Pay Or Die

It turns out that some of the Sackler family were pressing hard to get more people addicted to the opioids Purdue Pharma was selling, even as they were trying to avoid media coverage for their drug connections and donating to museums, which should now be removing the Sackler name from their halls.

But that’s only secondarily what this post is about. It turns out that manufacturers of insulin, which many people need to stay alive, have been gaming the system to make things more profitable for them and much more inconvenient for patients and doctors. But what’s human suffering compared to profit, hey Ray Sackler?

The exorbitant prices confound patients and doctors alike since insulin is nearly a century old now. The pricing is all the more infuriating when one considers that the discoverers of insulin sold the patent for $1 each to ensure that the medication would be affordable. Today the three main manufacturers of insulin are facing a lawsuit accusing them of deceptive pricing schemes, but it could be years before this yields any changes.

There are several reasons that insulin is so expensive. It is a biologic drug, meaning that it’s produced in living cells, which is a difficult manufacturing process. The bigger issue, however, is that companies tweak their formulations so they can get new patents, instead of working to create cheaper generic versions. This keeps insulin firmly in brand-name territory, with prices to match.

This is why we need a different healthcare system. I’m not well enough informed to know whether it’s single payer or Medicare for All, or something else. But this profiting off human suffering has to end.

Open thread.

Saturday Morning Open Thread: Social vs. Anti-Social Media

Michelle Goldberg, smart person in the NYTimes, “Our National Emergency Turns 2”:

I feared, at the beginning of this administration, that Trump would try to exploit American intelligence capabilities against his personal enemies, but instead he gets his intelligence from Fox News. The fact that so many high-level Trump associates have pleaded guilty to crimes is a sign of his corruption, but it also shows he hasn’t corrupted our entire system.

Trump has turned out to be the Norma Desmond of authoritarians, a senescent has-been whose delusions are propped up by obsequious retainers. From his fantasy world in the White House, he barks dictatorial and often illegal orders, floats conspiracy theories, tweets insults and lies unceasingly. But much of the time he’s not fully in charge. He has the instincts of a fascist but lacks both the discipline and the loyal lieutenants he’d need to create true autocracy.

That doesn’t mean, however, that the country isn’t coming undone. Trump’s bumbling incoherence, coupled with his declining political fortunes since the midterms, makes him seem less frightening than he once did. But, two years in, the jaded weariness many of us have developed might obscure how bad things are. We’re living through an unprecedented breakdown in America’s ability to function like a normal country.

The shutdown throws our crisis into high relief. For the first two years, Trump destroyed American norms, standards and conventions. Now he’s cavalierly destroying American lives…

Gropey Glenn Thrush wails: But mah NARRATIVE!…

Approximate Mood

Steve earlier today (picture sucks because I was in the other room but if I got closer he would have moved) and me right now.

Friday Night Performative Dance of ‘Statesmanship’ Open Thread

In a parallel development, Bill Belachik, Tom Brady, and Rob Gronkowski all agree the Patriots are entitled to win this year’s Superbowl….

Who am I kidding? Belachik, Brady & Gronkowski are hard-working professionals who actually show up and do their damned jobs, unlike the grifters and leeches surrounding the Oval Office Squatter. So I’m guessing we’ll get a Very Serious Totally Not Partisan Emergency Statement tomorrow, assuming his handlers can find the right mix of pharmaceuticals to keep Donny Dollhands awake and more or less on script.


And in a fitting coda, Trump’s 2020 campaign manager has discovered Erick Erickson’s old Red State Trike Farce Strike Force direct-mail con:

Mueller’s Office Speaks

This could mean almost anything. But it looks like something is seriously wrong with the BuzzFeed report.

I don’t think there’s enough there to speculate on specifics, but I’m sure others will.

And open thread!


Guys, I’m starting to think there’s something to this Buzzfeed story about Trump suborning perjury and obstructing justice:

Hold up, Gidley — let a pro show you how to deflect:

Except last week Trump said actual supermarket tabloid rag The National Enquirer is more credible than The Washington Post, and The National Enquirer was running interference for Trump during the 2016, as we now know.

