2016 Presidential Horse Race

2016 Presidential Horse Race


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Wild Bill

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That's not true, banks would take that trade in a second. There is a reason large banks don't want anything to do with these loans. If you let banks choose who, how much and at what terms, then you would definitely see more banks wanting to get into the business. Even if they weren't protected by bankruptcy law and rate.

Libor is only the base rate in which it has to be tied to, the spread over that is the rate of return. That rate of return is capped.

The rate of return is capped but the number is not low. I can't recall the exact amount but it's in the high teens (it's not a handout).

I trust your opinion given your experience within the banking industry. I'm just not certain they would surrender the protection. It would lead to higher rates, of course. But it would also presumably lead to lower volumes of borrowers and decrease the amount of money being borrowed. This would be a better system, in my opinion. Less opportunity for some people but a better overall system. If the banks interests and consumers interest align on this issue, perhaps they'll push congress to make a change.
 

gkIrish

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SoFi. Takes like 3 days to get a response and the app is relatively easy. I've had 2 friends go from between 5-8% to 3.5% each.

I just did a quick pre-application and my interest rate does not really even go down.
 
K

koonja

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I just did a quick pre-application and my interest rate does not really even go down.

That sucks. FYI mine did not go down enough for me to make the switch, but I also am in deferment until 2018 so my interest doesn't currently accumulate.
 

dales5050

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Because their interest rates are kept artificially low. WAY below the rate that would normally be charged for a loan given to someone with so little credit history. So it's NOT "just like every other creditor".

This and if you can't pay for a car they can repo the car. But if you can't pay for school.....

If you could file for bankruptcy to clear student load debt it would be the most common path.

Take out massive loans and then the instant you graduate file. Wait out 7 years in your 20s with shitty credit and pay cash for everything. By the time you round 30 you have no debt. You can rebuild credit in just a couple of years.
 

Legacy

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Republican Revolutionary Wings

Republican Revolutionary Wings

The GOP’s French Revolution
Cruz plays Robespierre, Trump plays Napoleon.


In the famous cartoon depicting the futility and tragedy of the French Revolution, the ringleader of the “Reign of Terror,” Maximilien Robespierre, is shown putting the executioner in the guillotine because there is no one left to behead. The inscription on a monument behind him reads “Herein lies all of France.” For Republicans in 2016, the inscription may as well read “Herein lies our party,” because there is almost no one left to purge.

The most diverse and accomplished field of Republicans candidates in a generation is down to three. Marco Rubio, the charismatic Tea Party senator from Florida, was cast aside for being insufficiently pure. Now, Donald Trump, a demagogic authoritarian strongman posing as a Republican, is on the verge of taking over our party. And the hard truth is that in spite of the complex causes of Trumpism—globalization, wage stagnation, the collective failure of both parties to solve problems, etc.—we, as conservatives, are partly to blame.

The defining media narrative about 2016 has missed what’s been happening within the GOP. The real fight on the right isn’t between outsiders and “the establishment.” Instead, the divide is between two factions of conservatives that emerged in the government shutdown fight over Obamacare in 2013: an American Revolutionary wing of the Tea Party and a French Revolutionary wing of the Tea Party.

These factions differ deeply on what it means to be “anti-establishment.” The Americans believe our Constitution is based on a skepticism and mistrust of federal power. Our institutions, therefore, must continually be co-opted, subverted and renewed for the cause of liberty. The French, on the other hand, believe the only reliable reform is to burn everything to the ground.

The Americans favor persuasion, and tolerate incremental change and principled compromise. The French favor purges, and demand instant gratification and purity. The Americans believe the proper responses to anger are empathy, policy solutions and servant leadership. The French believe anger should be amplified, fomented and used to annihilate weak and impure opponents. The Americans believe in results and what works. The French believe in scorecards and what sells. The Americans are rebels for a cause. The French are the new RINOs—Rebels in Name Only.

The real fight on the right is between an American Revolutionary wing of the Tea Party and a French Revolutionary wing of the Tea Party.

The French revolutionaries found a ringleader in Ted Cruz and his misguided strategy to defund Obamacare in 2013. The Americans initially viewed the shutdown as the launch of Cruz’s presidential campaign—a grandiose but harmless scheme to brand himself as a heroic conservative fighter. What the Americans didn’t anticipate at the time was how ruthlessly and maniacally Cruz and his allies would direct voter anger at the very conservatives who had worked hardest to prevent the passage of Obamacare.
Cruz’s framing of the issue as a fight against the “surrender caucus,” a phrase he used to describe his less pure conservative colleagues, was a nihilistic “Reign of Terror” assault on conservatism. One Tea Party senator privately blasted the effort as an outburst of mini-McCarthyism. Cruz’s gambit was an anti-constitutional, postmodern gesture that asked voters to imagine a political system other than the one our founders had created—a system in which President Barack Obama would give up his signature achievement if Republicans would only “stand firm.” Cruz’s demand for an all-or-nothing frontal assault asked voters to suspend their belief in the system of separation of powers established by our Constitution—a system that typically only permits gradual, incremental change. (It’s worth noting that after the French Revolutionary plan to kill Obamacare failed, the American Revolutionaries, led by Rubio, carried on and struck a targeted but grievous blow to the law by killing a bailout fund for insurance companies.)

Even worse, by condemning senators such as Ron Johnson (R-Wisc.), Richard Burr (R-N.C.) and Kelly Ayotte (R-N.H.) as insufficiently conservative, Cruz demonstrated a willingness to jeopardize the Bill of Rights to further his own political interests. Conservative hopes of protecting free speech, religious liberty and the Second Amendment depend in part on maintaining seats occupied by senators Cruz derided as members of the “surrender caucus.”

In an interview with The New Yorker, Cruz once said, “In both law and politics, I think the essential battle is the meta-battle of framing the narrative.” Cruz is correct about that. But this election cycle he has lost control of his own narrative, and Donald Trump is in control instead. That’s not to say that the narrative has changed. The Cruz effect is the Trump effect. Trump is simply the Napoleon in Cruz’s French Revolution—the strongman who swoops in to bring order out of chaos, and a voice to those angered by the “establishment’s” betrayal and failures.

Yet, instead of building on our gains, the French insisted on perpetuating a fiction that conservatives were a marginalized and victimized minority. Voters had to overthrow the establishment, Cruz insisted, even though Cruz and other conservatives had become a dominant part of that establishment.

And now, Trump threatens to undo everything conservatives have gained. For Trump, conservatism continues to be a second language. True conservatives embrace the apparent paradox of republican governance—we seek to acquire power to limit power. Our goal is to diminish federal control in order to elevate individuals and local communities. For Trump, though, it’s all about Trump and state power. He’s a populist without portfolio or principles—a strongman without ideas and no vision beyond strength.

As the candidate still in the race with the best shot at beating Trump, Cruz has a responsibility to mitigate the damage he helped cause. He needs to forsake his role in the French Revolutionary uprising and rejoin the American faction. Cruz can be forgiven for a being a double-minded politician—an evangelical nihilist—but he can help himself by embracing the rarest of virtues in politics: humility.
 
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dales5050

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That's not entirely accurate. Not all loans are kept artificially low or subsidized to any extent. Most of mine are tied to the LIBOR and the others are fixed at 6.8%, not exactly a handout given the rates right now.


Secured debt, like a home, is low. I am paying 3.65% on my mortgage.

Unsecured debt, which is what a school loan is, goes to the low 20s. So ya...6.8% is an artificially low number.
 

Wild Bill

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Secured debt, like a home, is low. I am paying 3.65% on my mortgage.

Unsecured debt, which is what a school loan is, goes to the low 20s. So ya...6.8% is an artificially low number.

I'm well aware of the distinction. Your estimates for unsecured rates are a bit high. I've been offered unsecured loans for less than 6.8% and I just did a quick google search and found five lenders offering less than 6.8% for an unsecured loan. Of course these are qualified borrowers and a 20 year old with limited credit history probably doesn't qualify.

I prefer a system where these creditors were treated no different than other creditors. I realize that means the increased risk would increase the rates. That's fine by me.
 
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dales5050

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I'm well aware of the distinction. Your estimates for unsecured rates are a bit high. I've been offered unsecured loans for less than 6.8% and I just did a quick google search and found five lenders offering less than 6.8% for an unsecured loan. Of course these are qualified borrowers and a 20 year old with limited credit history probably doesn't qualify.

I prefer a system where these creditors were treated no different than other creditors. I realize that means the increased risk would increase the rates. That's fine by me.

Credit Cards are unsecured debt. A student loan has the same collateral as credit cards.
 

MJ12666

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Exclusive - Transatlantic divide: how U.S. pays three times more for drugs | Reuters



Now I am not saying saying that we should have the exact same prices as the U.K. or that there isn't consequences for lower priced drugs (such as reduced R&D by the companies) but there is little doubt that on average we pay significantly more than other countries for pharmaceuticals. It is one of the reasons that healthcare spending is so high in this country.

ETA: For example we spent almost 400 Billion on pharmaceuticals in 2014, so if we were paying the U.K. prices (and the price difference is similar across all drugs not just the top 20) you are talking a significant amount of savings.

That was not my question. The quote I was asking about related to the government somehow saving an astronomical amount of money based on some type of government efficiency related to purchasing pharmaceuticals. I am pretty sure that is not true but I before I disagree I need to know the rational for this comment.
 
