We all know that when we buy things in bulk, we can save money.  Economic theory and our own shopping experiences are that sellers are much more likely to give the consumer a break on the per-item cost if the consumer buys more of them. 

Over the long haul, buying in bulk can save real money.

And that’s what government can do.  Governments are the biggest purchasers of health care – both through public programs like Medicare (health insurance for seniors), Medicaid (health insurance for lower income individuals) and through health coverage for public employees.

At the federal level, the government currently negotiates drug costs for veterans (through the Veterans Administration) and Medicaid beneficiaries.  Yet, because of a federal law passed in 2003, the government is specifically prohibited from negotiating for Medicare drug prices.

That prohibition was part of a deal that expanded drug coverage to seniors.  The 2003 Medicare Prescription Drug, Improvement, and Modernization Act expanded the Medicare program by creating a voluntary prescription drug benefit known as Part D.  The benefit took effect in 2006 and provided prescription drugs through private stand-alone drug plans and Medicare Advantage plans.  

However, as part of the deal and to sweeten the benefits for pharmaceutical companies, that law prohibited the Secretary of Health and Human Services (HHS) from negotiating Medicare drug costs. 

Instead, Medicare prescription drug prices are negotiated between prescription drug manufacturers and hundreds of insurance companies that administer Part D plans.  Of course, insurance companies have some clout, but it is nothing compared to the negotiating power of the federal government.  As a result, Medicare drug costs are higher – and seniors must pay more.

Generally, those who support allowing the federal government to negotiate for lower Medicare prescription drug costs argue that Medicare beneficiaries should receive the same lower prescription drug prices that veterans and Medicaid beneficiaries receive.  Specifically, establishing the government as the single negotiating entity, instead of thousands of individual private plans, would result in significantly lower prices for beneficiaries and reduce program costs.

Opponents argue that doing so would be a form of price control that would interfere with market competition.  They also cite concerns that a reduction in prescription drug manufacturers’ profits may result in less money for researching and developing new drugs.  Opponents ignore the facts that drug therapy research is often conducted using taxpayers’ dollars and that allowing the Veterans Administration and Medicaid to negotiate drug costs has not impacted the pipelines for new medicines.

Since passage of the 2003 law, there have been numerous unsuccessful attempts to allow the federal government to negotiate Medicare drug prices, in the same way it does now for veterans.  That fight has reached a new peak as part of the Congressional debate over the Biden Administration’s Build Back Better Act, the proposed $3.5 trillion stimulus program.

The President’s plan is central to the Congressional budget reconciliation debate.  Under Congressional rules, budget reconciliation proposals merely require majority approval in the U.S. Senate – circumventing the filibuster obstacle that requires 60 votes to end debate on policy-focused bills.  Measures considered under budget reconciliation must be narrowly tailored to the implementation of the federal budget.  A plan to change the nation’s immigration policy, for example, has been barred from budget reconciliation since that plan was more policy than budget.

However, when it comes to Medicare drug costs, the plan to allow the government to negotiate for lower costs is far more compelling.  The nonpartisan Congressional Budget Office has estimated that allowing Medicare to negotiate prices would save government health plans more than $450 billion over 10 years.  And those savings clearly make sense as part of a multi-trillion-dollar budget plan.

Of course, the benefits would not be to the government alone.  Lower drug prices would result in lower costs for Medicare beneficiaries.  Under drug price negotiation, Medicare beneficiaries would see a savings from an estimated 9% of the Part D base premium in 2023 to 15% in 2029.  The lower prices would benefit the more than 45 million Americans who participate in Medicare prescription coverage.

As the Congressional debate over budget reconciliation and the Biden plan unfolds, making sure that seniors benefit from lower drug costs and the government saves hundreds of billions of dollars must be a top priority.  The financial health of the nation – and the health of seniors – hang in the balance.

Last week was Climate Week in New York City.  Climate Week NYC is an annual series of events focused on the growing harm caused by global warming and is coordinated with the United Nations.  This event was one of many as the world moves toward a global summit on climate change being held in Glasgow, Scotland in early November (COP26). 

The global summit is an annual meeting of the world’s leaders to report on how they are addressing the growing threat posed by global warming.  In 2015, at the Paris Summit, every country agreed to work together to limit global warming to well below 3.62 degrees Fahrenheit and aim for no more than 2.7 degrees above pre-industrial temperatures, to adapt to the impacts of a changing climate, and to make money available to deliver on these aims.

