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BANKRUPTING FEDERAL PROGRAMS WITH DRUGS

Overall prescription drug prices rose 8.2 percent in 2006, slightly slower than in 2005. However, prices of some cate­gories of drugs increased much faster. The cost of drugs used to treat diabetes went up 15.5 percent in 2006 - the second year of double digit increases for these products. One tech­nique drug companies use to boost revenues and reduce generic substitution is to steeply hike the price of a drug that is about to go off patent, prompting patients to switch to a newer product made by the firm that still has a long patent life (St. Louis Post Dispatch, 04/26/07, Kaiser Daily Health Policy Report, 2/21/08).

Prescription drug spending will increase to $1,537 per person by 2017, up from $761 per person in 2007. Out-of-pocket spending on prescription drugs will remain about 18 percent of total drug costs. The share covered by private insurance will shrink from about 41 percent to 33 percent over the decade, while the share covered by public insurance will increase from 40 percent to 49 percent in 2017 (Baltimore Sun, 2/26/07).

Drug companies have raised the prices on medications needed by low-income seniors, and on "unique" medications with no therapeutic substitute, in response to the passage of Medicare Part D, according to a study published in Health Affairs. Seniors who are "dual-eligible" for Medicaid account for about 29 percent of Part D enrollees, and a higher share of drug utilization. Previously, drug companies were required to give Medicaid their "best price" on medications for this population, but this is no longer the case now that low­income seniors have been shifted into private Part D drug plans. Several drug giants reported rosy gains based on this shift in their annual reports. Additionally, prices on unique brand-name drugs used disproportionately by the elderly had major price increases during the first half of 2006. The enhanced market power of the manufacturer created by Part D" is a threat to Medicare's financial stability, concluded the report (Frank and Newhouse, Health Affairs, Jan/Feb 2008).

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This is the webpage where human rights meets financial realities head on. Is it possible to discuss the affordability of human rights, in particular, a social/economic right like the right to health care? It is this project's position that funding and financing of reform must be discussed for the discussion to have any reality. Also see Financing of Universal Health Care in this FAQ. However, we hold it to be unethical to discuss restrictions on necessary health care, or any sort of rationing of care while we sit back and allow enormous portions of our health care expenditures to be set aside for personal greed. We don't refer to "normal capitalist operating profits" as either enormous or representing personal greed. Isn't it unethical, though, to discuss how many people we can afford to treat with a given life-saving medication, while we sit by ,watching single CEO's walk away with sacks of many millions of dollars for a "year's work"?

Similarly, Project EINO believes that as a society in order to have such an ethical discussion of costs and health care which we can afford, we must first establish some ground rules and a proper environment. If we are going to discuss what the public can afford to save and protect lives and to preserve quality of life, then we need to understand what has happened in this country during the last 25 or 30 years regarding public funds. Where we used to find the funds for "great society" projects and where we are extracting taxes today. This context for an ethical discussion is the largest and most undiscussed news story over the last several years.

Without an understanding of how far expenses for social necessary services have been shifted onto the backs of the lowest paid workers, already, it is impossible to have an ethical discussion of what funding should be considered available for decent health care for American workers today. I have included on this page citations where possible, all uncited data should be investigated further using the Jack Erasmus' excellent book "The War at Home: The Corporate Offensive from Ronald Reagan to George W. Bush" Kyklos Productions 2005, as the key reference.

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STUDY SHOWS GROWING INEQUALITY -RICHEST 1% HAVE FIFTH OF INCOME

In the past quarter-century, and especially in the last 10 years, America's very rich have grown much richer. In 2004, the richest 1% of households -- 719,910 of them, with an average annual income of $326,720 -- had 19.8 % of the entire nation's pretax income. That's up from 17.8 % a year earlier. The study, titled "The Evolution of Top Incomes," also found that the richest one-tenth of 1% of Americans -- 129,584 households in 2004 -- reported income equal to 9.5% of national pretax income.

The median value of stock holdings for the wealthiest 10% of Americans was $110,000 per household in 2004. The value of stocks held by the other 90% of Americans averaged $8,350. "We've had a 30-year trend of income inequality. What's new in the last five years is the degree to which tax policy has made that worse, rather than leaned against that trend," said Jason Furman, a senior fellow for the liberal Center for Budget and Policy Priorities and an economist at New York University.

