Etiquette



DP Etiquette

First rule: Don't be a jackass.

Other rules: Do not attack or insult people you disagree with. Engage with facts, logic and beliefs. Out of respect for others, please provide some sources for the facts and truths you rely on if you are asked for that. If emotion is getting out of hand, get it back in hand. To limit dehumanizing people, don't call people or whole groups of people disrespectful names, e.g., stupid, dumb or liar. Insulting people is counterproductive to rational discussion. Insult makes people angry and defensive. All points of view are welcome, right, center, left and elsewhere. Just disagree, but don't be belligerent or reject inconvenient facts, truths or defensible reasoning.

Saturday, October 15, 2022

News bits

Federal judge forced to make a crackpot ruling
by a crackpot Supreme Court ruling
As radicalism and crackpot reasoning engulf the federal courts, one can watch the rot set in and deepen over time. Watching democracy and the rule of law rot away is sort of like a spectator sport if one adopts the right mindset. Salon writes:
For decades, federal law has forbidden gun owners from scratching out the serial numbers that manufacturers are legally required to place on firearms. The reason is obvious: These serial numbers help state and federal law enforcement trace guns that are used in crimes and identify suspected shooters. Indeed, the only apparent reason anyone would remove a serial number is to avoid becoming a suspect after their gun is used illegally. On Wednesday, however, a federal judge ruled that the law prohibiting alteration of serial numbers violates the Second Amendment. Why? Because serial numbers were virtually nonexistent when the amendment was ratified in 1791, so the government has no power to mandate them today.

This decision in United States v. Price by U.S. District Judge Joseph R. Goodwin, a Bill Clinton appointee, may sound shocking. But it is a perfectly plausible application of the Supreme Court’s June ruling in New York State Rifle & Pistol Association v. Bruen. In that case, Justice Clarence Thomas declared all gun restrictions presumptively unconstitutional if they infringe on “the individual right to armed self-defense.” (The Constitution says nothing about “self-defense,” but Thomas gleaned this right from its penumbra.) A gun restriction may only survive legal scrutiny, the justice declared, if it had an “analogue” in 1791, when the Second Amendment was ratified, or 1868, when it was imposed on the states. The burden falls on the government to prove the existence of a historical analogue.  
Thomas’ test has already wreaked havoc in the lower courts. One judge has struck down a Texas law that prohibits 18 to 20-year-olds from carrying a handgun outside the home. People under 21 are significantly more likely to commit gun homicides—but in Bruen, Thomas announced that courts may never consider the real-world, life-saving impact of gun safety laws when gauging their constitutionality. A different Texas judge invalidated a federal law barring individuals from purchasing a handgun while they’re under indictment, even for a violent felony offense. Just last week, another judge struck down New York’s ban on concealed carry in airports, train stations, domestic violence shelters, summer camps, the subway, and other “sensitive locations.” Now Goodwin, who sits in West Virginia, has joined the chorus of lower court judges who feel that Bruen obliges them to strike down longstanding, widely accepted firearm laws.  
Goodwin acknowledged the “argument” that “firearms with an obliterated serial number are likely to be used in violent crime and therefore a prohibition on their possession is desirable.” But he explained that this argument “is the exact type of means-end reasoning the Supreme Court has forbidden me from considering.” Even if the serial number law demonstrably saved tens of thousands of lives each year, that fact would be totally irrelevant to the constitutional analysis.
A single crackpot radical right Supreme Court ruling based on rigid ideological “reasoning” made-up in the fly has forced the entire federal judiciary into crackpottery and rot. Make no mistake fellow spectators, this is just the beginning of the rot, not the end.

A spectator watching the rot set in


Bill Mahr gets in a snit about The Herschel
Political commentator Bill Maher slammed Georgia GOP Senate candidate Herschel Walker as “unfit for office” and called him a “f—ing idiot.”

On his HBO show “Real Time” on Friday, Maher pointed to numerous statements Walker has made and reports about him that have come out that he said show why Walker should not be elected to the Senate.

“He’s just a f—ing idiot on a scale on a scale almost impossible to parody,” Maher said.

He said Walker has admitted to threatening violence against multiple people around him, including his ex-wife. He said Walker has lied about his past on numerous occasions, including by falsely claiming to have been a police officer and an FBI agent.
What set Bill of seems to lie in the difficulty of parody a creature as bizarre as The Herschel. Poor Bill. He’ll get over it. Send him thoughts and prayers.

