- Associated Press - Wednesday, August 22, 2018

Excerpts from recent editorials in the United States and abroad:

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Aug. 19

Toronto Star on President Donald Trump’s administration unveiling its Space Force plan:

An iconic scene in Stanley Kubrick’s film, 2001: A Space Odyssey, shows one of our ape ancestors discovering that a skeleton’s thigh bone can serve as a new kind of tool - a weapon.

The eureka moment is full of unmitigated primal brutality: the ape uses the bone to smash the rest of the skeleton to bits and, later, to bludgeon a less evolved rival who shows up to a bone fight with nothing more than threatening grunts and flailing arms. The murdered ape’s allies run for their lives, having no doubt learned a lesson. The arms race had begun.

In the real world, the race has brought us to the nuclear suicide pact known as “mutually assured destruction” and to a bully with the nuclear launch codes, U.S. President Donald Trump. Show him a bone and he’ll want to wield it.

This month, his administration gave in to Trump’s wishes for a sixth branch of the military and unveiled what it’s calling “Space Force,” a “space warfighting” military plan. Trump endorsed it with the excitement of a child unwrapping a new Star Wars toy, tweeting: “Space Force all the way!”

The toy analogy isn’t completely facetious. Shortly after the announcement, Trump’s re-election campaign manager, Brad Parscale, notified supporters in a letter that they’ll soon be able to buy Space Force merchandise. They’ll also get a chance to vote on which of six Space Force logos will emblazon the T-shirts, space ships, lightsabers or whatever the campaign might have in mind.

“As a way to celebrate President Trump’s huge announcement, our campaign will be selling a new line of gear,” Parscale wrote. “But first we have to make a final decision on the design we will use to commemorate President Trump’s new Space Force - and he wants YOU to have a say.”

Trump will no doubt insist on the final say for the logo. And it’s not hard to imagine him doing the big reveal on the White House lawn.

Details are sketchy, as with most things coming from the attention-challenged president. Space Force would be a new military force, alongside the army, navy, air force, marine corps and the coast guard. The force would develop “space warfighting operations to protect U.S. national interests,” according to a Pentagon report. What that means is anyone’s guess.

Also unknown is the cost; deputy defence secretary Pat Shanahan estimated the price tag at “billions of dollars.” And given how easily the military spends money, and the cost of anything related to space that might just about cover the uniforms.

Less than a year ago, Defence Secretary Jim Mattis was opposed to this ridiculous idea. Setting up a space force, he argued, would increase bureaucracy at a time when streamlining operations and integrating war-fighting among the existing military branches was the priority. But Trump is nothing if not bullheaded. The more he’s told no, the more he charges on. And 10 days ago Mattis did an about-face, and the vice president unveiled the big plans.

One hopes Congress at least - which refused to fund a space force last year - sticks to its guns.

The last time a U.S. president was dazzled by the idea of militarizing space was in 1983, when Ronald Reagan announced the Strategic Defence Initiative. Immediately dubbed Star Wars, the plan was to shoot down incoming Russian nuclear missiles with space-based, nuclear-armed laser beams. The initiative ate up billions of dollars in research funding but never achieved liftoff.

Trump’s ludicrous plan deserves the same fate. It should at best be regarded as a distraction, one of the many he has used to divert attention from his chaotic and perilous presidency. Dinky toys for his supporters is all this plan should produce.

Online: https://www.thestar.com/

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Aug. 19

The Wall Street Journal on the Food and Drug Administration approving the first generic competitor to Mylan’s EpiPen:

A couple of years ago Washington fell into anaphylactic shock over the high cost of EpiPens, devices that shoot adrenaline into someone having an allergic reaction. But the Trump Administration this week injected some overdue competition into the market that could lower prices for millions of Americans.

On Thursday the Food and Drug Administration approved the first generic competitor to Mylan ’s EpiPen. The competing drug is manufactured by the Israeli pharmaceutical company Teva. One might wonder why a simple spring device filled with a cheap medicine didn’t have competitors, even decades after invention.

That was one question in 2016, when Congress hauled in Mylan CEO Heather Bresch to register outrage about the more than $600 list price of a two-pack of pens, which millions of kids and adults have to keep on hand. Not everyone pays full price after rebates and discounts, and some of the shock came from insurance designs that increased out-of-pocket costs. But the sticker price had increased more than 500% over 10 years.

Yet if Mylan kept prices high, the company had help from the FDA. The agency had not articulated standards for a class of drugs known as “complex generics” such as inhalers, which are more fraught than proving similarity to, say, a molecule pill. Mylan thus had no direct competition, though it now sells its own generic copy.

