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Thread: 2020 American Political Scene

  1. #271
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    Quote Originally Posted by Bigfella View Post
    Speaking of insulin, why does insulin cost so much in the US? It is fairly cheap all over the industrialized world, yet it can be very expensive in the US. The stuff has been out of patent since it was discovered, and the improved versions under patent are only marginally better. Seems emblematic of the whole US health system.

    Trump could probably win the election by promising decent price controls on drugs that the 'free market' (guffaw) make so expensive for many Americans. But hey, that is 'socialism'. Can't have that. Insane.
    Meh, I won't josh you around. Because we let them and we're willing to pay it.


    tbm has a good long-form answer. PBMs theoretically serve as middle-men between pharmacies and insurance companies. Handling pharmacy claims and handling medical claims are basically entirely different industries so it makes sense to have PBMs. In practice, major PBMs are basically combined with major insurance companies, and they are all looking to form strategic relationships with pharmacies as well....major vertical integration.

    So, PBMs negotiate drug discounts. So, we have no idea how expensive insulin really is in the United States. The PBMs negotiate those discounts and probably keep a big cut (no one knows how large).

    People like to blame insurance companies, but not all insurance companies are owned by major PBMs and a lot of them really dislike this. You might remember Amazon and Berkshire and some other company trying to make their own PBM. However, this is extremely difficult since this is a business of relationship and sales, and the Big Boys have market power, and the Little Boys do not.

    Also, modern insulins are a LOT better than older insulins. We (the royal we) are trialing out once a week insulin shots. If you still want old, cheap insulin, you can buy at Walmart for $25/bottle. It won't work for everyone, and you have to basically monitor your carbs like a porn addict cruising the Hub or you run the risk of severe medical incident.
    "The great questions of the day will not be settled by means of speeches and majority decisions but by iron and blood"-Otto Von Bismarck

  2. #272
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    Colin Powell's criticism means four ex-chairmen of the Joint Chiefs of Staff have now bashed Trump

    WASHINGTON -- When former Secretary of State Colin Powell, a retired Army general, rebuked President Donald Trump on Sunday, saying he had "drifted away from the Constitution," he became the fourth former chairman of the Joint Chiefs of Staff to speak out against Trump's desire to use active-duty soldiers to confront protesters.

    According to several military experts contacted by NBC News, it is unprecedented for so many former top military officials to criticize a sitting commander-in-chief harshly and publicly.

    "It's unusual for any flag officers, or indeed any former officers, to speak out against the commander-in-chief," said David Segal, the founding director of the Center for Research on Military Organization at the University of Maryland, saying officers generally try to remain apolitical. "In the 50 years I've been studying the military, I can't think of a precedent.

    "And the fact that there hasn't been any pushback, I think, is even more telling," he said. "I don't see any controversy from the ranks or from society."

    Former White House and State Department official Heather Hurlburt agreed.

    She said that when there have been heated public debates in the past about how the military should be used, they have not provoked the same response from flag officers. She cited the large protests against the Vietnam War, the transition from the draft to an all-volunteer force, the Reagan administration's actions in Central America, the repeal of "don't ask, don't tell" and the decision to allow women to serve in combat.

    Hurlburt, now at the New America Foundation, said that when such controversies occur, former Joint Chiefs chairmen definitely make their views known in private. However, she said, "it's rare for any to speak publicly, and in none of the instances above did four speak out."

    Powell's statement Sunday followed criticism of Trump from more than a half-dozen former flag officers, including retired Navy Adm. William McRaven, commander of the raid that killed Osama bin Laden; Trump's own former defense secretary, James Mattis, a retired Army general; and three other former chairmen of the Joint Chiefs.

    On Tuesday, retired Navy Adm. Mike Mullen called Trump's desire to use active-duty forces to suppress protests "sickening." Retired Army Gen. Martin Dempsey called it "dangerous" and "very troubling" in an interview with NPR on Thursday. Retired Air Force Gen. Richard Myers said the tear-gassing of protesters outside the White House on Monday night filled him with "just absolute sadness" and said he was glad he was not advising Trump.

