House approves bill to expand gun-sale background checks
By MATTHEW DALY
Thursday, February 28
WASHINGTON (AP) — The Democratic-controlled House on Wednesday approved a measure requiring federal background checks for all firearms sales and transfers, the first major gun control legislation considered by Congress in nearly 25 years.
Democrats called the 240-190 vote a major step to end the gun lobby’s grip on Washington and begin to address an epidemic of gun violence that kills thousands of Americans every year, including 17 people shot and killed at a Florida high school last year.
The bill is the first of two the House is voting on this week as Democrats move to tighten gun laws following eight years of Republican control. The other bill would extend the review period for background checks from three to 10 days.
Both bills face dim prospects in the Republican-controlled Senate and veto threats from President Donald Trump, who said they would impose unreasonable requirements on gun owners.
Just eight Republicans joined 232 Democrats to support the bill, while only two Democrats voted against it.
The White House said in a veto message that the background-checks bill could block someone from borrowing a firearm for self-defense or allowing a neighbor to take care of a gun while traveling.
Democrats called those arguments misleading and said gun owners have a responsibility to ensure firearms are properly handled. The bill includes exceptions allowing temporary transfers to prevent imminent harm or for use at a target range.
The long-delayed bill would merely close loopholes to ensure that background checks are extended to private and online sales that often go undetected, Democrats said.
“People who are felons or are dangerously mentally ill shouldn’t have guns,” regardless of whether they buy them from a federally licensed dealer or their next-door neighbor, said Rep. Mike Thompson, D-Calif., a key sponsor who has pushed for expanded background checks since the 2012 killing of 20 elementary school students in Newtown, Connecticut.
“For six-and-a-half years, we had no cooperation from the past majority” in the House, Thompson said. “We couldn’t get a hearing on the bill. We couldn’t get a vote. Today, we’re here to tell you it’s a new day. With this (Democratic) majority, we have made a commitment to address the issue of gun violence.”
While Republicans mostly opposed the bill, the GOP scored a procedural victory when the House accepted a Republican amendment requiring that gun sellers notify Immigration and Customs Enforcement when an illegal immigrant tries to buy a gun. Twenty-six Democrats joined with Republicans to support the amendment, offered by Rep. Doug Collins, R-Ga.
House Speaker Nancy Pelosi downplayed the GOP proposal, saying, “We won a big victory — get the message.”
Pelosi, D-Calif., called the House vote “historic” and hailed the bill as “a long-overdue, commonsense action to end the epidemic of gun violence in America.”
To demonstrate her support for the bill, Pelosi wore an orange dress while other Democrats wore orange ties or scarves, the color used by the movement against gun violence.
Rep. Madeleine Dean, D-Pa., said she hopes the symbolism will soon become obsolete.
“I long for the day when orange scarves are a fashion statement, not a cry for help,” said Dean, who was wearing a bright orange scarf.
House Minority Whip Steve Scalise, R-La., who was gravely wounded in a 2017 shooting at a congressional baseball practice, said stricter background checks would not have prevented his shooting or other tragedies.
“What it would do is make criminals out of law-abiding citizens,” Scalise said. “If you go hunting with a friend and your friend wants to borrow your rifle, you better bring your attorney with you because depending on what you do with that gun you may be a felon if you loan it to him.”
Democrats said the bill includes exceptions allowing temporary transfers for anyone who feels threatened by a domestic partner or other person. The bill also allows a gun owner to loan their weapon and for use at a target range.
“There is no reason to continue to make it easy for people who are legally prohibited from possessing firearms to acquire them by circumventing the background check process,” said Rep. Jerrold Nadler, D-N.Y., chairman of the House Judiciary Committee. The background checks bill would “close this dangerous loophole and save lives,” Nadler said.
Collins, the top Republican on the Judiciary panel, said the bill “foolishly presumes criminals who flout existing laws will suddenly submit themselves to background checks.”
Democrats and other bill supporters are “delusional” if they think “a criminal trading cocaine to another criminal for a firearm will reconsider due to” the background checks bill, he said.
