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Big Pharma should cut ad spending to fight climate change
If Big Pharma actually cares about the environment, there are plenty of areas they can become more sustainable without risking lives.
Hot, isolated, and running out of supplies, parts of Puerto Rico near desperation.
Four days after Hurricane Maria left Puerto Rico in a communications and power blackout, some regions outside of San Juan remained completely disconnected from the rest of the island — and the world.
JUNCOS, Puerto Rico — In the heat and humidity here in the central mountains, Meryanne Aldea fanned her bedridden mother with a piece of cardboard Sunday as the ailing woman lay on her side, relieving a large ulcer in her back.
The 63-year-old mother, Maria Dolores Hernandez, had cotton stuffed in her ears to keep flies out, since her now screenless windows were letting all sorts of bugs in. The gray-haired diabetic woman spoke with her daughter about her worries: that she would run out of prescription drugs, that they were almost out of generator fuel to keep her insulin refrigerated and to run the fans at night. With all the heat, she feared that her ulcer would become infected.
But she worried most about her daughter’s home on the floor above hers, which was destroyed by Hurricane Maria. The shrieking winds had ripped off the zinc roof and the pounding rains had soaked the unprotected rooms below. While the outer concrete walls were mostly intact, everything else was ruined, covered by dirty tree branches, leaves, glass and debris.
Aldea reached out to hold her mother’s hand.
“Relax,” she said. “It’s okay.”
Four days after a major hurricane battered Puerto Rico, leaving the entire island in a communications and power blackout, regions outside San Juan remained disconnected from the rest of the island — and the world. Juncos, in a mountainous region southeast of the capital that was slammed with Maria’s most powerful winds, remains isolated, alone, afraid.
For many residents, the challenge of accessing the essentials of modern life — gasoline, cash, food, water — began to sink in. And government officials had no answers for them. Estimates for the return of electricity and basic services will be measured not in days but in weeks and months. For those most vulnerable, far too long.
Many have been openly wondering when help will arrive, whether from local officials or from the federal government. The first thing some villagers ask when they see outsiders: “Are you FEMA?”
Puerto Rico Gov. Ricardo Rosselló is warning that his government needs broader assistance from the federal government, calling on the Pentagon especially to provide more aid for law enforcement and transportation. Rosselló said he’s also worried that Congress will shortchange his island once the initial wave of emergency relief is gone.
“We still need some more help. This is clearly a critical disaster in Puerto Rico,” he said Sunday night. “It can’t be minimized and we can’t start overlooking us now that the storm passed, because the danger lurks.”
For federal agencies trying to respond to Maria, the situation in Puerto Rico and the U.S. Virgin Islands is inescapably more challenging than the situations in Texas and Florida after hurricanes Harvey and Irma. It’s difficult to get onto the islands.
The airports and harbors here were severely damaged. That means the islands are more isolated than ever, even as the humanitarian crisis has worsened by the day.
So although massive amounts of food, water, fuel and other supplies have been dispatched by federal agencies and private organizations, with more resources on the way, this has been an obstacle-filled process.
Federal agencies have succeeded in clearing the use of the Port of San Juan for daytime operations, but other ports remain closed pending inspections. Many roads are blocked, inhibiting relief convoys. The Transportation Department has opened five airports in Puerto Rico and two in the U.S. Virgin Islands, but only for military and relief efforts.
Six commercial cargo ships have delivered supplies including food, water and generators to the Caribbean islands, and more supplies are on the way by ship from Florida and by air from Florida and Kentucky. Among the provisions: The Defense Logistics Agency is sending 124,000 gallons of diesel fuel to Puerto Rico.
In addition to concerns about basic survival, on the west side of the island worries have intensified about a ruptured dam that has been tenuously holding back the waters of Lake Guajataca. Government officials said Sunday that the “fissure” in the dam is “large and will collapse at any time.” Throngs of residents in nearby towns have been urged to evacuate. The dam’s failure could lead to massive amounts of water flowing unabated through coastal communities.
In Juncos, scores of homes were destroyed, and thousands of homes sustained damage, Mayor Alfredo Alejandro estimated. Four highways are inaccessible by car, and two bridges were harmed. Roofs of homes all over town are gone, and almost all government buildings were damaged.
Mountains typically brimming with trees and other vegetation are brown and desolate, stripped of all greenery. The mayor of 17 years said he discovered a river he never knew existed in his town, because it was always overgrown with plants. Curved bamboo lining the winding roads were left as bare sticks.
Less than a week ago, Alejandro said, “I had a pretty town.”
“Today I have a desert,” he said.
Puerto Rico’s executive director of emergency management said in an interview that aerial views of destruction in this region looked “more like a tornado than a hurricane.”
But Maria’s destruction in the town was just the beginning. The mayor said Juncos “anxiously” needs diesel, water, hospital equipment and satellite phones for local leadership.
Some local responders in Juncos were forced to clear area streets by hand with machetes, because the town doesn’t have enough chain saws.
Just two gas stations were functioning in the town, and lines stretched for more than half a mile. Some people walked and rode bicycles for miles with empty gas canisters in hand.
One of the town’s two supermarkets was open Sunday, and employees would let in only 10 people at a time to avoid chaos. Residents, who stood in line for hours, could purchase only rationed food. There is no functioning bank or cash machine in the entire municipality.
When Aldea, 37, and her 5-year-old daughter walked through her shell of a home in Juncos after the hurricane had passed, the child hardly said a word. She scoured her pink room, with pony stickers on its walls, and picked out a couple of soaked dolls and coloring books.
