Greed is Good: UK COVID-19 Vaccine Edition

♠ Posted by Emmanuel in Europe,Health at 3/24/2021 01:31:00 PM

Is the UK topping this table due to "greed" at the EU's expense?

 

The height of 80s money worship is symbolized by the 1987 film Wall Street whereGordon Gekko, Michael Douglas' memorable character, reasoned that "greed is good." As a person who came of age during that decade, all I can say those were the days, my friends, even if I do not necessarily agree with the sentiment. Or has "greed is good" logic been consigned to the dustbin of history? Of all the darndest places, we are now being refamiliarized with the phrase in the age of COVID-19. Supposedly we're in this enlightened age where getting everyone vaccinated is in everyone's interests. Given the increased global interconnections we have nowadays, not suppressing the virus in one part of the Earth means that all of us remain vulnerable. Or so that logic goes. 

Now we have reports that UK Prime Minister Boris Johnson argued in private that "greed is good" when it comes to COVID-19 vaccinations. That is, the UK would not have controlled the spread of the virus in recent weeks had it not been greedier with allowing foreigners access to the vaccine:

Capitalism and greed gave Britain its success in vaccinating its population, Prime Minister Boris Johnson told lawmakers in a closed meeting, a remark that could rile up Brussels at a time when Britain faces an EU threat to block vaccine imports. “The reason we have the vaccine success is because of capitalism, because of greed my friends,” The Sun newspaper quoted Johnson as telling Conservative lawmakers on a Zoom meeting on Tuesday evening. Johnson then tried to row back and said: “Actually I regret saying it” and asked lawmakers repeatedly to “forget I said that”.

Needless to say, that statement is not playing well with other Europeans who are considered behind the UK in vaccinating their citizens. Witness the AstraZeneca vs. EU row over allowing vaccines made in the Netherlands to be exported to the UK (AstraZeneca has joint Swedish-British ownership). Fun times:

Britain has so far mounted the fastest COVID-19 vaccine programme of any big country. But it now finds its programme threatened by the EU, which has been far slower in rolling out vaccines and faces a third wave of infections. The European Commission is expected on Wednesday to extend powers to block exports, a move that could hit supply of doses bound for Britain. Johnson’s remarks come after a week in which British ministers have tried to calm the row.

Downing Street declined to comment on Johnson’s remarks when contacted by Reuters, but unidentified sources gave the BBC a bizarre array of explanations.The greed comment, according to the BBC’s political editor Laura Kuenssberg, was apparently a joke about one of his cabinet colleagues, Chief Whip Mark Spencer, who was gobbling a cheese and pickle sandwich while the prime minister spoke.

Cheese and pickle sandwiches, Gordon Gekko... and COVID-19 vaccines. These are interesting times. 

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The West's WTO Hypocrisy on COVID-19 Meds?

♠ Posted by Emmanuel in Health,Intellectual Property,Trade at 2/16/2021 12:37:00 PM

Should intellectual property laws upheld by the WTO be waived during a COVID-19 pandemic?

I almost forgot to post this one, but it's better late than never, I guess. There have been endless allusions to the idea that, rich or poor, the countries of the world are all in this fight against COVID-19 together. However, when push comes to shove, it appears the reality of the matter is rather different: A few weeks ago, large developing countries put forth the idea at the WTO that intellectual property rights on COVID-19 medicines should be abrogated while a global pandemic is going on. 

Perhaps unsurprisingly if regrettably, European and American countries indicated not being willing to go along. Since a consensus would have been required for an IP waiver on COVID-19 medicines to come into effect at the WTO, this effort was admittedly a long shot from the start:

Wealthy nations [...] reiterated their opposition to a proposal to waive intellectual property rules for COVID-19 drugs, three trade sources said, despite pressure to make an exception to improve access to drugs for poorer countries. Supporters of the waiver say existing intellectual property (IP) rules create barriers on access to affordable medicines and vaccines and they want restrictions to be eased, as they were during the AIDS epidemic.

But opposition from the European Union, the United States and some other wealthy nations at a meeting on Friday, means the proposal set to go before the World Trade Organization’s (WTO) General Council next month is likely to fail.

“If rich countries prefer profits to life, they will kill it by tying it down in technicalities.” said a delegate supporting the motion who attended the closed-door meeting. The 164-member WTO body usually has to agree by consensus unless members agree to proceed to a vote, which is exceptional.

Populous developing countries India and later China pushed for lifting IP restrictions on COVID-19 medicines, although you have to wonder if they have competing commercial interests since they too have production capabilities in making these medicines should IP be waived. Then again, the current WTO head Ngozi Okonjo-Iweala (this article was written before she became its Director-General) also supported the initiative:

The proposal was first raised by India and South Africa in October. Since then, China, which has five COVID-19 vaccine candidates in late-stage trials, has voiced its support, as have dozens of other WTO members, mostly from developing countries.

The World Health Organization says it supports tackling barriers to access to COVID-19 medicines, as does Nigeria’s Ngozi Okonjo-Iweala, selected by a panel to be the WTO’s next director-general.

You have to wonder though if some developing countries might want to declare medical emergencies that compel them to waive such IP on COVID-19 medicines under "compulsory licensing" procedures allowed by the WTO:

In 2001 — at the height of the AIDS crisis and under pressure from governments whose citizens were dying because they could not afford life-saving medicines — the World Trade Organization waded into the battle between intellectual property and public health. The resulting Doha Declaration ruled that the Agreement on Trade-Related Aspects of Intellectual Property Rights “should not prevent members from taking measures to protect public health.”

It confirmed that governments retained several mechanisms for guaranteeing affordable access to medicines, including issuing compulsory licenses, which allow them to use an invention without the patent holder’s consent in extraordinary circumstances. This applies not only to new drugs but also to existing medications whose patents have been extended because pharmaceutical companies made minor changes to formulations or discovered a new use for the medication.

Given the uncertainty over access to treatments for COVID-19, several countries have been laying the legislative groundwork to issue compulsory licenses for products that patent holders refuse to make accessible.

I think developing countries will first observe whether they can avail of more COVID-19 medicines they believe they need under the COVAX initiative. If that avenue proves unfruitful, then don't be surprised to see "compulsory licensing" claims start appearing. Make no mistake that our world remains riven by North-South divides even amidst a global pandemic. 

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US Obesity & Stupidity: Barr, Pompeo & Trump

♠ Posted by Emmanuel in Americana,Health at 12/28/2020 02:49:00 PM

Who's the fattest of them all? Everyone else's well-being may be victims of their brainless girth.

