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Lawmakers venting over High Drug Prices: Is Congress to be blamed as Culprits?

Republican- and Democratic-controlled congresses, and presidents of both parties, may have set the stage for the high drug prices that have consumers on edge

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Mylan CEO Heather Bresch testifies on Sept. 16, 2016, before Congress over the cost of her company's EpiPens. Lawmakers are outraged at high prescription drug costs, without acknowledging the role Congress may have played. VOA
  • Republican- and Democratic-controlled Congresses and presidents of both parties may have set the stage for the high drug prices that have consumers on the edge
  • Government sponsored coverage injected more dollars into the medications market, and new consumer protections curtailed some blunt instruments insurers used to control costs
  • Congressional indignation was on display recently as House members grilled Mylan CEO Heather Bresch about price increases for her company’s EpiPens

Lawmakers are venting over high prescription drug costs, but if Congress is looking for culprits, it might want to look in the mirror.

Republican- and Democratic-controlled congresses and presidents of both parties may have set the stage for the startling price increases that have consumers on edge.

In the last 13 years, Congress passed major legislation that expanded taxpayer-financed coverage for prescription drugs but lacked explicit mechanisms for dealing with costs, instead relying mainly on market forces.

Lawmakers look like unwitting enablers in the eyes of some experts.

“Congress in attempting to expand access to prescription drugs has inadvertently created a situation where price increases are much more rapid,” said economist Paul Ginsburg, a former congressional adviser on Medicare who now directs the Brookings Institution health policy center.

Government-sponsored coverage injected more dollars into the market for medications, and new consumer protections curtailed some blunt instruments insurers used to control costs, such as annual and lifetime limits on the dollar value of coverage.

“The history we see over and over again is that when the government steps in as a guaranteed payer without regard to price, it will be taken advantage of,” said Dr. Peter Bach, director of Memorial Sloan Kettering’s Center for Health Policy and Outcomes.

Government’s role

Congressional indignation was on display recently as House members grilled Mylan CEO Heather Bresch about price increases for her company’s EpiPens, prefilled syringes that deliver a rescue drug for people suffering life-threatening allergic reactions. The company was accused of gouging patients, but there was little introspection about the role of government.

It’s not that a secret signal went out from Capitol Hill making it OK for Mylan to charge $608 for an EpiPen two-pack. Instead, government policies make it easier to introduce new medications at a high price and to charge more for existing drugs.

“It has dramatically changed the pricing environment,” Ginsburg said. “If a manufacturer sets the price higher, there will be less resistance to that price because a lot more people will be able to access that drug than in the past. The rational thing for the manufacturer would be to raise the prices both of existing drugs and newly introduced ones.”

Activists hold signs containing the image of Turing Pharmaceuticals CEO Martin Shkreli in front the building that houses Turing's offices, during a protest in New York highlighting pharmaceutical drug pricing, Oct. 1, 2015. VOA
Activists hold signs containing the image of Turing Pharmaceuticals CEO Martin Shkreli in front the building that houses Turing’s offices, during a protest in New York highlighting pharmaceutical drug pricing, Oct. 1, 2015. VOA

Consider the following:

  • Passed in 2003 under President George W. Bush, Medicare’s Part D’ prescription benefit provided drug coverage to seniors. Medicare was forbidden to negotiate prices. Instead, private insurers and pharmacy benefit managers would keep costs in check. For a while it seemed to be working amid greater use of generic drugs. But expensive new specialty drugs and price increases for some older medications changed things. A feature of the program that protects beneficiaries from catastrophic costs has allowed drug makers and insurers to pass the bill for very expensive medications on to taxpayers.
  • Enacted in 2010 under President Barack Obama, the Affordable Care Act, or ACA, expanded coverage for the uninsured. It made prescription drugs an essential benefit and barred dollar limits on insurance coverage. The drug industry supported the legislation and, according to documents released by House Republicans, got a White House commitment not to seek Medicare rebates opposed by drug makers. The administration helped defeat an attempt to let patients import lower-cost drugs from abroad.
  • Obama’s health care law provided makers of cutting-edge biologic drugs 12 years of protection from generic competitors, not a shorter period sought by consumer advocates.

“It’s not clear to what extent Part D and the ACA may have directly caused the very large increases in drug prices in the last five years or so,” said Rick Foster, formerly Medicare’s chief actuary. “Having said that, it wouldn’t surprise me if the significant increase in insurance coverage, and especially the catastrophic protection, contributed to the drug price increases.”

Drug industry responds

The drug industry, a formidable lobby, rejects such speculation.

