July 31, 2019

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Trump Administration’s Prescription Drug Importation Plan Is Likely To Face Challenges

The Trump administration announced plans to allow the importation of prescription drugs from Canada. But the plan is just the first step and is likely to face challenges.



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The Trump administration’s launching a process that could eventually allow lower-cost prescription drugs to be imported to the U.S. from other countries, including Canada. This comes as there’s intense bipartisan focus on lowering the cost of prescription drugs. NPR White House correspondent Tamara Keith reports.

TAMARA KEITH, BYLINE: Don’t expect to go to your pharmacy tomorrow and pick up cheap Canadian drugs. What the Department of Health and Human Services announced today is a plan to begin a lengthy rule-making process that could eventually see some pilot projects get the go-ahead. Or, as HHS Secretary Alex Azar put it in an interview on MSNBC, it’s an alert to interested parties that there’s a new historic open-mindedness.

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ALEX AZAR: So that they could start thinking about how they would plan for this because we want to see those plans right away as soon as the regs are ready.

KEITH: There’s been a law on the books for more than 15 years that made importation possible, says Bill Pierce, who was at HHS during the George W. Bush administration.

BILL PIERCE: The law allowed for drug importation. However, it could only happen if the HHS secretary certified it as safe and that it would provide significant savings.

KEITH: But through three administrations, no HHS secretary has made such a certification. And earlier in his tenure, Azar even called the idea of importing cheaper drugs from other countries a gimmick.

RACHEL SACHS: So the fact that he has now stated his intention to encourage its use is a big change for him.

KEITH: Rachel Sachs is an associate professor of law at Washington University in St. Louis who specializes in prescription drugs. Sachs says the Trump administration has made a lot of big announcements like the one today, but there isn’t much to show for it.

SACHS: They’ve already abandoned two of them, and the third is still in the really early stages of being proposed. So they haven’t yet implemented anything that would be particularly beneficial for patients.

KEITH: When it comes to prescription drugs, the politics are a lot simpler than the policy. Voters frequently list drug prices as a top concern. Just this past weekend, Democratic presidential candidate Bernie Sanders took a busload of people to Canada to buy insulin.

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BERNIE SANDERS: People here are paying one-tenth of the price for the vitally important drug they need to stay alive.

KEITH: A Kaiser Family Foundation poll from earlier this year found 80% of those surveyed think Americans should be allowed to buy drugs imported from Canada. But Pierce says importing drugs on a large scale is a lot more challenging than it sounds. U.S. drugs are carefully tracked from manufacturer to the pharmacy counter. But drugs not originally destined for the U.S. don’t have the same supply chain control.

PIERCE: Even though we trust the Canadians, we like the Canadians, we can’t say that. The FDA can’t tell the HHS secretary, I know where that pill’s been.

KEITH: Which could also open up concerns about counterfeit drugs. And Pierce says there’s another issue.

PIERCE: The Canadian government’s not that interested in helping us in any way, shape or form on this because their drug supply’s limited. It’s specific to Canada.

KEITH: The drug industry lobbying group PhRMA raised many of these same concerns in a statement, saying this importation scheme is far too dangerous for American patients. And in the past, the industry’s objections have proven potent.

Another shortcoming critics point out – the administration’s planned proposal won’t cover the class of drugs that includes insulin, the diabetes drug that has focused the public’s attention on the high price of prescription drugs.

Tamara Keith, NPR News.

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A New Trump Rule Could Weaken A Civil Rights Era Housing Discrimination Law

The Trump administration is moving to weaken the civil rights-era Fair Housing Act — making it much harder to bring lawsuits alleging discrimination in housing, according to housing advocates. But conservative groups applaud the move and say it would stop frivolous lawsuits.

A draft of the Department of Housing and Urban Development rule, obtained by NPR, would target a powerful weapon that’s used in discrimination cases. It’s called “disparate impact.” That means that to prove discrimination in a lawsuit, plaintiffs don’t have to prove, for example, that a bank employee is refusing to make loans to people of color. They just have to show that a company has a business practice that, on its face, may not purposefully discriminate but has a discriminatory effect.

Wanda Onafuwa says a house next door to her in Baltimore fell into disrepair after Bank of America foreclosed on the property.

Courtesy of Wanda Onafuwa


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Courtesy of Wanda Onafuwa

“It’s important because it allows us to really get at discrimination that’s not intentional,” says Nikitra Bailey, a lawyer with the nonprofit Center for Responsible Lending. She says the Trump administration’s new rule would severely restrict this very important tool for fighting discrimination in housing.