    Segal sees a change in the military and thinks it is being drawn into politics more than in previous generations.

    "I think it clearly is a break from the past," he said. "The question is whether it portends a change in direction or a reflection of this particular moment in time and this particular president."
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  3. #273
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    Quote Originally Posted by tbm3fan View Post
    I'll expand on my previous answer to you. First it starts with health insurance companies that sell health plans. Health plans are closely regulated under the Affordable Care Act. The insurance company also has and sells pharmaceutical plans which are not regulated. Consequently the margins on health plans are small but the margins on pharmaceutical plans are not and the insurance company makes up for that on the drug side. Since the insurance company owns the drug plans they can require the patient to use these products and then raise prices.

    The middlemen, next in line, are the three pharmacy benefit managers (PBM) who control 94% of the market mainly because they are owned by the insurance company. Gotta love vertical intergration. The PBMs have a pay to play strong arm approach with the pharmaceutical companies to take the majority of profits. The payola part. A drug like Travatan (glaucome) made $800 million, of which $600 million went to the PBMs, and only $200 million to Novartis. They pay because the PBM owns the formulary that provides drugs to their patients and charge exorbitant rates to companies that want their drugs accessible. To compensate, the pharmaceutical companies increase their prices, passing the increase onto the patient.

    The next middlemen under the PBM are the health insurance brokers. Some brokers are ethical but the vast majority receive kickbacks from the insurance company to sell their pharmaceutical drug plan. Another hidden fee to inflate prices and 90% of the drugs go through PBMs that offer these kickbacks. As opposed to Canada which doesn't have PBMs, health insurance brokers and other layers to the cost of drugs.

    Now Trump signed a bill on transparency but we really need to actually fix the system rather than try to find out ways to pay for it. Guess who would be against this very sane approach? Those three entities I mentioned and then their guys in Congress who are more interested in themselves then in the true benefit of the patient. Making insulin cheaper was nice but the devil is in the details and I can bet my bottom dollar there is a financial way around this for the insurance companies and PBMs to make up for this in another manner. Their hands are in the pie and when you squeeze your hand tighter pie oozes out elsewhere for them to maintain their profits.
    It seems in the healthcare industry the "free market" has ended up creating a massive corrupt bureaucracy which provides zero value addition but sucks in huge amounts of money from the pockets of common people into a black hole. It is a giant socialist job-creation scheme that ironically may only be tackled by actually socializing healthcare. It would be funny if it wasn't tragic.

    Just provides further proof that healthcare cannot be treated as a commodity. It just does not work, unless you're ok with large numbers of people suffering because they cannot afford it.
    Last edited by Firestorm; 08 Jun 20, at 20:40.

  4. #274
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    Are they gone for good? The Trump supporters who regret their vote

    Donald Trump once famously boasted he could shoot someone on Fifth Avenue, and not lose supporters. For years that seemed true.

    But his latest actions – including the deployment of an ad hoc paramilitary force against protesters on avenues around the country – may have been too much.

    New polls show Trump’s support is slipping among key groups, some showing him at a double-digit disadvantage to Democratic rival Joe Biden.

    Last Monday night, police and soldiers violently cleared protesters so Trump could walk from the White House to St John’s church for a photo opportunity. At that moment, Nolan Fuzzell had seen enough.

    Fuzzell is a table server at a restaurant in Lawrence, Kansas, and previously supported Trump. But after the photo stunt he tweeted: “Beginning to regret wearing all Trump gear on Election Day 2016. This is not right, on any level.”

    So how did Trump lose supporters like Fuzzell, and are they gone for good?

    It’s helpful to remember, first, what the president has asked of Republicans. He has treated the party like Theseus’s ancient ship, replacing one plank at a time until it becomes unrecognizable as itself. From a party whose elites sought to reject Trump in 2016, it has now become almost unerringly loyal and much changed.

