An interesting article in the Journal of Clinical Oncology (via yesterday’s Jerusalem Post) argues that the U.S. Food and Drug Administration practice of approving many oral cancer drugs for use only after patients have fasted is putting patients at increased risk of overdosing, and causes them to “flush costly medicines down the toilet.”
According to the article by Mark Ratain, a professor of medicine at the University of Chicago Medical Center, many oral drugs are absorbed more effectively when taken with food — particularly fat-soluble drugs. But at the FDA’s insistence, dosage levels for most oral cancer drugs are “based on data from patients who take their pills on an empty stomach” because of the variability in diets among cancer patients. When going through chemotherapy, patients’ appetites will vary substantially, as will the amount and types of food they’ll eat. Ratain argues that patients who eat too soon after taking their medicines will therefore be put at a substantial risk of overdose because too much of the drug will then be absorbed. And, because most cancer drugs are fairly toxic, he argues that “risk of overdose is clearly more compelling” than the risk arising from dietary variability, and suggests that the FDA change its policies accordingly.
You’d think that reducing the risk of overdose would be a compelling argument on its own, but Ratain takes his plea too far by trying to make an economic argument as well. He suggests that, by approving oral cancer medicines for use with food, doctors could lower the doses they prescribe. That in turn would help patients save tens of thousands of dollars , since many of these drugs cost thousands of dollars each month. Taking a drug such as Zytiga (abiraterone acetate) after fasting ”means the amount of the drug available to fight cancer is decreased by 80 to 90 percent,” Ratain points out. “At least three-quarters of it, at a per-patient cost of about $5,000 a month, is literally wasted. It gets excreted and flushed away.” Instead, taking it with food “would save patients and their payers approximately $3,750 per month at current prices.”
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American jobs will soon be outsourced due to the Dodd-Frank financial “reform” law passed in 2010 with strong support from the Obama administration. That law contains provisions that will result in money being managed by foreigners, rather than Americans, and result in American financial employees being fired or relocated to Europe. Under proposed agency rules, these provisions will impose costly regulations on U.S.-based operations — but not foreign operations of the very same bank — “even if no American money is at risk,” but only foreigners’ money. Proprietary trading and investments in private equity using money from abroad will be restricted if done by American employees, but not if done by foreign employees.
As Bloomberg financial news notes:
A rule limiting proprietary trading by U.S. banks may be extended to overseas firms with operations in the country, according to four people familiar with the matter. Regulators next month will issue a proposal to carry out provisions of the so-called Volcker Rule, part of the Dodd-Frank financial-regulation law, that will clarify the types of offshore trading allowed under the rule, the people said. The Volcker Rule . . . has prompted U.S. banks such as Goldman Sachs Group Inc. (GS)to close proprietary-trading operations. Overseas banks say that a strict interpretation of the rule may also force them to fire or relocate U.S. employees who are involved in proprietary trading, even if no American money is at risk. “There is no question that we would lose jobs,” said Wayne Abernathy, vice president of the American Bankers Association in Washington. “A lot of what the banks have been doing in recent years to diversify their services are activities that can easily be done by foreign competitors.” . . .The language of the bill is subject to interpretation by regulators at agencies including the Federal Reserve and the Federal Deposit Insurance Corp. . .
Foreign banks often employ New York-based investment advisers and managers to work on offshore proprietary trading. If such trading were forbidden under the Volcker Rule because U.S. employees are involved, the banks would simply move those jobs overseas, Miller said. “It’s a jobs issue — if we can’t use a U.S. sub-adviser, we’re going to use an adviser sitting in London or Frankfurt, so that job is not here anymore,” Miller said in an interview. “Allowing foreign banks to employ U.S. firms as sub-advisers encourages foreign banks to invest in U.S. securities.” International banks employ more than 250,000 U.S. citizens and permanent residents, according to IIB. Credit Suisse Group AG, Societe Generale and Deutsche Bank AG are among the overseas banks that manage trades in the U.S. and would be affected by the rule. U.S. bank executives, including JPMorgan Chase & Co. (JPM) Chairman and Chief Executive Officer Jamie Dimon, argue that the Volcker Rule places domestic banks at a disadvantage to foreign rivals that aren’t subject to the same restrictions in their home countries.
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OPINION
LOS ANGELES TIMES EDITORIAL: “Dealing with Day Laborers”
“Redondo Beach has spent nearly a decade defending a misguided 1986 city ordinance that bans day laborers from soliciting work from public sidewalks, alleys, medians or highways.