“We don’t have a house anymore,” Aldea explained to her daughter, Darangellie. “We’re going to have to start new with what we have.”
Aldea, who works as a secretary in the mayor’s office, is living with and taking care of her mother in the tiny room downstairs. Darangellie spends most of the days with a relative in town, but at night she sleeps with her mother. The child has asthma and needs to use a daily nebulizer treatment — requiring her mother to turn on their generator at night. They have enough diesel to power the generator for one more day.
She has a half-tank of gas left and can’t set aside the entire day that would be necessary to wait in line for more because she has to care for her daughter and mother. It doesn’t help that driving to town for her job — which usually takes seven minutes — now takes more than a half-hour because of blocked or inaccessible roads.
But Aldea remained calm. More than anything, she is thankful to be alive: “If I don’t stay strong, how can I take care of the two people who depend on me?”
Across town, a second-level three-bedroom apartment was ripped to shreds in the storm, the cooking appliances, kitchen counters and cabinets the only surviving evidence of the wooden structure.
Maribel Quiñones Rivera, 53, lived with her husband in the home for decades, raising her children and grandchildren there. During the hurricane and in the days that followed, she sought shelter with relatives in their apartment directly below.
On Sunday, she still hadn’t walked upstairs to see the debris up close. When asked why, she shook her head and cried. “I can’t,” she said.
To make matters worse, Quiñones Rivera and her relatives are out of cash — they used their last $30 to buy gasoline. They have five or six bottles of water left.
There are some moments of hope amid the misery in Juncos. On Sunday, about 30 people gathered in a small blue church for Mass. The priest apologized for the lack of a microphone and said the service would be brief.
Aida Sanchez, a member of the congregation, said she came to thank God.
“Because despite the circumstances,” she said, “we’re alive.”
Achenbach reported from Washington. Daniel Cassady in San Juan and Ed O’Keefe in Washington contributed to this report.
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Trumpcare and climate change will have the same victims.
Advocates are working hard to connect the dots between climate change and healthcare policy for lawmakers.
In May, when Melissa Mays heard that the U.S. House of Representatives passed a bill to repeal and replace Barack Obama’s signature Affordable Care Act, the Flint, Michigan, resident raced to Washington, D.C.
Her three sons rely on specialists — neurologists, gastroenterologists, infectious disease doctors, physical therapists, and rheumatologists — to deal with numerous ailments that resulted from drinking Flint’s contaminated water. A Medicaid expansion program helps cover their care, and both the House legislation and its hotly debated Senate counterpart would eliminate those funds.
“They’re not seeing what they’re doing — how it’s going to affect actual human lives,” says Mays. “Flint’s not an outlier. We’re one of many, many poisoned communities.”
The bills, she says, threaten to “take what little help we have to try to regain our health.”
The Senate’s Better Care Reconciliation Act of 2017 would reduce the deficit by $321 billion in the next 10 years, according to the Congressional Budget Office, in part by cutting Medicaid. It would also cause a full 22 million people to lose insurance. After several Republicans refused to endorse the legislation, Senate Majority Leader Mitch McConnell announced he would delay voting on the bill until after the July 4th recess.
If passed, Americans with chronic health issues will likely be at risk. According to environmental health advocates and experts, the most pronounced impact would fall on the same shoulders that climate change disproportionately affects: communities of color and low-income people. Because of higher premiums, “few low-income people would purchase any plan,” the CBO estimates. And fifteen million people would lose Medicaid coverage under the current Senate proposal.
“It becomes a death sentence,” says Tamara Toles O’Laughlin, executive director of the Maryland Environmental Health Network.
John Balmes, a professor of environmental medicine at the University of California, San Francisco, says that while Obamacare isn’t perfect, the Senate’s plan isn’t a worthy alternative. Cutting Medicaid in particular, he says, is “silly.”
“I don’t know of a single healthcare organization — whether it be physicians, nurses, or hospitals — that supports what Congress is trying to do,” Balmes explains. “That should tell the legislators something.”
In March, organizations including the Sierra Club, Green Latinos, and the League of Conservation Voters sent a letter to congressional leaders urging them to protect preventative and emergency care for people who live in low-income and front-line areas.
“These communities and the women who live within them face a greater risk of getting sick, losing their livelihoods, living in poverty, and being displaced when weather disasters strike,” the letter read. “These communities are also the least likely to have affordable access to healthcare they need to discover early warning signs of illnesses like those caused or exacerbated by environmental factors.”
In June, with the Senate bill on the horizon, more groups signed onto a similar letter.
Advocates are working hard to connect the dots between climate change and healthcare policy for lawmakers. Toles O’Laughlin rattles off a “laundry list” of climate-related threats facing Maryland communities, including mosquito-born disease, truck traffic, and high heat. All of them also have health consequences.
“We as a human species are impacting the environment,” says Miriam Rotkin-Ellman, a senior scientist with the Natural Resources Defense Council. “Those conditions can and do impact our health — particularly for children or our most vulnerable populations.”
The Senate bill technically bars insurers from discriminating against patients with preexisting conditions. However, it makes it possible for states to allow insurers to offer plans that don’t cover “essential health benefits” — which can include everything from hospitalization to prescription drugs, maternity care to emergency health services. Denying those benefits to front-line communities that have high rates of asthma, heart disease, or cancer, could make it impossible for people to manage chronic illnesses.
