RUTHFULLY YOURS

This story was co-published with NPR’s Shots blog.

The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless.

But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Cantrell called Roy Gerona, a University of California, San Francisco, researcher who specializes in analyzing chemicals. Gerona had grown up in the Philippines and had seen people recover from sickness by taking expired drugs with no apparent ill effects.

“This was very cool,” Gerona says. “Who gets the chance of analyzing drugs that have been in storage for more than 30 years?”

The age of the drugs might have been bizarre, but the question the researchers wanted to answer wasn’t. Pharmacies across the country — in major medical centers and in neighborhood strip malls — routinely toss out tons of scarce and potentially valuable prescription drugs when they hit their expiration dates.

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term “expiration date” was a misnomer. The dates on drug labels are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee their effectiveness, typically at two or three years. But the dates don’t necessarily mean they’re ineffective immediately after they “expire” — just that there’s no incentive for drugmakers to study whether they could still be usable.

ProPublica has been researching why the U.S. health care system is the most expensive in the world. One answer, broadly, is waste — some of it buried in practices that the medical establishment and the rest of us take for granted. We’ve documented how hospitals often discard pricey new supplies, how nursing homes trash valuable medications after patients pass away or move out, and how drug companies create expensive combinations of cheap drugs. Experts estimate such squandering eats up about $765 billion a year — as much as a quarter of all the country’s health care spending.

Experts say the United States might be squandering a quarter of the money spent on health care. That’s an estimated $765 billion a year. Do you believe you’ve encountered this waste? Tell us.

What if the system is destroying drugs that are technically “expired” but could still be safely used?

In his lab, Gerona ran tests on the decades-old drugs, including some now defunct brands such as the diet pills Obocell (once pitched to doctors with a portly figurine called “Mr. Obocell”) and Bamadex. Overall, the bottles contained 14 different compounds, including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers.

The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations.

“Lo and behold,” Cantrell says, “The active ingredients are pretty darn stable.”

Cantrell and Gerona knew their findings had big implications. Perhaps no area of health care has provoked as much anger in recent years as prescription drugs. The news media is rife with stories of medications priced out of reach or of shortages of crucial drugs, sometimes because producing them is no longer profitable.

Tossing such drugs when they expire is doubly hard. One pharmacist at Newton-Wellesley Hospital outside Boston says the 240-bed facility is able to return some expired drugs for credit, but had to destroy about $200,000 worth last year. A commentary in the journal Mayo Clinic Proceedings cited similar losses at the nearby Tufts Medical Center. Play that out at hospitals across the country and the tab is significant: about $800 million per year. And that doesn’t include the costs of expired drugs at long-term care pharmacies, retail pharmacies and in consumer medicine cabinets.

After Cantrell and Gerona published their findings in Archives of Internal Medicine in 2012, some readers accused them of being irresponsible and advising patients that it was OK to take expired drugs. Cantrell says they weren’t recommending the use of expired medication, just reviewing the arbitrary way the dates are set.

“Refining our prescription drug dating process could save billions,” he says.

JIM TALENT Senator, MO Republican (2002–2007)
A number of writers in these pages have been critical of the meeting between Donald Trump Jr., Rob Goldstone, and a Russian lawyer. They include a lot of people I respect highly. Here are a few: Charles Krauthammer, David French, and the editors of National Review.

The visceral reaction of these writers was that there was something terribly abnormal or unethical about Trump Jr. being eager to meet with Goldstone and his Russian contact.

I didn’t react the same way. My first impulse was to think that, if I had been Trump, I too would have wanted to get useful information from the Russian, or at least to see what information she had. I wouldn’t have “loved” the idea, as Trump Jr said he did, but I would have wanted to listen to what the contact had to say.

After reading the NR articles, I thought perhaps I was missing something. So I called one of my former campaign staffers and asked him what he would have done in Trump Jr.’s place.

He said that “it would have been campaign malpractice not to explore the opportunity.” He added: “The first thing I would have done was to call the lawyers to see how I could proceed.”

