Thursday, November 28, 2019

WALL STREET PLUNDERS - 6 WALL STREET COMPANIES KEPT AMERICAN ADDICTED TO OPIOID AND RAKED IN THE OBSCENE PROFITS - The companies, including Johnson & Johnson and McKesson Corporation, received subpoenas from Brooklyn prosecutors.


6 Drug Companies’ Role in Opioid Epidemic Scrutinized by Prosecutors

The companies, including Johnson & Johnson and McKesson Corporation, received subpoenas from Brooklyn prosecutors.




Credit...Spencer Platt/Getty Images

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Federal prosecutors in Brooklyn have opened a criminal investigation into whether several large drug companies intentionally skirted regulations in order to promote the sale of addictive opioids, according to corporate filings and a person familiar with the matter.
The investigation is part of a heightened law enforcement scrutiny around the country into companies that make and distribute prescription painkillers. Drug companies have faced criminal probes and multibillion-dollar lawsuits for their alleged role in the opioid epidemic.
This year, federal prosecutors in Manhattan and Cincinnati have brought novel cases against companies that distributed opioids to pharmacies, using criminal conspiracy charges typically deployed against drug dealers.
At least six companies disclosed in recent regulatory filings that they received grand jury subpoenas from federal prosecutors in Brooklyn: Johnson & Johnson, Teva Pharmaceutical Industries Ltd., Mallinckrodt PLC, Amneal Pharmaceuticals Inc., AmerisourceBergen Corporation and McKesson Corporation.

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The subpoenas were sent out as recently as August, according to the filings. The criminal investigation was first reported by The Wall Street Journal.
Prosecutors from the Eastern District of New York asked the companies to hand over documents related to the marketing and sale of opioids, the filings said. The subpoenas also sought information about the companies’ internal programs and policies to stop the abuse of opioid medications.
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Prosecutors are examining whether the companies violated the federal Controlled Substances Act, a broad statute that regulates drug distribution and possession, according to corporate filings and a person familiar with the investigation. The law has been used to impose penalties against pharmacies that failed to adequately control prescription painkillers from reaching the black market.
To bring criminal charges under the statute, the government must prove that the companies or their executives intentionally avoided complying with regulations that require them to flag suspicious orders of opioid medications.
A spokesman for Johnson & Johnson said the company’s procedures for distributing opioid medications complied with the law, adding that monitoring data showed the company’s opioids were rarely abused.

A spokeswoman for Teva said the company was cooperating with the subpoena and was confident in its monitoring policies.
A spokesman for Mallinckrodt declined to comment. Officials at AmerisourceBergen, McKesson and Amneal did not respond to requests for comment.
As deaths from opioid overdoses have surged in the past few years, law enforcement officials across the country have sought to use criminal prosecution against corporate executives accused of contributing to the epidemic. Last year, the Justice Department created a task force to pursue makers and distributors of prescription opioids.
“We will use criminal penalties,” said the United States attorney general at the time, Jeff Sessions. “We will use civil penalties. We will use whatever tools we have to hold people accountable for breaking our laws.”
Opioid cases have become such a priority for the government that the United States attorney for the Eastern District, Richard P. Donoghue, has asked every prosecutor in his criminal division to take on an opioid-related case, according to people familiar with the office.
Earlier this year, for the first time, federal prosecutors in Manhattan brought felony drug-trafficking charges against a major pharmaceutical distributor and two of its former executives. Prosecutors said the former executives at the company, Rochester Drug Cooperative, or RDC, ignored red flags and shipped tens of millions of oxycodone pills and fentanyl products to pharmacies they knew were distributing the drugs illegally.
One of the former executives pleaded guilty to three criminal counts, including intentionally failing to report suspicious bulk orders of fentanyl and other opioids. He is cooperating with prosecutors. The other former executive has pleaded not guilty.
As part of the case, the company agreed to a deal in which it would avoid criminal charges as long as it pays a $20 million fine, complies with the controlled substances law and submits to five years of supervision by an independent monitor.
The company admitted in court papers that it intentionally violated federal narcotics laws by shipping opioids to pharmacies, knowing that the prescription medicines were being sold and used illicitly.
In a similar case in Cincinnati, federal prosecutors this year brought criminal charges against a pharmaceutical distributor, Miami-Luken Inc., saying the company ignored “obvious signs of abuse.” Among other allegations, the government said the company had distributed more than 2.3 million oxycodone pills to a pharmacy in a town of approximately 1,400 people.
The company, which closed, was charged alongside two of its former officials and two pharmacists. All have pleaded not guilty.
Lawsuits around the country have also accused big opioid makers and distributors of using misleading marketing and playing down how addictive the painkillers were in order to increase sales.
Jan Hoffman contributed reporting.