Other injectors are on the market but a pharmacist can’t substitute these versions thanks to issues as minor as the instructions for the device, though there is no clinical distinction. Companies like Teva have spent years ensnared in FDA processes, and in the meantime Mylan could increase prices without market consequences.

Before he became the current FDA Commissioner, Scott Gottlieb told Congress in 2016 about the “Catch-22” for drugmakers: They couldn’t win approval as a generic because another injection device wasn’t exactly the same as EpiPen, but other regulations also make it hard for competitors to get branded alternatives through the FDA’s new drug approval pathway.

Dr. Gottlieb has made clarity for such complex generics a priority at the FDA, and on Thursday he called the Teva device approval part of the agency’s efforts to remove barriers to competition. The approval is particularly timely amid supply shortages of EpiPens.

On all the evidence, products face the sharpest price decline when two generics are competing with the branded version. More drugmakers will jump into a market if they see an opportunity to make money and a regulatory agency that doesn’t construct needless barriers to entry.

At the time of the EpiPen brouhaha, Hillary Clinton called for a federal “consumer response team” that would rove around and penalize companies for price spikes. The laugh-cry moment is that the Trump Administration has flirted with a response from the Clinton playbook: Importing price controls from Europe for drugs with expired patents that lack competition.

President Trump seems to think that drugs are too expensive because of unfettered markets, but the EpiPen episode is a reminder: The real culprit is often not too much freedom but big business exploiting big government to keep prices high.

Online: https://www.wsj.com/

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Aug. 21

The Washington Post on President Donald Trump’s former lawyer Michael Cohen pleading guilty and the conviction of Paul Manafort, Trump’s former campaign chairman:

On Tuesday, the president of the United States was credibly accused in federal court of directing one of his subordinates to commit a federal crime. The effect of their alleged conspiracy against campaign finance laws was to defraud American voters, who were prevented from learning potentially relevant information ahead of Election Day 2016. This admission came from President Trump’s longtime lawyer Michael Cohen as he pleaded guilty to eight felony counts. Mr. Trump cannot pretend these crimes did not occur or that they have nothing to do with him.

Neither can Congress.

In an extraordinary coincidence, Mr. Cohen’s plea in New York City came within minutes of a jury in a federal courthouse in Alexandria announcing the conviction of Paul Manafort, Mr. Trump’s former campaign chairman, also on eight felony counts. It made for a historic day, and not one Americans could take pride in.

For special counsel Robert S. Mueller III, whom Mr. Trump has been vilifying with increasing bile, it was another day of vindication. Mr. Mueller’s office prosecuted Mr. Manafort and, having uncovered Mr. Cohen’s misdeeds, had handed that matter to fellow prosecutors in New York. Mr. Mueller continues to demonstrate with quiet professionalism and steady results that his investigation is anything but the “witch hunt” of Mr. Trump’s insult-mongering.

For a president who had promised to hire only the best, the twin results represented a stunning rebuke. Throughout these prosecutions, Mr. Trump vacillated between distancing himself from Mr. Manafort (he worked for the president for only “a very short period of time”) and embracing him (he is “a very good person”). Similarly, Mr. Trump flipped from fury that Mr. Cohen’s offices were raided to claiming that he and Mr. Cohen were never all that close. …

In Mr. Manafort, he hired a campaign chairman who made millions working for people interested in undermining democracy in the former Soviet Union, then used exotic methods to bring the money to the United States. As his scheme was unraveling, he was counting delegates for Mr. Trump’s Republican National Convention balloting.

Mr. Cohen spent years in the Trump Organization apparently putting out fires Mr. Trump started. This practice resulted in an illegal 2016 campaign contribution consisting of a $130,000 payoff to Stormy Daniels, an adult-film star alleging an affair with Mr. Trump. Trump lawyer Rudolph W. Giuliani said in May this was part of “a long-standing agreement that Michael Cohen takes care of situations like this, then gets paid for them sometimes.” In fact, Mr. Cohen said in court Tuesday that he paid hush money to Ms. Daniels “at the direction of” Mr. Trump. Campaign finance experts say Mr. Trump may now be considered a co-conspirator in Mr. Cohen’s crime. Meantime, Mr. Cohen also committed bank and tax fraud relating to his New York taxi and other businesses.

These revelations of guilt come on top of those of others who spent time in Mr. Trump’s orbit, including former national security adviser Michael Flynn, who admitted in a December plea deal that he lied to the FBI about his contact with Russian officials.

