eccentric habits. By October 2015, the cost to British taxpayers of policing the embassy had exceeded £12 million. On leaving, he was immediately arrested and has been held at Belmarsh since, as his appeal against his extradition to the US continues.
snip
Julian Assange could be freed as US prosecutors 'consider lesser charges'
Downgrading to a misdemeanour offence may allow WikiLeaks founder to reach a plea deal without going to the US, ending a 14-year legal saga
https://www.thetimes.co.uk/article/julian-assange-could-be-freed-as-us-prosecutors-consider-lesser-charges-pm50zb7c2
https://archive.is/dekgZ
American prosecutors are said to be considering downgrading charges against Julian Assange in a move that could end a 14-year-old legal battle and may see him freed from HMP Belmarsh. Assange, 52, was charged in May 2019 with conspiring with Chelsea Manning to obtain classified documents and publish them on his WikiLeaks platform.
Assanges actions risked serious harm to United States national security to the benefit of our adversaries and put the unredacted named human sources at a grave and imminent risk of serious physical harm and/or arbitrary detention, the Justice Department said. But sources have told The Wall Street Journal that the 18-count indictment for releasing classified information could be downgraded to mishandling classified information a misdemeanour offence.
The lesser charges could lead to the Australian-born Assange potentially entering his plea remotely, without setting foot in the US. He sought asylum in the Ecuadorean embassy in London in June 2012 and remained there until he was forced out in April 2019, having overstayed his welcome and exasperated officials.
Protesters and supporters gathered outside the building visitors included Pamela Anderson and Lady Gaga and he irritated staff with his eccentric habits. By October 2015, the cost to British taxpayers of policing the embassy had exceeded £12 million. On leaving, he was immediately arrested and has been held at Belmarsh since, as his appeal against his extradition to the US continues.
snip
March 21, 2024
Lancet study says decline will lead to staggering social change in West amid influx of migrants from sub-Saharan Africa
https://www.thetimes.co.uk/article/britain-falling-birth-rate-fertility-immigration-r6n0cbjdh
https://archive.is/TVhba
Plummeting birthrates will leave Britain heavily reliant on immigration for the remainder of the century, according to research published in The Lancet. A global study found that birthrates had tumbled in all major western nations since 1950 and forecast that this trend would continue until 2100, leading to staggering social change. To maintain public services and economic growth, high-income societies including the UK will have no choice but to rely on an influx of immigration from poorer countries in Africa with higher birthrates, the study concluded.
It said adopting pro-natal policies such as free childcare could provide a small boost to the number of babies born, but this approach would not be enough to sustain populations, meaning open immigration will become necessary. A team of international researchers led by the University of Washington examined data from 204 countries showing trends in fertility rates the average number of children had by women in their lives. To maintain the current population without immigration, birthrates must sit at the replacement rate of 2.1 children per woman.
The UKs fertility rate has fallen from 2.19 in 1950 to 1.85 in 1980 and 1.49 in 2021, one of the lowest rates in western Europe. The study forecasts that this decline will continue, dropping to 1.38 in 2050 and 1.3 in 2100, posing enormous challenges in how to care and pay for an ageing population. This dramatic decline in birth rates has been mirrored around the world, as improved education and contraception mean women are having fewer babies than ever before. By 2050, three in four countries are expected to have a shrinking population.
Sub-Saharan Africa is one of the few areas where a baby boom is continuing, and the regions population is set to keep growing. Niger, for example, is forecast to have a fertility rate of 5.15 in 2050. The study found that more than half of all the worlds babies would be born in sub-Saharan Africa in 2100, up from about a quarter in 2021. Dr Natalia Bhattacharjee, lead author on the study, said the dwindling working-age population in western nations would create fierce competition for migrants to sustain economic growth. She said: The implications are immense. These future trends in fertility rates and live births will completely reconfigure the global economy and the international balance of power and will necessitate reorganising societies.
snip
snip
Falling birthrate to leave UK reliant on immigration until 2100
Lancet study says decline will lead to staggering social change in West amid influx of migrants from sub-Saharan Africa
https://www.thetimes.co.uk/article/britain-falling-birth-rate-fertility-immigration-r6n0cbjdh
https://archive.is/TVhba
Plummeting birthrates will leave Britain heavily reliant on immigration for the remainder of the century, according to research published in The Lancet. A global study found that birthrates had tumbled in all major western nations since 1950 and forecast that this trend would continue until 2100, leading to staggering social change. To maintain public services and economic growth, high-income societies including the UK will have no choice but to rely on an influx of immigration from poorer countries in Africa with higher birthrates, the study concluded.
It said adopting pro-natal policies such as free childcare could provide a small boost to the number of babies born, but this approach would not be enough to sustain populations, meaning open immigration will become necessary. A team of international researchers led by the University of Washington examined data from 204 countries showing trends in fertility rates the average number of children had by women in their lives. To maintain the current population without immigration, birthrates must sit at the replacement rate of 2.1 children per woman.