When Health Care Stocks Rise, Patients Suffer

By Deane Waldman
When a stock price rises or has a better P/E ratio, this is generally considered a measure of success. Is this true for health insurance stocks? Stockholders certainly are happy, but what about the purchasers of the carriers’ policies? Are patients smiling when the stock price goes up?
The primary function of any healthcare system is not to save money or to insure people. It is to facilitate timely access to needed care. Having an insurance policy, whether private or government-supplied, is considered the key to a doctor’s office. One might surmise that when an insurance seller does well, so does the insurance buyer. 
Is there a relationship between the financial condition of companies that sell health insurance and the people who buy their policies?  
Financial Data
The ten-year period of 2007-2017 was chosen as it spans a time before the Affordable Care Act was passed in 2010 and three years after the ACA was implemented. Some market changes could be at least in part attributable to the ACA.
The seven companies listed in Table I represent major sellers of health insurance. Together, they cover more than 128 million Americans (Table I), including more than 4 million with Medicare supplemental policies.
Over the ten years, stock prices rose 157 percent to 635 percent (Table I). During the same period, the S&P 50 increased 82 percent. The one-year forward price/earnings (P/E) in 2007 ranged from 8.27x to 16.44x. By 2017, the P/E ratio has increased in every case, from 17.45x to 23.3x. The one-year relative P/E ratio also increased in five out of seven stocks and decreased slightly in two.

Table I: Sellers of Health Insurance
Company
Stock Price (12/31/year)
Americans covered by company policies*
2007
2017
Change
Anthem
 $       87.73
 $     225.01
 ↑ 157%
40.8 million
Cigna
 $       53.73
 $     203.09
 ↑ 278%
11 million
Humana
 $       75.31
 $     248.07
 ↑ 229%
13 million
UnitedHealthcare
 $       58.20
 $     220.46
 ↑ 279%
41.6 million
Centene
 $         6.86
 $       50.44
 ↑ 635%
14 million
Molina
 $       25.80
 $       76.68
 ↑ 197%
3.5 million
Wellcare Health
 $       42.41
 $      201.11
 ↑ 374%
4.4 million
S&P 50
 $  1,468.36
 $   2,673.61
 ↑ 82%
N/A
 Yr=year. S&P 50=Standard and Poor’s top 50 companies. (*) published enrollment numbers are from different years, 2015 to 2019.

Access to Care

Two useful metrics of access to healthcare are wait time to see a primary physician and the percentage of physicians willing to accept Medicaid patients. In 2018, 74.8 million Americans were enrolled in Medicaid.  People with no identified primary doctor, whether Medicaid or uninsured, tend to forego routine or preventative care and use emergency rooms for care.  
In 2007, 74 percent of U.S. physicians accepted new Medicaid patients into their practices. That percentage decreased to 55 percent ten years later.  From 2007 to 2017, due largely to Medicaid expansion under the Affordable Care Act, the number of uninsured Americans declined from 47.5 million to 39.9 million.
The maximum wait time to see a primary care physician was chosen rather than the average wait time because medicine is practiced on individuals, not on populations. The patient who waits the longest is most likely to suffer harm from the delay. The maximum wait time in 2007 was 99.6 days. It has increased to 175.7 days.   
The change in stock prices and decline in access to care are not merely coincidental. They are statistically related. Pearson’s chi square test (c2=24.5582) indicates a strong correlation, p<0.0001.
Solution
A host of factors influence the price of a stock including general economic conditions, competition, leadership and capitalization of companies, and the regulatory environment. However, all factors culminate in the public perception of future earnings, which affects the price people are willing to pay for a stock.
Evidence suggests a link between a rise in prices of insurance stocks and a decline in patients’ access to care. Health insurance sellers increase profits by (a) not paying for patient care, and/or (b) delaying payments, so the retained earnings can be invested. This “three D” strategy -- delay, defer, or deny care -- generates profits and drives the stock price upward while closing the door to the doctor’s office.
Reduction in availability of care is an adverse impact -- a symptom of healthcare dysfunction. To reverse it, one must identify and treat the root cause, which is the system, not the individuals.
Third-party payment structure is the root cause -- it misaligns the incentives by rewarding the outcome consumers don’t want, less care, instead of incentivizing the desired outcome, access to medical care.
To realign the incentives requires reconnecting buyer (patient) with seller (provider) so the buyer pays the seller directly rather than the third party, government or insurance. When buyers spend their own money instead of OPM (other people’s money), they automatically align the incentives to get what they want: care. When the third party pays, it gets what it wants: profit for insurance carriers and power for the federal government.
Reconnection of buyer and seller is a market-based approach and the antithesis of government-controlled single-payer or Medicare-for-All. For those who would claim that Americans cannot afford to pay for their care, the facts suggest otherwise. In 2018, the average American family spent $28,166 on healthcare costs, representing more than 45 percent of median gross income.
Market-based financing of healthcare would be less expensive and could provide timelier care than the system we currently have or changes in healthcare being planned by Washington.
Deane Waldman, MD MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science at University of New Mexico; and author of “Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine.”

