Democratic House Majority’s First Order of Business: Restore Democracy

In the 2018 midterm elections Democrats won 8.8 million more votes than their Republican opponents and won as of this writing 39 seats in and control of the U.S. House of Representatives.  Yet due to gerrymandering, the structural failure of the U.S. Senate, Republicans continue to hold an outsize measure of control in Washington - a  control that benefits the wealthy, large corporations and corrupt politicians to the detriment of average Americans.  In a column in the Washington Post, Democrats lay out their plan to re-balance democracy in favor of the majority, not the select few and racist minorities. Among the reforms the House Democrats seek to enact - getting them through the Senate may be an obstacle - are: (i) ending dark money form politics and forcing donors to be identified. As of now, we still do not know who paid Acting Attorney General Whitaker $1.2 million through a shell "charity," (ii) closing down the revolving door between Congress and large corporations, and (iii) ending gerrymandering and Republican voter suppression efforts.  Unless one is part of the greed driven 1%, a racist, or a vulture capitalist, these goals should be attractive to decent moral citizens.  Here are column excerpts:

Americans went to the polls and sent a powerful message: The election not only was a resounding verdict against Republicans’ assault on Americans’ health care and wages, but also it was a vote to rescue our broken democracy.

In the face of a torrent of special-interest dark money, partisan gerrymandering and devious vote-suppression schemes, voters elected a House Democratic majority determined to bring real change to restore our democracy.

The new Democratic House is ready to deliver with H.R. 1: a bold reform package:

First, let’s end the dominance of money in politics. For far too long, big-money and corporate special interests have undermined the will of the people and subverted policymaking in Washington — enabling soaring health-care costs and prescription drug prices, undermining clean air and clean water for our children, and blocking long-overdue wage increases for hard-working Americans.

So let’s rein in the unaccountable “dark money” unleashed by the Supreme Court’s Citizens United v. Federal Election Commission decision by requiring all political organizations to disclose their donors, and by shutting down the shell game of big-money donations to super PACs.

Next, let’s make sure that when public servants get to Washington, they serve the public. Restoring the public’s trust means closing the revolving door between government and private industries, and imposing strong new ethics laws to stop officials from using their public office for personal gain. To do so, we will expand conflict-of-interest laws, ban members of Congress from serving on for-profit boards, revamp the oversight authority of the Office of Government Ethics, and prohibit public servants from receiving bonus payments from their former employers to enter government.

Finally, let’s make it easier, not harder, to vote. Since the Supreme Court took the teeth out of the Voting Rights Act, Republican political operatives have increasingly turned to blatant schemes to make it more difficult for the Americans left behind to participate in elections — a narrow agenda all too often targeted at communities of color.
We must renew the Voting Rights Act to protect every citizen’s access to the ballot box and restore the vital safeguard of pre-clearance requirements for areas with a history of voter suppression. We will promote national automatic voter registration, bolster our critical election infrastructure against foreign attackers, and put an end to partisan gerrymandering once and for all by establishing federal guidelines to outlaw the practice.

These are the reforms that will ultimately change the balance of power in Washington. When we get dark money out of politics, clean up corruption and ensure fair elections, we will dismantle the ability of special interests to stack the deck of our democracy and our economy against hard-working Americans.

[W]ith a system that works for the people, we will deliver policy outcomes that make life better for all Americans: We will lower health-care costs and out-of-control prices for prescription drugs. We will rebuild the United States’ infrastructure, raise the minimum wage and put leverage back in the hands of workers and consumers. We will finally advance common-sense, bipartisan solutions to prevent gun violence. We will confront discrimination with the Equality Act , pass the Dream Act to protect the patriotic young undocumented immigrants who came here as children, and take the first step toward comprehensive immigration reform.

We have a responsibility to honor the vision of our founders, the sacrifices made to expand the right to vote and our duty to the American people.

Here in Virginia, we can aid in the effort by electing Democrat majorities to both the Virginia Senate and the House of Delegates in November, 2017, and end Republican obstruction.  

