Nation editor-at-large and host of MSNBC’s All In with Chris Hayes.
Sebastian Jones catches some under-the-radar shenanigans from two house Democrats and a Republican on behalf of Big Pharma:
At a North Carolina town hall yesterday, the President went out of his way to mention a brewing legislative battle on Capitol Hill: the fight over how long to grant drug manufacturers monopolies on a new class of drugs called biologics and when to allow cheaper, generic alternatives.
The current proposed legislation--HR 1427 introduced by Representatives Waxman (D-CA) and Deal (R-GA)-- would grant biologics the same 5-year period of exclusivity traditional pharmaceuticals receive now and would limit a manufacturer's ability to get an extension of that monopoly, requiring, for example, a "significant therapeutic advance."
However, Representatives Eshoo (D-CA), Inslee (D-WA) and Barton (R-TX) are planning to introduce an amendment which tows the brand-name industry line that a 12-year monopoly is needed and waters down the criteria for a given biologic's period of exclusivity to be extended. The practice of getting extensions for small tweaks to the original product--things like shifting the delivery method from a pill to an injection or changing the dosage from twice a day to once a day--has been labeled "evergreening" by consumer groups. This month, the European Union's antitrust regulator said she would begin to monitor the practice closely.
In a copy of the amendment obtained by The Nation, the conditions under which a drug's exclusivity may be renewed are numerous and strikingly vague:
"A change…that results in a new indication, route of administration, dosing schedule, dosage form, delivery system, delivery device or strength; or a modification to the structure of the biological product that does not result in a change in safety, purity, or potency."
This essentially grants big drug manufacturers the ability to wait until the 11th hour to make slight adjustments and receive a substantial extension.
These prolonged monopolies, preventing the production of generics and keeping drug prices high in a healthcare system fraught with increasing costs, might explain why the President has expressed concern about the issue.
Full text of the Eshoo, Inslee and Barton Amendment is below. Also, for more information on the biologics issue, check out this recent editorial from the Post.
Today's the 44th anniversary of Medicare, the single payer health insurance program that provides care for millions of senior citizens. It is the nightmare come true! Forty-three million of our citizens groaning under the yoke of socialism! I kid of course. The program, while not without its flaws, has displayed significantly less cost inflation than private insurance, has lower administrative costs and very high satisfaction among its participants. It's so politically popular that when red-state elected representatives go to town halls they hear things like: "keep your government hands off my Medicare" (!) from angry constituents. Yes.
This has got me thinking: Republicans opposed Medicare when it was created. They hate socialized medicine, government-run health care and the public option now. So why don't they put their money with their mouths are and propose scrapping Medicare? Any bills like this been introduced? If not, why not? I seriously think every single conservative and Republican caught railing against government run healthcare needs to be asked if they support disbanding Medicare.
The following comes from a reader and frequent correspondent. This is not someone with particularly progressive politics. In fact, he only very recently has come to identify as a Democrat. No radical lefty, he.
I don't get the democrats on this one. Even if Charles Grassley and Olympia Snowe vote for this deal, the Republicans will still run against it as the Obama/Pelosi plan. Why not stick to your guns, treat the problem from a parliamentary perspective, and put through a plan that you actually think is optimal. The current attempt won't protect their downside at all and may limit the upside. Very frustrating.
More than frustrating. Enraging.
The House leaves town at the end of the week, the Senate one week later, and hopes for a health care bill before they vacate are all but nil. (Tell Congress to stick around and get the job done here.) They won't return until the second week of September, and meanwhile 14,000 people a day are losing their healthcare.
This week, Chairman Waxman continues negotiating with the conservative Blue Dog (pseudo)Democrats to try to get the House health care bill through his Energy and Commerce Committee. Even if the House could bring a bill to the floor for a vote, it probably won't until it knows where the Senate is headed. House Dems don't want to take a tough stand only to be left hung out to dry by Senate Dems as they strip the bill of a public option and a surcharge on the wealthy.
Over in the Senate, God only knows what Max Baucus is up to as he continues to try to woo brofriend Chuck Grassley. He's now working with just six members of the Finance Committee -- three Democrats (including him) and three Republicans. Majority Leader Harry "I'm no LBJ" Reid hopes to have the Baucus health care bill by the August recess so they can spend that month merging it with the decent Health, Education, Labor and Pensions Committee version.
Since the Senate won't have a health care bill to vote on, it will take up the FY10 $34.2 billion Energy and Water Appropriations bill which -- according to CongressDaily -- includes $27.4 billion for the Energy Department, $5.4 billion for Army Corps of Engineers, and $1.1 billion for the Interior Department.
The House will consider the $636.3 billion FY10 Defense Appropriations bill. The Senate voted last week to discontinue the F-22 fighter jet (after the current 187 already authorized) and the House is expected to follow suit. It's a small victory, but a very necessary one. If we couldn't get this cut then we can't get anything. Now other cuts remain possible.
