August 30, 2023

Wednesday, August 30, 2023. Annette’s News Roundup.

I think the Roundup makes people feel not so alone.

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Joe is always busy.

U.S. Announces First Drugs Picked for Medicare Price Negotiations.

The price negotiation program, established by Democrats as part of the Inflation Reduction Act, is expected to save the government tens of billions of dollars in the coming years.

The Biden administration on Tuesday announced the first 10 medicines that will be subject to price negotiations with Medicare, kicking off a landmark program that is expected to reduce the government’s drug spending but is being fought by the pharmaceutical industry in court.

The medications on the list are taken by millions of older Americans and cost Medicare billions of dollars annually. The drugs were selected by the Centers for Medicare & Medicaid Services through a process that prioritized medications that account for the highest Medicare spending, have been on the market for years and do not yet face competition from rivals.

Drugs Selected for Price Negotiations

1. Eliquis, for preventing strokes and blood clots, from Bristol Myers Squibb and Pfizer

2. Jardiance, for diabetes and heart failure, from Boehringer Ingelheim and Eli Lilly

3. Xarelto, for preventing strokes and blood clots, from Johnson & Johnson

4. Januvia, for diabetes, from Merck

5. Farxiga, for chronic kidney disease, from AstraZeneca

6. Entresto, for heart failure, from Novartis

7. Enbrel, for arthritis and other autoimmune conditions, from Amgen

8. Imbruvica, for blood cancers, from AbbVie and Johnson & Johnson

9. Stelara, for Crohn’s disease, from Johnson & Johnson

10. Fiasp and NovoLog insulin products, for diabetes, from Novo Nordisk

The final list had some overlap with what experts had anticipated. Its release was an important moment for Democrats, who have campaigned on a promise to lower the cost of prescription drugs. President Biden will mark the occasion with remarks at the White House on Tuesday afternoon — another sign that he intends to make lowering health care costs a theme of his 2024 re-election campaign.

Medicare gained the authority to negotiate the price of some prescription medicines when Congress passed the Inflation Reduction Act last year, a signature legislative achievement for the president. Tuesday’s announcement is a key step toward those negotiations, which will unfold over the coming months, with the new prices taking effect in 2026. Additional drugs will be selected for price negotiations in coming years.

The negotiation program is projected to save the government an estimated $98.5 billion over a decade. It is also expected to eventually reduce insurance premiums and out-of-pocket costs for many older Americans, though the magnitude of those savings remains to be seen.

Medicare already pays reduced prices for drugs on the list, reflecting rebates that are passed down by pharmacy benefit managers, the middlemen that negotiate discounts with manufacturers. But before passage of the Inflation Reduction Act, Medicare was explicitly barred from negotiating prices directly with manufacturers.

Republicans in Congress opposed authorizing Medicare to negotiate prices, criticizing the move as tantamount to imposing government price controls. Beyond Mr. Biden, other Democrats up for re-election next year have also sought to highlight the program as a major achievement.

Polling by KFF, a health policy research organization, has found broad, bipartisan public support for allowing Medicare to negotiate prices. In a survey late last year, 89 percent of Democrats and 77 percent of Republicans said they favored the plank of the Inflation Reduction Act that authorizes negotiations.

“There are very few issues in American politics that are popular no matter where you live or what your political party is,” said Leslie Dach, a longtime Democratic strategist and the chairman of Protect Our Care, a health care advocacy group.

But Mr. Biden and his fellow Democrats face the challenge of drawing attention to the negotiation program. In a KFF survey in July, only a quarter of Americans were aware of its existence.

Now that the list of drugs is public, their makers have until Oct. 1 to declare whether they will participate in negotiations with the government. Companies that decline to negotiate must either pay a large excise tax or withdraw all of their products from both Medicare and Medicaid, the federal-state program that provides health coverage to low-income people.

Six pharmaceutical manufacturers — Astellas Pharma, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Johnson & Johnson and Merck — have taken the Biden administration to court in an attempt to block the Medicare negotiation program. The industry’s main trade group and the U.S. Chamber of Commerce have also filed suit.

