This week, Joe Biden gave a populist State of the Union. And the administration reduced the price of inhalers and slashed credit card late fees. But Biden also cut his own Antitrust Division's budget.
Our government is based on bribery via campaign contributions, special tax breaks, and back-office deals. Imagine leaders concerned solely for the good of the country and world.
What I find nuts are people I have met who really like the sound of those "No Labels" creeps. Most of them for some reason are also of the "corporations have way too much power" belief. Hello! No Labels' big problem with both Trump and Biden is they are not friendly enough to corporate power. What is it that causes people to turn their brains off whenever the words "bipartisan" or "centrist" get uttered?
Matt, great stuff as always. Remember we can always want more, but we have to win to get it. Can you really have imagined an administration with both Rohit Chopra and Lina Khan in major policy positions! People = Policy!
Good stuff as always, Matt. I think it is fair to point out that Trump appointed Powell, not Biden. Moreover, the issue with FERC's transmission policy and the right of first refusal is complicated by a lot of things, not least of which being that states regulate poles and wires companies. Still, I am a lot more energized to fight for a second Biden term.
Biden could have selected someone else. "Biden reappoints Jerome Powell as Fed chairman at a critical time for the economy. Federal Reserve Chairman Jerome Powell has been selected for a second term at the helm of the Fed, a move likely to be welcomed by markets. Biden nominated current Fed governor Lael Brainard to serve as vice chair."
While Powell certainly has his flaws, on big macro issues he has been great and will probably go down as one of the greatest Fed Chairs in history. From the utter shenanigans the Fed did in April 2020 to keep the global markets alive, to pioneering a keen focus on a full employment economy over inflation concerns (with the sub goal of closing the employment gap between minorities and white workers), he has been pretty revolutionary.
From his tenure we know now that you can run a pretty hot economy that favors workers while bringing down inflation without causing a massive recession (Indeed, almost every economist swore we would have to have a recession that would hurt workers). And his pretty aggressive advocacy for congress to pass the first massive stimulus bill demonstrated that it's better to go big and that giving money to households is critical. Compare his track record with any of the other G7 Central bankers and the resulting economy is pretty clear. I really don't think people understand the magnitude of paradigm change we are in
I do not see Biden and Trump as equals on the anti-monopoly situation, because according to Trump's plans he won't be funding the department and Lina Khan, the star of the show, will be gone. Secondly, Trump supports a White Supremacist agenda, which Biden is more successful in undoing. Also, I wanted to point out that years ago in Germany I was able to get my daughter's asthma medication at a pharmacy for 35€ which is about what the USA is going to have now, so that is a good deal. At the time in the USA it was around $300. These things are lifesaving, so I am glad to hear this. For my own inhalers as well. I am back and forth between the two countries. I care about health care and air travel. Boeing 737s terrify me still until they fix their problems with management and oversight.
Also-epipens. While Congresspersons Maxwell Frost & Doris Matsui have introduced legislation to lower costs, it only applies to those “with employer-based or individually purchased health insurance”. ?!?! Once again leaving out those most in need of financial assistance. One can only buy them in two-packs (effectively twice the price) and have a relatively short expiry.
Find me non-progressives who want to address monopolies. Progressive culture is joyless, irritating, and awful, but progressives are the only faction that is actually proactive about addressing corporate power.
An ex.friend of mine suggested he could be half progressive by working for National so-called progressive issues while he was filling his pockets with local loot/plunder from local money interests. I informed him you can't be half progressive or half pregnant!
Could you explain how a deputy press flak going to work for Apple is a sign of corruption? It may be obvious to you, but it’s not at all obvious to me.
“There’s also obvious corruption; a long-time Biden aide, Olivia Dalton, just announced she’s leaving her position in the White House to work for Apple.”
Also, my understanding of Trump‘s tariffs were that he simply paid off American farmers for their loyalty and votes, and he didn’t demand anything of them or produce any more food or lower prices, or reduce horrific agricultural practices or make people treat Ag Workers better.— he just used tax money mainly raised in blue states to buy votes in red states . What was so great about that? Concentration in big Ag didn’t go down.
He also didn’t do a damn thing to unsnarl the tariffs on Chinese solar panels, which is an industry that we are not going to get back in 1 million years, and what we should want to be as productive as possible, in order to keep the costs of decarbonization Declining worldwide.