The UKs fertility rate has fallen from 2.19 in 1950 to 1.85 in 1980 and 1.49 in 2021, one of the lowest rates in western Europe. The study forecasts that this decline will continue, dropping to 1.38 in 2050 and 1.3 in 2100, posing enormous challenges in how to care and pay for an ageing population. This dramatic decline in birth rates has been mirrored around the world, as improved education and contraception mean women are having fewer babies than ever before. By 2050, three in four countries are expected to have a shrinking population.
Sub-Saharan Africa is one of the few areas where a baby boom is continuing, and the regions population is set to keep growing. Niger, for example, is forecast to have a fertility rate of 5.15 in 2050. The study found that more than half of all the worlds babies would be born in sub-Saharan Africa in 2100, up from about a quarter in 2021. Dr Natalia Bhattacharjee, lead author on the study, said the dwindling working-age population in western nations would create fierce competition for migrants to sustain economic growth. She said: The implications are immense. These future trends in fertility rates and live births will completely reconfigure the global economy and the international balance of power and will necessitate reorganising societies.
snip
snip
Global fertility in 204 countries and territories, 19502021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
https://www.thelancet.com/action/showPdf?pii=S0140-6736%2824%2900550-6
https://www.thelancet.com/action/showPdf?pii=S0140-6736%2824%2900550-6
March 21, 2024
https://prospect.org/health/2024-03-21-pbm-insurer-mafia-community-pharmacies/
Pharmacy benefit managers (PBMs) are the shadowy middlemen who decide what drugs you can buy, where you can buy them, and at what costwithout disclosing how much they charge to your employer, to your doctor, or your pharmacist. And as HEALTH CARE un-covered has reported, the biggest PBMs are now owned by Big Insurance. PBMs are a poorly understood component of Americas permanent and escalating health care snafu, but they are a growing presence in our lives. Their business practices have created administrative and financial barriers to the prescription drugs patients need, even as PBMs Big Insurance owners rake in record profits.
A new Biden administration rule may rein in some of the worst practices of PBMs. But in responseand to protect profit marginsthe PBM/Insurance industry, led by UnitedHealths Optum, Cignas Express Scripts, and CVSs Caremark, has launched a full-on onslaught against independent pharmacies by dropping reimbursement rates. Many independents are being forced out of business. With them out of the picture, the PBMs will be better able to steer patients to their own pharmacies, mail-order operations, and, at least in Cignas case, big investor-owned corporations like Walgreens that theyve struck deals with. Last year, Republican Ohio Attorney General Dave Yost said that PBMs are modern gangsters, and that they were designed to protect and negotiate on behalf of employers and consumers after Big Pharma was criticized for overpricing medications, but instead they have absolutely destroyed transparency, scheming in the shadows to control drug prices on all sides of the market.
By pursuing practices that drive independent pharmacies out of business, the big insurers can make drug prices even more opaque, resulting in higher costs to ordinary Americansand monopolizing the pharmacy market in the same way that they have already monopolized pharmacy benefits. In just the past year, more than 300 independent pharmacies have closed. (The last independent pharmacy in my town of Brattleboro, Vermont, closed in January 2023, blaming chaos and quirkiness of the pharmaceutical world.) Meanwhile, PBMs are contributing more and more to revenue and profits at UnitedHealth, Cigna, and CVS, which collectively control 80% of the PBM market. The total pharmacy spending controlled by UnitedHealths OptumRx, for example, grew by nearly 30% in a single year to $159 billion, the company recently reported. Cignas Evernorth saw a 9% growth. CVS does not report its Caremark revenues separately, but CVS enjoyed a 73% overall growth in operating income in 2023. Among the three, they spent $12 billion buying back their stock in 2023.
Denise Conway owns an independent pharmacy in Ohio. She points out one of the key benefits of independent pharmacies: the human touch that they have with patients, as opposed to a faceless corporate overlord. Independent pharmacies have an ability to answer the phone, said Conway. Our phone rings nonstop because we physically answer the phone. We have someone to talk to face-to-face and person-to-person. Independent pharmacies have charge accounts, people dont have to pay right away if they dont have the cash on hand. At mail-order and chain pharmacies, Conway pointed out, People have to wait hours, days, and weeks to get medication filled. If youre waiting days or weeks you are in a life and death situation. If we cant fill a prescription quickly, we are on the phone with that patient to ask them if we should transfer it somewhere else, knowing that everything we touch is a persons life, she said.
snip
related
https://wendellpotter.substack.com/p/nearly-half-of-every-dollar-spent
As members of Congress get back to business after the holidays, they seem to be poised to pass legislation that would address some of the abuses of pharmacy benefit managers (PBMs), the middlemen who extract so much money from the pharmaceutical supply chain. Recent research adds more urgency to the need to rein those companies in. And its important to point out that the three biggest PBMs, all of which are owned by big for-profit insurance companies, control 80% of the market. Thats far more concentration than in the pharmaceutical industry, as youll see below.
