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.
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?
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.”
A selection of three essential articles read aloud from the latest issue of The Economist. This week, how will governments cope with the expensive legacy of covid-19? (11:05), unscrupulous autocrats in the pandemic of power grabs (17:52), and, why Netflix’s success will continue. Zanny Minton Beddoes hosts.
Syndicated columnist Mark Shields and New York Times columnist David Brooks join Judy Woodruff to discuss the week’s news, including President Trump’s controversial medical commentary, the respective roles of federal and state governments in the crisis, American public opinion on pandemic restrictions, congressional pandemic relief and how they’re handling social distancing.
Historically, the U.S. Centers for Disease control and Prevention has been the agency in charge of predicting, and containing outbreaks of disease. But as Covid 19 ravaged the country, the agency took a backseat to the White House.
Michelle Fay Cortez and John Tozzi discuss how the agency has handled the pandemic response, its early missteps, and how its role is likely to change in the future.
As one of the leading figures in the field of international relations, Joseph S. Nye, Jr., Harvard University Distinguished Service Professor Emeritus, has had a major influence on the way that policymakers think American foreign policy.
In his new book, “Do Morals Matter: Presidents and Foreign Policy from FDR to Trump,” Professor Nye explores the question of how heavily moral questions weigh on the decisions of U.S. presidents since the end of World War II. On this episode of Behind The Book, produced by Library and Knowledge Services at Harvard Kennedy School, we take a look at Professor Nye’s new book and how he assesses the legacy of past presidents based on the morality of their foreign policy.
“Do Morals Matter: Presidents and Foreign Policy from FDR to Trump” is published by Oxford University Press.
Joseph S. Nye Jr., is the University Distinguished Service Professor, Emeritus and former Dean of the Harvard’s Kennedy School of Government. He has served as Assistant Secretary of Defense for International Security Affairs, Chair of the National Intelligence Council, and Deputy Under Secretary of State for Security Assistance, Science and Technology.
His most recent books include The Power to Lead; The Future of Power; Presidential Leadership and the Creation of the American Era; and Is the American Century Over. He is a fellow of the American Academy of Arts and Sciences, the British Academy, and the American Academy of Diplomacy.
In a recent survey of international relations scholars, he was ranked as the most influential scholar on American foreign policy, and in 2011, Foreign Policy named him one of the top 100 Global Thinkers.
Seema Verma, administrator for the Centers for Medicare and Medicaid Services, sits down for a rare one-on-one interview with special correspondent Sarah Varney of Kaiser Health News. They discuss President Trump’s plan for sustaining public health insurance programs, how the administration would respond if Obamacare is struck down by the courts in the future, and the latest Medicare for all proposals.