July 15, 2019

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Trump Taps Health Care Expert As Acting Top White House Economist

President Trump has named Tomas Philipson as acting chair of his Council of Economic Advisers. Philipson, who is already a member of the council, is a University of Chicago professor who specializes in the economics of health care.

He previously served as a top economist at the Food and Drug Administration and the Centers for Medicare & Medicaid Services.

Philipson takes over from White House economist Kevin Hassett, whose departure was announced on Twitter last month.

“I want to thank Kevin for all he has done,” Trump tweeted. “He is a true friend!”

“I’m leaving on very good terms with the president,” Hassett said in an interview. He stressed that two years is a typical tenure for CEA leaders, many of whom come to the White House on loan from universities.

“One of the reasons why CEA has stayed an objective resource over all these years is that the chairmen have tended to turn over after a couple of years, which is not really enough time to go native,” Hassett said. “If you stay here too long, then you might end up being too fond of all the political types over in the West Wing and it might be a little bit harder to tell them the difficult truths.”

Hassett, a sunny optimist who co-authored the book Dow 36,000 at the height of the dot-com bubble, hasn’t felt the need to tell many difficult truths. While many forecasters predict a slowdown in the U.S. economy this year, Hassett continues to project economic growth of at least 3%.

Colleagues describe Philipson as a top-notch economist and a creative problem-solver.

“Tom is a very fresh thinker,” said Mark McClellan, a veteran of the George W. Bush administration who recruited Philipson to work for him, first at the FDA and later at CMS. “Tom had a great background in health economics and wanted to do work that was very policy relevant. So it was a win-win.”

Although Philipson grew up in Sweden, where the vast majority of health care costs are covered by the government, he stresses market-oriented reforms and consumer choice.

“Coming from the University of Chicago, it’s probably not surprising that as an economist he would envision a big role for consumers in improving how markets function,” McClellan said. “I would emphasize as well, though, that he has a good understanding of government institutions and the role of regulation.”

At the FDA, McClellan said, Philipson helped institute a system in which drugmakers and medical device manufacturers paid higher fees to facilitate faster approvals. At CMS, he worked on Medicare Advantage — a program that allows about a third of Medicare recipients to get their benefits through private insurers.

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Oklahoma Opioid Trial Ends

Monday was the last day in a widely-watched trial about opioid addiction in Oklahoma. The state sued opioid manufacturers, but only Johnson & Johnson fought it in court after others settled.



ARI SHAPIRO, HOST:

Today the state of Oklahoma laid out its closing argument for holding a pharmaceutical company responsible for the national opioid epidemic.

(SOUNDBITE OF ARCHIVED RECORDING)

BRAD BECKWORTH: Because the facts in this case showed the causation is causation. When you oversupply, people die.

SHAPIRO: That’s Brad Beckworth, lawyer with the Oklahoma Attorney General’s Office. On the other side, Johnson & Johnson attorney Larry Ottaway said opioids are already subject to a litany of rules.

(SOUNDBITE OF ARCHIVED RECORDING)

LARRY OTTAWAY: This is not a free market. The supply is regulated by the government.

SHAPIRO: This is the first such trial in the U.S., many are set to follow. Joining us from the courthouse is Jackie Fortier. She’s a reporter for StateImpact Oklahoma, and she’s been covering the case for NPR. Hi there.

JACKIE FORTIER, BYLINE: Hi.

SHAPIRO: You’ve been in court for about seven weeks. You’ve listened to 38 witnesses. What top line have we learned from this trial?

FORTIER: I mean, this trial was really an opportunity to pull back the curtain and show the public how part of the pharmaceutical industry operates. And originally, Attorney General Mike Hunter had sued three drug companies, but two of those settled before the trial. That was Teva and Purdue Pharma, which makes OxyContin. And that left just Johnson & Johnson.

So during the trial, lawyers for the state picked over their business strategy and claimed that the company helped drive a surge in opioid prescribing among doctors, and that led to a pain medication market worth billions.

SHAPIRO: So the central argument by the state is that basically the drug companies created the opioid crisis. Is that what they’re saying?

FORTIER: Yeah. The state says that Purdue Pharma really kickstarted the epidemic with OxyContin in the ’90s. And then Johnson & Johnson decided to compete with its own product. But the state says the company was just too aggressive. It’s falsely claimed that there was a very low addiction risk.

And then Johnson & Johnson purchased prescribing data from pharmacies, and that told them which doctors were prescribing lots of Purdue’s OxyContin. Johnson & Johnson then targeted those specific doctors in Oklahoma to try to get them to switch over to their company’s opioids.

SHAPIRO: So when you say they targeted doctors, they used drug sales representatives who worked for the drug company. Those representatives visit doctors and staff. How important were those people in this trial?

FORTIER: They were very important. Their goal is to market specific drugs to doctors. It’s a common practice. But the state says that Johnson & Johnson took it too far. As evidence, the state wheeled in 34 boxes full of reports that drug reps wrote about their meetings with doctors. And we learned that drug reps encouraged some Oklahoma doctors to continue prescribing opioids even after some of those doctors’ patients died from overdoses. They even kept visiting doctors who’d been disciplined by the state for prescribing too many opioids.

