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Ruth King

How FDA Rules Made a $15 Drug Cost $400 For many older medicines, government forces the original, name-brand version off the market. By Mark L. Baum

https://www.wsj.com/articles/how-fda-rules-made-a-15-drug-cost-400-1491434230

The theory is that generic drugs should be less expensive than the original. By the time a generic hits the market, the drug’s patent has expired, allowing competition from companies that didn’t spend millions of dollars to develop it. As more options become available, prices are supposed to drop. But because of quirks in America’s regulatory system, it doesn’t always work out this way.

In 2009 the Food and Drug Administration approved a new version of colchicine, which treats symptoms of gout. Prices rose from 25 cents to $6 per pill. Two years later, the agency approved a new hydroxyprogesterone, which helps prevent premature births. It went from $15 to $400 an injection. In 2014 the FDA approved a generic of the man-made hormone vasopressin. Prices jumped from $11 to $138 for an injection.

What explains the counterintuitive price increases? All these prescription drugs fall under a category known as DESI drugs, named for their inclusion in an FDA program called Drug Efficacy Study Implementation. These drugs came to market before 1962, when getting FDA approval for a drug required proving its safety but not its efficacy. Such drugs, manufactured under expired patents, are used by millions of Americans today.

But once the FDA approves a new-drug application for a DESI drug, the existing drug can be pulled from the market. The “new” drug is treated as a material advance because it underwent testing for safety and efficacy—even though the DESI version was proved safe and effective over decades of actual use. The developer of the new drug may also get a new period of market exclusivity that lasts three years.

This makes little sense. Market exclusivity should let pharmaceutical companies recoup their often enormous investments in genuinely new drugs. Giving monopoly protection for what is essentially a generic version of a DESI drug merely enriches sharp-dealing companies while injuring patients.

Another reason generics often face no competition was described by Scott Gottlieb, President Trump’s nominee for FDA commissioner, in these pages last year. He noted that a generic-drug application can cost as much as $15 million. This high upfront cost is part of why would-be manufacturers of generics often pass on the opportunity to compete against branded drugs with smaller markets. This has allowed many pharmaceutical companies to raise prices with impunity. CONTINUE AT SITE

The Arab Boy on the Israeli Tennis Team Sports can change the world—as they did my life—by helping us see each other differently By Fahoum Fahoum see note please

Are there any Jewish players on teams in any Moslem/Arab nation ? Sounds nice and lofty but the only team sport Hamas, Hezbollah, ISIs know is team Jihad…..rsk
Mr. Fahoum is a graduate of Columbia University’s master’s program in negotiation and conflict resolution.

Tennis changed my life. Growing up as a Palestinian citizen of Israel, I struggled with an identity crisis, feeling caught between two worlds. But when I was 8, I started playing tennis in Haifa. Eventually I became the first Arab Muslim on the Israeli junior national team, representing the country in European and world championships.

This was a personal success. More important, though, it gave me a platform for building bonds with Jewish youth. The tennis court was an island where everyone felt like they belonged. My teammates and I embraced the same identity. I built trust with my doubles partner and the people on the other side of the net, too.

Once my parents realized the sport’s potential to bring people together, they established the Coexistence Program at the Israel Tennis Center in Haifa. It introduced young Arabs and Jews to the game, while transforming on-court partnerships into off-court friendships. The program, which began in 2001 with around 10 children, now operates nationwide with hundreds of participants.

When I was growing up, Israeli high schools and colleges did not have organized sports. But Americans know well the power of sports, as I learned when I came to Quinnipiac University in Connecticut on a tennis scholarship. Even though my teammates and I came from different corners of the world, we were all Bobcats. Social psychologists have a name for this phenomenon of a shared, complex identity. They call it a “superordinate identity.”

Playing sports can help reframe a conflict. It builds the groundwork for cooperation by putting teammates in the same boat. To paraphrase the late Morton Deutsch, a professor at Teachers College, Columbia University, this creates a positive interdependence: If you swim, I swim, and if you sink, I sink. It galvanizes people to do what is best for the team. If another player is in a better position to score than you are, you will pass the ball.