As Ge Bai, Ph.D., CPA, professor of health policy and management at Johns Hopkins Bloomberg School of Public Health and professor of accounting at Johns Hopkins Carey Business School, explained in a recent episode of the excellent Relentless Health Value podcast, PBMs take far more money out of the supply chain than any other entity, including the drug makers. Bai told podcast host Stacey Richter that researchers at Hopkins and the University of Utah looked at the 45 most commonly used generic medications taken by patients enrolled in a Medicare Part D pharmacy plan in 2021. They found that for every $100 spent by the Part D plans, $41 went to the PBMs, $30 to the manufacturers, $17 to the pharmacies that dispense the drugs, and $12 to the wholesalers.
In other words, more than half of every dollar paid by Part D plans went to intermediaries (middlemen), and many of those middlementhe big insurers that own the big PBMsalso operate Part D plans. In fact, as the researchers noted in an October 2023 article in JAMA: All but 29.9% of Medicare Part D dollars spent on 45 high-utilization generic drugs went to intermediary gross profit. And then there is this: Those insurers/PBMs make Part D enrollees pay varying amounts of money out of their own pocketsin some cases significant amountsbefore their Part D plans will pay a dime.
No wonder so many people on Medicare walk away from the pharmacy counter without their medications because of what they have to shell out. Its money many of them simply do not have. Theyre seniors and disabled people, and many if not most have little or no income besides their Social Security checks. As Bai and Richter point out, 90% of the medications Americans take are generics, which are far cheaper than brand-name drugs. And Bai says generics should be cheaper in America than in other countries. Manufacturers, she explains, get, in general, lower revenue in the United States for generic drugs than from other countries. We have very affordable generic drugs then from the manufacturers perspective, but probably not from the patients perspective.
snip
The PBM-Insurer Mafia Comes for Community Pharmacies
https://prospect.org/health/2024-03-21-pbm-insurer-mafia-community-pharmacies/
Pharmacy benefit managers (PBMs) are the shadowy middlemen who decide what drugs you can buy, where you can buy them, and at what costwithout disclosing how much they charge to your employer, to your doctor, or your pharmacist. And as HEALTH CARE un-covered has reported, the biggest PBMs are now owned by Big Insurance. PBMs are a poorly understood component of Americas permanent and escalating health care snafu, but they are a growing presence in our lives. Their business practices have created administrative and financial barriers to the prescription drugs patients need, even as PBMs Big Insurance owners rake in record profits.
A new Biden administration rule may rein in some of the worst practices of PBMs. But in responseand to protect profit marginsthe PBM/Insurance industry, led by UnitedHealths Optum, Cignas Express Scripts, and CVSs Caremark, has launched a full-on onslaught against independent pharmacies by dropping reimbursement rates. Many independents are being forced out of business. With them out of the picture, the PBMs will be better able to steer patients to their own pharmacies, mail-order operations, and, at least in Cignas case, big investor-owned corporations like Walgreens that theyve struck deals with. Last year, Republican Ohio Attorney General Dave Yost said that PBMs are modern gangsters, and that they were designed to protect and negotiate on behalf of employers and consumers after Big Pharma was criticized for overpricing medications, but instead they have absolutely destroyed transparency, scheming in the shadows to control drug prices on all sides of the market.
By pursuing practices that drive independent pharmacies out of business, the big insurers can make drug prices even more opaque, resulting in higher costs to ordinary Americansand monopolizing the pharmacy market in the same way that they have already monopolized pharmacy benefits. In just the past year, more than 300 independent pharmacies have closed. (The last independent pharmacy in my town of Brattleboro, Vermont, closed in January 2023, blaming chaos and quirkiness of the pharmaceutical world.) Meanwhile, PBMs are contributing more and more to revenue and profits at UnitedHealth, Cigna, and CVS, which collectively control 80% of the PBM market. The total pharmacy spending controlled by UnitedHealths OptumRx, for example, grew by nearly 30% in a single year to $159 billion, the company recently reported. Cignas Evernorth saw a 9% growth. CVS does not report its Caremark revenues separately, but CVS enjoyed a 73% overall growth in operating income in 2023. Among the three, they spent $12 billion buying back their stock in 2023.
Denise Conway owns an independent pharmacy in Ohio. She points out one of the key benefits of independent pharmacies: the human touch that they have with patients, as opposed to a faceless corporate overlord. Independent pharmacies have an ability to answer the phone, said Conway. Our phone rings nonstop because we physically answer the phone. We have someone to talk to face-to-face and person-to-person. Independent pharmacies have charge accounts, people dont have to pay right away if they dont have the cash on hand. At mail-order and chain pharmacies, Conway pointed out, People have to wait hours, days, and weeks to get medication filled. If youre waiting days or weeks you are in a life and death situation. If we cant fill a prescription quickly, we are on the phone with that patient to ask them if we should transfer it somewhere else, knowing that everything we touch is a persons life, she said.
snip
related
https://wendellpotter.substack.com/p/nearly-half-of-every-dollar-spent
As members of Congress get back to business after the holidays, they seem to be poised to pass legislation that would address some of the abuses of pharmacy benefit managers (PBMs), the middlemen who extract so much money from the pharmaceutical supply chain. Recent research adds more urgency to the need to rein those companies in. And its important to point out that the three biggest PBMs, all of which are owned by big for-profit insurance companies, control 80% of the market. Thats far more concentration than in the pharmaceutical industry, as youll see below.