Bill’s frustration


In other The Herschel news 
In a different article, the Hill writes:
The Memo: Walker gives GOP hope with Georgia debate performance
Republican Herschel Walker won a moral victory by avoiding disaster at his sole televised debate with Sen. Raphael Warnock (D-Ga.) Friday.

In the process, the former football star will have given his party hope that he can overcome a checkered campaign to prevail in the race, which could plausibly determine control of the Senate.
There you have it. The Herschel wins by not being a disaster in a debate he clearly lost. 

Poor Bill
Send thoughts and prayers


About those exorbitant drug prices
A new study finds no correlation between R&D spending and outlandish drug prices.

Americans, though, probably weren’t shocked. Prescription drugs in the US cost about 2.5 times what they do in other countries, and a quarter of Americans find it difficult to afford them. Almost every new cancer drug starts at over $100,000 a year. And a 2022 study found that every year, the average price of newly released drugs is 20 percent higher.

How drug prices are set in the US is a mysterious black box. When rationalizing their lofty price tags, one of the most common reasons pharmaceutical companies will cite is that a high price is needed to make good on the money invested in research and development.

But is that true? “You hear it so much,” says Olivier Wouters, an assistant professor of health policy at the London School of Economics and Political Science. “That’s why I was like, well, let’s get some data, because I don’t believe it. I don’t think anyone believes it.”

To anybody in the field, the response to the paper’s finding is: Well, duh. We know what drives drug pricing, says Ezekiel Emanuel, chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania. “It’s, ‘How far can I go? What will the market bear?’” Still, Emanuel says, it’s important to have empirical data like this study to refute the industry’s claim.

Every so often, there are small glimpses behind the curtains into how pharmaceutical companies actually decide on a drug price. An example of this is the hepatitis C drug Sovaldi, which was put on the market in 2013 for a steep $84,000 per 12-week course. In 2015, an 18-month-long US government investigation that reviewed some 20,000 pages of internal company documents revealed that Gilead, the company that owned the drug, had set the high price as a way “to ensure its drugs had the greatest share of the market, for the highest price, for the longest period of time”—in essence, that it was prioritizing profit. In response Gilead said it “stand[s] behind the pricing of our therapies because of the benefit they bring to patients and the significant value they represent to payers, providers, and our entire healthcare system by reducing the long-term costs associated with managing chronic [hepatitis C virus].”

Thursday, October 13, 2022

The 1/6 Committee today: The evidence is clear that Trump is a traitor

Once again, the evidence the 1/6 Committee is presenting or repeating so far makes it clear and undeniable that the ex-president never had any intention of accepting a loss in the 2020 election. He was planning to subvert his loss before the election. After the election, he knew he had lost but kept lying about it to the public. An open question is whether anything will come of this in court.

Any Republican politician who continues to support Trump is complicit in treason, a liar and unfit for any elected office. 

The Republican Party is a deadly enemy of democracy, truth, the people and the state.


Q: Are rank and file Republicans who still support Trump complicit in treason and lies? 

News bits: Attacks on democracy, wildlife in decline

The radical right empire that Leonard Leo quietly built
Behind the scenes, though, these groups have something in common: They are part of an ambitious coalition developed in recent years by the conservative activist Leonard A. Leo, who until now has been best known for his role in pushing the appointments of conservative judges to the center of the Republican Party’s agenda.

Most of the initiatives were financially supported, or in some cases launched, by an opaque, sprawling network shaped by Mr. Leo and funded by wealthy patrons, usually through anonymous donations that critics call “dark money.”

An investigation by The New York Times of Mr. Leo’s activities reveals new details of how he has built that network, with relatively little public attention, into one of the best-funded and most sophisticated operations in American politics, giving him extraordinary influence as he pushes a broad array of hot-button conservative causes and seeks to counter what he sees as an increasing leftward tilt in society.

The network represents a dramatic expansion of tactics and focus for Mr. Leo, who spent nearly three decades working mostly behind the scenes to pull the judiciary to the right as an executive at the Federalist Society. His success in that effort, and expansion into other polarizing fights, is rapidly making him a leading target of criticism from the left.

His philosophy is defined by a belief that the federal government should play a smaller role in public life and religious values a larger one, and that institutions and individuals should be challenged for embracing what he sees as subversive liberal positions.

