- Associated Press - Tuesday, November 24, 2015

The Kansas City Star, Nov. 21

Reject fear-based arguments, support useful refugee programs:

The casualties from the horrific Nov. 13 terrorist attack on Paris were still being counted when U.S. politicians and others honed in on what they consider an immediate threat to national security: Syrian refugees.

More than 30 governors, including Sam Brownback of Kansas, quickly announced that these individuals were not welcome in the states.

From there, the chatter escalated into disgraceful attacks against the Muslim religion and its followers that hearkened to some of the most shameful episodes in U.S. history.

The mayor of Roanoke, Va., cited the use of internment camps for Americans of Japanese descent during World War II to justify his opposition to resettling Syrian refugees in his city - as though that profound act of injustice had been a good move.

On the GOP campaign trail, Donald Trump issued an un-American call for a registry of all Muslims living in the United States. Ben Carson made comments that seemed to equate refugees seeking to enter the U.S. with “a rabid dog running around your neighborhood.”

U.S. Sen. Rand Paul tied up progress on crucial spending bills with an amendment that would ban the use of taxpayer dollars for assistance for newly resettled refugees from 34 troubled nations.

These faith-based bouts of hysteria are surely heartening to the Islamic State and other terrorist movements, whose recruiting efforts rely on young Muslims feeling alienated and disenfranchised.

Concerns about safety in the wake of the Paris attacks are understandable and warranted. A successful attack on U.S. shores would be a prize for any terrorist group, and we depend on U.S. intelligence and law enforcement agencies to prevent that from happening.

But the focus on the refugee resettlement program is misguided.

For one thing, all of the Paris attackers identified so far were European Union nationals. One carried a fake Syrian passport, but authorities do not know whether the man had recently come from that country. There is no indication that he was a refugee.

And unlike many European nations, the U.S. isn’t being swamped by migrants fleeing Syria, Iraq and other war-torn countries. The ocean separating us from those conflicts allows for an exceptionally deliberative selection process.

If the Islamic State wanted to slip an operative into America, posing as a refugee would be the slowest and lowest-percentage way to go about it.

Applicants for resettlement must first pass a United Nations screening process that includes face-to-face interviews, background checks, fingerprinting and other biometric data. Applicants who fall into one of about 45 “categories of concern” regarding their associations and work history in Syria are disqualified.

Those who clear the U.N. screening enter the U.S. vetting process, which involves more interviews, background checks and databases. The process takes at least 18 months and usually longer. Those who finally make it here are screened again upon arrival and after their first year in the country.

For politicians to demand “meaningful security checks,” as Brownback did this week, is like asking for the postal service to deliver the mail. It’s already happening.

People intent on reducing the possibility of terrorists entering the United States would more logically zero in on travelers with student, tourist and work visas. If the Paris attacks are the measure, then people with European Union passports should be suspect.

But let’s not do that. The world is too open and interconnected to allow paranoia about every traveler of a certain nationality.

The best defense against terrorism is not to keep whole groups of people out but to work to make sure that people who are here appreciate and cherish the opportunities and values that come with being in America.

That means we don’t stigmatize people of certain nationalities or religions. We create a pipeline of jobs and education for new arrivals so that we limit the prospects of resentment and radicalization. We give refugees and immigrants a hand up so they can fully engage in American life, not set themselves apart.

We participate in the world community by taking in our share of people fleeing war and oppression. And we benefit from their willingness to work hard and create a better life for their children and grandchildren.

The politicians and commentators who are ginning up this unfounded fear of perhaps the least likely group of people to cause harm to America are ignoring history and current realities. They are allying themselves with the nation’s meanest instinct - to shut out people who are different.

Their unprincipled ambitions and actions are what is to be feared, not legitimate refugees from any land.

___

Jefferson City News-Tribune, Nov. 20

Side effects may include…:

When it comes to health care, who do you trust?

Do you rely on the advice of medical professionals, your own informed research, television advertisements for prescription drugs and medical devices, or some combination of the above?

The American Medical Association (AMA), which represents doctors, recently voted in favor of a ban on what is known as direct-to-consumer (DTC) advertising of prescription drugs and medical devices.

You probably have seen the ads; you may be among viewers who are alienated, or amused, by the litany of side effects.

The AMA is not amused. Although only Congress or the federal Food and Drug Administration is authorized to ban pharmaceutical advertising, the association’s House of Delegates voted to call for the ban.

AMA board chair-elect Patrice A. Harris said the “vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices. Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”

The Pharmaceutical Research and Manufacturers of America disagrees. The trade group’s Tina Stow said the ads offer “scientifically accurate information to patients so that they are better informed about their health care and treatment options.” In addition, she said, the ads lead to “important doctor-patient conversations about health that might otherwise not take place.”

As a rule, we support efforts to help the public become better informed. The case can be made, however, that the ads are designed primarily to persuade.

And persuasion on health care choices prior to, or in the absence of, a conversation with a physician is not healthy or wise.

The rising costs of prescription drugs also supports the AMA’s proposed ban.

Justin Wm. Moyer reported Thursday in the Washington Post: “Though some forms of DTC drug advertising has been permitted for decades, regulatory changes the FDA made to guidelines in 1997 made such spots ubiquitous. Within a decade, the industry’s budget for DTC ads ballooned from little more than $300 million to more than $3 billion.”

That steep rise in costs is making it difficult, or prohibitive, for some patients to afford the drugs their doctors prescribe.

DTC advertising may be healthy for the pharmaceutical industry, but its value to patients is questionable and a known side effect is higher prices.

___

St. Louis Post-Dispatch, Nov. 19

Everyone pays with drug price-gouging:

It is unconscionable - sometimes even deadly - for pharmaceutical companies to jack up the costs of life-saving drugs just because they can.

