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WASHINGTON, DC - SEPTEMBER 19: Speaker of the House Nancy Pelosi (D-CA) departs a press conference ... [+] at the U.S. Capitol September 19, 2019 in Washington, DC. Pelosi and House Democrats introduced legislation intended to lower prescription drug prices.Photo by Win McNamee/Getty Images)

As part of their spending bill, Congressional Democrats are advancing legislation that'll empower Medicare to "negotiate" drug prices in the program's Part B and Part D benefits. They insist this policy enjoys broad support among voters.

But they're misleading the public.

What Democrats are proposing is in fact a sweeping system of price controls. Evidence from abroad demonstrates that such schemes are certain to restrict access to new medicines, particularly for those who are older, living with disabilities, or fighting serious illnesses.

To the extent that Americans support "negotiations," it's only because they've been lied to.

The two drug-pricing reforms under consideration by Congressional Democrats would give the Department of Health and Human Services immense power to dictate the prices Medicare pays for drugsan arrangement more akin to a shakedown than a negotiation.

Under the House proposal, the price that Medicare pays for the most popular brand-name drugs would be capped at 120% of the average price paid in six foreign countries: Australia, Canada, France, Germany, Japan, and the United Kingdom. Companies that refuse to sell their medicines at this artificially low price would be subject to an excise tax of as much as 95% on each drug's gross sales.

In other words, drug companies would be given a choice: Either submit to the government's pricing demands, or forfeit nearly every penny a medicine earns.

The Senate Finance Committee's proposal takes a domestic tack, limiting Medicare's drug prices to the prices the Department of Veterans Affairs' health system pays.

In deciding prices, the VA and the governments of Canada, the UK, and other nations calculate what they are willing to pay for certain drugs with a metric known as a quality-adjusted life year or QALY.

Take my native Canada. By some estimates, that government's drug-pricing board values one year of perfect health at $50,000 Canadian (or about $40,000 US). From this benchmark, the government can then calculate whether a drug extends a patient's life sufficiently to justify its costs. If it fails this test, the government doesn't cover the medicine.

There is plenty to find reprehensible about such analyses. For one, they place a dollar value on human lifesomething no government should do.

Such analyses also lead to severe restrictions on which drugs patients can access. Of the new medicines launched between 2011 and 2018, for instance, fewer than half were available to Canadian patients. And just 60% were available to patients in the UK. By comparison, American patients had access to nearly 90%.

QALY analyses are also inherently discriminatory, as they place less value on the lives of sick and disabled patients compared to healthy ones. In practice this means that health systems which rely on QALY calculations are less willing to pay for medicines that benefit chronically ill patients or those with physical impairments.

By basing Medicare's drug prices on those paid at the VAor Canada and the UK among otherslawmakers are in fact smuggling discriminatory QALY-based policies into Medicare through the backdoor.

These facts rarely reach patients, of course, which is why the idea of drug price "negotiations" polls well. But as I detail in a new issue brief, when Americans learn the facts about price-control policies, they reject them by wide margins.

In a recent survey of likely voters, nearly 78% opposed the use of QALYs under Medicare. When told that the Democrats' drug-pricing policies would likely restrict access to medicines for older Americans and those with disabilities, 72% said they were less likely to support the reform.

After learning that these reforms would take treatment decisions out of the hands of doctors, leaving them to bureaucrats and their calculations of the value of a human life, three quarters of voters were less likely to support these reforms.

Democrats aren't looking to encourage "negotiations." They're simply trying to save the government money on drugs by dictating the price. Their strategy for achieving this goal is to deny access to the latest medicationsespecially to the oldest and sickest patients.

This policy will garner public support only to the extent Democrats continue to hide the truth.

Here is the original post:
Democrats Drug Pricing Reforms Arent What They Seem - Forbes

America has a lot of free stuff. Get to the United States and you will be able to have nearly everything taken care of by the U.S. government. That seems to be the prevailing wisdom held by many migrants who make the journey from Central America through Mexico to our southern border, and eventually, with our lax immigration policies, into America.

It should be noted that two of the many reasons why the Roman Empire failed is because they were unable to protect their borders and the lavish spending of its Emperor Nero, which brought on an economic recession.

Countries have borders, which they control for their own protection. Most countries allow new people to enter only systematically, legally. We forget this point, or the Biden administration is not able to manage this situation.

Forget about the risk of spreading COVID-19 and the possible encroachment of drug cartels and the drug trade, the impact of which play an integral role in the carnage on our streets, many of these people could be seeking to do us harm in other ways.