Sports recognizes no language barriers. Drop a soccer ball into a group of kids in Israel, South Africa or Ireland, and watch what happens. There will be no need for an introduction, let alone an explanation of the rules. Instead players communicate using their bodies within an established system of rules that makes them “speak” soccer fluently. Just as sports altered my path, it has the power to change the world.

That’s why the United Nations has declared April 6 the International Day of Sport for Development and Peace. Athletics can provide entertainment and exercise, yes, but also so much more. It can be used as a tool for tackling social issues—fighting obesity, empowering women, integrating refugees or promoting peace. Sports are more than mere games. They’re essential to the healthy transformation of society.

A Resolute Message for China From Taiwan to North Korea, Trump can make clear to Xi that America is no longer in retreat.A Resolute Message for China From Taiwan to North Korea, Trump can make clear to Xi that America is no longer in retreat.

https://www.wsj.com/articles/a-resolute-message-for-china-1491434611

This week’s summit with Chinese President Xi Jinping is the most important meeting President Trump will have during his first 100 days in office. The 21st century could well be defined by the Washington-Beijing relationship. Things are not going well so far for the home team. China is on the march globally, and Mr. Trump inherited “no drama Obama’s” U.S., which has been watching it happen.

Remembering Mr. Trump’s campaign promises, the White House may be tempted to focus the summit on China’s many violations of its multilateral trade commitments, including pirating intellectual property; tilting domestic markets in favor of Chinese companies, especially state-controlled ones; and discriminating against foreign litigants in judicial proceedings. China’s mercantilist policies have harmed America and the liberal international trading order generally. All merit extended discussion.

But it’s even more important that Mr. Trump enter the meeting with a coherent strategic plan to address geopolitical and economic disputes. He should feel no pressure to bridge, let alone resolve, any of them now. He should instead focus on conveying clearly his administration’s worldview, which is very different from his predecessor’s.

Making America’s foreign policy great again should mean that apologies, acquiescence, disinterest and passivity are terms that no longer describe or apply to Washington’s leaders. No grandiose final communiqué is needed; a simple statement that the two leaders had a full and frank exchange of views will suffice.

Topping the agenda should be North Korea’s nuclear-weapons program, the most imminent danger to the U.S. and its allies. Secretary of State Rex Tillerson and Defense Secretary Jim Mattis have made clear how seriously they view the prospect of Pyongyang fitting an intercontinental ballistic missile with a nuclear warhead and threatening targets in the U.S. The president must follow up vigorously, or the Chinese may underestimate how strongly the U.S. feels about the North Korean menace.

The only real way to end the North Korean threat is to reunify the peninsula by merging North Korea into the South. China will find that difficult to swallow. But if the Trump administration can demonstrate the many benefits to China flowing from the regional stability and global security that reunification would bring, Beijing should come around.

North Korea has achieved its current nuclear capabilities despite 25 years of American attempts to halt its progress. U.S. options for stopping Kim Jong Un from taking the final step are now severely limited. Moreover, the U.S. and China must bear in mind that whatever North Korea can do, Iran can do immediately thereafter—for the right price. As Pyongyang inches ever closer to producing deliverable nuclear weapons, the prospect of a pre-emptive U.S. strike against its nuclear infrastructure and launch sites cannot be ruled out.

Beijing has itself threatened to turn the international waters of the South China Sea into a Chinese lake by building bases on disputed rocks and reefs. In the East China Sea, Beijing seeks decisive ways to break through “the first island chain” and into the Pacific. Taiwan is a target; Mr. Xi will repeat the phrase “One China” monotonously in hopes of hypnotizing the Trump team into believing it means what Beijing believes it means, rather than our longstanding interpretation.

The Obama administration’s policy was to call for China, Vietnam, the Philippines and others to resolve their territorial disputes through negotiation. This might have worked had U.S. military forces been sufficiently deployed to support the other claimants and manifest America’s will not to accept Chinese faits accomplis. Instead, Mr. Obama presided over the continuing world-wide decline of our naval capabilities. While Mr. Trump is committed to reversing that decline, it won’t happen overnight. Accordingly, as when Ronald Reagan replaced Jimmy Carter, Mr. Trump must display political resolve, buying time until the necessary naval assets are once again at sea. Otherwise, China gets what it wants with cold blue steel, not diplomatic niceties. CONTINUE AT SITE

California’s Wasted Winter Rains The drought is over but the greens keep sending the water out to sea.