In 2003, the wealthiest 10% held 37.2 % of national income. [EINO: these numbers conceal the enormity of the problem, because payroll taxes which are very restricted for wealthy Americans have increased most steeply and payroll taxes are excluded from the CBO numbers. i.e. the largest middle-class taxes are not called "taxes" by the feds. No, it's just earned money withheld from most workers and going into the general funds of the government, whatever the heck you want to call that.]

To request a copy from this McClatchy newspaper of Nov 03, 2006, Raleigh News and Observer CLICK HERE Or for the report it's based on (PDF) CLICK HERE

CHIEF EXECUTIVE AT HEALTH INSURER IS FORCED OUT

Dr. William W. McGuire, a medical entrepreneur, was forced to resign from the company Oct 15, 2006 and to give up a portion of the $1.1 BIL he holds in harshly criticized stock options. At UnitedHealth, even the man named to replace Dr. McGuire as chief executive has been a beneficiary of backdated options: Stephen J. Hemsley, who has been Dr. McGuire's top lieutenant. He will lose a sizable portion of his options, the company said. [Oh poor Hemsley! He's not going to steal over a billion of our health care dollars? How much then, just a measley half or quarter billion?]

To view or request a copy of this articel from The New York Times, October 16, 2006 CLICK HERE

SHAM COMPANIES HIDING THE ASSETS

Sham companies hiding the assets of super-wealthy Americans and corporations offshore are costing the US Treasury as much as $100 BIL a year in lost taxes, a Senate subcommittee hasl documented. Facilitated by lawyers and banks, elaborate semi-legal scams are used to hide cash overseas even as Americans use the funds while avoiding the IRS. The Senate Homeland Security and Governmental Affairs Subcommittee on Investigations will release a report today detailing its yearlong investigation of these schemes. "Neither their methods nor their purpose will stand the light of day," said Sen. Carl Levin, D-Mich., of the tax shelters, calling them a "total sham."

The Senate panel estimates that wealthy individuals avoid paying between $40 BIL and $70 BIL in taxes annually and corporations evade $30 BIL in taxes a year by using these offshore companies. Some of those accused in the report have pleaded guilty to tax evasion, and others are under investigation. "Let me be clear: The abuse of offshore tax havens raises the amount of taxes for you and me," said Sen. Norm Coleman, R-Minn., chairman of the subcommittee. [Meanwhile CEO's and politicians think it's reasonable to discuss whether we as a nation can afford decent health care for all our hard-working people.]

To view this article or request a copy from McClatchy Newspapers (Raleigh N&O), by Ely Portillo, Aug 01, 2006 CLICK HERE

CONGRESS PUNTS ON CHILDREN'S HEALTH CARE IN FAVOR OF TAX SHELTER FOR WEALTHY

It is stunning that as one of its final acts, the 2006 GOP-dominated Congress chose to attach to the tax extenders bill a provision making Health Savings Accounts more lucrative as tax shelters for wealthy individuals even as they refused to provide funds needed to ensure that up to 600,000 low-income children keep their health insurance through the State Children’s Health Insurance Program in 2007.

It has been known all year that without additional SCHIP funding, 17 states would face SCHIP shortfalls in 2007. When decision time came, Congressional leaders declined to act. Coverage for up to 600,000 low-income children will be at risk as a result. However, they took a special-interest HSA bill that had never been considered on the floor of either the Senate or House and attached it to the same bill to which they declined to attach the needed SCHIP resources.

To say this is disappointing would be an understatement. Just in time for Christmas, Congress has provided another windfall for Uncle Scrooge and a lump of coal for Tiny Tim.

For this article from the Center on Budget and Policy Priorities, Dec 7, 2006 CLICK HERE

Sources: Bureau of Labor Statistics, CPS and CES; US Census 2000; Monthly Labor Review, July 2004 and author’s calculations

From the election of 2000 through the election of 2004 (GW Bush's first term), for the first time since 1929 more jobs in America were lost than created in a consecutive four year period. Officially, more than a million jobs disappeared from January 2001 through October 2004; unofficially many more. ^{REF 10} More than three million of the jobs lost were well paid, often unionized, manufacturing and related jobs, replaced by nearly 2 million lower paid service and other jobs at least a third of which were part time or temporary jobs with few or no benefits. But the loss of jobs is not the only similarity with 1929, the year that marked the beginning of the Great Depression. The percent of unionized workers today in the private sector in the U.S. has declined by more than half over the past 20 years, to only 7.8%. That figure is well below even the 11% recorded in 1929 following the decade long open-shop anti-Union drive of that earlier period. ^{REF 1}

