Dylan's Nobel

I know Dylan is The Seer to many.  Not just...guys.  I caught the early, nasal years.  Some things struck me: 20 years of school and they put you on the day shift; William Zanzinger.  But who was he imagining when he warned:

"Go away from my window.
Leave at you own chosen speed.
I'm not the one you want, babe.
I'm not the one you need.

"You say you're looking for someone
 Who's never weak, and always strong.
Someone to defend you and protect you
Whether you are right or wrong,
Someone to open each and every door...

"Well it ain't me babe!"

Geez, I hope not.  In any case, I didn't linger.

I marvel at Joni Mitchell lyrics, rhythms (dug up the records - yes, records!  after a recent move):

"Just before our love got lost
You said 'I am as constant as the Northern Star,'
I said
'Constant in the darkness, where's that at?
If you want me I'll be in the barn..."

Sippie Wallace via Bonnie Raitt ("Give It Up or Let Me Go"), Randy Newman ("Rednecks," "Sail Away...").  Plenty more.  Well, congrats to Bob and fans.

There's a class on Dylan at Harvard.  Where, in doubtless unrelated news, the food service workers are on strike.

Thank You For Patiently Waiting

“The TPP* will bring us into the 21at century… Global supply chains…Winners and losers…”  Pres. Obama

The Warriors, a Team Beyond Comparison

By Harvey Araton, NYT  5-31-16                 

“Golden State has drastically extended the standard scoring range, which makes comparing it with storied N.B.A. teams of yore like distinguishing between a smartphone and a land line.”

First try: 10 a.m. 

Me: Hello, AT&T?  I just moved, and there’s supposed to be a forwarding message at my old phone number to my new number.  But I just called my old number, and my old answering message is still playing.  Also, my password no longer works at my old number, so I can’t tell if anyone’s left me a message at the old number.  Can you help, please?

Agent:  Hello. Thank you for calling AT&T.  No worries, we will take care of your problem.  Will you please tell me your current phone number and the 3-digit code at the end of your bill?

Me: Sorry, I just moved and I don’t have by old bill handy.  I can tell you the amount of my last bill, though, for identification.

Agent: No worries. Can you please tell me your current phone number and the 3-digit code at the end of your bill?

Me: No, I don’t have my paper bill with me, I just moved, but I can tell you the amount I paid on my last bill, since it’s written here in my checkbook.

Agent: I’m so sorry, let me understand.  Do you need new service?

Second try:10:15 

Me: Hello, AT&T?  I just moved, and there’s supposed to be a forwarding message at my old phone number to my new number.  But I just called my old number, and my old answering message is still playing.  Also, my password no longer works at my old number, so I can’t tell if anyone’s left me a message.  Can you help? Please?

Agent: That is a different department.  No worries, we will take care of your account, Miss Ellen.  Can I put you on hold while I contact the other department?

10:25

Agent:  Thank you for patiently waiting.  Miss Ellen, can you tell me the 3-digit code at the end of your phone number on your bill?

Third try: 10:30

Me: [allow your imagination to run wild]

Agent: Let’s see, the problem is that your old number isn’t due to be discontinued until the first of the month, which is tomorrow.  I checked, and there’s no way to move the date up today.  But that disconnect will happen tomorrow.  Then your callers will get an automatic message, telling them to call your new phone number.

Me:  Thank you, that is very helpful.  But the other problem is that my password for the old number doesn’t work, so I can’t tell if anyone’s left me a message there.

Agent: I see.  Let me get our technical team on the line, to reinstate your password for the day.  I’m going to put you on hold, and we’ll get someone on the line who can help.

[I am on hold.  I go to iTunes to try to download some music.  iTunes tells me I am no longer subscribed to whatever part of their service I need to get a new song to play.  Would I like to download the new program?  I click on the icon to download the updated program.  Meanwhile I listen to the tunes I already recorded:  Judy Collins “We Want a Revolution” suite from Marat/Sade; “You Don’t Own Me,” Leslie Gore; “The Longest Time,” Billy Joel; and on to Katie Goodman, Kweskin Jug Band, Taj Mahal, and Tom Lehrer.]

10:45

[Recording]:  You’ve reached the repair department at AT&T.  Due to heavy volume, your call may not be answered for up to 4 minutes.

[The Comcast tech couldn’t find the connection to the internet in our new place, so we’re working off of borrowed wireless until we can get real Ethernet service, next week. 

[iTunes sends a message that there has been an error in downloading the updated program.  I can try again later.  Meanwhile, it would like to add or update service from Apple, Quicktime, and other programs.  I think about “The Golden Notebook,” and get up to unpack.]

