Pres. Obama Plans "New Season" Of More Direct Health Care Advocacy
(The White House's new push for Health Care Reform.)
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President Barack Obama has talked a lot about health care lately, but some allies say he has been too vague. Now he's thinking of throwing more details and personal weight into the debate, which polls indicate Republicans have been winning in recent weeks.
Faced with falling approval ratings and increasingly impatient with Senate negotiations, Obama is considering a speech in the next week or so in which he would be "more prescriptive" about what he feels Congress must include in a health bill, top adviser David Axelrod said Tuesday in an interview.
The speech might occur before the Sept. 15 deadline the White House gave Senate negotiators to seek a bipartisan bill, Axelrod said. He suggested that two key Republicans have not bargained in good faith.
"We're obviously entering a new season here and this issue has been debated and discussed and chewed over at great length now," Axelrod said. Advisers say this "new season" will involve more hands-on advocacy from Obama.
Congress reconvenes next Tuesday after an August recess in which critics of Obama's health proposals dominated many public forums.
Some Obama allies feel he gave too much leeway to Congress, where one bill has passed three House committees, another has passed a Senate committee and a third has been bogged down in protracted negotiations in the Senate Finance Committee.
Politico reports that Obama aides see the need for a change:
Top officials privately concede the past six weeks have taken their toll on Obama's popularity. But the officials also see the new diminished expectations as an opportunity to prove their critics wrong by signing a health care law, showing progress in Afghanistan, and using this month's anniversary of the fall of Lehman Brothers to push for a crackdown on Wall Street.
Axelrod indicated that Obama would not offer new proposals but would be more specific about his top priorities.
"The ideas are all there on the table," Axelrod said. "Now we are in a new phase, and it's time to pull the strands of these together."
He said there is serious discussion in the White House of Obama "giving a speech that lays out in specific ways what he thinks" about the essential elements of a health care bill.
Axelrod said it was possible that the speech could occur before a planned Sept. 15 Obama address on health care in Pittsburgh.
Obama has called for innovations such as a public health insurance plan to compete with private insurers, but he has not insisted on it. It was not clear Tuesday the degree to which he might press for various proposals in a new speech.
Obama also plans to meet with Democratic congressional leaders when lawmakers reconvene next week.
Axelrod condemned recent comments by two chief Senate Republican negotiators – Charles Grassley of Iowa and Mike Enzi of Wyoming – who have sharply criticized key elements of Democrats' health care plans even as they insisted that a workable bipartisan plan was possible.
Their remarks, Axelrod said, "were not exactly consistent with good-faith negotiations."
In an August fundraising letter, Grassley asked people for "support in helping me defeat Obama-care." He said Democratic-drafted bills would be "a pathway to a government takeover of the health care system."
Enzi, in a radio address Saturday, said Democratic proposals would restrict medical choices and make the country's "finances sicker without saving you money."
The two men are part of a six-senator, bipartisan negotiating team that also includes GOP Sen. Olympia Snowe of Maine. Hopes for a workable bipartisan plan have dimmed in recent weeks, and Axelrod's comments were the most dismissive yet from a White House official.
Congress' August recess was brutal for Obama and his allies, as lawmakers faced raucous crowds denouncing Democrats' health proposals. When Congress comes back Tuesday, Democratic leaders hope to change the dynamic by holding quiet, closed-door sessions with nervous colleagues and arguing that far-reaching health care changes can be good politics as well as good policy.
They also hope GOP-led opposition has peaked. But that's far from clear, and Republicans are eager to hand Obama his first major defeat.
A new CNN/Opinion Research poll found that 53 percent of Americans disapproved of Obama's handling of health care, while 44 percent approved. In March, far more people had approved than disapproved.
Liberal groups have held hundreds of events in a bid to show that a robust overhaul is more popular than August's news reports would suggest.
The message lawmakers will hear when they return to Washington "will be very different than what they heard when August started," said Jacki Schechner of Health Care for America Now. One idea her group will stress, she said, is that the politically smart vote, even in toss-up districts, will support widespread changes meant to expand health insurance coverage and options.
Some Democrats say congressional leaders will have to trim more costs from the health bills even though it would antagonize liberals and make it harder to cover uninsured people, one of Obama's top goals.
"That's the kind of thing we're going to look at," said Rep. Chris Van Hollen, D-Md., a member of the leadership who is tasked with getting his colleagues re-elected.
Republicans approach Labor Day feeling upbeat about the ground they gained during the August recess. Some are confident that no amount of closed-door hand-holding of nervous Democratic lawmakers will reverse the momentum.
"After a disastrous month at home, the fact that Democrats' new health care strategy is to hide in Washington from the people who elected them to get health care passed shows what bad shape they're in," said Antonia Ferrier, spokeswoman for House Republican leader John Boehner of Ohio.