The suits make a variety of constitutional claims, including that the requirement that drugmakers negotiate or pay a fine violates the Fifth Amendment’s prohibition on the taking of private property for public use without just compensation. (New York Times).

From the Wall Street Journal - The nam­ing of the 10 drugs sub­ject to price ne­go­ti­a­tions kicks off a lengthy process. Drug­mak­ers have un­til Oct. 1 to say whether they will join in the ne­go­ti­a­tions. 

If they don’t ne­go­ti­ate or ac­cept the price re­sult­ing from it, com­pa­nies face a tax of up to 95% on a med­i­cine’s U.S. sales, or they can pull all of their drugs from Medicare and Med­icaid cov­er­age. (WSJ)

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The storm, the President and Florida.

President Biden told reporters at the White House that he spoke last night to Gov. Ron DeSantis of Florida and assured him that the state would have all the federal resources it needs after Idalia hits. He added that officials were worried about storm surge, which is expected to be life-threatening on parts of the coast. (Source. NY Times).

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There seem to be no limits to the anti-democracy GOP in Tennessee.

GOP silences ‘Tennessee Three’ Democrat on House floor for day on ‘out of order’ rule; crowd erupts.

NASHVILLE, Tenn. (AP) — Republican lawmakers voted Monday to temporarily silence a Democratic member of the so-called Tennessee Three during an already tense House floor session after determining the young Black member violated newly enacted rules designed to punish disruptive members.

The move directed at Rep. Justin Jones prohibited him from speaking on and debating bills for the remainder of the day, which came a week into a special session that Republican Gov. Bill Lee called in reaction to a deadly shooting at a Christian elementary school in Nashville in March.

The House and Senate are locked in an icy standoff over what to pass as families close to the shooting have increasingly voiced their frustrations with the legislative process. Various mental health, juvenile justice, school safety and other proposals are among what’s being considered.

Republican legislative leaders aren’t taking up any significant gun control changes, including the governor’s push to keep guns away from people judged to pose a threat to themselves or others.

The vote to silence Jones prompted loud cries and chants that drowned out proceedings for several minutes even after the House speaker ordered the gallery to be cleared out.

Moments prior, Jones had been criticizing legislation that would have allowed more law enforcement officers in schools and began listing other resources that the state should be providing.

House Speaker Cameron Sexton had warned Jones not to stray off topic. Under new rules adopted by the GOP-dominant chamber last week, members can be silenced anywhere from a day to the rest of the year for not sticking to the bill being debated.

“What our schools need are mental health professionals,” Jones said. “We need funding for mental health, for counselors. We need to pay our teachers better. We don’t need more police in our schools.”

Sexton then ruled Jones out of order, setting up a vote on whether to quiet him for the rest of Monday’s session.

What happened next was a chaotic flurry of legislative proceedings, where Democrats outraged at the decision to move ahead to try to silence Jones for the day began pleading with their GOP colleagues to change their minds. Republican lawmakers remained unconvinced, however, with 70 GOP members voting to silence Jones. Democratic members then angrily left the chamber with Jones.

The crowd, which included gun control advocates urging change in a special session after a deadly Nashville school shooting in March, shouted “fascists” and “racists,” and Sexton ordered troopers to clear out the gallery of the public.

“Look, House rules are House rules,” Sexton told reporters afterward. “We voted on it. Might not like the rules, but the rules are what they are.”

Many in the crowd remained in the stands, and their cries of “vote them out” and “Whose house, our house” drowned out the legislative proceedings for several minutes, enough at one point that a Republican lawmaker said he couldn’t hear what he was supposed to be voting on.

Earlier that session, Sexton warned Jones he was nearly “impugning the reputation” of Republican Rep. Gino Bulso by calling Bulso’s bills “reprehensible,” “asinine,” and “insulting,” including one being discussed at the time that would allow private schools with pre-kindergarten classes to have policies allowing guns on campus.