“You can’t avoid exposure if you’re constantly being exposed to something as a basic tenet of your life,” says Toles O’Laughlin.
Making insurance harder for low-income communities to access has the potential to reinforce the economic status quo. Medical expenses account for the largest percentage of personal bankruptcies in the United States — and experts suggest that Obamacare played a role in fewer people going broke.
“With health goes wealth,” says Amy Kyle, an environmental health research scientist at University of California, Berkeley. “The more people can maintain their health, the better they are able to maintain their ability to go to school, get jobs, et cetera.”
The deficit savings some Republicans are harping on aren’t the only economic calculation to factor into the healthcare equation. Everyone will bear some financial burden if Congress decides to roll back preventative care, especially for low-income Americans. More people will likely seek treatment in emergency rooms, for example. That will lead hospitals to charge more for everyone since many ER visitors can’t foot their bills.
“Emergency room care is not cheap,” says Balmes. “Having access to primary care is a major benefit both for the people who live in fence-line communities and for society as a whole.”
Until senators return from recess on July 10, the fate of the Senate bill will likely remain murky. McConnell is currently trying to cobble together a version that will win enough Republican support to pass a bill. He’s sent two revised versions to the CBO to be scored.
Meanwhile, Melissa Mays is holding out hope that her family will still have access to the critical health care it needs.
“The current path they’re on is just reiterating that human lives don’t matter at all, only corporate dollars,” she says of the Republican efforts to upend the ACA. “They should be ashamed of themselves.”
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Trump has to rescue Obamacare or admit he’s a liar.
The president-elect might have forgotten his campaign promises. But we won't.
The president-elect might have forgotten his campaign promises. But we won't.
By Bernie Sanders January 9 at 6:00 AM
Bernie Sanders is a U.S. senator from Vermont.
Ready to fight for Americans’ health care. (Jacquelyn Martin/Associated Press)
It didn’t take long. During the first week of 2017, the new Republican Congress has begun efforts to dismantle America’s health-care system. Their long-standing goal, consistent with their right-wing ideology, is to take away health insurance from tens of millions of Americans, privatize Medicare, make massive cuts to Medicaid and defund Planned Parenthood. At the same time, in the midst of grotesque and growing income and wealth inequality, they’re preparing to allow pharmaceutical companies to increase drug prices and to hand out obscene tax breaks for the top one-tenth of 1 percent.
Let me be absolutely clear: The impact of repealing large pieces of the Affordable Care Act, which Republicans are planning to put on Donald Trump’s desk on his first day in the White House, would be devastating. If Republicans get their way, 30 million Americans, 82 percent of whom are from working families, will lose their health insurance. With Medicare privatized, seniors will see their premiums increase by as much as 50 percent while their benefits are cut and funding for nursing-home care dries up. Underfunded hospitals around the country, particularly in rural areas, could be forced to close their doors, leaving millions of Americans with nowhere to turn for critical medical care. Patient protections, like preventing insurance companies from denying coverage because of a preexisting condition, removing the cap on maximum health-care benefits, allowing children to stay on their parents’ health insurance plans until age 26 and preventing discrimination by insurers, would be eliminated.
Meanwhile, the pharmaceutical industry’s greed will be rewarded as prescription drug costs for older Americans will likely rise by as much as 50 percent, and the wealthiest 2 percent can look forward to a $346 billion tax break.
Not only is the Republican plan immoral and bad economic and social policy, it violates numerous promises that Donald Trump made to the American people during his campaign. Trump told senior citizens and the American working class, many of whom ended up voting for him, that he was a different kind of Republican, and that he would not cut Social Security, Medicare or Medicaid. In a May 2015 tweet, Trump said: “I was the first & only GOP presidential candidate to state there will be no cuts to Social Security, Medicare & Medicaid.” In September, he told “60 Minutes” that if he was elected president, his health-care plan would take care of “everybody.”
Trump now has a choice: He can tell the American people that these campaign promises were lies and that he never intended to keep them. Or (and I hope this is the case) he can instruct his Republican colleagues to end their efforts to cut Social Security, Medicare and Medicaid and inform them that if they don’t, he will veto any bills that cut those life-and-death programs.
Those are Trump’s options. As we enter the new year, our message to Republicans is simple and straightforward: We will not allow you to punish the elderly, disabled veterans, children, the sick and the poor while you reward your billionaire friends. Instead, we will fight back. We will rally millions of Americans to make it clear to Republican leadership that we will not accept this vicious attack against senior citizens and working families. We will demonstrate in their communities, jam up their phone lines and throw them out at the ballot box if they go forward with their plans.
That is why on Jan. 15, I and Democratic members of Congress, trade unions, senior citizen groups, health-care activists and all those who believe in economic and social justice are organizing a day of action called “Our First Stand: Save Health Care.” Rallies will be held around the country, including one in Michigan that Senate Minority Leader Charles E. Schumer (D-N.Y.) and I will be attending along with Michigan’s U.S. senators.
If Trump allows the Republican Party to go ahead with its plans, it will dismantle the health-care system and jeopardize the economic security of millions of Americans. Democrats in Congress will resist, but real change never starts from inside the Beltway. It always comes when millions of Americans at the grass-roots level stand up and fight for economic, social, racial and environmental justice. We always win when we stand together. We lose when we are apathetic or allow demagogues to divide us. That’s why it’s more important than ever to recommit to building a progressive movement that transforms the economic and political life of our country.
