Victoza is an injectable prescription medicine that may improve blood sugar in adults with Type 2 diabetes when used with diet and exercise. It is not recommended as the first medication to treat diabetes, and should not be used in people with Type 1 diabetes or diabetic ketoacidosis. Victoza has not been studied with meal-time insulin. Victoza is not insulin. Do not take Victoza if you have a personal or family history of medullary thyroid cancer, multiple endocrine neoplasia syndrome Type 2, or if you are allergic to Victoza or any of its ingredients. Symptoms of a serious allergic reaction may include swelling of face, lips, tongue, or throat, fainting or dizziness, very rapid heartbeat, problems breathing or swallowing, severe rash or itching. Tell your doctor if you get a lump or swelling in your neck. Serious side effects may happen in people who take Victoza, including inflammation of the pancreas, pancreatitis, which may be fatal. Stop taking Victoza and call your doctor right away if you have signs of pancreatitis, such as severe pain that will not go away in your abdomen, or from your abdomen to your back, with or without vomiting. Tell your doctor about all the medicines you take, and if you have any medical conditions. Taking Victoza with a sulfonylurea or insulin may cause low blood sugar. The most common side effects are nausea, diarrhea, and headache. Some side effects can lead to dehydration, which may cause kidney problems. 

Pharma ads. I’ve always hated them. The main reason is this: consumers are not legally allowed to purchase prescription drugs without the consent of a licensed doctor, so why should there be any effort to create a brand awareness among consumers? No one with Type 2 diabetes is standing around thinking, “I’m in the mood for a Victoza today!” It’s not a thing you ‘buy’, it’s a treatment solution that only a doctor can provide.

Secondly, watch just about any pharma ad on mute, and you’ll see that aside from the drug name’s typography, there’s not a lot brand creation going on anyway. Just about every ad features people hiking, boating, travelling in general, doing outdoorsy stuff that few people, healthy or sick, can object to. “Oooo, that looks nice. I’d love to be able to ride a bike down the street.” What it wants to do is make you think: Are you uncomfortable? That’s not your fault, it’s a disease! We have a pill you can take, and then you can be outdoors hiking in New Zealand!!

But with Obamacare starting to take effect, something else starts to stand out, another reason why they should go away. Let’s look at what is referred to as the “Major Statement” of any pharma ad: the side effects. This is the pharma equivalent of “Professional driver on closed course. Do not attempt” of any car ad. It’s legal CYA language. I’ve transcribed the above ad’s Major Statement here. As you read through it, it becomes clear that the wording was born out of an era when the lawyers could not safely assume that the consumer had access to a regular doctor.

- Tell your doctor if you get a lump or swelling in your neck.
- Call your doctor right away if you have signs of pancreatitis.
- Tell your doctor about all the medicines you take, and if you have any medical conditions.

See what I mean? The lawyers behind Victoza want to make sure that if you ONLY go to see the doctor because you saw their ad, that you contact your doctor on these specific side effects because they might be due directly to what Victoza is doing to you. All of it is to do directly with the product and the consumer.

But as the ACA makes healthcare more affordable and universally accessible, more people will start to have a doctor they can comfortably see regularly (preventative services don’t even require a copay). You won’t have to be told to “tell your doctor about any medical conditions you have” because he/she will already know. You won’t have to be told to tell your doctor if you have signs of pancreatitis due to Victoza, because you’ll call your doctor if you have the signs regardless. Because you can do so without fear of going bankrupt.

The new healthcare normal should mean that you don’t need to be told what to tell your doctor about - you and your doctor will have a relationship already. Just another reason why pharma ads should go away.

ALSO: The FDA is apparently aware that Major Statements are too long, resulting in ‘reduced consumer comprehension”. Unfortunately, the avenue they’re discussing is shortening the Major Statement with a more general “Talk to your doctor about the risks”. Rhetorically, that does feel like a step towards assuming the consumer has a doctor. But I still believe the answer is doing away with the ads altogether.