Reservoirs and rivers are overflowing as storms have pounded California this winter, and after years of drought that should be good news. The problem is that misguided environmentalism is wasting the water windfall and failing to store it for a non-rainy day.

Hydrologic records indicate that this year could be the wettest on record in California. Statewide snowpack measures 160% of average. Precipitation in Palm Springs exceeds the historic norm by more than 50%. Lo, the desert is actually blooming. Most of the major reservoirs in the north are full, and some are releasing hundreds of billions of gallons of water to prevent flooding and make room for the melting snowpack this spring.

While farmers and communities downstream can capture some of the discharges, millions of acre-feet will invariably flow into the ocean due to lack of storage capacity and rules to protect endangered fish species. One problem is that while the state population has increased 70% since 1979, storage hasn’t expanded. Water districts in southern California have developed small local reservoirs and groundwater basins, but what’s most needed is storage in the north where most of the rain and snow falls.

The Public Policy Institute of California estimates that five proposed reservoirs could add four million acre-feet of storage capacity at a cost of $9 billion. Yet environmentalists have opposed every significant surface storage project for three decades. The state is even razing four hydroelectric dams on the Klamath River that green groups complain impede fish migration.

Ah, the fish. Regulations intended to protect smelt and salmon have limited pumping at the Sacramento-San Joaquin River Delta. As a result, some seven million acre-feet of water that was once available for Central Valley farmers and Southern California is flushed into San Francisco Bay each year.

Meanwhile, a 60-mile dry riverbed on the San Joaquin River that hasn’t borne fish since the 1940s is being restored at a cost of $1.7 billion to farmers and state and federal taxpayers. The river restoration is expected to divert an additional 170,000 acre-feet each year, but it could be more since the Chinook salmon that environmentalists want to revive require cool temperatures—meaning more water—to spawn and survive. Government biologists are spending millions of dollars to truck (literally) salmon around the valley while trying to calibrate optimal temperatures and water flows. Yes, these salmon have chauffeurs.

Russia’s Strategic Crossroads Srdja Trifkovic

In his latest RTRS interview (Bosnian-Serb Republic public TV service), Srdja Trifkovic talks about Russia’s complex political and economic power structure, which is mostly at odds with the image of an authoritarian Kremlin monolith presented in the Western media.
[Video here—Trifkovic segment starts at 6 minutes. Excerpts, verbatim translation from Serbian.]

Q: Professor Trifkovic, you’ve just come back from Moscow where you attended the Economic Forum, but it was also a political forum?

ST: The Moscow Economic Forum is a major annual gathering of economists and experts who advocate a change in the macroeconomic policy of the Russian government. They act from the standpoint of what one may call “patriotic opposition.” They argue that the country’s economy and financial structures are still unduly dominated by the upholders of the Washington Consensus, and by the oligarchs who continue to control the flows of money through their ownership of many private commercial banks.

Q: Are you trying to say that the Russian government is pro-American?

ST: No, but within her economic and financial structures there are officials—like Elvira Nabiullina, head of the Central Bank of Russia—who reject dedollarization, which is advocated by the “patriotic” wing of the government, as embodied in the deputy prime minister in charge of the defense industry . . .

Q: You mean Rogozin?

The Dems’ Political Area 51 Conspiracy theories abound while media ignore the real story. Bruce Thornton

The Democrats and some Republican NeverTrump bitter-enders are still so addled by losing the election that they have lost themselves in a political Area 51. Like peddlers of space-alien autopsies and earthling abductions, they are spinning preposterous conspiracy theories straight out of Invasion of the Body Snatchers, while the real story––the illegal leaks of classified intelligence involving American citizens––is ignored.

We all know the lurid scenario: Vladimir Putin, filled with hatred of Hillary for criticizing and sanctioning him for his invasions of his neighbors’ territories, “hacked” the election in order to tilt the outcome to Donald Trump. Trump, after all, said some vaguely nice things about Vlad during the campaign, and most likely has secret dodgy business interests in Russia. Several of Trump’s friends probably do too, and so they cooperated with Russian intelligence, its WikiLeaks minions, and its propaganda rag Russia Today to smear Hillary and the Democrats. And, don’t forget, it’s likely Vlad has some embarrassing untoward info on Trump he can use to blackmail the president. QED.

