The Will To Act.

More examples of how big greedy business has run away with the best interests of the American public, and also a heads up view of Italian citizens who are so dissatisfied with budget cuts (sound familiar?) that workers are striking in protest. Drug makers are exempt from House budget-cuts relating to prescription drugs; an Oregonian senator has cut the agency that counts salmon, no doubt with an eye to destroying even more salmon habitat in order to line his own pockets with utilities revenue. The greed just keeps on keeping on, and any end to all this malfeasance seems too far in the future to protect the things in this country that need to be protected, such as poor children, endangered species, and senior citizens, to name a few. Does anyone with any sort of power care about this? Pessimism is our enemy in these times. Hope, and the will to act must remain foremost. Our country and our people depend on the willingness—the will—of people with power to make these greedy bastards step down, step out, and move on, preferably to the nearest prison cell.

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Drugmakers Win Exemption in House Budget-Cutting Bill

By Jonathan WeismanWashington Post Staff Writer
Wednesday, November 30, 2005; A08

As part of a House budget bill that reduces spending on Medicaid prescription drugs, pharmaceutical giant Eli Lilly and Co. and other businesses secured a provision ensuring that their mental health drugs continue to fetch top price at a cost of hundreds of millions of dollars to the states.

The provision -- inserted by Rep. Steve Buyer (R-Ind.), whose district flanks Lilly's Indianapolis headquarters -- would largely exempt antipsychotic and antidepressant medications from a larger measure designed to steer Medicaid patients to the least expensive treatment options.

The House Energy and Commerce Committee approved Buyer's amendment this month over the strenuous objections of Chairman Joe Barton (R-Tex.) and the National Governors Association. It survived unchallenged in the $50 billion budget-cutting bill that narrowly passed the House just before Congress left for Thanksgiving recess.

Mental health advocates defend Buyer's provision, saying it is necessary to ensure that vulnerable mental health patients receive proper treatment.

Andrew Sperling, the director of legislative advocacy for the National Alliance on Mental Illness, said his organization has been fighting efforts to restrict access to mental health drugs for years and strongly backed Buyer's amendment. "We believe these [restrictive] policies are destructive and contrary to good clinical policies," he said. "We don't like them."

To opponents, however, Buyer's measure underscores the excessive power that corporate interests wield on Capitol Hill. Critics say the measure also violates the purpose of the budget-cutting bill, which was drafted to give state governments the flexibility to cut program costs in ways that minimize the harm done to beneficiaries.

"This is obviously an attempt to prevent state Medicaid offices from getting cheaper, just-as-beneficial drugs to patients, and it's really going to stick it to the taxpayers," said Steve Ellis, a vice president and Medicaid analyst at Taxpayers for Common Sense.

The Congressional Budget Office has estimated that the provision will raise federal drug spending by $125 million over five years, while state officials say they are likely to face far higher costs.

In a letter to the California congressional delegation, Gov. Arnold Schwarzenegger (R) estimated the provision would raise the state's prescription drug costs by $50 million a year.

"This would definitely limit states' flexibility," Barton protested earlier this month, before nine committee Republicans joined 22 Democrats to override the chairman's wishes. "And again the underlying basis of the bill is to give states more flexibility, not less flexibility."

Under the budget-cutting bill's Medicaid provisions, states would be allowed to create lists of preferred medications. Then, for the first time, they could charge higher co-payments -- even to poor children and pregnant women -- for medicines not on those lists.

The bipartisan National Governors Association, which promoted the changes, maintains that states will save billions of dollars by guiding patients away from newer drugs that may be far more expensive -- but no more effective -- than older alternatives.

But the Buyer amendment carves out an exception for mental health drugs. Under the provision, states could not limit access to such medications unless they could prove to a drug review board that such restrictions would do no harm to patients.

If a state won approval from a review board, patients seeking to go outside the preferred list of mental health drugs would have the right to appeal. If that appeal was not resolved in 24 hours, the state would have to grant a 30-day supply of the medication.

Mental health medicines need special attention because the complex human brain responds very differently to different drugs and different dosages, advocates of the amendment say.

"This provision will help protect a vulnerable patient population and help ensure they receive appropriate medical care," said Ed Sagebiel, a Lilly spokesman. He acknowledged that his company sought the provision, but he noted that other drug companies did so as well, as did mental health advocacy groups. "On behalf of the patients, I ask, why is that wrong?" he said.

The governors group warned that the cost differential between an older, established drug such as Prozac and a new entrant can be staggering, while the difference in utility is often marginal.