His expanded effort focuses on a variety of causes, including restricting abortion rights in the states; ending affirmative action; defending religious groups accused of discriminating against L.G.B.T.Q. people; opposing what he sees as liberal policies being espoused by corporations and schools; electing Republicans; and fighting Democratic efforts to slow climate change, increase the transparency of money in politics and expand voting access.
This is more evidence of (i) the increasingly radical Christian theocratic nature of the Republican Party, (ii) Christian nationalist desire to discriminate against those it deems unworthy, e.g., the LGBTQ community, and (iii) its staunch resistance to doing anything about climate change. That is radicalism. 

The NYT’s assertion that Leo wants to expand voting access is puzzling. The article linked to discusses Republican efforts to restrict voting access, not to expand it. That may be a typo. 

Note that Leo wants to gain power to oppose and reverse what he sees as liberal tendencies in society and business, e.g., concern for climate change, defense of civil liberties for the LGBTQ community, etc. Those changes are what is happening naturally in American society and commerce. That is evidence that Leo is an autocrat or authoritarian, not a democrat.


Declines in wildlife
Declines in wildlife by humans and the climate change are increasing. The NYT writes:
Researchers Report a Staggering Decline in Wildlife. 
Here’s How to Understand It.

It’s clear that wildlife is suffering mightily on our planet, but scientists don’t know exactly how much. A comprehensive figure is exceedingly hard to determine. Counting wild animals — on land and at sea, from gnats to whales — is no small feat. Most countries lack national monitoring systems.

One of the most ambitious efforts to fill this void is published every two years. Known as the Living Planet Index, it’s a collaboration between two major conservation organizations, the World Wide Fund for Nature and the Zoological Society of London.

The assessment’s latest number, issued Wednesday by 89 authors from around the world, is its most alarming yet: From 1970 to 2018, monitored populations of vertebrates declined an average of 69 percent. That’s more than two-thirds in only 48 years.

.... start with three populations: birds, bears and sharks. The birds decline to 5 from 25, a drop of 80 percent. The bears fall to 45 animals from 50, or 10 percent. And the sharks decrease to 8 from 20, or 60 percent.

That gives us an average decline of 50 percent. But the total number of animals fell to 92 from 150, a drop of about 39 percent.

The index is designed that way because it seeks to understand how populations are changing over time. It doesn’t measure how many individuals are present.

So, is it still bad?

Yes. Some scientists think the report actually underestimates the global biodiversity crisis, in part because devastating declines in amphibians may be underrepresented in the data.

And, over time, the trend is not turning around.

“Year after year we are not able to start improving the situation, despite major policies,” said Henrique M. Pereira, a professor of conservation biology at the German Center for Integrative Biodiversity Research who was not involved in this year’s report.

Wednesday, October 12, 2022

Canceling the cancelers: Toxic polarization outs itself in the federal courts

Can you cancel “cancel culture” by canceling the cancelers? Some Republican judges are answering with an emphatic “Yes!” — which shows that their commitment to free and open debate isn’t quite what they would have you believe.

This very public attack on Yale Law School isn’t just about hypocrisy over free expression, or even just about the politicization of the judiciary. It also shows that in a way, this isn’t an argument the right actually wants to win. The controversy itself is the point.

The story starts a couple of weeks ago, when Judge James C. Ho of the U.S. Court of Appeals for the 5th Circuit announced in a speech that he would no longer accept clerks from Yale Law School, which he described as a place where censorious liberals suppress conservative voices with a particular cruelty. “Yale not only tolerates the cancellation of views — it actively practices it,” he said, and Ho encouraged other judges to follow his lead.

Although some conservatives objected, on the whole the right celebrated. The Federalist trumpeted Ho’s speech, calling Yale a “cancel culture cesspool.” Sen. Ted Cruz (R-Tex.) tweeted that “Judge Ho’s takedown of cancel culture" was “a courageous and important stand that I hope other judges will replicate!”

And some have. Another appeals court judge, Elizabeth Branch of the 11th Circuit, said she too would refuse to hire clerks from Yale (like Ho, she is restricting her boycott to future students, not those currently enrolled). The conservative Washington Free Beacon reported that a dozen other judges were taking up Ho’s call, though they wanted to remain anonymous.

