Preliminary Thoughts on Trump's Drug-Price EO's

Okay, so as we all know, drug prices ARE out of control, here in America, a problem that we all had hoped ACA/Obamacare would help with - the idea of insuring everybody, by creating a government fair-market price to compete with regular price.

The government "fair-market" insurance option to compete with commercial insurance options was brilliant in theory, but had some major problems in practice when it came to income limits and tax penalties, most of which have been fixed - but with the main problem has not been fixed, and can't unless we come up with some form of price regulation itself. 

Because in response to ACA/Obamacare, instead of lower their prices to compete with the government market plan, all that participating commercial insurance companies and pharma companies did was just raise their prices, so that prices all around, government market and regular commercial insurance, were even higher than before (just like gas prices can raise and lower their prices at whim) and then tried to blame Obamacare for making their doing so necessary.

So it became clear that we do need some sort of restrictions - but the question is then how can we do that, while still maintaining fair-market competition?

And as we all know, I'm a Democrat, so you would think I would like these new EO's, yes?

Well, I'm still reading on it, these are just my preliminary thoughts, so forgive me if I'm off in full understanding - but from what I've read thus far - not so much.

Why?

Because these are complex systemic issues that putting a single-cap threshold on price/out-of-pocket cost won't solve.

That's exactly the problem with Medicare as it is - Medicare is not allowed to negotiate the price of drugs, like commercial insurance companies - they're only allowed to just give a blanket threshold cap on price (which affects, but does not limit commercial price) -  which is why we know a cap threshold won't work (see this and other reasons why below.)

Also, it's not JUST the fault of pharma, like Trump said - it's also the fault of insurance companies themselves (again, see below).

More importantly, EO's don't carry as much power/weight as congressional law, especially in healthcare - they won't make much, if any, difference.

In fact, Trump's decision seems more of a reckless, sudden, desperate "karate chop" of a slapping a Band-Aid down on the gushing-artery of a systemic, complex, bleeding problem.

(Perhaps after largely ignoring/neglecting the issue entirely, for the last 3-1/2 years, as well as because he's dropping like a rock in the polls behind Biden in the polls, after his Portland stunts and COVID response? ;).

Although, I'm a Democrat, contrary to propagandized and popular belief, we do NOT want everything free - we just want more assistance to people who genuinely cannot afford certain necessities, and we want more consumer protection laws and labor protection laws for them as well.

Thus, I'm a fan of fair-market competition, because it actually works -when it truly is "fair-market competition," and includes both consumer protection laws and labor protection laws.

(Also, valuing "fair-market competition" should NOT be confused valuing "trickle-down economics" - they are not one in the same. "Trickle down" theory has been repeatedly proven to only work locally, and has never once proven to work at the national corporate or international corporate level.)

The problem is, it's NOT a fair, competitive market, it's being abused with little to no consumer protection - and despite Trump blaming JUST Big Pharma for that - both pharma AND insurance companies should share the blame.

Because even though we have generics and biosimilars on the market, some prices still never come down, the way they're supposed to when there's lot of viable competition - which is the fault of pharma.

*HOWEVER* insurance companies are equally to blame, especially for the patient out-of-pocket cost share.

That is because insurance companies choose a particular drug as being on preferred or non-preferred formulary, often based more on whatever contracting deal with discounts/rebates that they receive from the manufacturer, rather than the actual efficacy and safety of the drug.

They DO take clinical efficacy into account, but if there are two similar drugs, they're going to put the one on "preferred" formulary if the manufacturer gives them the better deal, even if somewhat inferior. 

In other words, out of two similar drugs, insurance companies will often choose to put on their preferred formulary  (cheaper-cost to the patient) - whichever drug  manufacturer offered them the biggest discount and rebates - even if that drug has been proven less effective and less safe than the other option. 

As a result, you, the patient, will often have to step through and trial/fail the generics AND the preferred brand first, before you can get to the better/safer drug - simply because the more effective/safer drug did not offer the insurance company better rebates/discounts versus the other one - which will cost you, the patient, more out of pocket, because it's on the "non-preferred"formulary, based on the manufacturer-insurance contracting deal.


As you might imagine, this broken aspect of our current healthcare system pisses off doctors and pharmacists like nothing else, because they believe they should have most of decision power on treatment for a patient, not the insurance company. 

 They're okay with passing checkpoints for coverage, but are NOT always okay with the fact that in the end, the insurance company decides what drug treatment the patient is on, based on the almighty dollar being king.

You will also find that most doctors, ethical ones, don't even care if they, personally, get to share in the drug-manufacturer rebates - they still would prefer choosing the best treatment over the cost/rebates (at least the ethical ones, do) - because they took an oath to provide the best care possible to the patient, not provide the best bottom line profit.

This is why I say corporate health insurance companies are just as much to blame as Big Pharma, and why we Americans say that healthcare has become too commercialized, as well as why we would all like more transparency on how commercial insurance companies make their formulary decisions on a particular drug, as well as want to allow Medicare to be able to negotiate price, just like commercial insurance does.