That pretty much sums up my opinion. If I were running in a close race against an opponent who had been credibly accused of using her foundation to do favors for foreign entities, and a contact from one of those entities had approached my campaign with an offer of information, I would have wanted my campaign to follow up, albeit with caution. (More on the cautious part later.)

I would have been suspicious, of course, of the motives of the representative and the foreign entity. Maybe somebody was playing my campaign — setting us up. On the other hand, I would have also thought that it was precisely people connected with the foreign entity who might have the kind of information that would expose illegality by my opponent.

In other words, my reaction was that the meeting proves nothing other than that the Trump campaign was exploring a lead it thought credible, as it would have explored any other credible lead, whatever the source, and as most campaigns would have done in similar circumstances.

I ran for office eleven times, and in four highly competitive races: one for Congress, one for governor, and two for the Senate. Naturally, I wanted very much to win, in part because nobody likes to lose, but also because I really felt that I could accomplish worthwhile things in office.

To be sure, in any given election, many voters think that all of the candidates are pretty worthless, but understandably enough, the candidates themselves rarely see it that way. President Trump wasn’t the first politician, and won’t be the last, who believed that he could make America great again if only he could get elected.

In addition, when you become the nominee of your party, you have a responsibility to do everything you can to succeed. The agenda of your movement is at stake, your party is counting on you, and your supporters are working hard to elect you. Of course, every campaign should operate within ethical as well as legal constraints, but a candidate doesn’t have the luxury of eschewing an opportunity for political advantage because it carries some risk or is in some way distasteful.

I think most politicians of both parties would feel that way. And most candidates wouldn’t care too much about whether a foreign entity was rooting for them to win. How, really would you know what a foreign government is thinking? And what difference would it make to your campaign if you did know?

It’s a pretty good bet that Vladimir Putin preferred Barack Obama to Mitt Romney in 2012, given this episode, and this one.

So what should Obama have done? Blow the race to frustrate the Russians?

One of the things the press likes to do is to raise the visibility of something that has been part of the political culture for a long time, when by focusing on it they think they can embarrass a politician they don’t like. The press manifestly dislikes President Trump, and it has now discovered how terrible it is that foreign governments get involved in our elections — as if that never happened before, and as if the media hadn’t pretty much ignored it when it did.

I am not accusing Charles, David, or NR’s editors of engaging in such a double standard. But a double standard definitely is at play in much of the coverage of the Goldstone-Trump Jr. meeting.

Now for the caution part. Politics is a highly regulated affair, and so is dealing with foreign entities and people who purport to represent them.

The Trump campaign should have had experienced lawyers and senior national-security advisers, and those people should have been consulted when the request for a meeting was made. They could have helped lower the risks attendant to such a meeting. In fact, I would have had a lawyer and an intelligence professional attend the meeting, to assess the motives of the parties, the value of any information, the possibility of foreign intrigue, and whether the information should be shared with the authorities.

Samantha Power has agreed to testify before a congressional panel, although an exact date has not yet been confirmed, a spokesman for the former ambassador told Fox News.

“Ambassador Power strongly supports any bipartisan effort to investigate and address Russia’s interference in our electoral process and she wanted to engage both House and Senate Committees charged with investigating it,” David Pressman, counsel to Power and partner at Boies Schiller Flexner LLP, told Fox News. “Ambassador Power is very much looking forward to providing any assistance and encouragement she can to bipartisan efforts aimed at addressing this serious threat to our nation’s security.”

Red flags were immediately raised when House investigators identified Power as someone who was involved with the “unmasking” of Americans connected to the Trump campaign. She was President Obama’s ambassador to the United Nations, not an intelligence analyst. What business did she have unmasking the names of Trump campaign/transition officials?

According to Fox News, several other Obama officials are appearing on Capitol Hill this week to testify behind closed doors as well:

Former Director of National Intelligence James Clapper appeared before both the House and Senate Intelligence Committees on Monday.