The House will also need to address the Highway Trust Fund which will run out of money during the recess if no action is taken.
The House Financial Services Committee takes its first stab at the financial regulatory overhaul, with a markup tomorrow of the Corporate and Financial Institution Compensation Fairness Act of 2009 "to provide shareholders with an advisory vote on executive compensation and to prevent perverse incentives in the compensation practices of financial institutions."
The Senate Judiciary Committee will vote on the nomination of Judge Sonia Sotomayor on Tuesday. The only Republican who has announced his intention to vote for her is South Carolina Senator Lindsey Graham.
Other notable hearings: Senate Foreign Relations examines the Internally Displaced Persons Crisis in Pakistan on Wednesday, and a Comprehensive Strategy For Sudan on Thursday. (House Foreign Affairs also looks at Sudan and a Comprehensive Peace Agreement on Wednesday)…. Chairman John Tierney's National Security and Foreign Affairs Subcommittee holds a hearing tomorrow on The Plan for Withdrawal of US Assets from Iraq…. On Wednesday, House Armed Services examines "Psychological Stress in the Military: What Steps are Leaders Taking?"…. Keith Ernst, director of research at the Center for Responsible Lending, will testify tomorrow at a Joint Economic Committee hearing on preventing foreclosures…. On Thursday, House Judiciary looks at Reforming the Military Commissions System.
Finally, for US soccer fans -- all 17 of us (and I count myself as one) -- President Obama meets with FIFA President Sepp Blatter today, and CongressDaily reports that he will lobby for the US to host the World Cup in 2018 or 2022. Here's hoping for some Obama magic.
From crack DC intern Sebastian Jones:
During last night's primetime press conference, Christi Parsons of the Chicago Tribune asked President Obama a pointed question about the transparency his administration had often promised during the campaign and seemingly failed to deliver once in power. The President's response, short and direct, was also relatively misleading. Examining the record, we fact-check his remarks.
1) Meeting Health Care Executives
Obama: "Well, on the list of health care executives who've visited us, most of the time you guys have been in there taking pictures, so it hasn't been a secret. And my understanding is we just sent a letter out providing a full list of all executives. But frankly these have mostly been at least photo sprays where you could see who was participating…"
Fact-Check: Until yesterday, that the Obama administration was having meetings with health care executives and lobbyists at the White House as early as February 4th was not public knowledge. When Citizens for Responsibility and Ethics in Washington (CREW) filed a freedom of information request last month for records pertaining to visits by 18 industry executives and lobbyists, their request was denied. An earlier FOI request in May for information on Coal industry executives and their White House visits was similarly denied, both using the same legal arguments that the Bush administration employed to keep Dick Cheney's energy task force meetings out of the public eye. CREW has filed suit in both cases.
Also worth noting is that yesterday's letter released by the White House did not affirm (or satisfy) the FOI request from CREW, but rather was an "exercise of [presidential] discretion"--basically the White House saying that while they believe the public is not necessarily entitled to this information, they'll provide it anyway.
2) Putting Health Care Negotiations on C-SPAN
Obama: "With respect to all the negotiations not being on C-SPAN, you will recall in this very room that our kickoff event was here on C-SPAN, and at a certain point you start getting into all kinds of different meetings--Senate Finance is having a meeting, the House is having a meeting. If they wanted those to be on C-SPAN then I would welcome it. I don't think there are a lot of secrets going on in there."
Fact-Check: Regarding C-SPAN, Obama told a crowd at an August 11, 2008 town hall, "What we'll do is, we'll have the negotiations televised on C-SPAN so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies." With regards to there not being "a lot of secrets going on" in congressional meetings, this article from today's Roll Call describing the secrecy surrounding Sen. Max Baucus' bipartisan talks would suggest otherwise.
3) TARP transparency
Obama: "And the last question with respect to TARP. Let me take a look at what exactly they say we have not provided. I think that we've provided much greater transparency than existed prior to our administration coming in. It is a big program. I don't know exactly what's been requested. I'll find out and I will have an answer for you."
Fact-Check: Testifying before congress the day before the President's presser, TARP Special Inspector General Neil Barofsky told lawmakers that "although Treasury has taken some steps towards improving transparency in TARP programs, it has repeatedly failed to adopt recommendations that…are essential to providing basic transparency."
For a comprehensive list of Obama White House transparency short-comings, check out this post from Glenn Greenwald.
Just got back from an hour-long interview Speaker Pelosi gave to a few journalists on healthcare. I've interviewed the speaker a number of times, and it always strikes me how vast the gap must be between Pelosi's public persona as a kind of gentle earnest liberal grandmother, and her behind-the-scenes role as an incredibly effective vote wrangler. At one point she said that she's always called Washington DC "the city of the perishable. When you got the vote, you take the vote." And at this she pounded her fist into her hand with relish and a smile that made me think about just how much she seems to like her job.