Thus, one threshold-cap price oversimplifies all of the complexities of the actual clinical aspects of the drugs themselves, not taking into account that all drugs are not equal even in the same class - what drugs have already been tried/failed, safety and tolerability, black-box warnings/drug-drug interactions, routes of administration, mechanisms of action, subgroups that would benefit from a certain drug versus another, etc.

As I've mentioned, I currently have two gigs as a contractor - one as a medical transcriptionist for a large university hospital and clinic, and the second is transcribing the interviews between independent marketing research companies, who have been hired on behalf of various pharmaceutical manufacturers.

Just as a brief overview of what I'm typing on this second gig, without giving any private info away, the independent marketing researchers have been hired by various manufacturers to get feedback from expert physicians, insurance-company medical directors, insurance CFOs, hospital and clinic P&T finance committee members, pharmacists, and pharmacy directors.  

The interviews are blinded - meaning the respondents (and myself) do not know who the pharmaceutical company is nor the name of their product, and the pharmaceutical company doesn't know who they are.  

The interviews are conducted either before or during a clinical trial, to find out what they'd like to see as far as trial design - primary and secondary endpoints for clinical trials on new drugs -  and/or what they think of the preliminary results of these trials.  

Above all, they always ask their input on price point, especially compared to other drugs already existing in the same class (if there even is a class yet, but usually there is, because we still don't have a lot of actual revolutionary cures yet, besides some gene therapies are promising). 

They will also offer different "what if" scenarios, regarding whether their new drug came in at parity, lower, or  higher compared to other drugs in the class. 

That's about all I can say about that ;)

However, general point being, all of the groups - clinical, payer, pharmacy - are all carefully weighing the efficacy value versus safety value versus the route of administration (oral, infusion, injection) value versus price value of all the other drugs in the class, before they give those answers. 

What I have learned is how complex trying to do this really is, how hard it is to know where to come in, if you have a new product in the same class.   

If you're not an actual cure, but your drug's efficacy, safety, and routine of administration (oral/infusion/injectable) may be better/preferred - which is the case most of the time - you're still competing against a drug that came out three years before your product and has more time of real-world usage.

Therefore, despite clinical trials, both clinicians, and especially insurance companies, are still likely going to reach for what they know and are comfortable with using in the real world, where we know we have lots of patient compliance/adherence problems, versus a controlled clinical trial that shows better efficacy, but where it's ensured patients will receive the dose.

So IMO, not reflective of anyone else but me - the problem is with the price of that very first drug in the class that becomes the key comparator - that's where we need some sort of restriction, but  - not all the "me toos" that come after that have to compete with it, that are often improved versions with better efficacy?

However, this isn't as easy as a "cap" - because there IS value in a drug in a disease that we had absolutely no options in before, and there should be.

HOWEVER, at present, that first drug in class, despite not being an actual cure, can charge whatever they want, the sky is the limit, because there's nothing else in that class to compare it to - even if it doesn't do all that much, isn't all that safe, and they're charging 100 times what it costs to actually make the drug. 

If a drug is not an actual cure and isn't all that safe, there is no good reason it should cost $400,000 a year, I'm sorry - and you know dang well it doesn't cost the company even half of that to make, including research and development and clinical trials. 

Also to be kept in mind, the first drug in class will typically not be the best - within 3 to 5 years, a better brand will come along, as well as generics and biosimilars - and yet, as I said, doctors, and particularly insurance companies - will still want to reach for that tried-and-true, real-world drug they're comfortable with before that new, better one.

However, when I say "some sort of restrictions on that first drug in class," I do NOT mean just placing a blanket threshold restriction on the first drug in class - because what if the next drug in the class truly is better, or even an actual cure - is there not greater value in that?

For example, right now, we have lots of drugs aimed at heart disease with different mechanisms of actions, it's a very crowded space.

At present, we can't actually repair or cure heart disease with a drug - we can only try to prevent or help reduce the calcium plaque burden by lowering cholesterol.

But what if we had a drug that could actually repair heart vessels, reverse the damage?

Though it's first in class, it would ordinarily set the price; however, if there's a threshold cap, it doesn't matter - the price for the actual cure will be the same as the drugs that only help prevent - is it fair the actual cure for the disease would have to come in at parity or lower than the non-cure?

Of course not.

Now, the non-cure still has some value, because it can still help prevent heart disease in people who don't have it yet; so theoretically, according to fairomarket economics, they would lower their price to compete with the cure, right?

However, what incentive would they have to do that, considering the cost of the cure and the non-cure are at exactly the same price threshold?

On the other hand, let's say the drugs have similar mechanisms of actions and similar targets; let's say they both lower cholesterol, but the newer brand is actually better and safer than the first drug in class.   

With a threshold cap, even though the first drug is an inferior and less safe product, they're still priced the same. Is that fair?

Of course not.

So you see the problem with trying to place a single threshold cap price on all drugs.

Some of the interviews I transcribe are international - U.K., France, Spain, Germany. 

Of course, they have varying degrees of socialized healthcare and we don't - but I think we should do a thorough evaluation of their systems, what works and what doesn't, before we start laying down blanket generalization restrictions on things without considering what's happened before us, when people tried to do that.

In other words, study what works and what doesn't, regarding these other systems first. 