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MJ12666

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Exclusive - Transatlantic divide: how U.S. pays three times more for drugs | Reuters



Now I am not saying saying that we should have the exact same prices as the U.K. or that there isn't consequences for lower priced drugs (such as reduced R&D by the companies) but there is little doubt that on average we pay significantly more than other countries for pharmaceuticals. It is one of the reasons that healthcare spending is so high in this country.

ETA: For example we spent almost 400 Billion on pharmaceuticals in 2014, so if we were paying the U.K. prices (and the price difference is similar across all drugs not just the top 20) you are talking a significant amount of savings.

Americans Spent a Record Amount on Medicine

I went back and read the story. I would need to see exactly how the British organization that completed the study made their calculation, but I believe they compared the US listed wholesale price in the US against UK government negotiated prices. The US listed wholesale price is only paid by small independently owned pharmacies. This is very misleading in that large drug plan distributors in the US do not pay anywhere near the listed wholesale price. If you could compare what they pay against the price paid by the UK governmental agency I do not believe the difference will be that large. The British organization cannot get this lower US price because it is confidential.
 

pkt77242

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That was not my question. The quote I was asking about related to the government somehow saving an astronomical amount of money based on some type of government efficiency related to purchasing pharmaceuticals. I am pretty sure that is not true but I before I disagree I need to know the rational for this comment.

I think that that idea comes from "if" the U.S. had a single payer system. Under that scenario the single payer system would have significant leverage to bargain lower prices. Basically sell it to us at a lower price or you don't get access to the almost 320 million U.S. market. This in theory would lower the price of pharmaceuticals in the U.S. While it is possible that a company wouldn't want to meet the price demands of a single payer system doing so would significantly hurt revenue. Obviously if the demanded price was unreasonable such as losing money on the drug than the company might opt to skip, but if they are selling it in the UK (again single payer system) for significantly less than it tells you there is room to negotiate.
 

kmoose

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I think that that idea comes from "if" the U.S. had a single payer system. Under that scenario the single payer system would have significant leverage to bargain lower prices. Basically sell it to us at a lower price or you don't get access to the almost 320 million U.S. market. This in theory would lower the price of pharmaceuticals in the U.S. While it is possible that a company wouldn't want to meet the price demands of a single payer system doing so would significantly hurt revenue. Obviously if the demanded price was unreasonable such as losing money on the drug than the company might opt to skip, but if they are selling it in the UK (again single payer system) for significantly less than it tells you there is room to negotiate.

Not necessarily. There may be more government mandated quality control procedures in the US than in the UK, making it more expensive to produce doses for the US market. That's the problem with articles like these. They just look at cost, and assume that all other factors are equal. Without comparing the requirements that have to be met, to sell the drug in a specific market, the conclusions are not reliable.
 

Rizzophil

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Trump is a buffoon, a racist, a sexist, a liberal one day and a conservative the next, clueless on MAJOR policy issues, a guy who has given jobs to foreigners and taken his companies to foreign countries instead of giving those jobs to Americans (you know, the same people he claims to love), a narcissist, a fraud, is purposely trying to divide this country between white and non-white (and succeeding, sadly) and just a general awful human being.

I'm not even a Hillary fan, but I'd even take her over Trump. The man is literally rolling out the red carpet to get Hillary into the White House (check the polls), and his followers are too stupid to realize it. Considering how much he has supported Hillary and said how great she was doing in the past, I wouldn't be surprised if he is happy she will win the general. #nevertrump

I didn't vote for Trump but the press conveniently isn't going after Hillary.

1). She constantly lies
2). Her lies about Benghazi killed Americans.
3). She rakes in the cash from foreign sources. Read Clinton Cash.
4). She will continue the job crusher of Obamacare
5). Most probably the worst Secretary of State of all time.
6) Hillary charges unveristities hundreds of thousands of dollars for a speaking engagements and turns around and says education should be free.
7). She blasted all of the women that bill Clinton had sex with as president but now is all about women's rights.
8). She should and will be indicated for breaking US law for classified Intel.
9). Per her emails, she doesn't even know how to use a fax machine.
10). I will never support her in public office. Never.
 

MJ12666

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I think that that idea comes from "if" the U.S. had a single payer system. Under that scenario the single payer system would have significant leverage to bargain lower prices. Basically sell it to us at a lower price or you don't get access to the almost 320 million U.S. market. This in theory would lower the price of pharmaceuticals in the U.S. While it is possible that a company wouldn't want to meet the price demands of a single payer system doing so would significantly hurt revenue. Obviously if the demanded price was unreasonable such as losing money on the drug than the company might opt to skip, but if they are selling it in the UK (again single payer system) for significantly less than it tells you there is room to negotiate.

Let's just assume that he was referring to a single payer system, the saving I do not believe would be as great as you think. This is because, again, the major private drug distributors already get big discounts over listed wholesale prices. Additionally, the common misconception is that drugs purchased under current US government programs are buying at listed wholesale prices since the government is barred from negotiating prices. What is not talked about is that the pharmaceutical companies MUST sell to the government at the lowest wholesale price charged to any private US purchaser during the covered period. If it is discovered that they did not they are subjected to extremely high fines in addition to reimbursing the company for the difference in price. All major pharm companies selling to US government programs (both state and federal) have regulatory departments who monitor this closely so they are compliant with this lowest price regulation and the government routinely conducts audits to ensure compliance. So could a single payer system squeeze some savings? Sure but not as much as you think.
 

Whiskeyjack

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CevvS1lWwAAbIXi.jpg
 

pkt77242

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Not necessarily. There may be more government mandated quality control procedures in the US than in the UK, making it more expensive to produce doses for the US market. That's the problem with articles like these. They just look at cost, and assume that all other factors are equal. Without comparing the requirements that have to be met, to sell the drug in a specific market, the conclusions are not reliable.

Except that isn't the real driver of cost. Even the Pharmaceutical trade companies, say that the increased profits from the U.S. pay for their R&D (they also say that it helps pay for their advertising here in the U.S.). They don't even list the cost of regulations as the reason. Is it possible that there is a slightly higher cost to bring a drug to the market in the U.S. vs. the UK (or the rest of the EU), sure but if it is significant why doesn't it get mentioned by the drug companies? Why isn't the Pharma trade group saying that instead of talking about R&D? If you believe that it costs 3x more to bring a drug to the market in the US (or even 2x more), I have some ocean front property here in AZ to sell you.


Here is an article from the WSJ (not exactly liberal leaning) talking about the high cost of medication in the U.S.
Why the U.S. Pays More Than Other Countries for Drugs - WSJ

Pharmaceuticals cheaper abroad because of regulation - CNN.com


How The US Subsidizes Cheap Drugs For Europe
Pharmaceutical companies have long defended the high price of drugs as necessary to pay for the research and development of new drugs, but the differences in pricing essentially means that consumers in the U.S. are contributing more than those in other countries. The U.S. accounted for 46 percent of global life sciences research and development--the vast majority of which is in biopharmaceuticals--according to the December 2013 issue of R&D Magazine.

“The U.S. is the global leader in biomedical innovation,” Mark Grayson, a spokesman for PhRMA, a pharmaceutical industry trade group that represents many of the world’s biggest drug companies, said in an email. “The research is for medicines that will be sold in the U.S. but obviously will be sold around the world,” he added.
Some also point to excessive sales and marketing costs as pushing up drug prices—and sometimes even exceeding spending on research and development.
Why do Americans spend so much on pharmaceuticals? | PBS NewsHour

Americans also have faster access to new drugs than patients in many other countries. That’s in part because the U.S. has always been a very attractive market for pharmaceutical companies: It’s big, accounting for 34 percent of the world market; has low levels of price regulation; and offers few barriers to market entry once FDA approval has been secured. (By contrast, in some other countries there may be a time lag between clinical approval of a drug and the point when it is added to official lists of reimbursable drugs.)

But if Americans take more pharmaceuticals, they also pay more for them. Prices in the U.S. for brand-name patented drugs are 50 to 60 percent higher than in France and twice as high as in the United Kingdom or Australia. That’s because in many countries, government agencies essentially regulate the prices of medicines and set limits to the amount they will reimburse; they may only agree to pay for a drug if they feel that the price is justified by the therapeutic benefits. This centralized approach can also give them more bargaining power over drug makers.

By contrast, in the U.S. insurers typically accept the price set by the makers for each drug, especially when there is no competition in a therapeutic area, and then cover the cost with high copayments. Where there are competing drugs, insurers enjoy more bargaining power and may negotiate discounts with manufacturers in exchange for lower cost-sharing for patients.
 

pkt77242

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Let's just assume that he was referring to a single payer system, the saving I do not believe would be as great as you think. This is because, again, the major private drug distributors already get big discounts over listed wholesale prices. Additionally, the common misconception is that drugs purchased under current US government programs are buying at listed wholesale prices since the government is barred from negotiating prices. What is not talked about is that the pharmaceutical companies MUST sell to the government at the lowest wholesale price charged to any private US purchaser during the covered period. If it is discovered that they did not they are subjected to extremely high fines in addition to reimbursing the company for the difference in price. All major pharm companies selling to US government programs (both state and federal) have regulatory departments who monitor this closely so they are compliant with this lowest price regulation and the government routinely conducts audits to ensure compliance. So could a single payer system squeeze some savings? Sure but not as much as you think.

You really don't think they could squeeze more savings? I disagree.
Why the U.S. Pays More Than Other Countries for Drugs - WSJ

Look at the chart in this WSJ article and tell me that there couldn't be significant savings. It compares Medicare pricing vs. Norway, UK and Ontario.