As Ge Bai, Ph.D., CPA, professor of health policy and management at Johns Hopkins Bloomberg School of Public Health and professor of accounting at Johns Hopkins Carey Business School, explained in a recent episode of the excellent Relentless Health Value podcast, PBMs take far more money out of the supply chain than any other entity, including the drug makers. Bai told podcast host Stacey Richter that researchers at Hopkins and the University of Utah looked at the 45 most commonly used generic medications taken by patients enrolled in a Medicare Part D pharmacy plan in 2021. They found that for every $100 spent by the Part D plans, $41 went to the PBMs, $30 to the manufacturers, $17 to the pharmacies that dispense the drugs, and $12 to the wholesalers.
In other words, more than half of every dollar paid by Part D plans went to intermediaries (middlemen), and many of those middlementhe big insurers that own the big PBMsalso operate Part D plans. In fact, as the researchers noted in an October 2023 article in JAMA: All but 29.9% of Medicare Part D dollars spent on 45 high-utilization generic drugs went to intermediary gross profit. And then there is this: Those insurers/PBMs make Part D enrollees pay varying amounts of money out of their own pocketsin some cases significant amountsbefore their Part D plans will pay a dime.
No wonder so many people on Medicare walk away from the pharmacy counter without their medications because of what they have to shell out. Its money many of them simply do not have. Theyre seniors and disabled people, and many if not most have little or no income besides their Social Security checks. As Bai and Richter point out, 90% of the medications Americans take are generics, which are far cheaper than brand-name drugs. And Bai says generics should be cheaper in America than in other countries. Manufacturers, she explains, get, in general, lower revenue in the United States for generic drugs than from other countries. We have very affordable generic drugs then from the manufacturers perspective, but probably not from the patients perspective.
snip
March 21, 2024
https://www.liberalpatriot.com/p/trumps-achilles-heel-white-college
Both Joe Biden and Donald Trump are struggling to rebuild their respective winning coalitions. After exploring Bidens weakness with Hispanic voters last week, we turn to Trumps most glaring vulnerability: college-educated white voters. From Iowa to Super Tuesday, Trump performed worst in counties with higher proportions of these critical voters. The one county he lost in Iowa? Johnson Countythe states most educated. The three counties Nikki Haley won in South Carolina? The Palmetto States most educated.
Interestingly, Haleys performancelargely representative of the non-Trump votealso positively correlates with the 2016-2020 Democratic swing. In other words, Haley did best, and Trump worst, in places that trended left between the last two presidential elections. This suggests that Trump is struggling to reclaim Trump 2016-Biden 2020 voters, especially those with college degrees. Polling supports this theory: recent averages have Biden winning white college voters by 15 points, even as Trump leads overall.
In analyzing Haleys vote share, there remains one necessary caveat. We still dont know the proportion of her primary supporters who will come home to Trumpor how many were really Democrats all along. But exit polling does suggest that many college-educated Haley voters, regardless of their ideological lean, simply wont vote for Trump in November. If this holds, expect the already-huge gap between white college and non-college voters to expand to historic levels.
Trump's Achilles Heel: White College Voters
https://www.liberalpatriot.com/p/trumps-achilles-heel-white-college
Both Joe Biden and Donald Trump are struggling to rebuild their respective winning coalitions. After exploring Bidens weakness with Hispanic voters last week, we turn to Trumps most glaring vulnerability: college-educated white voters. From Iowa to Super Tuesday, Trump performed worst in counties with higher proportions of these critical voters. The one county he lost in Iowa? Johnson Countythe states most educated. The three counties Nikki Haley won in South Carolina? The Palmetto States most educated.
Interestingly, Haleys performancelargely representative of the non-Trump votealso positively correlates with the 2016-2020 Democratic swing. In other words, Haley did best, and Trump worst, in places that trended left between the last two presidential elections. This suggests that Trump is struggling to reclaim Trump 2016-Biden 2020 voters, especially those with college degrees. Polling supports this theory: recent averages have Biden winning white college voters by 15 points, even as Trump leads overall.
In analyzing Haleys vote share, there remains one necessary caveat. We still dont know the proportion of her primary supporters who will come home to Trumpor how many were really Democrats all along. But exit polling does suggest that many college-educated Haley voters, regardless of their ideological lean, simply wont vote for Trump in November. If this holds, expect the already-huge gap between white college and non-college voters to expand to historic levels.