And just as 1929 (Great Depression) marked the beginning of a decline in hourly wages and incomes for working class Americans, so too has real take home pay of workers fallen under George W Bush, a decline that accelerated in 2004 and promises to continue even faster in 2005.~ "By 2002, the share of income held by the top 1% (or 1.3 million taxpayers) was at the highest level since the run up to the Depression.^REF2 But the higher the income within that 1.3 million the even greater were the gains. 1970 the wealthiest 13,400 families among the richest 1% taxpaying households had incomes roughly ioo times that of the average working American, at $3.6 million compared to $32,700 a year. In 2004 that same 13,400 increased its income to 560 times that of the average working class taxpayer, to $24 million a year compared to $35,400. Expressed an other way, by 2004 that same wealthiest 13,400 received 21.7% of national income - or just about equivalent to the 22.5% share of total national income they enjoyed in 1929 on the eve of the Great Depression. ^{REF 3}

Since the 1970's there has been a dramatic shift in the distribution of national income generated each year - from working class Americans who earn an hourly wage to those who make their living from profits, dividends, interest payments, stock trades, inheritance, and other forms of capital. (The richest 10% of all taxpaying households in the U.S. saw their share of total annual income rise from 33% in 1970 to 48% by 2000 - a gain of 10%. Conversely, the remaining 90% of the 134 million taxpaying households saw their share of national income by 2000 decline by the same 15% - from 67% to 52%. Fifteen percent may seem a modest number, but when it is 15% of $6.2 trillion in total gross federal tax returns (in 2002) it amounts to ap proximately $900 billion a year.^{REF 4} .

Had the $900 billion shift in income in 2002 from workers to the richest 10% not occurred, it would mean that the roughly ioo million working dass Americans in the US. would have received an additional $9,000 each in their paychecks that year. That 15% and $900 billion was not divided proportionately among the richest 10% of taxpayers, a group of about 11 million. The richest 90- 95% (the bottom half of the richest 10%) with average annual incomes of $103,000 in 2000 realized little increase in their share of national in come over the period. Although their incomes in absolute terms ^{REF 5} All the $900 billion transferred from the 100 million working class Americans went to the richest 5% of taxpayers.

Apart from this failure to produce promised jobs, the nearly $600 billion in personal income tax cuts contained in the 1981 Tax Act did not mean significant tax reduction for the middle and lower income taxpayers. With median family income in 1980 around $25,000 a year, there was virtually no net tax reduction for those with annual incomes of $50,000 or less. Most of the cut in income taxes went to the top 5% of taxpayers, the lion’s share of which went to those with i^{REF 6}

According to a Kaiser Family Foundation Trust’s survey of 3000 corporations, that 32.2% worker’s share of the total cost of monthly premiums comes to about $3,300 a year.^{REF 7} That compares with a work er’s share of the cost of monthly premiums of $1,890 in 2000 for a growth of about $1,500 a year for monthly premiums alone. And again, that’s only the cost of monthly premiums. The $3,300 does not account for the additional share of costs being absorbed by workers in higher deductibles and co-pays. Workers’ share of the latter have risen even faster than for monthly premiums. Monthly Premiums have risen consistently from 11% to 14% from 2001-2003.

For example, U.S. government data show conclusively that the discontinuance of company provided medical care over the past decade, 1993-2003, has involved millions of cases. The percent in 2003 of the em ployed workforce participating in company provided medical care plans was only 45%, down from 63% in 1993.^{REF 8} That’s 18% of 132 million or 24 million workers, not counting their dependents. For the tens of millions in service work occupations, only 22% today have company provided medical coverage. And for the nearly 25 million part time workers today, only 9% have any employer provided coverage. Black and Hispanic workers have been even more disproportionately affected than these av eragenumbers for allworkers indicate.

