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the 9-12-13 Penny Press

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THE PENNY PRESS,SEPTEMBER <strong>12</strong>, 20<strong>13</strong> PAGE 7Commentary: Doug FrenchSweet Crony CapitalismSugar prices continue to get hammered as <strong>the</strong> sweet stuff piles up in silos.The sugar price has been cut in half over <strong>the</strong> past two years. This wouldn’tbe a big deal except sugar processors borrow from <strong>the</strong> U.S. Department ofAgriculture. As we pointed out back in March, quoting <strong>the</strong> Wall Street Journal,The USDA makes loans to sugar processors annually as part of a programthat is rooted in <strong>the</strong> 1934 Sugar Act. The loans are secured with some 4.1 billionpounds, or 2.05 million tons, of sugar that companies expect to produce from<strong>the</strong> current harvest. That comes to almost a quarter of total U.S. output that <strong>the</strong>USDA forecasts for this year.The latest news is <strong>the</strong> USDA just loaned American Crystal Sugar Co. $71.2million. It’s very late in <strong>the</strong> season for a company to be taking out a loan. Thecrop year ends October 1st. Until this loan was made, <strong>the</strong> government had lent$1.1 billion to sugar processors, secured with 2.6 million tons of <strong>the</strong> sweetener.As of a couple weeks ago, 27% of those loans remained outstanding.The USDA is doing all it can to raise prices. Alexandra Wexler reported for<strong>the</strong> WSJ last week, “The U.S. Department of Agriculture bought sugar from adomestic processor and sold it to an ethanol producer at a loss of $2.7 million,<strong>the</strong> latest move by <strong>the</strong> agency to boost prices and stave off defaults on federalloans.”While Bernanke’s buying bonds to elevate financial asset prices, <strong>the</strong> USDAis buying sugar to prop up <strong>the</strong> price of sweetener. Here’s <strong>the</strong> plan: “By buying<strong>the</strong> sugar, <strong>the</strong> USDA aims to boost prices to a level where sugar processors willbe able to repay $298 million in outstanding federal loans that come due at <strong>the</strong>end of August and September.”The USDA needs a price of 20.90 cents a pound to prevent defaults. Thegovernment has already spent $53.4 million buying sugar and will likely becoming up with more. The sugar program guarantees processors a minimum pricebecause lord knows <strong>the</strong> American people can’t live without….domestic beet andcane farmers. That must be it, <strong>the</strong>re’s plenty of sugar produced worldwide.Sugar futures are up since June because speculators know <strong>the</strong> USDA mustbuy. “Sugar brokers and refiners say <strong>the</strong> government needs to remove ano<strong>the</strong>r300,000 to 500,000 tons of sugar from <strong>the</strong> market before October to prevent anyloan defaults.”As far as American Crystal, who can blame <strong>the</strong>m? As <strong>the</strong> WSJ points out,<strong>the</strong> company has nothing to lose. They posted 300 million pounds of sugar at23.93 cents a pound. If <strong>the</strong> price settles above that, <strong>the</strong> company sells <strong>the</strong> sugarand repays <strong>the</strong> loan. If <strong>the</strong> price falls, it defaults and sticks Uncle Sam with <strong>the</strong>sugar at a price <strong>the</strong>y couldn’t sell it for in <strong>the</strong> market.Sweet crony capitalism down on <strong>the</strong> farm.DOUG FRENCHCommentary: Sally PipesAbuse of Drug Discount Program:Corrosive Crony CapitalismFederal lawmakers are constantly tinkering with <strong>the</strong> healthcare market.Often, <strong>the</strong>se invasions have perverse consequences.Indeed, one federal initiative designed to provide poor Americans withdiscounted drugs has morphed into an ungainly operation fattening <strong>the</strong> bottomlines of pharmacies and hospitals.Enacted in 1992, <strong>the</strong> “340B” program requires drug companies to providesteep discounts on drugs to qualifying hospitals and clinics. The program wasmeant to help institutions that serve large numbers of low-income or uninsuredAmericans.From <strong>the</strong> outset, however, 340B has been plagued with problems. And now,it often fails to actually help vulnerable patients.The first major flaw is <strong>the</strong> program’s eligibility requirements for healthcareproviders. The existing eligibility formula does not measure obviously relevantmetrics such as <strong>the</strong> percentage of uninsured patients a hospital serves or <strong>the</strong>amount of uncompensated care it provides.A Government Accountability Office report confirmed that even somehospitals that just “provide a small amount of care to low-income individuals...could claim 340B discounts.” And a study by Avalere Health found that stateswith fewer uninsured residents actually had higher shares of hospitals takingadvantage of 340B.Second, <strong>the</strong> program doesn’t require that discounted medications bedispensed only to people who actually need <strong>the</strong>m. As a result, many hospitalsare selling drugs <strong>the</strong>y purchased on discount at full price to patients with privateinsurance coverage.Finally, <strong>the</strong> hospitals and pharmacies dispensing <strong>the</strong>se drugs aren’t requiredto pass <strong>the</strong> savings onto patients.As a result of <strong>the</strong>se gaping flaws, a drug program meant to help <strong>the</strong> uninsuredhas turned into an arbitrage operation that lets hospitals and retail pharmacies buybillions of dollars’ worth of steeply discounted drugs, bill insurance companiesand patients <strong>the</strong> full retail price, and <strong>the</strong>n pocket <strong>the</strong> difference.When Sen. Charles Grassley (R-Iowa) looked into <strong>the</strong> program, he foundthat <strong>the</strong> Duke University Hospital — where only 5 percent of patients wereuninsured — was able to leverage <strong>the</strong> discount program to boost its net incomeby almost $50 million last year.“Hospitals are reaping sizable 340B discounts on drugs and <strong>the</strong>n turningaround and up-selling <strong>the</strong>m to fully insured patients,” Grassley wrote in a letterto <strong>the</strong> agency overseeing <strong>the</strong> 340B program.340B now represents an unholy alliance between moneyed interests andpublic regulators. The free market has been undermined. Many low-incomepatients genuinely in need of help are being left out in <strong>the</strong> cold. Drug companiesare being forced to sell a growing volume of products at severe discount —leaving many with little choice but to make up for those lost revenues by raisingprices on o<strong>the</strong>r consumers.Congress and regulators have compounded <strong>the</strong> problem over <strong>the</strong> yearsby repeatedly expanding 340B. Almost one-third of hospitals nationally nowparticipate.The largest and most troubling expansion came in 2010, when regulatorsauthorized hospitals to contract with an unlimited number of outside pharmaciesanywhere in <strong>the</strong> country to dispense 340B discounted drugs. Previously,hospitals could only use in-house pharmacies or contract with a single pharmacy.This particular change has led to a dramatic increase in <strong>the</strong> number ofcontract pharmacies benefiting from 340B. In 2010, <strong>the</strong>re were just under 4,000.Today, that number has jumped to 30,000 — a 700 percent increase.Accordingly, <strong>the</strong> total value of 340B discounts has also exploded and isprojected to grow significantly in <strong>the</strong> coming years.These expansions are making a bad problem even worse. 340B is toooften being abused to bolster hospital profits. Healthcare providers shouldbe competing in a free and open market — not exploiting a well-intentionedprogram meant to help low-income Americans.The abuse of 340B represents corrosive cronycapitalism at its worst. Lawmakers need to fix this program.SALLY PIPESSally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at <strong>the</strong> PacificResearch Institute. Her latest book is The Cure for Obamacare (Encounter 20<strong>13</strong>).

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