Contrary to popular belief, in the U.K, they do NOT just blanket price restrict medications, with one cap price on everything - there are varying levels of thresholds, based on all of the issues I mentioned above - PLUS- QALYs, which is unique to almost all other nation's healthcare systems.

What's a QALY?

QALY stands for Quality Adjusted Life Year - meaning they also take into account quality of life for the patient with a point  system that factors into that price. 

Some people think it's absurd and irrelevant, some people think it's the greatest thing since sliced bread, particularly clinicians.

Because what it means is, unlike here in the U.S., UK's payer system is just as concerned about the quality of life for the patient as the clinicians are - not just better lab values and less costly overall treatment. 

Now, here in America, insurance companies look at bottom line - i.e., do the patient's vitals and labs look better, have they had less days in the hospital/doctor visits?

Doesn't really matter that the patient has missed a week of work, hasn't slept in three years, visits the hospital still once a month instead of 3 times a month - all they want to know is if definable endpoint lab values are met and if they avoided the ER more. 

However, the U.S. DOES have a point with not yet adopting a QALY system - because how DO you objectively measure quality of life?

These assessments are subjective, based on patient and doctor feedback attestation, whereas the other data is objective, measurable data.  

Because you could be having a flare of a disease or a bad day, and are feeling overly negative while your quality of life is being assessed, right?  

Or what if the patient has mild dementia or cognitive impairment and can't assess their quality of life properly, and the physician doesn't know if they're able to complete their normal activities of daily living well?

And yet quality of life DOES still have value to be considered -  because if you're still missing days of work, can't sleep or eat, does it really matter that your lab values show mild improvement and you only go to the ER only once a month  instead of 3 times a month? 

No --  but that's all your insurance company cares about here in the U.S.   They don't care if you miss work or can't sleep or eat, they only care that about what they had to pay for. 

So I'm wondering if there's a balance between the two if there's value between totally ignoring quality of life issues entirely, like we do in the U.S., and overrating them, which often happens in the U.K - that we could perhaps consider and factor into these drug-price issues as well? 

Regardless, these are weighty decisions, that take committees and subcomittees, weighing the true value proposition of a drug, clinically, quality of life, and economic impact - not a blanket-price threshold?

However, I don't have an MBA or an MD - but that's precisely my point - these issues are way too complex for us to just over-simplify and blanket generalize by putting a threshold cap on price? 

Just my opinion.

  

Video: Portland Mayor Tear Gassed During Peaceful Gathering

See it for yourselves, on video ...

No one was rioting, it was a PEACEFUL gathering - ALL WEARING MASKS - in which the mayor spoke to crowd - who were literally holding yellow peace signs up - and (finally) publicly gave his public support to protesters.









Then the federal agents showed up and began shooting flash-bangs and tear gas into the crowd.  

Then mayor walked over to where they were launching the tear gas (in hopes of staving it off?), but they continued to launch the tear gas and flash bangs anyway.


What this Reality-TV show president wants is drama, to provoke violence and a war - for the tail to wag the dog.

To provoke peaceful gatherings into riots, so he can justify the use of tear gas and rubber bullets, by reversing the order of events.

The right to peaceful assembly is protected by our constitution - and this was clearly a peaceful demonstration that you can see with your own eyes.

Do NOT buy Trump's narrative that all, or even MOST, protesters are rioting and committing crime and thus need to be put down - IT'S A LIE.

If there is rioting now, it WILL be in self-defense - never forget the actual order of events.

As much as Trump has falsely claimed all Democrats, including Biden, want to defund local police (not true, and Biden is NOT in favor of defunding police) -- Trump sure is doing a great job of undermining and usurping local police authority himself, isn't he?

People, Trump's campaign website in 2016 clearly stated he wanted a federal police force from the get-go - did you all not read his platform before you voted, or you just read the part about anti-abortion/anti-LGBTQ marriage and signed up?

Though there have been some small pockets of violence (as there are at every protest, regardless of political side), the protests have been largely peaceful, as you can see for yourself on the video.

Again - if they riot now, it will be in self-defense - never forget the actual order of events, as we go along.



Still praying for you, Portland ...


_______________________



PS - Also do not believe that any right-wing headlines that are saying riots happened because the Democratic mayor was there - like Fox News is reporting - THIS IS ALSO A LIE - as you can see for yourselves on video.

As you can clearly see, the mayor was initially booed when he came onstage (because he had been on the fence about whether to support protests or not).

HOWEVER -  the organizer spoke and acknowledged the mayor's mistakes, but said they were happy he was joining now and was welcome, and then let him speak - and he finally made clear he was going to join them in BLM protest and began chanting WITH them.

You can clearly see for yourself that the flash-bangs and tear gassing started AFTERWARDS -  though there was no rioting or violence at all - just cheering and chanting.

I swear, I think right-wing/White-House-controlled press spends all day and night trying to think of ways they can twist what actually happened to Trump's benefit  - just like government-controlled communist/fascist press. 

OMG - Trump Wished Ghislaine Maxwell Well At His Press Conference Today?

