On July 26, 2020, US President Donald Trump signed an executive order under which the US government’s Medicare Part D program would have negotiated lower prescription drug prices based on an “International Price Index.”

Implementation of the order was delayed pending counter-proposals from Big Pharma, but the Democratic response was swift. “Instead of meaningfully lowering drug prices, President Trump’s Executive Orders would hand billions of dollars to Big Pharma,” House Speaker Nancy Pelosi (D-CA) complained, without explaining why or how.

On September 9, the US Department of Health and Human Services released the Biden administration’s “Comprehensive Plan for Addressing High Drug Prices.”

Here’s the problem the report identifies: “Patients in other comparable countries regularly pay substantially less for prescription drugs than Americans.”

Here’s the report’s solution: “Allowing the Secretary of HHS to negotiate Medicare prices will achieve fair prices for beneficiaries when markets fail to do so. Allowing commercial payers, including employer and Marketplace plans, to access those prices will extend savings to additional consumers.”

Sound familiar? It should. It’s essentially Trump’s plan.

It’s also Pelosi’s plan, as expressed in the Elijah E. Cummings Lower Drug Costs Now Act, which would allow HHS to negotiate drug prices and limit what it could offer to 120% of the average price paid by other wealthy western countries.

Just to be clear, if the American political establishment was really interested in lowering drug prices, it would eliminate prescription coverage under Medicare (and if it was really interested in lowering healthcare costs in general, it would eliminate Medicare).

Neither of those things being “on the table,” so to speak, having Medicare drive a harder bargain when paying for prescription drugs just makes sense — not because, as the HHS report pretends, Medicare is distinct from “the market,” but because Medicare is a substantial player IN the market.

Medicare Part D isn’t a monopsony (that is, a single buyer, just as a monopoly is a single seller), but it is the biggest single buyer of prescription drugs in the US healthcare market.  It’s well-positioned to demand a quantity discount, or at least a reasonable price. And it should. Overpaying for prescription drugs is healthcare’s version of paying “defense” contractors $800 for toilet seats.

Why do Republicans and Democrats both talk a lot about controlling Medicare spending on drugs, but never actually get the job done?

That’s no mystery: Big Pharma makes bigger campaign donations and hires more lobbyists than you do.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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“We’ve been patient, but our patience is wearing thin,” US President Joe Biden said on September 9 as he announced his plan to require more than 80 million private sector American workers to consent (sic) to a COVID-19 vaccine, or submit to weekly testing, or be fired by companies with more than 100 employees (those companies will be fined $14,000, by the Occupational Safety and Health Administration, for each instance of failure to enforce the edict).

The ostensible purpose of the mandate is to combat a raging COVID-19 pandemic, but that supposed purpose doesn’t pass the smell test.

US COVID-19 deaths in August, according to the US Centers for Disease Control, came to less than 1/3 the number for January — and total deaths from all causes in the US in August came to 1% less than the expected number (less than 100% for the first time since January 2020), compared to 138% of the expected number in January.

With the “delta” variant, the virus is taking exactly the path one expects high-R0 respiratory viruses to take: Getting more contagious, but weaker, passing from “pandemic” to “endemic.” Vaccine mandates and media scare campaigns won’t change that trajectory. Vaccines are certainly helping reduce deaths in the meantime, but any supposed emergency is over and has been for some time.

Biden’s vaccine mandate brings to mind another vaccine mandate from last year:

As of May 2020, Moderna’s COVID-19 vaccine had established its basic safety according to the US Food and Drug Administration’s criteria, but its efficacy was still being tested.

FDA — which subsequently gave “fast-track” full approval to an Alzheimer’s drug that has likewise proven its safety but not its efficacy — mandated that you couldn’t receive that vaccine.

Hundreds of thousands of Americans died while FDA sat on its hands for six months before issuing its first COVID-19 vaccine “emergency use authorization.”

FDA wouldn’t let you have the vaccine even if you wanted it.

Now Biden’s trying to force you to accept it even if you don’t want it.

These mandates aren’t about vaccines, or about COVID-19.

They’re about letting the serfs know who’s in charge, and maybe scoring a few partisan culture war points.

No number of deaths is too many for FDA where the question of establishing its authority is concerned.

No amount of damage to civil liberties or the economy is too severe if it allays Joe Biden’s impatience with your slowness to bend the knee.

Resist much, obey little.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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Twenty years after the 9/11 attacks, the US government is finally — well, probably, kinda sorta — ending its lost war with Afghanistan, drawing down its presence in Iraq, and reducing the heat of its “global war on terror” from a rolling boil to  hot-tub temperature.

Good news, right?

After two decades of getting groped at airports, searched and surveilled without warrant or even probable cause, and paying through the nose to finance the murders of hundreds of thousands of civilians  in the Middle East and Central Asia BECAUSE OSAMA BIN LADEN, we can get back to an America that looks a little bit more like an America nobody under the age of 20 or so remembers, and a little bit less like East Germany, right?

And without the burden of $70 billion per year in Afghanistan war costs alone, not even counting other “war on terror” boondoggles, we can take a chainsaw to the “defense” budget and cut America’s military machine down to something resembling a reasonable size, right?

Well, not so fast.

So far there’s no sign of the Transportation Security Administration being disbanded or of the FBI ceasing to use paid informants to  manufacture “terror plots” to justify its existence, or of the NSA taking off its headphones, cruising off to the break room for a cup of coffee, and letting us make our phone calls with a reasonable expectation of privacy.

And the US House Armed Services Committee wants to increase the “defense” budget by even more than President Biden has requested, rather than give it even a moderate haircut.

What’s up with that?

The national security state that took root in the US after World War 2 has always required a designated enemy, a boogey-man sufficiently threatening to make its massive and continuous transfers of wealth from your wallet to the bank accounts of “defense” contractors seem reasonable.

Until 1990, the main designated boogey-man was the Soviet Union. When that paper tiger fell through the shredder and into the dustbin of history without warning, a decade-long scramble to manufacture a new enemy ensued, and found success when al Qaeda finally managed a successful stroke on US soil after years of warning of its intention to do exactly that if US troops didn’t get out of Saudi Arabia.

Now that the “war on terror” — an obvious scam from the beginning — is all played out after working its boogey-man magic for 20 times as long as even the most optimistic con artist would likely have predicted way back when, it requires a replacement. Hopefully a more expensive replacement, and certainly one that doesn’t reduce the revenues of the previous grift.

What kind of gift do you get for the country that has everything, including ubiquitous surveillance cameras, facial recognition systems, airport body scanners, and “Real ID” internal passports?

Well, the traditional 20th anniversary gift — and, it seems, the national security state’s romantic and thoughtful choice of new designated enemy for America — is China.

Happy anniversary, I guess. But frankly I’d prefer divorce papers and no alimony demands.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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