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Early optimism among business lobbyists and executives that Donald Trump’s election heralded better days has slowly given way to uncertainty as the president-elect fires off mixed and sometimes confusing messages on healthcare, taxes and trade.

An initial euphoria in the business world fueled a powerful post-election stock rally. Some of that has frayed as questions arise over the nuts and bolts of Trump’s campaign promises, although many in the business community said they remained optimistic.

Doubts deepened over the weekend as Trump declared he would replace President Barack Obama’s signature healthcare plan known as Obamacare with “insurance for everybody” — a goal far beyond Republican designs — and criticized a key component of a plan in Congress to overhaul corporate taxes. In a later interview, he appeared to adjust both stances, possibly adding to the confusion.

“It is fair to say that since the election, there has been mounting uncertainty about exactly what the specific policies are likely to be with regard to tax reform and replacing Obamacare,” a financial industry official said.

Expectations for faster growth, tax reform and a quick repeal of Obamacare, officially known as the Affordable Care Act, have “given way to ‘We are not really sure what he means by that,’” the official said.

A veteran Republican financial lobbyist said she was under constant pressure from clients to predict what the new administration was planning but had no reliable answers.

President Barack Obama turns from the podium at the conclusion of his final news conference, Jan. 18, 2017, in the Brady Press Briefing Room of the White House.

President Barack Obama turns from the podium at the conclusion of his final news conference, Jan. 18, 2017, in the Brady Press Briefing Room of the White House.

Wrench in Obamacare repeal

Trump appears to have thrown a wrench into Republican plans to repeal Obamacare with mixed signals on the details and timing of a replacement plan.

Congressional Republicans have focused on limiting government involvement in the healthcare system and eliminating the law’s individual mandate that forces people to have insurance.

But Trump told the Washington Post he was almost done with a plan to replace Obamacare with “insurance for everybody,” while forcing drug companies to negotiate directly with the government on prices for Medicare and Medicaid.

Trump’s recent attack on the border adjustment tax was another sign of his unpredictability, the financial lobbyist said.

That measure would tax imports and exempt exports in an effort to encourage companies to keep jobs and production in the United States. In an interview with the Wall Street Journal on Friday, Trump called the proposal “too complicated.”

“Anytime I hear border adjustment, I don’t love it,” Trump told the Journal. “Because usually it means we’re going to get adjusted into a bad deal. That’s what happens.”

Chris Krueger, an analyst at the investment firm Cowen and Co., said Trump’s comments to the newspaper about the border adjustment proposal were “breathtaking.”

“Trump is like a policy bull who seems to bring his own china shop with him to destroy it with every interview,” Krueger wrote in a research note.

In an interview with the news outlet Axios on Tuesday, Trump appeared to adjust both positions. He said the border adjustment idea was still “on the plate.” As for Obamacare, he said his comments were in response to proposals in which “people with no money aren’t covered,” which he said were unacceptable.

Lobbyists said the Trump transition team’s lack of interest in their input was clear in the past two weeks as it summoned trade groups to daily “listening sessions” at the American Enterprise Institute think tank. The agriculture, financial, transportation and tech industries were among the sectors that got a one-hour session, according to participants.

Senate Armed Services Committee member Elizabeth Warren questions Defense Secretary-designate James Mattis, Jan. 12, 2017 on Capitol Hill, during the committee

Senate Armed Services Committee member Elizabeth Warren questions Defense Secretary-designate James Mattis, Jan. 12, 2017 on Capitol Hill, during the committee’s confirmation hearing for Mattis.

‘Goat rodeo’

In the sessions, Wall Street lobbyists were encouraged to talk fast: a giant television screen overhead counted down two minutes of allotted time.

“It was a goat rodeo. We all got a couple minutes to speak. What can you really say in that time?” said another financial services lobbyist. “They wanted to check the box — ‘We’re listening to Wall Street.’ But who even knows where these transition people will be in a few days?”

Lobbyists also have been alarmed that the transition team has not included them in preparations for confirmation hearings for many nominated Cabinet officials, including potential Treasury Secretary Steven Mnuchin.

“If you want someone to explain how Elizabeth Warren can hammer you 12 different ways, ask a lobbyist,” said the financial services lobbyist, referring to the Democratic U.S. senator from Massachusetts and frequent critic of Wall Street.

