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Saturday, March 2, 2024

FAILURES & SCANDALS OF THE INTERNATIONAL RED CROSS

 Overview 

The American Red Cross is the largest contributor to the International Committee of the Red Cross (ICRC), which has a long history of visiting prisoners of war and hostages. Lately, the organization has been losing credibility and as a result of financial strain, it has been forced to cut jobs. The ICRC has been under increasing pressure to do more to assist Israelis who are being held captive by Hamas. The group has come under fire for failing to denounce the October 7 attack on Israel by taking a neutral stance in the dispute. A $2.8 million lawsuit was recently filed against the ICRC on behalf of persons and the families of those taken hostage by Hamas. The lawsuit is being led by Israeli human rights organization Shurat HaDin. It claims that the International Committee of the Red Cross (ICRC) has not moved quickly enough to help free the hostages. The ICRC is also under pressure to suspend its partner, the Palestinian Red Crescent Society, as it has been found that its ambulances have been used to transport terrorists and weapons, which is a violation of its fundamental principles. When asked if a Red Cross staffer had advised the family of an Israeli hostage taken by Hamas to worry more about the people of Gaza than their loved one, the chief spokesman for the International Committee of the Red Cross (ICRC) was accused of playing word games in a January 2024 interview on CNN. The spokesperson expressed regret that the family had heard something different, instead of offering an apology. He was pushed even harder for not accepting responsibility for the staff member's behavior. The ICRC's impartiality was also called into doubt later in the interview as it condemns Israel more than Hamas, the group responsible for starting the conflict.

[MORE]

https://www.offthepress.com/wp-content/uploads/2024/02/2.6.24-IAF-Red-Cross-Israel-.pdf

HHS Says Only 2 Pages Of Scientific Evidence Back Support For “Gender-Affirming Care”

The Department of Health and Human Services said it has only two pages of literature supporting Assistant Secretary Rachel Levine’s assessment that “gender-affirming care” is “necessary” for transgender youth, prompting allegations that the transgender-identifying Biden administration official has violated the Department’s scientific integrity policies by baselessly claiming it’s settled science.

Protect the Public’s Trust (PPT), a nonprofit watchdog, filed a Freedom of Information Act request for “records of scientific evidence, studies, and/or data to support the Assistant Secretary’s claim that ‘gender-affirming care is medically necessary, safe, and effective for trans and non-binary youth,'” as well as for “records of surveys of medical professionals regarding the value and importance of ‘gender-affirming care’ for minor children.”

In response, HHS produced only a single document—a two-page PDF called “Gender-Affirming Care and Young People.” The document is also on HHS’ website and is not a scientific study, but rather a brochure that declares that “research demonstrates that gender-affirming care improves the mental health and overall well-being of gender-diverse children.”

It supports the statement with a footnote to a single study that showed that transgender-identifying young people were slightly less suicidal when receiving treatment — 51% who were receiving such care were suicidal, slightly lower than the 62% who weren’t receiving hormones but wanted them. The HHS document also states that puberty blockers are reversible and hormone therapy is partially reversible.

HHS claimed that Levine — a man who believes he is a woman — made no other mentions of “gender-affirming care” in his emails, PPT said. 

PPT on Tuesday wrote to the HHS Inspector General requesting that the office open an investigation, saying that Levine is violating the Department’s scientific integrity policies by making politically-motivated declarations and misrepresenting scientific evidence. 

“This suggests that Assistant Secretary Levine has constantly, continually, ‘everywhere I go,’ made unequivocal statements regarding the medical necessity, safety, and effectiveness of gender-affirming care based entirely upon a single two-page document,” the letter said. 

The complaint, obtained exclusively by The Daily Wire, says that government officials using their stature as science officials to make politically motivated statements and casting them as irrefutable science risks a further “loss of trust” in scientific institutions that would be “cataclysmic.”