[WARNING: In the spirit of Trump's disdain for political correctness, I am waiving it for this post, although the subjects here fully deserve the opprobrium they receive.] I do not need any encouragement to poke fun at American obesity since I've always considered it as part of US descent into, ah, fatheadedness. Prominent examples of US decline are its recent political class: Chicken Barr, Portly Pomepo and Plump Trump. These lard-assed eater-leaders exemplify current Americanness to the rest of the world--fat and obnoxiously loud despite having nothing good to say (or do). While busy wrecking the United States--and the rest of the world by sheer dint of America's influence and reach--the question is posed: How can the planet be saved from more malevolent Yankee lardasses?

This post was inspired by a Quora question asking who is the most obese among these biggies. I'm not entirely certain, but I'd say (1) Barr, (2) Pompeo, (3) Trump in terms of body mass index. No matter; all are comfortably obese. The more important question is the relation between obesity and stupidity as the title states: Trump and Pompeo have teamed up to destroy America's reputation abroad. Barr has done the same to the Department of Justice but lost Trump's favor anyway. That's some reward for longtime sycophancy.

Now, the evidence is not clear on whether low IQ leads to being fat or the other way around. Is it that fatsos like these cannot comprehend what it takes to maintain one's health, or that being fat has deleterious effects on cognitive functioning? That chicken-and-egg question remains unresolved. (In terms of sheer idiocy, Trump's idea that minimal exertion is the key to health literally takes the cake[s].) Still, one can probably make the intermediate argument that low IQ is an obesity risk based on existing research on the subject matter:

Although the present findings provide valuable information on the link between low IQ and obesity, it is important to understand that IQ is a nonmodifiable risk factor that is rarely assessed in the general population. Therefore, the development of obesity prevention programs focusing on intelligence is difficult to implement. Nevertheless, IQ may be regularly assessed in specific situations such as the follow‐up of children with developmental difficulties or the follow‐up of adults with psychiatric disorders. Our findings suggest that low IQ is an independent risk factor for obesity even after adjusting for several potential confounding factors. Thus, we believe that individuals with low cognitive abilities should be screened for obesity on a regular basis. Furthermore, the management of individuals with low IQ should be transdisciplinary, and should involve several health professionals (eg, dietitian, physiotherapist, and general practitioner) in order to evaluate their health behaviors (eg, diet and physical activity) that may lead to obesity.

They say that people choose the leaders they deserve. In the US case, you can at least vouch for its leaders exemplifying the, ah, width and breadth of its population. Physique-wise, and I would argue intellect-wise, these three are representative democracy weighing in fully on leadership attributes. 

Stopping Americans from electing obese people--who then put even more of their kind in leadership positions--is probably an overlooked way to avoid further American damage to the rest of the world. Given current trends, though, non-obese people are becoming an endangered species Stateside, so too bad for us all.

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Missing US Innovation: Assisted Suicide On Demand

♠ Posted by Emmanuel in Americana,Health,Innovation at 7/16/2020 06:10:00 PM

Numbers don't lie: There isn't much to live for Stateside. Healthcare is largely misspent there, so how about the opposite?

The United States is perceived as an innovator leading the rest of the world. Sometimes, its innovations are not necessarily ethically or socially edifying. Witness the emergence of its sprawling prison industrial complex. No other country on earth spends as much on incarceration or throws as many of its own people behind bars. Usually those jailed are us colored people, but that's another discussion for some other time. Suffice to say that fortunes have been made in this industry. Profiting off the misfortunes of others--such as with "private" prisons--is a staple of Americana. Facebook's critics deride it as a hate-for-profit outfit. So, why not innovate by combining the "on demand" nature of video on demand like Netflix, Amazon Prime, etc. with just ending the folly of it all?

Now, it's well-known that the United States stands apart from other OECD (i.e., "developed") countries in having a falling life expectancy the past several years. 2018 was an exception--albeit a very marginal one--when it fractionally rose. Still, 2020 promises to more than wipe out any such gains. The reasons for these declines are equally well-known: radical inequality is causing those left behind--many of whom are Trump voters disaffected with American life, by the way--to harm themselves. Suicides, drug overdoses, and other so-called deaths of despair. In a way, voting for Trump was an act of desperation itself. What sensible reason was there to believe that a serial bankrupt would right the United States' financial situation? Faced with epochal health, financial, and social crises, America is reeling from endless self-inflicted blows by electing this fraudster in 2020. So, those desperate enough to vote for Trump find themselves over worse off.

But I digress. Trump is a symptom, rather than a cause of much of what ails America. I'll get more into America's obesity 'n' indebtedness complex soon enough, but suffice to say that Trump is simply exacerbating already-prevalent US pathologies. Wondering aloud, therefore, why doesn't the United States pioneer assisted suicide on demand? Legally speaking, it's in the same line of thought as another fine US invention, no fault divorce. In short, spare everyone the drama and just get it over with. As believers in the free market, Americans should be comfortable with this service: If the market is always right, then let the laws of supply and demand give adult Yanquis the right to top themselves quick ‘n’ easy. Instead of leaving a physical mess of your guts splattered all over the place, why not make ending it all a quick and convenient process--no questions asked?

2019 set a new Stateside record for drug deaths following a slight drop in 2018 fatalities, which were largely attributable to fewer prescription opioid-related deaths. 2020 is continuing 2019's rising trend, with early numbers suggesting the pandemic is boosting drug deaths. Fentanyl figures large:

Drug deaths in America, which fell for the first time in 25 years in 2018, rose to record numbers in 2019 and are continuing to climb, a resurgence that is being complicated and perhaps worsened by the coronavirus pandemic. 

Nearly 72,000 Americans died from drug overdoses last year, according to preliminary data released Wednesday by the Centers for Disease Control and Prevention — an increase of 5 percent from 2018. Deaths from drug overdoses remain higher than the peak yearly death totals ever recorded for car accidents, guns or AIDS, and their acceleration in recent years has pushed down overall life expectancy in the United States. 

It looks as if 2020 will be even worse. Drug deaths have risen an average of 13 percent so far this year over last year, according to mortality data from local and state governments collected by The New York Times, covering 40 percent of the U.S. population. If this trend continues for the rest of the year, it will be the sharpest increase in annual drug deaths since 2016, when a class of synthetic opioids known as fentanyls first made significant inroads in the country’s illicit drug supply. 

Trumpmerica isn't getting any better, and removing the symptom (Trump) certainly won't be the cure for what ails that country. Almost all health, economic and social indicators suggest things are getting worse. Absent any real hope for change, many are turning to self-harm to end it all in increasing numbers. Americans are masters at profiting from other's misfortunes. In the name of liberty--and commerce, it must be said--this industry is long overdue. As I mentioned, not all innovations are edifying, but some are just...necessary. Aside from being illegal, fentanyl and its ilk represent a messy way of suicide. What's required is something convenient and prepackaged--on demand, indeed.

In post-COVID-19 America, there is arguably no innovation more strangely missing than assisted suicide on demand. [Cue Blue Oyster Cult for mood music.]

