Promises Made – Promises Kept. Biden on “Obamacare.”
Posted on | October 17, 2022 | Comments Off on Promises Made – Promises Kept. Biden on “Obamacare.”
Mike Magee
As the saying goes, “History repeats!” This is especially true where politics are involved.
Consider for example the past three decades in health care. It is striking how many of the players in our nation’s health policy drama remain front and center. And that includes President Biden who recently commented on the 12th anniversary of the passage of the Affordable Care Act (Obamacare):
“The ACA delivered quality, affordable health coverage to more than 30 million Americans — giving families the freedom and confidence to pursue their dreams without the fear that one accident or illness would bankrupt them. This law is the reason we have protections for pre-existing conditions in America. It is why women can no longer be charged more simply because they are women. It reduced prescription drug costs for nearly 12 million seniors. It allows millions of Americans to get free preventive screenings, so they can catch cancer or heart disease early — saving countless lives. And it is the reason why parents can keep children on their insurance plans until they turn 26.”
The seeds for the ACA were planted when President Clinton assumed office in 1992, and put his wife Hillary Rodham Clinton, in charge of creating a government driven plan. Efforts to find a complex middle ground showed promise but ultimately failed. Seeing an opening, conservative Republicans declared in 1994 that it was “Dead on Arrival’ – and it was. Though there were some incremental expansions of coverage for vulnerable populations, like the Children’s Health Insurance Plan (CHIP) guided thru the Senate by Ted Kennedy as part of the 1997 Balanced Budget Act, the first signs of significant innovation and progress came later from Kennedy’s home state of Massachusetts.
Leading the charge in 2006 was the state’s Mormon, uber-capitalist, Republican Mitt Romney. With an eye toward a Presidential run, that would come six years later, he adopted the Heritage Foundation plan, complete with an “individual mandate”, and worked with the state’s Democratic legislature to enact the law. The mandate required all to be insured or pay the greater of $695 per adult and $347.50 per child per year or 2.5% of household income annually to the state.
When Barack Obama assumed the Presidency in 2008, the annual per capita health bill in the U.S. had reached nearly $8000 per year, twice the amount of any comparator developed nation in the world. Coming in, President Obama knew health care would be his signature legislation, and that he’d pay a steep price for it.
From the outset, three things were clear. First, a second run of the famous “Harry and Louise” ads that collapsed the Clinton health care effort in 1992 had to be headed off. So Obama met with each of the four health sectors – the AMA, the American Hospital Association (AHA), PhRMA, and the insurers – and made significant early concessions. No Medicare price negotiations or importation from Canada for PhRMA; lucrative Medicare Advantage plans for insurers; protected non-profit status and continued subsidies for hospitals for medical education and serving the underserved; and no changes in reimbursement for doctors.
Second, the template for what became the Affordable Care Act would be the Massachusetts universal health care initiative, a product of a Republican think tank and a Republican governor. Third, Republican Majority Leader Mitch McConnell would do everything within his power to block and destroy the legislation since he had already pledged that his single objective as Leader was to assure that Obama would be a single term President.
On March 23, 2010, President Obama signed the Affordable Care Act into law initiating a decade long war with Republicans on two fronts. First, in Congress, Republicans voted to repeal the law more than 60 times, all unsuccessfully. The most dramatic attempt came on July 28, 2017 when John McCain teamed up with fellow Republicans Lisa Murkowski and Susan Collins, and managed to appear in the chamber near death from brain cancer to provide a camera ready “thumbs down” to the Trump/McConnell effort.
Over this same decade, Republican-led states in parallel had attacked the law on Constitutional terms, chipping away at the statutes, without offering an alternative. Opponents termed the act “Obamacare” as if it were a pejorative label. The President turned that on his critics stating, “I have no problem with people saying Obama cares. I do care.”
“Repeal and Replace” became the rallying cry of Republicans. They didn’t succeed. But numerous challenges to the constitutionality of the legislation continue to this day.