Lawyers for the city say the law is designed to stop individuals from spilling out into traffic while looking for work and jeopardizing public safety. A district court tossed out the ordinance as an unconstitutional restriction of free speech. City officials persisted with a legal appeal, ignoring previous trial court decisions overturning similar laws, and instead arguing that the measure doesn’t seek to limit what people say on public sidewalks, just how they behave.”
GOPROUD: “Rick Santorum Owes Gay Soldier An Apology”
“Tonight, Rick Santorum disrespected our brave men and women in uniform, and he owes Stephen Hill, the gay soldier who asked him the question about Don’t Ask, Don’t Tell repeal, an immediate apology. That brave gay soldier is doing something Rick Santorum has never done – put his life on the line to defend our freedoms and our way of life.”
MEGAN MCARDLE: “Is Irish Austerity Paying Dividends?”
“Last year, the failure of Irish austerity was on the lips of every left-wing wonk in America. Paul Krugman, the leader of this school of thought, has compared austerity to bloodletting and other such primitive medical quackery (a comparison he repeated a couple of days ago). He compared Ireland’s embrace of austerity unfavorably to Spain’s reluctance, and used Ireland as a sort of Keynesian object lesson.”
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The Justice Department’s auditors have been getting a lot of press lately. They found that the department paid $16 each for muffins at a recent event in Washington. At another event in San Francisco, the department spent $76 per person on lunch.
According to the Hilton hotel chain, which hosted the D.C. muffin event, the auditors didn’t read the invoice very carefully:
Hilton Worldwide, which manages and franchises hotels including the Capital Hilton where the conference took place, says the price included not only breakfast baked goods but also fresh fruit, coffee, tea, soft drinks, tax and tips. It says the report misinterpreted its invoices, which often use shorthand and don’t reflect the full menu provided.
So it appears that part of the story has been exaggerated. The $76-per-person lunch in San Francisco, also held at a Hilton, included “slow-cooked Berkshire pork carnitas, hearts-of-romaine salad — and coffee at $8.24 a cup.” That one still looks dodgy. A bit fancy for a government conference. But the muffins do seem to have been blown out of proportion.
In related news, after an assistant told Federal Reserve Chairman Ben Bernanke that the muffins didn’t actually cost $16, he was reportedly overheard muttering to himself, “soon…”
CEI Weekly is a compilation of articles and blog posts from CEI’s fellows and associates sent out via e-mail every Friday. Also included in the weekly newsletter is a brief description of CEI’s weekly podcast and a feature on a major CEI breakthrough made during the week. To sign up for CEI Weekly, go to http://cei.org/newsletters.
CEI Weekly
September 23, 2011
>>Featured Story
On Wednesday, CEI hosted an awards ceremony on Capitol Hill for the Congressmen who have earned 100% Pro-Worker scores on the WorkplaceChoice Congressional Labor Scorecard. Learn more about the event—and read press releases from Reps. Michelle Bachmann and Jeff Landry about receiving the awards—here.
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For all the talk about fairness and equity with the so-called Buffett Rule, there is one sneaky loophole in the Obama revenue proposal that has largely escaped notice.
In doublespeak that would make even George Orwell do a doubletake, President Obama’s “financial crisis responsibility fee” would tax banks, insurance companies and brokerage houses that have paid back their bailout money — and even some firms that never took a bailout — to pay the tab of irresponsible firms, namely the auto companies that still owe the government billions.
“We also ask the largest financial firms — companies saved by tax dollars during the financial crisis — to repay the American people for every dime that we spent,” President Obama proclaimed in the Rose Garden on Monday. But the fine print in the 80-page plan the president submitted to the Joint Committee on Taxation makes it clear that this fee will only be on firms that have already repaid the Troubled Asset Relief Program funds and likely on some firms who never took a dime of taxpayer money.
“Although many of the largest financial firms have repaid the Treasury for their TARP assistance, they continue to implicitly benefit from the TARP funds that bolstered their balance sheets during a period of great economic upheaval,” the administration states. A fee of an unspecified amount “will be restricted to financial firms with assets over $50 billion and will be imposed until all TARP costs have been recouped.”
Notice that for all the talk of “repayment,” the tax is not on recipients of TARP per se, but financial firms with assets of more than $50 billion. Fidelity Investments, for instance, has weathered the storm relatively well and has not taken any TARP money. But since it has assets of more than $1 trillion under management, Fidelity would still likely be hit by the Obama tax. And some of the TARP recipients, like BB&T Corp., hadn’t engaged in the foolish mortgage and credit practices, yet were pressured by the government to take the bailout money so the “bad banks” wouldn’t be stigmatized by taking TARP money.