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ASEAN's CoronaControl Meets US & UK's CoronaSlaughter

♠ Posted by Emmanuel in Americana,Europe,Health,Southeast Asia at 6/24/2020 06:24:00 PM

Reputable scientists want to hold the criminally negligent Trump and Johnson accountable... but whither ASEAN?

With a blog subtitle featuring the words "elegant despair," I have primed you, dear reader, not to expect feelgood stories on this blog. Today, however, there may be some reason to hope that countries whose leadership is not criminally negligent actually can do something about the harms caused by COVID-19. Members of the Association of Southeast Asian Nations (ASEAN) have been faring rather better than one would expect given their development status. The contrast is especially remarkable when compared to the examples of criminal negligence you observe in the US and UK [1, 2], which I have already written about at length. To cut a long story short, from ASEAN Economic Community News Today:

With some wealthy Western countries doing quite appallingly, calls for accountability are growing. One highly regarded scientist recently postulated on Twitter that “Nuremberg-style trials for accountability” should be held for leaders of countries that recorded more than 10 deaths per one million population.

“A nation with more than 100 deaths per million population was catastrophically unsuccessful”, said Professor Richard H. Ebright, a Board of Governors Professor of Chemistry and Chemical Biology at the prestigious Rutgers University, and a Laboratory Director at the Waksman Institute of Microbiology.

Lest you think it's the bloc's wealthiest countries that are faring the best--Malaysia and Singapore--it appears that its most recent and least developed members which are confronting COVID-19 the best. Granted, the likes of Cambodia, Laos, Myanmar and Vietnam [CLMV] do not have anywhere near as many international travel links, but you would think their less advanced healthcare systems would be less able to cope with outbreaks. Yet, just as the supposedly "developed" US and UK rank first and third in the global league table of COVID-19 fatalities, these CLMV countries have escaped the brunt of the disease:

Replying to an email from AEC News Today, Professor Ebright said that “it is striking that every nation in the [Southeast Asian] region, from richest to poorest, appears to have done so well compared to the US, UK, and EU (subject to caveats about low testing rates in Indonesia, Cambodia, Laos, and Myanmar)”.

While CLMVT government leaders are coming under increasing pressure to ease international travel restrictions, most are standing firm in maintaining hard borders as they continue returning citizens from around the world. Some have put in place entry processes designed to ensure that only those people who *really need to enter* are doing so.

Now, ASEAN members have huge variations in any factor you can name--geography, population, religion, wealth, economic and political systems. According Dr. Ebright, though, it's not whether your country is an autocracy or a democracy that appears to matter in confronting COVID-19, which couldn't care less about humans or their politics. What really matters, then?

Discussing the success and failure of nations in combating the spread of the SARS-CoV-2 virus, Professor Ebright said, “nations that [had] successfully suppressed [the] outbreak include both small and large, both island and non-island, and both autocratic and democratic. The “sole relevant parameter for success or failure is whether governments took prompt resolute action (success) or whether it did not (failure).

“In nations where travel controls were (1) promptly implemented and (2) promptly expanded to include emerging zones of infection, travel controls were extremely effective in suppressing the outbreak”, he said, adding that “a fast and strong response by government equals success. A slow and weak response by government equals failure”.

I don't want to laud ASEAN members' achievement too much lest I jinx our region. Suffice to say, if the pseudo-Christian Trump actually read the good book instead of holding it up like a piece of meat, COVID-19 appears to be turning over the league tables not just within ASEAN but in the rest of the world -

So the last shall be first, and the first last: for many be called, but few chosen.

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Coincidence? UK Tops W European Obesity; COVID-19 Deaths

♠ Posted by Emmanuel in Europe,Health at 5/05/2020 09:17:00 PM

Flat on his bum Boris Johnson is the perfect metaphor for the UK's COVID-19 response.

Is it a coincidence that a certain European island country tops the region's obesity and COVID-19 death league tables? I think not. Probably the worst insult you can hurl at the British is that they are the Americans of Europe. Now that's a lot of baggage--which they mostly carry around the waist, as it turns out. Especially nowadays, that transcontinental dietary "special relationship" isn't working out so well. Just as the US has the fattest people among all OECD nations, the United Kingdom has the portliest Western Europeans. First, let's face the fats:

The UK is the most obese country in western Europe, according to the Organisation for Economic Co-operation and Development. Its annual Health at a Glance report, published on Friday, shows that 26.9% of the UK population had a body mass index of 30 and above, the official definition of obesity, in 2015. Only five of the OECD’s 35 member states had higher levels of obesity, with four outside Europe and one in eastern Europe.

The OECD’s report, which says obesity in the UK has increased by 92% since the 1990s, illustrates the scale of the public health challenge, with fears it could bankrupt the NHS. Tam Fry, chair of the National Obesity Forum, said: “One could weep over the figures, the result of successive governments who have, for the last 30 years, done next to nothing to tackle obesity.

The British have also done next to nothing to deal with this obesity problem. Their lardy PM Boorish Johnson [sic] has even suggested a rollback of the UK's too little, too late sugary drinks tax. (Is being outrageously fat an indicator of Britishness from Johnson's point of view, too?) This sort of happy-go-lucky, what-me-worry-about-my-waistline attitude is actually not very funny at all given the health consequences and the associated strains placed on public finances. The right-wing Daily Telegraph has even featured an op-ed that suggests the UK finally do something about its obesity epidemic in light of the rising COVID-19 death toll there:

The same ailments keep emerging: diabetes, heart disease and high blood pressure. Data from the first 2204 Covid ICU admissions show 73 per cent were overweight, a condition linked to those diseases. Not only does carrying more visceral weight put greater pressure on the lungs, excess body fat causes the immune system to dysfunction, instigating the cytokine storm that floods lungs causing pneumonia-like complications.

For decades successive governments have been negligent in tackling obesity head on. Whether it’s subservience to the food and drink industry that contributes almost £30bn to the economy, or an aversion to becoming a Nanny State, obesity has ballooned without concerted intervention. More than half of the British diet is ultra-processed food with 60 per cent of the population overweight.

I don't want to say this, but I fully expected to see what's since become true: Just now, the UK has exceeded Italy and now tops European COVID-19 fatalities after you tot up fatalities in Northern Ireland:

Britain has the worst coronavirus death toll in Europe, official figures showed on Tuesday, prompting calls for an inquiry into the handling of the pandemic. The government’s tally of fatalities across the UK reached 29,427 for those who tested positive for coronavirus, exceeding the 29,029 recorded in Italy – until now Europe’s worst-hit country.

Italy’s total does not include suspected cases, however. Newly released data from the Office for National Statistics showed that 29,648 deaths were registered in England and Wales with Covid-19 mentioned on the death certificate by 2 May. With the addition of the official death figures for Scotland and Northern Ireland, this was calculated to take the UK’s toll to 32,313.

