President Biden has released a health care plan that proposes reducing the age of eligibility for Medicare to 60 years and introducing a public option. Larry Levitt, MPP, Executive Vice President for Health Policy at the Kaiser Family Foundation, and Karen Joynt Maddox, MD, MPH, Co-Director of the Center for Health Economics and Policy (CHEP) at @Washington University School of Medicine, and Lawrence O. Gostin, JD from the O’Neill Institute for National and Global Health Law at Georgetown University discuss prospects for health care reform under the new administration.
Joe Biden walks to the White House as the new president of the United States.
#Tunisia on Thursday commemorates the 10th #anniversary since the flight into exile of iron-fisted President Zine El Abidine Ben Ali, pushed from power in a popular revolt that foreshadowed strife and civil war in the region, known as the #ArabSpring. FRANCE 24’s Chris Moore tells us more.
Tunisia, officially the Republic of Tunisia, is a country in the Maghreb region of North Africa, covering 163,610 square kilometres. Its northernmost point, Cape Angela, is also the northernmost point on the African continent.
This film is the history of the League of Nations from 1930 to the onset of the Second world War: that 10-year span ending when Geneva, surrounded by Axis Powers, almost faded into memory.
The Pentagon is the headquarters building of the United States Department of Defense. As a symbol of the U.S. military, the phrase The Pentagon is also often used as a metonym for the Department of Defense and its leadership.
Located in Arlington County, Virginia, across the Potomac River from Washington, D.C., the building was designed by American architect George Bergstrom and built by contractor John McShain. Ground was broken on 11 September 1941, and the building was dedicated on 15 January 1943. General Brehon Somervell provided the major motivating power behind the project; Colonel Leslie Groves was responsible for overseeing the project for the U.S. Army.
The Pentagon is the world’s largest office building, with about 6,500,000 square feet (150 acres; 0.60 km2) of floor space, of which 3,700,000 sq ft (85 acres; 0.34 km2) are used as offices. Some 23,000 military and civilian employees, and another 3,000 non-defense support personnel, work in the Pentagon. It has five sides, five floors above ground, two basement levels, and five ring corridors per floor with a total of 17.5 miles (28.2 km) of corridors. The central five-acre (2.0 ha) pentagonal plaza is nicknamed “ground zero” on the presumption that it would be a prime target in a nuclear war.
Dr Thomas Gift, Visiting Fellow at the LSE United States Centre, provides explanation and commentary on some the key questions about government in America: what are the separate branches of government, their responsibilities, and how do they work (and not work) together?
After nearly 500 days of negotiations, Belgium finally has a national government. It consists of seven parties but excludes the two biggest – both Flemish nationalist parties. Is Belgium’s complex political system workable in the long term?
And can the country hold together? Andrew Mueller asks Régis Dandoy, Carl Devos and Barbara Moens.
Wildfires are a fact of life in California but extent and devastation in the American West feel dramatic this year: More than 5 million areas of uncontrolled fires lead to incredible footage on the news & reports of orange skies in Oakland or San Francisco. The 2020 fire season has broken almost every record in terms of frequency and ferocity. We analyzed several factors like climate change, housing development and fire suppression & management to see what’s behind the largest and most destructive wildfires in the state’s history and what can be done to solve the worsening problem?
There may be few issues that unite Americans ahead of the 2020 election as do their concerns about the cost of prescription drugs.
A clear majority — 75% — of respondents to a July survey said the cost of prescription medicines would be among the factors likely to influence their votes this year, according to a report from Gallup and the nonprofit West Health. Gallup reported on results from 1,007 interviews conducted with adults between July 1 and July 24.
1. What are the 2020 presidential candidates saying they will do to lower drug prices?
Both President Donald Trump, a Republican, and former Vice President Joe Biden, a Democrat, have highlighted insulin costs in their discussions of the need to lower drug prices.
In a January interview with the New York Times editorial board, Biden noted the widespread discontent among Americans about sticker shock often experienced at pharmacies. He spoke of a need for the federal government to act to make medicines more affordable.
“This is a place where I find, whether you’re Republican or Democrat, you think you’re getting screwed on drug prices. And you are, in terms of everything from insulin to inhalers and a whole range of other things,” Biden said. “So, again, can I guarantee that it gets done? No, but I can tell you what, if anybody can get it done, I can, and I think there’s a consensus for it.”
2. Why doesn’t Medicare, the biggest U.S. purchaser of drugs, directly negotiate on drug prices?
Congress has taken different approaches in designing the terms under which the two largest federal health programs, Medicaid and Medicare, buy drugs.
Medicaid is a program run by states with federal contributions and oversight. It covers people with low incomes and disabilities. Almost 67 million people were enrolled in Medicaid as of May 2020, including about 29 million children. In 1990 Congress decided that drugmakers who want to have their products covered by Medicaid must give rebates to the government. The initial rebate is equal to 23.1% of the average manufacturer price (AMP) for most drugs, or the AMP minus the best price provided to most other private-sector payers, whichever is greater. An additional rebate kicks in when prices rise faster than general inflation.
3. What’s the deal with rebates and discounts?
There’s widespread frustration among lawmakers and policy analysts about the lack of clarity about the role of middlemen in the supply chain for medicines. Known as pharmacy benefit managers (PBMs), these businesses describe the aim of their business as making drugs more affordable for consumers. Insurers like Cigna and UnitedHealth operate some of the nation’s largest PBMs, as does pharmacy giant CVS Health, which also owns insurer Aetna.
“They will tell you their mission is to lower drug costs,” said Rep. Earl L. “Buddy” Carter, a Georgia Republican, a pharmacist and a critic of PBMs, in a speech on the House floor last year. “My question to you would be: How is that working out?”
4. What is the “distinctly American” phenomenon of specialty drugs?
Kesselheim also has written on what he terms “Specialty Drugs — A Distinctly American Phenomenon.” That’s the title of a 2020 paper in the New England Journal of Medicine Kesselheim authored with Huseyin Naci, an associate professor of health policy at the London School of Economics.
In this Perspective article, Kesselheim and Naci look at how the “specialty” designation morphed from its origin in the 1970s. It then referred to a need for extra steps for preparation and delivery of new injectable and infusion products.
5. How much does it cost to bring a new drug to market anyway?
The median cost for a medicine developed in recent years was $985 million, according to a study published in JAMA in March 2020, “Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018.”
“Rising drug prices have attracted public debate in the United States and abroad on fairness of drug pricing and revenues,” write the study’s authors: Olivier J. Wouters of the London School of Economics; Martin McKee of the London School of Hygiene and Tropical Medicine; and Jeroen Luyten of Leuven Institute for Healthcare Policy, KU Leuven, Belgium. “Central to this debate is the scale of research and development investment by companies that is required to bring new medicines to market.”
More than a decade of losses have put the U.S. Postal Service in a dire financial situation. To understand how this happened, WSJ takes a look back at how the modern postal service became an entity balancing public service and the need for profit.
Photo Illustration: Jacob Reynolds/WSJ