Former White House Chief of Staff Denis McDonough will also testify this week, Fox News was told.

But according to the Washington Free Beacon, House investigators now see Power as “central to efforts by top Obama administration officials” to unmask American citizens named in classified intelligence community reports related to Trump and his presidential transition team.

The names of Trump allies in the raw intelligence reports were leaked to the press in what many in Congress and the current administration claim is an attempt by Obama allies and former officials to damage the White House.

A former senior U.S. official told WFB: “Unmasking is not a regular occurrence—absolutely not a weekly habit. It is rare, even at the National Security Council, and ought to be rarer still for a U.N. ambassador.”

“It might be defended when the communication in question relates directly to U.N. business, for example an important Security Council vote,” explained the former official, who would only discuss the matter on background. “Sometimes it might be done out of other motives than national security, such as sheer curiosity or to defend a bureaucratic position. Or just plain politics.”

The Intelligence Committee’s focus of Power and other key Obama officials is a prime example of the Obama administration’s efforts to spy on those close to Trump, according to sources familiar with the ongoing investigation.

“The subpoena for Power suggests just how pervasive the Obama administration’s spying on Americans actually was,” said one veteran GOP political operative who has been briefed on the matter by senior Congressional intelligence officials. “The U.N. ambassador has absolutely no business calling for the quantity and quality of the intelligence that Power seems to have been asking for.”

The source questioned why Power would need to uncover such classified intelligence information in her role at the U.N.

“That’s just not the sort of thing that she should have been concerned about, unless she was playing the role of political operative with the help of the intelligence community,” the source said. “It gives away what was actually going on: the Obama administration was operating in a pervasive culture of impunity and using the intelligence community against their political opponents.”

Rice was scheduled to speak to House Intelligence Committee this week, but the meeting was reportedly postponed. Some sources speculated this could be a delaying tactic by Rice aimed at pushing the testimony back until after Congress’s summer recess. CONTINUE AT SITE

“Majority Leader Mitch McConnell spurred Republican senators Thursday to resolve internal disputes that have pushed their marquee health care bill to the brink of oblivion,” reports the Associated Press. At a White House meeting on Wednesday, President Trump urged the GOP lawmakers to try one more time to avoid pushing themselves into political oblivion.

According to the A.P.:

Aiming to finally resolve the issue, McConnell has said he’ll force a vote on the legislation early next week.

After a face-to-face lecture from Trump, around two dozen of them staged a nearly three-hour bargaining session Wednesday night to resolve their disputes. When it was over, none offered specific examples of any progress.

“We still do have work to do to get to a vote of 50, but people are committed to continuing that work,” said Sen. John Barrasso, R-Wyo., a member of the GOP leadership who hosted the meeting in his office.

Also attending Wednesday’s private meeting were health secretary Tom Price and Seema Verma, the Medicaid and Medicare administrator. It was interrupted by prayer after the lawmakers learned that [Sen. John] McCain, 80, had a cancerous brain tumor.

Earlier Wednesday at the White House, Trump told them they must not leave town for their August recess without sending him an “Obamacare” repeal bill to sign.

“I’m ready to act,” Trump said, foisting the responsibility on Republican lawmakers, not himself.

Of course it’s the U.S. Constitution, not Donald Trump, that has foisted the responsibility of passing bills on the elected legislators. And, as reported by the Journal, Mr. Trump makes a good case that GOP senators have a moral responsibility as well:

“Any senator who votes against starting debate is really telling America that you’re fine with Obamacare,” Mr. Trump said before a lunch with the senators Wednesday. He gestured at one wavering GOP lawmaker, Dean Heller of Nevada, saying, “He wants to remain a senator, doesn’t he?” and warned lawmakers not to leave town in August without a deal.

“I’m ready to act, I have pen in hand, believe me, I’m sitting in that office. You’ve never had that before,” Mr. Trump said. “For seven years, you’ve had an easy rap: ‘We’ll repeal, we’ll replace, and he’s never going to sign it.’” CONTINUE AT SITE