Otherwise, we’ll be back where we were eight years ago, when millions of American families struggled to make a living without any way to pay for health care if they got sick. Elderly people, children and disabled veterans will be denied access to doctors and medication, and many will suffer or die prematurely.
Fifteen years ago, Donald Trump said he was for universal health care. I hope he still is. The truth is we shouldn’t be debating whether to take health care away from 30 million Americans. We should be finding ways to join the rest of the industrialized world and guarantee health care to all people as a right. This is the conversation American policymakers need to be having right now. And we’re not going to let Trump or Congress forget it.
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Drug-addled WV county files suit against pain-pill shippers.
The elected leaders of West Virginia’s poorest and most drug-ravaged county are suing the nation’s three largest prescription drug distributors.
Drug-addled WV county files suit against pain-pill shippers
Eric Eyre , Staff Writer
December 23, 2016
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The elected leaders of West Virginia’s poorest and most drug-ravaged county are suing the nation’s three largest prescription drug distributors.
The McDowell County Commission filed a lawsuit Friday against Cardinal Health, McKesson Corp. and AmerisourceBergen, alleging the out-of-state drug companies fueled the county’s opioid epidemic by shipping an excessive number of pain pills there. Commissioners also sued Dr. Harold A. Cofer Jr. The state Board of Medicine disciplined Cofer earlier this year amid an investigation into his prescribing of controlled substances.
“McDowell County was once a thriving community, now laid wasted by drug addictions that have destroyed lives, broken up families and caused a dramatic increase in crime, addiction-related social and health issues, overdoses and even death,” said John Yanchunis, a Florida lawyer representing county commissioners.
The McDowell County lawsuit comes five days after a Gazette-Mail investigation revealed that drug wholesalers shipped a disproportionate number of highly addictive painkillers to southern West Virginia. The region, including McDowell County, also shouldered a disproportionate number of overdose deaths.
In February, the state Board of Medicine investigated allegations that Cofer wrote prescriptions for two patients who later overdosed and died after taking narcotics that the doctor prescribed. The board ordered Cofer to drug screen patients, monitor their pill counts and enroll in a pain management course in Atlanta, according to a consent order filed Feb. 23. The board did not suspend Cofer’s license.
Reached at his clinic Friday, Cofer declined comment.
McDowell County, which has 28,000 people, was shipped 9 million hydrocodone pills (sold under brand names like Lortab) over six years, and another 3.2 million oxycodone (OxyContin) tablets, according to DEA records obtained by the newspaper.
McDowell County has the highest drug overdose death rate of any county in the United States. The county ranks second in the nation for overdose fatalities caused by prescription opioids.
The drug wholesalers are some of the largest corporations in America. The companies had the ability to “slow down, question, inspect, alert or otherwise limi the flow” of prescription opioids into McDowell County, “but chose not to do so,” the lawsuit alleges.
Instead, the wholesalers supplied millions of doses of narcotics that supported the demands of bogus pain clinics that churned out illegal prescriptions, according to the suit.
“In over 36 years of litigation, this is one of the most outrageous actions by businesses to profit over the misery and depth of despair destroying families and communities in West Virginia,” said Harry Bell, a Charleston lawyer who’s also representing McDowell County commissioners.
McDowell County faces a $600,000 budget shortfall this year.
Last week, county commissioners proposed laying off six sheriff deputies, nearly half the department. Sheriff Martin West strongly objected, and commissioner instead found a temporary fix to save the deputies’ jobs. Commissioners voted to shift funds -- $21,000 a month -- from the county ambulance authority to the sheriff’s office. The ambulance authority was idled last year.
The commission’s lawyers argue the drug firms’ and doctor’s actions have caused “addiction and destruction” and left the county to deal with a “continuing financial drain on its resources.”
“Filing this suit before the holiday is important to provide hope to the citizens of McDowell County that in the new year they will begin to see relief from the suffering they have endured as a result of the dumping of these dangerous, highly addictive drugs in their back yard,” said Mark Troy, a third lawyer on the case.
A Cardinal Health spokeswoman declined comment Friday.
AmerisourceBergen spokesman Gabe Weissman said he couldn’t comment on the lawsuit’s specifics because the company had yet to receive a copy of the McDowell County complaint.
“The characterizations of our industry by some of the lawyers quoted in this article are inaccurate and obviously inflammatory,” Weissman said, “but certainly do not represent a true understanding of the challenge that regulatory authorities, distributors, physicians and pharmacists face when working to provide access to medication for those who need it while preventing misuse by those who don’t.”
A McKesson spokeswoman said the company would get back to the Gazette-Mail if the wholesaler had comment. The firm hadn’t released a statement by Friday afternoon.
This isn’t the first time drug wholesalers have been sued in West Virginia.
In 2012, former Attorney General Darrell McGraw filed lawsuits against Cardinal Health, AmerisourceBergen and a dozen other smaller drug distributors, alleging the companies helped fuel West Virginia’s prescription drug problem.
The Department of Health and Human Resources, along with the Department of Military Affairs and Public Safety, have since joined the lawsuit as plaintiffs.
In January, Attorney General Patrick Morrisey sued McKesson in Boone County Circuit Court. The case has moved to federal court.
Most of the smaller drug wholesalers have settled their lawsuits with the state. They have denied any wrongdoing. To date, the settlements have netted the state more than $6.7 million.
Also Friday, Cardinal Health announced it had agreed to pay a $44 million fine to the U.S. Justice Department to settle allegations that the company failed to report suspicious drug orders from pharmacies in Florida and Maryland. As part of the same investigation, the U.S. Drug Enforcement Administration suspended Cardinal Health license to distribute narcotics from its Lakeland, Florida, warehouse between 2012 and 2014.