Social counterrevolution and the decline in US life expectancy
A study published this week in the Journal of the American Medical Association (JAMA) details the fall in life expectancy in the United States from 2015 to 2017, a streak unprecedented in modern times.
Virginia Commonwealth University professor Dr. Steven H. Woolf and Eastern Virginia Medical School student Heidi Schoomaker analyzed life expectancy data for the years 1959-2016 and cause-specific mortality rates for 1999-2017. The data shows that the decline in life expectancy is not a statistical anomaly, but the outcome of a decades-long assault on the working class.
The report exposes a country in the grips of a profound social crisis. The record stock prices touted by Trump are, in fact, a measure of the increased economic exploitation that has produced the fall in life expectancy among workers.
Protesters assemble a makeshift memorial to those lost to drug overdoses last year during a demonstration in support of a proposed supervised injection site, outside the federal courthouse in Philadelphia, in September [Credit: AP Photo/Matt Rourke]
The shuttering of thousands of factories and mines, countless store closures and downsizings, along with the slashing of wages, pensions and health care benefits to meet the demands of Wall Street investors have literally killed hundreds of thousands of workers across the United States.
Life expectancy increased annually from 1959 until it stopped rising in 2010, plateauing at zero growth before beginning its descent after 2014, when it peaked at 78.9 years. By 2017, life expectancy had fallen to 78.6 years.
Not coincidentally, 2010 was also the year that Obamacare was signed into law an attack on health care sold as a progressive reform. The decline in life expectancy since then exposes Obamacare’s regressive character, only one of the reactionary legacies of the Obama administration.
Obamacare was part of a deliberate drive by the ruling class to lower the life expectancy of working people. As far as the strategists of American capitalism are concerned, the longer the lifespan of elderly and retired workers, who no longer produce profits for the corporations but require government-subsidized medical care to deal with health issues, the greater the sums that are diverted from the coffers of the rich and the military machine.
A 2013 paper by Anthony H. Cordesman of the Washington think tank Center for Strategic and International Studies (CSIS) frankly presented the increasing longevity of ordinary Americans as an immense crisis for US imperialism. “The US does not face any foreign threat as serious as its failure to come to grips with… the rise in the cost of federal entitlement spending,” Cordesman wrote, saying the debt crisis was driven “almost exclusively by the rise in federal spending on major health care programs, Social Security, and the cost of net interest on the debt.”
Meanwhile, conditions for the rich have never been better. This is reflected in the growing life expectancy gap between the rich and the poor. The richest one percent of men live 14 years longer than the poorest one percent, and the richest one percent of women 10 years longer than the poorest.
Despite expending far more per capita on health care than other major capitalist countries, the United States has fallen far behind when it comes to life expectancy and mortality. The US began to lose pace with other developed countries beginning in the 1980s, and by 1998 had fallen below the average for countries in the Organization for Economic Cooperation and Development.
The first nodal point, in the early 1980s, corresponds to the initiation of the social counterrevolution by the administration of Ronald Reagan, which involved union busting, strikebreaking, wage-cutting and plant closings on a nationwide scale, combined with cuts in education, health care and other social programs. This was launched with the breaking of the PATCO air traffic controllers’ strike in 1981, carried out with the complicity of the AFL-CIO. Reagan’s social policies were rapidly adopted by the Democrats and continued by the Clinton and Obama administrations.
The second major inflection point was the Wall Street crash of 2008, which was followed by trillions in bailouts for the banks on the one hand and brutal austerity against the working class on the other. The ensuing decade has seen the explosion of the opioid crisis, which has ravaged communities across the United States.
According to the JAMA report, the decrease in life expectancy is the outcome of nearly three decades of increasing mortality among midlife working-age adults, those 25-64. This is mainly the result of a dramatic rise in drug overdoses, alcohol abuse, suicide and a series of organ system diseases.
Age-Adjusted Mortality From Unintentional Drug Overdoses, by Race/Ethnicity, US Adults Aged 25-64 Years, 1999-2017. Values in parentheses indicate relative increases in age-adjusted mortality rates by race/ethnicity between 2010 and 2017. Source: CDC WONDER.
Between 1999 and 2017, drug overdose mortality among those in their prime working years increased an astounding 386.5 percent, going from 6.7 deaths to 32.5 deaths per 100,000. The increase in mortality was greatest for the youngest of this cohort, between the ages of 25 and 34, rising 531.4 percent.
The report found that between 2010 and 2017, the overall midlife mortality rate increased from 328.5 to 348.2 per 100,000, resulting in 33,307 deaths that would not have occurred if the rate had held steady.
The rise in mortality has impacted workers across every racial and ethnic group, with the largest number of excess deaths occurring among white workers—a grim refutation of the concept of “white privilege.” By means of such racialist conceptions, the ruling class seeks to promote racial and national divisions even as the reality of social life confirms the fundamental identity of interests of workers of all races and nationalities.
Woolf and Schoomaker found that the largest relative increase in midlife mortality was concentrated in New England and the Ohio Valley, two areas that have been hit particularly hard by deindustrialization and the opioid crisis. Approximately one third of the excess deaths since 2010 occurred in just four states—Ohio, Pennsylvania, Indiana and Kentucky. Eight of the top 10 states for excess deaths are in the Midwest and Appalachia.
“What’s not lost on us is what is going on in those states,” Dr. Woolf told the New York Times. “The history of when this health trend started happens to coincide with when these economic shifts began—the loss of manufacturing jobs and closure of steel mills and auto plants.”
This JAMA analysis exposes the commission of a crime on an immense scale. “When society places hundreds of proletarians in such a position that they inevitably meet a too early and an unnatural death,” Friedrich Engels wrote in 1845 in The Condition of the Working Class in England, “yet permits these conditions to remain, its deed is murder just as surely as the deed of the single individual.”
The responsibility for driving workers to an early grave lies with the capitalist system’s insatiable demand for ever greater profits. The key accomplices in this crime have been the unions, which serve as the corporations’ industrial police force on the shop floor, ensuring the orderly closure of plants and imposing one concessions contract after another.
In this mad drive for profits, workers are being squeezed past the breaking point. The Amazonifaction of work and the growth of the “gig economy” in the last decade have dramatically increased the exploitation of the working class. Workers are driven to powerful painkillers including oxycontin and opioids simply to cope with the injuries and illnesses that result from overwork.
The reemergence of the class struggle across the US and internationally has shown the way forward. However, while tens of thousands of auto workers, teachers and other workers have taken strike action in the last year, their struggles have been betrayed by the unions.