Sarah Huckabee Sanders is the only one who remembers the go-to strategy of straight-up lying:

Well, lying is her full-time job. Anyhoo, I hesitate to say it, but this feels something like a turning point. We’ll see.

Today In Congressional Delegations That Haven’t Been Cancelled In A Fit Of Presidential Pique: Where In The World Is Lindsey Graham?

Why he’s right here meeting with Erdogan in Ankara!

emIHA Photo/em

I’m sure President Erdogan has important facts for Senator Graham regarding matters under his oversight as chairman of the Senate Judiciary Committee. Perhaps Turkey’s National Intelligence Organization has SIGINT that will once and for all put to bed whether Associate Justice “I Like Beer” Kavanaugh was or was not having brewskies with PJ and Squi. I’m sure that Erdogan, being a noted proponent of the Rule of Law, wanted to ensure this got to the right person.

The Daily Sabah has the details:

U. S. Republican Sen. Lindsey Graham arrived in Turkey on Friday for meetings with top officials, including President Recep Tayyip Erdoğan and Foreign Minister Mevlüt Çavuşoğlu.

In both meetings, Erdoğan and Çavuşoğlu discussed with Graham the murder of Saudi dissident journalist Jamal Khashoggi and the U.S. decision to withdraw from Syria.

It is important to remember that while Senator Graham is a member of the Foreign Relations Committee, he is not the Senate Foreign Relations Committee’s chair. That would be Senator Risch, who has no professional or personal experience with foreign policy or foreign relations. He’s a former prosecutor and former governor from Idaho.

While Senator Graham was en route to Turkey to conduct congressional business far, far outside of his actual duties and responsibilities, the President and his enablers – Mick “Man of a Thousand Jobs” Mulvaney, Bill “I Fix Sexual Harassment Issues for All My Bosses” Shine, Mercedes “My Family Were Refugees, Which is Why it is Important that No One Else’s Can Be” Schlapp, Sarah “I Slept Through the Class on Bearing False Witness at Ouchita Bible College” Huckabee Sanders, Stephen “I Don’t Care if I am Jewish, I can too be a White Supremacist!!!” Miller, and Jared “Shonda for the Goyim” Kushner and Ivanka “Almost a Willowy Shiksa” Trump, decided to further endanger Speaker Pelosi, the other members of the House who were scheduled to go with her on her Congressional Delegation to NATO in Brussels and Afghanistan, as well as the military and civilian personnel scheduled to meet with them in Afghanistan.

Maybe if Speaker Pelosi were to play golf with the President and let him cheat like Senator Graham does, she might be able to go somewhere some day.

And that last bit is serious. Because of changes made in the wake of 9-11, the Speaker of the House flies on official US aircraft for security purposes. This is not a legislative requirement. There is no statute that requires it, however, it has become the customary and routine security arrangements for the Speaker of the House, no matter who he or she is, and no matter how badly they’re annoying the President on policy disagreements. While Speaker Pelosi has the wherewithal to travel commercially, this isn’t a change in policy being made after a review, this is a temper tantrum that placed not just Speaker Pelosi, but other members of the House of Representatives, members of their staffs, members of their security details assigned for the trip, and the military and civilian personnel awaiting them in Afghanistan in danger.

We are off the looking glass and through the map.

Open thread.

Open Thread: The Only Things the Reicht-Wingers Recycle Are Their Paranoid Fantasies

“Prayer rugs” at the border, my flabby white arse — that was one of the OOOH SCARY ooga-booga Sean Hannity talking points from the summer of 2014.

Some of the ranchers along that border use barbed wire or razor wire atop their fences, and IIRC were turning up abandoned carpet samples that migrants used to get over the wire without injury. When the normal people laughed at Sean’s ‘killer Mooslim!!!’ theories, some numbnut supporter showed up with a no-really-guys ‘prayer rug’ that turned out to be a soccer jersey.