“National pharmaceutical drug companies are not exempt from following the law,” Adolphus P. Wright, Special Agent in Charge for the DEA Miami Field Division, said in a release. “This settlement sends out a clear message that all drug companies will be held accountable when they violate the law and threaten public health and safety.”
The settlement allows Cardinal Health to “continue to focus on working with all participants in addressing the epidemic of prescription drug abuse,” said Craig Morford, chief legal and compliance officer for the company.
Reach Eric Eyre at ericeyre@wvgazette.com or 304-348-4869, or follow @EricEyre on Twitter.
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Ballot Bullies: How corporations learned to love direct democracy.
No state quite matches the high-roller financial showdown that happens every election season in California. Our ability to attract big spenders on the initiatives, referenda and state constitutional amendments that confront an increasingly confused electorate is unparalleled.
It’s been 105 years since California voters were granted, by a progressive governor and his forward-thinking allies, the right to make laws at the ballot box. We were not the first to gain the privilege; 11 states got there first. Today 24 states allow for direct legislation, which they exercise with varying degrees of intensity when the need arises.
But no state quite matches the high-roller financial showdown that happens every election season in California. Our ability to attract big spenders on the initiatives, referenda and state constitutional amendments that confront an increasingly confused electorate is unparalleled. As of mid-October, more than $400 million had been spent on the 17 measures on the 2016 California ballot. Compare that with Colorado, which ranks second in ballot measure campaigns and whose seven initiatives and two referenda this year cost donors a total of $67 million, a “high-water mark” according to the Colorado Independent.
This was not what John Randolph Haynes had in mind at the end of the 19th century, when he fought to bring citizen lawmaking to the people. A thoughtful humanist with bold progressive ideas about how to preserve democracy, Haynes came to California from Pennsylvania’s coal county in 1887 to find the state legislature in the thrall of the Southern Pacific Railroad Company. Every shred of legislation proposed in Sacramento had to pass muster with the railroad oligarchs; politics were dominated by scoundrels.
More than 20 years later, Haynes’ solution, known back then as “direct democracy,” was intended, in the words of Governor Hiram Johnson, to “eliminate every private interest from the government, and to make the public service of the State responsive solely to the people.” Among its early victories was the abolition of the poll tax—certainly a win for the common man. Less than a century later the ballot initiative and referendum process had become, in the words of journalist David Broder, “not only a radical departure from the Constitution’s system of checks and balances, it is also big business,” a playground for millionaires and corporations that view initiative campaigns as a far less cumbersome means of achieving their various agendas than lobbying legislators to pass their bills.
Over the next few days, Capital & Main writers will examine some major issues that are part of the 17 measures on the November ballot in order to take a hard look at corporate influence over California’s ballot-box legislation:
Dean Kuipers looks at the perennial muscle of the tobacco industry, exercised this year over Proposition 56, which seeks an additional $2 tax on each pack of cigarettes;
Judith Lewis Mernit writes about the deceptive setup that might cause California voters to veto a state law to ban single-use plastic bags even though 60 percent of those polled support it;
Jim Crogan tallies up the enormous contributions Big Pharma has made to oppose Proposition 61, an initiative to control state agencies’ prescription drug costs;
Plus illustrations by Lalo Alcaraz (see above), videos and infographics.
All of the measures we will explore have brought in big money: Pharmaceutical companies have ponied up $109 million to oppose Prop. 61; the tobacco industry has doubled down with $66 million to quash the first cigarette tax in 18 years. And four out-of-state corporations banded together to sink $6 million to overturn a state law passed in 2014 that would ban single-use plastic bags.
Part of the reason wealth concentrates in ballot-box lawmaking is that unlike candidate races, there are no limits on contributions made to initiative campaigns; the U.S. Supreme Court ruled in 1981 that any such restrictions would violate the First Amendment’s guarantee of free association. Another part is the price of admission—simply gathering sufficient signatures to get a state or amendment on the ballot costs at least $2 million and as much as $6 million, depending on deadlines, timing and the aggressiveness of a campaign.
That pretty much counts out any middle-class activist with an eye on citizen lawmaking. It also gives outsized power to billionaires with big ideas. “A single individual with deep pockets and a pet project can almost single-handedly get an initiative on the ballot,” says Kim Alexander, who established the California Voter Foundation in 1994 to foster a better-informed electorate. And even that single individual can be outspent, in a game of one-upmanship that ends only when one side runs out of cash. Witness Los Angeles real estate developer Steve Bing’s 2006 bid to establish a tax on oil-and-gas extractors. Bing bankrolled his $61 million Proposition 87 campaign with $50 million of his own money, but the oil and gas industry spent more— $94 million—and prevailed. It was, at the time, the most money ever spent on an initiative campaign.
Money, however, isn’t everything. “Just as it’s not possible to get an initiative on the ballot without money, it’s also not possible to win a campaign with only money,” Alexander says. Pacific Gas & Electric, for instance, in 2010 spent $46 million to effectively outlaw community power companies; the opposition spent less than $100,000, and won.
In fact, most propositions, no matter how generously supported, fail in California, says Shaun Bowler, a political science professor at the University of California, Riverside, and author of Demanding Choices: Opinion Voting and Direct Democracy. And plenty of high-stakes opposition campaigns go down, too, which might make the investment in California’s ballot-box governing look dubious to the casual observer.
