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DFA's Weekly Physician's Rounds


Three main storylines this week (besides the Michael Cohen testimony) 

1.)   Background Checks on All Gun Sales: The U.S. House of Representatives passed two common-sense bills to ensure that there are background checks on ALL gun sales and can keep guns away from those who shouldn’t have them. The ball is now in Senator Mitch McConnell’s court. 

2.)   RX CEO’s: Seven top pharmaceutical CEOs were called in to testify before the Senate Finance Committee to justify why prices for prescription drugs were so high. … “But while committee leaders Grassley and ranking Democrat Ron Wyden of Oregon made it clear from the start they wanted to talk about list prices and price transparency, the executives kept the conversation to rebates and broader supply chain issues.” 

3.)   MEDICARE FOR ALL: Democrats in the U.S. House of Representatives unveiled a proposal to move all Americans into the government’s Medicare health insurance program.  The legislation has more than 100 co-sponsors. 




FINALLY: Finally, we have done more than thoughts and prayers. Finally, we have taken a vote to expand background checks and help save lives ...For six long years, we worked on this issue, and the previous majority would not even let us have a hearing, let alone a vote to expand background checks” Representative Mike Thompson (D-CA)

TWO SECURITY LINES: “America’s current background check system is like having two types of security lines at the airport: one for people who are willing to be screened, and one you can waltz right through carrying whatever you want, We applaud the House for moving so quickly.” John Feinblatt, President - Everytown for Gun Safety

 ONE LESS REASON TO WORRY: "After my son's death, I dedicated my entire life to advocating for common-sense gun safety solutions, but it was the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, that finally motivated me to join this legislative body, … The overwhelming bipartisan support for universal background checks symbolizes the power of advocacy and the incredible power of the survivors, family members, and students who have shared their stories. ... H.R. 8 will ensure that mothers and fathers have one less reason to worry." Representative Lucy McBath (D-GA) 

A MUCH-NEEDED STEP: Today, exactly 25 years after the Brady Bill went into effect, the House of Representatives took a much-needed step towards preventing that type of tragedy from ever happening again. No one should be able to buy a gun just because a background check took a little too long to be completed. We need to provide our law enforcement agents with the time and resources they need to properly ensure that guns are not falling into dangerous hands. We will continue to pursue every avenue to strengthen the Brady Background Check system, and we look forward to pushing this bipartisan bill through the Senate and into law.”   Kris Brown - President, Brady United Against Gun Violence 


House Passage of Gun Safety Bills Reflects Political Shift

The House put on a display of Democratic priorities this week with two bills to bolster background checks on firearms purchases, showing just how quickly the politics of gun control have turned. ... the outcome showcased a turn of events as Democrats — and some Republicans —more fully support gun control measures they were hesitant to tackle even a few years ago….Polling, though, shows attitudes are shifting. A survey conducted by The Associated Press-NORC Center for Public Affairs Research last year found that nearly 7 in 10 adults favored stricter gun control measures. That was the strongest level of support since The Associated Press first asked the question five years ago. (Lisa Mascaro, Associated Press)

A Guide to the House’s First Major Gun Control Vote in Years

The House this week is set to pass the first major gun control legislation in over two decades, with Democratic lawmakers expected to approve two measures strengthening background checks for all firearms sales. The last time the House put high-profile legislation expanding gun control laws to a vote was in 1994, when it passed the Federal Assault Weapons Ban and made it illegal to manufacture a number of semiautomatic weapons for civilian use. That legislation expired after a decade and was not renewed by a Republican-controlled Congress. But riding a new wave of urgency after a series of mass shootings — and the activism inspired by the school massacre in Parkland, Fla., last February in which 17 students and teachers were killed — House Democrats have pledged to take meaningful action on the issue, beginning with the twin bills. The Bipartisan Background Checks Act, which the House will take up on Wednesday, requires universal background checks, closing a loophole for buyers at gun shows and online…. The second piece of legislation, the Enhanced Background Checks Act, will be voted on Thursday. Sponsored by Representative James E. Clyburn of South Carolina, the majority whip, the bill seeks to extend the initial background check review period to 10 days from three. (Catie Edmondson, New York Times)

U.S. House Passes First Major Gun Control Law in Decades

The House voted on Wednesday to require background checks for all gun purchasers, including those at gun shows and on the internet — the first significant gun control bill to clear the chamber in a quarter of a century. The 240-to-190 vote is the first of two gun control measures expected to be put to House lawmakers this week, a turning point in gun legislation after 25 years when the National Rifle Association dominated the chamber. Last year’s massacre at Marjory Stoneman Douglas High School in Parkland, Fla., prompted a wave of student-led activism that pressed Democrats to unite around gun control, and the activists cheered when the measure cleared the 218-vote threshold for passage. The Democratic victory was tempered, however, after Republicans prevailed in adding a provision that would require the F.B.I. to alert Immigration and Customs Enforcement if an undocumented immigrant tried to obtain a firearm. Twenty-six Democrats, primarily from moderate or Republican-leaning districts, broke party lines to support the measure. But Speaker Nancy Pelosi of California and other Democrats insisted that would ultimately have little import. (Catie Edmondson, New York Times)