The Trump tariffs helped reshore industries, which is why Biden retained them. Going to work for Apple when Apple is under investigation by the administration is dodgy.
Biden policies — things that aren’t subject to the whims of the Oval Office occupant — are what has led to the surge of making things here. No business of any significance bet its future on the dependability of Mango Mussolini’s tariffs, since anyone with a brain knows that making investment decisions in reliance on Trumps favor is a suicide move.
As for workers going to work for businesses under investigation, what exactly is dodgy? Every ginormous business in America is likely to be under a number of investigations by some element of government. A major element of fighting corporate power is getting rid of non-competes and other anti-competitive practices that mean that workers are restricted from where they can go next. If you’re proposing that minions who work for an administration all be subject to “non-competes” and anti-revolving door stuff, then it’s hard to see how a minor press flak would be covered, nor is it obvious that Biden is getting anything out of the deal (which is what would make it dodgy). I had to look up Dalton to even know who the heck you were talking about —
If we propose that everyone who takes a job with a Democratic administration needs to vow not to work for a regulated or investigated business (for life? for a term of years?) after leaving the administration, we are going to have a hard time staffing up precisely those levels where the lofty principles are getting ground into sausage.
The Trump tariffs did little to onshore manufacturing (instead vendors just sought out third countries like Vietnam) and mostly affected consumers by raising prices. In general, Tariffs are pretty inefficient as they just shift who receives benefits from consumer (they don't get cheaper goods) to producers (usually big business). Additionally it lowers competition because domestic firms no longer need to compete with global firms and can become inefficient (you can see this in the legacy American car companies which have become pretty lackluster and struggle to compete abroad).
Biden kept the tariffs because it would be political suicide to remove them, not because they are good policy
Always easy to vilify PBMs, but like 'em or not - they do serve a legitimate function in our Casino Healthcare and that function won't end with the dissolution of PBMs. It'll just become more opaque (than it already is). Cuban's great - but his drug company isn't always the lowest price either - so there's that.
The only real function of PBMs is to deliver tiered pricing - as the mechanism to maximize revenue/profits. It's not that different from commercial coverage (tiered to support tiered pricing on the hospital/provider side).
It's always a good gut check tho on just how dysfunctional our gov't is. Of course $740 million (the amount of money the healthcare industry spent on lobbying in 2023) buys a shit-ton of dysfunction ;-)
Kentucky didn't eliminate PBMs - just reduced the number to 1 independent (vs those owned by pharmacy chains).
... and again - the function of opaque/tiered pricing doesn't end - even with the elimination of PBMs so it's squeezing a balloon. "And whether or not we pass something or not, the costs keep going up nonetheless." Sen. Ralph Alvarado (R-Winchester), co-chair of the Interim Joint Committee on Health, Welfare and Family Services for Kentucky
Yes, Kentucky eliminated its use of corporate PBMs and instead hired its own single independent to handle Medicaid spending. And that one state saved a massive amount of money on a small amount of spending. PBMs inflate prices by something like $50-100B a year.
Alvarado said that in 2022 *in favor* of eliminating PBMs.
Missed my point. I'm not defending PBMs - in fact - I'm saying why have ANY?
We have PBMs (1 or N) because they do serve a necessary function in our Casino Healthcare - and that function is delivering tiered pricing. And yes, there is a profit for providing that function. By credible calculations, PBM margins (nationally) are ~2%.
Sure - KY saved millions - but how many more millions could they have saved by eliminating the "middlemen" entirely? Do we even know what that amount is?
The fact is - individual states don't have enough leverage. KY has ~1.6M Medicaid enrollees - which is (percentage wise) larger than many other states, but not much of a dent in ~70M enrolled in Medicaid nationally - and let's be honest. The Federal Gov is still funding the lions share of Medicaid in every state.
Sure - Alvarado opposes PBMs, but his quote is independent of political POV b/c he's right. It doesn't matter what legislators do - prices still go up. Here's the KFF quote from July, 2023:
"Since 2000, the price of medical care, including services provided as well as insurance, drugs, and medical equipment, has increased by 114.3%. In contrast, prices for all consumer goods and services rose by 80.8% in the same period."