Anyone, however, who wants to have an influence in national politics, be it industrial lobbyist or environmental activist, ignores California at their peril. “California is massive,” Bowler says. “It’s the fifth-largest economy in the world. We’re bigger than Canada, bigger than Italy.” Standards and regulations adopted in California become national standards; technologies developed to meet California rules are adopted throughout the nation.
There are also reasons for participating in California’s direct democracy that have nothing to do with winning, Bowler says: “Individuals and interest groups spend money in California, basically, because they can.” It’s a place where they have an opportunity to make their presence known, to remind people that they matter.
“It’s a little bit like being in a bar fight,” Bowler says. “To prove you’re the tough guy, you kick someone’s dog outside. You’re letting people know you’re in the game.”
Another practiced strategy is to use the initiative process to bleed opponents white, rendering them weakened or even useless for future combat. That’s what happened in 1998, when anti-tax crusader Grover Norquist orchestrated a campaign to force California unions to obtain annual written permission from each and every member before spending a penny on political action. “Paycheck Protection” measures like Proposition 226, Norquist crowed, would “crush labor as a political entity,” and cash flowed in from across the country to support his California foray. Richard Mellon Scaife, the oil-invested billionaire in Pittsburgh, Pennsylvania; Indiana insurance tycoon J. Patrick Rooney; and even Bristol-Myers Squibb, the New York City-based medical supply conglomerate, added tens of thousands of dollars to the half million supplied by Norquist’s anti-tax advocacy outfit, Americans for Tax Reform, headquartered in Washington, D.C.
Thanks to a vigorous grassroots counter-campaign by the California Labor Federation and the AFL-CIO, Prop. 226 was rejected by 53 percent of voters. Norquist, however, still called it a win. After all, proponents of 226 had spent just $6.5 million, but they’d forced the labor movement to sink more than $24 million into fighting them— almost as much as the AFL-CIO had spent in 1996 on its entire slate of U.S. congressional candidates.
“Even when you lose,” Norquist boasted to a 1999 conference in Washington, D.C., “you force the other team to drain resources for no apparent reason.” Labor, he argued, had been severely diminished as a political force heading into the November election. (In the presidential year 2012 a like-minded initiative, Proposition 32, also forced labor to outspend the ballot measure’s backers, by $73 million to $60 million.)
In the short term, that was probably true. But over the long term, the Prop. 226 battle paid off exactly as AFL-CIO field organizer Ken Grossinger said it would, when he wrote about it in 1998. Beating back an initiative that would have hobbled labor’s political clout in California, he argued, shored up the grassroots base, galvanizing labor’s political forces. In the same way, Republicans under Governor Pete Wilson watched their fortunes decline after 1994, as the state’s sizable Latino population mobilized against Proposition 187, an initiative that would have denied undocumented immigrants public services. Both labor and Latinos, politically engaged, helped turn California a deeper shade of blue.
John Randolph Haynes and Hiram Johnson, had they lived to see it, might be horrified at direct legislation’s descent into a special-interest cash contest. But they wouldn’t be surprised, says Daniel A. Smith, a political science professor at the University of Florida-Gainesville, and the co-author of Educated by Initiative: The Effect of Direct Democracy on Political Organizations in the American States. “The initiative process in California has never been a purely amateur mechanism to alter public policy,” he says. “People decry the amount of money, the special interests involved in ballot campaigns, but corporate interests realized very quickly that they could play the game, too.”
Smith says the “really strong irony” is that Johnson himself inspired early 20th century industrialists to take up the game. “Progressives took over the government,” he says, closing off industry’s former avenue of influence. Moneyed interests then took advantage of the very mechanism progressives had created for the people, only to achieve their own corporate agendas. As early as 1922, so much money was spent on initiative campaigns that the state senate convened a special investigation to look into the issue. “The power of money” over direct legislation, they found, “was made strikingly manifest.”
But the power of money wasn’t enough to move those same senators to end the citizen lawmaking process, and none likely will. For all their gripes, California voters actually like their ballot-box governing. “California voters are deeply protective of their rights,” Kim Alexander says. “As much as people like to complain about it, California voters don’t want to see their right to make laws directly through the ballot eroded.”
The most worthy thing we can all do, then, to safeguard the intent of direct democracy is to exploit the state’s robust transparency laws—“the best in the country,” Alexander attests—to understand exactly what each of our votes will mean.
“We have much more information as voters in California than anywhere else in the world,” she says. “We have much more power, too. If California voters understand that power, every November is an awesome opportunity.” But only if we know what we’re doing.
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The chemistry of a US presidency.
Election season sees a chemical industry unenthusiastic about either candidate, and a research community overwhelmingly backing the Democratic nominee.
BY REBECCA TRAGER27 SEPTEMBER 2016
Election season sees a chemical industry unenthusiastic about either candidate, and a research community overwhelmingly backing the Democratic nominee
America is set to vote for a new president on 8 November, and the next occupant of 1600 Pennsylvania Avenue will have to be able to address complex issues at the intersection of science and politics. As voting day nears, it is clear that the chemistry of this election is quite different from those of past years.
In recent history, the chemical industry has been pro-Republican come election time, but in the current face-off between Democrat Hillary Clinton and Republican challenger Donald Trump, the sector appears to favour Clinton, while the reverse may be true for the biotech industry. The academic and scientific communities, however, back Clinton overwhelmingly.