She seemed confident about the House being able to pass a healthcare bill with a "strong" public option, the importance of which she repeatedly stressed. "That's gonna happen," she said flatly. She also said that for all the stories about Democrats rebelling over the Ways and Means proposed surtax on the rich, she's gotten very little push back from members of her caucus.
And unlike Democrats in the Senate, Pelosi didn't seem overly concerned with getting a bipartisan bill. "This is bigger than anything we've done in our political lives," she said of passing healthcare reform. "It's the most noticeable initiative that Congress can take that improves the lives of Americans." Republicans, Pelosi said, know just how politically potent the issue is and how much successful reform would benefit Democrats. And that's why they're devoted to killing it. Jim DeMint's comments that defeating healthcare would "break" Obama, "blew their cover." Pelosi said. "They will do anything to stop it."
All of that said, Pelosi, who urged forward momentum and no delay, wouldn't commit to a firm time line. And she was restrained and diplomatic in responding to questions about members of the Blue Dog caucus that have sought to slow things down. While she suggested the house would pass their version of the bill before August recess, she stopped short of promising it. She clearly feels the urgency, however. "Ideas can melt in the sun," she said, "especially in August."
UPDATE: Ezra Klein has some more excerpts from the interview here.
At the risk of stating the blindingly obvious, I think it's incredibly important for anyone even vaguely on the center-left to understand what's at stake in this healthcare fight. Talking to an immigration reform activist a few weeks ago he described healthcare reform as the "front end of the wedge. If we can't get that through, forget immigration reform." That's true for pretty much every other item on the left's agenda. Jim DeMint was speaking the truth.
Since Washington lives on drama, and the 24 hour news cycle exacerbates that tendency, it's very easy to lose perspective. But this letter from a reader at TPM summed up how I'm feeling pretty well:
if this country cannot pass a bill which insures that every citizen has access to medical care, which every developed country has managed to do (and got done many many years ago), there is something very fundamentally and structurally wrong with this country.
Such an event, in my mind, would confirm that we live with a completely corrupt and dysfunctional form of government. Forty nine states, each with bicameral legislative bodies, some of which have distinguished themselves recently with unabashed levels of incompetency and cluelessness. Then, graft a federal government over that, which is also bicameral, the non-representative portion of it being filled with officials who are certifiable morons and/or who are bought and sold like whores by wealthy contributors.
Talk about a Waterloo.
This is a defining moment in our history. Do we fulfill our supposed status as a "shining city on a hill" or continue our long slow decline into a second rate oligarchy?
The defining feature of this decade thus far has been elite failure and oligarchic corruption. If there's going to be a pivot onto a new path of progress this is it.
If there's one thing that everyone seems to agree on, it's that the current financial crisis is complicated. There's two problems with this. First, it's not, fundamentally, true. The causes for the crisis are fairly simple when you strip away the artifice and lingo. (Most notably an $8 trillion housing bubble that the financial over-class insisted wasn't a bubble.) But more importantly, the perceived complexity of the issues are being cynically manipulated by those responsible to stem the tide of popular anger and insulate themselves from the wholesale reforms that are necessary.
In a piece on the bailout, Matt Taibbi referred to this posture of condescension as the "eye-roll." As soon as you ask a question -- why did you think housing prices would go up forever -- you are treated to the eye-roll which is the posture of those in power to the supposed ignorance and idiocy of those attempting to figure out just how they broke the world.
The point is that complexity has an enervating affect on the polity: people can only marshal anger and action about the crisis if they feel that at some basic level they understand it. Before we have politics, or a broad call for reform, we must have some broadly shared understanding of what went wrong and who's responsible. That's why a new Pecora Commission is so vital.
The original commission was created during the Great Depression as a fact-finding enterprise, to figure out how things could have gone so wrong. The hearings attracted tremendous attention and their uncovering of the self-dealing and corruption on Wall St. laid the ground work for future regulatory reforms.
The Obama administration has attempted to skip first step of this process. They've brought together the relevant stakeholders to craft a plan for financial reform, but have bypassed the necessary step of educating the public on their stake in the reform fight's outcome.
Unless and until the public feels knowledgeable enough to get angry, to fight for specific policies and solutions, the crafting of a new financial order will be left to the existing players. And they are sure to tip the scales in their favor and endanger the entire economy all over again.
If we've learned one thing in this decade, it's how dangerous it is to allow elites to make decisions based solely on conversations they have with themselves. A new Pecora Commission holds out the promise of giving the public a voice.