In 2012, 26 Republican led states Attorney Generals joined in a suit to challenge the individual mandate which worked its way up to the Supreme Court. This was a component of the Massachusetts law designed to insure that all citizens and organizations would participate and contribute to even risk-sharing essential for insurance viability. Romney had tried to remove the clause from the Massachusetts bill but his veto was overridden by the Massachusetts legislature. In the federal bill the mandate was the “stick” to counterbalance the various “carrots” of premium subsidies.
The petition against the ACA mandate became the landmark case – National Federation of Independent Business v. Sebelius, 567 U.S. 519 (2012). The argument for repeal of the mandate was based on the fact that the administration had justified the mandate as constitutional based on the Article 1 Section 8 Commerce Clause or Necessary and Proper Clause. On June 28, 2012, Chief Justice Roberts disappointed fellow Republicans with a complex decision that split the difference.
As he stated in his closing: “The Affordable Care Act is constitutional in part and unconstitutional in part. The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it. In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance. Such legislation is within Congress’s power to tax.”
Roberts did support Republicans on a separate issue. The ACA had mandated that all states expand eligibility to Medicaid and agreed to subsidize 90% of the added expense. Republican states challenged the right of the federal government to impose those changes.
The Court’s ruling stated, “As for the Medicaid expansion, that portion of the Affordable Care Act violates the Constitution by threatening existing Medicaid funding. Congress has no authority to order the States to regulate according to its instructions. Congress may offer the States grants and require the States to comply with accompanying conditions, but the States must have a genuine choice whether to accept the offer.”
President Obama and Vice President Biden declared victory, praising the decision, and House Speaker Nancy Pelosi honored the lifelong campaign for universal health care by Ted Kennedy, who had died of brain cancer 10 months earlier, stating that he could now “rest.” Despite Republican pledges to fight on, as the New York Times wrote that day this ruling “may secure Obama’s place in history.”
President Biden echoed these same sentiments recently stating, “When I ran for President, I promised I would protect and build on Obamacare — and that’s exactly what my Administration has done. Thanks to the American Rescue Plan, ACA premiums are at an all-time low, while enrollment is at an all-time high…We’ve made tremendous progress, but our work is far from over.”
Need more specifics?
- “Thanks to the American Rescue Plan, ACA premiums are at an all-time low, while enrollment is at an all-time high.”
- “Four out of five Americans can find quality coverage for under $10 a month, and families are saving an average of $2,400 on their annual premiums.”
- “… increased enrollment to a record high 14.5 million Americans … including nearly 6 million who enrolled for the first time…”
- “…an additional 18.7 million low-income Americans now covered by Medicaid expansion.”
- “…the HealthCare.gov enrollment rate increasing by 26 percent for Hispanic Americans and 35 percent for Black Americans.”
Imagine’s Lyrics 51 Years Later – On National Indigenous Peoples Day.
Posted on | October 10, 2022 | 2 Comments
Mike Magee
John Lennon‘s Imagine was released as a single today 51 years ago. Many of the comments in response to last week’s Hcom question (“How civilized are we humans?”) focused on aspirations for hope, peace, and mutual understanding. Yesterday was the 8th national holiday on our calendar – originally Columbus Day, now Indigenous Peoples Day. At the core, the day is intended to recognize and celebrate our differences. In 2006, Jimmy Carter said, “In many countries around the world – my wife and I have traveled to about 125 different countries – you hear John Lennon’s song ‘Imagine’ used almost equally with national anthems.” In this spirit, take a few minutes to read and reflect on Lennon’s original words which suggest that, even in our complex diversity, there is much we share in common.
Imagine there’s no heaven
It’s easy if you try
No hell below us
Above us, only sky
Imagine all the people
Livin’ for today
Ah
Imagine there’s no countries
It isn’t hard to do
Nothing to kill or die for
And no religion, too
Imagine all the people
Livin’ life in peace
You
You may say I’m a dreamer
But I’m not the only one
I hope some day you’ll join us
And the world will be as one
Imagine no possessions
I wonder if you can
No need for greed or hunger
A brotherhood of man
Imagine all the people
Sharing all the world
You
You may say I’m a dreamer
But I’m not the only one
I hope someday you’ll join us
And the world will live as one
How Civilized Are We Humans?