Moreover, no state could meet the requirement of proving that one drug is equivalent to another, because drugmakers' clinical trials compare their products with placebos, and scant evidence is available comparing one drug with another, said Stan Rosenstein, deputy director of California's Department of Health Services.

With more than 15 companies making mental health drugs, Lilly hardly has the market cornered, according to Sagebiel. Lilly does have six such medicines, including Prozac, which now has a generic alternative; Cymbalta, a newer antidepressant; Strattera, for attention-deficit (hyperactivity) disorder; Symbyax for bipolar depression; and Zyprexa for schizophrenia.

Lilly has been adept at using Washington for its own purposes, Ellis said. The company fought for years to extend the patents on Prozac and stave off a generic version. In 2002, it was at the center of a political firestorm over a provision, slipped into the giant law that created the Department of Homeland Security, that shielded vaccine makers from lawsuits by families of autistic children.

And it was Lilly's home-state congressman, Buyer, who got the amendment on mental health drugs through the House.

Lilly's headquarters are located in downtown Indianapolis, which falls within the congressional district of Rep. Julia Carson (D). But many of Lilly's employees live in Buyer's suburban Indianapolis district, and -- unlike Carson -- Buyer is a member of the committee with jurisdiction over Medicaid.

Lilly has been the biggest corporate contributor to Buyer's campaigns. Since 1989, the drug company has donated $46,500 to Buyer's congressional campaigns, according to the Center for Responsive Politics.

Mike Copher, Buyer's chief of staff, said Buyer's interest in the matter stemmed not from his district's proximity to Lilly but from his work as chairman of the Veterans' Affairs Committee and his former position on the House Armed Services subcommittee on military personnel.

© 2005 The Washington Post Company
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Zeroing Out the Messenger
Idaho Senator Eliminates Funds for Center on Salmon Survival

By Blaine HardenWashington Post Staff Writer
Wednesday, November 30, 2005; A21

PORTLAND, Ore. -- In a surgical strike from Capitol Hill, Sen. Larry E. Craig (R-Idaho) has eliminated a little-known agency that counts endangered fish in the Columbia River.

The Fish Passage Center, with just 12 employees and a budget of $1.3 million, has been killed because it did not count fish in a way that suited Craig.

"Data cloaked in advocacy create confusion," Craig said on the Senate floor this month, after successfully inserting language in an energy and water appropriations bill that bans all future funding for the Fish Passage Center. "False science leads people to false choices."

Here in Portland, Michele DeHart, a fish biologist who is the longtime manager of the center, said she is not mad at Craig.

"What's the point?" asked DeHart, 55, who for nearly 20 years has run the agency that keeps score on the survival of endangered salmon as they negotiate federal dams in the Columbia and Snake rivers.

"I have never met the man," she said. "Never talked to him. No one from his office ever contacted us. I guess I am flabbergasted. We are biologists and computer scientists, and what we do is just math. Math can't hurt you."

But the mathematics of protecting salmon swimming in the nation's largest hydroelectric system can hurt your pocketbook -- particularly in the Northwest, where dams supply power to four out of five homes, more than anywhere in the country.

Salmon math has clearly riled up Craig, who in his last election campaign in 2002 received more money from electric utilities than from any other industry and who has been named "legislator of the year" by the National Hydropower Association.

The Fish Passage Center has documented, in excruciating statistical detail, how the Columbia-Snake hydroelectric system kills salmon. Its analyses of fish survival data also suggest that one way to increase salmon survival is to spill more water over dams, rather than feed it through electrical turbines.
This suggestion, though, is anathema to utilities -- and to Craig -- because water poured over dams means millions of dollars in lost electricity generation.

Last summer, a federal judge in Portland, using data and analysis from the Fish Passage Center, infuriated the utilities. He ordered that water be spilled over federal dams in the Snake River to increase salmon survival. Shortly after Judge James A. Redden issued his order, Craig began pushing to cut all funding for the Fish Passage Center.

"Idaho's water should not be flushed away on experimental policies based on cloudy, inexact assumption," Craig said in a news release.

On the Senate floor this month, he justified elimination of the Fish Passage Center on the grounds that "many questions have arisen regarding the reliability of the technical data" it publishes. Craig quoted from the report of an independent scientific advisory board that in 2003 reviewed work done by the Fish Passage Center.
But one of the report's authors, Charles C. Coutant, a fishery ecologist who retired this year from the Oak Ridge National Laboratory, said Craig neglected to mention that the board found the work of the center to be "of high technical quality."

