Daily Digest

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Daily Digest 4/13 - Big Oil Scrambles To Cut Tesla’s Lifeline, Climate Chaos Is Coming

Saturday, April 13, 2019, 12:36 PM

Economy

America’s Upper Middle Class Feeling the Pinch Too (Adam)

As of the end of 2018, net worth as a share of the U.S. total had shrunk considerably for the upper middle class. In one generation, U.S. wealth held by households from 50th to the 90th percentiles fell from 35.2 percent of the total to 29.1 percent. Most of this wealth has transferred to the top 1 percent of U.S. households.

The U.S. Immigration System May Have Reached a Breaking Point (tmn)

Gone are the days when young, strong men waited on the Tijuana River levees for their chance to wade across the water, evade capture and find work for the summer. These days, thousands of people a day simply walk up to the border and surrender. Most of them are from Central America, seeking to escape from gang violence, sexual abuse, death threats and persistent poverty. The smugglers have told them they will be quickly released, as long as they bring a child, and that they will be allowed to remain in the United States for years while they pursue their asylum cases.

The Controversial 1935 Nobel Peace Prize For Speaking Truth to Power (Jesse)

During the years of the Weimar Republic (1919 – 1933), his political commentaries gained him a reputation as a fervent supporter of democracy and a pluralistic society. He was convicted in 1931 of revealing state secrets, the illegal German militarization, and served 18 months in prison. He was released in 1932.

Chinese scientists defend implanting human gene into monkeys' brains (Sparky1)

One of the lead researchers Su Bing, from the Chinese Academy of Sciences' Kunming Institute of Zoology, said the experiment has been reviewed by the university's ethics board and had followed not only Chinese and international best scientific practices, but also international animal rights standards.

Employers Can Buy Retirement Security for $2.64 an Hour (tmn)

But Dalio then went on to present myriad data showing that many Americans make too little money to live on, let alone save, with harmful consequences. He counts among them diminished health, education and economic mobility, high rates of incarceration, and widening wealth and income disparity that raise the risk of social unrest. In an interview with 60 Minutes on Sunday, he called it “a national emergency.”

Capitalism vs. Socialism, Part I (Phil D.)

They will gladly tolerate a higher degree of redistribution on W2 income as long as they can maintain special access to freshly printed money, to buy up and depreciate the assets while charging you rent, variable interest rate spreads, and inflating away their debt burdens.

How the Navy’s Top Commander Botched the Highest-Profile Investigation in Years (jdargis)

Pollio, a Navy attorney, was alarmed. It appeared to her that Richardson had effectively pronounced guilt before trial. And he had done so in public, in front of an audience whose members could conceivably participate in the military’s judicial proceedings.

“I was shocked that he would say that,” Pollio would later recall in court testimony.

Midwest flooding is causing an exodus of U.S. workers (thatchmo)

"It's important to consider that severe weather caused by climate change may have lasting consequences on the economic health and vitality of regions like the Midwest that are already struggling to retain jobs and talent," said Guy Berger, LinkedIn's chief economist.

Big Oil Scrambles To Cut Tesla’s Lifeline (Michael S.)

Now, however, FCA plans to avoid the fines by pooling its vehicle emissions with those of Tesla, A payment of more than one billion dollars, perhaps as much as two billion, would likely convince Tesla to pool with FCA. The additional cash would help Tesla fund another year’s operations as the company now burns around $700 million in cash per quarter.

Trump’s Grudge Against Puerto Rico Is Blocking Needed Disaster Aid Across The US (tmn)

People recovering from natural disasters all across the country, from the West Coast to Puerto Rico to the Midwest and the South, are struggling to rebuild and survive day to day as Congress again failed to pass a disaster relief bill this week, stalled on the president’s unwillingness to provide more disaster relief for Puerto Rico. Congress is now beginning a two-week break through April 29.

Climate Chaos Is Coming — and the Pinkertons Are Ready (tmn)

In the intervening years, the Pinkertons have survived in no small part because of their ability to adapt to the changing landscapes of crime. To differentiate his agency from common bounty hunters, Pinkerton worked to professionalize his ranks with formal attire, pay and badges and created what probably was the first national criminal database. In the following years, as railroads opened up the frontier and settlement brought with it the rule of law, Pinkerton turned to what he saw as the “riotous element” growing in company towns. Between 1877 and 1892, Pinkertons were dispatched to break up some 70 labor strikes — either by going undercover to provide intel, or through brute force.

