Milwaukee Journal Sentinel, Sept. 23
The price of pain in the U.S.
There is big money in pain, which is why the makers of prescription painkillers seem so interested in ensuring that doctors keep prescribing opioids despite an addiction crisis that has claimed 165,000 lives in the United States since 2000.
An investigation by The Associated Press and the Center for Public Integrity, published last week in the Journal Sentinel and other newspapers, showed that even as drug makers claim to be fighting the prescription drug epidemic, they are using a 50-state strategy and handing out millions of dollars in campaign donations to weaken or outright kill legislation to limit the use of drugs such as OxyContin, Vicodin and fentanyl.
The AP and the center found that between 2006 and 2015, Big Pharma spent more than $880 million nationwide on lobbying and campaign contributions. That was far more than advocates for a crackdown on prescription drugs could spend; it dwarfed what the gun lobby doled out over the same period.
The findings mirror reporting since 2011 by the Journal Sentinel’s John Fauber and MedPage Today, which found that money from drug makers was a pervasive influence.
The solution is for legislators and physicians to show courage in the face of these pressures. Legislators and Congress should take appropriate action to ensure that the drugs are available to those who need them but aren’t overprescribed. And physicians, knowing the risk, should be more reticent in prescribing these drugs.
There is plenty of evidence that doctors have been overprescribing.
Sales of prescription opioids rose fourfold from 1999 to 2010, the investigation found. Purdue Pharma, which makes OxyContin, had about $2.4 billion in sales from opioids last year alone, AP and the center report. And, all the while, deaths by overdose rose.
Opioids undoubtedly have a place in a sensible medical landscape, especially for cancer patients or end-of-life care. But studies show little evidence that opioids are effective for treating routine chronic pain. One study cited by the AP and the center from a hospital system in Pennsylvania found that about 40 percent of chronic non-cancer pain patients who received opioids showed signs of addiction.
“You can create an awful lot of harm with seven days of opioid therapy,” David Juurlink, a toxicology expert at the University of Toronto, told reporters. “You can send people down the pathway to addiction when they never would have been sent there otherwise.”
Lawmakers and physicians need to confront this scourge.
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The Capital Times, Sept. 21
The ethical collapse of Justices Michael Gableman and David Prosser
As he engaged in a desperate hunt for national money to help Republicans retain control of the Wisconsin Senate in a series of 2011 recall elections, Gov. Scott Walker reached out to Karl Rove. The governor, whose grip on state government was at risk after a mass uprising of Wisconsinites who opposed what they decried as assaults on labor protections, public services and public education, was asking for a big assist from the former political director of the Bush-Cheney White House, who controlled a conservative super PAC known as American Crossroads. In his May 4, 2011, email to Rove, Walker asked for an email list, names of big donors to call, and a “million or two from American Crossroads.”
Even in the world of big-money politics, a “million or two” does not come simply for the asking. A case must be made for that kind of money - and for the names of individuals who could give more of that kind of money. So Walker explained that a veteran Republican operative, R.J. Johnson, would make things work. “R.J. was the chief adviser to my campaign,” wrote Walker, who added that “I always called him my Karl Rove …”
“Bottom line: R.J. helps us keep in place a team that is wildly successful in Wisconsin,” wrote Walker in an email highlighted by The Guardian newspaper last week in a story about documents associated with a John Doe inquiry into allegations that Walker and his associates engaged in criminal wrongdoing. Previous revelations and leaks regarding the John Doe have shined light on the governor’s outreach to Rove and Walker’s bragging about how his “team” ran things in Wisconsin.
But the details contained in the Guardian story, and in the leaked documents themselves, focus particular attention on a line in Walker’s email that described the critical role Johnson played in shaping the state Supreme Court’s conservative majority.
“He ran the effort that defeated the first incumbent Supreme Court justice in decades back in 2008 and Club for Growth-Wisconsin was the key to retaining Justice Prosser,” wrote Walker. Johnson’s name has long been associated with the Wisconsin Club for Growth, a highly secretive, politically aggressive operation that refuses to disclose the sources of funding for the campaigns it runs.
Justice David Prosser had just been re-elected in a brutal April election, which saw the incumbent jurist prevail over his challenger by barely 7,000 votes out of 1.5 million cast.
The favorite of Walker and his allies in the 2008 election was Justice Michael Gableman.