Just gonna put this here.

Just gonna put this here.

"There’s just no room for meaningful compromise here thanks to our old friend taxes. As you’ll recall, Republicans don’t want to raise them and they especially object to raising taxes on high income individuals. They want to lower taxes on high income individuals. It is true that sometimes (1999-2000) they want to do this to avoid a dangerous budget surplus while at other times (2001, 2008-10) they want to do it as economic stimulus while at yet other times (2003-7) they want to do it as a long-term growth strategy or (2011-2013) as a tax simplification strategy. But the policy ask—lower taxes, especially on rich people—doesn’t change."

From Matthew Yglesias at Slate.

So true. Surplus? Give it back to Americans with lower taxes. Economic slowdown? Stimulate the economy with lower taxes. Budget deficit? Increase revenue somehow by lowering taxes.

Don’t forget, too, that the GOP used to looooooooooove stimulus. Remember the Economic Stimulus Act of 2008, when Bush tried to avoid a recession by giving everyone $300? Just gave people free money. 

Remember in 2006, when gas prices were high? Senate Republicans’ solution was to give everyone $100. Just give people free money. (this ultimately never happened, but the fact that it was floated as an actual GOP solution speaks volumes).

And yet during our “Great Recession”, Obama’s stimulus wasn’t to just GIVE people money. It was to borrow money (with historically low interest rates that basically makes it free), and spend that money on infrastructure and public projects that the government tends to fund anyway. So roads and bridges are fixed, electrical grids repaired, and millions of people are given a job, with pay, to fix and repair all these things. Not $300, or $100, but a JOB. Which gives them an income, which they then spend, which increases demand, which increases employment, all of which increases tax revenue without raising tax rates, thus lowering the deficit. And then we pay back that borrowed money 1-for-1 (thanks to low interest rates). And we’re left with full employment, a stronger infrastructure, and low low budget deficit.

To the GOP, smart stimulus is a freedom-destroying idea. Maybe Obama should have just suggested we give everyone $300?

"

Republicans don’t have a war on women. We’re having a war for women. To empower them to be something other than victims of their gender.

If the Democrats want to insult the women of America by making them believe that they are helpless without Uncle Sugar coming in and providing for them a prescription each month for birth control, because they cannot control their libido or their reproductive system without the help of the government, then so be it. Let us take that discussion all across America, because women are far more than the Democrats have played them to be.

"

- Mike Huckabee

Um, what? Democrats’ attempt to include birth control for women without a copay is ONLY because they believe women can’t control their libido without the government telling them when to do sexy-times? I mean, this is the ultimate in projection.

Also important to remember: many women take birth control for reasons having nothing to do with sexy-times and contraception.

We knew that the GOP would instantly be against everything Obama was about when he won election in 2008. Part of the way they decided to do that was take the state of the nation during the recession - in which unemployment was high, resulting in increased use of welfare programs - and claim it’s Obama’s plan all along.  

Unemployment insurance, food stamps, and the like are a safety net. They’re the sprinklers that turn on when there’s a fire in the building. The GOP decided to cast Obama as one who believes the sprinklers should ALWAYS BE ON, and cites the fact that they’re still on (because of a slow recovery, IMO because the GOP killed Obama’s jobs plan because of “spending”) as evidence.

It’s ridiculous, yes. But you could see where it was leading years ago, and it’s only getting worse: a vilifying of the poor. In order to be “against” an imaginary Obama that believes welfare benefits should be plentiful and never-ending, they have forced themselves to be against those who genuinely need them (again, because of the slow recovery made possible in part by GOP obstruction). Moochers, takers, lazy couch-sitters eating caviar and steak on their wide-screen TVs and their Obama Phones.

Maybe they don’t hear themselves, but when you see it all at once - like in the segment above - it sure does make the right sound like a bunch of douche canoes.

So, Cruz and the far-right shut down the government to try and get rid of “government health care”, and in doing so should have used as leverage the fact that the shutdown was denying children government health care?