‘We are concerned about both candidates,’ states Larry Sloan, the outgoing president and chief executive of the Society of Chemical Manufacturers and Affiliates. Although Sloan says Trump would be more likely to revisit the ‘excessive regulations’ that have burdened the chemical industry under the Obama administration, he states that Clinton is more pro-trade and more inclined to revisit big global trade deals. Trump has repeatedly promised to withdraw from some of the US’s biggest global trade agreements.
Sloan also criticises the Republican candidate as ‘not very knowledgeable’ on the recent overhaul of the 40-year-old law Toxic Substances Control Act (TSCA) that regulates chemicals in America. This bipartisan achievement, endorsed by the chemical industry and some environmental organisations, was signed into law by President Obama in June. It gives the Environmental Protection Agency (EPA) enhanced authority to require testing of new and existing chemicals.
Sloan and many other observers agree that the EPA desperately needed this new authority, but they say more money and staff are required. Trump’s repeated vow to dismantle, or at the very least severely curtail, the EPA doesn’t bode well for TSCA.
Two former chiefs of the EPA who served in Republican administrations have also spoken out against Trump and endorsed Clinton, saying that he has shown ‘a profound ignorance of science and of the public health issues embodied in our environmental laws’.
Raising budgets, stapling green cards
In Clinton’s response to 20 questions about science and technology and coordinated by ScienceDebate.org, Clinton vows: ‘Advancing science and technology will be among my highest priorities as president.’ She goes on to assert that the US is ‘underinvesting in research’.
Source: © Joe Raedle / Getty Images
Clinton is far more popular among scientists than Trump
Clinton’s technology and innovation plan, released in June, proposes increasing the research budgets of key US science agencies. She also wants to automatically grant permanent residency to foreign nationals who receive master’s or PhD degrees in science, technology, engineering and mathematics (Stem) from US institutions. That proposal would enable highly skilled Stem workers to circumvent the temporary H-1B guest worker visa process. Clinton also wants ‘start-up’ visas to allow top entrepreneurs from abroad to come to the US and establish businesses.
Advancing science and technology will be among my highest priorities as president
HILLARY CLINTON
By comparison, Trump wants to revamp the H-1B visa programme so that Americans are hired over cheaper foreign graduates. The Republican candidate is also calling for a lower corporate tax rate to encourage innovation, and slashing or eliminating spending on certain federal agencies and programmes, including the EPA and the Department of Education.
‘He has clearly demonstrated no interest in funding fundamental research,’ says Lawrence Krauss, a professor at Arizona State University’s school of earth and space exploration. ‘It is not clear to me he even understands what that is.’
Donna Nelson, an organic chemist and president of the American Chemical Society (ACS) who spoke with Chemistry World in a personal capacity, recalls that Clinton has described science and innovation as a foundation for the future. She notes that science funding seems to be ‘an afterthought’ for Trump.
‘God knows’
‘What Hillary Clinton would do is to extend the Obama administration’s support for science and technology,’ says Michael Lubell, the director of public affairs at the American Physical Society. ‘In the case of Donald Trump, I would say “God knows”.’
We must make the commitment to invest in science, engineering, healthcare and other areas that make the lives of Americans better
DONALD TRUMP
However, Trump does note in his response to ScienceDebate.org’s 20 questions that, despite increasing demands to curtail spending and balance the federal budget, ‘we must make the commitment to invest in science, engineering, healthcare and other areas that make the lives of Americans better, safer and more prosperous’.
Nevertheless, Nelson points out that Clinton has experience with the general science policy infrastructure that was in place during her husband Bill Clinton’s term as president. She can draw from that foundation, Nelson states, while Trump is trying to develop an original infrastructure.
Source: © Joe Raedle / Getty Images
Trump has picked up qualified support among the business community but his unpredictability has caused jitters
Neal Lane, a physicist who served as science adviser to former president Bill Clinton and as director of the National Science Foundation before that, emphasises that Hillary Clinton has talked a lot during the campaign about the importance of investment in research and innovation in general. She has also discussed science education and workforce issues, as well as the necessity of having knowledgeable and skilled people emigrate to the US. By contrast he says Trump has not ‘said much of anything about the importance of research, anything positive about immigration and in many other ways has denigrated the importance of science to policymaking and to the country’.
Potholes take precedence
As an example of his last point, Lane cites remarks by Trump about investment in space science, technology and exploration. While campaigning in November, Trump said practical problems like potholes take precedence over space exploration. Trump also appeared to disparage the National Institutes of Health (NIH) – the nation’s well-respected biomedical research agency – on public radio last year. But what’s gotten Trump in most trouble with the scientific community is his questioning of climate change, calling it pseudoscience and even tweeting that ‘the concept of global warming was created by and for the Chinese in order to make US manufacturing non-competitive’.
His policies, if implemented, would be a disaster – talented people from around the world would be denied entry
LAWRENCE KRAUSS, ARIZONA STATE UNIVERSITY
In his response to the ScienceDebate.org questions, Trump says ‘there is still much to be investigated in the field of “climate change”’, and he suggests that ‘the best use of limited financial resources’ would be to focus on things such as ensuring access to clean water worldwide, new energy sources and tackling diseases like malaria.
Former Republican congressmen John Porter, who served as the long-time chair of the House of Representatives subcommittee that funds science agencies, backs Clinton for president and says Trump ‘has no knowledge of science or the value of research’. From a support-for-science perspective, Porter says he would be ‘very, very unhappy’ if Trump is elected president. By contrast, he describesClinton as ‘very aware of the value of science’.