Under the Paris Agreement, countries committed to bring forward national plans setting out how much they would reduce their emissions.  They agreed that every five years they would come back with an updated plan that would reflect their highest possible ambition at that time.

This year’s summit in Glasgow is (delayed by a year due to the pandemic) when countries update their plans for reducing emissions.  But the commitments laid out in Paris did not come close to limiting global warming to 2.7 degrees, and the window for achieving this is closing. The actions taken this decade will be crucial to forestall the worst of the harm caused by global warming.

The United States has squandered much of the past five years due to the reckless leadership of the Trump Administration, which not only pulled out of the Paris Agreement but seemingly did everything it could to hasten the devastation from climate changes driven by the burning of oil, gas, and coal.

The result has been stunning:  According to the EPA, over the last few months alone, weather disasters have struck one in three Americans across the country.

Here in New York, state government stepped into the breach caused by the failures of the Trump Administration to respond to the environmental dangers posed by climate change.  Under former Governor Cuomo, myriad actions were taken to reduce the state’s support for expanding the use of oil and gas and to pledge for a greater reliance on renewable, clean sources of power.

The state even set legal goals for itself in statute:  In 2019’s “Climate Leadership and Community Protection Act,” the state pledged to reduce its greenhouse gas emissions 85 percent by 2050, mandated a goal of a zero-greenhouse gas emission electricity sector by 2040, including 70 percent renewable energy generation by 2030.

This past week, Governor Hochul announced projects – both big and small – that strengthened New York’s efforts toward those goals.  She announced funding for water infrastructure projects designed to make those systems more resilient from the ravages of more intense storms, plans to modernize New York’s old hydroelectric plants operating in upstate New York, funding for various wind and solar projects, approved legislation requiring that cars sold in New York starting in the year 2035 must be zero emission vehicles, and she proposed that the state increase the size of its proposed environmental bond act from $3 billion to $4 billion – whether the state approves that bond sale will be a question for voters to decide in 2022.

The biggest proposal that she advanced was that New York was proposing two massive plans to bring electricity to New York City – home to almost half the state’s population and the state’s primary financial engine.  One of those plans was to bring hydroelectric power down from Quebec in Canada and the other would transmit power generated by wind and solar sources from upstate to New York City. 

Of course, the reliance on hydro power does have adverse environmental impacts and even wind and solar power can cause problems.  But none of these options pose the same existential threat generated by the burning of oil, coal, and gas – the sources of global warming. 

And while the policy agenda advanced by New York State’s leaders are cutting edge, delivering the goods, and showing the nation – and the world – how to get it done will be crucial.  The actions taken so far are important, but so will be the development of a reporting system that shows New Yorkers how well the state is progressing.  Let’s not lose sight of the fact that we all pay for these proposals, mostly through small surcharges to our monthly electric bills.

To meet the long-range goals set in state law, New York must be taking steps now.  The governor’s pledges from this year’s Climate Week are important.   She now needs to set up a transparency system to ensure that New Yorkers can determine whether her environmental rhetoric meets the policy reality.

New York’s redistricting commission unveiled its constitutionally required first drafts of new political boundaries for Congress, state Senate and state Assembly districts.  New York’s constitution sets September 15^th as the deadline for the first sets of commission maps.  That release is to be followed by a series of public hearings to get input on the proposal.  After receiving that input, the commission develops a formal plan for submission to the Legislature for consideration in early 2022.

Redistricting follows the Census – the once-in-a-decade process for determining the population of the nation.  The U.S. Census Bureau then sends the finalized population data to the states so that they can adjust their political boundaries to reflect population changes within their localities over the past ten years.  In New York State, the overall population increased since the last census in 2010, but within the state some regions grew in population and others shrank.

The state’s redistricting commission is charged with developing plans to be presented to the Legislature for how New York’s Congressional and state legislative boundaries must change to ensure that districts have similar populations.

It’s a complicated process, made worse this year by the COVID pandemic and the bumbling of the Trump Administration.  As a result, the commission received its data months late, so only had one month to prepare draft maps for public consideration.

This year marks the first time that New York has relied on a redistricting commission to develop its plans.  In decades past, the maps were developed by a state legislative committee.  Supporters of the creation of this new system insisted that it would lead to an independent process.  Opponents argued it would not.

So far, the opponents are right.

The commission’s membership consists of an equal number of Democrats and Republicans picked by the legislative leaders.  Not surprisingly, that partisan make-up led to gridlock.  As a result, the commission released two sets of maps last week – one from Democrats and one from Republicans.