Posted on | October 5, 2022 | 4 Comments
Mike Magee
“These are unprecedented times.”
This is a common refrain these days, from any citizen concerned about the American experiment’s democratic ideals.
Things like – welcoming shores, no one is above the law, stay out of people’s bedrooms, separation of church and state, play by the rules, fake news is just plain lying, don’t fall for the con job, stand up to bullies, treat everyone with the dignity they deserve, love one another, take reasonable risks, extend a helping hand, try to make your world a little bit better each day.
But I’ve been thinking, are we on a downward spiral really? Or has it always been this messy? Do we really think that we’ve suddenly bought a one-way ticket to “The Bad Place”, and there are no more good spots to land – places that would surprise us, with an unpredicted friendship, a moment of creative kindness, something to make you say, “Wow, I didn’t see that coming.”
I’m pretty sure I’m right that human societies, not the least of which, America, will never manage perfection. But is it (are we) still basically good? What does it mean to be human, and more specifically American?
In their 1980 book, “Fearfully and Wonderfully Made”, written by surgeon Paul Brand and Christian popular writer Philip Yancey, they included a story, attributed to an unidentified speech given by Margaret Mead some time in the past. While it has never been able to be validated, if the anthropologist really said it or not is probably inconsequential, because it rings true to so many.
Here’s one account of the full (non-verified) response:
“Years ago, anthropologist Margaret Mead was asked by a student what she considered to be the first sign of civilization in a culture. The student expected Mead to talk about fishhooks or clay pots or grinding stones.
But no. Mead said that the first sign of civilization in an ancient culture was a femur (thighbone) that had been broken and then healed. Mead explained that in the animal kingdom, if you break your leg, you die. You cannot run from danger, get to the river for a drink or hunt for food. You are meat for prowling beasts. No animal survives a broken leg long enough for the bone to heal.
A broken femur that has healed is evidence that someone has taken time to stay with the one who fell, has bound up the wound, has carried the person to safety and has tended the person through recovery. Helping someone else through difficulty is where civilization starts, Mead said.”
So let’s say this is true. One follow-up question I would have liked to ask Mead was, What was the helper’s motivation, do you think? Was it mutual survival? Was it engrained human kindness or empathy? Was it love? And do you think the the recipient of the care was surprised?
The capacity to be surprised, I think, is no small thing. It ties back to a bit of advice my father used to offer when I was young. “Guard against being too knowledgeable.” What he was advising (with limited success back then) was that “certainty,” directed at circumstances, people, or conditions (and especially in moments of anger or fear) can land you way off the mark and lead to regrets.
To embrace the capacity to be surprised in a good way requires that we maintain openness to the possibility that people and circumstances may not be exactly what we think. An excellent example of this was the behavior of Surgeon General C. Everett Koop in the face of the HIV/AIDS epidemic during the Reagan administration.
Koop at the time was a Don Quixote type character, a long time and aggressive pro-life campaigner and companion of uber-conservative minister, Francis Schaefer. When he was approached by Carl Anderson, a Catholic aide to North Carolina Senator Jesse Helms about accepting a nomination as Surgeon General, it seemed a sure thing and he promptly resigned his post as head of Pediatric Surgery at the University of Pennsylvania. After all, he not only had Helms support, but also Strom Thurmond and conservative Catholic Henry Hyde were firmly in his corner as well.
But what followed was nearly a year of bruising political combat as the AMA, the American Public Health Association (APHA), and a New York Times editorial on April 9, 1981 titled “Dr. Unqualified” attacked him with a vengeance
As he approached his 65th birthday in limbo, he quietly reached out to all sides, and finally in October, 1981, was permitted to plead his case before a Congressional committee that included Ted Kennedy and Henry Waxman. In that hearing, he stated to their surprise, “It is not my intent to use any government post as a pulpit for theology.”