"Craig was very selective in reflecting just the critical part of a quotation from the report," said Coutant, who has worked on Columbia River salmon issues for 16 years. "It did give a misleading impression about our board's view of the Fish Passage Center."

Craig also said on the Senate floor that "other institutions" in the Northwest now do "most" of the data collection work done by center. He said getting rid of the center would reduce redundancy and increase the efficiency of regional fish programs.

But according to another recent independent scientific assessment of the work of the center, there was little duplication of data collection between the center and other organizations; it recommended that the center continue to receive funding to meet a substantial need in the Northwest for information on salmon survival.

Fish and game agencies in Oregon, Washington and Idaho, Indian tribes with fishing rights on the river and the governors of Oregon and Washington have all said that eliminating the Fish Passage Center is a bad idea that would reduce the quality of information on endangered salmon.

Echoing a number of regional experts on salmon recovery, Jeffrey P. Koenings, director of the Washington Fish and Wildlife Department, said in a letter to the regional congressional delegation that it makes no economic sense to kill the center.

"Eliminating or reducing funding for the Fish Passage Center will actually increase salmon recovery costs, as the states and tribes will need additional staff to replace the lost functions," he wrote.

Money for the center has come from the Bonneville Power Administration (BPA), a federal agency that sells power from federal dams.

In 1980, Congress passed a law ordering that salmon in the Columbia hydro-system receive "equitable treatment," along with electricity generation, irrigation and barge transport. BPA was compelled to fund the Fish Passage Center in 1984 as part of the effort to ensure equitable treatment for fish.

Craig blocked this funding mechanism by inserting a sentence in an energy and water spending bill that says, "The Bonneville Power Administration may make no new obligations in support of the Fish Passage Center."
Here in Portland, DeHart said she did not want to speculate about Craig's motives. "I guess it is just that old cliche about killing the messenger," said DeHart, whose office will close in March.

Other prominent players in the region's decades-old salmon vs. power debate are less reticent.

Don Chapman, an Idaho fisheries biologist who has worked for regional utilities, state agencies and environmental groups, wrote Craig a letter accusing him of bad faith. "I state flatly that your attempt to dismantle the Fish Passage Center is wrongheaded and vindictive," he wrote.

Asked about these charges, Craig's spokesman, Dan Whiting, responded by e-mail: "This is about improving the program, taking advocacy out of science and ensuring we have dams and salmon in the Northwest. It is not about vindictiveness or retribution by Sen. Craig -- that is not his style."

© 2005 The Washington Post Company
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Strikers in Italy protest budget cuts

By Elisabetta Povoledo
International Herald Tribune

FRIDAY, NOVEMBER 25, 2005

ROME In the sixth general strike since Prime Minister Silvio Berlusconi came to power in 2001, tens of thousands of Italian workers took to the streets Friday to protest widespread spending cuts in the government's 2006 general budget.

Public transportation workers, airline pilots and railroad personnel walked out for several hours, paralyzing airports and train stations, and triggering traffic mayhem throughout the country. Most public administration offices were closed as a result of the strike called by Italy's three main labor unions, which represent more than half of the country's work force.

Berlusconi is facing re-election next spring, and Italy's weak economic growth has reflected negatively on the prime minister in recent opinion polls, which show him several points behind Romano Prodi, leader of the center-left opposition. On Friday, Berlusconi dismissed the strike as a "trite ritual that has no effect."

The government has already won a confidence vote in the Senate tied to the budget. The lower house is expected to vote next week on the budget, which must be approved before the end of the year.

"This strike is sacrosanct because there's a great difference between the reality of the country and the deafness of a government that continues to make mistakes," Guglielmo Epifani, leader of Italy's largest union, CGIL, told the thousands of demonstrators in Rome's central Piazza Navona on Friday. As irate workers blew whistles and chanted, Epifani ticked off sectors that will be affected by government cuts, from state aid to local administrations, to health care and education.

The 2006 budget foresees nearly 17 billion, or $20 billion, worth of deficit-cutting measures, as well as one-time measures like real-estate sales of state property. But union leaders object that the government has proposed little to stimulate Italy's stagnant economy - which grew 0.3 percent in the third quarter - or to curb the public debt.

"The government hasn't come up with a constructive plan of action so that we can be competitive against countries that have low labor costs like China," said Elvira Di Cioccio, who works for Esso and is a CGIL union representative.

In Milan, Savino Pezzotta, leader of the CISL union, said that the budget was "harmful for workers and retired people and useless for the development of the country," and lacking the "courage to face the country's real problems," which he listed as industrial development, the defense of earning power and Italy's depressed South.

Copyright © 2005 the International Herald Tribune