As I've said to conservative friends, Trump's biggest strength is entirely apolitical: he's a very skilled dealmaker and usually phenomenal at reading the room; and his single biggest weakness is that it's apolitical and not agenda-driven: he almost never cares who he's making deals with and as often as not is reading the wrong room.
That said, I'll repeat here the idea I had the other week: Biden should lob some Trumpian rhetoric in Trump's general direction specifically on how concrete enforcement policy (and personnel choices!) has made a difference for the populist antitrust, anti-Big-Tech, anti-Big-Business movement, in hopes of goading Trump's ego into crusading in favor of antitrust (and other) enforcement and such to prove he's a better populist than his opponents. Whether he wins or loses, it would be helpful to have the yuge man ranting and raving wrestling style about how we need more people fighting for us like Lina Khan, and I really do think he could be prodded into it even though he doesn't consistently "get it" on his own accord.
Brother Matt, do you believe there are actually 100 sincere members of the so-called Progressive caucus?
What have they done? They allowed Pelosi to stay in office when he only needed about 8 votes to get rid of her. The only needed about the same number of votes stop the inflation reduction act, which has 250 to 300,000,000,000 of pork for so-called green energy.
Sincerity is irrelevant, the progressives are the most likely to vote for stronger antitrust and against corporate power. Some are bad and they have very annoying identity nonsense but that's just the way things are. The Inflation Reduction Act was generally good, and included things like capping pharma prices and subsidies for domestic battery production, which will be used in all sorts of machinery. Also, $250B over ten years isn't a big deal, $250B is about what the Fed hands to the banks every year, more or less.
Matt, you remind me of my brother, the bears could be downed 35 to nothing in the fourth quarter, but he thinks they could come back. That sounds like you and the pussies.
If you look at the vote counts for stronger antitrust laws, it's always progressives who have the highest percentage of support and conservative Republicans who have the lowest percentage of support. That may make no sense, since GOP voters want stronger antitrust laws, but it is what it is. Hopefully that changes, and there are reasons to assume it will, but it hasn't yet.
As for the Bears, well, I'm watching the game right now, and it's the Biden administration, spurred largely by Elizabeth Warren who was the first Senator to call for antitrust action against Google all the way in 2016, who is pursuing a host of actions to break up dominant firms. You will not find anyone who is as eager to see the GOP take up this mantle as I am. Some of them are. But right now the progressives, and not all of them, who are the key voting block to do.
Matt, I'm sure you already are following Chomsky. Take a look at Michael Hudson who's an MMT person like stephanie kelton, Pavlina, Randy, Bill, Warren and lots of other folks lots smarter than most of us, sadly including me::), Hudson has the most current flaw in our system.... compound interest rates are off-the-charts stupid
Bro Matt, if you're clinging to the progressive philosophy as I did for almost 40 years, you're doomed to be a failure like me, sorry bro, that's the way i see it
Biden/US are war criminals, and Israel/Saud's are #2, but there are lots of candidates that you know better than me. Would Trump of been impeached or charged with a war crime for blowing up the pipelines?
Great update, but a question re: Forest Service quote—-
Having two fire retardant sources not only increases COMPLETION in the sector, or COMPETITION in the sector? Hope I don’t sound persnickety but I’m reading a distinct meaning in the word as written.
Thanks Matt, good summary. Per your GPO link, healthcare suppliers factor in GPO fees when pricing their products. Ten years since my retirement but recall fees at that time were around 3%. A large percentage especially for commodity like products. GPOs original mission of buying aggregation now eclipsed with the consolidation of Hospital groups like UPMC, HCA. Novant etc, who amass their own purchaser leverage. Agree with you on PBMs and GPOs.
Good summary. I feel caught up.
Our government is based on bribery via campaign contributions, special tax breaks, and back-office deals. Imagine leaders concerned solely for the good of the country and world.
My piece is all about how there’s a lot going on that is good for the country.
What I find nuts are people I have met who really like the sound of those "No Labels" creeps. Most of them for some reason are also of the "corporations have way too much power" belief. Hello! No Labels' big problem with both Trump and Biden is they are not friendly enough to corporate power. What is it that causes people to turn their brains off whenever the words "bipartisan" or "centrist" get uttered?