The cumulative U.S. trade deficit with China during Bush’s first term in office, 2001-04, amounted to more than $475 billion. That's money lost from the US economy which might have accrued to American business and workers. If the U.S. Commerce Department’s own ‘rule of thumb’ is correct that 13,000 jobs are lost for every $1 billion in trade deficit, if one even halves that ‘rule of thumb’ to 6,500 jobs lost for every $1 billion in deficit then the net loss of jobs to China would amount to more than 3 million since Bush took office. Somewhere between the previously noted 950,000 lost jobs calculated by independent sources, and the 3 million estimate per the Commerce Department’s, lies a number that likely represents the totaliobs lost due to the current gross imbalance of trade with China.

More than three million jobs in manufacturing were lost during the first three and a half years of Bush’s first term, a number equivalent to the entire decade of the 1980's. Meanwhile, the service sector shows a slowdown in job creation needed to offset the accelerating job loss in manufacturing. The three and a half years of bloodletting in manufacturing jobs under Bush was staunched briefly for a few months in mid-2004, but resumed again soon after in 2004 and has continued to decline into 2005 despite the continual growth of productivity and output in manufacturing.^{REF 9} Notwithstanding the obvious fact that Bush’s first term is not a full decade, it is clear nevertheless that short of some renewed explosion of servicesjobs in Bush’s second term services employment for the rest of the current decade will continue to absorb a smaller relative share of the loss of manufacturing jobs, compared to what that services sector had been able to absorb during the two preceding decades, 1980-2000.

What the shift in millions of manufacturing to service jobs has meant for wages and earnings is evident in the figures for annual compensation earned in 2002 by workers in manufacturing compared to those with a manufacturing job at the end of 2002 had an annual total compensation (wages and benefits) of $56,154 while a ( services job averaged only $41,275 and a retail services job only $31,005. In other words, workers who lost manufacturing jobs and were able to find new lower paid service employment saw their compensation drop by as much as 40%. This big a shift in earnings involving tens of millions Americans.

They are part time due to economic reasons. They could not find full time regular jobs so they took part time work in the interim. ‘Voluntary’ part time refers to workers who choose to be part time employed, usually for personal reasons that are unrelated or indirectly related to economic necessity although the connection between economic and personal reasons may be more fundamental than appears. Many voluntary part time workers are really working part time due to eco nomic reasons not picked up by employment surveys, so the definitions are not precise.

With the beginning of the Corporate Offensive in 1980 and the Reagan recession which quickly followed, involuntarily part time jobs increased dramatically. During the five year period from the beginning of 1979 through 1983 and the Reagan reces sion, involuntary part time jobs increased by 81.8%. This temporary jobs increased by a minimum of 1.5 million during the 1980s, growing fourfold, and providing wages at 75% of full time work. Less than a fourth received health and other benefits. During the 1980s, for example, only 23% of temporary workers re ceived any health insurance through employers, and they received less as well in terms of other benefits like paid vacations and holidays when compared to regular, permanent employees. Temp workers are explicitly prevented by NLRB rules from being part of the union bargaining unit and therefore becoming union members. And they are even more easily manipulated by management in terms of hiring and firing during different phases of a business cycle, providing management more ‘flexibility’ in staffing and cost savings.

There were approximately 38.9 million contingent-alternative jobs, or 29% of the total U.S. workforce of about 132 million, as of the end of year 2000. Contingent-Alternative Jobs Under George W. Bush Government official attempts to estimate the true scope and magni tude of contingent-alternative work and jobs in the U.S. were in effect discontinued after George W. Bush took office. No further biennial sur veys such as those conducted by the BLS between 1995 and 2001 were undertaken after February 2001. This forced the tracking of this critical area of job restructuring in the U.S. economy and of these kind of low paid, low benefit contingent-alternativejobs to various private sources.

Sources: U.S. Census Bureau; AFL-CIO Industrial Union Council Revitalizing American Manufacturing, 2003.

It is ironic that, as corporations now shift more costs to retirees or en courage them to drop out, those same corporations are about to receive a major subsidy and handout from the Bush administration as part of Bush’s Prescription Drug Plan recently passed by Congress. The Bush drug plan is essentially a windfall for corporations. It allows them to col lect a subsidy from Medicare, a tax free payment equal to $250 tO $5000 for each retiree. Corporations will thus benefit in several ways. First, by shifting costs to retirees. Second, by lowering the company’s liabilities as retirees drop out. And, third, from receiving government subsidies for those that remain in the health plan despite the company shifting costs to them. It should be no surprise that corporations have been and will continue to reap significant financial gains from the shifting of health care costs to retirees.

