Where previous nominees flailed around, caucus support for Johnson was resounding. Scalise and Jordan were both Speaker nominees for a number of odd days before it became clear there was no path forward; Jordan saw massive rifts form in his relationships with a handful of his caucus after they received a slew of death and other threats in his name. Emmer was the nominee for just over the run-time of Avengers: Endgame. But when Rep. Elise Stefanik (R-N.Y.) nominated Johnson on the House floor, caucus members reportedly cheered and chanted, “Mike! Mike! Mike!”
In his remarks, not only does Johnson claim Roe “gave constitutional cover to the elective killing of unborn children,” but he rails against the imagined economic detriments of abortion, pushing his caucus’ outlandish claim that by depleting a hypothetical workforce, abortion has defunded social security: “Think about the implications of that on the economy. We’re all struggling here to cover the bases of social security and Medicare and Medicaid and all the rest,” Johnson says. “If we had all those able-bodied workers in the economy we wouldn’t be going upside down and toppling over like this… Roe was a terrible corruption.” Mind you, social security and health care have been gutted in the last several years by Republican lawmakers, not people who choose to end a pregnancy.
Alas, this is the man who will be presiding over the House moving forward as the threat of another government shutdown looms. This is the man who will be relied on to forge the bipartisan agreements necessary to pass a budget and keep the wheels of our government in motion. You’ll have to excuse me if I’m not feeling overly optimistic about things right now.
Covid shots may slightly increase risk of stroke in older adults, particularly when administered with certain flu vaccines
Brenda Goodman, CNN – October 25, 2023
Joe Burbank/Orlando Sentinel/AP
Vaccines for Covid-19 and influenza may slightly increase the risk of strokes caused by blood clots in the brains of seniors, particularly when the two vaccines are given at the same time and when they are given to adults who are age 85 and older, according to a new study.
The safety signal was detected by experts at the US Food and Drug Administration who analyzed data from Medicare claims.
It is the second study to find an elevated risk of stroke for seniors after Covid-19 and flu vaccinations given together. The US Centers for Disease Control and FDA issued a public communication in January explaining that one of their near real-time vaccine safety monitoring studies—called the Vaccine Safety Datalink–had picked up a small and uncertain risk of stroke for older adults who received a dose of Pfizer’s bivalent Covid-19 vaccine and a high-dose or adjuvanted flu shot on the same day. That study triggered the FDA’s broader look at strokes after vaccination noted in the medical records of seniors on Medicare.
That said, the risk identified in the FDA’s study appears to be very small—roughly 3 strokes or transient ischemic attacks for every 100,000 doses given–and the study found it may be primarily driven by the high-dose or adjuvanted flu vaccines, which are specially designed to rev up the immune system so it mounts a stronger response to the shot.
In additional analysis of the Medicare claims data, the FDA researchers found a very slightly increased risk of stroke in adults ages 65 and older who’d only gotten a high dose flu shot. In absolute terms, the extra risk from high-dose flu shots amounted to 1-2 strokes for every 100,000 doses.
“The absolute risk is miniscule,” said Dr. Steve Nissen, a cardiologist and researcher at the Cleveland Clinic in Ohio. “I mean it is trivial in comparison to the risk for people over 85 of dying from Covid.”
At least five other recent studies—many launched to try to tease out this link, have not found any additional risk of stroke after vaccination for Covid-19, influenza or both.
“Available data do not provide clear and consistent evidence of a safety problem for ischemic stroke with bivalent mRNA Covid-19 vaccines when given alone or given simultaneously with influenza vaccines,” said Dr. Tom Shimabukuro, director of the Immunization Safety Office at the CDC in a public presentation of the data on Wednesday to the CDC’s Advisory Committee on Immunization Practices.
Researchers say they are continuing to probe the possible link, but in the meantime, they say everyone should still get vaccinated since any tiny increase in risk of a stroke after vaccination is dwarfed by the increased risk of stroke or other serious outcomes following either a flu or Covid-19 infection.
“The risk of serious disease associated with both influenza and Covid for the population at highest risk, which is of course, older persons, is so much greater than the potential increased risk associated with a vaccine,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.
“That’s a hard equation for the average person to do,” Schaffner said.
Spread out your shots?
Schaffner said people who are worried could consider getting each shot at different times rather than together.
“That’s a reasonable thing to do,” he said.
Schaffner, who is in his mid-80s, said he got both his Covid and flu vaccines at the same time, in the same arm, and had very little reaction afterwards.
A few weeks ago, however, Dr. Peter Marks, head of FDA’s Center for Biologics Evaluation and Research, said he was planning to get his Covid-19 vaccine first, followed by his influenza vaccine about two weeks later.