Matt, great stuff as always. Remember we can always want more, but we have to win to get it. Can you really have imagined an administration with both Rohit Chopra and Lina Khan in major policy positions! People = Policy!
Good point!
Good stuff as always, Matt. I think it is fair to point out that Trump appointed Powell, not Biden. Moreover, the issue with FERC's transmission policy and the right of first refusal is complicated by a lot of things, not least of which being that states regulate poles and wires companies. Still, I am a lot more energized to fight for a second Biden term.
Biden could have selected someone else. "Biden reappoints Jerome Powell as Fed chairman at a critical time for the economy. Federal Reserve Chairman Jerome Powell has been selected for a second term at the helm of the Fed, a move likely to be welcomed by markets. Biden nominated current Fed governor Lael Brainard to serve as vice chair."
Would the senate have accepted someone else?
Yes
While Powell certainly has his flaws, on big macro issues he has been great and will probably go down as one of the greatest Fed Chairs in history. From the utter shenanigans the Fed did in April 2020 to keep the global markets alive, to pioneering a keen focus on a full employment economy over inflation concerns (with the sub goal of closing the employment gap between minorities and white workers), he has been pretty revolutionary.
From his tenure we know now that you can run a pretty hot economy that favors workers while bringing down inflation without causing a massive recession (Indeed, almost every economist swore we would have to have a recession that would hurt workers). And his pretty aggressive advocacy for congress to pass the first massive stimulus bill demonstrated that it's better to go big and that giving money to households is critical. Compare his track record with any of the other G7 Central bankers and the resulting economy is pretty clear. I really don't think people understand the magnitude of paradigm change we are in
i'm guessing your a pussy to be wanting another biden term
I do not see Biden and Trump as equals on the anti-monopoly situation, because according to Trump's plans he won't be funding the department and Lina Khan, the star of the show, will be gone. Secondly, Trump supports a White Supremacist agenda, which Biden is more successful in undoing. Also, I wanted to point out that years ago in Germany I was able to get my daughter's asthma medication at a pharmacy for 35€ which is about what the USA is going to have now, so that is a good deal. At the time in the USA it was around $300. These things are lifesaving, so I am glad to hear this. For my own inhalers as well. I am back and forth between the two countries. I care about health care and air travel. Boeing 737s terrify me still until they fix their problems with management and oversight.
🙏🏻💪🏻🤟🏻
Also-epipens. While Congresspersons Maxwell Frost & Doris Matsui have introduced legislation to lower costs, it only applies to those “with employer-based or individually purchased health insurance”. ?!?! Once again leaving out those most in need of financial assistance. One can only buy them in two-packs (effectively twice the price) and have a relatively short expiry.
We need Sincere Reformers, not pussy progressives
Find me non-progressives who want to address monopolies. Progressive culture is joyless, irritating, and awful, but progressives are the only faction that is actually proactive about addressing corporate power.
Progressives aren’t getting it done Matt and there is zero doubt about it
I suggest looking at climate folks to get shit done,
hopefully, but it's almost a coin toss
An ex.friend of mine suggested he could be half progressive by working for National so-called progressive issues while he was filling his pockets with local loot/plunder from local money interests. I informed him you can't be half progressive or half pregnant!
that was kissing the ass of the local moneyed interests which obviously was not for 'we the people'
I canceled my subscription. Why can’t I get an immediate cancellation and refund? It’s laughably lame that this isn’t done by default.
Could you explain how a deputy press flak going to work for Apple is a sign of corruption? It may be obvious to you, but it’s not at all obvious to me.
“There’s also obvious corruption; a long-time Biden aide, Olivia Dalton, just announced she’s leaving her position in the White House to work for Apple.”
Also, my understanding of Trump‘s tariffs were that he simply paid off American farmers for their loyalty and votes, and he didn’t demand anything of them or produce any more food or lower prices, or reduce horrific agricultural practices or make people treat Ag Workers better.— he just used tax money mainly raised in blue states to buy votes in red states . What was so great about that? Concentration in big Ag didn’t go down.
He also didn’t do a damn thing to unsnarl the tariffs on Chinese solar panels, which is an industry that we are not going to get back in 1 million years, and what we should want to be as productive as possible, in order to keep the costs of decarbonization Declining worldwide.