Also the VA bargains prices and many times get the prices 10-20% lower and they don't have the bargaining power of the single payer system.
 

NDPhilly

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Trump is a buffoon, a racist, a sexist, a liberal one day and a conservative the next, clueless on MAJOR policy issues, a guy who has given jobs to foreigners and taken his companies to foreign countries instead of giving those jobs to Americans (you know, the same people he claims to love), a narcissist, a fraud, is purposely trying to divide this country between white and non-white (and succeeding, sadly) and just a general awful human being.

I'm not even a Hillary fan, but I'd even take her over Trump. The man is literally rolling out the red carpet to get Hillary into the White House (check the polls), and his followers are too stupid to realize it. Considering how much he has supported Hillary and said how great she was doing in the past, I wouldn't be surprised if he is happy she will win the general. #nevertrump

Yeah but his white make america great again hat goes great with my vineyard vines shirts, salmon pants, and sperrys

Honestly cant decide between Cruz and Kasich for the republican primary. Like Kasich waaaaaaay more, but it feels like a wasted vote.
 

Legacy

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Let's just assume that he was referring to a single payer system, the saving I do not believe would be as great as you think. This is because, again, the major private drug distributors already get big discounts over listed wholesale prices. Additionally, the common misconception is that drugs purchased under current US government programs are buying at listed wholesale prices since the government is barred from negotiating prices. What is not talked about is that the pharmaceutical companies MUST sell to the government at the lowest wholesale price charged to any private US purchaser during the covered period. If it is discovered that they did not they are subjected to extremely high fines in addition to reimbursing the company for the difference in price. All major pharm companies selling to US government programs (both state and federal) have regulatory departments who monitor this closely so they are compliant with this lowest price regulation and the government routinely conducts audits to ensure compliance. So could a single payer system squeeze some savings? Sure but not as much as you think.

U.S. Could Save up to $16B if Medicare Part D Prices are Negotiated: Paper (from Wall Street Journal)

In the latest bid to alter the prescription-drug pricing landscape in the U.S., a new paper argues that the federal government could save between $15.2 billion and $16 billion annually if it negotiated with drug makers for Medicare Part D medicines and obtained the same prices that are paid by Medicaid or the Veterans Health Administration.

In bolstering their case, the authors say that 27 of 31 countries in the Organization for Economic Cooperation and Development have been able to purchase a select group of medications at less than 50% of what is paid in the U.S. They also maintain that U.S. costs per capita for pharmaceuticals are $1,010, which amounts to more than twice the $498 paid, on average, by OECD countries.

“We thought that brand-name medicines were a little bit more expensive for Part D, but we never thought that it would be twice as much as in other developed countries,” Marc-André Gagnon, one of the authors, who is an associate professor in the School of Public Policy and Administration at Carleton University, says in a statement. “It is like pouring money down the drain.”

The paper, which was jointly published by Carleton University and Public Citizen, the advocacy group, notes that Medicare Part D spent $69.3 billion on prescription drugs in 2013, but maintains that most of the spending is for brand-name medicines. For instance, the authors cite research from Avalere Health, a research firm, showing about 58% went to brand-name drugs in 2011.

The Centers for Medicare and Medicaid Services, you may recall, is precluded from negotiating prices for medicines for Medicare Part D. The Bush administration agreed to that provision in exchange for pharmaceutical industry support for the Part D program, which was created in 2006. Ever since, critics have argued that savings could be realized if negotiations with drug makers were permitted

We asked the Pharmaceutical Research & Manufacturers of America for comment and will update you accordingly.

In the past, the industry trade group has addressed such criticism by arguing many Medicare Part D medicines include rebates that are negotiated by private plan sponsors and these have generally increased each year. The trade group has also maintained four out of five prescriptions filled under the program are for lower-cost generic drugs.

Drug makers have also insisted that, by opening the door to price negotiations, they would have fewer incentives to offer favorable rebates to Medicare Part D plan sponsors and this would ultimately lead to higher premiums. From there, they argue, higher premiums would likely cause more people to forego prescriptions, which would result in higher health care costs down the road.

[UPDATE: PhRMA sent this: “Proposals to fundamentally alter the structure of the successful Medicare Part D program would hurt both taxpayers and beneficiaries. Part D program has been widely successful, keeping total costs low – $349 billion lower than initial CBO 10-year projections – through plan competition and negotiation. Robust negotiation occurs in Medicare Part D between plans and biopharmaceutical companies, resulting in substantial rebates, often as much as 20 to 30%, with average rebate levels increasing each year of the program.

“Further, spending on retail prescription medicines has consistently accounted for just 10 percent of U.S. health care spending and is expected to remain stable through the next decade, compared with other OECD countries that spend a higher percentage of their health care dollars on prescription medicines. Proposals that could jeopardize beneficiaries’ access to medicines by driving up premiums, reducing choice and restricting coverage are misguided and misplaced.”]

But the authors of the paper write that Medicare Part D, “even with its rebates, spends 198%, almost twice the median of the amount paid for brand name drugs in the 31 OECD countries. And based on other analyses, even within the U.S., Medicare Part D pays on average 73% more than Medicaid and 80% more than VBA for brand-name drugs.”

They also pointed to a report by the Office of Inspector General at the U.S. Department of Health and Human Services, which found that Medicare Part D plan sponsors underestimated the beneficiary rebates in 69% of their bids for 2008. And this resulted in artificially inflated premiums for Medicare Part D beneficiaries.

And so, the authors make these recommendations: Medicare Part D should reduce brand-name drug prices to at least the level of Medicaid or the Veterans Health Administration; mandatory discounts for drugs that increase over the rate of inflation should be introduced for both brand-name and generic drugs, and mandatory generic substitution for all plans under Medicare Part D should be introduced.

Prices for Brand-Name Drugs
Under Selected Federal Programs
(from the Congressional Budget Office, June, 2005)

At that time, "Purchases of pharmaceuticals by federal and state governments
accounted for over 20 percent of total U.S. expenditures
for outpatient prescription drugs in 2003."

This analysis relates Average Manufacturer Price (AWP) for Brand Name Drugs to those under select federal programs.

The Federal Supply Schedule (FSS) Price Relative to the AWP: 53 Percent
For federal purchasers, the Federal Supply Schedule for
pharmaceuticals program is intended to obtain or beat
the lowest prices negotiated for brand-name drugs between
manufacturers and their most-favored commercial
customers under comparable terms and conditions. The
Department of Veterans Affairs negotiates FSS contracts.

Under the Veterans Health Care Act of 1992, the Congress
also established a separate brand-name drug discount
program for the four largest—the Big Four—federal
purchasers of pharmaceuticals: VA, DoD, PHS
(including the Indian Health Service), and the Coast
Guard.13 The Big Four account for more than 95 percent
of purchases made under FSS contracts.

For single-source brand-name prescription drugs, CBO
estimates that the price available to the Big Four is about
49 percent of the AWP, on average.
 
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Whiskeyjack

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Here's an article from The American Interest titled "Immigration and the Political Explosion of 2016":

GOP politicos and pundits looking on in horror as Donald Trump lays waste to the Republican Party had better brace themselves: immigration fights can dominate and disrupt the politics of an entire generation in America. It has happened before.

Twice previously in U.S. history, concerns over mass immigration have combined with a growing sense of social and economic crisis to wreak havoc on the political status quo. Popular reactions against the Irish immigration (c. 1830-1860) and the so-called “Great Wave” from Southern and Eastern Europe (1880-1924) became potent political movements when a segment of the American public connected the immigration issue to deeper questions about the economy, community, and national identity. These movements destroyed or took over old parties, changed the national agenda, and altered the course of our history. Now, as concern over the breakdown of the Blue Model intersects with anger about mass immigration, we are experiencing a third such crisis in American politics.

Immigration by itself isn’t the problem; rather, when a wave of mass immigration coincides with deep and painful structural changes in American life, then parties explode and history changes. When the mass of Americans feel the economic ground shifting under their feet and fear for their livelihoods, when the financial sector seems out of control, when social and civic equality seems threatened by economic polarization as the country’s religious identity seems to be shifting, when security threats appear to be rising while politically empowered plutocrats conspire to lower middle class incomes and competition from cheap foreign labor threatens American jobs, politicians need to watch out. These are the times when the issue of mass immigration explodes onto the political scene to disrupt politics and challenge the party system.

In the 1830s large numbers of Irish immigrants, driven by poverty and oppression, began to arrive in the United States. This stream swelled to flood proportions when the Potato Famine hit the Emerald Isle in 1845. The newcomers were dirt-poor and suspiciously Catholic (and accompanied by a smaller but significant number of Catholics from southern Germany, who also began to immigrate in large numbers around then). America until that time had had only a small Catholic population, and our Protestant working class held a series of centuries-old prejudices against Catholicism (as the enemy of liberty) and the Catholic Irish in particular (as the traditional enemy of the English and the Scots-Irish ethnic groups that made up much of the native-born American population).

The Catholic newcomers entered an America that was already primed for political turmoil. Anger at elites and suspicion of high finance had fueled the Jacksonian revolt and Old Hickory’s war against the Second National Bank in the 1830s. The early stages of industrialization were beginning to undermine the role of the independent small craftsmen in the cities, pointing toward a future in which permanent service to another (factory employment), rather than a cycle of apprenticeship and then self-employment, would become the norm. This was also a period of relatively free trade: in 1844, Congress passed the Walker tariff, significantly lowering trade duties (these would be lowered further in 1857). This measure, along with the repeal of the British Corn Laws, significantly boosted international trade—a process which, as we have learned, has losers as well as winners.