Democrats noted that Bulso himself had been told to stay on topic, including when he said Jones “continually misrepresents facts to the public,” then later said Jones “makes outrageous statements,” without being put up for a vote on whether he should be silenced.

Not long after, Jones said lawmakers should “stop trying to put more guns to start a gun fight in our schools that would not protect our children. What is one little Glock against an AR-15?”

Sexton then declared Jones out of order.

Jones was among the two Tennessee lawmakers expelled earlier this year for his role in a pro-gun control protest inside the Tennessee Capitol, propelling him into the national spotlight as the new face of Democratic politics. (Associated Press).

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It is always hard to know when change will come. Here it is. Spain 2023.

A Forced Kiss, and a Reckoning With Sexism in Spain.

The nonconsensual kiss that Luis Rubiales, the president of Spain’s soccer federation, pressed on Jennifer Hermoso has come to embody the generational fault line between a culture of machismo and more recent progressivism.

Celebrating Spain’s women World Cup championship.

Jennifer Hermoso, top goalscorer in the history of both the Spain and Barcelona women’s teams, was the victim of Luis Rubiales, the president of Spain’s soccer federation, who forcibly kissed her, following the Spanish team’s win.

Laura Marqués has never been much interested in soccer. She doesn’t watch the Spanish league games or know the names of the players. She didn’t even watch the Spanish women’s team win the World Cup final this month. But after the president of Spain’s soccer federation forcibly kissed one of the players during the medals ceremony, setting off a momentous national debate about feminism, equality and abuse, soccer is all she has been thinking about.

“We’ve been talking about soccer a lot this week,” Ms. Marqués, a 26-year-old lawyer, said as she walked in downtown Zaragoza with a friend. She said she considered the unwanted kiss an all-too-common act of casual aggression, an abuse of power by an authority figure and a shameful eclipsing of the women’s moment of glory by the country’s stubborn, if fading, culture of machismo, the often-ingrained sense of masculine pride and entitlement.

“Everything that happened showed what the players have been complaining about for a long time, and nobody believed how serious it was,” she said. “It’s the straw that broke the camel’s back.”

The celebratory and nonconsensual kiss on the lips that Luis Rubiales, the president of Spain’s soccer federation, pressed on Jennifer Hermoso, one of the team’s star players, has come to embody the generational and cultural fault line between deep traditions of machismo and the more recent progressivism that has put Spain in the European vanguard on issues of feminism and equality. Some commentators have taken to calling it Spain’s #MeToo moment.

On Monday, Spanish prosecutors said they had opened a preliminary investigation into whether Mr. Rubiales, 46, could be charged with committing a crime that could constitute sexual aggression. The group he leads, the Royal Spanish Football Federation, called on him to resign. In a statement after meeting for hours on Monday to discuss the issue, it cited “the unacceptable behaviors that have seriously damaged the image of Spanish football.”

Against the politically charged backdrop of recent Spanish elections that largely rejected the nostalgic and anti-gender identity politics of the chauvinistic far right, Spain’s establishment is clearly picking a side. Leading politicians on the left and right, the country’s top cultural figures and even an increasing number of voices from within the machismo culture of Spanish soccer have rallied to support Ms. Hermoso — who said she felt like a “victim of aggression” after a nonconsensual and sexist act — and to condemn Mr. Rubiales, who has decried “false feminism,” described himself as the victim of a “social assassination” and insisted Ms. Hermoso initiated the exchange.

“What happened last week was an epochal moment that will have important repercussions,” said Máriam Martínez-Bascuñán, a professor of political sciences at the Autonomous University of Madrid. She said the immediate condemnation of Mr. Rubiales — even by members of Spain’s main conservative party — reflected how far the country’s feminist movement had come. She noted that in the last 20 years, Spain had been a pioneer in gender and equality legislation.

In 2004, it recognized domestic violence as explicitly gender-based violence, and in 2022, after a horrific gang rape, the government passed a law that classifies any nonconsensual sex as rape.

The backlash to the kiss by Mr. Rubiales, Ms. Martínez-Bascuñán said, showed that the country had no intention of backsliding.