“When asked for ‘records of scientific evidence, studies, and/or data’ and for ‘records of surveys of medical professionals’ to support these claims, HHS was able to provide only a single information sheet – essentially a piece of marketing material with cherry-picked data and agenda-driven assertions,” the complaint said. “This is the opposite of science and evidence-based policymaking and flies in the face of the agency’s pledge of ‘adherence to professional practices, ethical behavior, and the principles of honesty and objectivity when conducting, managing, using the results of, and communicating about science and scientific activities.'”

Michael Chamberlain, the group’s director, said the agency’s failure to provide evidence for its claims explains “why trust in government health officials has evaporated.”

“When we asked HHS to provide this data, all they offered was a single two-page information sheet with links to cherry-picked, often activist-generated research to justify irreversible and possibly dangerous measures,” Chamberlain told The Daily Wire. “Meanwhile, European health services are actively withdrawing their support for these therapies. Even in the face of this, the Assistant Secretary accuses skeptics of ideological motives.”

Levine has regularly used his role as a science official to declare that “the treatment options for gender-affirming care for transgender youth really are evidence-based,” and opposition to it is “unconscionable.” 

“Gender-affirming care for transgender youth is essential,” he told Reuters.

“There is no argument among medical professionals—pediatricians, pediatric endocrinologists, adolescent medicine, physicians, adolescent psychiatrists, psychologists, et cetera—about the value and the importance of gender-affirming care,” Levine told NPR. The HHS website similarly hides behind “science,” saying, “At HHS, we listen to medical experts and doctors, and they agree with us, that access to affirming care for transgender youth is essential.”

Such assertions not only ignore a growing body of scientific literature and experts, but declare that they do not exist, PPT said.  

“These statements not only do not acknowledge the contrary evidence, they assert that there is none,” the group argues. “In spite of voluminous scientific evidence from around the world, as well as a growing number of policy decisions in other countries that run in the opposite direction, Adm. Levine has consistently made assertions indicating there is no data, studies, or evidence that contradicts or does not support these statements. The Assistant Secretary has also not only ignored the burgeoning controversy regarding the use of these treatments for minors, but has declared that it simply does not exist, that there is not a modicum of controversy in the scientific or medical communities regarding these treatments.”

“In fact, the opposite appears to be true. There appears to be little evidence in support of the statements issued by Adm. Levine. HHS was provided the opportunity to present the evidence upon which these statements are based. Instead of producing reams of studies, data, and evidence, the agency was unable to deliver anything but a single two-page information sheet, with a few cherry-picked studies. It is difficult to imagine a more clear-cut case of an official violating HHS’s scientific integrity policies and undermining the state of science in pursuit of a controversial policy agenda.”

PPT pointed the Inspector General to a significant volume of information rebutting the claim that there “is no argument among medical professionals” about gender transitioning.

The New York Times this month highlighted children who said they were rushed into a gender transition and regretted it, and therapists who are now skeptical of an “affirming” model. Britain closed its transgender clinic and warned doctors that many youth are just going through a phase. Norway, Finland, and Sweden also found a lack of evidence that the benefits of hormones, puberty blockers, and surgeries outweigh the risks.

The authors of a landmark 2019 study that was used to support the idea that gender transitions lead to mental stability later corrected their study, stating that their data “demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care visits.”

To the contrary, the authors acknowledged, “individuals diagnosed with gender incongruence who had received gender-affirming surgery were more likely to be treated for anxiety disorders compared with individuals diagnosed with gender incongruence who had not received gender-affirming surgery.”


https://www.dailywire.com/news/hhs-says-it-has-only-two-pages-of-scientific-evidence-backing-its-support-for-gender-affirming-care

Wide Voter Consensus on ‘Border Security First’ Approach to Illegal Immigration

 74% of voters agree with a ‘border security first’ approach to illegal immigration that would prioritize securing the border and fixing our immigration laws before deciding what to do with illegal immigrants already in the country.

  • 46% “strongly agree.”  

