Questioning the standard pharmaceutical industry defense of high drug prices

Katie Porter asking some interesting questions

The pharmaceutical industry has long defended astronomically high drug prices for Americans by arguing they need to spend billions and billions of dollars to find new drugs. The industry threat is that if drug prices are regulated by government negotiation, the industry will go extinct and new drugs will cease to come forth from the miracle of the operation of the unfettered free market.

The following 2-minute video of Democratic California Representative Katie Porter (Harvard Law School (2001), Yale University (1996), Phillips Academy — Andover) questioning AbbVie CEO Richard Gonzalez is of some interest in this matter.

Questions: If the AbbVie financials presented in the video are reasonably representative of the entire big pharma industry, how well has unregulated free markets served the public interest in this economic sector compared to the private sector? Will Porter's questioning of Gonzalez make any noticeable difference in drug prices or industry propaganda? Does any difference need to be made? Katie Porter for president 2024?

Attacks on the free press by autocratic radical right capitalism continue

NPR segment on media consolidation

Under the ex-president's corrupt, anti-democratic, autocratic administration, political attacks on the free press and news media were stepped up enormously. Before then, news media had been under severe economic stress. Media presence was shrinking ever since cable TV came along and converted news from news to infoTAIMNET, i.e., little information, lots of entertainment and corporate restrictions on what could even be reported. The owners did not, and still do not, want to offend advertisers or themselves via reporting inconvenient truths.  

In 2017, the FCC repealed its rule limiting concentration of media ownership in different markets. A single owner could now legally dominate entire markets with their propaganda and anti-democratic demagoguery. The Washington Post wrote: "Federal regulators rolled back decades-old rules on Thursday, making it far easier for media outlets to be bought and sold — potentially leading to more newspapers, radio stations and television broadcasters being owned by a handful of companies. .... With the rise of blogs, websites and podcasts, [FCC Chairman Ajit Pai] said, traditional media outlets now face more competition than ever — and rules that once enforced a diversity of viewpoints are no longer needed."

That was a lie. The FCC rules were intended to reduce the diversity of viewpoints in major news outlets. That is what happened in the wake of the 2017 rule change. A central goal of the radical right Republican propaganda Leviathtan has been to consolidate media ownership into the hands of fewer and fewer politically radical right owners. After the FCC rule change, the radical right Sinclair Broadcasting Leviathan bought dozens of media outlets. Sinclair immediately ramped up its fascist propaganda output. People in newsrooms who objected to spewing propaganda and lies were fired (some even faced having to pay Sinclair for quitting) and replaced with people willing to do the job right. Doing the job right meant deceiving and polarizing the American people.

Media consolidation and direct attacks on journalism continue today. The New York Times reports on a new wave of consolidation with an imminent dismantling of news reporting in the name of profitability. The NYT writes:

Tribune Publishing, the owner of some of the largest metropolitan newspapers in the United States, will be acquired by a hedge fund with a reputation for slashing costs and cutting newsroom jobs, after shareholders voted to approve the deal on Friday.

The sale of Tribune, whose titles include The Chicago Tribune, The Baltimore Sun and The New York Daily News, to Alden Global Capital comes at a time of crisis for local news. The coronavirus pandemic exacerbated the headwinds facing small newspapers as spending from advertisers collapsed. But even before the pandemic, more than 2,000 American newspapers closed between 2004 and 2019 and about half of the jobs in the industry were lost, according to researchers at the University of North Carolina.

The losses have hollowed out local news coverage across the country, and with growing polarization and rampant disinformation, reliable coverage of institutions like state houses and city councils is more important than ever. The slump has crippled outlets that people rely on to know about everything from school board decisions to local sports scores.

Alden, the second-largest newspaper owner in the country, will gain control of nine daily newspapers, adding them to a stable of about 200 other publications. Alden says its intention is to ensure newsrooms can survive, but its critics point to a record of slashing spending and cutting back on reporting as it focuses on extracting profits for its shareholders.  

“The purchase of Tribune reaffirms our commitment to the newspaper industry and our focus on getting publications to a place where they can operate sustainably over the long term,” Heath Freeman, the president of Alden, said in a statement Friday.

There is no reason to believe that Aldon has any concern for loss of journalists in pursuit of sustainable operations. Its track record speaks for itself. Aldon is ruthlessly for-profit, but at least it is honest about it. Other than making money, it has no social conscience or moral compass. Journalists just cut into profits and thus need to go. Good looking entertainers are what's needed for these hurly burly days of capitalism.