For the next five years, he fought back against HHS Secretary Margaret Heckler, Reagan’s domestic policy chief ”family values” enforcer Gary Bauer, and Education Secretary Bill Bennett, to be allowed to address publicly the HIV/AIDS crisis. From 1983 to 1985, Koop was excluded from the Executive Task Force on AIDS. Finally, In October, 1986, Reagan first uttered the word, AIDS. By then, over 16,000 Americans were already dead.
Koop was finally given the green light to lead on a response to the crisis, and knew that public education had to be his primary tool. What became known, only years after, was that his primary friend and ally in the effort was the NIH’s Tony Fauci. Koop would consult with Fauci, day by day, as he formulated his drafts in secret. His 8-page pamphlet, titled “Understanding AIDS: A Message From The Surgeon General” arrived on 107 million doorsteps in America on May 26, 1988.
Senators Helms, Thurmond, Hyde and prominent conservative Christian televangelists attacked with a vengeance. He took the heat, stood up for America, and to the pleasant surprise of many who had earlier opposed him, stated “I’m the nation’s doctor, not the nation’s chaplain.”
Twenty years later, veteran ABC journalist, Dr. Timothy Johnson, had this to say about his friend: “He’s always willing to dialogue and listen to the other side. I think that’s a great strength.”
Truth and Trust in Science.
Posted on | September 29, 2022 | 6 Comments
Mike Magee
“The key is trust. It is when people feel totally alienated and isolated that the society breaks down. Telling the truth is what held society together.”
Those words were voiced sixteen years ago in Washington, D.C. It was October 17, 2006. The HHS/CDC sponsored workshop that day was titled “Pandemic Influenza – Past, Present, Future: Communicating Today Based on the Lessons from the 1918-1919 Influenza Pandemic.”
The speaker responsible for the quote above was writer/historian and Johns Hopkins School of Public Health adviser, John M. Barry. His opening quote from George Bernard Shaw set a somewhat pessimistic (and as we would learn 14 years later, justified) tone for the day:
“What we learn from history is that we do not learn anything from history.”
This was two years after the close of the 2002-2004 SARS epidemic with 8,469 cases and an 11% case fatality, and six years before MERS jumped from Egyptian camels to humans, infecting over 2,500 humans with a kill rate of 35% (858 known deaths.)
Specifically, John Barry was there that day in 2006 to share lessons learned from another epidemic, the 1918 Flu Epidemic which is now estimated to have killed roughly 700,000 Americans among a population that was roughly 1/4 our current size, with 2/3 of the deaths occurring over just a 14 week period from September through December, 1918.
The main point that Barry was trying to make that day focused on public communication during an epidemic, namely that “The truth shall set you free.”
Here were some of his 2006 reflections on 1918, a public health catastrophe at a time when the U.S. was focused on promoting strength not weakness during WW I.
“At best, they communicated half-truths, or even out-right lies. As terrifying as the disease was, the officials made it more terrifying by making little of it, and they often underplayed it. Local officials said things like ‘if normal precautions are taken, there is nothing to fear’…”
“Communication was rarely honest, because honesty would hurt morale.”
“There was a lot of cognitive dissonance. People heard from authorities and newspapers that everything was going fine, but at the same time, bodies were piling up.”
“Many times public health officials knew the truth but did not tell it. ..In many cases they were just plain lying.”
“The attitude of authorities was: ‘This isn’t happening, don’t worry about it.’”
Barry’s primary message that day was that communication breeds trust, and without trust, society breaks down. His words:
“The key is trust. It is when people feel totally alienated and isolated that the society breaks down. Telling the truth is what held society together.”
“The fear was so great that people were afraid to leave home or talk to one another. Everyone was holding their breath, almost afraid to breathe, for fear of getting sick.”