    Under Trump’s leadership, Republicans have gone to war against their traditional allies, the FBI. They have cozied up to their old opponents, in Russia. Republican leaders have signed off on federal deficits so gargantuan – this year it will top a trillion dollars – they would make Franklin D Roosevelt blush.

    Trump adherents have had to boycott the reddest of American sports, professional football.

    Towering Republican heroes – political like Mitt Romney, military like John Kelly, both like John McCain – have come under Trump’s withering attack.

    Trump’s own former defense secretary, James Mattis, felt compelled to speak out against the treatment of American citizens during protests following the death of George Floyd at the hands of police. Comparing the president to Nazi propagandists, Mattis wrote: “We must reject and hold accountable those in office who would make a mockery of our constitution.”

    Among other things Trump has asked evangelical Christians, his staunchest allies, to overlook lurid descriptions of his sexual escapades, hush money paid to a porn actor and – with difficulty – the abandonment of vulnerable Christian communities in northern Syria.

    But the most difficult demand of Trump’s followers is unfolding now.

    For years, activists on the right railed against the possibility of US military deployment within the country’s borders. A conspiracy theory about such a program – called “Jade Helm 15” – grew so adamant that in 2015 Texas senator Ted Cruz requested an explanation from the Pentagon. It was a figment of the fevered rightwing imagination.

    But now, under Trump, the American self-invasion is coming true: squads of troops from agencies that normally oversee prisons, borders and drug enforcement have taken to the streets, often with no identifying insignia, to tamp down protests and riots. This week, active-duty troops mustered outside Washington, awaiting Trump’s command.


    The troop build-up alarmed Mattis, a retired marine general.

    “Militarizing our response, as we witnessed in Washington DC, sets up a conflict – a false conflict – between the military and civilian society,” he wrote. “It erodes the moral ground that ensures a trusted bond between men and women in uniform and the society they are sworn to protect, and of which they themselves are a part.”

    All these circumstances have converged to chip away at Trump’s previously granite-hard base.

    Fuzzell, the regretful waiter in Kansas, is not alone.

    “If I were a Republican operative, I’d be concerned about some of these numbers,” said Natalie Jackson, director of research at the Public Religion Research Institute (PRRI).

    PRRI’s latest poll shows Trump with an 11-point deficit to Biden. And underneath that margin, Jackson said, there are some previously unseen trends. For example, 47% of white voters with no college degree saw Trump favorably.

    “That’s an all-time low,” Jackson said. In 2019 that rating had averaged 52%. “It’s statistically significant.”

    Much of the drop may be because those non-degreed white voters – Trump’s hard core – have suffered mightily during the coronavirus outbreak.

    “They are more likely to work in the service industry, and are losing jobs at a higher rate, or going to work at a significant risk to their health,” Jackson said.

    It’s difficult to know, yet, how the current civil unrest may affect Trump’s support. But the initial signs are not in his favor. PRRI researchers collected their information around the country between May 26 and 31. Midway through that span, protests reached an inflection point when rioters burned down the Minneapolis police’s third precinct building.

    So the researchers, curious about the protests’ effect, divided their polling into pre- and post-precinct-burning samples. Among all Republicans, Jackson said, Trump’s favorability dropped a whopping 9% after the precinct fire, from 88% to 79%.

    Republican leaders have not turned against Trump, largely, but they have fallen silent. After Trump’s photo with a Bible outside St John’s, senators Mike Enzi of Wyoming and Rob Portman of Ohio told NBC, separately, they couldn’t comment because they were “late for lunch”.

    Senate majority leader Mitch McConnell, of Kentucky, said he didn’t want to “critique other people’s performances”.

    Cruz did offer criticism, of a sort. He leveled charges of abuse of power: “By the protesters, yes.”