Questions: Is it fair and/or rational to believe that under current circumstances, (1) capitalism is generally inimical to professional journalism, and (2) waves of media consolidation is part of an overall fascist conservative political goal to control political messaging in as many outlets as possible? What response, if any, would be good for the pubic interest, or should capitalism be allowed to run free and wild as most or all Republican elites and billionaires believe it should? Do podcasts or small blogs, such as, say, Dissident Politics, really provide meaningful diversity of viewpoint compared to major broadcast and print media sources? Is this another conservative attack on democracy by weakening news reporting, or is it just capitalism doing its free and wild thing and needs to be left alone?

The great social and political value of reaching stasis in political disagreements

Abraham Lincoln and Stephen Douglas

Most people who engage in politics anywhere have come to understand that minds in disagreement usually do not change. Citing facts, truths and laying out reasoning rarely convinces anyone to change their minds. Often, maybe usually, inconvenient facts, truths and reasoning are mostly or completely rejected as lies, deceit and self-serving and/or partisan nonsense. 

In my experience, ideologues on the left and right tend to apply motivated reasoning, not sound reasoning, to the facts and truths they accept as real. That tends to make much of the rhetoric of disagreement irrational. The end result is that political disagreements usually melt down into people getting angry and talking past each other without ever reaching true mutual understanding. The end result is, in my opinion, usually more damaging to democracy and society than helpful. Generally, little light is shed and little or no humanizing understanding comes out if it. Instead, dehumanizing misunderstanding is common and society continues to polarize and distrust.

A few years ago, Mike Austin wrote a short article for IVN about the political and social value of getting to stasis in political disagreements. Stasis is the point at which people in disagreement understand and can state why they disagree. This end result clarifies the facts, truths and reasoning that provides the basis for disagreement. Onlookers can then decide for themselves what, if anything, to believe about the disputed issue. Austin's article has stuck with me because it gets at major truths about political disagreements and the value of clarity in political arguments. Austin wrote:

When Abraham Lincoln and Stephen Douglas held their famous debates in their 1858 Senate contest, there was only one issue in the country that mattered. The debates were entirely about slavery.

But there were not just two positions that one could hold about slavery. Nearly all of the American politicians in the first half of the 20thcentury took a position somewhere in between William Lloyd Garrison (who felt that slavery was an indisputable moral evil that should be eradicated from the face of the earth) and John C. Calhoun (who wrote that slavery was a positive moral good for blacks and whites alike and should be required in every state).

Emancipation was not even on the table in 1858. The major question at issue was how to handle slavery in the new territories that were then coming into the union. Douglas had hitched his star to “popular sovereignty,” or the position that each territory should decide for itself whether or not to allow slavery. Lincoln argued that while the federal government should not interfere with slavery where it existed, it should not allow expansion into any new territories.

These two positions dominated the Lincoln-Douglas debates, which were conducted in a format that we have never seen since. One candidate gave a 30-minute introduction, followed by a 90-minute speech by the other candidate, and a 60-minute rebuttal by the first. They were three-hour debates, and they required a lot more than sound bites.

But for all of that, Lincoln and Douglas spent most of the first four debates talking past each other. They both ignored the nuances of the other’s position and spent their time beating up the kinds of straw-man arguments that result from trying to force an opponent to defend the most extreme characterization of the position that they hold.

In the fifth debate, however, Lincoln changed his approach—and the course of American history forever—when he simply clarified the real terms of the argument:

"I suppose that the real difference between Judge Douglas and his friends, and the Republicans on the contrary, is, that the Judge is not in favor of making any difference between slavery and liberty-that he is in favor of eradicating, of pressing out of view, the questions of preference in this country for free or slave institutions; and consequently every sentiment he utters discards the idea that there is any wrong in slavery. Every thing that emanates from him or his coadjutors in their course of policy, carefully excludes the thought that there is any thing wrong in slavery. All their arguments, if you will consider them, will be seen to exclude the thought that there is any thing whatever wrong in slavery."

This was a very simple shift in a debating tactic, but an enormous shift in emphasis. Douglas did not disagree. He couldn’t. Even the suggestion that he felt that slavery was morally problematic would have cost Douglas any chance at the Democratic presidential nomination in 1860.

However, from this point on, rather than arguing about possible policies, or the intentions of the Founding Fathers, or the various implications of the Supreme Court’s Dred Scott decision, or any of the other things that they spent most of the first four debates discussing, they spent much of their time in the last three debates talking about the most important moral question of the century: Is slavery wrong?