What is required to meet the needs of the working class is a conscious political leadership with a socialist program on the basis of which workers can take control of the banks and corporations and run them democratically to meet human need, not private profit.


Health Care Doom on the Horizon

 

By Keith R. Jackson
The relationship between Americans and their health care delivery is about to make a dramatic change for the worse.  Consumers of health care are poised to vote for a federally managed system.  Why would they go down this predictably awful rabbit hole?  They'll do it because they are overwhelmed and frightened in the current system.  They'll do it because this may be the only option that a typical voter understands.  They'll do it because our elected leaders do not have the courage to enact changes that could make things work and don't want to give up power.  And it will happen because the media will demonize and target anyone who isn't on the socialist bandwagon.
Currently, we have a situation in America where the insured among us are utilizing health care less than in the past.  This is because of the financial implications of high-deductible insurance policies, most people's only affordable option.  As a result, it is arguable that the very people who bear the financial burden for our medical care — namely, the minority among us who are insured Americans — are among those getting the worst care in our country.  It is well known that Americans often live on the edge of their finances.  So when it comes to budgeting for our deductible when health issues arise, we are frequently left with hard decisions.  This often results in the insured tolerating illness rather than seeking appropriate, expensive care.
The result of this development will most assuredly result in even conservative voters being swayed toward a federally managed health delivery system.  With the elderly freely using Medicare and Medicaid participants getting treatment with seemingly no debilitating financial consequences, it would be easy to desire something similar for the rest of us.  After all, what could be more messed up than the current system, where a simple visit to the emergency room can lead to bankruptcy?
The federal option for health care delivery will undoubtedly be wretched.  Ask any veteran or doctors who trained at those hospitals about their experience with the V.A., the best example of a federally run health delivery option.  You'll hear stories that will curl your toes.  It is not possible for government to provide quality care in a timely manner affordably, just as equality and liberty can't coexist without one sacrificing itself to the other.  Add on the layers of bureaucracy in a federally run hospital to the inefficiencies and redundancies they mandate, and the results are predictable.
Yet the people may opt for it anyway, because it is hard to imagine relying on the current system creating a more affordable market.  We are not using the economic tools that work to bring down costs.  There is no such thing as capitalism or a free market in health care delivery.  If a group of doctors think they can provide better care at cheaper prices than your community hospital, they cannot easily do so.  Government regulations would not grant them permission, because it is more "in the community's interest" to keep the inefficient and expensive existing hospital afloat than to allow the creative destruction that capitalism provides.  Ending local government's control over "certificate of need" would lower costs, but politics keeps these laws going.
Additionally, hospitals are allowed to charge much more for services than private practitioners of medicine and surgery.  This is because they have convinced local governments that this is justifiable because they have to take care of the indigent.  A lot of the recent dramatic rise in health care costs is a result of the incestuous relationship between hospital corporations and the government.  Doctors are getting absorbed into hospital employment with the lure that their pay will not go down as precipitously if they are paid the higher allowable fees that they can bill through the hospital.
You can add the insurance industry to the hospital corporations and the government as the three players that keep the system unaffordable and non-competitive.  Many competitive options for insurance coverage could decrease cost.  But these are opposed by the industry and are lobbied away.  The laws that could make these legal are unlikely to be enacted because power would shift from government and insurance companies to the individual.
One such idea is insurance pooling.  Suppose that someone who would normally be almost uninsurable, like a 33-year-old waitress with Crohn's disease, could join in with other waitresses and shop as a group for policies across state lines.  This would put market forces to work and necessarily drive down her costs.  This is because most waitresses are young and fairly healthy, and the actuaries in the insurance companies would jump to bid for this business.  For particularly difficult to insure populations, there could even be federally subsidized pools.  This could work for the uninsured and unemployed.
For this concept to work, there would have to be allowances for buying insurance across state lines.  Politicians have too many pet causes to allow this to happen.  Most insurance coverage in New York City mandates coverage for transgender operations.  Years ago in Connecticut, insurance had to cover hair plugs.  As you might suspect, insurance can run much higher in these environments when compared to similar coverage (not including these boondoggles) in the upper Midwest.  If a resident of New York or Connecticut could buy the Midwestern policy for similar coverage without the local mandates, costs would go down.
Another priority would be transferring ownership of insurance to individuals rather than through their employers.  But tax incentives encourage the opposite.  Policies that do not end when changing jobs or crossing into other states would be preferable, but business tax deductions change the game.  If individuals could deduct insurance cost, as businesses have traditionally done, it could work.
Tort reform would remove a lot of dysfunction and wasteful spending.  But most lawmakers are lawyers, so the possibility of goring this cash cow is remote.  (What will happen to this sector if the federal government runs medicine?)  Allowing information technology to evolve naturally rather than instituting top-down, central control to the medical records, billing, and other information systems would result in savings, too.  But I.T. is essential to maintaining power, which makes any change non-negotiable.
Americans may have had enough, egged on by progressive media.  Plots to make medical care more affordable by re-introducing the free market and capitalism through changes in the current laws seem to have died off.  The fawning hero-worship directed toward former president Obama by the media glorified the idea of health care as a human right, with support for this wrong-headed idea achieving his goal of "fundamentally changing America."  Medicare for all is depicted in the press as a desirable idea despite common sense suspecting the contrary.  When it is shown that the cost of administering health care through the existing system proves that insurance companies eat up around a third of the health care dollar, it does seem ridiculous to maintain the status quo.  After all, the cost of administration in the Veterans Administration is far less.  But we know intuitively that care will be worse.  And, as anyone who knows history can tell you, giving them power over our health care decision-making will be the final nail in the coffin of our freedom.
Yet, when the simple idea of a Health Savings Account, a necessary pillar of any health care reform, is above the heads of many voters, we have lost.  Because the media will shoot down any politician brave enough to try anything but a federal option (remember Tom Price, [R-GA]?), it is harder than ever to have any kind of inertia for reasonable change.  With the shortsightedness of insurance companies and hospital corporations essentially pricing themselves out of existence for access to more money today, it looks hopeless.  And when federal debt continues to be viewed as a "so what?" by politicians and citizens alike, we are done. 