“False reassurance is the worst thing you can do. Don’t withhold information, because people will think you know more. Tell the truth— don’t manage the truth. If you don’t know something, say why you don’t know, and say what you need to do to know. Drown people with the truth, rather than withhold it.”
“The final lesson of 1918, a simple one yet one most difficult to execute, is that…those in authority must retain the public’s trust.”
But clearly that day, there was also a bit of a self-congratulatory air as well, an arrogance that today rings naive. John Barry says, “Today, I think, as opposed to back in 1918, we don’t have as much of a problem with misinformation…I want to emphasize that it is not likely that public health officials would tell outright lies.”
Twelve years later, on the 100th Anniversary of the 1918 Flu Epidemic, Barry re-released his New York Times best seller, “The Great Influenza: The Story of the Deadliest Pandemic in History”, a title that may not hold up as long as Covid-19 stubbornly holds on.
With Covid came Trump and his sycophants, and Barry’s theory (that mistrust can destroy societal order) was put to the test. In a 2020 interview at the University of Rochester, Barry holds strong to his messaging. “Those in authority must retain the public’s trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one.”
It is perhaps too easy to lay our current problems all on poor leadership at the top. Would that have been enough to deny the threat initially for months, and then spread false claims on fake cures, and then declare victory again and again prematurely? Was the public not somehow primed to accept such nonsense?
In the world I lived in for many decades, a profit driven world with vast rewards for scientific entrepreneurs, a world where progress up an integrated career ladder required cooperation, support for medical marketing on steroids, and bending the truth while turning a blind eye to errors of omission, truth was negotiable and trust was for the uninitiated.
A Red Painted Turtle On Rosh Hashanah.
Posted on | September 24, 2022 | Comments Off on A Red Painted Turtle On Rosh Hashanah.
Mike Magee
Tomorrow begins Rosh Hashanah, the Jewish New Year. This is the time when Jewish people ask God for forgiveness for their mistakes and errors over the past year and commit to learning from those mistakes as to not repeat them in the year ahead. The emphasis then is not on suffering, but on hope. And the remedies prescribed include “prayer, charity, and repentance” to be exercised in the 10-day period between the beginning of Rosh Hashanah and the end of Yom Kippur, the solemn fasting Day of Atonement, that this year extends from sunset on October 4 until after nightfall on October 5th.
The pinnacle of the liturgy, and the right notes of solemnity, according to many experts, is the Unetaneh Tokef, a poem focused on the judgement day for humanity, forecast as both “awesome and terrible.”
The poem recites out loud (in part) the questions we dare not ask.
How many shall pass away and how many shall be born,
Who shall live and who shall die,
Who shall reach the end of his days and who shall not,
Who shall perish by water and who by fire,
Who by sword and who by wild beast,
Who by famine and who by thirst,
Who by earthquake and who by plague,
Who by strangulation and who by stoning,
Who shall have rest and who shall wander,
Who shall be at peace and who shall be pursued,
Who shall be at rest and who shall be tormented,
Who shall be exalted and who shall be brought low,
Who shall become rich and who shall be impoverished.
But repentance, prayer and righteousness avert the severe decree.”
The Unetaneh Tokef entered the public culture for many as part of Leonard Cohen’s 1974 album, “New Skin for the Old Ceremony.” In that album, Cohen offers his version or take on the ancient and poetic prayer which resonates in an eerily familiar and contemporary way. Think an unpredictable pandemic and an utterly predictable Putin, forest fires and flooded streets, Sackleristic greed and our manmade opioid epidemic.
Cohen voices our despair in a single line: “And who shall I say is calling?”
Listen to these verses:
And who by fire, who by water
Who in the sunshine, who in the night time
Who by high ordeal, who by common trial
Who in your merry merry month of May
Who by very slow decay
And who shall I say is calling?
And who in her lonely slip, who by barbiturate
Who in these realms of love, who by something blunt
And who by avalanche, who by powder
Who for his greed, who for his hunger
And who shall I say is calling?
And who by brave assent, who by accident
Who in solitude, who in this mirror
Who by his lady’s command, who by his own hand
Who in mortal chains, who in power
And who shall I say is calling?