Lincoln lost the election, but he created a sense of moral and intellectual clarity that guided him, and the Republican Party, through the 1860 election and the Civil War.

And this is the power of clarifying what an argument is really about. Very few political arguments today reach what rhetoricians call the “point of stasis,” where the parties fully agree about where they disagree. When an argument has not reached a point of stasis, participants almost always push past each other and argue about glaring generalities, ridiculous extremes, and culturally prominent straw-men. When an argument reaches stasis, however, political arguments become capable of revealing positions, changing minds, and doing the hard work of democracy.

And this is why, in my opinion, the most important thing that Abraham Lincoln did in 1858 was to clarify the terms of the most important argument of the nineteenth century.

Trying to get to stasis is why I sometimes ask people for information and clarity in their reasoning. It's not to change minds. Instead, it is to get to understanding for myself and onlookers. Clarity of understanding tends to be humanizing. Misunderstanding tends to be dehumanizing, which tends to leads to polarization and distrust. Both are seriously damaging to democracy and social comity, maybe lethal.

Gun-Wielding St. Louis Attorney Joins Crowded GOP Field for Senate Seat

 REMEMBER THIS COUPLE?

Mark McCloskey became a conservative folk hero after confronting protesters in front of his mansion last summer with an AR-15.

ST. LOUIS (CN) — An attorney who waved an AR-15 rifle at civil rights protesters in front of his St. Louis home last year has announced his candidacy for U.S. Senate, telling Fox News on Tuesday night that “God came knocking on my door last summer disguised as an angry mob and it really did wake me up.”

Mark McCloskey joins an increasingly crowded Republican field vying to replace Republican U.S. Senator Roy Blunt, who announced he won’t seek reelection in 2022. Disgraced former Missouri Governor Eric Greitens and Attorney General Eric Schmitt have already announced their candidacies. Greitens stepped down as governor in June 2018 amid an affair scandal and criminal computer-tampering charges.

McCloskey, and his wife Patricia gained national notoriety last summer after waving guns at protesters in front of their St. Louis mansion. Mark, 63, and Patricia, 61, were each indicted for unlawful use of a weapon, a felony, and tampering with a weapon, a misdemeanor.

The McCloskeys claim the charges were politically motivated and successfully had St. Louis Circuit Attorney Kim Gardner dismissed from the case, though it is still pending with a special prosecutor. Missouri Governor Mike Parson, a Republican, has vowed to pardon the couple if they are convicted.

The incident made the couple folk heroes in conservative, pro-gun circles. They became outspoken supporters of former President Donald Trump and spoke at the Republican National Convention last summer.

In a brief video titled “Never Back Down” posted to his website, McCloskey uses Trump’s tough-talk rhetoric to appeal to the former president’s base. The video is set on a farm with McCloskey on a tractor, a stark contrast from his mansion in a private gated community in St. Louis.

“When the angry mob came to destroy my house and kill my family, I took a stand against them,” McCloskey said to begin the video, echoing claims he and his wife repeated to justify their actions last summer.

The Black Lives Matter protesters were on their way to then-Mayor Lyda Krewson’s house to demand her resignation when they were confronted by the McCloskeys.

The video shows still pictures of the McCloskeys during the confrontation with weapons drawn.

“Our nation is under attack,” McCloskey said. “Big tech, big business, the swamp in D.C., are all working together to destroy our God-given freedom, our culture and our heritage.”

McCloskey continues by saying the country needs defenders, but all politicians do is divide. He claims they teach us to hate each other over political, racial and economic differences.

The attorney then echoed Trump’s stance as a political outsider, stating he’s never run for office before. He quickly followed that by playing to the fears many in rural Missouri’s predominantly conservative voting base have.

“The mob is coming for all of us,” McCloskey said. “Cancel culture, the poison of critical race theory, the lie of systemic racism backed up by the threat of mob violence, attacks on the Second Amendment, erosion of election integrity are all intentionally designed to destroy all we hold near and dear.”

Blunt, 71, surprised the political world with his announcement earlier this month that he won’t run for another term next year. Before being elected senator in 2014 and again in 2018, Blunt served seven terms in the U.S. House of Representatives.

https://www.courthousenews.com/gun-wielding-st-louis-attorney-joins-crowded-gop-field-for-senate-seat/

The citizen's Grand Jury

Madison Smith and her mother, Mandy, in front of 

the McPherson County Courthouse - Mandy says she was was raped

An article the Washington Post published today describes a story of a woman, Madison Smith, who she alleges was raped. The local prosecutor declined to prosecute for rape and so Smith convened a grand jury on her own. Kansas law allows for that.