Nina Fedoroff, a molecular geneticist at Pennsylvania State University who served as the science and technology adviser to Hillary Clinton during the Obama administration, and Condoleeza Rice under Republican president George W Bush, echoes Porter. ‘She does understand the extent to which science drives our economy; Trump, not so much,’ says Fedoroff.
Immigration frustration
Fedoroff emphasises how hard it is for any foreign-born scientist to get through the US immigration system and obtain a green card, let alone become a citizen, and she notes that Clinton wants to ease that process. In contrast, Fedoroff calls Trump’s stance on immigration ‘a huge concern’. She notes that the nations he has identified as of concern from an immigration standpoint, like Iran and Pakistan, have ‘enormous talent pools’.
Krauss says that Trump is promoting xenophobia which is already stopping people coming to work and study in Stem in the US. ‘His policies, if implemented, would be a disaster – talented people from around the world would be denied entry,’ he states.
Clinton does understand the extent to which science drives our economy; Trump, not so much
NINA FEDOROFF, PENNSYLVANIA STATE UNIVERSITY
It does not appear that Clinton has an official committee of 30 or so top-level scientists to advise her campaign, as Obama did when he was running for president, but it is apparent that she still has plenty of support. Lane and Nelson are among what is described as a slew of prominent scientists offering their counsel to the Clinton campaign.
Lane says there will be ‘a long line’ of researchers and engineers who will be interested in helping a Hillary Clinton administration. ‘On the Trump side, I just don’t know – that is a totally different community,’ he adds. ‘I don’t know who would be on such a list, I have not heard of anybody.’
One person who has been linked with advising the Trump campaign on science and technology issues, though, is Republican congressman Lamar Smith, who chairs the House of Representatives’ science, space and technology committee. Smith has been involved in a number of public feuds with the academic community in recent years, however, questioning the value of a number of research grants. Smith, who trained as a lawyer and is not a scientist, has also repeatedly questioned the science of climate change.
Contributions to Trump and Clinton from the chemical and related manufacturing sectors reflects a lack of enthusiasm for Trump, compared with previous Republican candidates. The Center for Responsive Politics found that Trump received only about $43,000 (£33,000) in donations from the chemical and related manufacturing industry, which is less than a third of what Clinton has received. The last Republican challenger for the presidency, Mitt Romney, received $360,000 from this sector.
Industry cautious
Meanwhile, the US biotechnology industry appears unhappy with both major candidates. The Biotechnology Innovation Organization is not endorsing anyone, but the organisation’s president, former Republican congressman Jim Greenwood, has warned that ‘the stakes for the biotech industry could not be any higher’ in this election.
Greenwood has described the biotech sector as ‘fragile and under growing pressure’, noting that ‘a lone tweet by a candidate for high office can have unintended market moving consequences’. Those remarks appeared to reference incidents like the one in September 2015 when Clinton sent a tweet accusing drug companies of ‘price gouging’. The Nasdaq Biotechnology Index fell by 4.7% following that remark.
More recently, Clinton – who wants to reverse the ban on Medicare drug price negotiation – sent a tweet last month saying there is ‘no justification’ for Mylan Pharmaceuticals’ recent price hikes for EpiPens, used to treat serious allergic reactions. She said the price of the EpiPens has increased by more than 400% in recent years.
John Castellani, the recently retired president and chief executive of the Pharmaceutical Research and Manufacturers of America, argued when he led that organisation that Clinton’s plan to regulate prescription drug prices would ‘turn back the clock on medical innovation and halt progress against the diseases that patients fear most’. He said she is proposing ‘sweeping and far-reaching’ changes that would restrict patient access to medicines, lead to the loss of ‘countless jobs’, and erode the US’s standing as the world leader in biomedical innovation.
But Trump has attacked the biotech and pharmaceutical industries too, arguing that Medicare should be able to negotiate drug prices and import cheaper drugs from other countries.
Trump’s unpredictability problem
It is clear that Trump would work hard to cut taxes on corporations and slash regulations, which would appeal to the chemical industry and others. But Lane says it’s difficult for such sectors to support Trump because of the uncertainty surrounding the candidate and his positions.
Glenn Ruskin, who spent over a decade as a spokesman for the chemical industry before joining the ACS, agrees with Lane. ‘The one thing that industry thrives on is predictability,’ Ruskin says. He notes that Trump has repeatedly vowed to tear down the EPA regulatory regime but said nothing about what would replace it.
The Baker Institute for Public Policy at Rice University in Texas has just issued a report addressing how America’s next president should deal with science and technology policy. It urges the new commander-in-chief to select a top-notch scientist as an adviser before inauguration in January and develop a science, technology and innovation strategy within the first 100 days after taking office.
To help illustrate the importance of what is being recommended, retired Democratic congressman and physicist Rush Holt pointed out that former President Bush had no permanent science adviser in place when the 11 September 2001 terrorist attacks occurred. He suggested that this was why the response to the subsequent anthrax attacks was poorly coordinated.
In contrast, Holt, the chief executive of the American Association for the Advancement of Science, noted that Obama had already appointed John Holdren as his science adviser when he was drafting the economic stimulus package to counter the ‘Great Recession’ that hit in 2008. The result, Holt said, was that when the stimulus was enacted in February 2009, it contained an extra $21.5 billion to support R&D.;
Whoever becomes the next US president in January, experts warn they won’t be able to navigate the current geopolitical turbulence without first laying down a sufficient science policy infrastructure.
Rebecca Trager
US correspondent, Chemistry World
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