As a practical matter, this boycott makes almost no sense. Let’s grant for a moment that Yale has a stifling culture of silencing conservatives. That means the students Ho is shutting out of positions in his chambers would be the victims of this culture, not its perpetrators.

However firm their ideological commitments, we used to expect judges to let their decisions speak for themselves, with perhaps the occasional speech or interview thrown in. Now judges perform stunts designed to attract media attention — and that’s exactly what this is. At this point it wouldn’t be surprising to see Ho or others like him interrupt oral arguments in court to say, “Hang on, I was just totally owning the libs on Truth Social. Proceed, counsel.”

And it’s clear that, like many conservatives, Ho is moved to take action against the silencing of free expression only when it’s the expression of people he agrees with that is supposedly being silenced. And that lets liberals off the hook.

Who does Yale law school cancel? One was Ilya Shapiro. He is an influential radical right Federalist Society[1] legal theorist. He left Georgetown (but was not fired or disciplined) after an investigation of his Tweets about Biden's pick for the Supreme Court: “But alas doesn’t fit into the latest intersectionality hierarchy so we’ll get lesser black woman. Thank heaven for small favors?” Yale law students shouted him down at a Federalist Society speaking engagement at Yale. Shapiro could only get out a few words before the audience shouted him off the stage. 

What if the speakers at private engagements want to polarize and divide the audience by advocating lies, slanders and other forms of dark free speech? 

Does the cancellation of speakers in a private institution like Yale justify cancellation by federal judges of lawyers from a targeted law school? Courts are public places and speech generally cannot be censored. Speech can be censored in private places but not public places. 

Does choice of clerks for judges constitute speech, or is that just a hiring decision? Does one wrong justify another wrong? 


Footnote: The Federalist Society screens and picks ideologically loyal conservative and Christian nationalist, anti-government, anti-regulation federal judges for Republican presidents to nominate. That makes it influential and powerful. Wikipedia says this about the Federalist Society:
The Federalist Society for Law and Public Policy Studies is an American conservative and libertarian legal organization that advocates for a textualist and originalist interpretation of the U.S. Constitution. Headquartered in Washington, D.C., it has chapters at more than 200 American law schools and features student, lawyer, and faculty divisions. The lawyers division comprises more than 70,000 practicing attorneys (organized as lawyers chapters and practice groups within the division) in ninety cities. Through speaking events, lectures, and other activities, it provides a forum for legal experts of opposing views to interact with members of the legal profession, the judiciary, and the legal academy. It is one of the most influential legal organizations in the United States.

An opinion on Trump’s legal fate: But is it already too late?

THE INEVITABLE INDICTMENT OF DONALD TRUMP

Merrick Garland hasn’t tipped his hand, but it's clear to me that he will bring charges against the former president. 

As an appellate judge, Merrick Garland was known for constructing narrow decisions that achieved consensus without creating extraneous controversy. As a government attorney, he was known for his zealous adherence to the letter of the law. As a person, he is a smaller-than-life figure, a dry conversationalist, studious listener, something close to the opposite of a raconteur. 

And as the nation’s chief law-enforcement officer, he is a hyper-prudential institutionalist who would like nothing more than to restore—quietly and deliberately—the Justice Department’s reputation for probity, process, and apolitical dispassion.

But this is what I believe he is preparing himself to do.

I have been observing Garland closely for months. I’ve talked with his closest friends and most loyal former clerks and deputies. I’ve carefully studied his record. I’ve interviewed Garland himself. And I’ve reached the conclusion that his devotion to procedure, his belief in the rule of law, and in particular his reverence for the duties, responsibilities, and traditions of the U.S. Department of Justice will cause him to make the most monumental decision an attorney general can make. 