“If you want to minimize the chance of interactions and minimize confusing the side effects from one with another, you wait about two weeks between the vaccines,” Marks said on an FDA stakeholder call in September.
Other experts said they hoped the information wouldn’t confuse people or deter them from getting their vaccines, since the benefits of getting them still greatly outweigh the risks.
“The bottom line is that these are small signals. We’re not entirely sure whether they are valid, and they certainly do not lead themselves to any change in the recommendations for people getting either Covid or influenza vaccines at the present time,” Schaffner said.
For the study, FDA investigators looked at the medical claims of more than 5.3 million adults ages 65 and older who were enrolled in Medicare and received a bivalent Covid-19 vaccine made by Pfizer or Moderna. They saw no increased risk of stroke in the overall group after Covid-19 vaccination.
When they looked at adults ages 85 and older, they found an elevated risk of strokes caused by blood clots in those who’d had Pfizer vaccines, but not in those who got Moderna shots.
Seniors ages 65 and older who got a bivalent vaccine and high-dose or adjuvanted flu shot at the same time also had an increased risk of blood clots in their brains.
The study is observational, meaning it can only show associations, it can’t prove cause and effect. It was also posted as a preprint ahead of peer review by outside experts and publication in a medical journal.
Study sees link to seizures in young kids
A separate FDA investigation of more than 4 million records from three large commercial insurance databases, found a very small and tenuous link between seizures in children between the ages of 2 and 5 and Covid-19 vaccination. Children this age appeared to be slightly more likely to have seizures after Covid-19 vaccination compared to background seizure rates in the general population in 2020—a year when infectious diseases were lower in kids because of masks and social distancing.
The signal disappeared, however, when researchers compared it to background rates of seizures reported in US children in 2022, a year when infections in kids rebounded.
The study authors said their findings should be interpreted with caution, since most were associated with fevers, which are common in kids. Vaccination can also cause kids to run fevers.
They said they hoped their findings would be investigated in a more robust epidemiological study.
About 4% of children experience seizures triggered by fevers, according to the National Institute of Neurological Disorders and Stroke.
Dr. Phillip Yang, a cardiologist at Stanford Health Care, said the findings didn’t look particularly concerning.
“It’s not unusual after Covid vaccine that we have little bit of a fever that could trigger a seizure, and kids who are more susceptible to it. So again, it’s not a surprising finding,” Yang said.
Flu shots may protect against the risk of Alzheimer’s, related dementias
Marlene Cimons, Special to The Washington Post – October 25, 2023
Flu shots may protect against the risk of Alzheimer’s, related dementias
There are many good reasons to get a flu shot this fall, but here’s one that might surprise you: It could protect your brain.
Recent research suggests that regular vaccinations against influenza and other infectious diseases such as shingles, pneumococcal pneumonia, and tetanus, diphtheria and pertussis (whooping cough) may reduce the risk of developing Alzheimer’s disease and related dementias.
“Vaccines are the great public health success story of our generation,” said Paul E. Schulz, professor of neurology and director of the Neurocognitive Disorders Center at the McGovern Medical School at UTHealth Houston, who led several of the studies. “They keep you safe from any number of infections, many of which can be life-threatening. And now it appears there is another tremendous benefit, this one against a disease that is among the most feared.”
What the research says
A number of studies have found that people receiving vaccinations for flu and several other infectious diseases appear less likely than the unvaccinated to develop dementia, although scientists aren’t sure why. Some believe that infectious agents play a role in the development of Alzheimer’s disease and that vaccinations help by preventing or reducing the likelihood of getting these infections.
Alternatively, Schulz speculates that vaccines may curb an immune system reaction to amyloid plaque, a naturally occurring protein found in abnormally high levels in Alzheimer’s. The immune system sees plaque as a foreign invader and attacks it, causing chronic brain inflammation and the death of nearby neurons, which contribute to dementia, he said.
In quelling the immune response to amyloid, vaccines may save brain cells that the body’s immune system might otherwise kill, he said. It’s also possible that vaccines strengthen the immune system’s ability to get rid of plaque. “Fewer plaques lead to less inflammation and less brain cell loss,” Schulz said, adding: “We aren’t sure yet exactly what the mechanism is, but something is going on with the brain and the immune system that seems to make a big difference.”
Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development, said the studies “suggest long-term benefits from immunizations with vaccines that may go beyond the intended direct benefits.”
It is unclear why vaccinations may slow or prevent dementia, Hotez said. “In some cases, they may prevent viruses from causing direct neurological involvement, especially for neurotropic viruses, or indirectly through brain inflammation that can result from pathogens,” he said. “In other cases, they may stimulate innate immune mechanisms that may be protective against the sequence of events leading to dementia.”