*TPP = Trans Pacific Partnership

Escalating Drug Prices Likely from Secret “Fast Track” Trade Bill

Congress could vote this week on a “Fast-Track” trade bill that would dump a double whammy on the many Americans whose health and finances are already hit hard by the high price of prescription drugs.  Wikileaks and the NY Times today published a draft chapter on drugs, negotiated entirely in secret as part of the Trans-Pacific Partnership (TPP).  

If it approves proposed “Fast Track” rules, Congress would surrender its ability to amend this chapter, and whatever remaining secret text that the secret negotiations produced.

The leaked trade chapter, entitled Transparency and Procedural Fairness for Pharmaceutical Products and Medical Devices, was presented in December, 2014, to the 12 nations negotiating the Trans-Pacific Partnership (TPP).  It could derail present programs that offer access to affordable prescription drugs in the U.S. and abroad, including Medicare and Medicaid, and stymie future progress.   

How to create and produce affordable medicines, and assure wide access to the resulting products, is a critical, life-and-death concern for both the public and the drug industry.  A new treatment for Hepatitis C can transform lives, but the price tag of $80,000 a year will condemn too many to go without it.  Existing U.S. laws that rely on competition from copycat generic drugs to achieve affordability will be less effective in the case of new drugs classified as biologics, which are far harder and in some cases impossible to copy.  The TPP text reveals threats to existing and proposed systems that cover and finance access to medicines in the U.S., Australia, New Zealand, and elsewhere, and will increasingly have to address these emerging products, including policies on:

·       Direct-to-consumer advertising

·       Rules on the extent and timing of drug industry participation in government decisions about the selection and pricing of covered prescription drugs

·       The treatment of medical devices

·       The grounds for a drug company to initiate a trade charge against a country’s drug coverage and pricing systems

These threats and ambiguities are the inevitable result of misguided efforts to determine critical health, economic and social policy issues through the secret process of trade negotiations, dominated by commercial interests, while explicitly excluding and silencing other experts, consumer advocates, public officials, and the public at large from the debate. The few non-industry participants on trade advisory committees are prohibited from revealing or publicly discussing the contents of privileged negotiating text.  Such a process cannot succeed in a democratic system.

Open public debate reveals and helps to determine where agreement is possible, and which issues will remain contentious. It is the only basis for providing reliable assurance to our trading partners that the negotiations reflect what the U.S. will actually stick to.

Congress must vote No on Fast Track/Trade Promotion Authority.

- Ellen Shaffer, CPATH

Hobby Lobby's Religion: Boko Haram

House of Reps. all-male hearing on contraception, 2012

Hobby Lobby today announced that although it is a corporation, it does indeed have a religion: Boko Haram.  When its Christian owners argued before the Supreme Court to assert their right to deny insurance coverage for 4 types of birth control on the basis of the corporation's religious beliefs, Justice Sotomayor questioned "How does a corporation exercise religion?"  The Corporation itself has so far been silent on its actual religious affiliation.


"With so many of our successful practices under attack around the globe this month, we felt it was time to speak publicly in defense of our faith.  On May 6, a Boko Haram leader claimed responsibility for abducting hundreds of Nigerian school girls, planning to sell them. In the U.S., with legislation in Missouri and Louisiana aiming to strip abortion providers of their right to practice, and  proposals advancing in Congress to ban abortions after 20 weeks, when low-income women and women with medical abnormalities are most likely to need them, our staunch doctrine of assuring the long-term, structural subservience of women has been making enormous strides.


"The firing of Jill Abramson for her 'brusque' management style as NY Times editor, to be replaced by the man who had responded entirely appropriately by punching a hole in the wall at the Times, was simply more than we could have hoped for.


"This cascade of previously unimaginable successes has of course inflamed uncontrollably whiny, emotional, and humorless feminist apparatchiks around the globe, from groups like a Billion Rising, and the Trust Women/Silver Ribbon Campaign.  These modern women and their supporters would convince the US Supreme Court that it's time to set the record straight and dismiss Hobby Lobby's arguments, simply because they reflect the last gasp of the backwards, fringe mentality we represent. And frankly, the recent denunciation of Boko Haram by Al Quaeda contributed to prompting our declaration. By coming out publicly to claim our corporation's religious affiliation with Boko Haram, we intend to put all such diversions to rest."


(The corporation went  on to explain how this unique circumstance entitled it to claim its independent right to assert that Plan B should not be covered by Hobby Lobby because it is an abortifacient, which is otherwise labeled by mainstream scientific evidence as "absolutely without any foundation whatsoever.")

Tobacco: Symbol of Corrupt Trade Policy

The deadly tobacco industry increasingly deploys trade charges intended to bludgeon countries from Uruguay to Australia into abandoning policies that keep kids from getting addicted, and help smokers quit, as well documented in today's NY Times.