But the biggest question was that of slavery—which for many Americans was first and foremost a question of national identity, of the structure of the union, and of the economic basis of the country: would America become a nation of free farmers, or of slaves and masters? As slavery spread into the newly acquired territories in the West, citizens in the the north and old northwest feared being swamped by the spread of “slave power,” whereby slave owners could first muscle them out economically from the rich farmlands of the west and then, holding an increasing number of the states, dominate the nation politically. While many increasingly recognized the moral evil of slavery, others saw it as a question of how America’s traditional northern citizens (free, white, Protestant, self-governing men) would be able to live. They cared less about the fate of black Americans (whom often they were eager to keep away—Abraham Lincoln’s Illinois made it a crime to help a free black man enter the state, for instance) than about the fate of the white, Protestant American folk group.

When men who thought along these lines looked South, they saw plantation owners conspiring to undercut them with slaves; when they looked east, they saw plutocrats trying to undercut them with immigrant labor, and ‘doughfaced’ northern business leaders in collusion with Southern planters. Everywhere, fat cats and politicians neglected and conspired against the ordinary American working man and a new, well-educated, well-connected social elite seemed to be entrenching itself in political power.

For about two decades, the wave of Catholic immigration had prompted a growing but disorganized nativist reaction, one that manifested itself in angry editorials, local political fights, and even street violence, but not a national political movement. Then, as both the immigration and slavery issues came to a head around the same time, a portion of the northern middle and working classes freaked out. In the early 1850s, these forces coalesced suddenly and rapidly into the American Party, better remembered as the Know-Nothing Party. The Know-Nothings were stridently anti-Catholic and anti-immigrant, with a heavy rhetorical focus on national unity. But they lacked experienced political leadership, and their other policies were a grab bag of popular but often-contradictory proposals. (Sound familiar?) The new Party seized control of the Massachusetts state legislature in 1854, gained ground quickly elsewhere, and, running former President Millard Fillmore (who was nominated without his knowledge, while he was traveling abroad), won the state of Maryland in the presidential election of 1856.

The rise of the Know-Nothings marked and consummated the downfall of the Second Party System. The Know-Nothings emerged from the rapidly decaying Whig base and cannibalized a good deal of what was remained of the old American right. But the new party did not live to benefit from its own success. The Know-Nothings had misjudged which of the two elements of the crisis was the most important issue of their day. Unable to formulate a response to the slavery question that satisfied their northern and southern members, the party fell apart as rapidly as it had risen. (They were supplanted by the Republicans—who pointedly eschewed their nativism in favor of a broader conception of the American ideal.)

In many ways, Know-Nothingism had represented an attempt to avert the coming crack-up of the Union by going back to what had (in the view of its supporters) made America great—Anglo-Saxon Protestantism, with a heavy emphasis on national unity. This was wishful thinking: barring Catholics, enacting populist measures, and hoping really hard for national unity wasn’t going to make the issue of slavery fade away in the late 1850s. But Know Nothingism’s political appeal was, for a brief moment, undeniable. It took the Civil War to drive the immigration issue off center stage.

Anti-immigrant sentiment continued to roil the country even, as fans of the movie Gangs of New York will know, in the midst of the Civil War. A big drop in Irish immigration during the 1860s and 1870s quieted the immigration controversy in the aftermath of the conflict, and for the next generation, immigration remained a relatively unimportant issue.
Then, starting in 1880, a combination of czarist oppression, grinding poverty, the spread of railroads and steamships (which drastically reduced the price and increased the safety of travel), and the lure of opportunity in America (which was in the full swing of industrialization and westward expansion) caused millions upon millions of Eastern and Southern Europeans to head for America’s shores. By no means were the newcomers entirely unwelcome: the U.S. needed warm bodies in its factories and on its frontier. But the immigrants were conspicuously foreign in religion (Orthodox Jewish, Roman Catholic, or Orthodox Christian), dress, and manner, and they flooded into American cities in numbers never seen before. This “Great Wave,” or “New Immigration,” grew to overshadow other issues in public life, just as the old had. And, as the pressures of the Industrial Revolution grew, and the agrarian way of life that had long been the pillar of American prosperity began to break down, immigration would once more surge into the forefront of American politics.

The “Great Wave” came at a time of rising social stress. From the 1890 census, which declared the frontier officially “closed”, onward, the family farm rapidly declined as a source of mass employment. Farmers made up half of America’s labor force in 1880, but only 20% by 1930 (and trending downward). This “disrupted,” as we’d now say, the employment model for several generations of Americans. It also prompted a new crisis of national identity. Since the Revolution, Americans had seen themselves as a country of yeoman-farmers. The Northern victory in the Civil War, and the race to populate the West, had engrained this idea even deeper. Now, the farmer was disappearing. And it would be some time before the idea of the factory worker as blue-collar provider overtook the image of the independent farmer as the core way in which the American citizen saw himself.

In the meantime, this uncertainty provoked an ambient sense of crisis. The struggling, native-born farmers of the south and midwest looked to the northeast and saw a conspiracy of plutocrats beggaring his kind through powerful corporations and banks. The development of the vast farmlands of Argentina, Canada, Australia and elsewhere, the improvement of agricultural technology, and advances in shipping all exerted deflationary pressure that increased farmers’ anger. A series of financial crises—in which the big corporations benefitted from bailouts while ordinary borrowers and savers lost everything they had—undermined public confidence in the wisdom and the fairness of those who managed the economic machine. The Populist movement grew out of such feelings, and while it failed as an independent party, its grievances increasingly were given a hearing by Democrats.

The West and Midwest were among some of the earliest and most stridently anti-immigrant areas throughout this period, despite (as historians have often noted with some level of puzzlement) relatively low levels of immigrant population. Two factors likely influenced this. The immigrants were once again seen as supporting the economic interests of the Eastern plutocrats, and the immigrants again organized urban political machines. Increasingly, these machines dominated the national political scene at the expense of rural states and regions, particularly as the demographic weight of the country shifted to the cities.
But this was by no means all. It is impossible to think of almost any political question or movement during this period not touched by the combined controversies of the new immigration and national identity. The labor movement at first swung pro-immigrant (incurring the wrathful opposition of industrialists, who alleged—not without reason—that the immigrants contained a significant socialist minority), but, as immigrants were seen as forcing down wages and making it easier for management to fight unions, organized labor turned restrictionist. Progressivism in each party was fueled by a need to control the unwashed mob and stop them from spreading disease—but also from drinking (Prohibition), breeding (sterilization), and spreading foreign superstition in parochial schools. And immigration again contained a national security element, at first during the Anarchist scare of the late 19th century (during which the slayings of half a dozen European heads of state filled the newspapers, Leon Czolgosz assassinated President McKinley, and terrorists made several attempts on the lives of prominent industrialists such as John D. Rockefeller.) Later, following the Russian Revolution in 1917, Americans were concerned about the threat from Communists coming over among the immigrants.

In fits and starts in the 1880s and 1890s, and then in sustained fashion from approximately 1907 onward until 1924, huge fights over the Great Wave raged in Washington and across the nation. Smaller, symbolic votes didn’t buy off the restrictionists. (Though something as big—and ugly—as the Chinese Exclusion Act, which was passed in 1882 at the behest of West Coast restrictionists, did placate some of them.) Nor did failed restrictionist efforts on the national stage end the fight: two restrictionist bills were passed by Congress but vetoed by President Taft in 1912 and President Wilson in 1915. But restrictionists kept gaining ground: what had once been bipartisan opposition became bipartisan support for restrictionism. In 1917, Congress overrode a Presidential veto and passed a literacy test for would-be immigrants. Then in 1921 and 1924, two quota acts hammered the Golden Door shut. The 1924 Act shut down immigration to the U.S. almost completely for two generations, from 1924 to 1965; not even the persecutions of the 1930s or the revelations of the Holocaust after WWII were sufficient to break the anti-immigration consensus that had hardened across right and left, from elites and populists, during the preceding generation.

Not only did the restrictionists in 1924, unlike in 1856, achieve their aim; on their way to victory, they transformed both parties. Neither party came out of the 1880-1924 period looking the same as it went in, but the Democrats were particularly affected. As many modern Republicans are now recalling with horror, the Democrats went into their convention in 1924 deeply split, with the Klan endorsing one of the two leading candidates in order to block the other, Al Smith, the Catholic governor of New York, from becoming President. The “Klanbake,” as the convention came to be called, went to 103 ballots in Madison Square Garden, while 20,000 Klansmen held a cookout on the banks of the Hudson River. The splits between populists and elites, immigrants and nativists, Progressives and traditionalists that the Party had until then papered over (Democrats had held the White House only four years previously) were on full display as the convention dissolved into chaos. The eventual winner, a Kasich-style compromise candidate, went on to post 28% at the polls that November. And while the Democratic Party—unlike the old Whigs—survived and eventually recovered, you have to take into account that full restrictionism went into effect after that same year. The end of mass immigration allowed the wounded Democratic Party to survive, barely, until it was rescued by the Depression in 1932.

Now we are in the middle of another great wave. Since 1965, when Congress passed the Hart-Celler Act and reopened the doors to mass immigration (this time largely from the Western hemisphere and Asia), 59 million new immigrants have arrived in the United States. These immigrants form 18.9% of the current population; if you include children born to them, there have been 79 million newcomers, comprising 24.7% of the population.