This discussion relates back to the recent post here about the history of mass incarceration and the vast power that prosecutors have to prosecute or decline to prosecute.

Unlike the cowards, corrupt sleazeballs and cockroaches that run the modern corrupt, immoral Republican Party, Ms. Smith appears to have real guts and an actual moral compass. The WaPo writes:

For three years, the local prosecutor has resolutely refused to make her case: that what began as consensual sex in a college dorm room became a rape, and that she was unable to say “stop” because her classmate was strangling her.

But Smith invoked a vestige of frontier justice that allows citizens in Kansas to summon a grand jury when they think prosecutors are neglecting to bring charges in a crime. The law, dating to the 1800s, was originally used to go after saloonkeepers when authorities ignored violations of statewide prohibition. The 22-year-old graduate is believed to be the first to convene a citizen grand jury after a prosecutor declined to pursue a sex-crime charge.

Only five other states, all in the Great Plains or the West, have similar laws still on the books. The Kansas statute requires an individual to gather a certain number of signatures of support, which forced Smith to relive her trauma over and over in conversations with strangers.

For three years, the local prosecutor has resolutely refused to make her case: that what began as consensual sex in a college dorm room became a rape, and that she was unable to say “stop” because her classmate was strangling her.

Statistics show that most sex crimes don’t result in charges. Victim advocates blame cultural issues, halfhearted investigations and the broad discretionary power of prosecutors. “This is a problem across the nation,” said Kathy Ray of the Kansas Coalition Against Sexual and Domestic Violence. “There are gaps throughout the system.”

Unlike Smith, most victims have no way to seek justice when they feel a blind eye is being turned toward a crime. Only five other states, all in the Great Plains or the West, have similar laws still on the books. The Kansas statute requires an individual to gather a certain number of signatures of support, which forced Smith to relive her trauma over and over in conversations with strangers.

“The one person who I believed was supposed to fight for the victim on the legal side has pushed me aside, stalling, and waiting for me to give up,” Smith wrote in one statement to the court. “This is a common tactic used by defense attorneys, but now the prosecution. I won’t ever give up. Ever.”

It happened at Bethany College, a small Christian liberal arts school in Lindsborg, an hour north of Wichita. She had bumped into a friend, Jared Stolzenburg, while doing laundry in a dorm. They went to his room, talked some, started kissing. They progressed to sex — by mutual consent, she acknowledges.

Almost immediately, Stolzenburg began slapping her face and strangling her while continuing intercourse, according to court records.

“I tried to initially pull his hands off of my throat, and he squeezed harder every time,” Smith recounted in one court hearing. “He would strangle me for 20 to 30 seconds at a time, and I would begin to lose consciousness. When he would release his hands from my neck, the only thing I could do was gasp for air.”

The day after the assault, the college freshman stood in the driveway of her parents’ house three blocks from campus. “I was raped last night,” she told them, tugging down the collar on her hoodie to reveal a necklace of purple bruises.

Her parents called police and drove her to a nearby hospital for a forensic exam. The report noted the bruising and abrasion on her neck, as well as bruising inside her mouth. 

“Me taking his hands off of my throat is affirmative enough,” Smith shot back. “I couldn’t speak. How can I say ‘no’ if I can’t speak, if I can’t breathe?”

A former Minnesota prosecutor reviewed Kansas law for the Smiths and concluded that the attack qualified for a rape charge.

“I would contend that it is clear that if while strangling someone, they are pulling on your hands and gasping for breath, and they are crying, none of that sounds consensual to me,” said Julie Germann, who specialized in sexual assault cases. “I would not have a hard time taking that case to a jury at all.”

In my opinion, this case shows how limited the reach of the rule of law often (usually?) is. Nothing humans can design will be flawless. Science makes the reasons clear. The human mind is not a rational thinking machine. It is a biased, rationally flawed reality-distorting machine that evolved to make inconvenient facts, truths and reasoning go away as much as possible, thereby reducing cognitive dissonance (psychological and social discomfort) as much as possible.

Questions: Is it time to try to at least partly counteract the grossly excessive power and discretion of prosecutors by allowing all Americans to convene their own Grand Juries when they are denied justice? Or, is the "presumed innocent" deck so heavily stacked in favor of criminals, racists, rapists, and biased prosecutors and police that it is pointless? 