The Trump tariffs helped reshore industries, which is why Biden retained them. Going to work for Apple when Apple is under investigation by the administration is dodgy.
Biden policies — things that aren’t subject to the whims of the Oval Office occupant — are what has led to the surge of making things here. No business of any significance bet its future on the dependability of Mango Mussolini’s tariffs, since anyone with a brain knows that making investment decisions in reliance on Trumps favor is a suicide move.
As for workers going to work for businesses under investigation, what exactly is dodgy? Every ginormous business in America is likely to be under a number of investigations by some element of government. A major element of fighting corporate power is getting rid of non-competes and other anti-competitive practices that mean that workers are restricted from where they can go next. If you’re proposing that minions who work for an administration all be subject to “non-competes” and anti-revolving door stuff, then it’s hard to see how a minor press flak would be covered, nor is it obvious that Biden is getting anything out of the deal (which is what would make it dodgy). I had to look up Dalton to even know who the heck you were talking about —
If we propose that everyone who takes a job with a Democratic administration needs to vow not to work for a regulated or investigated business (for life? for a term of years?) after leaving the administration, we are going to have a hard time staffing up precisely those levels where the lofty principles are getting ground into sausage.
The Trump tariffs did little to onshore manufacturing (instead vendors just sought out third countries like Vietnam) and mostly affected consumers by raising prices. In general, Tariffs are pretty inefficient as they just shift who receives benefits from consumer (they don't get cheaper goods) to producers (usually big business). Additionally it lowers competition because domestic firms no longer need to compete with global firms and can become inefficient (you can see this in the legacy American car companies which have become pretty lackluster and struggle to compete abroad).
Biden kept the tariffs because it would be political suicide to remove them, not because they are good policy
Always easy to vilify PBMs, but like 'em or not - they do serve a legitimate function in our Casino Healthcare and that function won't end with the dissolution of PBMs. It'll just become more opaque (than it already is). Cuban's great - but his drug company isn't always the lowest price either - so there's that.
The only real function of PBMs is to deliver tiered pricing - as the mechanism to maximize revenue/profits. It's not that different from commercial coverage (tiered to support tiered pricing on the hospital/provider side).
It's always a good gut check tho on just how dysfunctional our gov't is. Of course $740 million (the amount of money the healthcare industry spent on lobbying in 2023) buys a shit-ton of dysfunction ;-)
PBMs serve no purpose. Kentucky replaced their PBMs and it was a smashing success.
Kentucky didn't eliminate PBMs - just reduced the number to 1 independent (vs those owned by pharmacy chains).
... and again - the function of opaque/tiered pricing doesn't end - even with the elimination of PBMs so it's squeezing a balloon. "And whether or not we pass something or not, the costs keep going up nonetheless." Sen. Ralph Alvarado (R-Winchester), co-chair of the Interim Joint Committee on Health, Welfare and Family Services for Kentucky
Yes, Kentucky eliminated its use of corporate PBMs and instead hired its own single independent to handle Medicaid spending. And that one state saved a massive amount of money on a small amount of spending. PBMs inflate prices by something like $50-100B a year.
Alvarado said that in 2022 *in favor* of eliminating PBMs.
Missed my point. I'm not defending PBMs - in fact - I'm saying why have ANY?
We have PBMs (1 or N) because they do serve a necessary function in our Casino Healthcare - and that function is delivering tiered pricing. And yes, there is a profit for providing that function. By credible calculations, PBM margins (nationally) are ~2%.
Sure - KY saved millions - but how many more millions could they have saved by eliminating the "middlemen" entirely? Do we even know what that amount is?
The fact is - individual states don't have enough leverage. KY has ~1.6M Medicaid enrollees - which is (percentage wise) larger than many other states, but not much of a dent in ~70M enrolled in Medicaid nationally - and let's be honest. The Federal Gov is still funding the lions share of Medicaid in every state.
Sure - Alvarado opposes PBMs, but his quote is independent of political POV b/c he's right. It doesn't matter what legislators do - prices still go up. Here's the KFF quote from July, 2023:
"Since 2000, the price of medical care, including services provided as well as insurance, drugs, and medical equipment, has increased by 114.3%. In contrast, prices for all consumer goods and services rose by 80.8% in the same period."