This brief article on Salon really does capture my continued befuddlement on the far-right’s anger over Obamacare. When I hear people like Rep. Paul Broun (R-GA) say that the ACA is going to ‘destroy everything we know as a nation’, I mean really? The model for this law has been in effect in Massachusetts for 7 years, and I’m pretty sure that state is still there.

I hear people say it’s a “government take-over of healthcare”. Not at all. I wish it were single-payer (Medicare for all), but it’s most definitely not. It’s still getting healthcare through private insurers.

But in this Salon article, look how many of these Hannity guests oppose Obamacare because…… why? Many of the ‘problems’ they cite are problems that have always existed in the less-than-ideal private insurance industry. One person says that Obama should have focused on “tort reform” to bring down the cost of health care. Tort Reform? If that isn’t a GOP talking point, I don’t know what is. Oh, I’m sure she was complaining for years, every month she had to pay her premium: “You know, I bet I’d pay less if we could just get some of that tort reform.”

All these people seem predisposed to hate it, and like many others I see who claim the same, their rhetoric doesn’t match the actual law. Now you see people pointing at the website snafus (unfortunate, yes) as proof that the law itself is a ‘trainwreck’. Imagine your favorite brick-and-mortar store opens a new website, and it keeps failing when you try to buy something from home. Does this website’s problems mean the brick-and-mortar store itself is flawed?

The ACA is more or less a simple three-legged stool. First, you force insurers to cover everyone, regardless of pre-existing conditions. It’s hard to argue against that (go ahead, Hannity, say “an insurance company should be able to deny health coverage to someone with cancer… or acne”). Second, because allowing sick people into the pool will cause premiums to rise, you ‘mandate’ that everyone purchase insurance, so that the risk is lowered by increased participation by healthy people. Oh, okay, “government don’t force me to buy something”, but don’t you want health coverage anyway? If you’re uninsured and your appendix bursts, you want to pay for it at cost? What if it bankrupts you? What if you can’t pay, and the rest of us pay for you?

Third, if you’re requiring all people to purchase private insurance, then you need to help out people on whom this purchase would be prohibitively expensive (i.e., the poor). So you have the subsidies based on income level. That’s the three main legs of the ACA stool. Sure, there’s other stuff for small businesses of 50 employees or more, but that’s the gist for most of us. And get this: about 80% of us already get our coverage through our employer*, so this doesn’t really affect us anyway. This is for the millions that are uninsured, mainly because they couldn’t afford it or couldn’t get coverage because they’ve been sick before.

Chill out, people. Get informed.

*I’ve always thought it anti-GOP to hear the GOP crow about “you want insurance, get a job!” The party of FREE MARKET CHOICE telling you to let your employer choose your policy for you, and make retaining that policy contingent on remaining employed at that one company.

The House, as 80s Screwball Comedy

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Let’s say there’s a school, Adams School. This school is made up of 100 students, an exclusive mix of Jocks and Nerds. Jocks tend to favor Jock policies, like an upgraded scoreboard, bigger school weight room, and protein shakes available in the lunchroom. Nerds tend to favor Nerd policies, like increased participation in math competitions, a wider variety of science textbooks, and better access to pocket protectors. But the two sides do tend to agree on other policies that benefit all.

How does Adams decide which policies to enact? It allows its student body to represent itself. The school votes for one President to preside over the entire student body. But there’s also a Student Council, made up of 10 representatives. Each one represents a Homeroom class of 10 students. Jocks vote for Jocks, Nerds for Nerds.

Let’s take this little world and see if we can’t see what’s so crazy about this shutdown nonsense, shall we?

MAJORITY RULES?

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Currently, there are 55 Nerds and 45 Jocks at Adams. When the election was held, Nerd Gilbert Lowe won the presidency with 55% of the vote over Jock Stan Gable. With that sort of majority school-wide, you’d expect the Student Council to be composed of 6 Nerds and 4 Jocks. Or at least split 5-5.