Schulz led a recent study that found a statistically significant difference in the incidence of Alzheimer’s after following two groups – one vaccinated against flu, the other unvaccinated – for up to eight years.
In the flu study, the researchers took participants from a national patient database, two groups of 935,887 each, one group vaccinated, the other not. To avoid the potential influence of various factors that could affect the results, the scientists ensured that each group shared many of the same characteristics, such as age, gender, how frequently they went to the doctor, and certain medical conditions, such as high blood pressure and elevated cholesterol.
Schulz and his colleagues found that an annual flu vaccination for three consecutive years reduced the dementia risk 20 percent over the next four to eight years, while six shots doubled it to a 40-percent reduction.
There were 47,889 cases of dementia in the vaccinated group, compared with 79,630 in the unvaccinated participants – a difference of more than 30,000 cases, Schulz said.
Similar results from other vaccines
In another study, his team found similar results with vaccines for other infectious diseases, including shingles, pneumococcal pneumonia and the combination of tetanus, diphtheria and pertussis (whooping cough), known as Tdap, or with tetanus and diphtheria without the pertussis component.
With the shingles vaccines, for example, (Zostavax, the early shingles vaccine, and Shingrix, the most recent one), the researchers compared 198,847 patients, who were vaccinated to an equal number who were not, Schulz said. Among the vaccinated, 16,106 patients developed Alzheimer’s during the eight-year follow-up, compared with 21,417 of the unvaccinated – or 5,311 fewer patients in the vaccinated group got dementia.
With Tdap and Td vaccines, the researchers compared two groups of 116,400 patients each, one vaccinated, one not. In the vaccinated, 8,370 individuals developed dementia over the eight years, compared with 11,857 in the unvaccinated – 3,487 fewer patients among the vaccinated.
With the pneumococcal vaccine, they compared two groups of 260,037 each, one group vaccinated, the other unvaccinated, and recorded 20,583 dementia cases among the vaccinated after eight years, compared with 28,558 unvaccinated people – 7,975 fewer patients in the vaccinated group, Schulz said.
In two studies conducted in the United Kingdom – still unpublished and under peer review – researchers at Stanford University found similar results. The first, among an older population in Wales, suggests that vaccination with Zostavax prevented an estimated 1 in 5 new dementia cases during a seven-year period, said Pascal Geldsetzer, assistant professor of medicine in the division of primary care and population health at Stanford University, who led the research.
The second analyzed mortality data for England and Wales and found a 5 percent difference in the probability of dying from dementia – or 1 in 20 deaths averted – during a nine-year follow-up.
For both studies, the scientists established two groups for comparison purposes based on the country’s birth date eligibility requirements. Those who turned 80 just before the vaccine program started were not eligible for the vaccine, and remained ineligible, while those who turned 80 just after the program began received the vaccine free over the course of the following year.
“It is likely that the only difference between the two comparison groups was a tiny difference in age, but a large difference in the probability of getting the shingles vaccine,” Geldsetzer said. “That makes our study fundamentally different in its approach to studies that simply compare people who get vaccinated with those who don’t. We think that our findings from this unique natural randomization strongly suggest a causal relationship.”
Need for more research
Experts said more studies were needed to determine the effects of the vaccine on the brain.
There may be undetectable factors that distinguish the vaccinated from the unvaccinated, despite researchers’ efforts to control for them, such as prior head injuries, genetics or environmental exposures, said William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University.
Regardless, experts agree that people should get their shots. “All this requires further studies, but vaccination, along with good diet, exercise, intellectual and emotional stimulation are key factors for healthy aging,” Hotez said.
No one should suffer from preventable diseases, Schaffner said: “Vaccinations are a critical means of staying well and living a healthy life.”
Mass shooting hits multiple locations in Lewiston, Maine
Jolie Lash and Riley Hoffman – October 25, 2023
At least 20 people are believed to be dead and dozens more have been injured after a bowling alley came under fire in Lewiston, Maine, Wednesday evening, law enforcement sources confirmed to ABC News.
There are also reports of shots fired at additional locations, including a local bar, according to law enforcement sources briefed on the situation.
PHOTO: Law enforcement vehicles are shown at a scene of a shooting in Lewiston, Maine, on Oct. 25, 2023. (Nichoel Wyman Arel)
A nurse at Maine Medical Center told ABC News the shooting unfolded at a bowling alley during its youth night.
“Maine Medical is on lockdown right now awaiting Lewiston patients,” the nurse said. “They just called for [emergency department] nurses and critical care nurses to come in, set up three stretchers to each single critical care bay. They just got their first two patients — both gunshot wounds to their thighs.”