Mr. Cohen and Mr. Manafort are heading to prison. Mr. Flynn has yet to be sentenced. But it is unclear whether the man they worked for, the president, will face any formal scrutiny or consequences. The Constitution largely assigns that job to Congress, and powerful Republican lawmakers have seemed more interested in covering for Mr. Trump than investigating him.

Tuesday’s events must bring that partisan abdication of public duty to an end. Congress must open investigations into Mr. Trump’s role in the crime Mr. Cohen has admitted to. It is far too soon to say where such inquiries would lead. But legislators cannot in good conscience ignore an alleged co-conspirator in the White House.

Online: https://www.washingtonpost.com/

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Aug. 22

Pittsburgh Post-Gazette on a Pennsylvania grand jury report accusing Catholic church leaders of covering up sexual abuse of children:

By and large, criminal complaints, affidavits and other documents prepared by law enforcement agencies are dry and poorly written.

They’re portentous, heavy on jargon and short on style, with one simple sentence following another monotonously. Even if rich in detail, getting through them can be a slog.

Not so the Pennsylvania grand jury report on sexual abuse of children in the Pittsburgh, Allentown, Erie, Greensburg, Harrisburg and Scranton dioceses. Echoing the format of a report another grand jury produced two years ago about sexual abuse in the Altoona-Johnstown Diocese, the 884-page document released Aug. 14 grabs readers from the very first sentence:

“We, the members of this grand jury, need you to hear this.”

What follows, as much of the nation knows by now, is a comprehensive account of the horrors perpetrated on children by men of the cloth over several decades. The graphic details of the crimes and scope of the church’s cover-ups are appalling.

But shock factor alone does not explain why the public reaction has been so visceral and why the report has resonated so strongly with so many. Presentation does. The report has a conversational, achingly honest tone that lays bare the misery of the victims, the heinousness of the crimes, the hypocrisy of a church that spurned the central tenets of its faith and a statute of limitations that now bars charges against most of the offenders.

“We are sick over all the crimes that will go unpunished and uncompensated,” the grand jury says. “This report is our only recourse. We are going to name their names and describe what they did - both the sex offenders and those who concealed them. We are going to shine a light on their conduct, because that is what the victims deserve. And we are going to make our recommendations for how the laws should change so that maybe no one will have to conduct another inquiry like this one.”

While officially the product of the grand jury, the document was written largely by a team from the criminal division of the state attorney general’s office. Attorney General Josh Shapiro was among the drafters and editors.

The report is free of jargon. It minces no words and pulls no punches, with some criticism leveled at law enforcement officials who failed to pursue allegations of abuse over the years and “left children without their rightful civic watchdogs.”

It personalizes the crimes and connects readers to the victims, introducing 68-year-old Julianne, assaulted when she was 14; Joe, who waited 55 years to tell the grand jury about the “naked, masturbating priest who told him to take off his pants and get into bed”; and Bob, 83, who “can’t bear to be touched by a man, not even to shake hands or to hug his own sons,” because of what happened to him long ago.

During an investigation that spanned two years, the grand jurors reviewed half a million pages of diocesan documents. They were a trove of evidence and a source of nefarious turns of phrase - “circle of secrecy” and “secret archive,” for example - that added heft to the grand jury’s report.

The groundswell of anger the report engendered creates an atmosphere ripe for change. The grand jury’s proposals to expand civil liability and end the statute of limitations for certain sexual offenses can be fodder for informed public discussion largely because the grand jury presented its findings as a compelling narrative in which anger, sadness and passion for change leap from the pages.

After reading it, the public cannot help but feel as the grand jurors did.

Online: https://www.post-gazette.com/

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Aug. 21

USA Today on the Environmental Protection Agency proposing to lessen regulation of coal-burning power plant emissions:

The Trump administration is committed to saving coal, when what it really needs to do is save the planet.

On Tuesday, the Environmental Protection Agency took another great leap backward, proposing new rules that are supposed to control heat-trapping greenhouse gas pollution but are really aimed at furthering the production and burning of coal.

Power plants generate more than a quarter of the 6 billion tons of carbon dioxide America pumps into the atmosphere each year. And this summer, scorching California wildfires from tinder-dry conditions, along with record-breaking heat waves and flooding around the world, have been vivid testament to the extreme weather that global warming makes more likely.

With the new rules proposed Tuesday, EPA would junk the Obama administration’s Clean Power Plan, which aimed to cut power sector emissions 30% from 2005 levels by 2030, giving states flexibility to meet mandatory goals.

A better idea would be a market-based carbon tax, with revenue rebated to consumers. But the Clean Power Plan was a next-best alternative.