But I believe, if the evidence of wrongdoing is as convincing as it seems, he is going to indict Trump anyway.  
In the case of Donald Trump, the prosecutor is Merrick Garland and discretion would allow him to decide that an indictment is simply not worth the social cost, or that the case is strong but not strong enough. Garland’s critics fret that when confronted with this moment, his penchant for caution will take hold.  
With the investigation of Trump, the legitimacy of the judicial system is at risk. Of course, the MAGA set will never regard an indictment of their leader as anything other than a sham. But the perceptions of the rest of the country matter too. .... Indicting the candidate of the opposing party, if it occurs, should feel reluctant, as if there’s no other choice.  
I was surprised he would resist the term [institutionalist]. I think he wanted me to understand that he is alive to the perils facing democracy—and isn’t naïve about what it will take to defeat them. Norms alone are not enough to stop a determined authoritarian. It wasn’t quite a reversal in his thinking; radicalizing Merrick Garland would be impossible. But it was an evolution. His faith in institutions had begun to wobble.  
With his optimism bruised, and his heightened sensitivity to the imminent threats to democracy, he’s shown a greater appetite for confrontation. There is no sharper example of this than his willingness to spar with Trump over the sensitive documents stashed at Mar-a-Lago.  
The deadline for indicting Trump is actually much sooner than the next Inauguration Day. According to most prosecutors, a judge would give Trump nearly a year to prepare for trial, maybe a bit longer. That’s not special treatment; it’s just how courts schedule big cases. 
The excruciating conundrum that Garland faces is also a liberating one. He can’t win politically. He will either antagonize the right or disappoint the left. Whatever he decides, he will become deeply unpopular. He will unavoidably damage the reputation of the institution he loves so dearly with a significant portion of the populace.

Faced with so unpalatable a choice, he doesn’t really have one. Because he can’t avoid tearing America further apart, he’ll decide based on the evidence—and on whether that evidence can persuade a jury. As someone who has an almost metaphysical belief in the rule book, he can allow himself to apply his canonical texts.

That’s what he’s tried to emphatically explain over the past months. Every time he’s asked about the former president, he responds, “No one is above the law.” He clearly gets frustrated that his answer fails to satisfy his doubters. I believe that his indictment of Trump will prove that he means it.

Foer’s reasoning makes sense, but is it right? No matter what choice Garland makes, one side will dislike or hate his decision. Foer understands the propaganda bonanza that Trump and the radical right propaganda Leviathan would create and unleash on the American people if there is an indictment. That is something Garland abhors. Foer foresees that a trial of Trump (i) would turn into a “carnival of grievance” and “a venue for broadcasting conspiracy theories about his enemies,” and (ii) be a “flash point for an era of political violence” with protesters and counter protesters outside the court, possibly leading to street violence. Social damage will be enormous. In my opinion, Foer is correct on all counts. 

But will Garland indict Trump? Personally, it does not feel that way based on Garland’s record to date. But if Foer is right about what drives Garland, he should be be and probably is right. 

If Foer is right, will it be too little too late to indict, try and convict Trump? It feels that way to me, but I could be wrong. The poison and horrifying autocratic-theocratic extremism that Trump unleashed on American society and the Republican Party is an uncorked genie. It is toothpaste out of the tube. But that assessment could also be wrong. And, if Trump is exonerated, he would be politically invincible. Democracy, the rule of law and secularist pluralism would fall to some form of cruel autocratic, plutocratic, brass knuckles capitalism and Christian theocratic kleptocracy.


Time is running out, or already has
As Foer points out, time for Garland to decide is running out. In my opinion, it may already be too late. If Garland indicts this month and the court gives Trump about one year to prepare, the trial would start in Oct. or Nov. 2023. Trump, as usual, would do everything in his power to delay and derail the court case, all the while whipping up his loyal base with faux grievances, lies and slanders. If a Republican is elected president in Nov. 2024, the lawsuit would almost certainly be dropped soon after the new president would be sworn in on Jan. 20, 2025. That would forever be the end of justice and the rule of law for Trump. He would forever be untouchable. And, democracy and the rule of law would continue their fall.

If that analysis is right, maybe Garland’s best choice is to not indict Trump and pray that democracy, inconvenient truth, secular pluralism, the rule of law and civil liberties can at least partly survive and remain more or less relevant. Either way, the rule of law and the DoJ and the rule of law will take another major hit in public trust.

At least for democracy and the rule of  law, the situation probably is a lose-lose. The American public is polarized and distrustful because poisonous dark free speech has deceived and captured tens of millions of minds.

Tuesday, October 11, 2022

News bits: Fibbing, COVID and drug prices

The ex-president aggressively fibbed --
no consequences are on the horizon 
CNN writes:
Newly released emails debunk Trump and allies’ attempts to blame the GSA for packing boxes that ended up in Mar-a-Lago. .... The email exchange between GSA officials and [Trump aide] Harrison is one of more than 100 pages of emails and documents newly released by the GSA that debunk claims from Trump and his allies that the government agency is to blame for packing the boxes containing classified documents that were later recovered by the FBI during the search of his Mar-a-Lago resort in August.