The most shocking thing Trump said today at his revived coronavirus briefing today was actually not his 180 on COVID, now telling everyone they should wear masks and it was "patriotic."  

(However, good luck with that lawsuit against Governor Beshear, now, AG Daniel Cameron ;)

No, the most shocking thing was his saying he didn't know why Ghislaine was in prison and wishing her well in her trial?

No, I'm not kidding. This is, without a doubt, the most disgusting thing I have ever heard Trump say, hands down.

When asked if he feared Ghislaine turning on powerful men, he responded:

"I haven't really been following it too much. I just wish her well, frankly. I've met her numerous times over the years, especially since I lived in Palm Beach, and I guess they lived in Palm Beach, But I wish her well, whatever it is."

Wait, rewind ... WHAT?

Who wishes a known fugitive of justice and alleged pedophile's groomer well in her court trial?

Who doesn't know what Ghislaine is accused of and is in prison awaiting trial for?

How could the President of the United States NOT know, when all of his own federal security agencies have been looking for her - and supposedly been unable to find her - for the past couple of years?!?


Hmm ... unless of course, you were one of those 'powerful men' the reporter was referring to, and you are afraid Ghislaine will reveal what she has on you, in exchange for a lesser sentence during plea bargain? ;)

But that can't be true - he's the chosen one, against abortion and LGBTQ marriage!

*snort*

Whatever.

I hate to tell you this Trump, but if she does have something on you, your loyalty and little inappropriate well wish to Ghislaine won't save you and it has nothing to do with loyalty.

In fact, if you ARE one of those men, there is no amount of loyalty, well wishes, hush money or any other leverage that would save you on this one. 

Because Ghislaine is NOT going to take a full sentence as a pedophile's groomer and end up in general population in prison, when there's a lesser sentence on the table, if she talks.

Because she won't live long enough to ever reap any "loyalty " benefits" for not taking a plea-bargain deal -  pedophiles in general population in prison won't live long enough.

But perhaps I'm dreaming our legal system isn't entirely broken and that money won't be able to buy her out of gen pop prison.

Or are you planning on pardoning her, too? 

Update: Portland's "Wall of Moms" (See Below Post) Was Also Tear-Gassed ...

(Updated)

... late last night at around 11 p.m. Pacific Time.

The moms were standing peacefully, locked arm and arm, in front of the young, peaceful BLM protesters, to protect them. 

However, today, even more parents of protesters showed up :)

Did you order all of this from your underground bunker again, Trump, like most big-mouth bullies do, who are actually cowards, manipulating/ordering other people to do their dirty work for you?  

Love them or hate them, you'd never see a Bush, a Clinton, a Biden, or Obama hiding in a bunker and tear-gassing even peaceful protesters, I guarantee you. 

(Then again, no one felt the need to protest, at least to this level, until you took over - and I mean that literally - so what do you think that's saying about how America really feels about you and how far you've regressed this country - and not in a good way?)

Literally, no one but your Republican lackeys are afraid of you OR your Twitter mouth anymore, and even they don't really respect you, they're just afraid of losing votes. 

So go back to your underground bunker with your blankey.  

Or is it a bar of gold you stole, your own personal version of the American flag missing stars for blue states,  and a picture of yourself on inauguration day, complete with photoshopped-in crowd? 

My preccciousss ... lol

Oh, fuck off, Trump :)

Why not let the real adults and  parents of America handle this, for a change?   


PS -- even Tom Ridge, first Secretary of the Department of Homeland Security and former Governor of Pennsylvania said: 

”The department was established to protect America from the ever-present threat of global terrorism. It was not established to be the president’s personal militia.”

Who would have ever thought that I would actually agree on anything said by the guy who who appeared on the Today Show in February 2003 - just a few weeks before Congress voted to fund the War on Terrorism (in Iraq?!?) -  and told us all to cover our windows with plastic trash bags and duct tape to "protect us from Anthrax." LOL

I remember laughing hysterically at watching this, while my ex-mother-in-law freaked out and both she and my ex-husband got mad at me, and she demanded we go to the store immediately and buy these things. 

I said to my exhusband ...

"No, I'm not using the last of our grocery money to buy trash bags and duct tape because Tom Ridge said so lol.  If she really believes this crap, let her go buy it and put it on the windows.  But don't you dare use our grocery money to do it, or I will divorce you on pure principle LOL."  

(I was joking, at the time.) 

"First of all, the anthrax was only sent to liberal politicians and journalists, not everyday people, and it wasn't "dispersed" in the air - it was sent via package, in the form of a concentrated pile of powder." 

"Secondly, anthrax isn't typically spread, or as effective, via the air, it's most effective in water systems or in concentrated, non-dispersed powder form, like the packages sent. Even if they DID air-drop it, plastic trash bags and and duct tape are NOT going to protect us from airborne pathogens lol." 

"And do you really think Kentucky would be the first place on their list? Why? lol."

"Lastly, this smells to me of the the GOP using the anthrax situation to spread more fear-mongering BS propaganda to turn the tide of Congress towards funding a war with Iraq and Saddam Hussein, despite the fact that the last time anyone heard from Osama bin Laden, he was still at the Afghanistan/Pakistan border." 