SHAPIRO: And what did Johnson & Johnson say about all of this?

FORTIER: Well, they actually blame Oklahoma. The company says, hey, state regulators are the ones who license the doctors prescribing our products. So that’s your role. You didn’t notify us that those doctors were disciplined. Another really big part of the company’s defense has been to point out that opioids have a legitimate medical purpose. They’re FDA approved. They come with warning labels. But ultimately, it’s up to doctors how they’re prescribed and which patients get that prescription.

SHAPIRO: So for people who are struggling with addiction to these drugs and for their families, what would a decision in this case mean?

FORTIER: Yeah. If Oklahoma wins, it could mean more access to treatments. The state is asking that the company pay more than $17 billion over the next 30 years. If the state loses, it’s still significant. There’s more than 1,600 opioid-related lawsuits. So the outcome of this trial is really going to be closely watched.

SHAPIRO: And when do we expect to know the outcome?

FORTIER: The judge is expected to issue an opinion in August, and it’s up to him to decide if Johnson & Johnson will pay anything, and if so, how much.

SHAPIRO: That’s Jackie Fortier, a reporter with StateImpact Oklahoma. Thanks a lot.

FORTIER: You’re welcome.

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Crowds Gather Each Week In Wisconsin To Watch Their Teams Play Ball — In Snowshoes

Huge crowds turn up each week to watch a game of baseball on a woodchip field, where the players wear snowshoes.

Mackenzie Martin/WXPR


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Mackenzie Martin/WXPR

Most snowshoes in the United States are probably in storage right now, gathering dust and waiting for temperatures to drop. In the town of Lake Tomahawk in the Northwoods of Wisconsin though, they’re getting a lot of use this summer.

Snowshoe baseball is exactly what it sounds like. It’s a game of baseball played on snowshoes, though it more closely resembles a bizarre game of softball.

Every Monday night in the summer—and on the 4th of July—hundreds of tourists and residents gather to cheer on players who strap on snowshoes and hit a large softball around a field of wood chips. This has been going on since 1961, when then town chairman Ray Sloan came up with the idea to turn the game into a spectator sport capable of entertaining both summer tourists and town residents. An earlier version of the game was played on frozen lakes. Hence, the snowshoes.

Admission is free, but slices of homemade pie cost $2. The pie is a big deal here, too. On any given night you can find 40 different flavors.

Sheila Punches says that “they come for the pie and stay for the game.” She’s been coming to games since the 1970s and she says pie is one way she measures its popularity.

“There was a time when 30 pies was enough,” she says. “Then it was 40, 50, 60, 70 … 100 pies is not too many pies to have. I think somebody said they had 160 pies last week for the 4th of July.”

Pie flavors range from the traditional — Raspberry Rhubarb or Apple — to the more unique: Banana Split, Margarita, and even Sawdust, featuring graham crackers and coconut flakes.

The game starts with a rendition of the national anthem by the local barbershop chorus. Then local commentators Adam Lau and Jimmy Soyck lead the way.

In a recent game, someone takes a swing, misses the ball, and switches bats.

“Oh, it’s the bat,” says Soyck into his microphone.

“It’s always the bat’s fault,” agrees Lau.

Then when the player does hit the ball, he trips right after leaving home plate. The crowd audibly cheers, then sighs.

This hilarious scene is all too common, especially for newer players. Soyck says you can’t run in snowshoes. It’s all in the shuffle.

“You gotta shuffle your feet. You can’t pick them up,” he says. “If you pick them up, you’re going over. No ifs, ands, or buts about it.”

The game carries on this way until about the 7th inning, when one lucky batter gets a disguised cantaloupe thrown to him instead of a ball. When the batter makes contact, he immediately scatters the baseball field with pieces of melon.

“When that thing hits, it splatters everywhere,” says Jeff Smith, who coaches the Snow Hawks, the home team. “It’s painted to look pretty much like those balls out there, and the batter isn’t supposed to know until he hits it.”

It’s easy to laugh at the idea of people playing softball on snowshoes in the middle of the summer, but fan Phil Hejtmanek says there are a lot of talented players here.

“The funny thing is these guys are really good,” he says. “You figure ‘oh, the outfielders aren’t going to be able to make any plays,’ but just you wait.”

When you drive into the town of just more than 1,000 residents, a sign reads: “Welcome to Lake Tomahawk: Home of Snowshoe Baseball.” The game is a part of this town’s history, with generations of families coming together each summer to watch the games.

Mackenzie Martin/WXPR


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Coach Jeff Smith says that it takes a lot of work from local volunteers to make each game run smoothly, but that he doesn’t expect the game to ever fade out.

“There’s too much passion amongst the townspeople around Snowshoe Baseball,” he says. “People get pretty serious about their home team winning and playing and they just want to be a part of it.”

Ultimately, this game is a part of this town’s fabric. Residents like Macey Macintyre grew up watching it.

“The whole town comes together just to watch this and you know it’s the whole town because you see everyone week in and week out,” she says. “It makes our town unique and it makes me just love my town and the people in it a lot more.”

So if you’re in Wisconsin’s Northwoods on a Monday night this summer and looking for some entertainment and good company, snowshoe baseball will be happening in Lake Tomahawk. The season ends in late August.

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