Of course.  The theory that an equal number of Democrats and Republicans on any board leads to what’s best for the public has long been debunked.  You need look no further than the much-maligned state Board of Elections to see that equal representation of the major parties often leads to gridlock, at best.

But when it comes to mapmaking, demography is destiny.

The multi-decade loss of population in upstate New York – particularly in the upstate areas between Buffalo and the Hudson Valley, continued since the last census.  As a result, those areas should expect to see legislative and congressional districts expanded geographically in order to add population.

Downstate and Hudson Valley areas should see districts shrink geographically, as those districts need to shed population.  Overall, the political representation should move toward the New York City metropolitan area, as it has in recent decades.

But how those district lines are drawn matters.  The Democratic plan appears to result in a reduction in Republican Congressional seats, for example.  According to one estimate, under the Democratic plan, the Republicans could lose as many as five representatives out of their total of eight now.  To some extent, that should be expected – New York voters have become increasingly Democratic, particularly during the Trump years.

And in this year’s redistricting, the stakes are incredibly high.  The House of Representatives certifies the presidential election results and historically it’s been a formality.  No one in modern times had ever expected a sitting President to back a coup attempt to overturn the election results.  Whether a House Republican Speaker would have stood up to that illegal attempt is unknown of course; it was a Democratic House Speaker and majority that rejected those efforts. 

In addition to shaping politics for the next decade, the lines drawn now – here as well as in states across the nation – may well determine which political party controls the House when it comes to acting on the Electoral College votes in 2024.  How lines are drawn this year could determine the course of American history.

Those stakes are staggeringly high.

At the end of the day, it will be up to New York’s Legislature and the governor to approve the final plan.  And with Democrats holding super majorities in both houses of the Legislature and control of the governor’s office, expect them to muscle through lines as they see fit. 

It didn’t have to be this way.  A truly independent redistricting commission would have drafted lines without partisan consideration.  But that didn’t happen, and we will soon see how this bipartisan system works out.

For many years, New York’s campaign finance laws have been mocked.  Appropriately so. 

From its sky-high campaign contribution “limits,” to its weak enforcement, to its “swiss cheese-like” disclosures, New York’s law has fostered a “pay-to-play” system coupled with near-total lack of accountability.  That system has contributed mightily to the scandals that have plagued state government.

Once again, that system has come under scrutiny.

Former Governor Cuomo left office last month with a massive campaign war chest.  According to the most recent reports, the former governor left with $18 million in campaign contributions.  The former governor had raised boatloads of money for an anticipated run for a fourth term.  He raised it the old-fashioned way – huge contributions that largely originated from special interests with business before the government.

Those contributions were not donated to the man, but to the candidate for governor.  What is to become of all that money now that he has left office? 

Under New York’s Election Law, there are general restrictions on how campaign contributions may be spent.  The law says that campaign “funds shall not be converted by any person to a personal use which is unrelated to a political campaign or the holding of a public office or party position.”

For many of us, it might come as a surprise that elected officials can use their contributions for any expenses outside of running for office.  After all, they are called campaign contributions for a reason.  Yet, state law allows campaign contributions to be used by a public official or political party chief for costs outside of running for office – as long as it’s not for purely personal reasons.  Using them to buy a yacht, for example, is verboten.

But it is a gray area.  There have been many instances in which an elected official used campaign contributions for things like a cover for their inground pool, the leasing of luxury cars, even a clown for a child’s birthday party.

The most egregious example, however, is when the campaign contributions are used to cover legal costs that are unrelated to a campaign.  The former Assembly Speaker and Senate Majority Leader drained millions from their campaign accounts in failed attempts to fend of prosecutions for corruption.  Both were convicted and sent to federal prison.

And other statewide officials forced from office left with significant campaign accounts.  For example, former Governor Spitzer and former Attorney General Schneiderman were forced to resign.  In both of their cases, they offered refunds to campaign donors. 

The situation with former Governor Cuomo is different, largely due to the amount of the war chest and how the former governor is intending to use it.

Despite public statements that he has no intention of running for office, the former governor is paying for a press person from his campaign war chest.  Why?  It’s not clear, but certainly this is in part an attempt to respond to media inquiries about the criminal, civil and legislative investigations still plaguing the former governor.