WHY IT MATTERS – This is a rebuke to those who favor so-called comprehensive immigration reform that includes a pathway to citizenship for illegal immigrants already in the United States.

HOW TO USE THIS DATA – The results highlight varying levels of support for different steps to discourage illegal immigration, providing guidance on what reforms should be emphasized.

Click on the image below to read the full report…or read the summary below.

Bipartisan Support for ‘Border Security First’

  • 74% agree that before making decisions about illegal immigrants already in the country, the U.S. should prioritize securing its borders, fixing immigration laws, and stopping illegal immigration.
  • This includes majorities of Republicans (89%), Democrats (60%), and independents (75%).
  • Gen Z (55%) and single women (58%) are the least supportive of this approach, but still have a majority in agreement.
  • 69% of Hispanics and 75% of immigrant families agree with a ‘border security first’ approach.
  • 82% of New Majority voters agree with a ‘border security first’ approach, including a large majority of those who are undecided (65%) and are currently planning to vote Democrat (73%) for Congress.
  • Left Minority voters are more divided, with 52% in agreement of a ‘border security first’ approach, and 38% disagreement.

Deporting Illegal Immigrants:

  • 66% support laws making it easier to deport illegal immigrants.
  • This includes majorities of Republicans (88%), independents (67%), Asians (75%), Hispanics (52%) and white (72%) voters – as well as a plurality of black (48%) voters.
  • There is a dramatic age divide, with Gen Z opposed 35%-54%, and Baby Boomers in support 77%-15%.
  • 76% of New Majority voters support making it easier to deport illegal immigrants, including 59% of those who currently plan to vote Democrat for Congress.
  • 52% of Left Minority voters oppose making it easier to deport illegal immigrants.

Ending Birthright Citizenship:

  • 58% support ending automatic citizenship for children born in the U.S. to non-citizen or legal immigrant parents.
  • This includes majorities of Republicans (76%) and independents (57%). Democrats are opposed 40%-50%.
  • Majorities of Asians (65%) and white (61%) voters support ending birthright citizenship, as well as pluralities of Hispanics (49%) and black voters (46%).
  • 66% of New Majority voters support ending birthright citizenship, including 54% of those who currently plan to vote Democrat for Congress.  

Modest Support for Other Reforms:

  • Support for other laws to discourage illegal immigration is more modest, and divisive among key voting blocks.
  • 58% support laws making it harder for illegal immigrants to get jobs in the U.S, but it is opposed by black and Hispanic voters.
  • 54% support not counting illegal immigrants in the census.  
  • 52% support making it harder for illegal immigrants to send money back home, but it is opposed by black, Hispanic, and Gen Z voters.

Breaking down MMT’s Guaranteed Jobs Scheme for Fighting Inflation

 For “Ask an Economist” this week, I have a question from John O. about Modern Monetary Theory (MMT). I’ve purposefully avoided MMT in the past for a few reasons. First, because it appears to be under-theorized. In other words, often when economists try to talk with MMT advocates, the advocates argue by retreating to previously unstated assumptions.

Second (relatedly), as economist Per Bylund put it: “In scholarly research, interest in MMT is limited… One reason for this is likely that MMT focuses on policy prescriptions rather than explanations… which makes it unsuitable for research.” This makes conversation about it difficult.

Regardless, I wanted to do my best to answer John’s inquiry. He says:

MMT holds that a Federally-funded, locally-administered Job Guarantee is a way to achieve full employment (everyone willing and able to work can have a job—not 96.3%, but 100%) and would also act as a price anchor, tending to dampen inflation, just as the buffer stock of unemployed workers does today, but without all the attendant miseries (crime, addiction, suicide, etc.) of unemployment.

So can we have a free lunch of 100% employment and no inflation? No. Let’s see why.

One of the golden calves of MMT is the idea of full employment—or 0% unemployment. As John notes, this doesn’t mean everyone has a job in MMT World (either in theory or practice). Zero unemployment just means everyone who reports himself as looking for work finds a job (instantly in this case).