Vice President Kamala Harris, the border czar, was seeking the root cause. That is as clear as asking why birds fly to get from one point to another. Answer: America gives free stuff!

Let us start with food, shelter, education and health care, including Medicaid. The Democrats, if they get their way with their Build Back Better $3.5 trillion package, would be able to hand out free community college, as well as free universal pre-K, free family leave, free child care. There would be little the U.S. government would not provide even for someone forcing their way into America. So, why not make the journey?

Who pays?

By law, some entitlements have established the means/resources to always be able to pay its recipients, at least theoretically, such as Social Security and Medicare. Other entitlements like food nutrition programs and housing assistance are far more unruly and pay out to recipients from tax revenues or tax increases from the rest of society. The latter are considered a safety net for deserving and needy Americans.

The Democrats want to increase the latter group, plus expand Medicare benefits, which could be fatal to our fiscal stability. Already we spend 62% of our budget on entitlements, 8% on servicing our nearly $29 trillion debt, and 15% on our national defense. This leaves only three nickels for all discretionary spending. Going beyond adds to the $29 trillion debt.

To say that the new programs filled with FREE STUFF will be paid for at least for X number of years is being disingenuous. It is not like Social Security or Medicare. In those programs we all contribute via our FICA and through Medicare deductions from our paychecks. Those dollars are placed in a trust account within the federal government. Those of working age help fund the respective trust accounts so those who are retired rightfully have those promised benefits.

Primary and secondary education is provided for every American as we pay for it in state and local taxes, mainly property taxes. The extension of free education for all pre-K children must also have a permanent revenue stream or else it will be added to our $29 trillion national debt.

All new programs must have a permanent source of revenue as there has never been a social entitlement program that has not become permanent.

So, the breachable border and getting FREE STUFF is where we stand today in Congress. Democrats refuse to see or address one of Americas biggest crises.

Gary Franks served three terms as U.S. representative for Connecticuts 5th District. He was the first Black Republican elected to the House in nearly 60 years and New Englands first Black member of the House. He is the host of the podcast We Speak Frankly and author of With God, For God, and For Country.

Go here to read the rest:
Franks: Democrats ignore crisis they contribute to at southern border - Boston Herald

Dallas County commissioners will begin considering new redistricting options this week, and the efforts could favor Democratic candidates in future elections.

Every decade, the county redraws its electoral maps with new data from the U.S. Census Bureau. Just like legislators in Austin are deciding state House and Senate boundaries, and the Dallas City Council will debate new districts, the Commissioners Court is tasked with adjusting its own lines based on population and demographic changes.

Technically, the commissioners do not have to redraw the district lines. The countys population grew by more than 245,000 since the last census to 2.6 million, but the distribution of residents didnt shift enough to force a change in the maps.

However, demographic differences give the Democratic-led Commissioners Court a chance to strengthen the voting power of minority groups. Over the past decade, the percentage of white non-Hispanic residents in the county dropped from 33% to 28%, while the Hispanic population grew from 38% to 40%. The number of Black residents has remained steady at 22%.

The Commissioners Court begins public hearings Tuesday on three options all of which dilute Republican voting power while solidifying Democratic control.

Especially in northern Dallas District 2, Commissioner J.J. Koch, the five-member courts lone Republican, said the suggested maps could shut him and other GOP candidates out.

[The maps] are a little bit shocking, Koch said. If that isnt gerrymandering, I dont know what is.

But the maps also will improve the voting power of Hispanics and keep cities grouped in single districts, which Dallas County Judge Clay Jenkins said was one of his primary goals in redistricting.

Its hard to draw these districts on a purely political basis, Jenkins said. The map should hold together communities of interest.

Heres what voters need to know about the countys redistricting process and how to weigh in:

Earlier this year, the county hired three outside consultants to review the Census data and propose new district lines.

The most important requirement is for each district to have the same general population. Districts must also comply with the Voting Rights Act by not discriminating against minority communities.

Jenkins who holds a countywide seat and is not bound by a specific district said that can often lead to partisan conflicts.

Theres no way to do redistricting where everyone is happy, Jenkins said. Its more personal than just about anything to the commissioners because its their district.

The Commissioners Court will determine districts for four members as well as five justice of the peace districts and five constable precincts. First, the county will decide the Commissioners Court districts, since those are affected by the population and the number of residents must be evenly distributed in each district.