Like the last two waves, this one has caused significant changes in the ethnic and religious makeup of America, and has affected the composition of many local communities even more drastically. But also like the last two waves, it has continued for several decades without, until now, provoking a political crisis. Just as in 1830s and ’40s and 1880s-1900s, a combination of the sense that in general, things have been going well for the American middle class throughout this period and that there were other, unrelated things to worry about (the Cold War did not, for instance, have a significant immigration component) have kept immigration politics relatively calm. It has been treated largely as one issue among many, albeit at times an important one, rather than a potential party-breaker.
But now, as the Blue Model breaks down—as manufacturing and white-collar clerical work no longer provides mass employment, as local governmental services decay, and as the national and local sense of community frays—we have a major political disruption. This is likely not a coincidence.

The factory jobs that replaced the family farm as the unit of employment and identity for many Americans have gone away—and they are never coming back. Competition from China was part of this—but only part. Automation is now stealing jobs even from China. Factory jobs in the old sense—picking up hubcaps and sticking them to each car that comes down the assembly line, while someone else drills the nuts into place—are increasingly rare everywhere, because that’s what robots are for. (This is why, as FiveThirtyEight recently pointed out, while manufacturing as measured by value added has risen 20% in the U.S. since 2009, manufacturing employment has only risen 5%.) And likewise, computers are destroying millions of clerical jobs that used to be the lower-middle-class, white-collar equivalent of factory work. The housing bubble probably papered the effects of this over for a little while, and the immediate economic emergency of the Great Recession took the blame for a few more years. But no longer.

Just as how at the turn of the 20th century, people failed to see how factory work would thoroughly replace family farming as the source of American income and identity, so too today we struggle to foresee what will come after “Allentown.” As then, so too now the opening of global markets has exacerbated this problem in certain regions. Other problems of the 1850s and 1900s-20s also exist. As the chasm between educated elites and the middle class is exacerbated by the tech revolution, concerns about inequality have increased. Due in part to the particulars of the 2008 crash, those who have lost most from many of the recent structural economic changes are increasingly convinced they are being conspired against by financial elites and politicians, as well as just left behind. And terrorism has yet again tied immigration to national security.
The same ingredients that fueled the political explosions of the 1850s and the 1920s have come together again. Each of these issues—mass immigration, employment, local community makeup, homeland security, and national identity—are highly sensitive for average Americans. People, including or perhaps even especially those who are not usually politically active, care deeply about them. When all of them are in flux at once, as we have seen, they can combine to create political explosions. This is the third such crisis, and we shouldn’t expect it to quietly die down. History says that those concerned about the future of the Republican Party are right to worry: in times like ours, immigration is a potent enough issue to break a party and provoke a realignment.

And here's an article by the NYT's Ross Douthat titled "#NeverReformConservatism at The Wall Street Journal":

I see that the Wall Street Journal editorial page has risen to the defense of House Speaker Paul Ryan’s relatively muted response to Trumpism, and what they’ve come up with is quite … revealing. In my deliberately tart critique of Ryan and the rest of the G.O.P. leadership, I suggested that he and other prominent conservatives were taking a “first, change nothing; second, do nothing” approach to the challenge of Trumpism, and essentially lying still and hoping the danger would pass over. The Journal’s counter-argument is a straightforward endorsement of exactly that approach: Trumpism too shall pass, the editorial avers, and in the mean time the important thing is to maintain the purity of Journal-approved conservatism, and to refuse any aid and comfort to all those deviationists and splittists who think that the party might not have exactly the right economic agenda for the voters and the times.

To #NeverTrump conservatives, then, the Journal offers at best an eyeroll at their passion; the important thing, now and always, is to be #NeverReformConservatism.

Do I exaggerate? Let’s work our way through the editorial, which defends the House Speaker against “a cast of conservative intellectuals who don’t like Mr. Ryan because he continues to believe in the Ronald Reagan-Jack Kemp vision of a tax-reforming, free-market GOP that focuses on economic growth.”

This description is, to begin with, absurd, since if the “cast” of intellectuals they have in mind is larger than just yours truly — though if I may be a little immodest, I do believe that I’m the primary target of the piece — it presumably includes figures like Yuval Levin and Jim Pethokoukis, who between them have written more words in praise of Ryan over the years than I can count … but I digress.

These nefarious intellectuals, the Journal continues, would “love to volunteer Mr. Ryan for a kamikaze political mission that leaves someone else to pick up the rubble in 2020.” That’s because we’re scheming to replace the pure faith of Kemp and Reagan with “a policy mix to address income inequality and promote redistribution … rather than aiming for faster growth” (again not quite an accurate description but what do you expect from an editorial too smug to even name the people it’s criticizing?), an agenda which Marco Rubio supposedly went all-in for this year (never mind that his tax plan also catered heavily to the Journal’s idées fixes and his Kempism on immigration clearly helped keep him from the nomination), and which we hope to impose on the party as a whole once we’ve sent Ryan spiraling into the U.S.S. Donald Trump.

But Ryan is too smart for our machinations:

Mr. Ryan is doing fine on his own … The Speaker hasn’t hesitated to condemn Mr. Trump’s bad ideas on the merits as they arise, including his Muslim travel ban. But Mr. Ryan also has other obligations, not least protecting the GOP from larger damage this election year.

Start with his role as chairman of the Republican National Convention in Cleveland, which could be contested for the first time in decades. He’s officially neutral, and he’ll undermine his credibility and impartiality if he joins the never-Trump clique—especially when the Trump campaign is already warning of riots and building a stabbed-in-the-back narrative if their man doesn’t get the nomination.

If Mr. Trump is the nominee, then Mr. Ryan must defend his party’s best interests. This means above all protecting the House majority that polls show a Trump nomination could imperil. If Mrs. Clinton is elected President and Chuck Schumer runs the Senate, a GOP House is the only defense against a policy repeat of 2009-2010. Mr. Ryan can’t simply write off the GOP nominee and the millions of votes Mr. Trump has won.

The House GOP’s role will also be crucial if Mr. Trump wins in November. The businessman has no fixed principles we can detect, and a GOP Congress would have to steer him away from his worst instincts on trade, immigration and isolationism.

This is, I must say, some ripely delusional stuff. Ryan has to appear neutral because Trump is threatening riots? I’m old enough to remember when the Journal editorial page opposed appeasement! Ryan shouldn’t risk any kind of rupture because if Trump is the nominee a Republican civil war might cost the G.O.P. the House? Trump as the nominee is itself the thing that might cost the GOP the House! Ryan should stand ready to “steer” a President Trump away from “his worst instincts”? I mean, there isn’t going to be a President Trump … but if there were, what does it say about the Journal’s editorial page, allegedly a bastion of liberty and cosmopolitan conservatism, that it wants the heir of Kemp and Reagan to keep his options open and his hands undirtied with #neverTrumpism, just in case he might get the chance to help an illiberal race-baiting violence-abetting war crimes-endorsing demagogue pass, I dunno, the biggest supply-side tax cut in the history of the Laffer Curve?

What it says is that the Journal has its eyes on the real enemy here. Say what you Trump’s protectionist “Bush lied, people died” white identity politics, at least he didn’t endorse a larger child tax credit:

The irony is that many of the same pundits now demanding that Mr. Ryan become their sword against Mr. Trump also praised the New Yorker last summer for his challenge to GOP orthodoxy. These former Trump apologists claimed the GOP should absorb his rage against the status quo. Instead of income-tax rate cuts, get behind family-friendly tax credits. Make peace with the entitlement state. Restrict trade and immigration allegedly to lift blue-collar wages. Alas for these would-be king-makers, Mr. Trump doesn’t take much advice.

Projection is a remarkable thing. For the record: The early anti-anti-Trumpism of certain reform conservatives (my own and to some extent others) largely consisted of comparing Trump to George Wallace and wishing for a Nixon, and the adaptationist “advice” we gave was entirely directed at other Republican politicians, not the Donald. Meanwhile as Trump’s demagoguery escalated it was the Journal’s longtime fellow travelers in the supply-side movement who explicitly warmed to him, and it’s the Journal itself, in this very editorial, that still seems hopeful that Speaker Paul Ryan can write amazing bills for President Trump to rubber-stamp.

Alas for these would-be king-makers … well, you know.

Then, finally, we have this:

The Trump insurgency has a long way to play out, and someone else could still win the GOP nomination. But whatever happens, Mr. Ryan and his political allies will have to limit the policy and political damage. That means preserving a vision of the GOP as a pro-growth, reform party that is inclusive and meets the challenges of the current era. Mr. Ryan knows how to do that better than his critics do.

In other words: Do nothing, change nothing, and hope Trump simply does his destructive work and passes on. And if the party is reduced to actual rubble in the process, well, the important thing is that the purity of a policy vision from thirty-five years ago has been preserved in its pristine, handed-down-from-heaven form.

The best that can be said of this “strategy” is that it aspires to follow the fourth path for G.O.P. elites that David Frum (if I may quote a splittist even more defective in his interpretation of Reaganism than the reform conservatives) laid out in his essay on the Republican Party’s rendezvous with Trumpism; it redefines “political victory” to just mean “what we have, we hold,” and treats the presidency “as one of those things that is good to have but not a must-have, especially if obtaining it requires uncomfortable change.” Better to reign in the House, in this theory, than to ever compromise your way to something more; better to hunker down and hope to live through Trumpism than to sully the purity of supply-side ideas and donor priorities with anything that might pander to all the “lucky duckies” in the government-addicted 47 percent.