It Pays to be Illegal in California

 

 By JENNIFER G. HICKEY  May 10, 2018 

It certainly is a good time to be an illegal alien in California. Democratic State Sen. Ricardo Lara last week pitched a bill to permit illegal immigrants to serve on all state and local boards and commissions. This week, lawmakers unveiled a $1 billion health care plan that would include spending $250 million to extend health care coverage to all illegal alien adults.
“Currently, undocumented adults are explicitly and unjustly locked out of healthcare due to their immigration status. In a matter of weeks, California legislators will have a decisive opportunity to reverse that cruel and counterproductive fact,” Assemblyman Joaquin Arambula said in Monday’s Sacramento Bee.
His legislation, Assembly Bill 2965, would give as many as 114,000 uninsured illegal aliens access to Medi-Cal programs. A companion bill has been sponsored by State Sen. Richard Lara.
But that could just be a drop in the bucket. The Democrats’ plan covers more than 100,000 illegal aliens with annual incomes bless than $25,000, however an estimated 1.3 million might be eligible based on their earnings.
In addition, it is estimated that 20 percent of those living in California illegally are uninsured – the $250 million covers just 11 percent.
So, will politicians soon be asking California taxpayers once again to dip into their pockets to pay for the remaining 9 percent?
Before they ask for more, Democrats have to win the approval of Gov. Jerry Brown, who cautioned against spending away the state’s surplus when he introduced his $190 billion budget proposal in January.
Given Brown’s openness to expanding Medi-Cal expansions in recent years, not to mention his proclivity for blindly supporting any measure benefitting lawbreaking immigrants, the latest fiscal irresponsibility may win approval.
And if he takes a pass, the two Democrats most likely to succeed Brown – Lt. Gov. Gavin Newsom and former Los Angeles Mayor Antonio Villaraigosa – favor excessive social spending and are actively courting illegal immigrant support.

COST to AMERICANS of the LA RAZA MEXICAN OCCUPATION in CALIFORNIA ALONE: $2,370 per legal.

All that “cheap” labor is staggeringly expensive!

"Most Californians, who have seen their taxes increase while public services deteriorate, already know the impact that mass illegal immigration is having on their communities, but even they may be shocked when they learn just how much of a drain illegal immigration has become." FAIR President Dan Stein.

Californians bear an enormous fiscal burden as a result of an illegal alien population estimated at almost 3 million residents. The annual expenditure of state and local tax dollars on services for that population is $25.3 billion. That total amounts to a yearly burden of about $2,370 for a household headed by a U.S. citizen.