Curiously, the Student Council has gone the other way: 6 Jocks and 4 Nerds. Looking at the overall make-up of the school, this doesn’t make a lot of sense. But here’s what’s going on.

GERRYMANDERING

For a procedural reason, every few years it’s up to either the Jocks or the Nerds to decide which Homeroom each student attends (and will vote from). Just leaving it to random chance, odds are you’d get a pretty even collection of classrooms. A few more Jocks in Homeroom A, a few more Nerds in Homeroom B, and so on, so that the average ratio across Homerooms matches that of the student body as a whole.

However, this time around, the Jocks had an idea. First, they took 30 of the 55 total Nerds and put them in Homerooms A-C, all together. 100% Nerds in those three classes. Those Homerooms will vote Nerd all the way, without a doubt.

Then, the Jocks took 20 Jocks and put them in Homerooms D and E. Those are 100% Jock, voting Jock.

Lastly, the Jocks took the remaining 25 Nerds and 25 Jocks and split them up so that the remaining 5 Homerooms go 4-1 for Jocks, even though there are the same number of each left.

Homeroom Breakdown

A - 10 Nerds
B - 10 Nerds
C - 10 Nerds
D - 10 Jocks
E - 10 Jocks
F - 4 Nerds, 6 Jocks
G - 4 Nerds, 6 Jocks
H - 4 Nerds, 6 Jocks
I - 4 Nerds, 6 Jocks
J - 9 Nerds, 1 Jock

So in a school that is 55% Nerd, the Jocks have crafted the Homerooms to give themselves an electoral advantage in the Student Council elections. 55 votes went to Nerds for Student Council, over 45 for Jocks, and yet Jocks won 2 more spots! They nominate one of their six to become Speaker of the Council. And it’s the Jock Speaker that decides what the Council will vote on.

HASTERT RULE

Normally, when a policy is proposed, it’s up to the Student Council to vote on it. There are Jock-favored policies and Nerd-favored policies, but there are also policies that are pretty simple and are either favored or killed with a clear majority.

Unfortunately, with the current situation the way it is, the Jocks in the Student Council have adopted a procedure named after a Jock of yore, Dennis “The Meat” Hastert. The Hastert Rule says that the Speaker of the Council may NOT bring any vote to the floor that won’t get all 6 Jock votes. It’s not an actual rule, but rather a way for the Jocks to present a unified front against Nerd President Gilbert.

So say the vote for a new weight room comes up. The Nerds are united against it, the Jocks united for it. So the Speaker brings it to a vote, because all 6 Jocks favor it. Bill passes.

But if there’s a Nerd issue, like new science textbooks, that the Nerds (school-wide) unanimously support, the Speaker won’t even bring it to the floor, because the Jocks don’t support it at all. Nerd issue doesn’t even see the light of day.image

Unfortunately, this can also apply for issues that share support on both sides. Say all the Nerds and 2 of the Jocks want More Parking Spaces outside the school. According to the Hastert Rule, the Jock Speaker WILL NOT bring that issue to the floor for a vote, even though a majority of the Student Council supports it. It’s because it’s not uniformly supported by the Jocks that the issue dies.

THE D (and E) PARTY

There are a small faction of Jocks, about 20 or so, that HATE President Gilbert. They don’t believe he should be President. They’ve questioned whether he’s even eligible (maybe he’s an illegal transfer, or his classes have never included athletics). These Jocks have been the most vocal, and have declared that they don’t want a SINGLE Nerd policy enacted.

A lot of those 20 Jocks are in Homerooms D and E, rendering those two Homerooms the most vocal opponents of President Gilbert. When the two Jocks that represent those Homerooms visit and hear from their ‘constituents’, all they hear is “DOWN WITH GILBERT”. So these two Jocks come into the Council thinking the ‘will of the people’ is exclusively “DOWN WITH GILBERT”. Any policy issue that might come before the Student Council that has the support of Nerds is de facto dead-on-arrival for Homeroom Reps D and E. Even the More Parking Spaces bill, which would pass with a majority on the floor, is loudly denounced by Reps D and E. I mean, if they don’t vote “DOWN WITH GILBERT”, their Homeroom might replace them with a Jock that will.