    But other Republican leaders, those who have less to fear from Trump, have begun to denounce him. The last Republican president, George W Bush, sided with the protesters with a clear reference to Trump. He wrote: “The only way to see ourselves in a true light is to listen to the voices of so many who are hurting and grieving. Those who set out to silence those voices do not understand the meaning of America – or how it becomes a better place.”

    Related: 'Trump is tearing apart America': how the world sees the US protests

    Senator Mitt Romney, of Utah, said in a statement: “From the news clips I have seen, the protesters across from the White House were orderly and nonviolent. They should not have been removed by force and without warning, particularly when the apparent purpose was to stage a photo op.”

    One voter, who requested anonymity due to threats, wrote in a message: “Considering how far right the Trumpublican party has moved, I’m now considered left.”

    So he started a Facebook page, directly titled I Regret Voting for Donald Trump in 2016.

    “Many are afraid of posting in public due to fears of being attacked by unforgiving people on the left,” the voter said.

    But his page has 8,600 followers now.
    _______________
    The article's premise, that Trump's base of support is eroding is, IMO, fanciful. He's had much worse numbers in the past. He's nowhere near his historically-worst approval ratings (August 2017, with an Approval Index of negative 26 according to Trump's favorite poll.

    But it's the comments in red that represent the hardest thing for me to understand about Trump followers: Once upon a time, practically yesterday, conservatives would've exploded in paroxysms of unfettered rage and possibly even violence, at the thought of any president doing such things.

    But Trump is worshiped.

    WHY?
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  5. #275
    Senior Contributor Mihais's Avatar
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    Because the other side is way more crazy and the alternative to the other side is the lovely events of past days multiplied to Kosovo levels.
    Those who know don't speak
    He said to them, "But now if you have a purse, take it, and also a bag; and if you don't have a sword, sell your cloak and buy one. Luke 22:36

  6. #276
    Defense ProfessionalSenior Contributor tbm3fan's Avatar
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    Quote Originally Posted by Mihais View Post
    Because the other side is way more crazy and the alternative to the other side is the lovely events of past days multiplied to Kosovo levels.
    I don't think so.

    For all this talk about anarchists on the left one couldn't be more wrong. The really true anarchist here, the one who is upending, and wants to continue to upend and even destroy American institutions (in his name) is sitting in the White House right now by the name of Trump. Not to mention with every passing day he becomes more and more like all those tinpot despots that Latin America and South America has endured for decades.

    If Trump were to disappear a lot of what we see would calm back down without that two bit pot stirrer around. Right now, in that context, he reminds me of another version of Charles Manson and his Helter Skelter. Only here instead of a apocalyptic race war, and yet to some extent yes, he is feeding a apocalyptic war between two political ideologies.

  7. #277
    Turbanator Senior Contributor Double Edge's Avatar
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    Quote Originally Posted by TopHatter View Post
    The article's premise, that Trump's base of support is eroding is, IMO, fanciful. He's had much worse numbers in the past. He's nowhere near his historically-worst approval ratings (August 2017, with an Approval Index of negative 26 according to Trump's favorite poll.
    Been a while since i saw that poll.

    What we are left to figure out is why that index swings as it does.

    Covid handling was ok until we get into the second week of April then the index goes negative two figures.

    Kinda recovers in the first two weeks and a bit in May and then the gap between approve & disapprove widens again and its remained like that.

    He's at negative 17 today btw

    Not seeing any spike in approve over the George Floyd thing. Some people like Rushdie were saying he would exploit it.

    You article says it would get worse and Rushide thought it would improve.

    The floyd thing has not made a difference either way.

    Quote Originally Posted by TopHatter View Post
    But it's the comments in red that represent the hardest thing for me to understand about Trump followers: Once upon a time, practically yesterday, conservatives would've exploded in paroxysms of unfettered rage and possibly even violence, at the thought of any president doing such things.

    But Trump is worshiped.

    WHY?
    We wil find out just how much in Nov ; )
    Last edited by Double Edge; 09 Jun 20, at 22:25.