This conspiracy theory is preposterous, and the media’s and Dems’ continued use of the phrase “hacked the election,” as if voting machines were meddled with, is rank propaganda and confirms the continuing absence of real evidence. Of course Russia tried to influence the election, as it has tried to influence every American election since the 1930s. And we have tried, and continue to try, to influence elections in other countries all over the world. Have the Dems forgotten how Obama in 2015 interfered in Israel’s elections by spending $350 on “campaign infrastructure” to be used against Benjamin Netanyahu? As for Americans colluding with Russia during an election, where was all this high dudgeon when in 1983 Ted Kennedy offered Soviet premier Yuri Andropov a quid pro quo? As Forbes reports of the deal, “Kennedy would lend Andropov a hand in dealing with President Reagan. In return, the Soviet leader would lend the Democratic Party a hand in challenging Reagan in the 1984 presidential election.” Kennedy also offered to visit Russia and help them with access to the American media.

This typical Trumpophobic hypocrisy is also evident in the amnesia about who was really getting chummy with Putin––Obama and Hillary. Taking missile-defense installations out of Poland and the Czech Republic; working on a “reset” of relations that had soured because of Russian territorial theft in Georgia and Moldova; Obama in 2012 asking Russian president Dmitri Medvedev to assure Vlad of his “flexibility” after the election––all comprise evidence of Obama’s appeasement more solid than the innuendo and rumor supposedly proving Trump colluded with Vlad.

Apathy, Balcony Girls & Refugee Honor Violence in Sweden A socialist utopia’s heartless nightmare. April 5, 2017 Dawn Perlmutter

An article by Rachel Aviv titled ‘The Trauma of Facing Deportation’ describes an unusual disorder known as ‘uppgivenhetssyndrom’ or ‘resignation syndrome’ that only exists in Sweden and is specific to the children of immigrants. Published in the April 3, 2017 issue of The New Yorker, Aviv describes how refugee children suffering from resignation syndrome fall into a coma-like state after being informed that their families will be expelled from the country. The Swedish refer to the condition as ‘apathy’ and the children as ‘de apatiska’, the apathetic. There have been several hundred cases of resignation syndrome in the past decade. The symptoms are very severe and typically begin with depression followed by a gradual withdrawal into an unconscious state that requires tube feeding. The children are unable to move, eat, drink or respond even to painful stimuli and are in this state for months sometimes years. The only known cure is for their families to receive residency permits to stay in Sweden.

A simple objective cultural explanation for resignation syndrome is that it is another manifestation of honor violence. However, studies that suggested the family was staging the illness were labeled xenophobic while research that theorized the migratory process precipitated the condition became the basis for government policy. Hence, a 2013 guide for treating apathy published by the Swedish Board of Health and Welfare advised “A permanent residency permit is considered by far the most effective ‘treatment,’ and that a patient will not recover until his family has permission to live in Sweden.” In brief, political correctness tainted the studies because it was more politically expedient to grant residency to all families with children suffering from the syndrome than to acknowledge that this could be another manifestation of honor violence where cultural traditions allow parents to abuse their own children. If honor violence is proven to be the reason for the syndrome than Sweden’s immigration policy is the cause of the illness not the cure.

Honor violence is a form of domestic violence that is committed by family members against other family members to either prevent the family from being dishonored or restore the families damaged honor. Victims of honor violence typically internalize the values of their family or community and feel guilty and responsible for the perceived offense against honor. Honor violence is typically attributed to assaults and murders of women who have refused arranged marriages or defiled the family’s honor by not following traditions. Honor violence is not always punitive for alleged violations of cultural traditions. Anything that preserves the family honor is permitted including forcing children into slavery or child marriage to settle a debt. Being deported back to a country where the family status and honor would be diminished could be motivation for shaming a child into staging resignation syndrome. The New Yorker article did not mention that the majority of mothers of the apathetic refugee children had been subjected to physical and/or sexual abuse and were described as severely traumatized. One study suggested a Munchausen by proxy scenario proposing the idea that the mother staged the illness as a method to cope with her own trauma. The theory characterized the syndrome as ‘lethal mothering’, a behavior that is consistent with honor violence. In honor based tribal cultures men can justifiably subject their wives to physical and sexual abuse and mothers can willingly harm their own children to preserve the family honor. A 2016 study claimed that almost all children with resignation syndrome suffered traumatization from physical abuse, harassment or by witnessing violence and abuse in the close family. Intrafamily violence is also consistent with honor crimes.