The idea that we should have full employment all the time is a revolt against the idea that there will be some natural rate of unemployment due to:

1) people’s skills not matching currently available jobs, or

2) because of short-term changes of employment due to labor market frictions.

The idea of the natural rate of unemployment is that even healthy economies have people who are looking for jobs for the above two reasons.

MMT advocates deny that this is necessary. Unlike economists, they see these unemployed workers as a wasted opportunity. In the words of MMT scholar Pavlina Tcherneva: “Unemployment holds a ‘special’ status in economic theory, compared to other social deprivations. Economists do not speak of the natural rate of hunger, or the natural rate of illiteracy, or the natural rate of homelessness.”

Except, to be clear, Tcherneva is essentially wrong about this. While it’s true we don’t measure things like the natural rate of illiteracy or homelessness, economists generally recognize that bringing the rate of crime, illiteracy, or homelessness down to zero is prohibitively costly.

Page through any introductory economics textbook and you’ll likely find a quip that “the efficient amount of anything is not zero.” That includes crime. It also includes unemployment. Unemployment is not unique in that sense like the quote above implies.

Certainly we prefer people to find jobs that suit them sooner, but sometimes the cost of finding a job immediately is higher than the benefits.

MMT advocates claim to fix this with a simple solution: a government-paid jobs program. Many iterations of such a program have been proposed, but their common feature is that the government-created jobs pay enough money that unemployed workers actually want them. Sometimes a “living wage” is proposed, but we should recognize that a living wage wouldn’t be enough to entice, say, an engineer between jobs.

How would the government pay for this? Ultimately, in MMT, the answer is that the government can print money to pay. We’ll come to issues with this later.

So MMT pursues full employment as a goal and claims the guaranteed jobs program will do so while “anchoring” inflation. Why? The idea is that if people are spending a lot (because they all have good-paying jobs) there will be lots of employment and therefore no need for the government-guaranteed jobs. As a result, spending from the government will decrease (and therefore money printing will as well).

This is the sense in which MMT advocates claim the guaranteed jobs policy is checking inflation. Spending increases by the public are offset by the spending decrease by the government, so prices stay stable.

This may sound good on the surface, but it breaks down as we look a little deeper.

There are two issues with this argument. First, the full employment described by MMT is not a good goal. Second, it cannot reliably temper inflation. These problems are related.

To see the issues with this system, consider what it would mean if we implemented it today. The government creates a new jobs program. Anyone who wants a good-paying job can get one and be paid in freshly printed US dollars. The new jobs created must exceed to jobs eliminated by higher taxes, otherwise we wouldn't achieve full employment.

What happens? New money enters the pockets of these workers, and they go and spend it. As they spend it, you have more money chasing the same amount of goods, meaning that you are going to have higher inflation.

One of the classic lines of MMT is that printing money does not cause inflation unless there is full employment. Our little thought experiment here shows that moving from some unemployment to full employment does indeed involve inflation. Historical precedent of events like stagflation (where the economy experienced increasing monetarily driven inflation and high unemployment) also shows that the MMT line isn’t true.

Why do MMTers say this then? Well, the logic is that as you hire people to these new government jobs, they start producing more as well. Inflation is caused by more money chasing the same number of goods. But what if we have more money chasing more goods produced by the new government jobs?

In other words, MMTers claim that while this program does increase the supply of money, that increase is offset by an increase in the supply of goods. These two cancel out, leading to no inflation. Our problem is solved. There’s no inflation because the new production of goods and services makes up for the new money-printing, and everybody has a good-paying job. With this policy everyone will get rich—and quick!

Sounds nice—doesn’t work. Here’s the problem. The government can create jobs, but jobs are not in and of themselves a good thing.

Here’s an example. Imagine the new guaranteed jobs program pays government workers to dig a hole and fill it in all day every day.