Yesterday, I took my 38 pound, 10 foot kayak, which fits inside my CRV, ten minutes away to a little pond in Avon, Ct. I had just read a piece on ecopsychology.
That’s the study of how nature, and humans immersion in it, benefits human health. That’s the raison d’être of an online magazine at Yale called Yale Environment 360. It’s a project published by Yale School of Environment which enjoys the support of the Ford Foundation, William Penn Foundation, and many others.
In 2020, they asked themselves “How long does it take to get a dose of nature high enough to make people say they feel healthy and have a strong sense of well-being?” After studying 20,000 people systematically, they had their answer. “Precisely 120 minutes” per week in a green space – whether a park, a small back yard, or the truly wild.
Unlike many health treatments, there were no significant disparities in the impact on feelings of healthiness these outings evoked. Ethnicity, occupation, poverty level, presence or absence of disability or chronic disease did not discriminate. The “calling” was ecumenical.
And yet each person’s journey, destination, and outcome is different. For me that day it was the the “calling” above, a red painted turtle (Chrysemys picta) on a log, similar to the many I had encountered as a young boy, exploring on a small lake, on my own, in northern New Jersey. It allowed me to quietly approach it, close enough to shoot the picture above, and share it (its vibrant colors, its sunshine reflection, its free spirit, and its full display of its own many ordeals) with you.
Happy Rosh Hashanah.
Constructed of star dust, could “Guardian Angels” still exist?
Posted on | September 14, 2022 | 5 Comments
Mike Magee
“EXCLUSIVE: Royal beekeeper has informed the Queen’s bees that the Queen has died and King Charles is their new boss in bizarre tradition dating back centuries. … He placed black ribbons tied into bows on the hives, home to tens of thousands of bees, before informing them that their mistress had died.”
So read John Dingwall’s exclusive in the Daily Mail posted at 03:48 EDT, 10 September 2022. In defense of what might first appear a bizarre practice, others were careful to provide evidence that the practice, of informing fellow natural creatures of important human losses, is well documented in art and literature, such as in “Der Bienenfreund” (“The Bee Friend”), an 1863 painting by the German artist Hans Thoma.
That painting arrived on the scene nine years after the death of German philosopher Friedrich Wilhelm Joseph von Schelling, a stalwart of “German Idealism.” His focus (in part) was on “humankind’s relationship to nature,” a subject that has received a spotlight as our planet’s “climate emergency” status has become undeniable.
As Stanford’s philosophy department sees it, “Schelling’s account of mind and world, particularly his insistence on the need not to limit our conception of nature to what can be objectified by scientific methods, is, in the light of the ecological crisis, proving to be more durable than his reception might until recently have suggested. The question Schelling still poses is how the capacity for expanding human knowledge and control of nature can be reconciled with sustainable ways of inhabiting that nature.”
Death undeniably disrupts the human order of things, but does it destroy our connection to life? Can we feel after death, and can those behind us somehow “feel” us? Is our organic chemistry, our DNA, transportable, translatable?
In Genesis 3:19 the reference to ashes and dust reads, “By the sweat of your brow you will eat your food until you return to the ground, since from it you were taken; for dust you are and to dust you will return.” But is that a one way street, or do we somehow maintain a cosmic, knowing, helping presence?
Judged by the now dominance of cremation as a choice over traditional burials, our comfort with rapid reconnection to our chemical and natural parentage is growing at an amazing rate. In America, we crossed the majority threshold in 2015. Currently nearly 60% of Americans who die are cremated. By 2040, the National Funeral Directors Association confidently projects that cremation will be the choice of at least 8 in 10 of our dying citizens.
Analysts offer a variety of explanations from cost savings, convenience, new Vatican liberalism, family migration, lack of homestead, and more. But is that all that is at work here?