  8. #278
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    lol, Kosovo levels.

    right now the level of unrest isn't even half as severe as the 1992 Rodney King riots, let alone the riots following the death of MLK.
    There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "My ignorance is just as good as your knowledge."- Isaac Asimov

  9. #279
    Defense ProfessionalSenior Contributor tbm3fan's Avatar
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    Quote Originally Posted by TopHatter View Post
    [B][SIZE=3]

    But other Republican leaders, those who have less to fear from Trump, have begun to denounce him. The last Republican president, George W Bush, sided with the protesters with a clear reference to Trump. He wrote: “The only way to see ourselves in a true light is to listen to the voices of so many who are hurting and grieving. Those who set out to silence those voices do not understand the meaning of America – or how it becomes a better place.”
    I don't know about that as you would think those Senators, whose re-election is precarious in blue leaning states would come out against Trump and try to save their asses. These would be people like Collins or Gardner but they are silent. So I guess they can kiss their asses goodbye and good riddens for selling out their principles. It seems many can't resist the 40 pieces of silver consequently Christ didn't stand a chance.
    Last edited by tbm3fan; 10 Jun 20, at 00:47.

  10. #280
    Defense ProfessionalSenior Contributor tbm3fan's Avatar
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    Quote Originally Posted by Double Edge View Post
    Been a while since i saw that poll.

    What we are left to figure out is why that index swings as it does.

    Covid handling was ok until we get into the second week of April then the index goes negative two figures.

    Kinda recovers in the first two weeks and a bit in May and then the gap between approve & disapprove widens again and its remained like that.

    He's at negative 17 today btw

    Not seeing any spike in approve over the George Floyd thing. Some people like Rushdie were saying he would exploit it.

    You article says it would get worse and Rushide thought it would improve.

    The floyd thing has not made a difference either way.


    We wil find out just how much in Nov ; )
    Watch Trump over the next months with bad news. He doesn't handle bad news well especially a drum beat of constant bad news. Just as he is incapable of actually running a Top 500 company he is also incapable of dealing with bad news that assaults his ego. He will do what he has always done, even more so, that is strike out and flail which is not a good look. I'm counting on it.

  11. #281
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    Quote Originally Posted by Double Edge View Post
    Kinda recovers in the first two weeks and a bit in May and then the gap between approve & disapprove widens again and its remained like that.
    That's been the case for his entire presidency: A gently undulating wave with barely any meaningful peaks or troughs.

    Quote Originally Posted by Double Edge View Post
    He's at negative 17 today btw
    I saw that, yeah. He seems to lose support as the week starts, and then recovers it later in the week, an endless cycle.

    It'll be interesting to see what tomorrow looks like, though. This current cycle is pretty short compared to the semi-recent past.

    If he sinks into the negative 20s and stays there awhile, that'll be fairly amusing....but ultimately meaningless with the election so far off, because he'll eventually recover.

    Incidentally, his worst sustained numbers, in August 2017 as noted, were due to a double-whammy of his reactions to Charlottesville and Hurricane Harvey.
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  12. #282
    Defense ProfessionalSenior Contributor tbm3fan's Avatar
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    I was just reading an article by Alan Alda and his involvement with science. When he was asked what the best medicine he could think of especially during shelter in place he said laughter.

    That made me thinking. I have been aware of Trump since the mid-70s. Seen him countless times over those decades on TV. You know what? I have never seen that man laugh once at all. All he does do is seethe. Never trust a man who can't laugh.

  13. #283
    Resident Curmudgeon Military Professional Gun Grape's Avatar
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    Quote Originally Posted by GVChamp View Post
    Meh, I won't josh you around. Because we let them and we're willing to pay it.


    tbm has a good long-form answer. PBMs theoretically serve as middle-men between pharmacies and insurance companies. Handling pharmacy claims and handling medical claims are basically entirely different industries so it makes sense to have PBMs. In practice, major PBMs are basically combined with major insurance companies, and they are all looking to form strategic relationships with pharmacies as well....major vertical integration.