The justice of the peace and constable districts will be decided later, and will be determined by evenly distributing the workload that comes out of each rather than the population. Justices of the peace preside over misdemeanor courts, small civil cases, landlord disputes and evictions. They can also perform marriage ceremonies. Constables are law enforcement officers who serve warrants and civil papers like subpoenas and restraining orders.

Technically the current maps do not need to change at all. The countys population distribution didnt change enough to make a difference in the Commissioners Court districts.

The population change in each district must remain under 10% on any new court-approved map. According to new census data, District 1 which encompasses much of East Dallas and is represented by Theresa Daniel changed the most with only a 1.7% decrease.

Commissioners on Tuesday will consider three new maps, and the options are available on the countys website.

In the 2020 election, all four Commissioners Court districts voted primarily for Democrats. The only toss-up was District 2, represented by Koch. Voters in that district were split 54% in favor of President Joe Biden, a Democrat, and 51% in favor of Republican Sen. John Cornyn.

But according to an analysis from The Dallas Morning News, the three proposals would all cede some Republican votes to districts 1, 3 and 4 all Democratic strongholds while giving Democrats a slight edge in Kochs too-close-to-call district.

For example, Koch said two of the map options would stretch Commissioner John Wiley Prices southern Dallas district north through Rowlett, a Republican stronghold.

All of them kind of cut me off from Anglo Republicans, Koch said, which is not something theyre supposed to be doing.

Price said his goal in redistricting is to think ahead about how each districts demographics will shift over the next decade and protect the voting power of minority communities. What they decide now will help determine the courts makeup in years to come, Price said.

Well always have some conversation about what you think is prescient, Price said. All youve got to do is see how its trending.

Redistricting rules mandate that similar groups of voters should not be split between districts because it would marginalize or dilute their voting power. Koch said that by taking portions of his Republican-voting district and splitting them among other commissioners, the court could disenfranchise white voters, who make up 28% of the countys population.

Theyre cracking the white Republicans to make it an all-Democratic court in the next 10 years, Koch said. They have the power of the pen.

In 2011, the court approved a new map based on the 2010 Census, which gave District 1 more Democratic voters. Daniel, a Democrat, was elected to the new district in 2012, replacing Republican Maurine Dickey.

A group of white residents sued Dallas County in federal court in 2015, saying the 2011 redistricting process was discriminatory toward white, Republican voters. The suit was thrown out by a federal judge, who said their voting power has been strengthened, rather than diluted, by the concentration of Anglos in [precinct 2] where they can reliably elect a Republican candidate.

The county has scheduled two public hearings. They will both be at 10:30 a.m. on Tuesday and Nov. 2 at the Dallas County Administration Building, 411 Elm St. Members of the public can also register online to attend virtually at the countys website.

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Dallas County is redrawing boundaries, benefitting Democrats. Heres why it matters to voters - The Dallas Morning News

WASHINGTON Senate Democrats will try again next week to advance a voting rights measure, Senator Chuck Schumer, the majority leader, announced on Thursday, though Republicans are expected to maintain their filibuster against the legislation backed by all Democrats.

In a letter laying out the coming agenda for the Senate, Mr. Schumer, Democrat of New York, said he would schedule a vote for next Wednesday to open debate on voting rights legislation that he and fellow Democrats say is needed to offset new restrictions being imposed by Republican-controlled state legislatures around the nation.

We cannot allow conservative-controlled states to double down on their regressive and subversive voting bills, Mr. Schumer said in the letter. The Freedom to Vote Act is the legislation that will right the ship of our democracy and establish common sense national standards to give fair access to our democracy to all Americans.

His decision intensifies pressure on Senator Joe Manchin III, Democrat of West Virginia, who had initially been his partys lone holdout on a sweeping voting rights measure passed by the House. Mr. Manchin helped draft a compromise version that he said he hoped could draw bipartisan backing, and sought time to win over Republicans to support it, but there is little evidence that any G.O.P. senators have embraced the alternative.

In the 50-50 Senate, it would take 10 Republicans joining every Democrat to muster the 60 votes needed to break a filibuster of any voting rights bill and allow it to be considered.

Mr. Manchins compromise narrowed the objectives of the legislation, which would require states to allow a minimum of 15 days of early voting, ensure that all voters could request to vote by mail and make Election Day a national holiday, among other provisions. It would also establish requirements for voter identification, but less onerous ones than sought by Republicans.