Is everything one, as the 23 year old Schelling long ago suggested? In 1798, he addressed a group of students in his home town square in Jena, Germany, 130 miles southwest of Berlin. The subject? The “secret bond connecting our mind with nature.” Expanding on the theme, he proclaimed, “At the first moment, when I am conscious of the external world, the consciousness of my self is there as well, and vice versa — at my first moment of self-awareness, the real world rises up before me…As long as I myself am identical with nature, I understand what living nature is as well as I understand myself.”
But does it work in reverse? As the headline read, “When the Queen Died, Someone Had To Tell The Bees.” But why? Did they need us to know what had happened, or could they sense it themselves – some break in the order of things – some disturbance?
And what if today our human actions have so poisoned and doomed the environment and its’ ecology, that the bees survival is hanging by a thread? Would they still be able to recognize the Queen’s entry into their realm? And if not, would her angelic dust lay useless at the wayside?
Constructed of star dust, it remains a human responsibility to act as “Guardian Angels” toward each other and the many life forms that share this fragile planet.
_________________________________________________
In memory of our beloved oldest sister, Grace, who is a “guardian angel” to her husband Sam, her children and grandchildren, and her 11 younger brothers and sisters.
“Beyond Nicotine”: What Could Possibly Go Wrong With That?
Posted on | September 7, 2022 | Comments Off on “Beyond Nicotine”: What Could Possibly Go Wrong With That?
Mike Magee
Connecticut attorney general, William Tong, took a turn in the spotlight this week, representing 33 states and Puerto Rico in announcing that vaping original, Juul, had agreed to pay penalties of $438.5 million to settle law suits against the company.
Juul in essence acknowledged that the company’s marketers had targeted young students, used social media to attract underage teens, and had given them free samples. With 45% of the company’s Twitter followers between ages 13 and 17, and an age verification methodology authorities labeled as “porous”, they were happy to get the nation’s attorney generals out of their hair.
Over the past four years, Juul has lost over 95% of its value. When Altria bought a 35% stake in the company in December, 2018, they paid $12.8 billion. That translates to just $450 million today. What were they thinking? At the time, Juul was fighting to preserve their “flavor pods” – with mango and creme brûlée favorites among teens.
But the F.D.A. took a hard line, attempting to shut them down completely, attacking vaporized natural and synthetic nicotine. Lobbyists for Altria and Juul argued that they had helped 2 million Americans quit traditional cigarettes. That was enough to gain a “temporary reprieve”, sending the F.D.A. back to the drawing board for “additional review.”
By the way, local and state campaigns to curb teen vaping seem to have had an effect. E-cigarette use in a survey in March, 2022, found 8% or some 2 million teens had used an e-cigarette in the past 30 days. As for traditional smokers, 31 million are still addicted to cigarettes and 16 million currently have a smoking-related chronic disease.
In the meantime, tobacco giant, Philip Morris International, took a different tact. Last week they inked the purchase of Danish oral drug delivery company, Fermin Pharma, for $813 Million. They then “doubled-down” this week, announcing their intention to purchase “inhalation specialist” Vectura for $1.2 billion.
What are they up to? Their official site says this is all part of their “Beyond Nicotine” strategy, and will now be pursuing “respiratory drug delivery” and “selfcare wellness.” How much is that worth in future revenue. The company projects $1 billion in net revenues from these ventures by 2025. This is in part because Vectura has significant expertise with 13 inhalable products already on the market and $245 million in 2020 sales.
The concise market message reads:
“Philip Morris International (PMI) is leading a transformation in the tobacco industry to create a smoke-free future and ultimately replace cigarettes with smoke-free products to the benefit of adults who would otherwise continue to smoke, society, the company, its shareholders and its other stakeholders.”
And PMI says the future is bright: “The market for inhaled therapeutics is large and growing rapidly, with significant potential for expansion into new application areas. PMI has the commitment to science and the financial resources to empower Vectura’s skilled team to execute on an ambitious long-term vision. Together, PMI and Vectura can lead this global category, bringing benefits to patients, to consumers, to public health, and to society-at-large.”
What could possibly go wrong with that?
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