The true figure is likely to be significantly higher due to missed cases and a lag in reporting.

It's not politically popular to tell your people that they're too goddamn fat. It's even more difficult to tell your people to slim down when you select "leaders" like the obese Trump or Johnson. The truth remains though is that the US and UK were in literally poor shape to deal with COVID-19.  

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COVID-19 Vaccine Development as Reality Show

♠ Posted by Emmanuel in Health at 4/20/2020 07:26:00 PM

This pharma reality show could use a loudmouthed, orange-faced fatty whose tagline is "You're FDA disapproved!"

Almost every conceivable activity has been turned into a reality show: (90s rap star) Vanilla Ice Goes Amish...a real-life 'Lord of the Flies' scenario where young'uns run society in Kid Nation...the list goes on and on. The age of Trump has transformed even normally staid and dignified human endeavors into, well, reality shows--and you could very plausibly argue that he's turned the entire USA into Kid Nation, but I digress.

Given Trump's incessant search for a COVID-19 miracle cure to save his political fortunes, we didn't have to wait too long before someone came up with--you guessed it--a reality show about developing a COVID-19 vaccine. Now, vaccine development is not something to be trifled with since the amounts spent and the tortuous path to commercialization--ensuring efficacy and safety--are hardly frivolous. Or maybe that was how vaccine development was like prior to November 8, 2016. Open up your LinkedIn account if you have one and you'll probably have a paid (spam) message from Johnson & Johnson hawking the program above. But it's hardly the only offender touting early-stage drugs to gain Trump's attention:

President Donald Trump’s habit of touting potential coronavirus cures during daily White House briefings has changed the game for drugmakers, who are dropping their usually secretive ways to aggressively court public opinion.

From Gilead releasing anecdotal results on the drug remdesivir to Johnson & Johnson’s new reality series on the making of its experimental vaccine, pharmaceutical companies are seeking to shape the narrative like never before. The PR push could raise false hope about therapies that don't end up working, or even put pressure on the Food and Drug Administration to approve drugs and vaccines whose effectiveness isn't clear.

Gilead’s unusual move last week to publish data from compassionate use of remdesivir raised eyebrows among researchers. To a trained eye, the information revealed little about the experimental drug’s safety or effectiveness — and Gilead has multiple clinical trials underway that are set to produce more definitive results in just a few weeks.

This Wild West approach to promoting drugs and vaccines this early in the development process is a dramatic reversal for the pharmaceutical industry, which is normally guarded about the information it releases about ongoing clinical trials and the FDA approval process.

Why has normal caution been thrown out the window? A quick stock bump helps in this time of depressed equity valuations. Ask Gilead. With pharma companies of all sizes trying to conserve cash, having Trump trumpet your drug instead of having to publicize it yourself helps, too. Still, you have to be very brave indeed since the drug may fail to make it through FDA trials--like 86% of them do.  Obviously, all potential COVID-19 vaccines and treatments are early-stage drugs whose futures are uncertain. That includes Gilead's remdesivir. 

Then again, maybe we are all TV infomercial hawkers now--pharma companies notwithstanding. Ours is such a dissipated age.

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Death Wish 6: Bolsonaro’s Brazilian Slaughterhouse

♠ Posted by Emmanuel in Health,Latin America at 4/18/2020 08:34:00 PM

"I'm sorry, some people will die. That's life." - Jair Bolsonaro.

 Charles Bronson starred in a number of increasingly formulaic action movies depicting gritty scenes of urban decay in the Death Wish series. The first of these movies actually garnered passable reviews and captured the zeitgeist of the times. By the fifth installment, though, its formula had worn out its welcome critically and commercially. That should not be especially troubling for fans of this series since a real-life Charles Bronson wannabe has been installed as a Latin American leader in Brazil. A real-life sequel appears to be unfolding in Brazil as its ultra right-wing Trump-alike Jair Bolsonaro dismisses COVID-19 as, well, a hoax.

The Death Wish series has been described as fascist in promoting dark vigilante justice.  Railing against homosexuals, left-wingers, and pretty much everyone else not aligned with his ultra right-wing agenda, Bolsonaro is a real-life personification of Charles Bronson's caricature. What better way to "cleanse" society of those weak enough to succumb to what he says is such a minor affliction? Some people will die, etc.

Unlike Trump who is occasionally swayed by reason--however fleeting--Bolsonaro is immune to persuasion by science and invents his own. (Unsurprisingly, he believes the number of cases and fatalities are being grossly inflated by political opponents.) He is one of the global "leaders" unwilling to compromise on the matter. Fortunately, Brazil's is a federal system of government, allowing saner local governments to implement quarantines and suchlike. Yet the lack of a meaningful and coordinated national-level response has invited criticism from left, center and right about Bolsonaro's competence (and sanity). According to former President Lula:

Jair Bolsonaro is leading Brazilians “to the slaughterhouse” with his irresponsible handling of coronavirus, the country’s former president Luiz Inácio Lula da Silva has said. In an impassioned interview with the Guardian – which came as Brazil’s Covid-19 death toll hit 1,924 – Lula said that by undermining social distancing and defenestrating his own health minister, Brazil’s “troglodyte” leader risked repeating the devastating scenes playing out in Ecuador where families have had to dump their loved ones’ corpses in the streets.

“Unfortunately I fear Brazil is going to suffer a great deal because of Bolsonaro’s recklessness … I fear that if this grows Brazil could see some cases like those horrific, monstrous images we saw in Guayaquil,” said the 74-year-old leftist.

Alike Trump, Bolsonaro does not adopt fringe positions for the heck of it. He may be delusional in downplaying the coronavirus' harms--and place millions of Brazilians in harm's way as a result--but there is a political calculation here still. He is playing to his base, and will act according to how things play out:

• If the disease peters out (likely through restrictions on movement placed by the governors), he can say he was right all along that COVID-19 was overhyped. 
• If the disease claims the lives of thousands more Brazilians, he can still claim to have been right since at least the economy is up and running again--providing livelihoods to tens of millions--which is the more important thing than the lives of a few thousand. 

Is Bolsonaro leading Brazil into the slaughterhouse? Bolsonaro doesn't really care, especially if those who die are the sundry "malign" elements in society who wouldn't vote for him anyway. That is modern-day fascist reasoning. What Bolsonaro believes is that, either way, his actions will play into the beliefs of his base, and that's how to win re-election. To him, it's a politically calibrated death wish absent any real talent at governing. Sounds familiar? We'll be heading back to Estados Unidos soon enough...

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Boris Johnson, UK's COVID-19 Trump-Alike

♠ Posted by Emmanuel in Europe,Health at 4/14/2020 07:36:00 PM

Meet that other Anglo-Saxon biggie causing unmitigated COVID-19 disaster, UK Prime Minister Boris Johnson.