March 21, 2024
https://www.politico.com/news/2024/03/20/in-arizona-biden-drops-8-5b-on-intel-will-it-help-his-campaign-00148079
President Joe Biden traveled to Arizona Wednesday to announce that chipmaking giant Intel would be getting billions of dollars as part of a landmark industrial policy that hes hoping will help pave the way for his reelection. But while the visit to the companys campus outside Phoenix reflected the central political bet Biden is making that domestic spending and jobs promises will capture more voters it also underscored how difficult its been to pull it off. The grant is the largest award to be made from the bipartisan CHIPS and Science Act of 2022, which directed $39 billion in subsidies to boost U.S. competitiveness in semiconductors.
We will enable advanced semiconductor manufacturing to make a comeback here in America after 40 years. Its going to transform the semiconductor industry and create entirely new ecosystems, Biden said. Biden said Intel would also invest over $100 billion across the country, in facilities in Arizona, Oregon, Ohio and New Mexico. Those investments should put the U.S. on track to produce roughly 20 percent of the worlds leading-edge chips by 2030, Biden said. He added that Intels new projects are expected to create 30,000 jobs nationwide in construction and manufacturing.
While Democrats rushed to praise the president, others often aligned with the party accused Biden of not doing enough to protect their interests as he sought a quick political win. Shawn Fain, president of the United Auto Workers, noted that Intel has not signed an enforceable agreement allowing workers to form a union. Fain endorsed Biden in January after months of delay over concerns the White House policy advancing electric vehicles could harm union labor. Workers in the auto industry know the importance of a strong semiconductor supply chain, he said in a statement, urging Intel to not just talk the talk, but walk the walk, and that means signing a neutrality agreement.
The news quickly electrified the Arizona political landscape. All four Republican House representatives voted against the bill that Democrats supported. Rep. Ruben Gallego, the Democratic contender for the seat of outgoing independent Sen. Kyrsten Sinema rushed to claim credit for the Intel award. Arizona has become an economic engine for the entire country, and I am proud to have helped secure this historic funding to bring thousands more good-paying jobs to Arizona, he said in a statement.
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Biden boosts Intel with massive CHIPS payout in swing state Arizona
The White House says grants will create 10,000 jobs in the state where Biden squeaked to victory in 2020.https://www.politico.com/news/2024/03/20/in-arizona-biden-drops-8-5b-on-intel-will-it-help-his-campaign-00148079
President Joe Biden traveled to Arizona Wednesday to announce that chipmaking giant Intel would be getting billions of dollars as part of a landmark industrial policy that hes hoping will help pave the way for his reelection. But while the visit to the companys campus outside Phoenix reflected the central political bet Biden is making that domestic spending and jobs promises will capture more voters it also underscored how difficult its been to pull it off. The grant is the largest award to be made from the bipartisan CHIPS and Science Act of 2022, which directed $39 billion in subsidies to boost U.S. competitiveness in semiconductors.
We will enable advanced semiconductor manufacturing to make a comeback here in America after 40 years. Its going to transform the semiconductor industry and create entirely new ecosystems, Biden said. Biden said Intel would also invest over $100 billion across the country, in facilities in Arizona, Oregon, Ohio and New Mexico. Those investments should put the U.S. on track to produce roughly 20 percent of the worlds leading-edge chips by 2030, Biden said. He added that Intels new projects are expected to create 30,000 jobs nationwide in construction and manufacturing.
While Democrats rushed to praise the president, others often aligned with the party accused Biden of not doing enough to protect their interests as he sought a quick political win. Shawn Fain, president of the United Auto Workers, noted that Intel has not signed an enforceable agreement allowing workers to form a union. Fain endorsed Biden in January after months of delay over concerns the White House policy advancing electric vehicles could harm union labor. Workers in the auto industry know the importance of a strong semiconductor supply chain, he said in a statement, urging Intel to not just talk the talk, but walk the walk, and that means signing a neutrality agreement.
The news quickly electrified the Arizona political landscape. All four Republican House representatives voted against the bill that Democrats supported. Rep. Ruben Gallego, the Democratic contender for the seat of outgoing independent Sen. Kyrsten Sinema rushed to claim credit for the Intel award. Arizona has become an economic engine for the entire country, and I am proud to have helped secure this historic funding to bring thousands more good-paying jobs to Arizona, he said in a statement.
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March 21, 2024
and it is working:
The Islamophobic Smear Campaign Dividing Democrats
A Biden Judicial Nominee Is Facing an Islamophobic Smear Campaign. Why Is It Working?
https://www.nytimes.com/2024/03/19/opinion/islamophobia-democrats-adeel-mangi.html
https://archive.is/njHW6
On paper, President Bidens nominee to fill a vacancy on the U.S. Court of Appeals for the Third Circuit, Adeel Abdullah Mangi, is an archetypical candidate for a federal judgeship. Mangi has a sterling legal education, which he followed with a distinguished career at a high-profile private firm mixing corporate litigation with important pro bono work. He also has a classic American story: He grew up in a poor country dreaming of a career as a lawyer and immigrated to the United States, where he ascended to the heights of his profession. The candidate has another quality that was especially appealing to Biden, who has made diversifying the federal bench a key priority: Mangi would be the first Muslim American federal appellate judge in the United States.