"I was with Bush when he warned, then bombed there,  to give OBL up.  But I have no clue why he's trying to turn the tide towards Iraq. I've seen nothing convincing that Osama bin Laden is there or even tied to the problems there." 

"The only reason I can think of is vendetta because Saddam Hussein was once on U.S payroll as an informant, but then turned against us.  Just like the Noriega.  Just like Pinochet. Just like Moammar Quaddafi.  Just like the Shah of Iran." 

"We keep doing that with known psychos, putting them on our payroll and supporting their psycho dictators regimens, then trying to act like victims later, like, "Oh, we didn't know he was an unstable, homicidal maniac when we first put him on the US payroll as an informant and gave him aid."

"Dohkay. I call bullshit." 

"Because I'm pretty sure you were all already well aware of the multiple reported human rights violations record that Hussein, Pinochet, Noriega, Quaddafi, and the Shah of Iran had, long before you gave any of them a dime, but thought you could control them. When has that back-scratching international diplomacy with total psycho dictators ever worked out once in our favor?"

"Regardless, hell if I know another reason why Bush wants a war in Iraq instead, do you?" 

"We don't even know who's mailing the anthrax yet, it could be anyone, even some lone psycho. We jumped to the Muslim conclusion with Oklahoma City, too, and look how that turned out.  Far-right-wing militia whack jobs."

Well, though I was joking about divorcing him over it, at the time, as we know now, I was right - about all of that I said that day.

Because now we know, the truth is:

1)  There was no evidence whatsoever that the anthrax scare of 2001 had anything to do with Iraq or Afghanistan, or anyone foreign, for that matter - it was a domestic issue.  Though tied up in court until his death, one lone psycho virologist sent concentrated powder via mail to certain liberal politicians and press. 

2)   Anthrax is not as effective airborne, it's most effective in water  - and in fact, plastic trash bags and and duct tape have been proven in experiments since NOT to protect you from much of anything at all, Anthrax, COVID, or anything else, but perhaps rain, and not even that if there's too much. 

3)  There were no weapons of mass destruction in Iraq, also BS propaganda to turn the tide towards war in Iraq instead of Afghanistan/Pakistan.

4)  Osama bin Laden was, in fact,  found and killed at the Afghanistan/Pakistan border, and there is no evidence supporting that he was ever in Iraq. 

5)  I did divorce my husband, but not because of that, so consider me half-right on that one - because in fact, he, AND his mother, were walking toxic trash bags full of Anthrax lol. 

I'm not sure why, people even listen to more modern Republicans after that, but even worse, Trump Republicans have somehow managed to convince people that all Republicans and Democrats that came before them were part of the swamp, even though they, themselves, have been part of the swamp for years - in fact, the worse kind of swamp monsters you could find lol. 

I'm also not sure why, after being so naive as a child/teenager, I have since been blessed/cursed with a very strong bullshit detector, that has often caused me numerous problems in life, but that I'm still curiously glad I have? lol 

It goes off nearly every time Trump opens his mouth. 

And though it has gone off with Ridge before, it's not going off now. 

Wait, I spoke to soon.  

Because THEN Ridge said THIS: 

“It would be a cold day in hell” (before he would have consented as a governor to what is taking place)." 

"I wish the president would take a more collaborative approach toward fighting this lawlessness than the unilateral approach he’s taken."

Really, Tom?

Because I couldn't help but notice that you criticized both the Governor of Oregon and Trump for how they handled things, but failed to mention what you would've done?

Oh, let me guess - cover all Portland's buildings with plastic trash bags and duct tape? ;)

Now, I'm not saying I would know what the hell to do, either - I'm just saying I just love it when political leaders criticize other political leaders as if they could do better, without ever offering an alternative solution.

I'm pretty sure, however, what I would NOT do is use the untrained DHS as my personal militia to march into  a state or city, without a request by the governor or mayor, tear-gassing and abducting/detaining even peaceful protesters, like some kinda crazed communist or fascist dictator, and try to call it "law and order."

Regardless - Okay, Ridge, that's enough outta you - now you've gone too far again and worn out your welcome, so please commence crawling back under whatever rock you've been hiding under for the past few years again :)

P.S. Portland's "Wall of Moms" :)

... then, a "Wall of Moms" - wearing face masks, of course - encircled around the young protesters to protect them (from being grabbed and thrown into unmarked vans and detained, whether peacefully protesting or not), locked arm-in-arm, and chanting, "Moms are HERE!  Feds Stay CLEAR!"

LOL!  That is AWEsome!

I love it!  Thank you, Ladies! 

So ...  can I check that off as a prayer answered yet?  ;)

"Patriot" Confusion, Prayers for Portland And Judge Salas

I understand fears of the government, I do - but it really depends on the administration in charge.

Therefore, I am confused by a political side whose entire premise foundation is supposedly built upon wanting small government, but then calls state and local government emergency health public mandates regarding social distancing and wearing masks, "socialism"...

... but then says absolutely nothing at all, or even cheering on,  Trump ordering federal marshals and DHS agents to physically grab even peaceful protesters in Portland and shoving them into unmarked vans to detain them, and tear gassing protesters,  labeling even peaceful protesters as "thugs." 