The Trump plan would allow each state to choose how, or even whether, to set standards for coal-fired power plants. Pollution control upgrades would be reduced.

Efficient coal burning would be encouraged, a move that could boost coal consumption, generating even more pollution. In addition to more carbon dioxide emissions, increases in microscopic airborne particulates could cause as many as 1,400 premature deaths each year.

The Trump administration claims its plan would cut greenhouse gas emissions by 33 to 34 percent below 2005 levels. But critics say that assumption merely piggybacks onto reductions - of as much as 28% - already attained by a power sector racing to embrace cheaper, cleaner natural gas and renewable sources such as wind and solar power. The true benefit of Trump’s plan? A mere couple of percentage points of reduction, if that.

All this is to save a fuel source already in decline. Meanwhile, America’s fight to prevent the globe from overheating catastrophically is turning into a capitulation.

Besides trashing the Clean Power Plan, the president is pulling the United States out of a Paris climate accord that nearly 200 other nations signed, and he intends to roll back vehicle-efficiency standards aimed at reducing tailpipe emissions, the greatest domestic source of greenhouse gases.

The new power plant rules and vehicle-efficiency rollbacks will likely be tied up in court challenges for years. That might stall Trump’s great leap backward in the fight against climate change. But the nation needs to move forward, aggressively, in what is becoming an existential struggle.

Online: https://www.usatoday.com/

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Aug. 20

Chicago Tribune on opioid overdose deaths:

Fatal aviation disasters are a rare event in the modern age. It would come as a shock to hear of a passenger jet crashing and killing everyone aboard. Now try to imagine it happening today, tomorrow, the next day and the day after. That will give you an idea of the death toll from drug overdoses in the United States.

Last year, according to a preliminary estimate from the Centers for Disease Control and Prevention, 72,000 lives were lost to overdoses. That’s 197 people dying every day - more than enough to fill a Boeing 737 passenger jet. It’s an increase of more than 6 percent over 2016.

Unlike airline crashes, these tragedies happen one by one, usually out of sight, unnoticed except by family, friends, first responders and emergency room personnel. But the staggering figures represent a crisis of historic proportions. The toll last year is nearly double the number of gun deaths in 2016. Though the CDC says the death rate from drug overdoses fell in a few states, it’s clear that in most places, efforts to combat this scourge are still falling short.

Two-thirds of the deaths involve opioids, including heroin, prescription painkillers and synthetic drugs such as fentanyl. The latter substances play by far the biggest role in the increase. Fentanyl is cheap and about 50 times more potent than heroin. When drug dealers mix it into their heroin supplies to save money, unsuspecting users can easily ingest a fatal amount.

Reversing the deadly tide is not easy. So far, the effort has been mounted on several fronts. Law enforcement has targeted suppliers, particularly those shipping fentanyl from China and Mexico. Public health agencies and medical providers have tried to expand access to treatment for those who are addicted - many of whom started by using opioids prescribed by their doctors and eventually resorted to black-market alternatives.

A multitude of lawsuits have been filed against pharmaceutical companies by local and state governments (including Chicago, Cook County and Illinois) and other parties accusing pharmaceutical companies of marketing these powerful drugs in an irresponsible way. Last week, President Donald Trump called on the Justice Department to consider filing a federal lawsuit as well.

This type of litigation may bring about changes in marketing and recover monetary damages. But it won’t eliminate dependence on the drugs that are doing so much damage. Attorney General Jeff Sessions has tripled the number of fentanyl prosecutions, including one against Chinese distributors, which may reduce the likelihood of lethal combinations. Equipping police and paramedics with naloxone, which can reverse overdoses, has saved a lot of lives.

The ultimate remedy, though, is to reduce demand by educating doctors and patients about the dangers of over-reliance on opioids, facilitating access to treatment and encouraging drug users to get it. The U.S. Department of Health and Human Services website has a feature to let those in need find treatment facilities in their ZIP codes. Some hospitals in California have begun giving overdose patients medications for managing withdrawal - which is demonstrably helpful in getting them to enter treatment afterward. Vermont has reduced overdose deaths by taking steps to better integrate such treatment into primary care.

Governments need to make a priority of expanding access to those who lack health insurance coverage. Last year, a presidential commission reported that only 10.6 percent of those who need substance abuse therapy actually get it.

Preventing many or most of these fatalities will not be an easy undertaking. But the chances of success will be much better if our policymakers recognize this epidemic as the national catastrophe it has become.

Online: http://www.chicagotribune.com/

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