But Kris Brown, president of Brady, a gun control group formerly known as the Brady Campaign to Prevent Gun Violence, said the bill will save lives.
Brown called the House vote “a monumental step forward for gun violence prevention in our country” and hailed Thompson and other lawmakers who pushed for the measure.
“On to the Senate!” she said.
Associated Press writer Lisa Mascaro contributed to this report.
When Will We Ever Learn?
By Ellen Lindeen
On Tuesday evening, February 27, 2019, I attended a beautiful, yet painful, event, entitled, “Vigil in Remembrance of Those Affected by Gun Violence.” The event, sponsored by Moms Demand Action, was at a local church, in my hometown, in the northwest suburbs of Chicago. Names of those who have been killed were read. Hopeful statements by survivors were also read by attendees, and while the familiar sites of many shootings were also named (Columbine, San Bernardino, Orlando, Sandy Hook … sadly, the list went on and on), we all lit candles. I was prepared to be there I thought. As a college professor of more than two decades, so many shootings have taken place at schools, that at the start of each semester, I have always looked around my classroom and imagined what I would do and say to protect students if someone with a gun appeared at the door.
Part of my usual classroom routine has always been to put quotes on the board for students each day we met. I have a long list of favorites, but the list continues to grow. In 2015, I felt I had to add the following when I learned the details. A fellow English instructor at a community college was killed on the first day of class. As a tribute to his life, I wrote on the board for my students:
“’Today is the first day of the rest of your life,’ written on the board on the first day of class in introductory Writing 115, at Umpqua Community College in Oregon by adjunct English professor, Larry Levine, 67, before he was shot along with nine others by a lone gunman.”
Honestly, I have become a bit numb when I hear of another shooting, but I still pay attention. Students in my classes in the last few years were born about the time of the Columbine shooting, so they’ve grown up with active-shooter drills. Yet, I still came to a difficult realization at the Vigil as I was listening to the featured speaker, Lauren Carr, a survivor from the 2008 shooting at Northern Illinois University. She explained that she was in the third row when someone entered her lecture hall at the right of the stage and began shooting. All the students around her were hit. Her laptop took a bullet and her seat had bullet holes, but somehow she escaped. She spoke bravely about her fears since the event, followed by anger, and then therapy, and now her active practice of looking for good in others.
Carr went on to explain that just a year ago, she and other survivors met in DeKalb, Illinois, on the NIU campus for the 10-year anniversary of the shooting, February 14, 2018. Many had stayed in touch but it was helpful to be together, facilitated by university professionals, to discuss their progress, to remember their friends, and to commemorate that they were still here and thriving, or at least attempting to thrive. Then Carr paused, and explained at a certain point during their reunion, some of them started getting texts, and then all of them did. The information they received revealed the facts of the mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida actively taking place. Ten years later, on Valentine’s Day again, another mass shooting disrupted our country, killed more young people, and destroyed the faith and trust the survivors from NIU were just beginning to feel.
Astounded, I realized that when the Parkland shooting occurred, I didn’t put the date together with the shooting at NIU exactly 10 years earlier. How common must these shootings have become for me, despite actively seeking for ways to prevent one in my own classroom, that the same date did not even register. I had not lost a loved one at NIU, but perhaps I just subconsciously decided to let February 14 stay Valentine’s Day?
Most Americans know we have a gun problem in the United States, but are we still looking for solutions? Thankfully, the Parkland students launched the March for Our Lives that many of us participated in, but have universal background checks been passed into law yet? Just last week, a gunman killed five people at a place of business in the city of Aurora, IL. A student from NIU was an intern there, reporting for his first day of work. Is this ever going to stop? When will it ever end? When will we ever learn?
Ellen Lindeen, syndicated by PeaceVoice,is an Emeritus Professor of English at Waubonsee Community College where she taught Peace Studies & Conflict Resolution and Human Rights & Social Justice.