When Mangi appeared before the Senate Judiciary Committee in December for a hearing about this lifetime appointment, Republican senators did not ask him about his legal background or judicial philosophy. Do you condemn the atrocities of Hamas terrorists? Senator Ted Cruz of Texas demanded of Mangi, a Pakistani American with no connection to Hamas or Palestinians other than the fact that he is Muslim, along with 1.8 billion other people across the globe. Such bad faith ambushes are Cruzs stock in trade, especially since the Oct. 7 attack on Israel by Hamas. So it was hardly a surprise that he and his Republican colleagues spent their allotted time insinuating that Mangi was an antisemite and an apologist not just for Hamas but also for the perpetrators of Sept. 11.
But what is much more worrying is that these tactics could work on some Senate Democrats. Right-wing judicial activists have been running a smear campaign against Mangi, including advertisements aimed at Senate Democrats like Jon Tester of Montana and Bob Casey of Pennsylvania, who are battling for re-election. The campaigns describe Mangi, with no evidence, as an antisemite and attempt to link him to Hamas and other terrorist groups. This means that Democrats who run the risk of losing their seats come November may see defending Mangis nomination as a potential risk to their chances at re-election. The campaign seems to be working. Over the past few days, CNN and HuffPost have reported that there may not be enough Democratic votes to confirm Mangi.
This is an outrage. The attacks on Mangi are utterly disingenuous. Major Jewish organizations, including the Anti-Defamation League, have made statements of support for Mangi, whose pro bono legal work has focused in part on fighting for religious liberty and against religious bias across multiple faiths. The American Jewish Committee, which has joined several amicus briefs to the Supreme Court led by Mangi, described him as a person of integrity, champion of pluralism and adversary of discrimination against any group. Abandoning Mangis nomination would be an unconscionable act at any time, but especially perilous for Democrats in the current political climate, when tens of thousands of Democratic primary voters in key states are expressing their outrage at Bidens policy in Gaza by voting uncommitted. Meanwhile, the right is using the attacks on Oct. 7 and the ensuing war in Gaza as a means to imply that any Muslim could be pro-Hamas or antisemitic. If Democrats acquiesce, they will set a dangerous precedent.
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https://www.nytimes.com/2024/03/19/opinion/islamophobia-democrats-adeel-mangi.html
https://archive.is/njHW6
On paper, President Bidens nominee to fill a vacancy on the U.S. Court of Appeals for the Third Circuit, Adeel Abdullah Mangi, is an archetypical candidate for a federal judgeship. Mangi has a sterling legal education, which he followed with a distinguished career at a high-profile private firm mixing corporate litigation with important pro bono work. He also has a classic American story: He grew up in a poor country dreaming of a career as a lawyer and immigrated to the United States, where he ascended to the heights of his profession. The candidate has another quality that was especially appealing to Biden, who has made diversifying the federal bench a key priority: Mangi would be the first Muslim American federal appellate judge in the United States.
When Mangi appeared before the Senate Judiciary Committee in December for a hearing about this lifetime appointment, Republican senators did not ask him about his legal background or judicial philosophy. Do you condemn the atrocities of Hamas terrorists? Senator Ted Cruz of Texas demanded of Mangi, a Pakistani American with no connection to Hamas or Palestinians other than the fact that he is Muslim, along with 1.8 billion other people across the globe. Such bad faith ambushes are Cruzs stock in trade, especially since the Oct. 7 attack on Israel by Hamas. So it was hardly a surprise that he and his Republican colleagues spent their allotted time insinuating that Mangi was an antisemite and an apologist not just for Hamas but also for the perpetrators of Sept. 11.
But what is much more worrying is that these tactics could work on some Senate Democrats. Right-wing judicial activists have been running a smear campaign against Mangi, including advertisements aimed at Senate Democrats like Jon Tester of Montana and Bob Casey of Pennsylvania, who are battling for re-election. The campaigns describe Mangi, with no evidence, as an antisemite and attempt to link him to Hamas and other terrorist groups. This means that Democrats who run the risk of losing their seats come November may see defending Mangis nomination as a potential risk to their chances at re-election. The campaign seems to be working. Over the past few days, CNN and HuffPost have reported that there may not be enough Democratic votes to confirm Mangi.
