It’s time to give Bernie his due. Sanders, the Vermont Senator from Brooklyn, is nearing the end of his political career, but he’s going out with a bang instead of a whimper.

Sanders, an avowed socialist who honeymooned in Russia, has long been considered a radical in the Democratic party, so much so that he actually left the party and became a declared independent who caucuses with the Democrats. But even as a radical outside the party he has managed to reshape the party in his own image.

At the virtual Democratic National Convention, Sanders stole the spotlight on the first night, and with good reason. Although he was considered too radical to be the face of the Democratic presidential candidate, he has become the framer of its political platform. Don’t take my word for it.

The Wall Street Journal editorial board says, “The ideas that once were deemed radical are now Joe Biden’s platform.”They say Joe Biden has made the unprecedented move from a moderate to a far left radical after winning the Democratic presidential nomination. Most candidates move closer to the center as they approach the general election to appeal to a wider range of voters. But not Uncle Joe.

The proof of this is his invitation to Sanders and his team to join the Biden team on platform task forces. Biden allowed radical Rep. Alexandria Ocasio-Cortez to co-chair the task force on climate change. He allowed Stephanie Kelton, the evangelist for Modern Monetary Theory or cost-free money printing, to sit on the economy panel. Even Rep. Pramila Jayapal, the Seattle proponent of Medicare for All, co-chaired the healthcare group.

Sanders is enjoying his moment. On Sunday’s Meet the Press, Sanders gushed, “The people on those task forces worked very, very hard. And I’m not here to tell you, as a strong advocate for Medicare for All, that we got everything we wanted. We surely did not. But I think if people look at the outcome of those task forces, they’ll find the reality that if those task force proposals are implemented, you know what, Joe Biden will become the most progressive president since Franklin Delano Roosevelt.”

He knows what he’s talking about. WSJ editors call the 110-page Biden-Sanders manifesto “the most radical policy document of either major party in our lifetimes. It leaps to the left of the Obama Administration on nearly every policy area, from education to taxes to climate change.”

Here are a few of the notable proposals:

• Medicare for All/ Elimination of private health insurance – Biden won’t admit this is the immediate goal but his “public option” and the reinstatement of the Individual Mandate will lead to the same result within a few years. The first step would be Medicare for anyone over 60 and Medicaid expansion would be expanded to all states. Bernie Sanders has to be ecstatic to be this close to his ultimate prize.
• Elimination of Carbon Fuels (The Green New Deal) – Democrats pledge to “retrofit” four million buildings and two million households in five years. All new American buildings will be “net-zero” in carbon emissions by 2030; all 500,000 school buses nationwide will be “zero-emission alternatives” within five years. America has become the leading producer of fossil fuels in the world under President Trump; an energy exporter no longer dependent on the unstable Middle East. Biden will reverse all that progress. If you want a peek into the Biden future, just look at California today.  They are experiencing frequent “Green Blackouts” because the renewable energy systems they are promoting can’t provide adequate energy for the state when demand is high in hot weather.
• All public-works projects must pass new climate test – This in practice will eliminate new fossil-fuel projects. That means all new public-works projects will suffer from the instability of renewable energy in meeting everyday energy demands.
• Right to work laws repealed and labor laws rewritten to favor unions – This would force all employees to join and support unions. This is bad for workers who must pay fees to unions they don’t believer represent them and will undermine our political system by providing funding for only those who bow to union policies.
• Most student loans written off/Public college free – Families making less than $125,000 per year would have no college tuition payments. Just imagine the cost of that to the taxpayers!
• Eliminate School Choice – Bowing to the teachers unions, Biden will eliminate federal funding for charter schools. He favors the teachers unions over the poor minority children who most benefit from these charter schools.
• Public policy based on race theory and political identity – It would create a new public credit facility at the Consumer Financial Protection Bureau to “provide consumers with a government option that seeks to minimize racial disparities.” The Federal Reserve will be given a third political mandate for redressing racial injustice, in addition to low inflation and full employment.

No one has bothered to explain how we’ll pay for all these proposals – that’s not important! These ideas were considered radical not long ago. Today, they make up the mainstream agenda of the modern Democratic party.The public would recognize the radicalism of Sanders, but not Biden. President Trump has called Joe Biden the “trojan horse” for the Democratic Party because they are using Biden to get their progressive agenda inside the walls of the White House. .This is not just a political slogan – it is reality.

The WSJ editors summarize: “The political cliché every four years is that party platforms don’t matter, and usually that’s true. This time is different. More than any recent nominee of either party, Mr. Biden has no clearly defined agenda of his own. Can you think of a single idea or proposal that is distinctively his? He has absorbed what his party wants, and the Biden-Sanders manifesto reflects that.”

Congratulations, Bernie.

(Note: As a physician, my expertise is principally on healthcare issues. For more on Medicare for All, plug in the words “Medicare for All” in the search engine and read earlier posts on this subject and others on single-payer healthcare systems and socialized medicine.)

“Never let a crisis go to waste.” We heard these immortal words from former White House chief of staff for President Obama, Rahm Emmanuel. It seems the teachers unions were paying attention. They don’t want to waste the opportunity to use the Covid-19 pandemic as a cudgel to force politicians to deliver their wildest dreams in the name of “safety” for school children.

Concerns for the welfare of children have never been on the minds of teachers unions before. Despite the overwhelming evidence that charter schools, especially in poor, urban neighborhoods like New York City, outperform their public school counterparts, the teachers unions are trying to eliminate charter schools. Their concern is only for teachers who pay union dues.

Now they are seizing on the Covid-19 pandemic to insist their demands be met lest the safety of children be compromised. This hypocrisy would be laughable except for the high price to be paid by those children who are denied an education.