So, the question is: Should a private individual who is not running for office use millions of dollars in campaign funds to pay for a personal press person to respond to media inquiries?  Is that why the donors sent their campaign contributions? 

Last week a coalition of reform groups filed a complaint with the state Board of Elections to act on the question.  Where is the line of what’s allowed and what’s not?  If the former governor can use his campaign funds to hire a press person, why not other personal staff?  A driver?  Or maybe even a butler?

It’s not likely that the State Board of Elections will act on this matter.  The law is more loophole than law, and elected officials have long viewed their campaign accounts as a personal cookie jar – an approach the Board of Elections has too often blessed.

That must change.  There are former elected officials that have held onto tens or hundreds of thousands of dollars in campaign contributions they collected over the years in office and then used those monies to continue to exert influence over politics for years after their terms ended.  In contrast, California politicians are required to close their committees 60 days after losing an election or leaving office.

The California approach makes sense.  Once the days of campaigning are over, it should be time to close the campaign account.

It also makes sense that New York laws should be changed to ensure that campaign contributions are used narrowly to cover expenses for running for office, nothing else. 

It’s long since time for Albany to close this loophole.

By the time Hurricane Ida hit the Northeast, it was downgraded to a tropical storm.  But its impacts on New York City, New Jersey and surrounding communities was devastating.  The damage to New York City was particularly bad: More than a half a foot of rain fell in just a few hours, overwhelming mass transit systems, inundating roadways, flooding basement apartments and resulting in the deaths of at least 45 people and leaving more than 150,000 without power across the region.

The scenes of waterfall-force rainwaters pouring into subways, of emergency teams rescuing people from the rooftops of cars and hundreds more from mass transit systems, underscored that our society is simply not prepared for the dramatic weather changes already triggered by the global warming crisis.

Governor Hochul has stated that New York needs to make long overdue infrastructure improvements to better handle flash floods and other problems related to a rapidly heating planet.  She is right.  But who should pay for those improvements?

While we need to rapidly wean the world off power generated by fossil fuels, the greenhouse gas emissions that are driving climate change will continue to cause global warming and the resultant weather changes and more powerful storms.

The price tag for New York, the nation, and the world, to adapt its infrastructure for this new reality will be enormous.  The question for policymakers must be: Who should pay for the needed infrastructure changes?

President’s Biden’s $3.5 trillion infrastructure plan currently under consideration by both the US Senate and the House, relies on revenues from increasing the corporate tax rate from 21% to 28%.  But should a corporate giant like Google pay an increase that is the same as Big Oil behemoth ExxonMobil?  After all, Exxon knew of the dangers resulting from the burning of fossil fuels as early as the 1970s, yet buried their own research and spent millions undermining climate science and making campaign contributions in order to block climate-science legislation.  Google didn’t do that.

No, ExxonMobil and the other big oil and gas companies should pay more.

There is an effort in the Congress to do just that and New York lawmakers are at the heart of the effort.  Representative Jamaal Bowman (NY) is spearheading the push to get the House to include a “Make Polluters Pay” provision in its budget plan to charge the big oil and gas companies an assessment of at least a half trillion dollars toward the nation’s costs of responding to climate changes.  His effort has been joined by a diverse coalition of other Representatives with support from Congressional firebrand Alexandra Ocasio-Cortez, longtime liberal lion Jerrold Nadler, suburban moderate Tom Suozzi, and Congressional environmental leader Paul Tonko.  These members are leaders in a group of 40 members who are urging House Speaker Pelosi to make the climate polluters pay for the damages from climate change. 

On the Senate side, the effort is led by US Senator Van Hollen (MD) with support by Senator Sanders (VT) and Senators Markey and Warren (MA), among others.  The most important Senator in this effort will be New York’s Chuck Schumer, who plays the critical role as Majority Leader.  It will be his influence that will make the difference in whether a “Make Polluters Pay” provision ends up in Senate’s budget plan.

The Van Hollen/Bowman approach is modelled on the toxic waste site “Superfund” clean up laws.  It is expected that both plans will be considered during the House and Senate budget debates over the next couple of weeks.

As children we all learned early on that if we made a mess, we were responsible for cleaning it up.  As the nation faces trillions of dollars in infrastructure costs, the portion for the damages caused by climate change should be borne by those most responsible for the mess – Big Oil. 

New York’s US Senator Schumer will play an outsized role in determining whether that lesson learned will be applied to the biggest polluters in the history of the world.  Here’s hoping that Senator Schumer makes the climate polluters pay.