As I've said to conservative friends, Trump's biggest strength is entirely apolitical: he's a very skilled dealmaker and usually phenomenal at reading the room; and his single biggest weakness is that it's apolitical and not agenda-driven: he almost never cares who he's making deals with and as often as not is reading the wrong room.
That said, I'll repeat here the idea I had the other week: Biden should lob some Trumpian rhetoric in Trump's general direction specifically on how concrete enforcement policy (and personnel choices!) has made a difference for the populist antitrust, anti-Big-Tech, anti-Big-Business movement, in hopes of goading Trump's ego into crusading in favor of antitrust (and other) enforcement and such to prove he's a better populist than his opponents. Whether he wins or loses, it would be helpful to have the yuge man ranting and raving wrestling style about how we need more people fighting for us like Lina Khan, and I really do think he could be prodded into it even though he doesn't consistently "get it" on his own accord.
What would Noam say, or Michael Hudson?
Matt, You are doing a great service for the American people! Keep it up!
I believe big money is pretending to be Progressive and they’re fucking them up big time!
Brother Matt, do you believe there are actually 100 sincere members of the so-called Progressive caucus?
What have they done? They allowed Pelosi to stay in office when he only needed about 8 votes to get rid of her. The only needed about the same number of votes stop the inflation reduction act, which has 250 to 300,000,000,000 of pork for so-called green energy.
Sincerity is irrelevant, the progressives are the most likely to vote for stronger antitrust and against corporate power. Some are bad and they have very annoying identity nonsense but that's just the way things are. The Inflation Reduction Act was generally good, and included things like capping pharma prices and subsidies for domestic battery production, which will be used in all sorts of machinery. Also, $250B over ten years isn't a big deal, $250B is about what the Fed hands to the banks every year, more or less.
Sincerity gives you a clue. Apparently you're clinging to the progressive life boat. GOOD LUCK as you're going to need it
Sincerity gives you a clue
That’s bullshit
Matt, you remind me of my brother, the bears could be downed 35 to nothing in the fourth quarter, but he thinks they could come back. That sounds like you and the pussies.
If you look at the vote counts for stronger antitrust laws, it's always progressives who have the highest percentage of support and conservative Republicans who have the lowest percentage of support. That may make no sense, since GOP voters want stronger antitrust laws, but it is what it is. Hopefully that changes, and there are reasons to assume it will, but it hasn't yet.
As for the Bears, well, I'm watching the game right now, and it's the Biden administration, spurred largely by Elizabeth Warren who was the first Senator to call for antitrust action against Google all the way in 2016, who is pursuing a host of actions to break up dominant firms. You will not find anyone who is as eager to see the GOP take up this mantle as I am. Some of them are. But right now the progressives, and not all of them, who are the key voting block to do.
Matt, I'm sure you already are following Chomsky. Take a look at Michael Hudson who's an MMT person like stephanie kelton, Pavlina, Randy, Bill, Warren and lots of other folks lots smarter than most of us, sadly including me::), Hudson has the most current flaw in our system.... compound interest rates are off-the-charts stupid
Matt, I"m a warrior and you're a warrior. Who are we trying to protect?
Matt, if the best you got is Warren, you're in bigger trouble than you think :}
Bro Matt, if you're clinging to the progressive philosophy as I did for almost 40 years, you're doomed to be a failure like me, sorry bro, that's the way i see it
Biden/US are war criminals, and Israel/Saud's are #2, but there are lots of candidates that you know better than me. Would Trump of been impeached or charged with a war crime for blowing up the pipelines?
Great update, but a question re: Forest Service quote—-
Having two fire retardant sources not only increases COMPLETION in the sector, or COMPETITION in the sector? Hope I don’t sound persnickety but I’m reading a distinct meaning in the word as written.
Ha thanks
Thanks Matt, good summary. Per your GPO link, healthcare suppliers factor in GPO fees when pricing their products. Ten years since my retirement but recall fees at that time were around 3%. A large percentage especially for commodity like products. GPOs original mission of buying aggregation now eclipsed with the consolidation of Hospital groups like UPMC, HCA. Novant etc, who amass their own purchaser leverage. Agree with you on PBMs and GPOs.
Yup.