Do you have any idea how "un-American" and communist that is, self-purported "Patriots?"

No, I'm sorry - because according to the U.S. Constitution , we still have due process of law, in this country - - which says you cannot detain and arrest people without probable cause, and you must inform them of why they are being detained and of their rights, including the right to an attorney, and put them through due process of law - none of which are being done by the federal agents (DHS and U.S. Marshalls) involved. 

If you're the sort that's afraid of the government more than you are the corporate businesses who line their pockets, and a true anti-communist conservative, then you would think what's going on in Portland would be what actually scares the B'Jesus out of you -  not state and local masks mandates and social-distancing restrictions - so again, I am confused as to why it doesn't? 

Is it ME that's confused, or are you, "Patriots?"

Thus, I am praying for Portland that this can be peacefully resolved, but I fear the way US marshals and DHS agents are handling it is only escalating the violence. 

_________________________________

In other news, a federal judge's son was just murdered, and her husband was gravely injured, when a man dressed as a FedEx driver opened fire, when her son answered the door for an faux delivery.

Salas is considered a liberal judge, recommended into office by high-profile Democrats, appointed as a federal judge by then-President Barack Obama.

Salas has ruled decisions on organized crime and gang-related crime, and most recently was assigned to a case regarding securities fraud by Deutsche Bank.

***Thus,  at the time this post was written, it is unclear whether the murder of her son/attempted murder of her husband were retaliation for her past rulings, or an attempt to prevent her future rulings***

However, feel free to Google "Deutsche Bank" for yourselves, choosing the news publication you trust, to see why so many people on both political sides are speculating about possible connections/motives associated with the Deutsche Bank case that was on her docket 4 days from now ...

Deutsche Bank is a private bank in Germany, notoriously associated with assisting with tax evasion and money laundering. 

You will find, regardless of publication, that Donald Trump and Jeffrey Epstein are both proven clients of Deutsche bank (verified by pending lawsuits).

The current legal question on the legal table, however, is regarding  whether they were not just clients, but actual investors in Deutsche Bank.

And that is what is essentially at the center of the current legal proceedings regarding Trump's tax returns/financial status, as well as Jeffrey Epstein's true financial assets and estate - trying to wrangle and court-order those records from Deutsche Bank, an international private bank, but have thus far been unsuccessful.

You will also find that Barack Obama and Joe Biden are/were neither clients of, nor investors in, Deutsche Bank.

It is unclear if the Clintons are/were ever clients or investors of Deutsche Bank.

HOWEVER, Deutsche Bank did fund Hillary Clinton's "closed" speeches to private banks during her campaign.

Most recently, as mentioned above, Deutsche Bank has made headlines for being involved in legal proceedings regarding both Jeffrey Epstein's estate, as well as the SCOTUS decisions on Trump's tax information/financial holdings public - including the SCOTUS punting part of that decision to lower courts - which would be federal court.

Now, here's where it gets complex and I think where people are getting confused regarding Deutsch Bank and Epstein, which is understandable. 

Despite articles stating as a fact that Salas was presiding over "the Epstein case," they're actually confusing 3 separate cases - Epstein's criminal case VS. Epstein's true financial assets/estate case VS. the Deutsche Bank Securities Fraud case.

Salas was to preside only over the latter, this week - the Deutsche Bank Securities Fraud case - as far as we know.

***HOWEVER  ***  the security-fraud case that Salas was to preside over would likely affect all the other cases -  to include Epstein's estate, as well as Trump's tax return/financial holdings - and thus why so many people are jumping to the conclusion that the murder is related to Deutsch Banks. 

Because it is possible - even likely - that Epstein WAS an investor in Deutsche Bank, as well as being an investor in the U.S. security-trading fraud situation - but that must first be proven in court.  

Even if he was a general investor, it must be next proven that Epstein was also specifically invested in that particular U.S. securities-fraud case that Salas was to preside over, and then at the center of this case is why, in addition to breaking SEC trading law, was this information about Epstein not revealed to the other investors.

However, the issue thus far - both with Epstein's true financial holdings, as well as Trump's true financial holdings - has been this:

Deutsche Bank is a private international bank; therefore, they do not have to comply with U.S. banking laws and regulations when it comes to private holdings and investments - nor are they included in taxable U.S. income - EXCEPT when it comes to securities trading in the U.S.

Thus, all of this speculation you're reading in the press is predicated on the assumption - some might even say the likelihood - that the entire motive for the securities-fraud case was a method to legally glean all of the financial holdings and investor information about Epstein from Deustche Bank, via a legitimate securities fraud case route.  

This ruling would then also open the door for Trump's financial holdings/taxable income.

Because using this route, at some point, Deutsche Bank would legally have to reveal ALL of their investors - not only to each other, but publicly - to be in compliance with U.S. federal securities trading laws.

Now are we getting a clearer picture?  

Pretty smart legal stuff.