Ms. Martínez-Bascuñán said the incident presented “a magnificent opportunity” for Spain’s feminists and progressives to reveal and change the sexism in even the most male-dominated institutions. She said that there was a “generational and gender-based” fault line, but that most Spaniards understood why the kiss was inappropriate, and those who did not understand “were not the majority at all.”

Indeed, the denunciation of the kiss, videos and photographs of which proliferated in Spanish social media and across the country’s newspapers and television screens, came from across the political spectrum.

Pedro Sánchez, the country’s acting prime minister and leader of the Socialist party who bet big, and successfully, on his own record of progressive and feminist upheavals in last month’s elections, said that the kiss was “unacceptable” and the subsequent apology by Mr. Rubiales was “not enough.”

Irene Montero, the acting minister of equality,described the kiss as “sexual violence,” a statement that prompted Mr. Rubiales to threaten to sue her and other left-wing politicians for defamation.

Cuca Gamarra, the secretary of the conservative People’s Party, described the kiss as “shameful.” Isabel Díaz Ayuso, the regional president of Madrid, who is widely seen as a potential conservative prime minister, called it “disgraceful.” An editorial published on Saturday in La Razón, a conservative newspaper, described the episode as a “national monstrosity,” and said the progressivism of Mr. Sánchez’s government had created an environment that enabled Mr. Rubiales and his “vulgar and inappropriate behavior in the Women’s World Cup final.”

The far-right party Vox, which tanked in the election after portraying laws against gender-based violence as biased against men, has remained silent.

But Spanish society has erupted, seizing on the incident as a major moment of reckoning for its clubby and often sexist soccer culture. More than a dozen female players rebelled last year, long frustrated with unequal pay; what they considered overly harsh and controlling treatment by their current coach, Jorge Vilda, including allegations that he rifled through their personal belongings; and a general culture of sexism.

Many were kicked off the team and missed the World Cup, but one of those players, Lola Gallardo, told the newspaper El País on Monday that it was worth the pain of missing the glory. “Ideas are ahead of a medal,” she said.

The entire team and dozens of other players signed a joint statement late Friday night saying they would not take the field to play for Spain “if the current managers continue.”

On Saturday, some of the members of the team’s coaching staff resigned, condemning Mr. Rubiales’s defensive response to the incident. Two of the women who signed the resignation letter sat in the front row at a Friday news conference where Mr. Rubiales announced he would not step down. They later said that they had been told to sit there in a forced show of support, but did not say by whom.

The players are seeking to end the days of machismo in Spanish soccer, and seal it with Mr. Rubiales’s kiss.

“It’s over,” Alexia Putellas, a star player, wrote in a post on X, formerly known as Twitter, expressing solidarity with Ms. Hermoso. At a Spanish league match in Seville on Sunday night, the home players came on to the field wearing shirts reading “It’s over.” The crowd roared in approval and chanted calls for the resignation of Mr. Rubiales and for the federation to be scrubbed of corruption.

On Friday, Misa Rodríguez, a player on the national team, posted on social media a cartoon of a little girl asking her grandmother to tell her about how the team won the World Cup. “We didn’t just win the World Cup, little one,” the grandmother answers. “We won so much more.”

Lola Índigo, a Spanish singer, stopped a concert in Marbella to express indignation at the men who gave Mr. Rubiales a standing ovation after his speech on Friday.

But while the condemnation of Mr. Rubiales has been nearly uniform in politics, media and public life, there remains throughout Spain those who wonder if the incident was as bad as it was being made out to be, or if Mr. Rubiales’s lips are too thin to hang a movement on.

“If they want to get rid of him for what he did before, then they should, but the kiss is nonsense,” said Beatriz Pena, a 55-year-old soccer fan who was shopping for her grandson at her local soccer team’s store. “It’s not sexual harassment or anything.”

Oscar Duarte, 48, bought a soccer shirt for his son on Monday, the same day that Mr. Rubiales’s mother locked herself in a church and began a hunger strike to protest what she considered to be a witch hunt of her own son. Mr. Duarte said he and his son had made sure to support the women’s team, watching the games and cheering the players’ victory during the final match.