Hard-Charging Democrats’ Cautious Strategy on Gun Control Reflects Limits of Political Change

But despite a sea change in gun politics — one that helped deliver the House majority to Democrats and has increased the task force’s ranks to 172, nearly three-quarters of the caucus — top leaders are determined to move cautiously. They have not announced firm plans for further gun votes, and prominent voices on the issue are hardly talking about action on aggressive measures such as an assault weapons ban that have long been liberal lodestars. Their caution — which extends from House Speaker Nancy Pelosi (Calif.) to Thompson to outspoken freshmen such as Reps. Lucy McBath (Ga.) and Jason Crow (Colo.) — stands in sharp contrast to other pockets of the Democratic caucus. On health care and climate change, for instance, liberals have been emboldened to push the envelope of what is possible, offering far-reaching proposals such as the Green New Deal and Medicare-for-all. (Mike DeBonis, Washington Post)




 GORDIAN KNOT: I feel like I need a Ph.D. in prescription drug-pricing to understand how the heck this industry works,” Senator Maggie Hassan (D-NH) During Senate Finance Committee meeting with seven senior pharmaceutical executives. 

ENTRENCHED POWER: This (pharmaceuticals) is a $460 billion industry, You think three hours of an orchestrated show before Congress will lead to different behavior? I don’t think so.” Ronny Gal,  Securities Analyst, Sanford C. Bernstein & Company,



Drugmakers Dodge a Senate Bullet, Find Some Sympathy on Pricing

A highly anticipated Senate hearing on surging drug prices that was billed as a replay of a decades-ago public reckoning for the tobacco industry produced few memorable fireworks. Instead, what emerged was a broad recognition that the U.S. health-care system is complex, and that easy fixes are in short supply. Lawmakers from the Senate Finance Committee largely refrained from bashing seven senior pharmaceutical executives who came to Capitol Hill to explain why medicines cost so much. Many of the techniques the industry has used to preserve its profits from blockbuster drugs came in for criticism, but company officials were able to place much of the blame on a patchwork of incentives that culminates in high out-of-pocket costs for patients. … The hearing marks the start of what is likely to be a prolonged bipartisan push to tackle soaring health costs that could extend far beyond drugmakers. Republicans and Democrats have been largely in agreement on the need to address an acute source of strain for many American families.  (Timothy Annett  and Anna Edney, Bloomberg News)

Drug Makers Try to Justify Prescription Prices to Senators at Hearing

Pharmaceutical executives, testifying before Congress, could not readily explain on Tuesday why the prices for many brand-name prescription drugs were much higher in the United States than in other developed countries. … Senator Robert Menendez, Democrat of New Jersey, the home to many drug and biotechnology companies, offered what he described as “a friendly warning” to the witnesses. “If you don’t take meaningful action to reduce prescription drug prices,” he said, “policymakers are going to do it for you.” … The hearing was political theater, but could also be a first step toward legislation to provide some relief to consumers, as lawmakers of both parties and President Trump have vowed to slow the relentless rise of drug prices. (New York Times, Robert Pear

Pharma CEOs Survive Senate Grilling With Few Concessions

Senate Finance Committee lawmakers exacted minimal policy concessions from seven top pharmaceutical CEOs Tuesday over hours of grilling. And they aren't likely to relieve tension with hospitals and insurers over drug prices. Following the hearing, stocks for most of the companies represented there rose slightly or held steady, while share prices for pharmacy benefit managers declined slightly. .. But while committee leaders Grassley and ranking Democrat Ron Wyden of Oregon made it clear from the start they wanted to talk about list prices and price transparency, the executives kept the conversation to rebates and broader supply chain issues. (Susannah Luthi, Modern Healthcare

Drug Industry Defense for High Prices: Blame Insurance Companies

A line of defense is emerging for top prescription drug companies whose top executives will be pulled before Congress on Tuesday to testify about high prices for medicine: They are not to blame. It’s a corporate version of a “devil made me do it’’ argument. The industry says it is trapped in a reimbursement system that has become badly distorted, one that rewards companies for jacking up list prices and then offering deep discounts, in the form of rebates, to win favorable treatment by insurance plans…. “I hope the drug co CEOs testifying tmrw don’t try to blame everyone but themselves/take no responsibility for their role in fixing the problem,’’ Grassley tweeted Monday. (Christopher Rowland, Washington Post



“The bill for the ER visit?... US $80.00 - Eighty. American. Dollars. Out of pocket. Full cost. No discounts. No insurance.  At one of the best hospitals in Taiwan. And if I had NHI, it would have been a fraction of that. This could have easily cost me hundreds or even thousands in the US without insurance. But here in Taiwan, I was able to receive speedy, quality care comparable to what I would have gotten in a US hospital for a relatively small amount of money. Given this experience, I no longer have a reason to fear or hesitate getting care in Taiwan should I ever need it. America, it's time to stop making excuses.” Kevin Bozeat, a 25-year-old student, studying in Taiwan


An American Got Sick in Taiwan. He Came Back With a Tale of the ‘Horrors of Socialized Medicine.’