*** However - though the timing IS curious, remember - all of this stuff we're reading in the press is still only motive speculation and circumstantial evidence  -  we have proof of nothing, yet.***

And as long as everyone's jumping on the Deutsche Bank motive-for-murder conclusion -  rather than retaliation for Salas's prior rulings, which is also high likely - don't forget,  that would make any investor in the Deutsch Bank securities fraud situation have a motive - not just Epstein.

Then again, it could be totally unrelated and retaliation for something Salas already ruled on years ago, for all we know.

All we know for fact is the current Deutsche Bank case that Judge Salas was assigned to was, and at least on the surface, appears to unrelated to any of the people above, just Deutsche Bank and some of its (at present, unknown) investors.

Having said that - while I think suspending our judgment until there's evidence is always a good idea - I also think America has a problem with confusing "suspending judgment until all the facts are in" with "turning a blind eye to facts that don't support our own narrative bias."

Meaning we often ignore facts, evidence, and possible motives, because of subjective bias - because we agree/disagree with their politics or because like them/dislike as a person.


By jumping to conclusions and turning a blind eye to misdeeds - based on our own political and personal biases - we have become our own worst enemy as a country :(

John Lewis :(

Speaking of peaceful 60s-style protests (end of my last post) , the last remaining member of Martin Luther King Jr's "Big 6" has died ...

Thank you, John Lewis - for what you endured, and for fighting all your life, for social justice. 

You will be missed ...

From Our Family Practice Physician's Office ...

Just sent this morning, via email  ...

(*The office name and contact information are blurred out for security reasons, due to past experience with the person mentioned in the post below. ;)


In other words, wear a mask or you won't be seen - no exceptions.


Note there are numerous physicians at my local doctor's office, who run the full range of the political spectrum - Democrats, Republicans (including Trump supporters), and everybody in between - and they all support the governor's mask mandate.

That is because not only do they listen to data and experts in the healthcare field rather than politicians, but because they see COVID with their own eyes everyday.

And additionally because the practice founder, Dr. Jeffrey Foxx, nearly died from COVID in March, only saved by volunteering for a plasma-treatment experiment, which is currently in fast-track FDA approval process for the treatment of COVID.

As a private-business practice, they have absolutely nothing to gain, politically or financially, by lying about an increase in new cases and deaths.

In fact, they are losing money due to COVID, and will lose even more money by requiring masks for service.

Which proves, of course, they have made the decision to put their patients' health and safety above both their politics and their money. 

(I wish everyone did.)

COVID is not a hoax and it isn't political.

Note the only people minimizing and denying COVID and making up conspiracy theories about it ARE politicians (and their puppet press and pundits) - not healthcare workers themselves, who see it every day.

That is because certain politicians want to keep you as in-person labor (without providing you with enough social distancing or PPE) on behalf of the corporations who finance their campaigns, as well as in-person voting for themselves - regardless of what's best for your health.

It is curious they tend to be from one political side, though - making things political that shouldn't be - isn't it? ;)


UPDATE:   7/17/2020


The Kentucky State Supreme Court placed a hold the lower circuit court's restraining orders on Governor Beshear - so for now, the mask mandate order still stands.

Additionally, we just passed our highest one-day total yet in Kentucky - 531 new cases, 8 deaths.


Simple pros and cons assessment ...


If you do believe in COVID and do wear a mask, and you're wrong -  the worst that can happen is - you look/feel foolish for believing it, and state/local government have temporary (and arguably unnecessary) control over your personal freedoms.

If you don't believe in COVID and don't wear a mask, and you're wrong - the worst that can happen is - you and/or someone you love dies from COVID.



This shouldn't be a tough choice, nor even up for debate. 


Additionally, you would think that those who are paranoid about government invasion of privacy would actually be reassured by the fact that the government actually WANTS you to wear a mask that covers your face - but, nooooo - lol

(You can't present logic to irrational belief, it only makes them angry - trust me, I know ;)  

In other news, the charges against the 87 "sit-in" protesters - including 2 reality TV stars and an NFL player-  for sitting on the lawn of Kentucky State Attorney General, Daniel "Uncle Tom" Cameron, have been dropped.

These were Breonna Taylor protesters, frustrated with no progress on the Breonna Taylor case, because Daniel Cameron has been spending his energy instead on either directly suing the Governor himself, or assisting other Republican lawsuits - over the Governor's mask mandates, prohibiting indoor/large-gathering Easter services, and other social restrictions (which have now expired anyway). 

They were like ...

"So, Mr. Attorney General ...  it's become clear that it's more important to you to sue/help your wealthy white Republican supports sue Democrat Governor over anti-public health beliefs, than it is finding justice for Bre as you promised?

"Oh okay - well, since you're denying COVID and have no problem with large gatherings - how 'bout 87 of us just sit right down on your front lawn and hang out with you - with masks on and facing forward rather than each other?

Maybe have a barbecue - "Hey Danny, want some ribs?"  LOL

I wouldn't have done that one, because it's private property, but I'm sorry - you gotta admit - it's kind of hilarious!

(And no, no one actually had a barbecue).

It really was simply a peaceful, good, old-fashioned, 60s style MLK "sit in"  :)

Cameron had them all arrested anyway, for not only trespassing, but "intimidating the legal process" - which is a felony charge.

