DL Open Thread Monday December 19 2022

Water? Pfft…We’ll live off tax cuts and bile!  

The Colorado River’s largest reservoirs stand nearly three-quarters empty, and federal officials now say there is a real danger the reservoirs could drop so low that water would no longer flow past Hoover Dam in two years.

That dire scenario — which would cut off water supplies to California, Arizona and Mexico — has taken center stage at the annual Colorado River conference in Las Vegas this week, where officials from seven states, water agencies, tribes and the federal government are negotiating over how to decrease usage on a scale never seen before.

Outlining their latest projections for Lake Powell and Lake Mead, the nation’s two largest reservoirs, federal water managers said there is a risk Lake Mead could reach “dead pool” levels in 2025. If that were to happen, water would no longer flow downstream from Hoover Dam.

Speaking of loss of habitat, San Fran appears to be on the leading edge of finding out what it is to be a citie sans workers.  

“Imagine a forest where an entire species suddenly disappears,” said Tracy Hadden Loh, a fellow at the Brookings Institution who studies urban real estate. “It disrupts the whole ecosystem and produces a lot of chaos. The same thing is happening in downtowns.”

Flight of stairs claims another Russian oligarch. 

Yet another oligarch has met a mysterious end as the death toll among the Russian elite continues to climb amid Vladimir Putin‘s war in Ukraine.

Dmitry Zelenov, a real estate tycoon, died on December 9 in the French Riviera town of Antibes.

The oligarch, 50, was out to dinner with some friends when he began feeling unwell and tumbled down a flight of stairs, sustaining serious head injuries, according to Russian news outlet Baza and local French outlet Var Matin.

One More French Lesson … About America’s dysfunctional drug system

As readers may recall, while I was in France this fall I gleaned a number of lessons about such issues as hospital billing and France’s superior system of banning drugstore chains. Here is one more.

Toward the end of our stay, my wife and I both got bad coughs (happily, not COVID). We went to our wonderful local pharmacist in search of something like Mucinex or Robitussin, which are not great but better than nothing.

“We have something much better,” said he. And he did. It’s called ambroxol. It works on an entirely different chemical principle, to thin sputum, facilitate productive coughing, and also operates as a pain reliever and gentle decongestant with no rebound effect.

We experienced it as a kind of miracle drug for coughs and colds. A box cost eight euros.

Ambroxol is available nearly everywhere in the world as a generic. It has been in wide use since 1979.

But not in the U.S.

A comprehensive review published by the National Institutes of Health judges ambroxol to be safe and effective. But as far as I can determine, no U.S. drugmaker has ever applied for FDA approval to sell it, which requires extensive testing and clinical trials, as if the drug were brand-new; the FDA does not take the word of, say, the European Medicines Agency.

As a drug manufacturer, you couldn’t make much money marketing and selling ambroxol as a generic, especially given the costs of getting it approved.

This leads me to suggest two reforms. First, we need a public agency to manufacture generics.

The promise of generics has been blunted because the big dogs at PhRMA, who want exorbitant profits and restricted competition, have been buying up generic drugmakers. (That should also be illegal.)

The FDA could also issue waivers to allow sale of generics that have been approved by reputable drug agencies abroad and have been in wide use for a long time with no problems.

In the meantime, it’s possible to go online and order ambroxol from Europe. This is decidedly a second-best.

When you track down all the anomalies and inefficiencies in the American health system, they all lead back to one thing—too much corporate power.