But, absent meaningful reform of federal regulations, it’s clear that some drug makers - like Turing Pharmaceuticals, which boosted the price of a treatment for parasitic infections from $13.50 a tablet to $750 overnight - will continue to put profits over patients’ lives.

Sen. Claire McCaskill, D-Mo., is leading the charge against such price-gouging. “We need to get to the bottom of why we’re seeing huge spikes in drug prices that seemingly have no relationship to research and development costs,” said Ms. McCaskill, announcing a bipartisan Senate investigation into drug pricing.

Ms. McCaskill is the ranking Democrat on the Senate Special Committee on Aging, which has subpoenaed documents from four pharmaceutical companies that have significantly increased prices on drugs in recent months. They have also asked for the CEO of Turing and other pharmaceutical companies to appear at a hearing on Dec. 9.

This scrutiny is absolutely necessary, some might even say critical. Pharmaceutical companies often justify outlandish prices by pointing to high research and development costs - but Turing didn’t invent Daraprim, the treatment for life-threatening parasitic infections - so that point is moot in this case.

The company acquired the rights to sell the drug, and then immediately boosted the price. This is not, unfortunately, an isolated case. In fact, there is evidence that buying up the rights to old drugs and radically increasing their prices has become a favored business strategy.

Valeant Pharmaceuticals purchased the rights to two heart drugs, Isuprel and Nitropress, then promptly and dramatically raised the costs for both. Even some generic drugs are seeing enormous price hikes: coxycycline, an antibiotic that’s been around for decades, went from $20 a bottle to $1,849.

Such unjustified increases can put needed medications out of the reach of some patients - and can blow holes in state and federal health care budgets. Health insurance companies, not ordinarily the subject of much sympathy, also bear the brunt of this kind of price gouging, and you can bet they will pass a good chunk of the cost onto customers.

A new wave of expensive specialty drugs, like recently approved treatments for hepatitis C and a new class of cholesterol medication, will only add to concerns about rising costs.

An analysis by Avalere Health - paid for by a health insurance industry group - found that 10 new “breakthrough therapies” could cost state and federal governments $50 billion over the next 10 years, with private insurance companies facing similar costs.

Pharmaceuticals can save lives and dramatically improve the treatment of serious illnesses, but unrestrained prices can bankrupt patients and cripple state and federal health care budgets.

Drug companies need to be able to recoup legitimate research and development expenses and make reasonable profits, but Congress must find ways to end the kind of irrational price-gouging exemplified by the Daraprim situation.

Democratic presidential candidates Hillary Clinton and Bernie Sanders have offered proposals to bring down prescription drug costs. Ms. Clinton’s proposal would force drug companies to invest more in research and development, and allow greater use of generics.

“That is not the way the market is supposed to work. That is bad actors making a fortune off of people’s misfortune,” said Ms. Clinton. “Pharmaceutical companies can charge astronomical fees, far beyond anything it would take to recoup their investment.”

Mr. Sanders’ plan would empower Medicare to negotiate drug prices - a long overdue step. The proposal would also allow consumers to order cheaper drugs from Canada and require drug companies to disclose the prices they charge in other countries.

Steps must be taken to end pricing abuses. Ms. Clinton is correct: This is not how the market is supposed to work. If pharmaceutical companies insist on abusing the free market, then regulatory reform is clearly necessary.

___

Hannibal Courier-Post, Nov. 21

Purchasing legal marijuana? Educate yourself first:

Four young men from Indiana sat in the Marion County Jail as of Friday night on drug offenses.

They probably thought they weren’t breaking any laws. A few hundred miles to the west, they weren’t.

According to the Marion County Sheriff, the quartet drove through the Hannibal area en route east, presumably back to Indiana, from Colorado. Deputies found marijuana and marijuana products during a consent search of the vehicle.

Purportedly, the group bought the goods in Colorado, where state law permits the sale, possession and consumption of marijuana.

Not so in Missouri.

Now each man, age 21 or 22, faces a felony.

It’s a harsh lesson learned in the confusing patchwork of marijuana laws in the country. Next door in Illinois, some medical patients can purchase marijuana perfectly legally. Those same patients can’t have those purchased goods in Missouri. Alaska, Washington, Oregon allow recreational use of the drug.

Still a no-no in Missouri.

No matter how your judgment comes down on marijuana use and the various laws which govern it, the deputies in Marion County did the right thing in arresting the four men.

We praise the officers involved for following through with their obligations.

Police do not follow the laws as they wish for them to be. They follow the laws as they are.

It is up to those wishing to engage in behavior that have different consequences from place to places to be cognizant of those differences.

It is up to those people to educate themselves first, not for police to show leniency after the fact.

The fact is, marijuana laws are on an evolving plain. Governing rules wildly vary between the states. These men apparently understood that, as they drove to Colorado - for what reason, we don’t know - where they knew the purchase of marijuana is legal. Ultimately, it was up to them to make sure they understood all the rules involved, including that carrying marijuana out of Colorado could result in serious repercussions.

They learned the hard way.

There’s no doubt marijuana laws will continue to change. The penalty for possessing small amounts of marijuana will become more lenient in Missouri starting in 2017.

Following the current trajectory, marijuana may be legal for recreational use in all states sooner rather than later.

With that in mind, we lament that either a lack of understanding or just plain poor choices has resulted in such major consequences for these young people. This could affect their abilities to get jobs or apply for schools (if they aren’t enrolled right now). A legal choice in Colorado and an illegal one in Missouri will haunt the quartet for a seriously long time.

They certainly learned a lesson.

Hopefully, others seeking to make the same choices will learn a lesson from their mistakes.

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