 I will be upfront and say that I detest Boris Johnson at least as much as Donald Trump. He is much of the same ilk: a clownish, loud-mouthed, and obese isolationist. Johnson is the best-known proponent of that exercise in self-harm known as Brexit. Still, there may be some slight differences that are in no way substantive between these two big-bellied blond-haired buffoons. Johnson epitomizes the romanticized view of British exceptionalism, that somehow curtailing personal freedoms through, say, a lockdown, would violate some fanciful, imaginary idea of Ye Olde England:

The Sun reported the prime minister’s remarks rather differently: “Mr Johnson said he realised it went against what he called ‘the inalienable free-born right of people born in England to go to the pub’.” In this version, the freedom to go to the pub was conferred by genetics and history, not on the “people of the United Kingdom” or “the British people”, but on “people born in England”. It does not apply to Scots, Welsh or Northern Irish people and certainly not to the 9.4 million people living in the UK who were born abroad. It is a particular Anglo-Saxon privilege.

And since we are in the terrain of the ludicrous, the Sun’s version actually made more sense. There is, of course, no ancient and absolute right to go to the pub – inns and public houses have been regulated in England at least since the 15th century. But what Johnson was really evoking was a very specific English sense of exceptionalism, a fantasy of personal freedom as a marker of ethnic and national identity.

That exceptionalism is not, alas, mere rhetorical self-indulgence. It helped to shape official policy towards the Covid-19 crisis. It lies behind both the idea that there should be a distinctive British response to this global challenge, and the assumption that there was something peculiarly unnatural in expecting Brits to obey drastic restrictions. Its legacy is the globally discredited policy of “herd immunity” and the late introduction, squandering Britain’s head start, of the lockdown.

What is the result of having this other joke of an Anglo-Saxon "leader", erm, "dealing" with Britain's COVID-19 response? Contrast the UK's slow-footed response with neighboring Ireland's:

At the time of writing, 365 people have died in Ireland of Covid-19 and 11,329 have died in the UK. Adjusted for population, there have been 7.4 deaths in Ireland for every 100,000 people. In the UK, there have been 17 deaths per 100,000. In other words, people are dying of coronavirus in the UK at more than twice the rate they are dying in Ireland. Yet, despite Ireland being your closest neighbour, this has barely been mentioned in the British press...

We knew of the measures and plans the Irish government was putting in place to protect us and we knew how far your government was slipping behind. When our taoiseach was closing our schools and universities, your prime minister was still telling you to wash your hands. When our government cancelled St Patrick’s Day celebrations, yours allowed the Cheltenham Festival to go ahead and, with it, a potentially massive multi-day super-spreading event of over 250,000 people. The contrast was disorientating.

Nor is it a case of apples and oranges comparing Ireland with the UK:

Comparisons between countries inevitably run into difficulties. Overall, Ireland has a lower population density than the UK, which arguably slowed transmission of the virus. However, a larger proportion of the Irish population is centred around the capital city: 39% of us live in the Greater Dublin area, whereas Greater London holds 16% of the population of England.

We’re a highly connected population, concentrated to the east of the country, all of which works against us in a pandemic. Given the ease of transmission of the coronavirus within the family home, another factor becomes relevant: the average household in Ireland is larger than that in the UK. Other comparators are more grimly equivalent: both Ireland and the UK began the pandemic with roughly equivalent levels of ICU beds, just over half the EU average.

There are consequences for electing "leaders" like Trump and Johnson,. People will needlessly die because of their buffoonery. What's more, people like the rotund Johnson strain health services while attempting to cope with the consequences of their poor health. Unfortunately, just as nearly every other American is obese, the UK sits at the top of Western European obesity league tables at 28.7%.

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American Obesity Supersizes COVID-19's Impact

♠ Posted by Emmanuel in Americana,Health at 4/07/2020 08:51:00 PM

Physique-wise, Trump is the perfect embodiment of the country he "leads".

The French author Joseph de Maistre famously said that "Every nation gets the leader it deserves." With the obese fraudster Donald Trump, the United States gets a leader whose bulbous, Jabba the Hutt-like physique mirrors the unhealthiness of its general population. To be sure, Trump's slothful response the COVID-19 outbreak Stateside is nothing short of disastrous--but what exactly did you expect? (See de Maistre's statement above.) From stating there's nothing to worry about with the coronavirus to downplaying the virus as a hoax meant to harm his political prospects, Trump is behaving true to form--a snake oil salesman to the last.

As I write, the United States now has the highest number of cases of COVID-19 of any country on Earth. To be fair to Trump, however, the United States' situation is not entirely down to the federal government's ineptitude. Often forgotten is that a nation's susceptibility to pandemics not only depends on the quality of its health system--a significant determinant of which is state action--but also the underlying health of its people. In 2004, Greg Critser described the United States as Fat Land. The title was true enough back then when the US obesity rate was around 30%. That statistic was, for me and many non-Americans, mind-boggling even then. Imagine now that the US obesity rate is 42.4%. 42.4! More than 4 in 10 Americans are at least as fat as their "leader".

Lest you think I'm just being mean, it's relatively uncontested that risk factors associated with obesity such as cardiovascular disease, diabetes, and respiratory illness have been found to exacerbate the severity of COVID-19 infection:

The huge burden of obesity and other chronic conditions among Americans puts most of us at direct risk. In fact, with obesity rates in the United States much higher than affected countries like South Korea and China, our outcomes — economic- and health-wise — could be much worse...

 Data from China suggest that many chronic health problems increase the likelihood of a bad outcome, including cardiovascular disease, which affects nearly half the adults in the United States in some form, and diabetes, which affects about 10 percent. In Italy, 99 percent of the fatalities were people with pre-existing medical problems, especially hypertension...

Moreover, in the United States, obesity-related metabolic conditions may put the public at exceptional risk. Today, more than two of three adults have high body weight, and 42 percent have obesity, among the highest rates in the world. Almost two in 10 children have obesity. Excessive weight, and the poor-quality diet that causes it, is strongly associated with insulin resistance, chronic inflammation and other abnormalities that may lower immunity to viral respiratory infection or predispose to complications.

Preliminary studies from China certainly do not contradict this assessment, which is proving uncannily accurate of where the US is headed. Speaking of which, early observations suggest that obese Yanks will not fare any better:

In a report from the CDC’s Morbidity and Mortality Weekly Report (MMWR) published Thursday, researchers conclude that Americans with diabetes, chronic lung disease and cardiovascular disease — all diseases linked to obesity — are at higher risk of experiencing a severe infection due to COVID-19.