Even Trump’s website sowed confusion about his intentions. A promise to dismantle the Dodd-Frank regulatory reforms was removed at the end of last year and has not been replaced. A Trump representative blamed a redesign, but bank lobbyists are not so sure — other content made it through the redesign.

Some companies have been reassured by Trump’s Cabinet nominees, who are seen as more predictable and supportive of the business establishment than the impulsive president-elect.

Senator Jeff Sessions, Trump’s pick for attorney general, has deep differences on values with the technology sector but is seen as an important Trump counterweight because he is a “deliberate decision-maker not prone to big dramatic mood swings,” a source at one major Silicon Valley firm said.

Attorney General-designate, Jeff Sessions, testifies on Capitol Hill, Jan. 10, 2017, at his confirmation hearing before the Senate Judiciary Committee.

Attorney General-designate, Jeff Sessions, testifies on Capitol Hill, Jan. 10, 2017, at his confirmation hearing before the Senate Judiciary Committee.

What about the tweets?

Many lobbyists and business officials said they remained optimistic and cautioned against reading too deeply into tweets or comments that Trump makes on policy.

“If Obama or Bush opined on a policy … most of Washington assumed that raising that question was a well-vetted intentional decision to send a signal,” a senior U.S. Chamber of Commerce official said.

Trump, by contrast, may simply be raising policy issues because he has questions on them, the chamber official said. The same financial industry official who acknowledged the uncertain climate also said he was still optimistic.

“There were a lot of candidates who were interviewed. There were names floated out there and … it was kind of a chaotic process,” the official said, referring to the process of picking candidates to fill Cabinet and other administration positions.

“But overall, I think one can make the observation that in making the final selections, Trump has shown … a very surprising even-handedness.”

Rishi (Ssharad Malhotra) turn devdas engrossing self in alcohol in Tanuja’s (Kratika Sengar) memory in Kasam Tere Pyaar Ki

In the upcoming episode there will be lots of high voltage dramatic situations seen amid Rishi and Tanuja in the daily soap.

Rishi has given the promise to Rano that Rishi would divorce Tanuja as soon as possible.

Rishi also fulfilled his promise and this made Rishi once again alone and aloof with only Tanuja’s memories.

Rishi instead of moving ahead in life got down the memory lane and started to visualize all the happy moments which Tanuja and Rishi have spent together.

Rishi turned drunkard

In the upcoming episode there will be lots of tragic situations seen amid Rishi and Tanuja in the ongoing serial.

Rishi in Tanuja’s memories started to drink alcohol in such big quantity that made Rishi loose his senses.

It would be very interesting to watch as to how would Rano react eyeing Rishi’s this state and what would be Rano’s call?

Stay tuned for further details and developments in story line.

The forces arrayed against Donald Trump’s presidency and the emboldened neo-fascist movement in the US range from the Central Intelligence Agency to oppressed minorities and women anticipating the loss of reproductive rights. They could soon encompass most of the world once Trump’s climate change threats meet resistance.

But opposition to Trump from above – moderate Republicans, Democratic Party elites, so-called Deep State opponents, exporting companies concerned about protectionism, as well as “budget deficit hawks” worried about Trump’s borrow and default history – could soon fade away.

In contrast, resistance from below will continue rising as progressive activists move out of their single-issue silos and offer each other solidarity. Could this resistance be mobilised into a global movement against Trump, perhaps drawing lessons from the victory against apartheid South Africa? Is a global sanctions strategy appropriate against the new president, his cronies and US corporations more generally?

Lessons from the past

Boycott Divestment Sanctions (BDS) campaigns now underway include a Palestinian call to oppose the Israeli state due to its legal and human rights violations. Another is the “divest-invest” campaign against the fossil fuels industry.

But the sanctions campaign against apartheid, which formed a critical part of the resistance against the South African regime, remains the exemplar. According to Ronnie Kasrils – a leader of the anti apartheid underground movement – the campaign

made apartheid’s beneficiaries feel the pinch in their pocket and their polecat status.

In 1985, the South Africa campaign drove a strategic wedge between white capitalists in the country and the racist Pretoria regime. Just as internal protests surged in the mid-1980s, the regime was confronted by a foreign debt crisis caused in part by the rising tide of sanctions. This finally broke the capital-state alliance and compelled the transition to democracy.

Breaking Trump’s ties to crony corporations would be a comparable project. At least in the short term, the impetus for such a campaign would be Trump’s stance on climate.