America's Insanely High Prescription Drug Prices

As the prior post noted, America continues to have one of the most flawed and expensive health care systems of any developed nation.  Much preventative treatment is not covered and our prescription drug prices are obscenely high compared to drug prices in other developed nations.   Why? Largely, because large pharmaceutical companies have bought and paid for members of Congress, especially Republicans.  The other reason is that programs like Medicaid and Medicare continue to fail to negotiate lower prices, in part because of politicians in the pockets of the pharmaceutical companies.  Imagine if there was a drug that could have a 99% track record of preventing disease but was so expensive - at least in America - that only a tiny percentage of those who would benefit can afford it even if they have "good insurance."  Due to the lack of affordability, many become ill and huge medical costs are incurred - costs that could have been avoided.  The drug exists: Truvada which taken daily and known as PrEP prevents HIV infection.  It cost about $55 to produce a year's supply, yet in America, the cost to patients is $20,000 per year.  I have focused on PrEP, but the same phenomenon applies to countless drugs that drive up medical costs into the stratosphere.  A piece in the New York Times looks at the USA experience versus other developed nations.  Here are highlights:

Last week, the High Court of England and Wales announced a momentous decision: It invalidated the pharmaceutical company Gilead’s patent on Truvada, opening the way to generic competition.

Truvada, a combination of two drugs, is one of the world’s most-used H.I.V. medicines. For treating H.I.V., it’s used along with a third drug. But many H.I.V.-negative people also take Truvada daily as a preventive. That’s called pre-exposure prophylaxis, or PrEP.
In the United States, Truvada is available only as a brand-name drug. It costs $20,000 a year.

Here’s how it will work in Britain’s National Health Service, according to Dr. Andrew Hill, a senior research fellow at Liverpool University who studies the cost of medicines. “The N.H.S. will say to a group of generic companies: ‘We need PrEP for 20,000 people. Give us your best price.’” The cost of making PrEP is $55 per year, Dr. Hill said. He believes that the generic will sell for between $100 and $200.

All over the world, more and more people are taking H.I.V. drugs. These medicines are very good at their job — keeping people healthy and noncontagious — so most patients will take them until they die of something that isn’t H.I.V. Patients are also starting earlier on antiretroviral therapy; the new recommendation is to start immediately upon diagnosis. And now with PrEP, a potentially enormous new group of patients has arisen: H.I.V.-negative people who are at risk for catching the virus.

It’s lucky, then, that Truvada will have generic competition. It should allow the health service to greatly lower costs and offer PrEP to anyone who needs it.

The health service does an admirable job with H.I.V. Around the world, countries measure the percentage of people living with H.I.V. who have no virus detectable in their blood. In the United States, only 49 percent have achieved this. In Britain, the number is 78 percent.

While the National Health Service has a lot of problems, it has some huge advantages over the American system that allow it to provide high-quality H.I.V. care in a cost-efficient manner. So it’s worth looking at what the British health service does right, because some of those strategies could work in America, even though the two systems are structured very differently.

Even when brand-name drugs have no generic equivalents, the medicines in the British system cost a small fraction of what they cost in America. Most brand-name triple therapies cost about $6,500, said Dr. Laura Waters, an H.I.V. physician who is a member of the health service’s H.I.V. Clinical Reference Group, which sets policy. She said that a combination pill that includes some generics would cost between $2,600 and $4,000. Full generics usually cost 70 to 80 percent less than comparable brand names. One completely generic H.I.V. regimen costs $400 per year. If America were to use more generics, much of the savings would stay with insurance companies and pharmacy benefit managers. That doesn’t help people with H.I.V. “The resources saved can and should finance a more aggressive effort to fight AIDS in America,” said Anil Soni, head of global infectious diseases for Mylan.

Could it happen with Medicare or Medicaid? Just a few states — New York, Georgia, Florida, California and Maryland — are responsible for a large share of Medicaid’s spending on H.I.V. drugs. They could lead a drive toward using more generic drugs. These drugs are already available, but doctors don’t prescribe them. Like the National Health Service, Medicaid would have to find ways to encourage (or cajole, entice or force) doctors to prescribe generics. If the generics were more widely used, that would encourage competition that could further drop the price.

Every day, America pays for H.I.V. drugs at higher and higher prices, for more and more people. There is no choice but to reform an unsustainable system.

“I just don’t understand why American payers don’t look up reference prices,” Dr. Hill said. “It’s $150 in England, so why are they spending $10,000? Surely they don’t have unlimited budgets in the U.S. But they behave as if they do.”

 Again, the same phenomenon applies to countless other drugs and is one of the reasons for America's exploding health care costs.