The study analyzed more than 7,000 cases of coronavirus from February 12 to March 28. Out of the 457 individuals admitted to the ICU in that time, 358 — or 78 percent — reported having one or more underlying health conditions. Nearly 11 percent of the ICU-admitted individuals listed diabetes, followed by 9.2 percent reporting chronic lung disease and 9 percent reporting cardiovascular disease. Less than 30 percent of COVID-19 patients who recovered without hospitalization reported having an underlying health condition.

Also read the full report to get a better picture of what's happening Stateside:

What is already known about this topic?
Published reports from China and Italy suggest that risk factors for severe COVID-19 disease include underlying health conditions, but data describing underlying health conditions among U.S. COVID-19 patients have not yet been reported.
What is added by this report?
Based on preliminary U.S. data, persons with underlying health conditions such as diabetes mellitus, chronic lung disease, and cardiovascular disease, appear to be at higher risk for severe COVID-19–associated disease than persons without these conditions.
What are the implications for public health practice?
Strategies to protect all persons and especially those with underlying health conditions, including social distancing and handwashing, should be implemented by all communities and all persons to help slow the spread of COVID-19.

Let's skip the fancy terms here: In plain English, there would be far fewer Americans with "underlying health conditions" that exacerbate COVID-19's impact if they simply weren't so fat. Trump's buffoonery has undoubtedly contributed to the United States' mounting death toll--near the top of global league tables already. However, Americans being as outrageously fat as he is should be noted as an extenuating factor.

As bad as things are Stateside, they are likely to get even worse when more cases pop up not in relatively healthier coastal cities but in the heartland where people are fatter and have a higher death rate as a result:

The coronavirus has been a far deadlier threat in New Orleans than the rest of the United States, with a per-capita death rate twice that of New York City. Doctors, public health officials and available data say the Big Easy’s high levels of obesity and related ailments may be part of the problem.

“We’re just sicker,” said Rebekah Gee, who until January was the health secretary for Louisiana and now heads Louisiana State University’s healthcare services division. “We already had tremendous healthcare disparities before this pandemic – one can only imagine they are being amplified now...”

New Orleans residents suffer from obesity, diabetes and hypertension at rates higher than the national average, conditions that doctors and public health officials say can make patients more vulnerable to COVID-19, the highly contagious respiratory disease caused by the coronavirus.  

And which places voted for Trump? In the end, you indeed get the leader you deserve.

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Fat-Shaming & Debt-Shaming Undisciplined Yanks

♠ Posted by Emmanuel in Americana,Health at 2/20/2019 02:52:00 PM

Oink, oink: Can the archetypal American Porker-in-Chief be fat-shamed...and debt-shamed, too?

It was perhaps inevitable that the lard-assed American President Donald Trump would be medically classified as obese sooner or later. And so it was that we recently received news that he is clinically obese. In this case at least, Trump exudes the true American spirit in being really, really fat: nearly 40% of his countrymen have the same kind of bulbous, fat-laden Jabba-esque physique. In a previous post, I have made the obvious connection between American health indiscipline and fiscal indiscipline. That is, American super-indebtedness and super-obesity originate from the same place, which is a lack of self-regulation.

What is the rest of the world to do with exploding American deficits as health spending on these  fatsos shoots into orbit? The estimated annual medical cost of obesity in the United States was $147 billion in 2008 US dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight [article here]. Ultimately, the rest of the world is paying the price for American obesity when it props up American indebtedness through the purchase of US Treasuries.

An interesting suggestion in the Atlantic argues that Americans have not been fat-shamed enough, resulting in a smug self-satisfaction about wallowing in pools of cellulite. Take, for instance, the social stigmatization of smoking that seems to have done wonders for forcing many folks to quite:

People don't hate being fat enough, basically, according to Hastings Center bioethicist Daniel Callahan. In an editorial published in the Hastings Center Report, he argues that nothing -- not diets, drugs, sugeries, nor appeals to our health -- is working, and goes on to make the case for fat-shaming people until they start eating more salad.

"An edgier strategy is needed," is his (earnest and entirely devoid of irony) way of putting it. The edgy strategy he came up with entails "social pressure combined with vigorous government action." Callahan likens it to the campaign to end smoking: The combination, in his experience, of being criticized, sent outside, and taxed for his "nasty habit" was the motivation he needed to quit. "The force of being shamed and beat upon socially," he writes, "was as persuasive for me to stop smoking as the threats to my health."

Trump is famously shameless; he's a lardbucket who's insulted any number of other people as fat despite his massive girth. However, it does make for an interesting idea: if Trump is so fat because he hasn't been fat-shamed enough, can the rest of the world debt-shame the United States? While the best solution from my perspective is to simply stop appeasing these debt-addled porkers altogether to instill discipline, maybe they haven't been shamed enough about their profligate ways that's causing this debt hemorrhage.

With a 40% obesity rate or so and $22 trillion in debt and counting, the rest of the world could surely do better in instilling discipline into these undisciplined Yanks. It is no mere coincidence that both American medical and fiscal are deteriorating rapidly with their poster boy, Donald Trump.

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To Lower US Drug Prices, Raise Them Abroad?

♠ Posted by Emmanuel in Americana,Health at 5/12/2018 02:48:00 PM

Trump's new health plan: Make Foreigners Sicker Than Americans.

With the exception of diehard Trump fans who would applaud anything he does [like bragging about grabbing women's private parts], his recently-released plan to reduce drug prices was met with mostly negative reviews by those who actually understand what it consists of [1, 2]. To non-Trump fans, this is as disappointing as it is predictable. Like American leaders before him, to be fair, Trump's plan doesn't involve making Big Pharma squirm. It neither drains the s wamp nor provides evidence that Trump alone can fix spiraling health care costs. Indeed, the relatively bulletproof nature of the drug giants is evident, as politicians have been unwilling to offend their interests (and bottom lines) once more.

How much do American politicians take the interests of Big Pharma to heart? When Trump helpfully suggests (rather unforcefully) that they make token price concessions, he still has their best interests at heart by suggesting that they sock it to foreigners instead by raising prices for them. This, of course raises several pointed questions, followed by a New York Times excerpt:

• Aren't there ethical concerns for pricing drugs significantly higher outside the world's richest country--especially developing countries?
• If foreign countries have successfully negotiated bulk discounts while buying for their national healthcare systems, then why should they be made to follow the abysmal US model wherein such bargaining is not practiced?
• Why should the US set policy setting the prices charged by American pharmaceutical firms abroad? Isn't the US a believer in a "market-based" economy?

[The Trump administration] has an idea that may not be so popular abroad: Bring down costs at home by forcing higher prices in foreign countries that use their national health systems to make drugs more affordable...

“We’re going to be ending global freeloading,” Mr. Trump declared at a meeting with drug company executives in his first month in office. Foreign price controls, he said, reduce the resources that American drug companies have to finance research and develop new cures. The White House Council of Economic Advisers fleshed out the idea three months ago in a report that deplored the “underpricing of drugs in foreign countries.”