Did employment increase? Sure. Did the supply of goods and services increase? I guess if you consider a newly dug and filled-in hole a good, then yes. The problem is that this isn’t really a product that consumers want. It doesn’t make anyone better off.

If you included this good in your inflation quantification, its price would certainly fall. But since no one wants to buy the unfilled and refilled holes, it really shouldn’t be included in the inflation quantification. Since the new production was wasteful, it doesn’t lower the prices of the goods relevant to consumers. As such, inflation does not actually fall, even if some quantifications which included newly dug and refilled holes indicate that it did fall.

In other words, this new production isn’t enough to curb the inflation that matters to real people. You need the right production. This oversight is a microcosm of a larger issue with MMTers where they ignore the territory of a healthy economy in favor of the map of its quantifications.

At this point it would be fair to point out that MMTers likely have slightly better proposals for what sort of jobs to create than a program that digs holes and fills them back in. Maybe we could have the new workers make hamburgers, cars, solar panels, or some tangible goods. Would that fix the issue?

No. The whole problem is that creating jobs is an engineering problem, as the government can get more output (jobs) by simply putting in more inputs (money); creating jobs which aren't wasteful, however, is an economic problem.

Of course, if the government spends more money, it can make more jobs. But which jobs are best?

Private, for-profit business has a mechanism to solve the economic problem of which jobs are best. If a private business hires a worker whose work output is not valued sufficiently by consumers, the business will make a loss on that worker. This loss signals to the business that the job does not create sufficient value to consumers to merit the costs associated with the job (such as wages and the worker’s use of other inputs).

A government-guaranteed job, no matter how it is facilitated, does not have access to the profit and loss mechanism.

As such, there is no way to tell if the output from the job is valued sufficiently by consumers to justify the loss of that worker in another line of production. Producing hamburgers will probably create a good that consumers like more than dug and refilled holes, but the point is that insofar as consumers were not willing to pay the worker to produce the hamburgers before the government stepped in, they do not sufficiently value the hamburger to warrant its production.

In the words of Murray Rothbard, "Private enterprise can get funds only from satisfied, valuing customers and from investors guided by present and expected future profits and losses. Government gets more funds at its own whim...."

So the price of hamburgers will fall (at least in the short run) if government pays thousands of workers an unreasonable amount of money to produce an excess of hamburgers, but since consumers did not really want to pay for those hamburgers in the first place, the lower price is relatively less important.

Inflation quantifications may pick up on this increase in productivity of hamburgers and show lower inflation numbers as a statistical result, but the thing driving the “lower” inflation is a product that consumers weren’t asking for more of. Just like cheaper dug and filled-in holes don’t really improve our well-being, a glut of cheaper hamburgers doesn’t help much either.

So which jobs should be created? There is no way for the government to tell because they don’t have the profit and loss mechanism! As the economist Ludwig von Mises pointed out with respect to government central planning:

The paradox of “planning” is that [the government] cannot plan, because of the absence of economic calculation. What is called a planned economy is no economy at all. It is just a system of groping about in the dark. There is no question of a rational choice of means for the best possible attainment of the ultimate ends sought. What is called conscious planning is precisely the elimination of conscious purposive action.

To reiterate simply: MMTers say that money printing to create jobs will not create inflation because the production of new goods and services means that the larger amount of money is matched by a larger amount of goods. The problem is that the goods produced by these government-guaranteed jobs have no rational tie to the desires of consumers, and therefore any lower prices caused by increase in their supply are not meaningfully connected to inflation as it relates to the values of those consumers.

Some inflation quantifications may appear to fall with the production of these guaranteed jobs, but insofar as they do fall, this is the result of the quantification 1) not properly capturing inflation as it relates to the prices people care about and 2) random chance that even irrational planning occasionally creates a valuable job.

This failure on the part of MMT advocates to notice the difference between economic quantifications and economic health is not unique to MMT. It’s a constant mistake of central planners. Economists were convinced for decades that the Soviet Union would overtake the United States in terms of economic well-being because the macroeconomic data indicated that the Soviet Union’s production outputs were growing faster than those of the US.