Like many Spaniards, Mr. Duarte was bothered that Mr. Rubiales grabbed his crotch in the vicinity of the Spanish queen and princess during the victory celebrations, but said he didn’t see anything so terrible about the kiss.

“It’s like a kiss I could have given to a friend,” he said, adding that it “was just a gesture of affection.”

But on Monday, Spanish prosecutors began looking into whether it was much more than that. (New York Times).

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I thought these two discussions 👇 might interest you.

Both contain some disturbing information.

The first is about bras.

I find bras totally uncomfortable, hot and itchy, for both work and leisure. But looking around, I seem to be in the minority. What are the rules for going braless? Is it OK to show my nips, or is it rude? — Eddye, Madison, Wis.

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You are not the only one having an anti-bra moment. When many dressing mores went out the window during the pandemic lockdowns, the no-bra movement, which has resurfaced regularly since the 1960s, once again began picking up steam (led, in part, by Florence Pugh, above).

Still, when it comes to the question of “to bra or not to bra,” especially as we return to offices and summer draws to a close, there are really three kinds of issues: the literal one, the physical one and the sociocultural one.

First things first: There are literally no rules, which is to say laws, that govern women’s underwear. Instead, laws focus on body parts, and what can be shown and not shown. Indiana, for example, prohibits public indecency and then defines it partly as “the showing of the female breast with less than a fully opaque covering of any part of the nipple.”

However, a number of states, including New York, Utah and Oklahoma, and many more cities (including Madison) allow women to go topless in public. Which also means braless.

This gets a little more complicated when it comes to workplace dress codes, according to Susan Scafidi, the founder of the Fashion Law Institute. New York City was, she said, the first jurisdiction to insist on “full gender neutrality,” meaning an employer can “require an individual identifying as female to wear a bra or hide her nipples, but only if the same rule applies to a male employee.”

It is possible to imagine “S.N.L.” having a field day with that. But the current situation is better than it was back in 2010, when the investment bank UBS issued a 44-page dress code, which, among other things, dictated that its female employees wear flesh-toned lingerie.

When it comes to federal law, Ms. Scafidi said, “it only requires that dress codes have gender parity with regard to burdens such as cost.” Whether bras constitute an extra financial burden has not yet been addressed.

As to the notion that bras are necessary for women’s health, Cassann Blake, chair of the breast services department at a Cleveland Clinic hospital in Weston, Fla., told its health blog that there is no particular medical reason to wear a bra (and that bras don’t prevent sagging) — though women with especially large breasts may find a sports bra eases back strain.

Which brings me to the elephant — or catcall — in the room. After all, abandoning the bra isn’t just about changing mores when it comes to underwear. It’s about gender norms, the reality (and historical fear) of women’s bodies, power struggles and sexual stereotypes.

To be faced with freed breasts, whether or not nipples are visible, is to be forced to confront deep-seated prejudices about all of this, and that is both upsetting and distracting to a lot of people. Especially at this particular moment in time, when control of women’s bodies and their reproductive purpose has become once again a hot-button political issue. It reminds me of the brouhaha that arose a few years ago when the parent of a Notre Dame student complained about girls in leggings, saying they were distracting for the boys.

It is not, of course, your job to make other people comfortable or to help them sort through their own feelings about all of the above. Though if you are actually on the job, it is also true that group dynamics matter, and you may not want to spend a chunk of time with colleagues having to discuss your breasts. At least for now, however, it is still your choice. (New York Times).

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The second is on sexism in a glorious moment.

Monday was the 60th anniversary of the March on Washington and Dr. King’s “I have a Dream” speech. Hopefully, these. Words by the author Dana Rubin (Speaking While Female) should not minimize the extraordinary achievement of that day, but instead should encourage us all to do even better.

From Dana Rubin—Where were the women speakers at the March on Washington?

Pauli Murray.