But even that gives the Journal’s vision too much credit, because a “do nothing/change nothing/let Trump stomp around” approach isn’t even a good strategy for holding the House of Representatives, let alone the Senate (and farewell and adieu to the Supreme Court, farewell and adieu to you ladies of Spain …).

No: It’s only a good strategy if your primary obsession isn’t the actual fate of conservatism, but your own power and influence within whatever rump remains.

Which is why there’s only one answer to the Journal’s strange brief against reform conservatism, its insinuations against all those unnamed “intellectuals” (hi!) who want to undermine Paul Ryan’s political position and conservatism’s future for the sake of a narrow ideological agenda: Physician, heal thyself.

Intellectually bankrupt.
 

Whiskeyjack

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Here's an article from The American Interest titled "Immigration and the Political Explosion of 2016":

GOP politicos and pundits looking on in horror as Donald Trump lays waste to the Republican Party had better brace themselves: immigration fights can dominate and disrupt the politics of an entire generation in America. It has happened before.

Twice previously in U.S. history, concerns over mass immigration have combined with a growing sense of social and economic crisis to wreak havoc on the political status quo. Popular reactions against the Irish immigration (c. 1830-1860) and the so-called “Great Wave” from Southern and Eastern Europe (1880-1924) became potent political movements when a segment of the American public connected the immigration issue to deeper questions about the economy, community, and national identity. These movements destroyed or took over old parties, changed the national agenda, and altered the course of our history. Now, as concern over the breakdown of the Blue Model intersects with anger about mass immigration, we are experiencing a third such crisis in American politics.

Immigration by itself isn’t the problem; rather, when a wave of mass immigration coincides with deep and painful structural changes in American life, then parties explode and history changes. When the mass of Americans feel the economic ground shifting under their feet and fear for their livelihoods, when the financial sector seems out of control, when social and civic equality seems threatened by economic polarization as the country’s religious identity seems to be shifting, when security threats appear to be rising while politically empowered plutocrats conspire to lower middle class incomes and competition from cheap foreign labor threatens American jobs, politicians need to watch out. These are the times when the issue of mass immigration explodes onto the political scene to disrupt politics and challenge the party system.

In the 1830s large numbers of Irish immigrants, driven by poverty and oppression, began to arrive in the United States. This stream swelled to flood proportions when the Potato Famine hit the Emerald Isle in 1845. The newcomers were dirt-poor and suspiciously Catholic (and accompanied by a smaller but significant number of Catholics from southern Germany, who also began to immigrate in large numbers around then). America until that time had had only a small Catholic population, and our Protestant working class held a series of centuries-old prejudices against Catholicism (as the enemy of liberty) and the Catholic Irish in particular (as the traditional enemy of the English and the Scots-Irish ethnic groups that made up much of the native-born American population).

The Catholic newcomers entered an America that was already primed for political turmoil. Anger at elites and suspicion of high finance had fueled the Jacksonian revolt and Old Hickory’s war against the Second National Bank in the 1830s. The early stages of industrialization were beginning to undermine the role of the independent small craftsmen in the cities, pointing toward a future in which permanent service to another (factory employment), rather than a cycle of apprenticeship and then self-employment, would become the norm. This was also a period of relatively free trade: in 1844, Congress passed the Walker tariff, significantly lowering trade duties (these would be lowered further in 1857). This measure, along with the repeal of the British Corn Laws, significantly boosted international trade—a process which, as we have learned, has losers as well as winners.

But the biggest question was that of slavery—which for many Americans was first and foremost a question of national identity, of the structure of the union, and of the economic basis of the country: would America become a nation of free farmers, or of slaves and masters? As slavery spread into the newly acquired territories in the West, citizens in the the north and old northwest feared being swamped by the spread of “slave power,” whereby slave owners could first muscle them out economically from the rich farmlands of the west and then, holding an increasing number of the states, dominate the nation politically. While many increasingly recognized the moral evil of slavery, others saw it as a question of how America’s traditional northern citizens (free, white, Protestant, self-governing men) would be able to live. They cared less about the fate of black Americans (whom often they were eager to keep away—Abraham Lincoln’s Illinois made it a crime to help a free black man enter the state, for instance) than about the fate of the white, Protestant American folk group.

When men who thought along these lines looked South, they saw plantation owners conspiring to undercut them with slaves; when they looked east, they saw plutocrats trying to undercut them with immigrant labor, and ‘doughfaced’ northern business leaders in collusion with Southern planters. Everywhere, fat cats and politicians neglected and conspired against the ordinary American working man and a new, well-educated, well-connected social elite seemed to be entrenching itself in political power.

For about two decades, the wave of Catholic immigration had prompted a growing but disorganized nativist reaction, one that manifested itself in angry editorials, local political fights, and even street violence, but not a national political movement. Then, as both the immigration and slavery issues came to a head around the same time, a portion of the northern middle and working classes freaked out. In the early 1850s, these forces coalesced suddenly and rapidly into the American Party, better remembered as the Know-Nothing Party. The Know-Nothings were stridently anti-Catholic and anti-immigrant, with a heavy rhetorical focus on national unity. But they lacked experienced political leadership, and their other policies were a grab bag of popular but often-contradictory proposals. (Sound familiar?) The new Party seized control of the Massachusetts state legislature in 1854, gained ground quickly elsewhere, and, running former President Millard Fillmore (who was nominated without his knowledge, while he was traveling abroad), won the state of Maryland in the presidential election of 1856.

The rise of the Know-Nothings marked and consummated the downfall of the Second Party System. The Know-Nothings emerged from the rapidly decaying Whig base and cannibalized a good deal of what was remained of the old American right. But the new party did not live to benefit from its own success. The Know-Nothings had misjudged which of the two elements of the crisis was the most important issue of their day. Unable to formulate a response to the slavery question that satisfied their northern and southern members, the party fell apart as rapidly as it had risen. (They were supplanted by the Republicans—who pointedly eschewed their nativism in favor of a broader conception of the American ideal.)

In many ways, Know-Nothingism had represented an attempt to avert the coming crack-up of the Union by going back to what had (in the view of its supporters) made America great—Anglo-Saxon Protestantism, with a heavy emphasis on national unity. This was wishful thinking: barring Catholics, enacting populist measures, and hoping really hard for national unity wasn’t going to make the issue of slavery fade away in the late 1850s. But Know Nothingism’s political appeal was, for a brief moment, undeniable. It took the Civil War to drive the immigration issue off center stage.

Anti-immigrant sentiment continued to roil the country even, as fans of the movie Gangs of New York will know, in the midst of the Civil War. A big drop in Irish immigration during the 1860s and 1870s quieted the immigration controversy in the aftermath of the conflict, and for the next generation, immigration remained a relatively unimportant issue.

Then, starting in 1880, a combination of czarist oppression, grinding poverty, the spread of railroads and steamships (which drastically reduced the price and increased the safety of travel), and the lure of opportunity in America (which was in the full swing of industrialization and westward expansion) caused millions upon millions of Eastern and Southern Europeans to head for America’s shores. By no means were the newcomers entirely unwelcome: the U.S. needed warm bodies in its factories and on its frontier. But the immigrants were conspicuously foreign in religion (Orthodox Jewish, Roman Catholic, or Orthodox Christian), dress, and manner, and they flooded into American cities in numbers never seen before. This “Great Wave,” or “New Immigration,” grew to overshadow other issues in public life, just as the old had. And, as the pressures of the Industrial Revolution grew, and the agrarian way of life that had long been the pillar of American prosperity began to break down, immigration would once more surge into the forefront of American politics.

The “Great Wave” came at a time of rising social stress. From the 1890 census, which declared the frontier officially “closed”, onward, the family farm rapidly declined as a source of mass employment. Farmers made up half of America’s labor force in 1880, but only 20% by 1930 (and trending downward). This “disrupted,” as we’d now say, the employment model for several generations of Americans. It also prompted a new crisis of national identity. Since the Revolution, Americans had seen themselves as a country of yeoman-farmers. The Northern victory in the Civil War, and the race to populate the West, had engrained this idea even deeper. Now, the farmer was disappearing. And it would be some time before the idea of the factory worker as blue-collar provider overtook the image of the independent farmer as the core way in which the American citizen saw himself.

In the meantime, this uncertainty provoked an ambient sense of crisis. The struggling, native-born farmers of the south and midwest looked to the northeast and saw a conspiracy of plutocrats beggaring his kind through powerful corporations and banks. The development of the vast farmlands of Argentina, Canada, Australia and elsewhere, the improvement of agricultural technology, and advances in shipping all exerted deflationary pressure that increased farmers’ anger. A series of financial crises—in which the big corporations benefitted from bailouts while ordinary borrowers and savers lost everything they had—undermined public confidence in the wisdom and the fairness of those who managed the economic machine. The Populist movement grew out of such feelings, and while it failed as an independent party, its grievances increasingly were given a hearing by Democrats.

The West and Midwest were among some of the earliest and most stridently anti-immigrant areas throughout this period, despite (as historians have often noted with some level of puzzlement) relatively low levels of immigrant population. Two factors likely influenced this. The immigrants were once again seen as supporting the economic interests of the Eastern plutocrats, and the immigrants again organized urban political machines. Increasingly, these machines dominated the national political scene at the expense of rural states and regions, particularly as the demographic weight of the country shifted to the cities.