“Fundamentally, we disagree that there is not adequate cost containment for medicines built into Part D, or the ACA,” said Lisa Joldersma, vice president of policy and research with the Pharmaceutical Research and Manufacturers of America.

“We think the market is best able to manage the holistic picture and to strike the right balance across cost containment, access and continuous innovation,” she added.

Mood for regulation

The public seems receptive to government action. A Kaiser Family Foundation poll released Thursday shows strong support for requiring drug companies to disclose how they set prices (86 percent), Medicare negotiations (82 percent), price limits on costly drugs to treat cancer and diseases like hepatitis (78 percent), and allowing Americans to import medications from Canada (71 percent).

Rep. Xavier Becerra, a senior California Democrat, says he doesn’t believe Obama’s overhaul and Bush’s prescription benefit are responsible for high-cost drugs. But he still thinks Congress has to act.

“I don’t think there’s anyone who doesn’t believe we need to do more aggressive oversight of the industry,” Becerra said.

It may be getting late, suggests Urban Institute economist Eugene Steuerle.

“Government simply cannot provide monopoly power and at the same time say that it will pay a price set in the private market by those companies,” Steuerle said. “Turning the power of the purse over to monopolists is absurd.” (VOA)

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Librarian of Congress likely to make Huge Collections more Accessible in US

Hayden has made history as the Library’s first woman director as well as the first African-American

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The 14th Librarian of Congress, Carla Hayden, during her interview with the Associated Press after a ceremony at the Library of Congress, where she took the oath of office, Wednesday, Sept. 14, 2016. Hayden, a former Chicago children's librarian, is the first woman and African American to serve in the role. (AP Photo/Pablo Martinez Monsivais) VOA

WASHINGTON, Mar 4, 2017: As riots convulsed the city of Baltimore, Maryland, in 2015, Carla Hayden kept a library in the heart of the chaos open. She says people in the neighborhood lined up outside the library to get in, even as a drugstore across the street was being looted and burned.

“The people did not touch the library, because it was the resource center in that community,” Hayden told VOA. “It’s beloved. It is protected. It is the place of hope in a community that needs hope.”

One year later, President Barack Obama elevated Hayden from her post as CEO of Baltimore’s Enoch Pratt Free Library to head the Library of Congress, which was established more than 200 years ago as the research arm for congressional officials.

She took over an institution that has been criticized, in recent years, for mismanagement, a lack of leadership, and falling behind in technological advances.

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Hayden’s focus is on upgrading the library’s technology to make the eclectic mix of 160 million items — from books and photos to sheet music and maps, even baseball cards — available to people everywhere.

Rare photo of unidentified African American soldier in US Civil War Union uniform with wife and two daughters between 1863 and 1865. (Library of Congress)
Rare photo of unidentified African American soldier in US Civil War Union uniform with wife and two daughters between 1863 and 1865. (Library of Congress) VOA

“I want the Library of Congress to open its arms to people around the world, to let people know it is available to them,” said Hayden, who colleagues say is warm and determined.

Library’s collections

Considered America’s library, the Library of Congress contains more than 30 million books and print materials from around the world in more than 450 languages. It houses a 1400s Gutenberg Bible, and owns the world’s largest comic book collection.

Portrait of Ella Fitzgerald, Dizzy Gillespie, Ray Brown, Milt (Milton) Jackson, and Timmie Rosenkrantz, Downbeat, New York, N.Y., ca. Sept. 1947] Music Division, Library of Congress. William Gottlieb, photographer.
Portrait of Ella Fitzgerald, Dizzy Gillespie, Ray Brown, Milt (Milton) Jackson, and Timmie Rosenkrantz, Downbeat, New York, N.Y., ca. Sept. 1947] Music Division, Library of Congress. William Gottlieb, photographer. VOA

While the public can view materials in reading rooms, they cannot check them out. Because the materials can’t be checked out, Hayden wants to make the library materials, especially those online, more accessible and interactive by using the latest technologies.

“We have things on our website that bring the collections to people wherever they are,” she said. “They can download materials, and participate in a 3-D virtual reality tour of the library.”

Hayden sees herself as “getting on the train that had already been started in the 1990s,” when the library first began digitizing its items. She is now developing a digital strategy to significantly increase the amount of online content.

She says the volume of items the library receives is enormous, with at least 10,000 items added to the collections every day of the workweek.

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Connection with books, libraries

During an interview with VOA, Hayden, 64, held her favorite book, Bright April, which she recalls checking out of a library when she was about 8. It’s about a young African-American girl who is a Brownie, a younger level of a Girl Scout, and experiences racial prejudice.

Hayden says she identified with the moral of the story — that even though people are different on the outside, they are the same on the inside.