This is an outrage. The attacks on Mangi are utterly disingenuous. Major Jewish organizations, including the Anti-Defamation League, have made statements of support for Mangi, whose pro bono legal work has focused in part on fighting for religious liberty and against religious bias across multiple faiths. The American Jewish Committee, which has joined several amicus briefs to the Supreme Court led by Mangi, described him as a person of integrity, champion of pluralism and adversary of discrimination against any group. Abandoning Mangis nomination would be an unconscionable act at any time, but especially perilous for Democrats in the current political climate, when tens of thousands of Democratic primary voters in key states are expressing their outrage at Bidens policy in Gaza by voting uncommitted. Meanwhile, the right is using the attacks on Oct. 7 and the ensuing war in Gaza as a means to imply that any Muslim could be pro-Hamas or antisemitic. If Democrats acquiesce, they will set a dangerous precedent.
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and it is working:
Senate Democrat opposes Muslim appellate court nominee Mangi
https://www.reuters.com/legal/government/senate-democrat-opposes-muslim-appellate-court-nominee-mangi-2024-03-20/
https://www.reuters.com/legal/government/senate-democrat-opposes-muslim-appellate-court-nominee-mangi-2024-03-20/
March 20, 2024
https://prospect.org/politics/2024-03-20-stay-strapped-or-get-clapped/
In the summer of 2021, reporter Jason Zengerle published a fluffy profile in The New York Times Magazine of a growing veteran-owned company. Can the Black Rifle Coffee Company Become the Starbucks of the Right? was filled with heartwarming photos. The brands three founders in baseball caps sitting around a conference table in front of a wall-sized rendition of Washington crossing the Delaware. Employees practicing for an adaptive athlete archery competition. (Its active meditation, basically.) The fellas chillin out in the companys converted warehouse with a lot of black metal and reclaimed wood. And also, should there be any doubt where readers sympathies were meant to lie, CEO Evan Hafer (who is Jewish) posing with his puppy dogs.
The gravamen of the piece was examining the risk brands take when they plant a flag on the terrain of contested political issues. Readers were to understand this, naturally, as a problem for #bothsides. One example: the time in 2016, when Apple and Bank of America asked the governor of North Carolina to repeal that states hateful, anti-trans bathroom bill, and conservative customers balked. Opposite that: the headache that emerged for the nice fellas at Black Rifle when investigators sought to identity the January 6th fugitive known as Zip Tie Guy for the tools he wore on his tactical belt, designed to hog-tie treasonous senators. The FBI had identified the baseball cap he wore, which featured an assault rifle silhouetted over an American flag, as a Black Rifle product.
I was like, Oh [expletive], Hafer was quoted. Here we go again. Again referred to the time Kyle Rittenhouse was photographed in a Black Rifle tee after bailing out of jail for fatally shooting a Black Lives Matter demonstrator. Hafer pronounced himself baffled. Why does this keep happening to us? The reader is supposed to be baffled, tooas when we meet Black Rifle employees like the quiet, haunted-seeming man who had been a C.I.A.-contractor colleague of Hafers and who, for a time, lived in a trailer he parked on the office grounds. Later, I asked Hafer what, exactly, the man did for Black Rifle. He just gets better, Hafer replied. He gets better. No wonder Hafer is so anguished by the thought that racists, of all people, could identify with his brand: Like, Ill pay them to leave my customer base.
Hafer could maybe save that money by not selling a coffee called Thin Blue Line. (If you dont see the racism in that symbolic clapback by politicized cops to the Movement for Black Lives, take your dog whistle in for repairs.) Or by making their YouTube channel, which has 1.19 million subscribers, a bit more of an unsafe space for those who prefer their social media minority-free; I had to scroll some 61 videos before spotting a single patch of non-Caucasian skin, save for the movie fight scenes in the Veterans react to series. None of the videos I reviewed featured women either. In the Black Rifle universe, veterans are bearded and beefy, infatuated with the healing power of arms, and, above all, aggressively in the face of anyone who disagrees. Thats the whole point.
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How the media misses the story of companies seeking profit by keeping traumatized veterans armed and enraged
https://prospect.org/politics/2024-03-20-stay-strapped-or-get-clapped/
In the summer of 2021, reporter Jason Zengerle published a fluffy profile in The New York Times Magazine of a growing veteran-owned company. Can the Black Rifle Coffee Company Become the Starbucks of the Right? was filled with heartwarming photos. The brands three founders in baseball caps sitting around a conference table in front of a wall-sized rendition of Washington crossing the Delaware. Employees practicing for an adaptive athlete archery competition. (Its active meditation, basically.) The fellas chillin out in the companys converted warehouse with a lot of black metal and reclaimed wood. And also, should there be any doubt where readers sympathies were meant to lie, CEO Evan Hafer (who is Jewish) posing with his puppy dogs.
The gravamen of the piece was examining the risk brands take when they plant a flag on the terrain of contested political issues. Readers were to understand this, naturally, as a problem for #bothsides. One example: the time in 2016, when Apple and Bank of America asked the governor of North Carolina to repeal that states hateful, anti-trans bathroom bill, and conservative customers balked. Opposite that: the headache that emerged for the nice fellas at Black Rifle when investigators sought to identity the January 6th fugitive known as Zip Tie Guy for the tools he wore on his tactical belt, designed to hog-tie treasonous senators. The FBI had identified the baseball cap he wore, which featured an assault rifle silhouetted over an American flag, as a Black Rifle product.