Pfizer to pay record $2.3 billion penalty
Pfizer Inc., the world’s largest drug maker, will pay a record $2.3 billion civil and criminal penalty over unlawful prescription-drug promotions.
Announcing the settlement Wednesday, the Justice Department said that it included the largest criminal fine in U.S. history — $1.2 billion. The agreement also included a criminal forfeiture of $105 million.
Authorities called Pfizer a repeat offender, noting it is the fourth such settlement of government charges in the last decade. They said the government will monitor the company’s conduct for the next five years to rein in the abuses.
To promote the drugs, authorities said Pfizer invited doctors to consultant meetings at resort locations, paying their expenses and providing perks.
“They were entertained with golf, massages, and other activities,” said Mike Loucks, the U.S. attorney in Massachusetts.
Loucks said that even as Pfizer was negotiating deals on past misconduct, they were continuing to violate the very same laws with other drugs.
Six corporate whistleblowers who first brought the misconduct to light will share $102 million of the settlement money.
Largest settlement involving drug company
FBI Assistant Director Kevin Perkins praised the whistleblowers who decided to “speak out against a corporate giant that was blatantly violating the law and misleading the public through false marketing claims.”
Associate Attorney General Thomas Perrelli said the settlement illustrates ways the department “can help the American public at a time when budgets are tight and health care costs are rising.”
The overall settlement is the largest ever paid by a drug company for alleged violations of federal drug rules.
The government said the company promoted four prescription drugs, including the pain killer Bextra, as treatments for medical conditions different than those the drugs had been approved for by federal regulators.
Use of drugs for so-called “off-label” medical conditions is not uncommon, but drug manufacturers are prohibited from marketing drugs for uses that have not been approved by the Food and Drug Administration.
Bextra, one of a class of painkillers known as Cox-2 inhibitors, was pulled from the U.S. market in 2005 amid mounting evidence it raised the risk of heart attack, stroke and death.
A Pfizer subsidiary, Pharmacia and Upjohn Inc., which was acquired in 2003, has entered an agreement to plead guilty to one count of felony misbranding. The criminal case applied only to Bextra.
The $1 billion in civil penalties was related to Bextra and a number of other medicines. A portion of the civil penalty will be distributed to 49 states and the District of Columbia, according to agreements with each state’s Medicaid program.
“These agreements bring final closure to significant legal matters and help to enhance our focus on what we do best — discovering, developing and delivering innovative medicines to treat patients dealing with some of the world’s most debilitating diseases,” said Amy W. Schulman, senior vice president and general counsel of Pfizer.
Justice officials discussed details of the deal at a news conference with FBI, federal prosecutors, and Health and Human Services Department officials.
Terms of the Settlement
In financial filings in January, the company had indicated that it would pay $2.3 billion over allegations it had marketed the pain reliever Bextra and possibly other drugs for medical conditions different than their approved use. The civil settlement announced Wednesday also covered Pfizer’s promotions of three other drugs: blockbuster nerve pain and epilepsy treatment Lyrica, schizophrenia medicine Geodon, antibiotic Zyvox and nine other medicines. Pfizer said the agreement with the Justice Department resolves the investigation into promotion of all those drugs, plus several related whistleblower lawsuits.
Under terms of the settlement, Pfizer must pay $1 billion to compensate Medicaid, Medicare, and other federal health care programs. Some of that money will be shared among the states: New York, for example, will receive $66 million, according to the state’s attorney general, Andrew Cuomo.
“Pfizer ripped off New Yorkers and taxpayers across the country to pad its bottom line,” Cuomo said. “Pfizer’s corrupt practices went so far as sending physicians on exotic junkets as well as wining and dining health care professionals to persuade them to prescribe the company’s drugs for patients in taxpayer-funded programs.”
Pfizer spokesman Chris Loder confirmed Wednesday that the $2.3 billion charge to the company’s earnings had been taken in the fourth quarter of 2008.
“No additional charge to the company’s earnings will be recorded in connection with this settlement,” he said.
In her statement, Schulman said: “We regret certain actions taken in the past, but are proud of the action we’ve taken to strengthen our internal controls and pioneer new procedures so that we not only comply with state and federal laws, but also meet the high standards that patients, physicians and the public expect from a leading worldwide company dedicated to healing and better health.”
“Corporate integrity is an absolute priority for Pfizer,” she said, “and we will continue to take appropriate actions to further enhance our compliance practices and strengthen public trust in our company.”
When Pfizer originally disclosed the settlement figure, it also announced plans to acquire rival Wyeth for $68 billion. That deal, which would bolster Pfizer’s position as the world’s top drug maker by revenue, is expected to close before year’s end.
Shares of Pfizer dropped 14 cents to $16.24 in midday trading.
Sources: MSNBC, Huffington Post, Politico
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