But this was by no means all. It is impossible to think of almost any political question or movement during this period not touched by the combined controversies of the new immigration and national identity. The labor movement at first swung pro-immigrant (incurring the wrathful opposition of industrialists, who alleged—not without reason—that the immigrants contained a significant socialist minority), but, as immigrants were seen as forcing down wages and making it easier for management to fight unions, organized labor turned restrictionist. Progressivism in each party was fueled by a need to control the unwashed mob and stop them from spreading disease—but also from drinking (Prohibition), breeding (sterilization), and spreading foreign superstition in parochial schools. And immigration again contained a national security element, at first during the Anarchist scare of the late 19th century (during which the slayings of half a dozen European heads of state filled the newspapers, Leon Czolgosz assassinated President McKinley, and terrorists made several attempts on the lives of prominent industrialists such as John D. Rockefeller.) Later, following the Russian Revolution in 1917, Americans were concerned about the threat from Communists coming over among the immigrants.

In fits and starts in the 1880s and 1890s, and then in sustained fashion from approximately 1907 onward until 1924, huge fights over the Great Wave raged in Washington and across the nation. Smaller, symbolic votes didn’t buy off the restrictionists. (Though something as big—and ugly—as the Chinese Exclusion Act, which was passed in 1882 at the behest of West Coast restrictionists, did placate some of them.) Nor did failed restrictionist efforts on the national stage end the fight: two restrictionist bills were passed by Congress but vetoed by President Taft in 1912 and President Wilson in 1915. But restrictionists kept gaining ground: what had once been bipartisan opposition became bipartisan support for restrictionism. In 1917, Congress overrode a Presidential veto and passed a literacy test for would-be immigrants. Then in 1921 and 1924, two quota acts hammered the Golden Door shut. The 1924 Act shut down immigration to the U.S. almost completely for two generations, from 1924 to 1965; not even the persecutions of the 1930s or the revelations of the Holocaust after WWII were sufficient to break the anti-immigration consensus that had hardened across right and left, from elites and populists, during the preceding generation.

Not only did the restrictionists in 1924, unlike in 1856, achieve their aim; on their way to victory, they transformed both parties. Neither party came out of the 1880-1924 period looking the same as it went in, but the Democrats were particularly affected. As many modern Republicans are now recalling with horror, the Democrats went into their convention in 1924 deeply split, with the Klan endorsing one of the two leading candidates in order to block the other, Al Smith, the Catholic governor of New York, from becoming President. The “Klanbake,” as the convention came to be called, went to 103 ballots in Madison Square Garden, while 20,000 Klansmen held a cookout on the banks of the Hudson River. The splits between populists and elites, immigrants and nativists, Progressives and traditionalists that the Party had until then papered over (Democrats had held the White House only four years previously) were on full display as the convention dissolved into chaos. The eventual winner, a Kasich-style compromise candidate, went on to post 28% at the polls that November. And while the Democratic Party—unlike the old Whigs—survived and eventually recovered, you have to take into account that full restrictionism went into effect after that same year. The end of mass immigration allowed the wounded Democratic Party to survive, barely, until it was rescued by the Depression in 1932.

Now we are in the middle of another great wave. Since 1965, when Congress passed the Hart-Celler Act and reopened the doors to mass immigration (this time largely from the Western hemisphere and Asia), 59 million new immigrants have arrived in the United States. These immigrants form 18.9% of the current population; if you include children born to them, there have been 79 million newcomers, comprising 24.7% of the population.

Like the last two waves, this one has caused significant changes in the ethnic and religious makeup of America, and has affected the composition of many local communities even more drastically. But also like the last two waves, it has continued for several decades without, until now, provoking a political crisis. Just as in 1830s and ’40s and 1880s-1900s, a combination of the sense that in general, things have been going well for the American middle class throughout this period and that there were other, unrelated things to worry about (the Cold War did not, for instance, have a significant immigration component) have kept immigration politics relatively calm. It has been treated largely as one issue among many, albeit at times an important one, rather than a potential party-breaker.
But now, as the Blue Model breaks down—as manufacturing and white-collar clerical work no longer provides mass employment, as local governmental services decay, and as the national and local sense of community frays—we have a major political disruption. This is likely not a coincidence.

The factory jobs that replaced the family farm as the unit of employment and identity for many Americans have gone away—and they are never coming back. Competition from China was part of this—but only part. Automation is now stealing jobs even from China. Factory jobs in the old sense—picking up hubcaps and sticking them to each car that comes down the assembly line, while someone else drills the nuts into place—are increasingly rare everywhere, because that’s what robots are for. (This is why, as FiveThirtyEight recently pointed out, while manufacturing as measured by value added has risen 20% in the U.S. since 2009, manufacturing employment has only risen 5%.) And likewise, computers are destroying millions of clerical jobs that used to be the lower-middle-class, white-collar equivalent of factory work. The housing bubble probably papered the effects of this over for a little while, and the immediate economic emergency of the Great Recession took the blame for a few more years. But no longer.

Just as how at the turn of the 20th century, people failed to see how factory work would thoroughly replace family farming as the source of American income and identity, so too today we struggle to foresee what will come after “Allentown.” As then, so too now the opening of global markets has exacerbated this problem in certain regions. Other problems of the 1850s and 1900s-20s also exist. As the chasm between educated elites and the middle class is exacerbated by the tech revolution, concerns about inequality have increased. Due in part to the particulars of the 2008 crash, those who have lost most from many of the recent structural economic changes are increasingly convinced they are being conspired against by financial elites and politicians, as well as just left behind. And terrorism has yet again tied immigration to national security.
The same ingredients that fueled the political explosions of the 1850s and the 1920s have come together again. Each of these issues—mass immigration, employment, local community makeup, homeland security, and national identity—are highly sensitive for average Americans. People, including or perhaps even especially those who are not usually politically active, care deeply about them. When all of them are in flux at once, as we have seen, they can combine to create political explosions. This is the third such crisis, and we shouldn’t expect it to quietly die down. History says that those concerned about the future of the Republican Party are right to worry: in times like ours, immigration is a potent enough issue to break a party and provoke a realignment.

And here's an article by the NYT's Ross Douthat titled "#NeverReformConservatism at The Wall Street Journal":

I see that the Wall Street Journal editorial page has risen to the defense of House Speaker Paul Ryan’s relatively muted response to Trumpism, and what they’ve come up with is quite … revealing. In my deliberately tart critique of Ryan and the rest of the G.O.P. leadership, I suggested that he and other prominent conservatives were taking a “first, change nothing; second, do nothing” approach to the challenge of Trumpism, and essentially lying still and hoping the danger would pass over. The Journal’s counter-argument is a straightforward endorsement of exactly that approach: Trumpism too shall pass, the editorial avers, and in the mean time the important thing is to maintain the purity of Journal-approved conservatism, and to refuse any aid and comfort to all those deviationists and splittists who think that the party might not have exactly the right economic agenda for the voters and the times.

To #NeverTrump conservatives, then, the Journal offers at best an eyeroll at their passion; the important thing, now and always, is to be #NeverReformConservatism.

Do I exaggerate? Let’s work our way through the editorial, which defends the House Speaker against “a cast of conservative intellectuals who don’t like Mr. Ryan because he continues to believe in the Ronald Reagan-Jack Kemp vision of a tax-reforming, free-market GOP that focuses on economic growth.”

This description is, to begin with, absurd, since if the “cast” of intellectuals they have in mind is larger than just yours truly — though if I may be a little immodest, I do believe that I’m the primary target of the piece — it presumably includes figures like Yuval Levin and Jim Pethokoukis, who between them have written more words in praise of Ryan over the years than I can count … but I digress.

These nefarious intellectuals, the Journal continues, would “love to volunteer Mr. Ryan for a kamikaze political mission that leaves someone else to pick up the rubble in 2020.” That’s because we’re scheming to replace the pure faith of Kemp and Reagan with “a policy mix to address income inequality and promote redistribution … rather than aiming for faster growth” (again not quite an accurate description but what do you expect from an editorial too smug to even name the people it’s criticizing?), an agenda which Marco Rubio supposedly went all-in for this year (never mind that his tax plan also catered heavily to the Journal’s idées fixes and his Kempism on immigration clearly helped keep him from the nomination), and which we hope to impose on the party as a whole once we’ve sent Ryan spiraling into the U.S.S. Donald Trump.

But Ryan is too smart for our machinations:

Mr. Ryan is doing fine on his own … The Speaker hasn’t hesitated to condemn Mr. Trump’s bad ideas on the merits as they arise, including his Muslim travel ban. But Mr. Ryan also has other obligations, not least protecting the GOP from larger damage this election year.

Start with his role as chairman of the Republican National Convention in Cleveland, which could be contested for the first time in decades. He’s officially neutral, and he’ll undermine his credibility and impartiality if he joins the never-Trump clique—especially when the Trump campaign is already warning of riots and building a stabbed-in-the-back narrative if their man doesn’t get the nomination.

If Mr. Trump is the nominee, then Mr. Ryan must defend his party’s best interests. This means above all protecting the House majority that polls show a Trump nomination could imperil. If Mrs. Clinton is elected President and Chuck Schumer runs the Senate, a GOP House is the only defense against a policy repeat of 2009-2010. Mr. Ryan can’t simply write off the GOP nominee and the millions of votes Mr. Trump has won.