The U.S. Trade Representative should fix this problem during negotiations on the proposed 12-nation Trans Pacific Partnership (TPP).  But stalemates in U.S. trade policy are perpetuating this obvious injustice.

Trade ministers derive priority status within governments based largely in outdated beliefs that they will magically conjure prosperity by conspiring in secret, allegedly to eliminate trade barriers such as tariffs and quotas which in fact have long go been substantially reduced.  The predominant business of agreements like the TPP is actually reducing "technical barriers" to trade - that is, democratically adopted laws and regulations that protect the public's health, environment, labor standards, and financial transactions.

In the secretive, rarified world of trade negotiations, even when public health succeeds in getting a proposal to the negotiating table on an issue like tobacco, it is subject to be traded away at any moment by a trade minister who views it primarily as a bargaining chip for deals on more important concerns, like sugar, cars, or financial derivatives.

The Center for Policy Analysis on Trade and Health (CPATH) has systematically documented how tobacco industry trade challenges threaten public health's rights to implement tobacco control measures. Medical and public health leaders in the U.S. and worldwide have echoed the call to "carve out" tobacco from trade agreements.

Malaysia presented a carve-out proposal at TPP talks in August, The USTR has advanced two increasingly weak compromises. Legal analysis from Georgetown [R. Stumberg, Safeguards for Tobacco Control: Options for the TPPA.  America Journal of Law and Medicine, 39 (213); 382-441] has confirmed in irrefutable detail that compromises short of a "carve out" would be virtually ineffective.

Tobacco use is the leading preventable cause of death worldwide, claiming 6.3 million deaths a year, including 1,200 Americans daily, and draining almost $200 billion a year in U.S. health care costs and lost productivity. Tobacco is barely a blip in the U.S. economy, and less than a fraction of a percent of our exports.

But the tobacco industry has made it clear that it will oppose any restriction on its rights to continue to appropriate trade rules. They've bought a box seat to the hermetically sealed, secretive trade negotiations, and the solid complicity of the U.S. Chamber of Commerce.

Public health has no such advantages.  Interestingly, though, we have the truth.  And in this possibly unusual case, the truth is increasingly difficult to ignore.

Report Back: CPATH to USTR - U.S. Must Protect Public Health in the TPP

The U.S. Trade Representative gave new meaning to the phrase, "magical thinking" at a Nov. 18 talk in San Francisco. And new urgency to the demand for an honest debate on the economy and on the Trans Pacific Partnership (TPP).

 

Last week, Wikileaks released the most detailed report of the proposed trade agreement to date It reveals the full text of the controversial intellectual property chapter, that would govern fundamental rights including access to medicines, internet freedom, and cigarette package warning labels. In addition, it shows which countries support which versions of the proposals.

The U.S. does not look good. The leaked documents delineate that the U.S. would allow corporations including Big Tobacco and Big Pharma to rake in enormous profits while exposing the public's health to continued havoc by challenging tobacco control regulations, extending patent and trademark rights that would raise the prices of medicines, and raise the cost and availability of health care through patenting surgical techniques, for example. Disturbing enough.

Scores of members of Congress had already signed letters denouncing these proposals, and pledging to block them. Public health and medical organizations, and entire nations, have urged the U.S. to curb these abuses.

But on November 18, United States Trade Representative Michael Froman and Agriculture Secretary Tom Vilsack engaged in a discussion at the Commonwealth Club of San Francisco, moderated by the Club's Greg Dalton. When Dalton specifically asked U.S.T.R. Froman to address concerns regarding the trade pact's limits on internet freedom and access to medicines, he got back the same happy talk the Administration has been babbling all along.

In a breath-taking effort to imagine that the entire population had lost the capacity for literacy, Froman asserted, "What we're trying to do with the TransPacific Partnership is open up markets in some of the fastest growing regions in the world, raising standards on labor, the environment, access to medicines, intellectual property rights, and create new disciplines for the 21st century global economy."

He went on to claim both that the TPP was the most transparent trade agreement ever negotiated, in view of the USTR's many consultations with every sector of American society, and that the American people would only fully understand how beneficial the TPP is once the negotiations are concluded and the public sees the final product.

Just prior to the public event, San Francisco Supervisor Eric Mar and Co-Directors of the Center for Policy Analysis on Trade and Health (CPATH), met briefly with Ambassador Froman, and urged him to protect public health and rein in Big Tobacco in the TPP trade negotiations.