A new way to pay for innovative drugs, provide universal access and not break the bank
February 28, 2019
Author: Neeraj Sood, Professor of Public Policy, University of Southern California
Disclosure statement: Neeraj Sood has been a paid scientific advisor to several organizations in the health care industry including health insurers, drug distributors, pharmacuetical firms, economic consulting firms, litigation consulting firms, health care start-ups, and professional organizations.
Partners: University of Southern California provides funding as a member of The Conversation US.
On the heels of congressional testimony by the CEOs of major drug makers, there are some important things to keep in mind. The U.S. faces a drug pricing crisis in large part because pharmaceuticals are in a golden age of advancement. A new pill cures hepatitis C. Immunotherapies devour cancer cells. Regenerative medicine promises longer life spans.
All of that advancement comes at a high cost. Drug companies seek recovery through high prices, which guarantees profits but reduces widespread access to the remedies. In particular, Medicaid, the federal and state health program for the poor, disabled and elderly, which enrolls 70 million Americans, faces major hurdles in paying for lifesaving treatments.
It has turned into a politically explosive predicament. A National Academies of Science consensus report which I was involved with and a paper in a leading medical journal that I authored suggests a way out, and Louisiana will be the first state to put this solution into practice.
A novel approach in a very poor state
Louisiana, which has a severe hepatitis C problem, is on the cusp of proving to other states that drug companies can make the money they need, while every Medicaid recipient who needs a cure gets one.
Nationally the hepatitis C story is a scandal. Even with a cure on the market, more than 20,000 Americans still die of the disease each year, more than the combined toll of 60 other infectious diseases. The reason for this high death toll is the high price tag of the curative drugs and as a result Medicaid restricts access to these drugs.
In Louisiana, only 384 of the 35,000 infected people who are on Medicaid or in prison got treatment in 2017 because of the prohibitive cost. Prices have dropped by two-thirds from the introductory level of US$80,000 per treatment, but even at that level eliminating the disease among Medicaid recipients would cost the state $700 million. Louisiana, which like other states shoulders part of Medicaid costs with the federal government, could afford that only if it blew up its budget for schools and health care, among other services.
The state is now on a path to secure immediate treatment for all infected prisoners and people on Medicaid by buying a license from a drug company. It is a concept that can be applied to other ground breaking remedies. The idea was first outlined in a consensus report for the National Academies of Sciences, Engineering and Medicine and later in a paper in the Annals of Internal Medicine. Here is how it will work:
Louisiana spent $35 million last year on hepatitis C treatments spread among several pharmaceutical companies. On Jan. 10, 2019, the state announced that it intends to use that amount as leverage, drawing the companies into a competition for the state’s business.
Louisiana is seeking to negotiate a contract with a single drug manufacturer to provide all the hepatitis pills the state needs for a lump sum, payable annually over a five-year contract that is roughly equal to the state’s current $35 million hepatitis C spending among all makers. Once a contract is signed in April, the company that won the contract will stand ready to supply as many pills as the state requires. The price-per-pill model disappears, so Louisiana can treat as many patients as it wants without worrying about the costs of treating additional patients.
Louisiana State Health Director Rebekah Gee spearheaded the effort to establish a license after the NAS study was published. The strategy exploits market competition among firms in a voluntary transaction that nevertheless breaks the current stranglehold high prices have over access to the medicines.
Under the status quo of “price-based contracting,” firms derive profits from high prices, which in turn means reduced access to the drugs. Instead, the Louisiana system is based on what is called “revenue based contracting,” which severs the link between profits and restricted access. That is, a firm that wins the contract with the state can ensure profitability by negotiating an appropriate lump sum payment, guaranteed over five years. Once a lump sum payment is set, the state’s cost of providing drugs to additional patients is close to zero because the contract stipulates that the pharmaceutical company is obligated to meet the volume of the state’s needs.
The question now is will drug makers participate in a competition to license their product to the state. The early outlook is positive. Gilead and Merck, makers of major hepatitis C drugs, both told the state in 2018 that they were interested, and AbbVie has said it intends to participate.
The deadline for submitting a proposed contract is Feb. 28, 2019, and the state hopes to implement the program by July 1. At that point, Louisiana could begin eradicating hepatitis C in its Medicaid and prison populations.