Ezra has a smart post up on the mechanisms of influence that the health insurance industry is using to affect the legislative process. "It's Not the Money. It's the Relationships," he says and includes a chart showing the various former Senate finance staffers who've gone to work for the insurance borg.
This is a really crucial point. We have a tendency to understand the economy of influence in DC has almost entirely a product of campaign finance, and the exchange of money. But in my two years here, I've been amazed at how much more powerful establishment social networks are. For another (depressing example) of this phenomenon, check out this item from Sam Pizzigatti's newsletter Too Much:
The Managed Funds Association, the industry trade group, has just hired a well-connected D.C. lobbying firm. How well-connected? Th e firm's newest star lobbyist, Carmencita Whonder, used to serve as the top financial policy adviser for Senator Chuck Schumer, the powerful New York Democrat. Hedge fund managers are hoping Whonder can save the loophole that lets them claim fee income as a capital gain. Ending this bit of tax sophistry, as the White House proposes, would over double the tax due on hedge fund windfalls. In 2008, the top 25 hedge fund managers averaged $464 million each.
Charlie Cray and I wrote about the scandal of the carried interest loop hole last year. If you want to know why it persists, this is more or less why.
This week -- a lot of appropriations work, more markups on health care legislation, the Senate gets started on its climate bill, and welcome Senator Al Franken….
The Senate is scheduled to take up the $3.1 billion Legislative Branch spending bill and the $42.9 billion Homeland Security bill. The House will vote on the $22.9 billion Agriculture bill, $48.8 billion State-Foreign Operations bill, and the $77.9 billion Military Construction-Veterans Affairs bill. The FY10 intelligence authorization act is also expected on the House floor -- there hasn't been an intelligence authorization bill enacted since FY05.
Senate Finance and Health, Education, Labor & Pensions (HELP) Committees will continue work on their respective health care bills this week. It remains to be seen whether the Senate Finance bill will include a public plan option. Sen. Schumer has been the strongest advocate for one on the Finance Committee, but on Face The Nation he was talking possible compromise through regional cooperatives, a weak alternative to HELP's proposed HHS-run plan (which could also still be amended). The House will continue its work on a health care bill as well and plans on bringing legislation to the floor before summer recess begins on August 8. The Congressional Black Caucus, Hispanic Caucus, Asian Pacific American Caucus, and Progressive Caucus, which together make up nearly 120 Members of the House and Senate -- will continue their advocacy for a strong public option.
The Senate Environment and Public Works Committee will get started on its climate bill which will probably be merged with the energy bill already approved by the Senate Energy and Natural Resources Committee. Hearings will kickoff tomorrow when the Committee will hear from Energy Secretary Steven Chu, Agriculture Secretary Tom Vilsack, and EPA chief Lisa Jackson. The Republicans are bringing in Governor Haley Barbour, who replaced Mark Sanford as chair of the Republican Governors Association (note: Sanford is gone, but Sarah Palin's mug is still on the RGA homepage. Any bets as to how long it will remain there?)
Work on transportation bills should start heating up this week. The Obama Administration announced last week that the Highway Trust Fund will run out of money in late August or early September. There is a bill to provide $20 billion for highway and transit infrastructure projects, which CongressDaily reports would last through March, 2011. Congressman James Oberstar is still pushing a $450 billion funding bill and $50 billion for high-speed rail. The Administration is also calling for a federal infrastructure bank -- with $2 billion funded this year and an additional $5 billion next year -- which would make grants and loans available "for projects that cross state lines or combine different modes of transportation."
Notable hearings this week: the House Energy and Commerce Committee examines the proposed Consumer Financial Protection Agency on Wednesday…. On Thursday, House Financial Services looks at the proposed role of the Fed in regulatory reform…. Also on Thursday, the House Judiciary Committee holds a hearing on "Home Foreclosures: Will Voluntary Mortgage Modification Help Families Save Their Homes?" (Chairman John Conyers has been a leading advocate for allowing bankruptcy judges to modify the principals on mortgages.)…. On Friday, a combined hearing -- the House Agriculture and Financial Services Committees examines over-the-counter derivatives regulation…. On the lighter side, if you're a college football fan and pissed off at the inane BCS rankings, check out the Senate Judiciary's hearing on BCS Antitrust Compliance tomorrow…. Finally, this one has the makings of a B horror flick: Burmese pythons, the snakehead fish, and White Nose Syndrome -- Sen. Ben Cardin chairs a hearing Wednesday on "Threats to Native Wildlife Species", Senators Carl Levin and Bill Nelson are among the witnesses (not the threats).
President Obama is out of town this week -- beginning with a summit in Moscow -- where he will meet with Russian President Dimitrii Medvedev and Prime Minister Vladimir Putin. He will also participate in G-8 meetings and visit the Pope in Italy, and deliver a speech in Ghana.