A suspect is not yet in custody and an active manhunt is underway. Androscoggin County Sheriff’s Office shared a photo of the alleged gunman on Facebook Wednesday evening, asking for identification help via messenger or email.
PHOTO In this image posted to the Androscoggin County Sheriff’s Office, a suspect in an active shooter event is shown in Oct. 25, 2023. (Androscoggin County Sheriff’s Office)
The White House said Wednesday evening, “The President has been briefed on what’s known so far about the mass shooting in Lewiston, Maine and will continue to receive updates.”
Governor Janet Mills posted on X that she was aware of the situation and urging “all people in the area to follow the direction of State and local enforcement. I will continue to monitor the situation and remain in close contact with public safety officials.”
ABC News’ Aaron Katersky and Josh Margolin contributed to this report.
This is a developing story. Check back for updates.
Ford, UAW reach tentative deal to end strike including record pay raise
Joseph White and David Shepardson – October 25, 2023
FILE PHOTO: United Auto Workers (UAW) local 862 members strike outside of Ford’s Kentucky Truck PlantIn this article:
(Reuters) -Ford Motor and United Auto Workers (UAW) union negotiators reached a tentative labor deal after a six-week strike, UAW President Shawn Fain and the automaker said on Wednesday, agreeing a 4-1/2-year contract with a record pay boost.
The deal, which needs approval by union leaders and members, would be the first settlement of strikes by 45,000 workers against Ford, General Motors and Chrysler-parent Stellantis that began Sept. 15.
“We told Ford to pony up and they did,” Fain said in a video post on Facebook, adding that the strike at Ford “has delivered”.
Fain said the UAW reached a historic agreement with Ford, including a 25% wage increase over the life of the contract. Ford workers will receive an immediate 11% wage hike. Including compounding and cost of living, worker pay will rise about 33% to over $40 an hour over the life of the contract.
In addition to the general wage hike, Fain said the lowest-paid temporary workers would see raises of more than 150% over the contract term and employees would reach top pay after three years. The union also won the right to strike over future plant closures, he said.
The UAW also succeeded in eliminating lower-pay tiers for workers in certain parts operations at Ford – an issue Fain highlighted from the start of the bargaining process, wearing T-shirts with the slogan “End Tiers.”
The Ford contract would reverse concessions the union agreed to in a series of contracts since 2007, when GM and the former Chrysler were skidding toward bankruptcy, and Ford was mortgaging assets to stay afloat.
“We know it breaks records,” Fain said in a video address Wednesday night. “We know it will change lives. But what happens next is up to you all.”
The UAW was preparing to strike at a key Ford facility in Dearborn this week if it had not reached agreement after striking at additional GM and Stellantis facilities this week.
But in an unexpected gesture to Ford, UAW-Ford Vice President Chuck Browning said in a video Wednesday that Ford workers now on strike should return to their jobs during the coming ratification process. That means production of Ford Super Duty pickups, Ford Bronco and Explorer SUVs and Ranger trucks could restart this week.
Ford confirmed the news. “We are pleased to have reached a tentative agreement on a new labor contract with the UAW covering our U.S. operations,” Ford CEO and President Jim Farley said in a statement.
If the Ford contract is ratified, it would set the standard for bargaining at GM and Stellantis and expire on April 30, 2028.
In statements, GM and Stellantis said Wednesday they are working to secure agreements as soon as possible.
“This lays the groundwork for the next two contracts and they should fall in line fairly quickly because all three were within a narrow gap of each other,” Sam Fiorani, vice president of global vehicle forecasting at AutoForecast Solutions.
“The strike so far has been painful for everybody and knowing what it takes to get a signed contract should bring them to the table much quicker,” he said.
The UAW ratcheted up pressure on the automakers by striking at each company’s most profitable plant – GM’s Arlington, Texas assembly plant, Ford’s Kentucky heavy-duty pickup factory and Stellantis’ Ram pickup plant in Sterling Heights, Michigan.
Total economic losses from the auto workers’ strike have reached $9.3 billon, the Anderson Economic Group said earlier this week.
The UAW’s campaign for a record contract converged with union efforts in Hollywood and at delivery giant UPS to win big pay increases. It also became the focus of attention by U.S. President Joe Biden and Republican rivals who see Michigan and other auto states as pivotal to their 2024 campaign strategies.
Biden joined Fain on a picket line last month, and praised the tentative agreement in a statement Wednesday night as a “testament to the power of employers and employees coming together to work out their differences at the bargaining table.”