Susan Rice’s Unraveling Web of Lies Obama’s attack on our democracy becomes too clear to ignore. Joseph Klein

Former President Barack Obama’s national security adviser Susan Rice is once again in the news, embroiled in a growing scandal. Bloomberg News has reported this week that Rice requested or directed the unmasking of the identities of U.S. persons in raw intelligence reports, who were involved with the Trump transition team. The communications of these individuals were apparently collected incidentally during the course of electronic monitoring of communications involving foreign officials of interest. Normally, Americans’ identities are masked, with generic references such as the title “U.S. Person One.”

According to Eli Lake’s Bloomberg report, “The intelligence reports were summaries of monitored conversations — primarily between foreign officials discussing the Trump transition, but also in some cases direct contact between members of the Trump team and monitored foreign officials. One U.S. official familiar with the reports said they contained valuable political information on the Trump transition such as whom the Trump team was meeting, the views of Trump associates on foreign policy matters and plans for the incoming administration.”

Daily Caller has reported that Rice “ordered U.S. spy agencies to produce ‘detailed spreadsheets’ of legal phone calls involving Donald Trump and his aides when he was running for president,” citing former U.S. Attorney Joseph diGenova as a source.

Circa has reported that Rice’s snooping actually preceded the election: “Susan Rice accessed numerous intelligence reports during Obama’s last seven months in office that contained National Security Agency intercepts involving Donald Trump and his associates.”

It also appears that the monitoring at issue had little if anything to do with the investigation of Russian interference in the presidential election.

These reports, and others along the same lines, raise serious questions about what Rice was doing with the unmasked identifiable information she obtained access to, even though nothing revealed so far indicates that Rice broke the law. She had the authority to request unmasking under certain circumstances where there was an intelligence need in the interest of national security for such information. But given Rice’s closeness to Obama and concern for preserving his legacy, politics, not national security, was more likely her primary motive.

Michael Doran, former National Security Council senior director, told the Daily Caller that “somebody blew a hole in the wall between national security secrets and partisan politics.” This “was a stream of information that was supposed to be hermetically sealed from politics and the Obama administration found a way to blow a hole in that wall,” he said.

It is a threat to our electoral democracy if a party in power is able to use the nation’s intelligence apparatus to do opposition research on the party out of power. This is what Rice appears to have done, perhaps to protect her boss’s legacy from being undermined by the new Trump administration. Rice denies all of this, of course.

Susan Rice’s White House Unmasking: A Watergate-style Scandal Her interest was not in national security but to advance the political interests of the Democratic party. By Andrew C. McCarthy —

The thing to bear in mind is that the White House does not do investigations. Not criminal investigations, not intelligence investigations.

Remember that.

Why is that so important in the context of explosive revelations that Susan Rice, President Obama’s national-security adviser, confidant, and chief dissembler, called for the “unmasking” of Trump campaign and transition officials whose identities and communications were captured in the collection of U.S. intelligence on foreign targets?

Because we’ve been told for weeks that any unmasking of people in Trump’s circle that may have occurred had two innocent explanations: (1) the FBI’s investigation of Russian meddling in the election and (2) the need to know, for purposes of understanding the communications of foreign intelligence targets, the identities of Americans incidentally intercepted or mentioned. The unmasking, Obama apologists insist, had nothing to do with targeting Trump or his people.

That won’t wash.

In general, it is the FBI that conducts investigations that bear on American citizens suspected of committing crimes or of acting as agents of foreign powers. In the matter of alleged Russian meddling, the investigative camp also includes the CIA and the NSA. All three agencies conducted a probe and issued a joint report in January. That was after Obama, despite having previously acknowledged that the Russian activity was inconsequential, suddenly made a great show of ordering an inquiry and issuing sanctions.