Despite Mr. Manchins outreach, there has been little sign of movement among Republicans who have been steadfast in their opposition to the Democratic voting push, calling it an attempt to federalize state elections and grab an advantage for the Democratic Party. Their blockade of the voting rights bill has spurred calls to eliminate or change the filibuster rules, but Mr. Manchin has resisted those efforts.

Some Democrats who have been agitating for such changes have held out hope that when Mr. Manchin saw that Republicans were unwilling to support even his compromise measure, he would drop his opposition to altering the rules, despite his repeated vows that he never would.

In his letter, Mr. Schumer said that Democrats would also continue their internal negotiations to come up with a final version of a sweeping social safety net bill that has been slowed by differences between progressives and moderates over its cost and contents. He warned that lawmakers would need to make concessions to get a final measure.

To pass meaningful legislation, we must put aside our differences and find the common ground within our party, Mr. Schumer said. As with any bill of such historic proportions, not every member will get everything he or she wants.

Link:
Democrats Plan Another Bid to Break G.O.P. Voting Rights Filibuster - The New York Times

WASHINGTON Three Washington lawmakers are at the center of a debate among Democrats that will decide the fate of the ambitious national agenda they campaigned on in 2020 and perhaps the partys fortunes in 2022.

Sen. Patty Murray played a central role in crafting the Build Back Better Act, which would raise taxes on large companies and the richest Americans to pay for a range of social programs aimed at lowering living costs for the rest of the country, including expanded health care, subsidized child care and tuition-free community college.

Its going to be a really big deal, Murray said in an interview. Were going to fundamentally reshape the American economy so we can level the playing field for working families, and we can do it by making sure that the very wealthiest and giant corporations pay their fair share, so that everyone can be successful.

But before they can do that, Democrats have to pare the legislation down from a cost of $3.5 trillion to a figure closer to $2 trillion to appease two centrist senators.

That reality presents them with a tough choice: fund all the programs they promised voters, but for just a few years, or jettison parts of the bill to fund their top priorities for the longer term.

Rep. Pramila Jayapal, who represents most of Seattle and chairs the Congressional Progressive Caucus, has pushed for the first option. In an interview, she said that because the bills provisions aim to help different groups of people expanding Medicare coverage for seniors, for instance, and cutting costs for college students dropping entire programs would mean breaking promises made to voters.

Rep. Suzan DelBene, whose district stretches from the Seattle suburbs to the Canadian border, heads the moderate New Democrat Coalition and has advocated the fewer, longer approach. If Republicans take control of either the House or Senate next year, she said in an interview, they could let programs with only short-term funding expire before they see their full impact.

The Progressive Caucus and New Democrats each count 95 members in the House, evenly splitting most of the partys slim, 220-seat majority. House Speaker Nancy Pelosi, D-Calif., has struggled to take a side.

After writing in a letter to all House Democrats on Monday that her members have overwhelmingly advised her to do fewer things well so that we can still have a transformative impact, Pelosi told reporters the next day her party may have to opt for short-term funding and she hoped they wouldnt drop any provisions.

After a late-September standoff between progressives and centrist Democrats forced Pelosi to postpone a vote on the Build Back Better Act, the speaker set an Oct. 31 deadline to vote on both that legislation and the bipartisan infrastructure package the Senate passed in August.

But Murray, the third-ranking Democrat in the upper chamber, shrugged that deadline off as a House-imposed mandate and said shes focused on getting the best package possible, with the strongest investments in the things that I care about.

The challenge Murray, Pelosi and other Democratic leaders face is that each member of their party cares about different priorities.

After Biden presented his sweeping agenda in two sets of proposals last spring the American Jobs Plan and American Families Plan lawmakers turned them into two bills. But instead of dividing the issues like the White House did, a group of moderate Democratic and Republican senators carved out provisions that could garner the 10 GOP votes needed to reach the 60-vote majority needed to pass most legislation in the Senate.

That bipartisan bill passed the Senate including $550 billion in new spending on roads, bridges and other infrastructure and with just one shot at bypassing a Senate GOP filibuster via special budget rules, Democrats piled the rest of Bidens agenda into the Build Back Better Act.

All 50 Democratic senators need to support a bill to use that once-a-year process, known as budget reconciliation, and opposition to the original $3.5 trillion price tag from Sens. Kyrsten Sinema of Arizona and Joe Manchin of West Virginia has forced the party to compromise on a lower number.

In its original form, the sprawling bill would provide two years of free community college, plus extra college funding through the Pell Grant program. It would guarantee universal pre-kindergarten and subsidies that ensure no family spends more than 7% of their income on child care. It would expand Medicare to cover hearing, vision and dental care and expand Medicaid coverage in states that havent already done so under the Affordable Care Act.