  


Exclusive–Mo Brooks: Healthcare for Illegal Aliens Latest Democrat Effort to Turn U.S. into California

JOSH EDELSON/AFP/Getty Images
JOHN BINDER
 5 Jul 201971
3:34

Providing free, American taxpayer-funded healthcare to all illegal aliens is just the latest effort to use mass immigration to turn the United States into the sanctuary state of California, Rep. Mo Brooks (R-AL) says.

As Breitbart News reported, the majority of 2020 Democrat presidential candidates have endorsed a plan to force taxpayers to pay for free healthcare for all 11 to 22 million illegal aliens living across the country. The plan would cost taxpayers at least $660 billion a decade.
Brooks told SiriusXM Patriot’s Breitbart News Tonight that Democrats’ “primary motivation” behind offering healthcare to illegal aliens is not compassion, but rather an effort to transform the U.S. into the state of California through mass illegal and legal immigration.
LISTEN:
Brooks said:
The motivation for all for this is even worse. They don’t have compassion for these illegal aliens. That’s not their primary motivation. Their primary motivation is the desire to acquire raw political power. That’s what it’s all about. [Emphasis added]
If you limit votes to American citizens, Democrats do not fair to well with us. So what they’re trying to do is import people who do not understand the foundational principles that have combined to make America a great nation and who … are much more likely to vote Democrat once Democrats give them voting rights. [Emphasis added]
Brooks detailed how California, the state where former President Ronald Reagan was governor, has been forever changed due to the country’s mass illegal and legal immigration policy that imports about 1.5 million foreign nationals a year.
“Let’s learn from history. California used to be a purple state. Remember, Ronald Reagan came from there … the Democrats have flooded California with noncitizens,” Brooks said. “And why do noncitizens vote Democrat so often? Well, let’s look at illegal aliens. The data shows that 70 percent of households that have an illegal alien in them are on welfare. The data shows that 60 percent of households that have a lawful immigrant in them are on welfare. So, you’ve got three different themes that the Democrat Party now relies on: One is racism, two is sexism, and three is socialism.”
“In California, what used to be a purple state, now out of 53 congressional seats, only seven are Republican … 46 are Democrat and seven are Republican,” Brooks said. “So they have seen how that strategy of importation of foreign voters has worked in California. They’re trying to do it in Texas, Nevada, New Mexico, Arizona, in every state where they can possibly do it. They want to flood the voting booths with people who are dependent on welfare and who do not understand the principles that have made us a great nation. That’s how they change the voter pool and they’re doing it successfully.”
Health insurance expert Linda Blumberg told the New York Times that any of the Democrats’ plans that offer free health care to illegal aliens is could likely to drive a mass migration of foreigners with “serious health problems to enter the country or remain longer than their visas allow in order to get government-funded care.”
Likely U.S. voters, by a majority, said they oppose being forced to pay for the healthcare of millions of illegal aliens living in the country, as Breitbart News reported. The latest Rasmussen Reports poll found that 55 percent of voters said they opposed such a plan, including 8-in-10 Republican voters, about 6-in-10 swing voters, and 62 percent of middle-class voters.
In the next two decades, should the country’s legal immigration policy go unchanged, the U.S. is set to import about 15 million new foreign-born voters. About eight million of these new foreign-born voters will have arrived through the process known as “chain migration,” whereby newly naturalized citizens are allowed to bring an unlimited number of foreign relatives to the country.
John Binder is a reporter for Breitbart News. Follow him on Twitter at @JxhnBinder. 


The Giants at the Heart of the Opioid Crisis


Credit...Anastasiia Sapon for The New York Times
There are the Sacklers, the family that controls Purdue Pharma, the maker of OxyContin. There are the doctors who ran pill mills, and the rogue pharmacists who churned out opioid orders by the thousands.
But the daunting financial muscle that has driven the spread of prescription opioids in the United States comes from the distributors — companies that act as middlemen, trucking medications of all kinds from vast warehouses to hospitals, clinics and drugstores.
The industry’s giants, Cardinal Health, McKesson and AmerisourceBergen, are all among the 15 largest American companies by revenue. Together, they distribute more than 90 percent of the nation’s drug and medical supplies.
New civil suits from the attorneys general in New York, Vermont and Washington State accuse distributors of brazenly devising systems to evade regulators. They allege that the companies warned many pharmacies at risk of being reported to the Drug Enforcement Administration, helped others to increase and circumvent limits on how many opioids they were allowed to buy, and often gave advance notice on the rare occasions they performed audits.

Three-fourths of prescriptions at a Queens pharmacy supplied by Amerisource were written by doctors who were later indicted or convicted, the New York complaint said. For more than five years, Cardinal shipped to a pharmacy with the highest oxycodone volume in Suffolk County, N.Y., despite continually flagging its orders as suspicious. McKesson kept shipping to two pharmacies six years after learning that they had been filling prescriptions from doctors who were likely engaging in crimes. The shipments stopped only last year, after the doctors were indicted.
“How do the C.E.O.s of these companies sleep at night?” Bob Ferguson, Washington’s attorney general, said at a recent news conference.


