Dana Blankenhorn

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The Bresch File

If there’s an identifiable villain in America’s health care cost crisis, it’s Heather Bresch. 

If you have a kid who might die from food allergies, or if it might happen to you, you have an EpiPen. If you have asthma and worry about a sudden attack, you have one. It’s a necessity, an insurance policy against sudden death.

The EpiPen contains epinephrine, more commonly known as adrenaline.  Adrenaline is a hormone that can increase your blood pressure and heart rate. If you’re scared, or highly energized, your body releases adrenaline and performs better. It can stop the shock from food allergies. It can stop an asthma attack. 

During most of the last decade, Bresch was the CEO of Mylan. As CEO, starting in 2011, she pushed huge price increases on EpiPens. She made small changes to the injector to win patent protection. She called epinephrine generic to avoid having to pay Medicaid rebates. Mylan bought the rights to make the EpiPen in 2007 and had a 95% market share in 2016, increasing the size of the market five-fold. By this time, Mylan was selling two-packs of the pens for $608. 

In response to the scandal, Bresch stonewalled Congress. She claimed price increases were the result of research costs. They weren’t. She pretended not to know key details on pricing or the company’s policies on patient assistance. Eventually, market pressure forced Mylan into a merger with Pfizer’s generic drug business, which is now called UpJohn. When the UpJohn deal was done, Bresch “retired.” At age 52.

Any prosecutor who couldn’t make a criminal case out of this isn’t worth their law degree. So far, no one has. Wonder why?

Mini-Kitchen

About 25 years ago, we re-did our kitchen.

Technology is now making that re-do look obsolete.

Kitchens are still being built as ours was. They’re energy hogs. There’s a big oven, a four-burner cooktop, and a dishwasher standard. These are built into the walls and counters. They take up a lot of space.

Meanwhile, there are a host of new mini-appliances that can replace all that. It’s going to be a hot niche this Christmas. We’re talking about air fryers, sous vide devices, “Instant Pot” devices and grill-griddle-air fryers. Plus, there are those ubiquitous Keurig machines and multi-purpose microwaves.

Two things are happening. One is that counterspace is now at a premium. So is shelf space for that matter. The other is that people are saving both money and energy. An electric oven like my Dacor can cost $3,000. All the devices I’ve mentioned above cost $1,000, total. They also use a lot less electricity.

Clouds Rule the World (For Now)

Some Friday thoughts on the clouds and the Cloud Czars.

America’s economy rules the world, and the Cloud Czars rule the American economy. Rather than celebrate this, we seem more interested in ending it.

The Czars seem happy with the status quo. They shouldn’t be.

Our measurement of tech’s impact is completely wrong. We measure it by market cap. We should be measuring it in productivity, which thanks to tech is growing worldwide. When productivity takes people out of the middle class, they turn against tech. Tech needs to be wary of that.

How can they be wary? Instead of just asking what government asking what we can do to tech, we should be asking how government can help tech toward more useful innovations.

Will Rogers Was Right

“I’m not a member of any organized political party. I’m a Democrat.”

Will Rogers’ saying of a century ago is just as true now, even though the political positions of the parties have reversed.

Republicans are united. Once you’re in, all you need do is follow the leader. They make it easy. You never have to think. It doesn’t matter if the leader is a madman, or you’re taking the country off a cliff. That’s why Joe McCarthy wasn’t fatal. Neither is Trump.

Democrats remain a collection of interests. Instead of ethnic machines and southern whites, it’s a rainbow of McGovern-era complainers.

Democrats make it very hard to be a Democrat. Liberal elites are constantly creating new red lines, and anyone who crosses one crosses them all. Anything that goes wrong, whether large or small, is a sign of the apocalypse, a sign to surrender rather than attack.

The Past is a Sad Country

Of all the songs on Jason Isbell’s breakout 2013 album Southeastern, it’s Relatively Easy that holds up best.

“You should know, compared to people on a global scale, our kind has had it relatively easy.” But people are still unsettled. A brother is on a church kick, “just another form of dope sick.” A man’s wife takes his kids away and he takes Klonopin, “enough to kill a man of twice his size.” The narrator tore up his loft and is now on parole, alone.

Everyone wants more, and prosperity doesn’t change it. We all think it was better back then, that it’s all terrible and about to get worse.

It isn’t. The past wasn’t good. We live longer than ever if we’re not getting ourselves shot, overdosing on drugs, or refusing vaccines. Middle class Americans are richer than anyone in the history of the world, thanks to technology and the creativity economy. We have nothing to complain about.