“I thought this little girl just reflected me,” she said.

Her love for that book, and many others, propelled Hayden to become a children’s librarian. She also became chief librarian for Chicago’s public library and the president of the American Library Association. By working in libraries with diverse patrons, she learned that it’s important to “recognize the cultural heritage of the neighborhoods.”

Traveling exhibits

Besides increasing online services, Hayden wants to make Library of Congress materials available through traveling exhibits, especially beyond city limits.

“The library is working on re-establishing a mobile service, taking an 18-wheeler truck and loading it up with facsimiles, sometimes with electronic information and devices, to help people connect with the Library of Congress directly,” she said.

Uncle Sam Poster "I want you for U.S. Army: nearest recruiting station" (Artist: James Montgomery Flagg, Published c1917)
Uncle Sam Poster “I want you for U.S. Army: nearest recruiting station” (Artist: James Montgomery Flagg, Published c1917) VOA

Hayden has a proven record of expanding outreach programs and technology in libraries.

More than 20 years ago, she paved the way for Baltimore’s public library system to become the first in Maryland to provide internet access.

Now she wants to ensure that millions of items in the world’s biggest library are accessible to everyone.(VOA)

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Report: Officials from President Barack Obama’s administration Worked to Protect Russia Hacking Intelligence

The report says information came from multiple U.S. allies, including Britain and the Netherlands, describing meetings between Russian officials and Trump associates that took place in European cities

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White House press secretary Sean Spicer speaks during the daily news briefing at the White House, in Washington, Tuesday, Feb. 7, 2017. Spicer discussed President Donald Trump's travel ban and other topics. (AP Photo/Carolyn Kaster) VOA

The New York Times is reporting that some officials from President Barack Obama’s administration made efforts to make information about possible links between Donald Trump’s campaign and Russian officials easier for future investigators to find.

The Times based its story on accounts from more than a half-dozen current and former officials, some of whom said they “were speaking to draw attention to the material and ensure proper investigation by Congress,” the newspaper said.

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The report says information came from multiple U.S. allies, including Britain and the Netherlands, describing meetings between Russian officials and Trump associates that took place in European cities. It also cites U.S. intelligence agency intercepts of Russian officials discussing contacts with Trump associates.

Trump rejected an earlier Times report that said U.S. authorities had information about repeated contacts between people associated with the Trump campaign and Russian intelligence officials.

White House spokesman Sean Spicer said there is nothing to the new report.

“The only new piece of information that has come to light is that political appointees in the Obama administration have sought to create a false narrative to make an excuse for their own defeat in the election,” the Times quoted Spicer as saying.

An intelligence review ordered by Obama concluded that Russian President Vladimir Putin ordered a campaign to influence the November U.S. presidential election with the goal of helping Trump’s chances of winning.

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The Times said the late days of the Obama administration featured officials working to process raw intelligence information into reports that were kept at a low level of classification to ensure more people could see them, and to pass along reports and sensitive information to members of Congress.

The newspaper said that according to former senior administration officials, Obama himself was not involved in the effort.(VOA)

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President Barack Obama and his wife Michelle Obama sign book deal with Penguin Random House

Penguin Random House acquired world rights to the books, and worldwide sales are expected to be significantly great

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Barack Obama his elder daughter Malia ,Michelle Obama and Sasha,

Washington, March 1, 2017: In a significant deal, the forthcoming books by former US President Barack Obama and his wife Michelle Obama will be published by Penguin Random House.

The announcement was made by the publisher late on Tuesday night, following an intense and much-anticipated auction among several prominent publishers.

Represented by Robert Barnett and Deneen Howell of Williams and Connolly (one of America’s premiere litigation firms), the terms of the agreement were not disclosed by the Obamas.

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Publishing industry insiders, however, expect this deal to be among the highest made till date, stretching into tens of millions of dollars.

“We are absolutely thrilled to continue our publishing partnership with President and Mrs Obama. With their words and their leadership, they changed the world, and every day, with the books we publish at Penguin Random House, we strive to do the same,” the Chief Executive of Penguin Random House, Markus Dohle, said in a statement.

“Now, we are very much looking forward to working together with President and Mrs Obama to make each of their books global publishing events of unprecedented scope and significance,” he added.

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Penguin Random House acquired world rights to the books, and worldwide sales are expected to be significantly great.

The Obamas plan to donate a portion of their advances to charity, it was revealed.

The publisher also plans to donate one million books in the Obama family’s name to First Book, a Penguin Random House nonprofit partner, and the Washington-based partner for the 2016 White House digital education initiative, Open eBooks. (IANS)