A spokesman for Trump did not directly address how these emails dispute claims made by the former president and allies, and instead attacked the Biden administration.

“A routine and necessary process has been leveraged by power-hungry partisan bureaucrats to intimidate and silence those who have dared to support President Trump and his America First agenda,” said Trump spokesman Taylor Budowich. “Why? Because Democrats have done nothing to deliver for the American people and they are left scrambling to fabricate a new witch-hunt to distract from their abject failures.”
That raises a thing or two. One, if Trump runs for president again in 2023 and 2024, he will be the Republican nominee. Most rank and file Republicans will vote for him despite his lies, crimes, treason and all the crap he has pulled. Most Republican elites will support their nominee. What does that tell you about most (~97% ?) of the GOP, e.g. pro- or anti-democracy, pro-or anti-truth, pro- or anti-rule of law, etc.?

Another thing, does anyone notice how Trump defends himself with blatantly obvious deflections, but that makes no difference to most Republicans? Most would still vote for and defend him if he runs for office again. Most who would not support Trump have been RFINO hunted out of the Republican Party.


COVID is partisan
New research from the National Bureau of Economic Research indicates that COVID deaths are higher among Republicans. The data was based on mortality data from 2018 to 2021 in Florida and Ohio. NBER writes:
Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat-leaning counties and evidence of a link between political party affiliation and vaccination views. .... We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states. Overall, the excess death rate for Republicans was 5.4 percentage points (pp), or 76%, higher than the excess death rate for Democrats. Post- vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 pp (22% of the Democrat excess death rate) to 10.4 pp (153% of the Democrat excess death rate). The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available.
That is more evidence that COVID vaccines work. It is also evidence that cult loyalty is killing Republican partisans more than necessary. 


Republicans want to repeal drug price controls
The Democratic bill that empowered Medicare to negotiate drug prices is being attacked by some Republicans. They claim it will slow drug development and/or reduce availability of existing drugs. Both claims are lies, including lies of omission. Florida Politics writes:
In anticipation of Midterm Election results, U.S. Sen. Marco Rubio has filed for a do-over of the legislation widely expected to reduce out-of-pocket drug costs for patients and lower Medicare costs.

Rubio has joined with fellow Republican U.S. Sens. James Lankford, Mike Lee and Cynthia Lummis in introducing the Protecting Drug Innovation Act that would roll back the feds’ authority to negotiate, set and control drug prices under Medicare.

“Democrats’ price controls will hurt Floridians,” said Rubio’s statement that his office released Friday. “There will be less innovation, which means life-saving cancer drugs may not be developed. There will be less production, which means life-sustaining insulin may be harder to find.”

With Rubio’s name on new legislation that would mean taking off the cap that limited seniors’ out-of-pocket drug costs to $2,000 a year, his challenger seized on the opportunity. Democratic U.S. Rep. Val Demings, running to unseat Rubio, released a statement Friday on the bill.
The Republican argument here is that lower drug prices will stop or slow development of new drugs. That may be true to some extent, but so what? First, most new drugs these days are me-too variants of drugs already on the market. When one looks at cost-benefit for new drugs, it is usually crappy. 

Second, if the private sector does not want to innovate without outrageously high profit margins, then let new drugs come from academic research. That would slow things down, but that's what we would have to live with. So far, one can strongly argue that the private sector is a failure in health care because the profit motive corrupts the whole health care sector, from drug companies, to insurance companies to actual health care providers. Everyone is chasing dollars first and foremost. Patients and the cost burdens on patients and/or taxpayers are not very important. We get poor value for our money

Another point: The price and availability of insulin has little to do with negotiated drug prices. There would still be profit in negotiated insulin prices, just not outrageous profit. Insulin, like lots of old but still effective drugs, has been on the market for decades. The insulin molecule as a drug is not going to change. There is nothing left to innovate. Despite no innovation, for-profit drug drug companies jacked up the price of insulin far more than inflation would dictate. That was greed pure and simple. Negotiated pricing would keep callous capitalist greed in check, but not affect the drug in any other way. 

So, if profits from negotiated drug are not enough for the private sector, then the government should step in a do the job the private sector is too greedy to do.

As usual, pro-business, anti-consumer Republican elites are lying about why they do what they do. In return, a grateful drug industry will dump cash into the politician’s accounts in return for their services in defense of the indefensible.