I was like, Oh [expletive], Hafer was quoted. Here we go again. Again referred to the time Kyle Rittenhouse was photographed in a Black Rifle tee after bailing out of jail for fatally shooting a Black Lives Matter demonstrator. Hafer pronounced himself baffled. Why does this keep happening to us? The reader is supposed to be baffled, tooas when we meet Black Rifle employees like the quiet, haunted-seeming man who had been a C.I.A.-contractor colleague of Hafers and who, for a time, lived in a trailer he parked on the office grounds. Later, I asked Hafer what, exactly, the man did for Black Rifle. He just gets better, Hafer replied. He gets better. No wonder Hafer is so anguished by the thought that racists, of all people, could identify with his brand: Like, Ill pay them to leave my customer base.
Hafer could maybe save that money by not selling a coffee called Thin Blue Line. (If you dont see the racism in that symbolic clapback by politicized cops to the Movement for Black Lives, take your dog whistle in for repairs.) Or by making their YouTube channel, which has 1.19 million subscribers, a bit more of an unsafe space for those who prefer their social media minority-free; I had to scroll some 61 videos before spotting a single patch of non-Caucasian skin, save for the movie fight scenes in the Veterans react to series. None of the videos I reviewed featured women either. In the Black Rifle universe, veterans are bearded and beefy, infatuated with the healing power of arms, and, above all, aggressively in the face of anyone who disagrees. Thats the whole point.
snip
March 20, 2024
Hong Kong - CNN
Hong Kongs legislature unanimously passed sweeping new powers on Tuesday that critics and analysts warned would align the financial hubs national security laws more closely with those used on the Chinese mainland and deepen an ongoing crackdown on dissent. The lengthy national security bill the first draft ran to 212 pages was rushed through the citys opposition-less Legislative Council with unusual haste at the request of city leader John Lee and debated over just 11 days.
Coming into effect on Saturday, the law introduces 39 new national security crimes, adding to an already powerful national security law that was directly imposed by Beijing on Hong Kong in 2020 after huge and sometimes violent democracy protests the year before. That law has already transformed Hong Kong with authorities jailing dozens of political opponents, forcing civil society groups and outspoken media outlets to disband and transforming the once freewheeling city into one that prioritizes patriotism.
Known locally as Article 23, the new national security legislation covers a raft of new crimes including treason, espionage, external interference and unlawful handling of state secrets, with the most serious offenses punishable by up to life imprisonment. Hong Kongs Chief Executive Lee described it as a historic moment for Hong Kong. We have completed a historic mission, lived up to the trust of the country and did not let the Central government down, he said, referring to Chinas Communist Party leadership in Beijing.
China and Hong Kongs leaders say the new laws are needed to plug loopholes as part of their drive to restore stability following the huge 2019 protests. They argue their legislation is similar to other national security laws around the world. Critics counter that what Chinas Communist Party views as national security offences are far broader and more sweeping, often ensnaring political criticism, dissent and even business activity that would not be criminalized elsewhere.
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Hong Kong passes second national security law, widening crackdown powers & aligning it more closely with mainland China
https://edition.cnn.com/2024/03/19/china/hong-kong-second-national-security-law-passed-intl-hnk/index.htmlHong Kong - CNN
Hong Kongs legislature unanimously passed sweeping new powers on Tuesday that critics and analysts warned would align the financial hubs national security laws more closely with those used on the Chinese mainland and deepen an ongoing crackdown on dissent. The lengthy national security bill the first draft ran to 212 pages was rushed through the citys opposition-less Legislative Council with unusual haste at the request of city leader John Lee and debated over just 11 days.
Coming into effect on Saturday, the law introduces 39 new national security crimes, adding to an already powerful national security law that was directly imposed by Beijing on Hong Kong in 2020 after huge and sometimes violent democracy protests the year before. That law has already transformed Hong Kong with authorities jailing dozens of political opponents, forcing civil society groups and outspoken media outlets to disband and transforming the once freewheeling city into one that prioritizes patriotism.
Known locally as Article 23, the new national security legislation covers a raft of new crimes including treason, espionage, external interference and unlawful handling of state secrets, with the most serious offenses punishable by up to life imprisonment. Hong Kongs Chief Executive Lee described it as a historic moment for Hong Kong. We have completed a historic mission, lived up to the trust of the country and did not let the Central government down, he said, referring to Chinas Communist Party leadership in Beijing.
China and Hong Kongs leaders say the new laws are needed to plug loopholes as part of their drive to restore stability following the huge 2019 protests. They argue their legislation is similar to other national security laws around the world. Critics counter that what Chinas Communist Party views as national security offences are far broader and more sweeping, often ensnaring political criticism, dissent and even business activity that would not be criminalized elsewhere.
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