The House GOP’s role will also be crucial if Mr. Trump wins in November. The businessman has no fixed principles we can detect, and a GOP Congress would have to steer him away from his worst instincts on trade, immigration and isolationism.

This is, I must say, some ripely delusional stuff. Ryan has to appear neutral because Trump is threatening riots? I’m old enough to remember when the Journal editorial page opposed appeasement! Ryan shouldn’t risk any kind of rupture because if Trump is the nominee a Republican civil war might cost the G.O.P. the House? Trump as the nominee is itself the thing that might cost the GOP the House! Ryan should stand ready to “steer” a President Trump away from “his worst instincts”? I mean, there isn’t going to be a President Trump … but if there were, what does it say about the Journal’s editorial page, allegedly a bastion of liberty and cosmopolitan conservatism, that it wants the heir of Kemp and Reagan to keep his options open and his hands undirtied with #neverTrumpism, just in case he might get the chance to help an illiberal race-baiting violence-abetting war crimes-endorsing demagogue pass, I dunno, the biggest supply-side tax cut in the history of the Laffer Curve?

What it says is that the Journal has its eyes on the real enemy here. Say what you will of Trump’s protectionist “Bush lied, people died” white identity politics, at least he didn’t endorse a larger child tax credit:

The irony is that many of the same pundits now demanding that Mr. Ryan become their sword against Mr. Trump also praised the New Yorker last summer for his challenge to GOP orthodoxy. These former Trump apologists claimed the GOP should absorb his rage against the status quo. Instead of income-tax rate cuts, get behind family-friendly tax credits. Make peace with the entitlement state. Restrict trade and immigration allegedly to lift blue-collar wages. Alas for these would-be king-makers, Mr. Trump doesn’t take much advice.

Projection is a remarkable thing. For the record: The early anti-anti-Trumpism of certain reform conservatives (my own and to some extent others) largely consisted of comparing Trump to George Wallace and wishing for a Nixon, and the adaptationist “advice” we gave was entirely directed at other Republican politicians, not the Donald. Meanwhile as Trump’s demagoguery escalated it was the Journal’s longtime fellow travelers in the supply-side movement who explicitly warmed to him, and it’s the Journal itself, in this very editorial, that still seems hopeful that Speaker Paul Ryan can write amazing bills for President Trump to rubber-stamp.

Alas for these would-be king-makers … well, you know.

Then, finally, we have this:

The Trump insurgency has a long way to play out, and someone else could still win the GOP nomination. But whatever happens, Mr. Ryan and his political allies will have to limit the policy and political damage. That means preserving a vision of the GOP as a pro-growth, reform party that is inclusive and meets the challenges of the current era. Mr. Ryan knows how to do that better than his critics do.

In other words: Do nothing, change nothing, and hope Trump simply does his destructive work and passes on. And if the party is reduced to actual rubble in the process, well, the important thing is that the purity of a policy vision from thirty-five years ago has been preserved in its pristine, handed-down-from-heaven form.

The best that can be said of this “strategy” is that it aspires to follow the fourth path for G.O.P. elites that David Frum (if I may quote a splittist even more defective in his interpretation of Reaganism than the reform conservatives) laid out in his essay on the Republican Party’s rendezvous with Trumpism; it redefines “political victory” to just mean “what we have, we hold,” and treats the presidency “as one of those things that is good to have but not a must-have, especially if obtaining it requires uncomfortable change.” Better to reign in the House, in this theory, than to ever compromise your way to something more; better to hunker down and hope to live through Trumpism than to sully the purity of supply-side ideas and donor priorities with anything that might pander to all the “lucky duckies” in the government-addicted 47 percent.

But even that gives the Journal’s vision too much credit, because a “do nothing/change nothing/let Trump stomp around” approach isn’t even a good strategy for holding the House of Representatives, let alone the Senate (and farewell and adieu to the Supreme Court, farewell and adieu to you ladies of Spain …).

No: It’s only a good strategy if your primary obsession isn’t the actual fate of conservatism, but your own power and influence within whatever rump remains.

Which is why there’s only one answer to the Journal’s strange brief against reform conservatism, its insinuations against all those unnamed “intellectuals” (hi!) who want to undermine Paul Ryan’s political position and conservatism’s future for the sake of a narrow ideological agenda: Physician, heal thyself.

Intellectually bankrupt.
 
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NDinL.A.

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Amazing how much lying Ted's speaking points have come into step with Trump.

That's gotta be the funniest thing of all-time. Trump and his mindless sheep calling Ted Cruz "Lying Ted". No candidate in history has been caught telling more Lies than Trump the Chump, but yet he acts like he never lies and his sheep completely believe him. Dude just makes shit up all the time, facts be damned. It's like we're all living in the Truman Show or something, that's how crazy this shit is.

There is a reason Trump loves the "poorly educated".
 

loomis41973

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That's gotta be the funniest thing of all-time. Trump and his mindless sheep calling Ted Cruz "Lying Ted". No candidate in history has been caught telling more Lies than Trump the Chump, but yet he acts like he never lies and his sheep completely believe him. Dude just makes shit up all the time, facts be damned. It's like we're all living in the Truman Show or something, that's how crazy this shit is.

There is a reason Trump loves the "poorly educated".


Any facts to back this up or just more hate ?

Would also love you to dispute the fact what i said is true about talking points.
 
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NDinL.A.

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I didn't vote for Trump but the press conveniently isn't going after Hillary.

WTH? Do you NOT read or watch TV at all? The press has been killing Hillary. The problem is, Trump is such a giant buffoon that he does/says something incredibly stupid/brash/vulgar every day, pushing her stories down on the docket. You can thank Trump for that - he loves the attention, good or bad.

Now let's take your other talking points:

1). She constantly lies
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No doubt. But nobody lies as much as Lying Trump.
2). Her lies about Benghazi killed Americans.
Deserves everything she gets for that, if proven to be true by a court, Absolutely.

3). She rakes in the cash from foreign sources. Read Clinton Cash.
Nobody rakes in more foreign cash than Trump. He brags about it all the time. He would rather line his own pockets than give AMERICANS jobs, and he fully admits it. And yet his mindless sheep actually believe this fraud cares more about Americans than himself lol. What a joke.
4). She will continue the job crusher of Obamacare
Trump has been about continuing a form of Obamacare forever. His "plan" is an absolute joke and so bare-boned it is ridiculous. Economists have torn it to shreds already (as they have with many of his "plans".

5).
Most probably the worst Secretary of State of all time.
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According to Trump, Hillary was a good Secretary of State: “Hillary Clinton I think is a terrific woman,” he told Fox News’ Greta Van Susteren in March of 2012. “I am biased because I have known her for years. I live in New York. She lives in New York. I really like her and her husband both a lot. I think she really works hard. ”I think she really works hard and I think she does a good job. I like her,” he added of the then-secretary of state. Funny how the narrative always changes with him.

6) Hillary charges unveristities hundreds of thousands of dollars for a speaking engagements and turns around and says education should be free.
And Trump defrauds students of his fake university tens of thousands of dollars, all to line his supposedly filthy rich pockets. What kind of asshole does that? And he is supposed to be anti-elite, anti-establishment??? Is this even real life?
7). She blasted all of the women that bill Clinton had sex with as president but now is all about women's rights.
Wait, you can't blast skanks and be about women's rights? Why not? I am for immigrant rights but if an undocumented breaks the law they should be on the first plane out of the US. I can't have that opinion? If I blast a a murderer for being a low-life thug, does that mean I can't say I'm pro 2nd amendment? Sorry, I'm not buying that criticism. Shit, Donald curses like a sailor, chastised and mocked a reporter (like a fucking 5th grader - it was embarrassing) for having the nerve to ask him about his foul language, calling her "PC" and "little miss perfect", but then when former Mexican President Fox used the F-word, Trumpy called him vile for using that 'filthy' word and said the wall just got 10 feet higher because he had the audacity to use such a filthy word. Ummmmmmm, who is the PC one? The dude's hypocrisy knows absolutely no bounds.
8). She should and will be indicated for breaking US law for classified Intel.
Won't happen, but people can dream.
9). Per her emails, she doesn't even know how to use a fax machine.
Donald answered a question about police brutality by talking about American jobs and ISIS. When pressed to answer the actual question, he remarked how attractive all the reporters in the room were, and then ended the interview. Soooooooo...

10). I will never support her in public office.
That's fine.

Like I said, I'm not even a Hillary supporter AT ALL. I am a registered Republican, and my candidate already lost. But I will put ANYBODY above that POS country-dividing fraud #nevertrump any day of the week.
 
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MJ12666

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U.S. Could Save up to $16B if Medicare Part D Prices are Negotiated: Paper (from Wall Street Journal)



Prices for Brand-Name Drugs
Under Selected Federal Programs
(from the Congressional Budget Office, June, 2005)

At that time, "Purchases of pharmaceuticals by federal and state governments
accounted for over 20 percent of total U.S. expenditures
for outpatient prescription drugs in 2003."

This analysis relates Average Manufacturer Price (AWP) for Brand Name Drugs to those under select federal programs.

The Federal Supply Schedule (FSS) Price Relative to the AWP: 53 Percent

I don't disagree with any of the above, I even agree with the $16B in savings on the Federal government negotiating drug prices, but $16B is not what I would call "astronomical". Quite frankly in the total amount spent on Medicare and Medicare it is a rounding error. My point is that while yes we might see some savings it will insignificant when compared to how much we spend as a nation on total healthcare.
 
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