Four years after Walker’s email declared that Johnson and the Wisconsin Club for Growth were vital to electing Prosser and Gableman, these two justices cast decisive votes in a state Supreme Court decision that shut down an investigation targeting the actions of Walker, Johnson and others. That investigation sought to determine whether the governor and his allies engaged in a conspiracy to illegally coordinate campaign activities in the recall fights of 2011 and 2012. The opinion in that 2015 high court ruling, which was written by Gableman, was so sweeping that the Milwaukee Journal Sentinel reported it could “reshape how campaigns are run in Wisconsin because it makes clear campaigns can work closely with outside groups, allowing more political money to flow without the names of donors being disclosed.”
Prosser and Gableman were asked to recuse themselves from the John Doe case, but both refused to do so. In light of Walker’s assertion in his email to Rove - and all the information that has been made available over the past several years with regard to the John Doe inquiry - it is now evident that the refusal put the justices at odds with established law. The U.S. Supreme Court has determined that the due process clause of the U.S. Constitution’s 14th Amendment requires jurists to recuse themselves when there is evidence of actual bias and when so-called “extreme facts” create a “probability of bias.” That standard was established in the 2009 case of Caperton v. A.T. Massey Coal Co., which established that major campaign activity on behalf of a jurist by a party to a case that comes before the jurist creates an appearance of a conflict of interest so “extreme” that the jurist’s failure to recuse himself constitutes a violation of due process protections.
Justice Anthony Kennedy wrote in the high court’s majority opinion: “We conclude that there is a serious risk of actual bias - based on objective and reasonable perceptions - when a person with a personal stake in a particular case had a significant and disproportionate influence in placing the judge on the case by raising funds or directing the judge’s election campaign when the case was pending or imminent.”
In a request that the U.S. Supreme Court overturn the Wisconsin Supreme Court’s decision to shut down a John Doe inquiry into illegal campaign activity, a group of Wisconsin prosecutors argue that Prosser and Gableman should not have heard the case because their campaigns benefited from work by individuals and groups that were a focus of the investigation. “Under any reasonable reading,” the prosecutors argue, those involved in the case “did not receive a fair and impartial hearing” from Wisconsin’s high court.
No matter what action the U.S. Supreme Court takes with regard to evidence of bias and the abandonment of ethical standards by justices on the Wisconsin Supreme Court, there can no longer be any question that Wisconsin legislators, prosecutors and members of the state judicial commission have a responsibility to address clear evidence that Justice Gableman and retired Justice Prosser failed to respect and honor their positions as a public trust and, further, failed to strive to enhance and maintain confidence in our legal system.
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The Journal Times of Racine, Sept. 25
Don’t use voter IDs to fund roads
We want to see the issue of Wisconsin’s highways and other roads addressed by our elected officials in Madison, so we’re open to new ideas on the matter.
But one suggestion came up last week which is a non-starter for us: Using voter identification cards as a means to fund transportation.
Gov. Scott Walker’s administration wants to stamp “voting purposes only” on the free IDs the state makes available, making it harder for people to use them for non-voting purposes, the Milwaukee Journal Sentinel reported Tuesday.
The Division of Motor Vehicles also wants the free IDs, born out of fears of voter fraud, to be cheapened in quality, with some fraud protections removed.
State officials believe the changes would prompt more people to pay for IDs that can be used more widely, thus increasing transportation funding by nearly $1 million over two years.
“I don’t think the elderly and low-income people who don’t drive should be the state’s target for boosting revenue for transportation spending,” said Jon Peacock, research director for the Wisconsin Council on Children and Families.
He said the proposal would create confusion because the state would begin issuing two types of IDs - ones that could be used only for voting and ones that could be used more broadly - as well as driver’s licenses.
“Do state lawmakers want a pharmacist to tell my 80-year-old uncle that he can’t get his heart medication because he has the wrong kind of ID?” Peacock asked.
The voter ID law Walker signed in 2011 required people to show photo ID at the polls, but also made state IDs free to those who said they needed them for voting purposes. As a result, few people pay the $28 fee for state IDs these days, according to budget documents.
Sherrie Tussler, executive director of the Hunger Task Force, said the free IDs have been helpful to low-income people who need them for a wide range of purposes, such as proving their identity when they pick up their children from day care.
“The only people who get hurt in this are poor people who don’t have $28,” she said of the proposal.
More to the point, the proposal by the Division of Motor Vehicles is aimed at people who don’t own or operate motor vehicles. The Department of Natural Resources does not charge those who do not hunt for a hunting license; the same principle should apply over at the DMV.
As Assembly Speaker Robin Vos, R-Rochester, and other Republicans put it in a letter to the governor last week put it, “conservatives believe in asking people to pay for the programs they benefit from.” It was in reference to the possibility of user fees for roads, but it then stands to reason that Wisconsin should not be looking for transportation funding from people without driver’s licenses.
We’d suggest that Gov. Walker’s administration and the Legislature try another route to solving the transportation funding issue.
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