June 21 2024
PBMs; green cards for graduates; RFK Jr; Red Sea; Ukraine
1 Three big Pharmacy Benefit Managers cover 200m Americans and inflate costs
2 ELECTION 2024 Trump discusses college graduate green cards, abortion, Ukraine, JFK, and more in interview
3 ELECTION 2024 RFK Jr will not debate next week
4 Aircraft carrier has fought Houthi attacks in longest sea deployment since WW2
5 US redirects arms to Ukraine at expense of other allies
6/21/1788 U.S. Constitution ratified
see ad astra on x @greg_loving
1 Three big Pharmacy Benefit Managers cover 200m Americans and inflate costs
The three largest pharmacy benefit managers, or P.B.M.s, act as middlemen overseeing prescriptions for more than 200 million Americans. They are owned by huge health care conglomerates — CVS Health, Cigna and UnitedHealth Group — and are hired by employers and governments. The job of the P.B.M.s is to reduce drug costs. Instead, they frequently do the opposite. They steer patients toward pricier drugs, charge steep markups on what would otherwise be inexpensive medicines and extract billions of dollars in hidden fees, a New York Times investigation found. Most Americans get their health insurance through a government program like Medicare or through an employer, which pay for two different types of insurance for each person. One type covers visits to doctors and hospitals, and it is handled by an insurance company. The other pays for prescriptions. That is overseen by a P.B.M. The P.B.M. negotiates with drug companies, pays pharmacies and helps decide which drugs patients can get at what price. In theory, everyone saves money.
The Times interviewed more than 300 current and former P.B.M. employees, patients, physicians, pharmacists and other industry experts, and reviewed court documents and patient records. The investigation found that the largest P.B.M.s often act in their own financial interests, at the expense of their clients and patients. Among the findings:
* P.B.M.s sometimes push patients toward drugs with higher out-of-pocket costs, shunning cheaper alternatives.
* They often charge employers and government programs like Medicare multiple times the wholesale price of a drug, keeping most of the difference for themselves. That overcharging goes far beyond the markups that pharmacies, like other retailers, typically tack on when they sell products.
* The largest P.B.M.s recently established subsidiaries that harvest billions of dollars in fees from drug companies, money that flows straight to their bottom line and does nothing to reduce health care costs.
* The P.B.M.s, which are responsible for paying pharmacies on behalf of employers, are driving independent drugstores out of business by not paying them enough to cover their costs. Small pharmacies have little choice but to accept these lowball rates because the largest P.B.M.s control an overwhelming majority of prescriptions. The disappearance of local pharmacies limits health care access for poorer communities but ultimately enriches the P.B.M.s’ parent companies, which own drugstores or mail-order pharmacies.
* P.B.M.s sometimes delay or even prevent patients from getting their prescriptions. In the worst cases, patients suffer serious health consequences.
Article Source: NYT
2 ELECTION 2024 Trump discusses college graduate green cards, abortion, Ukraine, JFK, and more in interview
Former President Trump proposed that all foreign-born graduates from US universities should receive green cards upon graduation, increasing the supply of “high-skill” immigrants into the US. According to the National Center for Education Statistics (NCES), in the 2019-2020 academic year, approximately 223,000 foreign-born students graduated from US universities at all degree levels (associate's, bachelor's, master's, and doctoral degrees). These so-called H1-B visas are widely advocated for within the business community,
In response to questions on abortion, he stated he does not support a federal ban but rather supports it being a state issue. On Ukraine, he committed to never sending US troops in-country and supported NATO neutrality, a departure from Biden Administration policy. Among other transparency initiatives, he committed to releasing all classified JFK assassination files, still secret after more than 60 years. He made the comments in a wide-ranging, 1-hour interview on the “All-In” podcast, released Thursday.
Article Source: Ad Astra
3 ELECTION 2024 RFK Jr will not debate next week
Robert F. Kennedy Jr. failed to qualify for the CNN presidential debate on June 27 by the network’s Thursday deadline, according to the outlet, a significant blow to his independent presidential bid that will deny him a coveted national stage alongside President Biden and former President Donald J. Trump. Mr. Kennedy in a statement on Thursday called his exclusion from the debate “undemocratic, un-American and cowardly.”
Article Source: NYT
4 Aircraft carrier has fought Houthi attacks in longest sea deployment since WW2
The USS Dwight D. Eisenhower aircraft carrier has been engaged in intense combat operations to protect commercial shipping from Houthi missile and drone attacks in the Red Sea for almost nine months, marking the most prolonged sea battle since World War II. The carrier’s deployment has been extended twice, raising concerns about the strain on the ship and its crew of 7,000 sailors. U.S. military leaders face a decision on whether to continue the carrier’s mission or find alternatives, such as deploying other ships or relying on allies, to maintain security in the volatile region. The U.S. operates 11 aircraft carriers, about 40% of the total number worldwide. Other countries have only one or two. Of the 11 U.S. carriers, four are deployed, three are in training and preparing to deploy, and four are in routine maintenance and repair, which usually lasts about a year or more.
Article Source: Cipher Brief
5 US redirects arms to Ukraine at expense of other allies
The United States will suspend the planned export of hundreds of air defense munitions to its allies and partners and redirect them to Ukraine, the White House said Thursday, as Russia continues its assault on the country’s power grid and other vital infrastructure. Speaking to reporters, National Security Council spokesman John Kirby characterized the decision as “difficult but necessary,” and said it would affect deliveries of Patriot and NASAMS interceptor missiles, principally. Ukraine, he said, faces a “desperate” need. It’s the latest in a series of recent steps by the Biden administration to reinforce Ukraine as it defends against an aggressive push by Moscow to break the country’s morale. Throughout the spring, the White House has approved large weapons transfers to replenish depleted stocks, rescinded its strict prohibition on the use of U.S. arms for strikes inside Russia, and solidified a 10-year security pact with Kyiv while leaders of the Group of Seven major democracies said they would tap billions of dollars in frozen Russian assets to sustain Ukraine’s fight.
Article Source: WaPo
6/21/1788 U.S. Constitution ratified
Sources
1. https://www.nytimes.com/2024/06/21/business/prescription-drug-costs-pbm.html?smid=nytcore-ios-share&referringSource=articleShare&sgrp=c-cb
2. https://podcasts.apple.com/us/podcast/all-in-with-chamath-jason-sacks-friedberg/id1502871393?i=1000659680213
3. https://www.nytimes.com/2024/06/20/us/politics/kennedy-qualify-cnn-debate.html?smid=nytcore-ios-share&referringSource=articleShare&sgrp=c-cb
4. Email
5. https://www.washingtonpost.com/national-security/2024/06/20/ukraine-patriot-air-defense/
Thanks for reading!