It would extend the monthly child tax credit payments of $250 to $300 per child, set to expire at the end of the year, that Democrats enacted through the $1.9 trillion pandemic relief package they passed in March. It would lower prescription drug prices, partly by letting Medicare negotiate prices for the first time, and guarantee 12 weeks of paid family and medical leave each year.

Other parts of the bill aim to combat climate change, including tax incentives to encourage clean energy production and electric vehicle adoption. The sheer number of provisions has posed a messaging challenge for Democrats: How do they explain it, let alone drum up public support for such a wide-ranging piece of legislation?

Murray, who chairs the Senate committee charged with health, education and labor issues, said her must-have priorities are affordable child care, paid family leave, lower health care costs and provisions to counter climate change.

Of course, everyone is advocating for what they feel strongest about now, Murray said, but she emphasized that none of that matters unless they craft a bill all 50 Senate Democrats will vote for.

The New Democrat Coalition has its own four-part set of priorities: Extend the child tax credit, create jobs through economic development grants, go big on climate by cutting carbon emissions, and lower health care costs by expanding Medicaid to cover more people and making health insurance subsidies enacted in the March relief bill permanent.

The Progressive Caucus has put forward a broader set of priorities, including investing in affordable housing and the care economy, combating climate change and lowering drug prices, using the money Medicare saves to expand health care.

The progressives have also sought to include sweeping immigration reform in the bill, but the Senate parliamentarian a sort of congressional referee ruled that those changes fall outside the scope of the reconciliation process, which applies only to budget-related provisions.

Democrats have proposed paying for the new spending by rolling back some of the tax cuts Republicans passed in 2017, when the GOP used the same budget reconciliation process to get around Democratic opposition.

Their plan would raise the corporate tax rate from 21% to 26%, still below the 35% rate that applied until 2018, with lower rates for businesses that earn less than $10 million a year. It would tax capital gains at a higher rate, especially for people who earn more than $5 million a year, and raise the income tax rate for those making at least $400,000 a year.

Those proposals would generate about $2 trillion in revenue over 10 years, which means if the Democrats choose to fund programs for just a few years, they would need to find other ways to raise revenue or finance the programs with borrowed money that raises the federal deficit but Jayapal said shes not worried about finding ways to pay for the programs.

We dont suffer from a lack of resources on the revenue side, she said. We suffer from a lack of will to actually tax people fairly.

The other downside to short-term funding, DelBene said, is that if Republicans win control of either the House or Senate in 2022 a scenario polling and precedent suggest is likely Democrats could be forced to watch parts of their bill expire before they have their full impact, leaving a program halfway done.

I think folks want to see governance work, DelBene said. They want to see us make decisions and have policy that is stable, that they can rely on.

To make her point, DelBene cited the child tax credit, which she played a lead role in transforming from a $2,000-per-child benefit available only to those who earn enough to owe that much in federal taxes into monthly payments totaling $3,000 to $3,600 a year for all but the wealthiest parents. A Columbia University study found the first round of payments, sent in July, lifted 3 million children out of poverty, but projected a far greater impact if the payments continue for years.

Meanwhile, Jayapal favors front-loading as many benefits as possible, in hopes that people will understand that government has their back, and we can look at the extension of those programs later.

One of the crises of democracy that were facing is that people dont believe that government is going to stand up for them, she said. The way to counter that is to show them that government really can do those things, and so were building towards a place where voters actually see the utility of government.

While she admitted her approach could let Republicans dismantle her priorities in a few years, Jayapal said she hoped the GOP would run into the same problem they faced when they tried to repeal the Affordable Care Act, a program that proved too popular to undo once Americans saw its benefits.

If Democrats dont do all the things the party campaigned on, Jayapal said, Then people are going to continue to have no faith in us because we promised something (and) we never delivered. They gave us the House, the Senate and the White House, we still didnt deliver.

Despite their different approaches, Jayapal, DelBene and Murray described the same goal: a federal government that more actively transfers wealth from the biggest businesses and the richest Americans to make life easier for the rest of the nation.

I want people to wake up in the morning and feel differently about their lives, their livelihoods and their opportunities, Jayapal said. I mean, to know that governments got their back and they can live a dignified life with opportunity and not suffer every day.

Read more:
Three Washington Democrats at center of crafting bill to 'fundamentally reshape the American economy' - The Spokesman Review