Trump’s climate chaos

Climate change denialism is the “default position” of Trump’s government, as confirmed by his chief of staff. According to Trump’s 100-day plan he will build fossil-fuel pipelines, airports, roads and bridges. He will cancel international obligations like the United Nations treaties and payments due to the Green Climate Fund. He will retract shale gas restrictions and the ban on the Keystone oil pipeline.

His plan also disempowers the Environmental Protection Agency and will attempt to “save the coal industry”. After that, expect privatisation of public land, including Native American reservations, in search of more oil.

In addition, Trump has chosen carbon-filthy individuals to fill the main climate-related Cabinet posts. These include secretary of state Rex Tillerson, EPA director Scott Pruitt and energy secretary Rick Perry.

Voices for sanctions and carbon tariffs

Already a decade ago, economist Joseph Stiglitz argued that

unless producers in America face the full cost of their emissions, Europe, Japan and all the countries of the world should impose trade sanctions against the US.

The idea was reaffirmed last November when climate justice advocate Naomi Klein reacted to Trump’s election:

We need to start demanding economic sanctions in the face of this treaty-shedding lawlessness.

States may also join in. French former president Nicolas Sarkozy had this to say: “I will demand that Europe put in place a carbon tax at its border, a tax of 1%-3%, for all products coming from the US, if the US doesn’t apply environmental rules that we are imposing on our companies.”

Micro-sanctions are already stinging Trump. He recently defended clothing retailer LL Bean against the #grabyourwallet boycott of 75 Trump-related firms. His ego may have been bruised by singer Cher’s “Turn him off” call aimed at denying the inauguration a substantial television audience. Most A-list entertainers rejected invitations to perform on inauguration day while dozens of Democratic Party members of Congress announced a stay-away.

Trump’s vulnerable business interests

Setting aside other personal pin-pricks from journalists and politicians which have drawn blood, activist and legal attacks on Trump’s business continue to mount. Decades worth of extreme corruption in real estate gambles, debt defaults and full-fledged bankruptcies, nonpayment of suppliers and tax chiselling have reportedly attracted more than 4,000 lawsuits. And the new president refuses to divest any of his business holdings.

Grievances against his family-firm holdings are legion, but political attacks on Trump-associated companies are far more important. Last February, for example, the activist network Color of Change petitioned a major sponsor of the Republican Party annual convention:

How can Coca-Cola, a company that heavily markets to and profits from Black people, fund a platform for a presidential nominee that is being bolstered into office by former Grand Wizard David Duke, the KKK, and other white supremacists?

After 100,000 signatures within three weeks, Coca-Cola agreed to withhold $600,000 it had earlier earmarked to help pay for the convention.

Another success is the “Sleeping Giants” Twitter network of several thousand clicktivists. Since last November they have discovered more than 1,000 businesses and nonprofit institutions advertising (most without being aware) on the Breitbart white nationalist website. They confronted these firms by sending them a screenshot and requested that they withdraw their advertising from the sites. Soon 400 firms had done so.

Mega-corporations are more difficult targets. The Dow Jones stock market index has soared since Trump’s victory on November 8, led by banking, oil and military firms. Trump’s cabinet and top officials come from Goldman Sachs bank, ExxonMobil oil, Koch Industries oil, Lockheed Martin military, Pfizer drugs, General Dynamics military, Wells Fargo bank, Amway beauty, Hardees food and Breitbart media. Some of these would be the most obvious targets for a people’s smart sanctions strategy.

As soon as the time is ripe it will be up to grassroots activists fighting hardest from within – and anyone else concerned about climate – to make the call: Boycott Divestment Sanctions USA.

The United States has signed defense cooperation agreements with Lithuania and Estonia, formalizing the deployment of thousands of troops to bolster NATO defenses in the face of Russian aggression. Henry Ridgwell reports four multinational battalions are being deployed in Estonia, Latvia, Lithuania and Poland.

The United States faces a major problem with prescription drug prices. Even as the prices of most goods and services have barely budged in recent years, the cost of drugs has surged.

During the presidential campaign, both Hillary Clinton and Donald Trump cited the high cost of prescription drugs as an issue that needed to be addressed. Most recently, the president-elect took direct aim at the pharmaceutical industry, saying it’s “getting away with murder” and arguing “new bidding procedures” are necessary to lower drug prices.

