GLENN BECK: “Where do you stand on the WEF, the World Economic Forum?”
ROBERT KENNEDY JR: “It is like we shouldn’t be paying any attention. It’s a billionaire’s boys club that’s arranging the world to shift wealth upward and to clamp down totalitarian controls on everybody else. And now, they got the capacity to do it. They got all these countries running around doing what they tell them to do. It’s astonishing to me that these people go to Davos in their private jets, and they’re able to tell these world leaders how to govern us in ways that eradicate our constitutional and civil rights and constantly shifting wealth upward.”
[O]n Thursday, the FTC voted to resurrect the Robinson-Patman Act, a bill prohibiting corporate bribery and price discrimination by middlemen that hasn’t been meaningfully enforced since the 1970s. I wrote several chapters in my book on the titanic fight in the 1930s to tame chain stores with this law, and the equally vicious conflict in the 1970s to stop enforcing it. The end of RPA enforcement is why chain stores like Walmart and Amazon took over our retail space, and why dominant middlemen control every area of our economy at this point. It’s worth noting that Robert Bork’s most hated statute was the Robinson-Patman Act, and he considered it a tremendous victory that he helped end the enforcement of the law.
So what happened at the FTC? All five commissioners voted on a policy statement saying that the use of rebates by dominant middlemen in the insulin market were a potential violation of different laws under the jurisdiction of the FTC, including the Robinson-Patman Act. This vote is a signal to every private antitrust lawyer, state attorney general, and judge, that the Robinson-Patman Act can once again be dusted off and used.
Insulin is a great test case for this law, because everyone knows how unfair and inefficient the insulin market truly is. It’s a medication that has been around since 1922, and yet it has been increasing in cost every year for decades. And while the three main producers engage in all sorts of schemes to push up cost, most of the high cost of insulin is actually a result the middlemen named pharmacy benefits managers - CVS Caremark, Cigna (Express Scripts), and United Healthcare (OptumRx) - who manage and control how medicine is priced and sold. PBMs demand rebates of up to 70% for the right to have an insulin company sell their product to patients. These rebates in turn massively drive up the price of insulin.
I've followed Matt Stoller for months and I now support his Substack newsletter. He discusses the over-concentrations of power in many places. This is incredibly important to having a meaningful understanding about what is going on in Washington DC. Mere Supply and Demand does NOT explain what is going on, contrary to many economists.
Krystal and Saagar talk at length with policy expert Matt Stoller about the monopolization of the American economy, supply chain shocks, corruption in government, consumer culture, meat packing consolidation, the anti-trust movement and more.
From Stoller's first Substack newsletter:
You see, I was taught basic economics by Martin Feldstein at Harvard, and he told us that banks and corporations were neutral technocratic institutions. And I believed him, because I was an arrogant Harvard student who trusted economists. Witnessing the policy choice to concentrate wealth and power during the Wall Street bailouts, and talking to lots of people in foreclosure who didn’t get a bailout, broke me of that illusion.
After you learn about Too Big to Fail banks, it’s hard not to look around and begin seeing that Too Big to Fail is everywhere. Eventually I came to read Cornered by Barry Lynn, and that book helped connect the dots and set me on the path to researching my own book, Goliath. (Later I found out Feldstein was on the board of AIG, which was one of the central villains of the financial crisis.)
What’s your story? And what monopolies are you noticing these days?
Today, corruption in these markets is so extreme that hospital executives themselves are often offered a cut of the fees from GPOs. In 2013, one analyst said that “many hospital executives who are part of the Premier alliance have learned to rely on that share back as an integral part of their annual compensation.” In other words, hospitals are buying supplies at inflated prices, and those suppliers use some of that extra money in direct bribes to hospital executives.
The legalization of kickbacks happened as a series of mergers in the 1990s consolidated power within the industry. In 1995, Premier Health Alliance, American Healthcare Systems, and SunHealth Alliance merged into the nation’s largest GPO, Premier. By 2017, the giants in the industry - Vizient, Premier, HealthTrust, and Intaler - came to manage $300 billion of hospital purchasing for 5000 health systems, or 90% of total medical supplies in the United States. These GPOs have deals with the three major distributors - McKesson, AmerisourceBergen and Cardinal Health - which precludes any smaller distributors from getting into the business. At this point, 90% of generic medicines are bought by just four firms.
And this consolidation and restructuring of hospital buying has ruined the American supply chain, and prevented the ability to rebuild it.
Here's where free market fundamentalism leads us: dulled consciences and oppression of those on the brink of homelessness.
From the U.K. Guardian:
Some of the richest people in the US, including billionaires Warren Buffett and Sam Zell, have made millions from trailer parks at the expense of the country's poorest people. Seeing their success, ordinary people from across the country are now trying to follow in their footsteps and become trailer park millionaires. The Guardian went to Orlando to learn the tricks of the trade from Frank Rolfe, the self-appointed dean of Mobile Home University, as he led would-be investors around a trailer park for sex offenders.
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