Consequently, if unmasking was relevant to the Russia investigation, it would have been done by those three agencies. And if it had been critical to know the identities of Americans caught up in other foreign intelligence efforts, the agencies that collect the information and conduct investigations would have unmasked it. Because they are the agencies that collect and refine intelligence “products” for the rest of the “intelligence community,” they are responsible for any unmasking; and they do it under “minimization” standards that FBI Director James Comey, in recent congressional testimony, described as “obsessive” in their determination to protect the identities and privacy of Americans.

Understand: There would have been no intelligence need for Susan Rice to ask for identities to be unmasked. If there had been a real need to reveal the identities — an intelligence need based on American interests — the unmasking would have been done by the investigating agencies.

The national-security adviser is not an investigator. She is a White House staffer. The president’s staff is a consumer of intelligence, not a generator or collector of it. If Susan Rice was unmasking Americans, it was not to fulfill an intelligence need based on American interests; it was to fulfill a political desire based on Democratic-party interests.

The FBI, CIA, and NSA generate or collect the intelligence in, essentially, three ways: conducting surveillance on suspected agents of foreign powers under the Foreign Intelligence Surveillance Act (FISA), and carrying out more-sweeping collections under two other authorities — a different provision of FISA, and a Reagan-era executive order that has been amended several times over the ensuing decades, EO 12,333.

As Director Comey explained, in answering questions posed by Representative Trey Gowdy (R., S.C.), those three agencies do collection, investigation, and analysis. In general, they handle any necessary unmasking — which, due to the aforementioned privacy obsessiveness, is extremely rare. Unlike Democratic-party operatives whose obsession is vanquishing Republicans, the three agencies have to be concerned about the privacy rights of Americans. If they’re not, their legal authority to collect the intelligence — a vital national-security power — could be severely curtailed when it periodically comes up for review by Congress, as it will later this year.

Why President Trump Should Break the ‘One China’ Spell Standing up for Taiwan, a key democratic ally, will benefit American interests in the long run. By Jianli Yang —****

Accepting the “one China” policy was a meretricious appeasement of Communist China by Kissinger/Nixon which betrayed Taiwan….rsk

— Jianli Yang is the founder and president of Initiatives for China / Citizen Power for China and a former political prisoner of the Chinese government.
During China’s recent “Two sessions,” in which some 5,000 governing elites gathered in Beijing to rubber-stamp the agenda of the Chinese Communist Party (CCP), Wang Hongguang, a retired Chinese general, publicly dared the United States to deploy a Terminal High Altitude Area Defense system (THAAD) in Taiwan. He boasted that the deployment would provide the Chinese People’s Liberation Army (PLA) with an excuse to use force to “liberate” the island.

Wang had earlier dared the U.S. to deploy Marines to guard the site of the American Institute in Taiwan, the de facto American Embassy on the island. He has threatened to use harsh countermeasures to retaliate against the government of Tsai Ing-wen, even though she had nothing to do with the decision to deploy the Marines in Taipei.

Wang’s threats came at the time of a major shift in President Trump’s tone and stance toward China. He has recently retreated from his strong rhetoric against the Chinese Communist regime and from his pre-inauguration position that the U.S doesn’t “have to be bound” by the so-called One China policy.

Trump’s flip-flop on the One China policy has caused unnecessary confusion in Asia. It has weakened the administration’s moral position and credibility and has arguably given Beijing the upper hand in the cross-Strait relationship.

In my view, the One China policy is a trap that has been plied by Beijing to legitimize and strengthen the CCP dictatorship, squeeze Taiwan’s international space, and force Taiwan to kneel at Beijing’s feet. President Trump should take a fresh look at the One China policy, and honor the “right” China.

The contentious One China policy arose from the reality of two Chinas: the Republic of China (ROC) and the People’s Republic of China (PRC). The United States recognized the ROC in 1913, two years after the Chinese overthrew the Manchus’ Qing Dynasty, in 1911. With Stalin’s support, the Chinese Communists won the civil war and founded the People’s Republic of China in 1949. The ROC, led by its authoritarian ruler Chiang Kai-shek, retreated to Taiwan.