However, he dropped all charges today, after someone pointed out  his hypocrisy in doing so - considering part of the lawsuit he has going against Governor Beshear, right now, is because Beshear forcibly quarantined for 14 days any social-distance-law defiers in early April - but he definitely did NOT actually arrest anyone, and certainly not on felony charges!

In addition to the protest itself, I also find his realized hypocrisy  hilarious!

Erm - Daniel "Uncle Tom" Cameron?

You know dang well white Kentucky Republicans are racist and just using you - they don't actually respect you, and you will fare no better than Uncle Tom did, in the end.  Look where Trump stuck renowned neurosurgeon Ben Carson - over urban housing/HUD?!?

And you're for damn sure you're not winning any points with Democrats and other black people. 

You're awfully young to commit career suicide - so I hope this was worth the few quick extra bucks you've made with your short-sightedness ...

Oh, what a world, eh? 

Yep, I've Seen It :)

(Edited/PS added)
... the "mimicry" of me, we'll call it, elsewhere.  

I just saw it last night, but apparently it's been going on for a few days?  Or so I'm told :)

It's a pretty bad impression of me, I've seen better - much better lol.

That one should be labeled:  "Saying things to impersonate as close as possible, to create online confusion, but not close enough to get in legal trouble again." :)

(Well, to be fair, that particular "avatar" isn't JUST an impersonation of me, this time -  it's an amalgam of a few other Southern-ish bloggers that blogged in the old days, once upon a time.)

(However, I am the favorite target.  Aren't I lucky?)

Apparently, this person still has trouble getting it through their head that we don't spell the word "color" and "favor" with a "u," here in America.

They also manage to eff up even the most common southern expressions, as well as use British words and terminology that no American would ever use lol.

I wonder what it must be like to be eternally 13 years old and to live for nothing more than giving hell to/hating someone for THIS long?

Someone who did literally nothing to you initially, but catch on to your behind-blog BS and call you on it, but only when you tried to involve me in it, and I told you "no." 

Then, when you terrorized my minor-child daughter -  as a preemptive strike warning to ensure I stayed terrified and quiet - I then had no choice to but call police. 

I don't hate you, I'm not even mad about it anymore.

And I know you think I'm afraid of you, which is what you want, and I used to be - but now, I actually just feel sorry you.  

Because it's really kind of sad.  

I mean, know I don't have much of a life, but that's really no life at all, if you're honest, is it? 

I mean, think about it - this is your entire life. 

The only sense of connection with other human beings you will ever have is online, by pretending to be numerous other people - - desperately trying to hide who you really are.  I'm not sure you even know who you are anymore, do you?

Targeting hurting/broken/vulnerable people and giving insincere flattery and "emotional support" to hurting/broken/vulnerable people, in order to gain their trust and try to involve them in your BS, to keep yourself out of further legal trouble.

The only sense of accomplishment or pride you will ever gain, in life, is the fleeting sense of power you feel, either by fooling online people or terrorizing them.  

Even the two or three members of your online "pod" only speak to you because they're afraid of what you'll do if they don't.  

They may act like they don't know?  But they know, rest assured - they know - they're just terrified.  MOST people know, nowadays.

But guess what? 

I'm not vulnerable and broken anymore - and I'm not afraid of you anymore, and I'm not even mad - now, I sincerely think it's extraordinarily sad that you feel you have to do these things to people, that's no kind of life :(
  
So, having said that, I know we're all quarantined and you're bored, but you'll tire soon of trying to provoke me again, and thus go off to impersonating/stalking/harassing/terroristically threatening one of your 23 other online victims - erm -  I mean targets, soon. 

Do you have a list of your targets or something, that you go down, and check off, then recycle it, regularly?  lol.  

So what, you get bored with no reaction from one, go on to the next name on the list to see if you can catch them on a bad day?  lol. 

Or is the goal to get a reaction from one of us, so you get your bully fix, then move on to the next name? 


Either way, welp, there you go - allow me to help you out with moving along to one of your other targets again, by giving you that reaction you crave -  then hibernating/taking a break again for a few days.

Not because I'm afraid, but because hibernating always works - after you escalate to try to get a reaction, I give a small reaction, and then just stay silent.

Then you always move on to one of your other targets, because when I stop writing, you run out of material to impersonate.

For example ...

You said you just saw a hummingbird "the other day," too - on the same day as me?  

Southern manners of speech?  

Female-led bands?

Wow, what amazing coincidences - because I wrote about all 3 things, this past week ;) 

(Seeing the hummingbird on the same day as me is especially coincidental ;)

I'm - erm - flattered,  but you and your 'special friend' (cough, cough enabler/instigator/monkey-organ grinder)  should really find your own, original material. 

(Plus I've seen this movie at least 100 times already, and it bores me to tears lol.)

But you know what? 

Ultimately, you failed  - I'm still here - and you just can't stand it, can you? ;)

I have plenty of work to do anyway.  Catch ya later, all!  :)

PS - When I return, this post will come down - because I'm also tired of having to address this, when there are more important things going on in the world to write about. 

Plus I'm as happy as anyone can be, despite troubled times, so I also want to share the joy I have now, in the life that I have with my husband  :)