Production, like job creation, is an engineering problem. More inputs mean more outputs, all else equal. The problem, though, is that not all production is production that benefits consumers (just like not all jobs are jobs that benefit consumers). In other words, the USSR was producing stuff, but it wasn’t stuff that helped benefit consumers. It was wasteful production—just like MMTers argue for wasteful jobs.

During the decades where the Soviet Union was rising in the opinion of experts, one economist boldly bucked the trend and pointed out that big production numbers were not the same as big economic well-being. The economist Murray Rothbard noted in his 1962 edition of Man, Economy, and State (well before the USSR’s collapse):

We may illustrate our analysis by noting the hullabaloo that has been raised in recent years over the supposedly enormous rate of Soviet growth. Curiously, one finds that the “growth” seems to be taking place almost exclusively in capital goods, such as iron and steel, hydroelectric dams, etc., whereas little or none of this growth ever seems to filter down to the standard of living of the average Soviet consumer. The consumer’s standard of living, however, is the be-all and end-all of the entire production process. Production makes no sense whatever except as a means to consumption. Investment in capital goods means nothing except as a necessary way station to increased consumption… There is every indication that the “pie-in-the-sky” day when living standards finally rise almost never arrives. In short, government “investment,” as we have noted above, turns out to be a peculiar form of wasteful “consumption” by government officials.

As these wasteful guaranteed jobs are created, not only do they create inflation via money creation; they actually destroy valuable inputs along the way. Most jobs do not use labor alone. A myriad of other machines and natural resources are combined with labor in production.

Government-guaranteed jobs would need these inputs as well in order for the jobs to function. These artificial jobs would then compete with productive employers for inputs necessary to create the jobs. Government burger-flipping jobs mean already-existing companies will have to compete more heavily for ovens. Oven producers wanting to create more ovens to satisfy the higher oven demand will have to compete for raw materials like metal, diverting these raw materials away from more useful lines of production. Input scarcity increases.

MMTers like to argue this isn’t an issue because we have lots of “idle” (or unemployed) inputs already. We can utilize those inputs for a free lunch. But wait a minute. If we have idle inputs all around the place, why are people constantly buying and creating new inputs?

It’s because companies “employ” the least costly unemployed inputs first. Some ovens need to be modified, cleaned, or fixed up before they are put in use. Some ovens aren’t as efficient as others. The point is that if a resource is idle, it is because it is expensive to employ. Employing idle resources is not a free lunch.

As government-guaranteed jobs that weren’t productive enough to earn a profit begin to enter the market, they compete for inputs against jobs which were productive enough to enter the market. This drives up input costs, causing private producers to lower their production. This decrease in supply is reflected in higher prices for consumers. This means more inflation in the goods consumers care about.

Labor is not the only input, so you cannot create full employment of inputs by having more jobs without regard to their productivity.

So, it might not surprise many FEE readers, but it turns out merely printing money and handing it out to people to do otherwise unprofitable jobs will not act as a bulwark against inflation.

Any government can increase the number of jobs, but creating jobs which improve the standard of living is the real issue. Many will promise they can do this, but, as Rothbard noted, the pie-in-the-sky day never seems to come.

https://fee.org/articles/breaking-down-mmt-s-guaranteed-jobs-scheme-for-fighting-inflation/

Kenya & Haiti Sign Agreement To Deploy Force To Caribbean Nation

 Via The Libertarian Institute,

The leaders of Kenya and Haiti inked a pact for a Kenya-led UN mission to the Caribbean nation. Nairobi plans to send 1,000 armed men, dubbed police officers, to Port-au-Prince as local authorities have all but lost control of Haiti’s capital city. The Joe Biden administration has been working for several years to create a UN force to invade Haiti to restore order. 