Sixty years ago today,  a quarter million people came to the nation’s capital for the March on Washington, an event often described as a collaborative effort among civil rights leaders and icons of the day. But where were women's voices heard on that historic day?

That’s the question asked by civil rights leader Pauli Murray three months later, when she blasted the male organizers of the march for discriminating against the women who had worked alongside them to make America more egalitarian.

Speaking to a women’s group in November 1963, she complained that of the fifteen people scheduled to speak at the Lincoln Memorial, only one was a woman.

Murray was a Yale Law School fellow who was widely respected for her pioneering work on race and gender. Her law school paper at Howard University had influenced Thurgood Marshall’s strategy in Brown v. Board of Education. Her book, States’ Laws on Race and Color, was considered “the Bible of the Civil Rights movement.”

She knew that the lack of women speakers at the Washington march was no accident. Planners originally wanted no women to speak, not even during the section dedicated to “Negro Women Fighters for Freedom.” Anna Arnold Hedgeman, the lone woman on the planning committee, complained.

Finally, organizers consented to give a spot to Myrlie Evers, widow of the recently assassinated Medgar Evers. But when she got stuck in traffic, activist Daisy Bates filled in.

Black American women, Bates told the crowd, would sit-in, kneel-in, and lie-in if necessary, “until every Negro in America can vote.” Though she wasn’t on the program, Josephine Baker also stepped up and gave a short speech.

All the other addresses were by men — including Dr. King’s iconic “I Have a Dream.” No women were included in the delegation sent to the White House.

Murray’s delivered her speech, “The Negro Woman in the Quest for Equality,” to the National Council of Negro Women. It's included in my new anthology, “Speaking While Female: 75 Extraordinary Speeches by American Women."

For Murray, the absence of a major contribution by a woman was “bitterly humiliating,” revealing a deep-rooted disrespect for Black women.

As she noted, two days before the March, organizer A. Philip Randolph had agreed to speak at the National Press Club — despite protests by female reporters that the club restricted women to the balcony. When Randolph asked, “What’s wrong with the balcony?” the women shot back, “What’s wrong with the back of the bus?”

He failed to see, Murray noted, “that he was supporting the violation of the very principle for which he was fighting: that human rights are indivisible.”

“Would the Negro struggle have come this far," she asked, "without the indomitable determination of its women?”

#womensvoices

#civilrights

#equalrights

(Source. Dana Rubin’s account on LinkedIn.)

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August's rare Super Blue Moon, the biggest full moon of 2023, rises today.

Wednesday's moon might still appear enormous, but for a different reason.

On Wednesday, Aug. 30, you'll no doubt hear the mainstream media proclaiming that on that night we will have an opportunity to witness a "supermoon." It's a term, or more specifically, a branding, of relatively recent origin. It originated not from astronomy, but astrology; first coined by an astrologer, who arbitrarily defined it as "a full moon which occurs with the moon at or near (within 90-percent of) its closest approach to Earth in a given orbit (perigee)." 

Indeed, at 12 noon ET on that fifth Wednesday of August, the moon will arrive at perigee, its closest point in its orbit relative to Earth at 221,942 miles (357,181 km) away. And 9 hours and 36 minutes later, the moon will officially turn full. Although a full moon theoretically lasts just a moment, that moment is imperceptible to ordinary observation, and for a day or so before and after, most will speak of seeing the nearly full moon as "full": The shaded strip is so narrow, and changing in apparent width so slowly, that it is hard for the naked eye to tell whether it's present or which side it is. 

And in addition to its "supermoon" status, this particular full moon will be the second to occur in the month of August, the first having occurred on Aug. 1. As a result, the second full moon of August on the 30th, will be also branded as a "Blue" moon. So, for what it's worth, what we'll have will be a "Super Blue Moon." 

However, unless there is some unusual atmospheric condition present such as airborne dust, ash or smoke, the moon will not appear blue but its normal yellow-white self. Nonetheless, thanks to mainstream media hyperbole, many will likely look forward to getting a view of this big late summer moon. (Space.com)
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