A third example of government assistance to corporate health care cost shifting involving retirees occurred in the spring of 2004. At that time the Bush administration’s Equal Employment Opportunity Com mission, the EEOC, the federal agency responsible for processing charges of age discrimination under federal law, conveniently ruled that corpo rations could unilaterally reduce or eliminate health benefits for retirees when they became eligible for Medicare at age 65. The EEOC declared such action did not violate the Equal Employment Opportunity Act. This move paved the way for an acceleration of benefit cuts for 12 million of the 15 million current retirees also eligible for Medicare. As a consequence of the EEOC ruling, companies can now cut benefits or raise costs for benefits for retirees faster than for actively employed workers and not be liable for age discrimination lawsuits. The new EEOC rules also effectively mean unions can no longer negotiate benefits for their retired members once those members started receiving Medicare. Also, system.

According to the Organization for Economic Cooperation and De velopment (0ECD), which monitors the economies of the thirty or Sc leading advanced industrial countries, health care in France and Ger many makes up 9.5% and 10.7% of GDP, respectively Switzerland 10.9%. Canada 9.7%. Moreover their health care costs have barely risen annual ly as a percentage of GDP since 2000, while in the US. it has been increas ing nearly 1%per year as a percentage of US. GDP since 2000. In addition, the per capita health spending of the other advanced economies tracked by the OECD is roughly half that of the US. Their administrative costs are about 15% of their total health spending.

US. government data show condusively that the dis continuance of company provided medical care over the past decade, 1993-2003, has involved millions of cases. The percent in 2003 of the em ployed workforce participating in company provided medical care plans was only 45%, down from 63% in 1993.48 That’s i8% of 132 million or 24 million workers, not Counting their dependents For the tens of millions in service work occupations, only 22% today have company provided medical coverage. And for the nearly 25 million part time workers today, only 9% have any employer provided coverage. Black and Hispanic workers have been even more disproportionately affected than these av erage numbers for all workers indicate. While some of the decline in coverage may be attributable to workers themselves dropping out because of the excessively high costs being shifted to them, certainly a significant percentage of the decline of 24 million is attributable to companies arbitrarily and unilaterally discontinuing their health insurance plans.

With the collapse of the stock market in 2000—01, a policy of artificially supporting the dollar was also designed to draw in foreign investors to Wall St., thus providing capital inflow to U.S. corporations while the eq uity markets were flat and declining. But a high dollar valuation spelled certain advantages to foreign corporations selling into the US. The high dollar meant foreign imports were cheaper. And as Americans purchased imported goods in greater numbers, US. import competing industries and their workers paid the price. A flood of imports exceed ing exports meant in turn a further growing U.S. trade deficit, and the displacing of more jobs in the US. One of the several reasons why the economic recovery following the 2001 recession was so delayed in terms ofjobs creation can be traced, at least in part, to the rapid decline of the US. trade deficit and its negative impact on job creation after 2001. Thus dollar policy, like that of corporate hoarding of productivity gains, both play major roles in lengtheningjobless recoveries. As indicated in Table 5.8 below, the US. trade deficit rose from a sig nificant $411 billion in Bush’s first year in office to $666 billion at the end of his first term in 2004, up 25% in just the past year. Bush’s interim US. dollar policy had much to do with the record trade deficits and sluggish jobs creation following the recession. The Bush dollar policy in particu lar exacerbated the trade deficits with NAFTA and China.

The shift to services jobs over the past quarter century absorbed a good part of the collapse in manufacturing employment but that ability to absorb has been clearly declining. It is likely as the decline in the US. manufacturing base continues to speed up, workers losing those jobs will increasingly find themselves without even service work and relegated increasingly to non-service contingent jobs, to the unemployed or discouraged workforce, forced into early retirement, onto disability rolls, to become part of the missing labor force, or forced into the growing pool of the hidden unemployed.