The council said that profit margins on brand-name drugs in the United States were four times as high as those in the more regulated markets of major European countries and Japan. The United States, it said, needs to “address the root of the problem: foreign, developed nations, that can afford to pay for novel drugs, free-ride by setting drug prices at unfairly low levels, leaving American patients to pay for the innovation that foreign patients enjoy.”

Moreover, there are no guarantees that increased profits abroad would translate into savings at home:

“There is absolutely no reason to believe that trade policies designed to raise prescription drug prices overseas will result in equivalent or any decreases in prices in the United States,” six House Democrats, led by Representatives Jan Schakowsky of Illinois and Rosa DeLauro of Connecticut, said in a recent letter to Mr. Trump.

People who work in the industry said it was unlikely that consumers would go to the pharmacy counter and see a meaningful reduction in drug prices before the end of the year.

Just because your "health care system" [sic for the United States] is supremely dysfunctional in no small part because of political inaction to confront price gouging, it doesn't mean that matters would be "improved" if you strong-armed other countries into making their systems as pathetic as America's.

The Hippocratic oath states that, first, medical professionals should do no harm. By the Trump administration's reckoning, a lot of harm should be done elsewhere to compensate for the ineptitude of American government officials unable to get their act together and extract meaningful concessions from drug firms who've been exceedingly successful at lobbying against rational drug pricing Stateside. 

BTW, I still recommend Marcia Angell's book on my virtual bookshelf on how Big Pharma actually doesn't put in most of theresearch for drugs but rather takes advantage of publicly-funded institutions. They only make profits afterwards by commercializing others' work.

5/15 UPDATE: See the New York Times for more on the decrepit state of the US health care system.

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El Gordo: How NAFTA Made Mexico Ameri-Fat

♠ Posted by Emmanuel in Americana,Health at 12/18/2017 01:23:00 PM

The Trumpian Buddha-esque physique is now achievable in Mexico thanks to NAFTA.

While Donald Trump likes to recycle easily refutable arguments about the North American Free Trade Agreement (NAFTA) being "the worst trade deal ever," he doesn't seem to mention one that should be of concern to his Mexican counterparts. While such self-interested reasoning is what you'd expect from an "America First"-championing US president, a woe that the Mexicans are now suffering from is actually one Americans are profiting from:

Mexico began lifting tariffs and allowing more foreign investment in the 1980s, a transition to free trade given an exclamation point in 1994, when Mexico, the United States and Canada enacted the North American Free Trade Agreement. Opponents in Mexico warned that the country would lose its cultural and economic independence.

But few critics predicted it would transform the Mexican diet and food ecosystem to increasingly mirror those of the United States. In 1980, 7 percent of Mexicans were obese, a figure that tripled to 20.3 percent by 2016, according to the Institute for Health Metrics and Evaluation at the University of Washington. Diabetes is now Mexico’s top killer, claiming 80,000 lives a year, the World Health Organization has reported.

For many Mexicans, Nafta promised to make real “the fever dreams of joining the modern economy,” said Timothy A. Wise, a trade expert at the Small Planet Institute and Tufts University. “All former rural workers would be in new jobs in the burgeoning manufacturing industries of the post-Nafta world. That just hasn’t happened.”

“The only way that Mexico became a ‘first world’ country was in terms of diet.”

And that's the real story here. While American agricultural and food production interests have succeeded in making Americans the fattest among developed nations, Mexico now trails by a minuscule margin among OECD nations as they've consolidated markets south of the border post-NAFTA. So, if Mexicaons haven't exactly achieved an American standard of living, they've at least achieved American super-sized waistlines:

Among its chief champions are American farm and food-retailing interests whose fortunes have benefited tremendously from the open market. Mexican exports to the United States have surged, and a more stable economic structure has evolved in Mexico. The country’s unemployment rate has stayed mostly constant, but average wages have fallen to $15,311 in 2016 from $16,008 in 1994, according to the Organization for Economic Cooperation and Development.

Critics of Nafta acknowledge the complex causes of obesity, but argue free trade intensified the problem by opening Mexico’s largely isolated economy. In addition to dramatically lowering cross-border tariffs, Nafta let billions of dollars in direct foreign investment into Mexico, fueled the growth of American fast food restaurants and convenience stores, and opened the floodgates to cheap corn, meat, high-fructose corn syrup and processed foods.

You take the good with the bad, I guess.

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TrumpCare: The Adios, Geezers "Health" Plan & IPE

♠ Posted by Emmanuel in Americana,Health at 3/14/2017 06:58:00 PM

I try not to focus excessively on US-only topics, but this I cannot resist since it has the potential to delay or waylay the rest of Trump's racist-isolationist-protectionist agenda. (Which is a good thing, obviously.) The gist of TrumpCare goes like this: Republicans have been planning to repeal and replace ObamaCare--the existing US health care law formally knows as the Affordable Care Act. However, incredible promises that this replacement would (a) cost less to patients, (b) cost less to the US government and (c) extend coverage to more people was always a stretch.

Just out is the non-partisan Congressional Budget Office [CBO] report scoring TrumpCare on (a)-(c). Accorcing to the CBO's estimates, (b) the cost of the health program to the US government will be reduced over a 10-year period. However, (a) the key senior constituency is set to pay significantly more than they pay now and (c) coverage would go down because TrumpCare makes healthcare unaffordable to many seniors by reducing their state-provided benefits. Moreover, many states will find little to gain by participating in TrumpCare given its unfavorable terms, making more seniors lose coverage.

As such, there is little care going on in TrumpCare or, more formally, the American Health Care Act. The way "savings" are achieved is by getting rid of older people from government health programs--those most in need of health care and those whose health spending is obviously the highest as a result. No mystery here:

But the way the bill achieves those lower average premiums has little to do with increased choice and competition. It depends, rather, on penalizing older patients and rewarding younger ones. According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured.

The remaining pool of people would be comparatively younger and healthier and, thus, less expensive to cover. Other changes would help make health insurance skimpier — cheaper, but with deductibles that are higher than those criticized by Republicans under Obamacare.

The American Association of Persons [AARP] summarizes the talking points of how the bill harms its members bigly:

AARP reiterates our opposition to this harmful bill. The nonpartisan CBO  revealed today that ‘the legislation would increase the number of uninsured broadly, [and] the increase would be disproportionately larger among older people with lower income; in particular, people between 50 and 64 years old…

The CBO analysis found that premiums would rise ‘20 percent to 25 percent higher for a 64-year-old.’ Putting the financial burden on older Americans is not the way to solve the problems in our health care system.’  Premiums for a 64 year old earning $26,500 would increase by $12,900 in 2026, from $1,700 to $14,600.