In October, at Washington’s urging, the UN Security Council approved a resolution that authorized Kenya to lead a UN police force in Haiti to return power to Prime Minister Ariel Henry, who has faced months of violent unrest in the wake of the 2021 assassination of President Jovenal Moise.

The people of Haiti did not elect the government in Port-au-Prince. Not long after Moise’s murder, then-Prime Minister Claud Joseph resigned at the behest of Western pressure, allowing Henry to assume power in his stead.

Since then, armed gangs have seized control over most of the city under Henry’s watch, at times occupying critical infrastructure, including its main port.

After the UNSC approved the force, opposition leader Ekuru Aukot in Nairobi challenged President William Ruto’s decision to send Kenyans to Haiti. In January, the Kenyan High Court ruled in favor of Aukot, blocking the deployment. 

The president later declared he could skirt the ruling by inking a pact directly with Port-au-Prince. That “reciprocal” agreement was signed on Friday. Ruto said he and Henry “discussed the next steps to enable the fast-tracking of the deployment,” though the leaders did not offer a timeline for the operation. 

The US-backed plan to send Kenyans to Haiti has met opposition in Port-au-Prince in addition to Nairobi. Haitians have protested Henry’s request for the UN deployment, as UN peacekeepers in Haiti have a legacy of rampant sexual abuses and, causing a cholera outbreak that killed thousands.

“The Haitian people have kept the bitter taste of a foreign force in charge of our situation: theft, rape, cholera, food dependence, deregulation of the economic system, without mentioning the fact that we don’t remember seeing then-gang leaders be arrested or rendered unable to do harm,” a Haitian think tank, Groupe de Travail sur la Securite (the Security Working Group), said of Henry’s initial request.

https://www.zerohedge.com/geopolitical/kenya-haiti-sign-agreement-deploy-force-caribbean-nation

'Deaths linked to excessive drinking surged during COVID-19 pandemic: CDC'

 Deaths linked to excessive drinking surged during the COVID-19 pandemic, according to a new study from the Centers for Disease Control (CDC).

The study in the CDC’s Morbidity and Mortality Weekly Report found that the average annual number of deaths from “excessive alcohol use” rose by around 30 percent from 2016-2017 to 2020-2021. In the same period, the average annual number of deaths from “excessive alcohol use” rose by around 27 percent for men and 35 percent for women.

“During the peak of the COVID-19 pandemic in 2020–2021, policies were widely implemented to expand alcohol carryout and delivery to homes, and places that sold alcohol for off-premise consumption (e.g., liquor stores) were deemed as essential businesses in many states (and remained open during lockdowns),” the authors of the study wrote.

The authors also noted that “[g]eneral delays in seeking medical attention, including avoidance of emergency departments for alcohol-related conditions; stress, loneli- ness, and social isolation; and mental health conditions might also have contributed to the increase in deaths from excessive alcohol use during the COVID-19 pandemic.”

A study from late 2021 found that the increased rate of consumption of alcohol would cause 100 more deaths and 2,800 additional cases of liver failure by the end of last year.

“The COVID-19 pandemic has had many unintended consequences with unknown long-term impact. Our modeling study provides a framework for quantifying the long-term impact of increased alcohol consumption associated with COVID-19 and initiating conversations for potential interventions,” Turgay Ayer, a co-author of the study and the George Family Foundation Early Career Professor of Systems Engineering at Georgia Institute of Technology, said in a release.  

https://thehill.com/policy/healthcare/4502372-deaths-linked-to-excessive-drinking-surged-during-covid-19-pandemic-cdc/

The ‘pill penalty’ that’s worsening American health

 While the Inflation Reduction Act, signed in August 2022, focuses mainly on subsidies to invest in clean energy projects, it also lets the government put price controls on certain advanced medicines for Medicare patients.

For no good reason, the act discriminates against a class of drugs that are easier to take, don’t require trips to the doctor or hospital and provide particular benefits to disadvantaged patients. You’re certainly familiar with this kind of drug. It’s called a pill.