“It’s huge,” Bailey says, because it allows fair housing lawsuits to obtain remedies for large numbers of people “without having to demonstrate each individual action of discrimination.”

The proposal, which is not yet public, is expected to be released in August.

In one current case, a fair housing group is suing Bank of America, alleging that when the bank foreclosed on homes in recent years, it treated the vacant houses very differently in white neighborhoods than it did minority neighborhoods.

Wanda Onafuwa lives next to one of these houses in Baltimore’s Tremont neighborhood. She works in accounting, owns her house and raised her kids there. She says it’s a nice, quiet street. But then Bank of America foreclosed on the house next door, and it fell into worse and worse disrepair.

“The grass wasn’t being mowed, there were no windows upstairs,” Onafuwa says. “So you have a bad rainstorm, and I don’t know what was going on with the roof, water would get in.”

She says water would fill the basement and then spill over into her basement. “There were rats running around.”

Onafuwa says she called the city and the bank repeatedly, but not much changed. Then, she says, a squatter started living in the vacant house — “a guy going in and out.” That’s even though, she says, there was no electricity hooked up. “It just looked pitch-black,” she says.

Lisa Rice, president of the National Fair Housing Alliance, which is bringing the lawsuit, says her group looked at foreclosed properties in more than 70 communities across the country with comparable levels of owner-occupied homes and other similarities.

“In the white communities that we looked at, the story was completely different,” she says. “The grass was mowed, the doors were secure, the windows were not broken, we didn’t see trash and debris.”

Bank of America said in a statement that it denies the claims in the lawsuit. “Our commitment to sustainable homeownership for low- to moderate-income and multicultural clients and communities has always been a hallmark of Bank of America,” it said.

But in a disparate impact lawsuit, you don’t have to show that a company meant to discriminate. The company might have had the best of intentions but still have adopted a policy that has an unequal outcome with a discriminatory effect.

Rice says these types of Fair Housing Act cases go back more than 40 years. In 2015, the Supreme Court upheld the use of disparate impact while imposing some limitations. But many corporations and conservatives don’t like this legal approach.

“There are always going to be racially disproportionate results for any policy,” says Roger Clegg, president of the Center for Equal Opportunity, a conservative think tank that focuses on civil rights issues. Clegg, who worked in the Justice Department in the Ronald Reagan and George H.W. Bush administrations, says these disparate impact cases are often unfair to defendants because the cases find discrimination where it’s not actually happening.

“If you have a landlord who says, ‘I’m not going to rent to people with a history of violent crime,’ ” he says. “The fact that that has a racially disproportionate result does not make it discrimination.”

So he says this disparate impact approach results in a lot of unfair lawsuits. And he says the Trump administration’s new rule will provide clarity about the limits under the 2015 Supreme Court decision.

But Bailey, of the Center for Responsible Lending, says the proposed rule goes way beyond that. “It really makes it more difficult to bring disparate impact cases, and then it limits the damages for discrimination,” she says.

Bailey says with African American homeownership rates at their lowest level in 50 years, this could set up more roadblocks.

The Department of Housing and Urban Development says it can’t comment on the proposed rule yet. But in an earlier statement, HUD Secretary Ben Carson said the department “remains committed to making sure housing-related policies and practices treat people fairly.”

But civil rights advocates say they’re worried. They say that beyond this proposed housing rule, the Trump administration is looking to roll back civil rights protections in education and in terms of which groups of people deserve protection from discrimination.

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The Sisters Of A-WA Share Their Great-Grandmother’s Refugee Story

VuHaus

“Hana Mash Hu Al Yaman”

“Mudbira”

“Malhuga”

Tair, Liron, and Tagel Haim are three sisters who record as A-WA. They are Arab Jews who live in Israel and spread the Yemeni folk traditions of their heritage around the world through electronic music. On the group’s latest album, Bayti Fi Rasi, the sisters tell the story of their great-grandmother, Rachel, who fled Yemen and arrived in Israel as a refugee as part of Operation Magic Carpet in 1949. Many of the songs, like “Hana Mash Hu Al Yaman” (meaning “Here Is Not Yemen”) address the difficulties Rachel faced on both sides of her journey as a refugee.

The sisters dropped by World Cafe to perform inviting and unique songs from Batyi Fi Rasi and to talk about their own journey as musicians from a small desert village in Israel to the international stage.

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