More than three million jobs in manufacturing were lost during the first three and a half years of Bush’s first term, a number equivalent to the entire decade of the 1980s. Meanwhile, the service sector shows a slowdown in job creation needed to offset the accelerating job loss in manufacturing. The three and a half years of bloodletting in manufacturingjobs under Bush was staunched briefly for a few months in mid-2004, but resumed again soon after in 2004 and has continued to decline into 2005 despite the continual growth of productivity and output in manufacturing.4 Notwithstanding the obvious fact that Bush’s first term is not a full decade, it is clear nevertheless that short of some renewed explosion of services jobs in Bush’s second term services employment for the rest of the current decade will continue to absorb a smaller relative share of the loss of manufacturing jobs, compared to what that services sector had been able to absorb during the two preceding decades, 1980-2000. What the shift in mfflions of manufacturing to servicejobs has meanfl for wages and earnings is evident in the figures for annual compensation earned in 2002 by workers in manufacturing compared to those with jobs in services for that year. A manufacturing job at the end of 2002 had an annual total compensation (wages and benefits) of $56,154 while a services job averaged only $41,275 and a retail services job only $31,005. In other words, workers who lost manufacturing jobs and were able to find new lower paid service employment saw their compensation drop by as much as 40%. This big a shift in earnings involving tens of millions of workers and going on for decades not only has lowered the overall av erage wage, but most certainly must have also had a significant impact on the performance of the U.S. economy as well by continuing to under mine effective demand.

They are part time due to economic reasons. They could not find full time regularjobs so they tookpart time work in the interim. ‘Voluntary’ part time refers to workers who choose to be part time em ployed, usually for personal reasons that are unrelated or indirectly re lated to economic necessity although the connection between econom ic and personal reasons may be more fundamental than appears. Many voluntary part time workers are really working part time due to eco nomic reasons not picked up by employment surveys, so the definitions are not precise. With the beginning of the Corporate Offensive in 1980 and the Rea gan recession which quickly followed, involuntarily part time jobs in-, creased dramatically. As Table 6.1 below indicates, during the five year period from the beginning of 1979 through 1983 and the Reagan reces sion, involuntary part time jobs increased by no less than 81.8%. This compares to a growth of the total work force during the same five year period of only 5.4%, and for voluntary part time jobs during the same period of 2.5%.

Temporary jobs increased by a minimum of 1.5 million during the 198os, growing fourfold, and providing wages at 75% of full time work. Less than a fourth received health and other benefits. During the 1980s, for example, only 23% of temporary workers re ceived any health insurance through employers, and they received less as well in terms of other benefits like paid vacations and holidays when compared to regular, permanent employees. Temp workers are explicitly prevented by NLRB rules from being part of the union bargaining unit and therefore becoming Union members. And they are even more easily manipulated by management in terms of hiring and firing during lifferent phases of a business cycle, providing management more ‘flex ibility in staffing and cost savings.

There were approximately 38.9 million contingent-alter native jobs, or 29% of the total U.S. workforce of about 132 million, as of the end of year 2000. Contingent-Alternative Jobs Under George W. Bush Government official attempts to estimate the true scope and magni tude of contingent-alternative work and jobs in the U.S. were in effect discontinued after George W. Bush took office. No further biennial sur veys such as those conducted by the BLS between 1995 and 2001 were undertaken after February 2001. This forced the tracking of this critical - area of job restructuring in the US. economy and of these kind of low paid, low benefit contingent-alternativejobs to various private sources. During George W. Bush’s first term the number of part time workers grew roughly by 1.6 million from early 2001 through 2003.

REFERENCES

1 Bureau of Labor Statistics, Dept of Labor, "Union Members" Jan 27, 2005

2 M Lawrence, J Bernstein, S Allegretto, "The State of Working America 2004-5, p.59

3 T Picketty, E Saez "Income Inequality in the United States, 1913-98", Nat'l Bureau of Economic Research, 2001

4 IRS Annual Report, 2002. Note the amount is much higher than $900 billion if pre-tax income is considered

5 rose more than 30% from 1970 to 2000, their share of the total income pie sti1l flat.DC Johnston, "Perfectly Legal", Penguin Books, p.35

6 Incomes of $100,000 and more.Frank Ackerman, "Reagonomics, Rhetoric vs. Reality", South End Press 1982, p.43

7 Bureau of National Affairs, 1995 "Basic patterns in union contracts"

8 Economic Policy Institute, Sept 2004 "The State of Working America", p.173

9 Wall Street Journal, April 4, 2005

10 Bureau of Economic Analysis, Nov. 2004