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Have a listen here.
E-Verify is a program that checks the immigration status of new hires. The House is expected to vote on legislation that would make E-Verify mandatory nationwide. Policy Analyst Alex Nowrasteh thinks E-Verify should be scrapped altogether. Not only does it make it more expensive for companies to hire people, it misses over half of the undocumented immigrants it is supposed to identify.
A recent Washington Post article by Lisa Miller discusses the separation of church and state in marriage. Miller concludes that the ways in which state-enforced contracts have been incorporated into the ritual of marriage makes it infeasible to separate the two. She has a point, not only have an array of legal property rights, alimony, and child support precedents evolved, but many governmental and business benefit programs have also. Firms routinely extend health benefits, for example, to employee families (an artifact of WWII tax law).
Miller comments on the stance of Tony Jones, an evangelical minister in Minneapolis, who refuses to sign marriage certificates as long as his state refuses to recognize same-sex marriages. Surprisingly, that position places him in the same camp as many traditional religious leaders who will only endorse marriage of heterosexual couples and refuse to perform nuptials for same-sex couples. States that have moved to recognize same sex marriage have generally respected that reservation — despite the separation of church and state doctrine.
But is Miller right? Is it really that difficult to separate the affirmative nature of marriage — the honor and respect given that union by the respective community — and the legal/contractual obligations of the joined parties to each partner and any children they may have? Isn’t this very entanglement evidence that the intrusion of government into value issues has gone too far and merits disentangling? After all, America is a highly legalistic society, with many complex contracts between parties. Couldn’t a standard form civil contract be introduced which would convey the obligations now granted via the marriage license? The federal government could elect to grant social security and other benefits on that basis; firms could elect to follow suit, design their own equivalent contract if they desired, or simply continue to recognize only traditional marriages.
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This week U.S. investigators accused Full Tilt, the online gambling website, which was shut down during the black Friday raids of being a “Ponzi scheme.” While it is true that the Full Tilt management team lied to their customers and certainly mismanaged company funds, they are not a Ponzi scheme. Furthermore, it is important to remember that one poorly managed company should not condemn an entire industry just as one bad person is no reason to condemn an entire group of people.
Full Tilt promised players that their accounts were segregated from the money used to operate the business and pay investors and executives.
Unfortunately, it appears that the company lied about that fact. Yet, all was fine until the U.S. government passed the Unlawful Internet Gambling Enforcement Act. When payment processing companies stopped processing deposits from American players Full Tilt did not stop allowing Americans to play on their site. Money was never taken out of Americans’ accounts because no bank would process the payments they thought might be deemed illegal by U.S. authorities. Instead of banning U.S. customers Full Tilt essentially created “phantom money” for American players to gamble with. The money that the players lost or won was paid out by the deposits from players in other countries who payments were actually put into the Full Tilt accounts. It appears that Full Tilt executives hoped they’d eventually find a bank to make the transaction of the American players’ deposits. Unfortunately they ran out of time when the Department of Justice shut them down, caused a global panic among their players and a subsequent mass attempt to withdrawal accounts. Of course, that is when everyone learned that the company did not, as they said, have funds equal to player deposits on hand. Oops.
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With Trade Adjustment Assistance (TAA) scheduled for a vote today, in debate on the measure yesterday, Sen. Orrin Hatch (R-Utah) gave a spirited speech outlining his opposition to the legislation. TAA was established to provide reemployment and assistance programs to people who lose or are at risk of losing their jobs because of trade. With dubious results, this program has also led to some questionable certification of workers eligible for TAA money, as CEI pointed out.
This wasteful policy will most likely be extended by Senate vote. The renewal is seen by many as a Republican handout to Democratic labor union interests, so that the administration will submit the pending Free Trade Agreement deals with South Korea, Colombia and Panama.
In his speech on the Senate floor, Hatch pointed to the losses to the American consumer and producers from holding up the three trade agreements, as well as the expansion of the program to just about every worker who has lost his job:
TAA money now goes to farmers, firms, community colleges, and service workers. Even more troubling, the critical nexus between job loss caused by trade agreements and TAA eligibility has been jettisoned. Today, all workers who lose their jobs allegedly due to “Globalization” could be eligible. As the global economy and global supply chains become more integrated, I suspect the potential number of beneficiaries, and the costs to the U.S. taxpayer, will grow enormously.
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