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Credit...Alex Brandon/Associated Press
Now, in what could be a test case, the United States attorney’s office for the Southern District of New York and the D.E.A. are wrapping up an investigation that appears likely to result in the first criminal case involving a major opioid distributor, Rochester Drug Cooperative, one of the 10 largest, people familiar with the matter said. The investigation began with an examination of possible crimes including wire and mail fraud and various drug violations, according to three people with knowledge of a federal grand jury subpoena served on Rochester in 2017, but it remains unclear what charges might be brought.
The state lawsuits also present evidence that government at all levels has been ineffective at policing the distributors. For the first decade of the crisis, the three largest companies did not even have meaningful programs to monitor suspicious orders, despite being required by federal law to track narcotics and to look out for spikes in orders and cash payments. Since then they have promised and failed to build robust systems to prevent widespread opioid abuse.

The distributors rebutted the new allegations.
“We reject the state’s suggestion that our employees circumvented safeguards to increase sales,” Kristin Chasen, a spokeswoman for McKesson, said in a statement. Cardinal, in its statement, said it had “developed and implemented a constantly adaptive and rigorous system to combat controlled substance diversion.”
Amerisource put the onus on the D.E.A., which it said receives data on all orders shipped and notifications of suspicious ones. “It defies common sense for distributors such as AmerisourceBergen to be singled out,” the company said in a statement.
In the two decades since OxyContin was introduced in 1996, there have been nearly 218,000 overdose deaths related to prescription opioids, according to the Centers for Disease Control and Prevention. While overdose deaths continue to rise, the number of opioid prescriptions has been falling since 2012.
But that is mostly because of a classification change that made drugs like Vicodin (which mix opioids with milder drugs) Schedule II narcotics, which placed more restrictions on prescribing them. Oxycodone, the powerful narcotic that is the main ingredient in OxyContin, was already a Schedule II drug and its sales have continued to rise, according to figures compiled by Iqvia, a health data provider.
The three largest distributors sold 1.6 billion oxycodone pills in New York alone between 2010 and 2018. It was distributors, said the office of Attorney General Letitia James of New York, who “jammed open the floodgates.”


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In 2017, after years of allegedly flouting legal requirements to monitor suspicious orders of opioids, McKesson agreed to a $150 million settlement with the Justice Department, a record for a distributor.

For most businesses, $150 million would be a lot of money. At McKesson, it was less than the $159 million retirement package the company granted its longtime chief executive, John H. Hammergren, in 2013. (After a public backlash — a Forbes headline asked if it was “The World’s Most Outrageous Pension Deal?” — the company later reduced the package to $114 million.)
It was among a string of settlements, and others came far cheaper.
In 2008, McKesson, which supplies Walmart, paid $13.25 million and Cardinal, the main CVS supplier, paid $34 million to settle federal claims that they had been filling suspicious orders.
Before 2007, only two of Cardinal’s roughly 40,000 employees were dedicated to addressing the problem, according to court filings. One McKesson compliance officer complained that asking for resources was like “asking for a Ferrari,” according to New York’s lawsuit.
More settlements followed, but little changed. Cardinal paid a total of $64 million in settlements with the Justice Department in 2012, 2016 and 2017, with similar agreements struck by its rivals. The policing of opioid sales continued to be largely delegated by law to the distributors.
The companies created order volume thresholds for different drugs that would trigger reporting to the D.E.A., but some were so lofty that they resulted in relatively few such reports, the complaints said.
Or they worked around them. In one industry practice, known as “cutting,” Cardinal canceled pharmacy orders “that exceeded a threshold” and allowed “a subsequent, often smaller order,” Vermont’s complaint said.


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Credit...Mustafa Hussain for The New York Times
Brandi Martin, a Cardinal spokeswoman, said that “cut orders are reported to the D.E.A.” and were not “a tactic to avoid reporting.”

Egregious moves spurred limited responses, according to the complaints. McKesson allowed one pharmacy a fivefold oxycodone increase over six months, then refused another request for an 80 percent increase. The company continued shipping to the pharmacy anyway, even after a rival stopped.
McKesson, in its statement, said it was continuing “to enhance and evolve” its compliance efforts.
By last year, executives were summoned by Congress. Both Mr. Hammergren, of McKesson, and George Barrett, the executive chairman of Cardinal at the time and its former chief executive, played down their roles in the supply chain.
During the hearings, Representative Kathy Castor, a Florida Democrat, picked out a single drugstore in rural West Virginia that had been swamped with opioids — 4,000 pills a day at one point from Cardinal, 5,000 from McKesson.
“Don’t you take responsibility?” she asked, adding, “You saw that paying the penalties on your settlement agreements was a cost worth paying because you were making so much money?”
“I wish we had moved earlier to stop shipping to that pharmacy,” Mr. Barrett said at the hearing. Mr. Hammergren echoed that, saying, “I would have liked to have made a decision faster.”
Ms. Castor was not satisfied. “This was the opposite of due diligence,” she said.
There was little enthusiasm for policing opioids at Rochester Drug Cooperative, New York’s complaint alleges.