Other states should not be far behind. A long-awaited report from the National Governors Association on controlling drug costs endorsed the idea. In January 2019, Washington state began soliciting bids from drug makers for a guaranteed price for its Medicaid beneficiaries.
There is every reason to believe that the licensing model will work for containing costs of other expensive new drugs as well. States, or a consortium of states, can offer long-term contracts that can assure drug companies of the return they need to satisfy shareholders and pay for development costs. The large number of possible contracts in the 50 states means there is plenty of business for companies to seek.
Licenses are a time-tested way to guarantee streams of revenue to manufacturers while lowering users’ marginal costs to zero. This model is common in many knowledge-based industries such as software where product development costs are high but once a product is developed, the cost of providing the product to an additional user is close to zero. It’s time to implement this pricing model in health care. It can lead us out of our prescription drug crisis by bringing universal access without breaking the bank.
Llewellyn King: Will Smart Cities Be Haven for New Kind of Lawyer?
By Llewellyn King
SAN ANTONIO — Disruption equals opportunity. That was the message that came across loud at a conference here organized by CPS Energy, the local gas and electric utility, on smart cities — a revolution that is underway and surging.
Simply, smart cities are convergence of digital technologies, from street lights to driverless vehicles. Cities — there are more than 19,000 of them in the world — represent a great new vista of business opportunity for new entrepreneurs.
Coincidentally, a small but distinguished law school in Carlisle, Pennsylvania, is, in its way, seeking to upend the traditional expectations of law students by teaching them law plus innovation and entrepreneurism.
Dickinson Law, founded in 1834 and is now part of The Pennsylvania State University, but operates autonomously, is seeking to turn out a new kind of lawyer: One who is interested in becoming an entrepreneur rather than simply practicing law.
The program is the concept of Samantha Prince, assistant professor of legal writing and entrepreneurship, who had been an entrepreneur as well as a lawyer. She told me that she wanted the Dickinson Law students to realize what a useful and versatile tool a law degree is, and how it can offer those who have one a wide range of opportunities beyond the traditional practice of law.
Prince, with the energetic support of dean Gary Gildin, told me many students have not come to Dickinson Law straight out of college but have had work experience, which makes them more open to a wider range of possibilities.
A partner at one of the large law firms in Washington told me that she wishes her education at one of the nation’s top law schools had been just a little less academic and broader. She said the curriculum was fascinating, but much of it was arcane and directed to the study of the history of law and its seminal turning points. No thought was given to the idea that she might want to use her legal knowledge in any other way than to practice law, probably in a big firm. That she has done.
Lawyers, of course, have always been entrepreneurial. But Prince says that has been in the confines of the profession.
Prince wants her students to think about — at least some of them — how they can use their legal knowledge to start a business, pulling together investors, creators and visionaries.
The faculty at Dickinson Law wants to see some students take their chances and test their mettle in the marketplace. One problem: The study of law is a study of what can go wrong, and new business is a belief in what might go right.
Prince’s students have something of an advantage as they tend to be older and to have had real-life experience. Already some of them are thinking of law differently: Zachary Gihorski wants to use his legal training to lead and shape the future of agriculture; Christian Wolgemuth wants to enter cybersecurity practice and eventually become an entrepreneur; and Ana Anvari wants to serve health care businesses by advising them on health care regulation and helping them to start up or expand their businesses.
Those who are thinking of self-employment may find the new vitality in cities a place of opportunity. The cities are going to be wide open to everything from better electric vehicle charging to automated garbage collection, to repair and maintenance of the automated systems, to restaurants delivering meals by drone. If you can think of it, it will probably be needed.
Although the big tech companies, from Google to Tesla, AT&T to Verizon and Amazon to IBM, are salivating over the new smart city opportunities. History teaches that great fortunes are made by new players when, so to speak, the ground shifts.
The ground is shifting in cities like San Antonio, Chula Vista, Calif., Boston and Houston.
Smart cities represent a huge entrepreneurial chance for smart people — lawyers and otherwise.
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