The Facebook post was illustrated with an image of an IV. “Went to the ER in Taiwan,” it began. Kevin Bozeat, a 25-year-old student, wrote about coming down with severe gastrointestinal symptoms while studying in Taiwan: stomach cramps, bouts of vomiting that would not abate and perhaps worst of all, he couldn’t keep any fluids down. Around 3 a.m., he decided it was time to go to the hospital for treatment, not knowing what to expect having never been to a hospital in Taiwan — a country that has a national health care system, or as Bozeat wrote, “socialized medicine.” He was checked-in and given IV fluids within 20 minutes of his arrival. Phlebotomists drew blood and the lab ran tests on it. Hospital techs performed an ultrasound to make sure he didn’t have gallstones or appendicitis. And eventually they diagnosed him with a stomach flu, gave him two prescriptions and discharged him. … “The bill for the ER visit? . . . U.S. $80.00.” He sarcastically titled his tale “The Horrors of Socialized Medicine,” noting he didn’t even have health insurance — in Taiwan or the United States. (Eli Rosenberg, Washington Post)

U.S. House Democrats Introduce Sweeping 'Medicare for All' Bill

Democrats in the U.S. House of Representatives unveiled an ambitious proposal on Tuesday to move all Americans into the government’s Medicare health insurance program, tapping into public frustration over the rising cost of healthcare that has become a key issue for the party as it seeks to gain control of Congress and the White House in 2020. The bill, unveiled by Democratic Representative Pramila Jayapal from Washington state, would transition the U.S. healthcare system to a single-payer “Medicare for All” program funded by the government in two years. The legislation is the party’s most high-profile and ambitious single-payer proposal in the new Congress and has more than 100 co-sponsors, many from the party’s progressive flank. It is unlikely to gain the support of any Republicans in the House or the Senate, who have derided single-payer healthcare as a socialist policy and oppose government interference in healthcare. It also remains unclear whether Democratic House Speaker Nancy Pelosi will bring the legislation up for a vote. (Yasmeen Abutaleb, Reuters)

As Over 100 House Democrats Embrace ‘Medicare for All,’ A Party Division Appears

Denouncing the profit motive in health care, more than 100 House Democrats rallied on Wednesday around a bill to replace most private health insurance with a national single-payer system, “Medicare for all.” The chief sponsor of the bill, Representative Pramila Jayapal, Democrat of Washington, said it would cure “a deep sickness within our for-profit system” of health care. But the bill highlights Democrats’ split over health policy going into the 2020 elections. Supporters of the bill, under which health care would be available to all Americans without premiums, co-payments, deductibles or “similar charges,” did not say how much it would cost or how they would pay for it. They said their proposal could save huge sums by cutting administrative costs and the bill-paying bureaucracy that works for insurance companies and health care providers. And Ms. Jayapal mentioned the possibility of levying “a wealth tax on the wealthiest Americans.” But only two hours after she introduced the bill, leaders of a more centrist group known as the New Democrat Coalition said Congress should initially focus on shoring up the Affordable Care Act, stabilizing insurance marketplaces and holding down prescription drug costs. (Robert Pear, New York Times)

Moderate Dems Revive Effort to Stabilize Obamacare Markets

A group of moderate House Democrats will make a push this year to stabilize ObamaCare's markets, reviving an effort that fell to partisan bickering in 2017.  The New Democrat Coalition, a caucus of 101 centrists, says the House should "immediately" work with Republicans to bring down ObamaCare premiums and reverse the Trump administration's "sabotage" of the health care law…. The task force wants to create a national reinsurance program to reduce premiums by helping insurance companies pay claims for high-cost patients.  It also wants to increase premium assistance and bring back insurer subsidies the Trump administration canceled in 2017.  A bill introduced in 2017 by Sens. Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.) would have funded a reinsurance program and three years of the subsidies for insurers.  But talks between Democrats and Republicans were derailed over a disagreement about the bill's treatment of abortion coverage.  .. "This is something that can be done this session, knowing that we can pass bills in the Democratic House, but we have to contend with a Republican Senate and with a Republican president," said Rep. Annie Kuster (D-N.H.) (Jessie Hellmann, The Hill)

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