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For years, only two people at Rochester were assigned to compliance, and one had other responsibilities. Amid discussions about hiring a compliance consultant, Laurence F. Doud III wrote in an email when he was the company’s chief executive that it was “making me ill as to how much this is going to cost.”
Mr. Doud is now suing Rochester, claiming wrongful termination and contending it conspired to blame him for conduct that the D.E.A. and federal prosecutors in New York are investigating in the criminal inquiry. (His suit was previously reported by The Democrat and Chronicle of the city of Rochester.) The current chief executive, Joseph Brennan, is on leave.
Rochester is a cooperative of pharmacies, so monitoring suspicious orders meant monitoring its own members. But it had practices that were similar to those of its larger rivals. Rochester’s upper limits on how many pills pharmacies could buy were “invariably so high that customers could not reach them unless their order volumes tripled from their historical purchasing patterns, rendering the system virtually useless,” New York alleges.
Sales were brisk. Between 2010 and 2018, Rochester sold 143 million oxycodone pills in New York.
The company added a Queens pharmacy with numerous cash buyers as a customer in 2016. The pharmacy was also filling prescriptions from out-of-state doctors and one who had been arrested over oxycodone prescribing practices, the complaint says.
In 2013, Rochester continued shipping to a pharmacy run by a pediatrician who had surfaced in headlines as running a pill mill, according to the complaint. In an email, one Rochester consultant called the situation “a stick of dynamite waiting for the D.E.A. to light the fuse.” The shipments continued.
In a $360,000 settlement in 2015, Rochester admitted that it had failed to report thousands of opioid transactions over five years. The subsequent criminal inquiry sought records including loans and lines of credit that Rochester had extended to its customers, according to people with knowledge of the 2017 subpoena.

Criminal charges are soon expected, with the company and current and former executives under scrutiny, the three people familiar with the matter said. They, like those with knowledge of the subpoena, spoke on the condition of anonymity because of the developing investigation. Such a prosecution would appear to be the first time a major distributor has been held criminally responsible in connection with opioids.


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Credit...Timothy A. Clary/Agence France-Presse — Getty Images
The D.E.A. and the office of Geoffrey S. Berman, United States attorney for the Southern District of New York, declined to comment on the inquiry.
Jeff Eller, a Rochester spokesman, declined to answer specific questions, citing the investigation, but he said that Rochester’s compliance department is more than six times larger than it was in 2013 and that the company “will continue to make a significant investment.”
Louis Crisafi’s opioid of choice was Actiq, a powerful fentanyl lollipop.
He allegedly left wrappers around the office, which was a bad idea, since he was a senior investigator for the Bureau of Narcotics Enforcement, a branch of the New York State Department of Health that monitors opioid sales.
Mr. Crisafi’s fentanyl use was noticed at work by several other investigators and was among the topics of a 2008 report issued by the state inspector general that raised concerns about the bureau, where many investigators reported to a pharmacist. (Mr. Crisafi, who left the bureau at the time, said he had a legal prescription and never used opioids on the job.)
States have had trouble policing opioid use — even among their own. Like similar agencies elsewhere, the New York narcotics bureau was ill-equipped, with fewer than 20 investigators overseeing distributors and manufacturers, along with the state’s 5,586 pharmacies and more than 120,000 prescribers.

Kenneth Post, a former director of the bureau, said it does not belong in the Health Department, which has close ties with health care providers.
“They’re policing their own, and it doesn’t work,” said Mr. Post, who left the agency in 2010. The Health Department called him a “disgruntled former employee.”

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Credit...New York State Inspector General
A 2012 audit by the state Comptroller’s Office found that the bureau had overlooked hundreds of thousands of flawed opioid prescriptions over two years.
The Health Department said in a statement that the bureau had only “limited investigatory” power, deflecting responsibility “to federal, state and local law enforcement.”
At the federal level, the D.E.A. does not closely monitor the millions of transactions involving controlled substances, said Paul T. Farrell, a lawyer who represents municipalities in lawsuits against drugmakers.
“The D.E.A. is not the T.S.A., which is responsible for looking at every passenger going through and screening out those who are threats,” he said, referring to the Transportation Security Administration. Instead, he said that “once a tip is made,” the D.E.A. will “reconstruct what actually happened.”

In a statement, the D.E.A. said investigations are presented to federal prosecutors, who choose “the appropriate litigation strategy.”
Distributors have marshaled lobbyists, contributing $1.5 million to sponsors and co-sponsors of a 2016 law thwarting the D.E.A.’s efforts to freeze suspicious drug shipments.
Distributors have also lined up lobbyists with ties to Gov. Andrew M. Cuomo of New York, where lawmakers included $100 million in opioid taxes or surcharges in two consecutive budgets, though last year’s measure is tied up in court. They have hired two firms founded or co-founded by onetime aides to former Gov. Mario M. Cuomo as well as Mercury Group, whose executives include former advisers to the current governor.
For now, distributors remain largely in control.
“It’s not a good system,” said Dr. Andrew Kolodny, an addiction expert. “It’s the fox guarding the henhouse.”

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