The Wall Street Journal editorial board is calling out the leader of the teachers unions, Randi Weingarten, of the American Federation of Teachers. Last week she demanded “safety strikes” if local unions deem insufficient the steps their school districts are taking to mitigate Covid-19. An alliance of teachers unions and progressive groups are calling for a “national day of resistance” around the country if their demands are not met. These demands include:

• Support for communities and families – canceling rent and mortgages, a moratorium on evictions/foreclosures; direct cash assistance to those not able to work or unemployed, and other social needs
• Moratorium on new charter or voucher programs and standardized testing
• Massive infusion of federal money to support the reopening funded by taxing billionaires and Wall Street

WSJ editors frame this well: “The phrase for this is political extortion. Rather than work to open schools safely, the unions are issuing ultimatums and threatening strikes until they are granted their ideological wish list. Children, who would have to endure more lost instruction, are their hostages.”

The unions are also lobbying their political allies to keep public charter and private schools closed. They succeeded in Maryland’s Montgomery County where Travis Gayles, the chief health officer, ordered private schools to remain closed until October 1. Fortunately, Marlyland Governor Larry Hogan overruled the commissioner. He said, “Private and parochial schools deserve the same opportunity and flexibility to make reopening decisions based on public health guidelines.”

The obvious but unstated goal is to eliminate private and charter schools. Public schools are funded whether or not they open because taxpayers continue to pay their taxes. But private and religious schools, which rely on tuition and donations, will suffer when their schools do not reopen. The Cato Institute’s Center for Educational Freedom estimates that 107 private and religious schools have been shut down permanently at least partly due to Covid-19. New York’s Catholic archdiocese has announced the closure of 20 schools.

These private and religious schools, as well as charter schools, represent a threat to teachers unions because their teachers are not union members. They have no control over their teachers and receive no dues from them. The attempt to eliminate their competition is a transparent ploy.

All this comes as no surprise. The United Teachers of Los Angeles (UTLA) had earlier revealed their equally progressive demands when California school districts closed their public schools. (Teachers Union Demands Reveal Progressive Agenda) Their demands go far beyond anything remotely related to the safety of children, including demands for Medicare for All, defunding police, and healthcare for illegal immigrants!

Anyone remotely paying attention will quickly realize the only real agenda of the teachers unions is whatever it takes to increase the ranks of their members. This has nothing to do with children or their safety.

Last post I discussed the Trump executive orders to reduce drug prices. I outlined the Trump plan with the following points:

• Ban drug-maker rebates in Medicare Part D
• Benchmarking Medicare’s reimbursement rates to International Pricing Index
• Specific lowering of drugs at Federally Qualified Health Centers

The Wall Street Journal editorial board opposes this plan and I discussed their reasons. For a review of their reasons for opposition, visit Part I. Today I will discuss another point of view from one who supports this plan.

Support for the Trump Plan

Avik Roy, healthcare economist writing in Forbes, supports the Trump plan. Roy supports the International Pricing Index (IPI), although he would prefer if the benchmark focused on countries with private health insurance, instead of single-payer systems, like Canada and the United Kingdom. While Medicare can generate savings by using an index that includes single-payer nations, it would generate even greater savings if the index was focused on countries with the most market-oriented health care systems.

He says the latest Trump plan, which calls for HHS Secretary Alex Azar to come up with a plan to test whether such a rule would reduce costs and improve outcomes, turbocharges the IPI. Instead of Medicare paying drug companies at the averageprice of a group of industrialized countries, Medicare would pay the lowest price among comparably wealthy nations.

He states this makes eminent sense. In any normal market, the biggest purchaser of a product is able to negotiate the lowest bulk price for that product. In the bizarre world of Medicare dug spending, taxpayers are forced to pay the highestprice even though they represent the largest market in the world for prescription drugs. Furthermore, the most-favored-nation approach will do the most to reduce seniors’ out-of-pocket costs, and the most to reduce entitlement spending and thereby the deficit.

He supports the Trump plan which requires pharmacy benefit managers (PBMs) to pass their discounts or “rebates” directly to the patients using those drugs, in way that would improve the efficiency of the prescription drug market and lower costs for seniors. He says that rebates amount to about $30 billion a year.

He also approves of eliminating providers from jacking up rates on drugs they obtain through the federally supported FQHCs and pocketing the difference. He argues these drugs have been provided by federal support and patients must not be overcharged when they receive treatment.

The drug lobby argues that these interventions by the Trump administration will undermine the “free market” for prescription drugs. Roy says a truly “free market” for prescription drugs does not exist in the U.S. He makes two points:

• Branded drugs in the U.S. are protected by government-imposed and government-enforced monopolies through the patent system.Monopolies are not markets. He argues drug-makers have used the system to extend their monopolies through trivial and non-innovative modifications to existing drugs in order to continue raising their prices.
• The U.S. health care system makes it easy for drug makers to charge whatever they want. The tax exclusion for employer-sponsored insurance prevents patients from shopping for the coverage and care that serves them best. Insurance mandates force coverage of certain drugs regardless of their cost. Medicare Part B effectively writes blank checks to drug companies to charge whatever they think they can without causing excessive reputational damage.

Roy concludes with these words:“President Trump has many faults, but he deserves credit for tearing up this stale ideological oaf. His executive order could save tens of billions in taxpayer funds, and help millions of low-and middle-income Americans better afford their medicines.” 

There you have it – two opposing points of view on an issue we all can relate to. We all want lower drug prices but we also want new and innovative drugs available as soon as possible. The Covid-19 pandemic has made this issue highly relevant as we all wait eagerly for the development of new drug therapies and an effective vaccine.

Is this new Trump plan to lower drug prices a good or a bad idea?

Let me know what you think.