That was the year that James O’Keefe managed to milk the marks by showing up at the border in an Osama bin Laden mask, in case that sparks any recollections.

They’re not in any way smart, these people, but they sure to Murphy the Trickster God are persistent. But then, so is shingles — and at least we’ve got vaccines for shingles.

Disturbing the Peace (Open Thread)

Last night, the mister and I took a sunset cruise in our little swamp boat and annoyed this innocent anhinga:

The bird is clearly saying “FUCK YOU!!” at the 24-second mark.

Anhingas are also called “snake birds” because they swim with their heads sticking out of the water, resembling a snake. After swimming, they roost in trees or on snags to dry their wings. Cormorants do the same and closely resemble anhingas, only cormorants have a curved beak. Here’s one we saw on the same excursion:

Got any big plans for the weekend? Is anyone participating in one of the Women’s Marches taking place nationwide? I was just reading a depressing account of the national Women’s March org — Women’s March Inc. Sounds like they’ve managed to fuck up the whole thing. Le sigh.

We’ll probably hang out at home, maybe go annoy some more swamp critters. You?

Trump is on Twitter fomenting anti-immigrant hatred. Maybe he’s trying to change the subject from the revelation that he committed a felony by directing an underling to lie to Congress, or maybe he’s trying to distract the media from the snowballing effects of the Trump shutdown. Or both. Maybe neither.

He’s claiming that ranchers are finding “prayer rugs” on the border — likely he’s narrating some Fox News reportage, which intersperses clips of interviews with American crackpots and shots of correspondents yelling “CARAVAN” at random pedestrians in Central America.

Rugs, though. That’s some scary stuff. Why, just yesterday, I tripped on a rug with an upturned corner and very nearly stubbed my toe on a coffee table leg.

Anyhoo, open thread.

The 2017 Market Stabilization Rule and Silver loading

The Trump administration enhanced Silver Loading by the emergency Market Stabilization rule that the Center for Medicare and Medicaid Services (CMS) pushed out in April 2017.

This rule had several major elements. The relevant one is that the rule expanded the bands of allowable de minimas variation from the actuarial value target of each metal band. Under the old rule, a non-Cost Sharing Reduction (CSR) subsidy plan had to be within two points of the target. A CSR plan had to be within one point of the target. The new rule changed those bands for non-CSR plans. Now a Silver, Gold or Platinum plan could be up to four points under the target.

The allowable spread between a baseline Silver plan and a maximally allowed CSR plan variant increased. Under the original rule, a CSR 94 plan could be no more than 27 actuarial value points (41%) richer than the standard silver plan that someone is buying.

Under the new rule, the CSR 94 plan could still be a 95% AV plan. However the baseline plan could now be a 66% AV plan. This is a gap of 29 actuarial value points or 44% of the baseline plan. This would have been an interesting factoid if CSR was still being paid through a direct payment. However, as we all know, CSR is not being paid directly.  Instead, it is being paid by insurers calculating what the CSR costs would have been and then rolling those costs directly into Silver premiums.

If we were in a world of no CSR but no market stabilization rule changing the allowable minimal actuarial value, the benchmark bump would several points smaller as the gap between the purchased Silver plan and the CSR plan would be smaller.  The size of the total net bump would be dependent on state characteristics of the marketplace but back of the envelope, the market stabilization rule in a CSR world added an extra point to the silver rates in 2018 above and beyond normal premium increases.  An extra point is not a lot when Bronze and Gold rates went up by 17 points and Silver rates went up by 33 points, but it is meaningful as it increases the number of counties and families exposed to a zero premium plan by a marginal amount.

On the Road and In Your Backyard

Good Morning All,

On The Road and In Your Backyard is a weekday feature spotlighting reader submissions. From the exotic to the familiar, please share your part of the world, whether you’re traveling or just in your locality. Share some photos and a narrative, let us see through your pictures and words. We’re so lucky each and every day to see and appreciate the world around us!