Supervisor Mar presented USTR Froman with a letter expressing his deep concerns that the provisions of the recently leaked Intellectual Property Chapter of the TPP "may undermine the right and ability of local, state, and national governments of participating countries from exercising their domestic sovereignty in order to adopt or maintain measures to reduce tobacco use and to prevent the harm it causes to public health." The letter posed key questions on U.S. proposals related to intellectual property rights and the tobacco industry, and requested a written response on how U.S. proposals will ensure that the United States and other TPP nations will be able to fully implement and enforce strong tobacco control legislation.

CPATH Co-Directors Ellen R. Shaffer and Joe Brenner articulated the concerns of major U.S. medical and public health groups, which are calling on the U.S. to take a leadership role to protect the public's health from tobacco-related disease and death, and to carve-out tobacco from the TPP negotiations. They presented a binder of letters and statements from CPATH, the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists, American Public Health Association, CA Health Officers Association, California Council of Local Health Officers, and the Public Health Institute, CA-Public Health Association-North, and Alameda County Public Health Commission.

During questions from the public, CPATH Co-Director Joe Brenner asked, "San Francisco and California have taken effective action to reduce tobacco-related disease and death. When California attempted to ban the carcinogen MTBE from gasoline to protect health for years ago, a Canadian company, which made a component, filed trade charges against the U.S. and sued for $970 million for lost profits under "investor-state" provisions in NAFTA. The U.S. is proposing to give corporations these same rights in the TPP, including to challenge local tobacco control regulations. Why?" USTR Froman responded that the U.S. has never lost a court challenge under these provisions, and that new TPP provisions are different. Wait 'til we see it.

"The ongoing efforts to usher through in secrecy a pact with nations representing 40% of the globe's gross domestic product is corroding our democracy," says Shaffer. "For example, an editorial in Bloomberg erroneously equated the secrecy of the TPP with the embattled but entirely transparent Obamacare health care reform program.

"To be clear: Trade negotiations have been a corporate-controlled subterranean process for decades. The Obama Administration didn't start this. But it has utterly abandoned the responsibility to change it. It is an anomaly in our democracy which we can no longer tolerate. The technical details matter, and we have a right to understand the fine print as well as the broad strokes. The United States must lead the way towards a 21st century trade agreement, that starts, proceeds and ends with a fully public debate."

Your support makes our work possible. Please contribute today:

http://www.cpath.org/id1.html

NYT: Why Some People Can’t Keep Their Insurance Plans

http://www.nytimes.com/interactive/2013/10/30/us/why-some-people-cant-keep-their-insurance-plans.html?ref=politics

Despite repeated assertions by President Obama that people who like their health insurance will be able to keep it under the new health care law, many people who bought insurance on their own — a small fraction of the insurance market — will have to buy new plans. Related Article »

Medicare, Medicaid,

military coverage

Share of people with

employer-sponsored

insurance

29%

49%

Uninsured

5%

16%

Individual market

10-15 million people

Policies must meet new standards ...

Beginning Jan. 1, new policies issued must cover a minimum share of health care expenses and offer 10 “essential health benefits”:

1.

Outpatient care

7.

Rehabilitative and habilitative

services and devices

2.

Emergency room visits

3.

Hospitalization

8.

Lab tests

4.

Maternity and newborn care

9.

Preventive services and

chronic disease care

5.

Mental health and

substance use treatments

10.

Pediatric services, including

dental and vision

6.

Prescription drugs

... unless a plan is grandfathered in ...

If a policy was in effect when the law passed in March 2010 and has not been changed significantly, people already on the plan could remain on it, and the plan would not have to meet the new requirements.

 

... but many people will need to purchase a new plan because:

• Many plans do not currently meet the law’s standards for coverage.

• Most people in the individual market do not keep their policies for more than a year, so most would not be eligible to be grandfathered.

• Insurance companies cannot change grandfathered plans or sell them to new customers, so they have incentive to cancel the policies.

Some people will also move to Medicaid coverage.

More than one million low-income adults currently in the individual market will be newly eligible for Medicaid in 2014 because they live in a state that has decided to expand the program.

 

Why Rates Are Increasing for Some People

The total cost of policies will be higher on average ...

Many plans offered on the individual market will have more benefits and more consumer protections than they did before. The pools will also cost more for insurance companies since they cannot deny people with pre-existing conditions.

In the individual market,

on average, rates for group will:

... but people will be affected differently ...

INCREASE

DECREASE

SEX The law bans insurers from charging women higher premiums than men of the same age.

MEN

WOMEN

AGE The law bans insurers from charging older adults more than three times the amount they charge younger adults.

YOUNG

OLD

HEALTH The law bans insurers from charging people with health problems more.

HEALTHY

UNHEALTHY

... and many people will be eligible for government subsidies.

An estimated 48 percent of people on the individual market will be eligible for tax credits to reduce their costs, based on their income level.