Another interesting facet is that the elderly turned out in yuuuge numbers for Trump. However, they will be among the worst affected--especially those living in rural areas where choices are few and costs are high as a result:

Among the counties where Trump won his biggest victories, nearly all would face deep cuts in tax credits under the Republican plan to replace Obamacare. And, in the parts of the country that would lose the most in tax credits, a majority of voters were Trump supporters.

The following chart shows the 25 counties where Trump captured the largest share of votes. In all but one, a typical middle-aged man buying health insurance on his own would lose money under the proposed GOP change, according to recent calculations from the Kaiser Family Foundation.

It is not for me to discuss the motivations of American voters for Trump in the limited space available. Even more perplexing are Trump's best efforts to do the most harm to his most committed voters. (I think seniors will still be around come the 2018 elections despite Trump's best efforts. Sorry, Trump.) Suffice to say, little political goodwill appears likely to emerge from the upcoming effort to pass TrumpCare. Either seniors are hurt in a big way--those whose age group has not only the highest voter turnout but also the highest Trump share of the vote--or much useless activity will be expended in promoting an ultimately futile bill in a manner that offends the electorate.

What will likely happen is that Republicans will suffer large losses in the Senate and, to a lesser extent, the heavily gerrymandered House in the 2018 midterm elections. So, there is a two-year windows before the midterm elections for Trump to get the rest of his wish list done. However, a TrumpCare setback will likely delay or (hopefully) derail other parts of his agenda until such a time that Republicans will not control the White House, House, and Senate simultaneously. The more legislative losses, the fewer congressional backers Trump will have. As Trump has correctly observed, few people back "losers." In the international sphere, his wish list includes:

• the ~$25B Great Wall of Trump on the US-Mexico border;
• the "border tax" discriminating unfairly against exports likely to set off a trade war;
• the massive $54B in additional military spending; and
• further anti-immigrant action

To paraphrase one of his predecessors, heckuva job, Trumpy. The less congressional allies Trump has for his quixotic agenda(s), and the fewer (predominantly elder) voters putting Trump sympathizers in office, the better off the rest of the world is.

I will elaborate more on the other international elements of Trump's racist-isolationist-protectionist policy package soon, but for now, rest assured that gridlock in Washington is better for the rest of the world. Or at least we should hope. I feel bad for American seniors, but again, they did vote for a known con artist.  Caveat emptor.

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Pfizer-Allergan Merger: Tax Avoidance Mothership

♠ Posted by Emmanuel in Europe,Health at 11/23/2015 03:48:00 PM

It'd be more appropriate if they depicted two accountants shaking hands.

In trying to be impartial by covering the entire ideological spectrum of IPE, my link list at the bottom includes the Tax Justice Network and Tax Research UK. These folks are frothing at the mouth all the time about persons and corporations (literally, corporate persons) not paying what is due by engaging in all sorts of fiscal tomfoolery. Large multinational corporations are prone to reporting most of their earnings in low-tax locations such as Ireland for obvious reasons. Needless to say, many nation-states are unhappy about their corporations not paying their fair share. Just recently, the US Treasury published guidelines about "tax inversion" to avoid American firms from relocating in the aforesaid low tax locations:

The Treasury Department has unveiled new regulations aimed at reeling in tax-dodging U.S. corporations trying to take advantage of friendly international tax codes. But the guidelines – which were designed to address an issue recognized as problematic by both the right and the left of the political spectrum, from GOP front-runner Donald Trump to President Barack Obama – are merely a bandage over a much deeper problem that will require congressional action to patch up...

It's interesting Obama referenced Ireland specifically, considering U.S.-based Pfizer pharmaceutical corporation is currently in the process of negotiating a merger deal with Dublin-based Allergan. Pfizer last year was sitting on a $74 billion chunk of change that had yet to be funneled back into the U.S. The company has said these earnings "are intended to be indefinitely reinvested overseas," and a deal with Allergan could potentially allow the pharmaceutical giant to avoid its U.S. tax obligations and instead face Dublin's more forgiving 12.5 percent corporate tax rate. If the deal goes through and Pfizer indeed moves its corporate residence overseas, it will become one of the largest companies in history to dodge U.S. taxation via inversion.

Ah yes, Pfizer. Guess what: despite politicians of all stripes including President Obama decrying Pfizer's tax avoidance gambit, its planned mega-merger is going ahead anyway. Just to show you how far this issue has gone in the US public eye, this excerpt is from USA Today:

U.S. pharmaceutical giant Pfizer(PFE) and Irish rival Allergan(AGN) Monday announced a record-breaking $160-billion merger, the largest in health-care industry history and the biggest yet using a controversial tax-saving strategy.

In a transaction expected to create the world's largest drugmaker, the companies said Allergan shareholders would receive 11.3 shares of the newly combined company for each of their existing shares, while Pfizer investors will get one share of the new company for each of their shares. The stock transaction is currently valued at $363.63 per Allergan share, for a total enterprise value of roughly $160 billion based on the $32.18 per share closing price of Pfizer stock on Nov. 20, the companies said.

The rather transparent ploy that they're using is making it appear as though the smaller Allergan is "acquiring" Pfizer, but nobody is being fooled here...not even USA Today:

U.S. pharmaceutical giant Pfizer(PFE) and Irish rival Allergan(AGN) Monday announced a record-breaking $160-billion merger, the largest in health-care industry history and the biggest yet using a controversial tax-saving strategy.In a transaction expected to create the world's largest drugmaker, the companies said Allergan shareholders would receive 11.3 shares of the newly combined company for each of their existing shares, while Pfizer investors will get one share of the new company for each of their shares. The stock transaction is currently valued at $363.63 per Allergan share, for a total enterprise value of roughly $160 billion based on the $32.18 per share closing price of Pfizer stock on Nov. 20, the companies said.

The deal terms call for the companies to combine under Allergan plc, which will be renamed Pfizer plc and trade on the New York Stock Exchange under the PFE ticker. The new combination would retain Allergan's legal and tax domicile in Ireland. Pfizer would have its global operational headquarters in New York and its principal executive offices in Ireland. The agreement is expected to face substantial regulatory scrutiny before its expected closing in the second half of 2016...

However, the new rules are not expected to have any immediate impact on the deal because the transaction is technically structured to have Dublin-based Allergan, with a market cap of roughly $122 billion, acquire New York-headquartered Pfizer, which has a market cap of approximately $200 billion.

Remember that Allergan itself is the result of a previous tax inversion:

Somehow, I doubt whether "When Irish Eyes are Smiling" and "Danny Boy" are playing at the White House or the Treasury Department right now--or at the Tax Justice Network or Tax Research UK [!]. Political scrutiny of this merger Stateside will be massive, and I for one would not bet on it being scuppered as a result. Watch this space.

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