How can Ms. Smith prove that she was crying and trying to remove Stolzenburg's hands from her throat because, after all, that is just a he said, she said situation, i.e., the law does not allow a conviction of the frisky (or vicious) Mr. Stolzenburg? Does anyone see the severe limits of the reach of the law here? Are we forever hobbled by the he said, she said stalemate that almost always leads the male to being acquitted? Compared to the converse, not many women rape men.

Why is so much fornicating going on in morally pristine Christian colleges? Are at least some Evangelical Christian students just garden variety immoral hypocrites, including Ms. Smith? Does it matter if people like me who are sympathetic to Smith raise these questions or (i) people who reflexively see Smith as a liar, or (ii) point to the impossibility of deciding in cases of he said, she said under current law?

On balance, are prosecutors enemies of the people?

The end of abortion rights is on the horizon

https://www.pewresearch.org/fact-tank/2021/05/06/about-six-in-ten-americans-say-abortion-should-be-legal-in-all-or-most-cases/

The Republican supreme court agreed to hear an abortion law case from Mississippi. The MS law prohibits abortion after 15 weeks of pregnancy, which is clearly unconstitutional under existing law and precedent of the last 48 years. In the past the supreme court declined to hear such cases and let stand appeals court decisions that struck down various laws from various states that were too burdensome on the right to abortion as outlined in Roe v Wade in 1973. That the court decided to hear this case indicates to me that it has found a set of facts it wants to use to overturn the Roe decision. 

The question the court will decide is whether there is a constitutional right to an abortion. The specific question the court will answer is this: “whether all pre-viability prohibitions on elective abortions are unconstitutional.” In other words, is any elective abortion constitutional? If the answer is no, then that's the end of all abortions based on a woman's choice to abort. 

It is reasonable to believe that the answer will be no, with about a 90% chance of that by my personal assessment. If the court does not overturn Roe, then taking up the case makes no sense because there is no disagreement among appeals courts about abortion law. To me, this is a clear signal that Roe is going to be overturned.

If it is no, the next question is how far will the court will go? It could leave abortions up to individual states, more or less restoring the old pre-Roe status quo. Or, maybe it would go further and declare that all abortions of choice are unconstitutional in all states. If it choses the latter option, then nearly all abortions in the US will be illegal. I do not have a feel for how likely the nationwide ban option is. Maybe it is unlikely, but probably not impossible given how radical the Republicans on the court are and how much they hate abortion. 

Given how the question is worded, if the answer is that no elective abortion is constitutional, then only reliance on state's rights would prevent the ruling from being nationwide. Maybe a nationwide abortion ban is the most likely outcome.

Republicans judges were put on the court specifically to overturn Roe. There has been a litmus test for Republican judges decades and it was Roe and abortion rights. Now the time of Roe is coming to an end.

America after Roe

Given the deep animosity of some or most republicans (and nearly all republican politicians and judges) to abortion, one can reasonably believe that laws will pass in republican states making essentially all abortions illegal in their states. They will probably also make it a criminal offense, e.g., murder or manslaughter, for a pregnant woman to leave or try to leave the state to get an abortion outside the state. If the supreme court says that abortions of choice are unconstitutional in all states, then pregnant women will have to travel outside the US to get an abortion and risk whatever punishments their states impose to try to stop them.

As usual, rich and most middle class women will usually be able to get abortions and poor women will usually be forced to have babies they do not want. Some women will try to get illegal abortions and some of them will die because of it. The lives of some women will be ruined. 

What the Republican court is probably going to do to Roe is not what most Americans support. That's no surprise. The fascist GOP usually rules without regard for public opinion. This case is no exception. That most Americans want to see Roe stay valid is of no concern. To head off a grumpy public response, the GOP might decide to crank up its massive anti-abortion propaganda, lies and slander machine to soften the blow. How successful that potential propaganda push might be is an open question.

If the court follows precedent for controversial decisions, the decision will be released at the end of June in 2021 or maybe 2022. That is when the court term ends, allowing justices who don't want to face big protests a chance to get the hell out of town and hope the backlash dies down before the next term starts in October of 2021 (or 2022).

On the positive side, it is reasonable to think that the number of unwanted pregnancies will noticeably decrease. Presumably most women will be very careful about birth control or abstinence from sex. Of course, that assumes that women are educated about sex and birth control methods. If they aren't they could be in for some nasty, life-changing surprises.

Question: Can one reasonably see this as another aggressive theocratic intrusion of Christianity into government, the law and society generally?