And because of the Hastert Rule, the Jock Speaker will not bring More Parking Spaces to the floor at all, because it does not have the backing of all 6 Jocks in the Council. Consider that: all Nerds support it, which means at least 55% of the entire school supports it. Add in the 2 Jocks that support it, and the percentage of the student body that supports the More Parking Spaces bill rises even higher. And yet it doesn’t even get a vote by a Student Council meant to reflect the student body’s wishes.

SHUTDOWN

Now, the Jocks (especially the extreme Jocks from D and E) have a specific target: a bill that the Jocks hate, that was passed a few years ago, before the Jocks reworked the Homeroom ratios and took the Student Council. This policy, the More School Nurses Policy, was supported by President Gilbert and passed with a majority vote when the Nerds controlled the Council.

The Jocks don’t like it, so they try to strike it down whenever they get a chance. The Jock Speaker brings countless bills to the floor saying “UNDO THE MORE SCHOOL NURSES POLICY”, because he knows the Jocks will vote for it (lest they get replaced by another Jock in the next election). The Jocks all vote for it, the Nerds all don’t, it passes. Of course, President Gilbert won’t sign these bills, because it was his bill, his idea. So it dies, and no new policy has been enacted. The Jocks know this, but want to be seen as trying to do it again and again.

Now Adams School has a dilemma: it relies on the student council to vote for the Prom Theme and Budget. Last year it was Enchantment Under The Sea, with $200 delegated for streamers, punch, and a DJ. This year, there’s not much disagreement on what the theme will be (Old West!), or what the budget will be ($190). But the Jocks see an opportunity.

Or more specifically, Jocks D and E see an opportunity. They say, “We won’t vote for the Prom Bill unless you get rid of the More School Nurses Program”. The Prom and School Nurses are completely unrelated issues. The Nerds all say, “That’s ridiculous.” Foremost, they’re not going to just agree to dismantle President Gilbert’s signature policy. But second, the idea that Adams’ prom – which will affect just about the entire student body – would be held hostage by two Jocks that are hell-bent on destroying School Nurses is just odd.

Now, if the Speaker brought a simple Prom Bill (Old West, $190) to the floor, it would get a majority vote: 4 Nerds and 2-3 Jocks. But because of the Hastert Rule, the Speaker won’t even consider a “clean” Prom Bill, because two of the Jocks (D & E) have vowed they won’t vote for it. So no prom.

BREAK IT DOWN

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So here’s why the Prom Shutdown is so far from what the school wants or what their representatives should be doing.

- The student body is more Nerd than Jock, yet the Homerooms have been set-up to give Jocks more voice than the Nerds. Thus, the Student Council doesn’t accurately reflect the student body as a whole.

- Additionally, because of the Hastert Rule, the majority-Nerd student body is further disenfranchised, because the only bills that will come up for a vote are bills that have unanimous Jock support. Often, those bills are not Nerd-friendly.

- And even bills that do enjoy a majority support school-wide, bills that would win a majority of Student Council votes, are tabled because of Homeroom Reps D & E.

The result? In a school made up of 55% Nerds, most of the policy decisions for Adams School are made by Homeroom Reps D & E. Two Jock-dominated Homerooms are now, more or less, running the a school with a slight majority of Nerds.

That’s not how this is supposed to work.

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(Yes, this is silly and reductive. It doesn’t account for the Senate, or the idea that people like Ogre can “switch sides” from Nerd to Jock or Jock to Nerd (rendering some Homerooms ‘toss-ups’), or outside money influence and campaign finance incentives for a particular position. But the bottom line is, the House of Representatives was set up to be a reflection of the country as a whole. It’s not, anymore)

I don’t know anything about Massachusetts’s 5th District, but this is a delightful candidate ad.