Gold & Silver

Click to read the PM Daily Market Commentary: 4/12/19

Provided daily by the Peak Prosperity Gold & Silver Group

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2 Comments

sand_puppy's picture
sand_puppy
Status: Diamond Member (Offline)
Joined: Apr 13 2011
Posts: 2141
Sepsis Drug: Anatomy of the way Big Pharm manipulates

One of the most striking discoveries for me was the ways in which the ideals of "science" can be used for power and profit.  

For example:  The Cochrane Collaboration will not include "scientific" studies funded by an industry that profits from the studies conclusions--such studies are designed to be overwhelmingly favorable.

In a lecture on hypertension management, a side-bar included on tricks used so that head-to-head randomized drug trials can be structured to produce the outcome desired.  Assume that a company has a patented NEW DRUG that promises to pay billions in revenues.  But the OLD DRUG is a cheap generic and actually works pretty well.   How can we convince doctors to prescribe NEW DRUG?  We need a "scientific sturdy" published in a "scientific journal" endoresed by a "panel of experts."

1.  If NEW DRUG doesn't last quite 24 hour, then, structure the protocol so that NEW DRUG is given at bedtime and blood pressure checks are done in the early morning, 12 hours later while effect is at its peak.

2.  If NEW DRUG tends to cause nausea, give on a full stomach.

3.  If OLD DRUG causes nausea, insist that it be given on an empty stomach ("to ensure consistent absorption") and which maximizes the reported side-effects and study dropout rates.

4.  Give OLD DRUG at too high a dose (too give lots of side-effects) or too low a dose (so that efficacy is less.)

5.  If NEW DRUG's side effects (like liver inflammation) show up in the 4-6 month time frame, run the study for 3 months only so you can report "no evidence of liver inflammation.")

The New England Journal of Medicine, October 2006,;355(16)1640-1642 Published a wonderful analysis of the high jinks used by the Eli Lilly company to sell its new drug for sepsis, Xigris.  (Xigris turned out to be a really crappy drug with minimal effectiveness and is now off the market.)

Lilly hired a PR firm to guide its marketing.  Its approach:

A.  Marketing initiatives aimed at physicians.

B.  Spread the word that the drug was being rationed because of the drug's cost and physicians were being "systematically forced" to decide who would live and who would die.  As a part of this effort, Lilly awarded a $1.8 million grant to form a task force to address the ethical issues raied by rationing in the ICU.

C.  A panel of "experts" (who just happened to all love Xigris) was convened to author guidelines for sepsis management prominently featuring Xigris which were published in Critical Care Medicine in 2004.   The managing editor of Critical Care Medicine who decided to publish the guidelines did not disclose that he was dual salaried at both the magazine and Eli Lilly.  In the accompanying editorial, CCM also did not mention that the ISDA explicitly refused to endorse the guidelines citing conflict of interest, bias, and lack of evidence for the drug's effectiveness in the role it was recommended for.

D.  Lilly awarded grants for the development of performance assessment bundles which were later embraced by the Center for Medicaid and Medicare Services (CMS).   (A "bundle is a check list of quality measures.)  To ensure high quality care, physicians and hospitals who complete 100% of the CMS sepsis bundle checklist are reimbursed at a higher rate by Medicare.  This is called a "pay for performance" initiative to incentize high quality care (and allows the CMS to define exactly what constitutes such "high quality.")   The sepsis bundles included use of Lilly's drug Xigris.  Physicians and hospitals would then need to use this expensive and useless drug inorder to capture full reimbursement for their ICU sepsis patients.  (Xigris has now been dropped from the bundle.)

This is a story where a Big Pharm company captured a prestigious medical journal, an advisory board of experts, published quality guidelines, and the Medicare reimbursement system.

VeganDB12's picture
VeganDB12
Status: Platinum Member (Offline)
Joined: Jul 18 2008
Posts: 767
wonderful summary

You touched on so many important points. Excellent post. The final sentence is especially important to digest....because it seems to be SOP.  The favored drugs are overly regulated while good generics are harder and harder to come by and spot shortages of essential generics abound. 

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