Trump didn’t get into specifics about what that would mean, but the most often suggested way to lower drug prices has been to expand the ability of major government buyers, such as Medicare, to negotiate prices.

While such negotiations could result in lower prices, we believe, based on our experience as economists and public policy experts, an alternative using public utility pricing would work better and ensure the discovery and distribution of important new medications.

Martin Shkreli, former CEO of Turing Pharmaceuticals, invoked the Fifth before Congress after earning scorn for raising the price of a lifesaving medicine by 5,000 percent. Joshua Roberts/Reuters

‘Medically necessary’

The recent drug price data are indeed frightening.

In 2015 spending on prescription drugs rose by 8.5 percent to US$309.5 billion, compared with a rise of just 1.1 percent for consumer goods and services. Spending for specialty drugs increased by an even heftier 15 percent, on average. Individual examples that made big headlines, such as Turing Pharmaceuticals raising the price of Daraprim (a lifesaving drug for people with weakened immune systems) from $13.50 to $750 a tablet, are even more extreme.

In a competitive market, prices of a product are forced down to their costs plus a fair profit. Drug companies, on the other hand, can get away with raising prices without losing customers because the demand for certain medications is insensitive to their cost. If a drug will save your life, you’ll probably pay whatever the cost, if you can.

The problem may soon get worse. Last May, Washington state’s Medicaid program was ordered to provide the hepatitis C drugs Sovaldi and Harvoni after a court ruled they were “medically necessary.” The Washington State Health Care Authority had previously provided Harvoni – which costs $94,500 for an eight-week course of treatment – and Sovaldi – $84,000 for 12 weeks – to only the sickest patients.

Since then, other participants in Medicaid and private insurance plans have filed similar suits. Some states, including Florida, Massachusetts and New York, have already altered their Medicaid programs to pay for such life-preserving expensive drugs.

If “medically necessary” rulings become more common, producers of these drugs will have no need to worry that higher prices will reduce sales. They will be able to charge whatever they want and increase revenue and profit without hurting unit sales because insurance providers will need to make such drugs available to their policy holders.

Negotiating prices could affect the supply of new drugs. Regis Duvignau/Reuters

A proposed solution

So what can be done to fix the problem?

Allowing more government agencies to negotiate prices is one option. While this has lowered the prices paid by the Veterans Administration, it may not be the best way to go in a market like the one for many innovative new specialty drugs in which consumers have no good substitutes to choose from.

Economists have shown that negotiated outcomes are not always the most efficient ones. As an example, if the government were to push drug producers too hard in negotiations, the public could get a great deal on prices in the short term but that could end up discouraging the development and testing of new drugs, which would hurt everyone in the long run.

A better approach is to start with a public utilities method, which is frequently used when there is a natural monopoly in production, such as for water or power. In these cases, state and local governments typically allow a company to have a monopoly over the market but also establish regulatory commissions to determine “fair” prices. Such prices take into account current costs, the need for investment in production facilities and the need to earn a rate of return on capital invested.

A wrinkle with drug developers is that they can incur substantial costs in their quest for new medications, including dead-end ideas and extensive testing. A 2014 report put the cost to develop a new drug at $2.6 billion, while others put it at around half that.

Under our proposal, an independent federal panel consisting of scientists, medical professionals, public health experts and economists – perhaps working as part of the FDA approval process and called on when the price of a drug is above a specific threshold – would determine the maximum price a government buyer such as Medicare or Medicaid could pay for a new drug. It could also do the same for existing treatments – for example, it could have turned down Turing’s huge Daraprim price hike.

A key element of this idea is that the panel would develop methods to identify and set maximum prices for existing and prospective drugs that cure a serious illness, improve the quality of life, limit contagion or otherwise provide large benefits to society. These procedures would need to make sure that producers of these important new drugs are sufficiently rewarded for those costly efforts.

A defensible drug-pricing system

Tough negotiations can help lower how much the government has to pay for its purchases, yet they’re not always the optimal way to achieve intended long-term results. With drugs, we definitely need to lower prices but we also need to ensure drug companies can “win” as well to avoid compromising their ability to develop lifesaving medicines.

While economists generally oppose government intervention in a “free market,” the current situation cries out for change. It is time to establish a defensible system for pricing drugs, one that both protects the public from price-gouging and encourages the development of new drugs.

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