Under the Inflation Reduction Act, the government can “negotiate” (a euphemism for “set” since the government is the lone buyer) the prices of small-molecule drugs — that is, pills, tablets and capsules — as soon as nine years after Food & Drug Administration has approved them.

But for biological products, or biologics, which are large-molecule drugs, typically administered as injections or intravenous infusions in hospitals and physicians’ offices, the exemption period is 13 years.

The gap — call it the “pill penalty” — is already having a big effect. By allowing four extra years to make back the $2 billion average cost of inventing a drug and bringing it to market, the government has made a biologic a much better place for risk capital than a pill. 

Eli Lilly CEO Dave Ricks said the difference “is about 50 or 60 percent of the value.” He added, “In 10 years, we’ll have far fewer small molecules being developed than we do today.” The company halted efforts for a small-molecule blood cancer drug because it “couldn’t make the math work.”

Limiting the patent life of small-molecule drugs will produce a huge drop in R&D spending and lead to “79 fewer” such medicines being developed, resulting in “116.0 million life years lost over the next 20 years,” according to an August study by Tomas Philipson, former acting chairman of the Council of Economic Advisers and five colleagues at the University of Chicago. 

The pill penalty also discourages the extensive R&D that occurs after a drug has been approved, leading to new indications (that is, treatments for different conditions) for the same medicine. Three out of five small-molecule cancer medicines were awarded at least one new indication after their initial approval.

A survey by PhRMA, the drug manufacturers’ trade association, found that 63 percent of member companies expect to shift their R&D focus away from small-molecule medicines. 

Why should we care? Discouraging the discovery of new medicines in pill form will harm the health of all Americans but, as the Chicago study notes, especially hurt the people the Inflation Reduction Act is supposed to help, including marginalized patients who have a more difficult time getting infusions outside their homes. 

“Many of these people are unable to travel for routine care,” Amy Hinojosa, president of MANA, a National Latina Organization, wrote in El Diario. “The cost of treatment doesn’t stop at the cost of medication.” 

Kevin Kimble, executive director of the Southern Christian Leadership Policy Institute, points out that “Black Americans are disproportionately likely to live with certain diseases for which easy-to-take pills are the holy grail of care.”

For example, Blacks and Hispanics account for 70 percent of new HIV infections in the United States. One of the great breakthroughs in treating that condition, once a death sentence, was the single-tablet regimen. It might never have occurred if the pill penalty had been in place. 

Small-molecule therapies have a special ability to target the processes within cells that allow cancer tumors to grow and spread. Three of the five most popular cancer medications are delivered as capsules: Revlimid for multiple myeloma, Imbruvica for leukemia and Ibrance for breast cancer. 

Pills are also critical in treating infectious diseases like Hepatitis C, neurological conditions and COVID-19. More than 30 different small-molecule antibiotics are included in the World Health Organization’s list of essential medicines. At a time when antimicrobial resistance is considered a global crisis, the last thing we should do is penalize the development of more of these easy-to-store pills.

But that is what’s happening. The Biden administration announced late last year that it had selected the first 10 drugs for price controls. Seven of them are small-molecule therapies.

One solution is to end the pill penalty by equalizing the exemption period for small-molecule drugs and biologics. That’s the aim of a bill introduced on Jan. 31 by Greg Murphy (R-N.C.), Don Davis (D-N.C) and Brett Guthrie (R-Ky.) called the Ensuring Pathways to Innovative Cures, or EPIC Act.

Of course, the worst unintended consequence of the Inflation Reduction Act-imposed price controls is their devastating impact on the development of new therapies in general. But right now, Congress can go a long way toward making Americans healthier by simply ending the pill penalty.

James K. Glassman, formerly a senior fellow at the American Enterprise Institute, served as under secretary of State in 2008 and 2009. He advises health care companies and nonprofits.

https://thehill.com/opinion/healthcare/4500713-the-pill-penalty-thats-worsening-american-health/