Submissions from commenters are welcome at

Have a great day and weekend, and enjoy the pictures!

Time for some doggies!

Read more

Friday Morning Open Thread: Shutdown Sh*tshow

(Tom Toles via

While we wait, not so patiently, for Robert Mueller and/or other experts to further discuss Buzzfeed‘s big reveal from last night…

From Vanity Fair, “Trump Doesn’t Understand Why He’s Losing the Shutdown”:

With each passing day, it seems less likely that Donald Trump will negotiate a speedy resolution to the ongoing government shutdown. Ordinarily, in the case of a political standoff, one side will concede after the consequences exceed their pain threshold, or once both sides grow tired of posturing and agree to compromise. Trump, however, appears to be lacking in any of the traits that might bring him to the negotiating table. He is, for one, largely apathetic to the 800,000 or so federal workers who are not getting paychecks (“most of the people not getting paid are Democrats,” he has said). He is arrogant enough to believe that the American people largely back his position, despite polling showing the exact opposite (58 percent of Americans told the Pew Foundation that they oppose the wall, and would also oppose a deal that included wall funding). And he lacks the political sophistication to understand what is motivating Democrats in Congress to hold firm.
Read more

‘Junkets’ Under Fire Open Thread: Calling Trump’s Cronies Amateurs Is An Insult to People Who Don’t Get Paid

Guess Trump really *did* enjoy his SooperSekrit Iraq drop-in… he got to hang around with real live G.I. Joes, and some of them were properly thrilled when he signed MAGA hats for them. Not sure his minions understood that normal people might have different reactions…

This Is Not Going to End Well for Europe: EU Regulator Denies McDonald’s Big Mac Claim

From Courthouse News:

(CN) — There’s only one Big Mac, right? Not so fast. In a supersized trademark controversy, a European regulator has ruled in favor of an Irish fast-food restaurant chain and stripped McDonald’s of its exclusive use of the name Big Mac in the European Union.

The European Union Intellectual Property Office, based in Spain, recently ruled in favor of a popular Irish burger chain called Supermac’s and said McDonald’s had failed to prove it can claim ownership of the Big Mac trademark.

McDonald’s on Thursday vowed to appeal and claims it still retains the trademark rights to Big Mac, the iconic stacked hamburger with its special sauce and storied history of Big Mac lovers, among them President Donald Trump, and John Travolta’s character in the film “Pulp Fiction.”

Supermac’s has challenged the American giant since 2014, claiming McDonald’s engaged in “trademark bullying” to stifle competition and stop it from expanding into Great Britain and across Europe. Supermac’s line of burgers and meals are similar to McDonald’s. On its menu is a Mighty Mac burger and it has plans for a SuperMac burger.

In its filings, McDonald’s claimed Supermac’s name was confusingly similar to Big Mac. McDonald’s Big Mac trademark covered not only burgers but also franchises.

The first Supermac’s restaurant opened on the main street of Ballinasloe in County Galway, Ireland, in 1978, and today there are more than 100 outlets across Ireland and Northern Ireland. Pat McDonagh, the chain’s founder, says Supermac was his boyhood nickname when he played Gaelic football.

If you’re still hungry for more, click the link and dig in!

How long until the President nukes Ireland and Spain?

Open thread!

Oh Hey This is Obstruction of Justice and Impeachable

But the Republicans won’t do anything about it:

President Donald Trump directed his longtime attorney Michael Cohen to lie to Congress about negotiations to build a Trump Tower in Moscow, according to two federal law enforcement officials involved in an investigation of the matter.

Trump also supported a plan, set up by Cohen, to visit Russia during the presidential campaign, in order to personally meet President Vladimir Putin and jump-start the tower negotiations. “Make it happen,” the sources said Trump told Cohen.

And even as Trump told the public he had no business deals with Russia, the sources said Trump and his children, Ivanka and Donald Trump Jr., received regular, detailed updates about the real estate development from Cohen, whom they put in charge of the project.

Dollhands should be in lockup.