    So, PBMs negotiate drug discounts. So, we have no idea how expensive insulin really is in the United States. The PBMs negotiate those discounts and probably keep a big cut (no one knows how large).

    People like to blame insurance companies, but not all insurance companies are owned by major PBMs and a lot of them really dislike this. You might remember Amazon and Berkshire and some other company trying to make their own PBM. However, this is extremely difficult since this is a business of relationship and sales, and the Big Boys have market power, and the Little Boys do not.

    Also, modern insulins are a LOT better than older insulins. We (the royal we) are trialing out once a week insulin shots. If you still want old, cheap insulin, you can buy at Walmart for $25/bottle. It won't work for everyone, and you have to basically monitor your carbs like a porn addict cruising the Hub or you run the risk of severe medical incident.
    Wife got her insulin delivered today. 6 boxes of Lantus Solostar pens. Each box contains 5 pens. We had a co-pay of $10 for all 35 pens.

    Right after Hurricane Michael, when computers were down, no telephones we went to the local pharmacy and tried to get her a refill. They couldn't process our insurance but you can buy insulin without a prescription. The cost, without insurance, was $100 a pen.
    Think about that. I pay $10 for 35 pens. Someone without insurance would pay $3500. I know I have good insurance but damn someone is making a killing off the uninsured. My insurance company didn't eat $3490 so the wife could get cheap drugs
    Human Scum. Proud Never Trumper

  14. #284
    Turbanator Senior Contributor Double Edge's Avatar
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    Quote Originally Posted by TopHatter View Post
    That's been the case for his entire presidency: A gently undulating wave with barely any meaningful peaks or troughs.
    Going by the approval index, he has spent 98% of his term in negative digit territory. His only positive patch is the first month of his term and then the disapproves overtake approves. When he gets to zero it lasts only for a day or little more before slipping back.

    The riots have not made a noticeable difference to his ratings over two weeks later. I cannot seperate the effect of riots from covid.

    The effects of covid have pushed him into double negative territory. A slight recovery but slipped back again into double negative.

    Compare that with similar patches in his term without covid and ask if even covid is that big of a problem for him ?

    We will know more in three months when the economic side effects become more pronounced. But that is what the stumulus was for and if it works as thought he makes the slow climb back into single digit territory.

    Quote Originally Posted by TopHatter View Post
    I saw that, yeah. He seems to lose support as the week starts, and then recovers it later in the week, an endless cycle.

    It'll be interesting to see what tomorrow looks like, though. This current cycle is pretty short compared to the semi-recent past.

    If he sinks into the negative 20s and stays there awhile, that'll be fairly amusing....but ultimately meaningless with the election so far off, because he'll eventually recover.

    Incidentally, his worst sustained numbers, in August 2017 as noted, were due to a double-whammy of his reactions to Charlottesville and Hurricane Harvey.
    If that index is negative double digits around polling time a second term is unlikely otherwise he's in.

    Low single negative numbers, in, double negative, out.

    We'd get a better handle of this if it was possible to correlate why that index rises or falls.

    There's a trigger that starts the difference, if things don't improve it slowly grows.

    At some point he does something to reverse the trend.

    This reminds me of celsius & Fahreheit. The latter is preferred in the US to the former elsewhere.

    The latter is more sensitive and shows changes faster.

    In a polling context it would be too sensitive and not suffciently dampened.
    Last edited by Double Edge; 10 Jun 20, at 16:14.

  15. #285
    Turbanator Senior Contributor Double Edge's Avatar
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    Quote Originally Posted by tbm3fan View Post
    I was just reading an article by Alan Alda and his involvement with science. When he was asked what the best medicine he could think of especially during shelter in place he said laughter.

    That made me thinking. I have been aware of Trump since the mid-70s. Seen him countless times over those decades on TV. You know what? I have never seen that man laugh once at all. All he does do is seethe. Never trust a man who can't laugh.
    What about his rallies ? he's got to be smiling a lot for those.

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