Absent from Fain and Browning’s summary of the contract terms Wednesday was mention of future pay and unionization at new joint-venture electric vehicle battery factories the Detroit Three are building with Asian partners.
Because they are owned by separate corporate entities, the automakers did not have to include those factories in this round of bargaining. Fain had pushed for assurances that battery plant wages would be comparable to wages at assembly plants, and expressed concern that UAW jobs at Detroit Three combustion powertrain plants would be lost over time to non-union battery operations.
(Reporting by Mrinmay Dey in Bengaluru; Writing by Peter Henderson; Additional reporting by Abhirup Roy; Editing by Cynthia Osterman and Christopher Cushing)
Instant view: Ford reaches tentative deal with striking UAW workers
Reuters – October 25, 2023
Striking United Auto Worker union members picket outside the Ford Michigan Assembly Plant in Wayne
(Reuters) – Ford Motor and United Auto Workers (UAW) union negotiators reached a tentative labor deal after a six-week strike, UAW President Shawn Fain said on Wednesday, agreeing on a 4-1/2-year contract that would provide a record pay boost.
The union is still in striking GM and Stellantis.
Following are reactions to the tentative deal:
SAM FIORANI, VP OF GLOBAL VEHICLE FORECASTING, AUTOFORECAST SOLUTIONS
“This lays the groundwork for the next two contracts and they should fall in line fairly quickly because all three were within a narrow gap of each other.”
“The strike so far has been painful for everybody and knowing what it takes to get a signed contract should bring them to the table much quicker.”
JOE BIDEN, U.S. PRESIDENT
“I applaud the UAW and Ford for coming together after a hard fought, good faith negotiation and reaching a historic tentative agreement tonight. This tentative agreement provides a record raise to auto workers who have sacrificed so much to ensure our iconic Big Three companies can still lead the world in quality and innovation…
“Critical to building an economy from the middle out and bottom up, instead of from the top down, is worker power. It’s showing how collective bargaining works by providing workers a seat at the table and the opportunity to improve their lives while contributing fully to their employer’s success. This tentative agreement is a testament to the power of employers and employees coming together to work out their differences at the bargaining table in a manner that helps businesses succeed while helping workers secure pay and benefits they can raise a family on and retire with dignity and respect.”
JEFFREY SCHARF, CHAIRMAN, ACT TWO INVESTORS, FORMER GM HOLDER, ON UAW AND CHIEF SHAWN FAIN
“If they can use this as a lever to organize Tesla and companies like that, he’s brilliant. If they fail to organize the other companies and the differential causes jobs to go out of Detroit and to the other companies, then he’s a failure. He won the battle, but whether he wins the war or not, which is to have more union workers getting paid more, is unclear. That’s what I would be more worried about if I was a young auto worker. I would worry about whether this is going to cost me my job in the long-term.”
GENERAL MOTORS STATEMENT
“We are working constructively with the UAW to reach a tentative agreement as soon as possible.”
STELLANTIS STATEMENT
“We remain committed to working toward a tentative agreement that gets everyone back to work as soon as possible.”
(Reporting by Abhirup Roy, David Shepardson and Joe White; Editing by Peter Henderson)
China rushes to swap Western tech with domestic options as U.S. cracks down
Reuters – October 25, 2023
Servers are seen inside Huawei’s factory campus in Dongguan, Guangdong province
BEIJING (Reuters) – China has stepped up spending to replace Western-made technology with domestic alternatives as Washington tightens curbs on high-tech exports to its rival, according to government tenders, research documents and four people familiar with the matter.
Reuters is reporting for the first time details of tenders from the government, military and state-linked entities, which show an acceleration in domestic substitution since last year.
China has spent heavily on replacing computer equipment, and the telecom and financial sectors are probably the next target, said two people familiar with the industries. State-backed researchers also identified digital payments as particularly vulnerable to possible Western hacking, according to a review of their work, making a push to indigenize such technology likely.
The number of tenders from state-owned enterprises (SOEs), government and military bodies to nationalize equipment doubled to 235 from 119 in the 12 months after September 2022, according to a finance ministry database seen by Reuters.
In the same period, the value of awarded projects listed on the database totaled 156.9 million yuan, or more than triple the previous year.
While the database represents only a fraction of tender bids nationwide, it is the largest collection of state tenders publicly available and mirrors third-party data. China spent 1.4 trillion yuan ($191 billion) replacing foreign hardware and software in 2022, marking a year-on-year increase of 16.2%, according to IT research firm First New Voice.
But Beijing’s lack of advanced chip-manufacturing capabilities prevents it from completely substituting products with alternatives that are entirely locally made, analysts say.
Previous domestic substitution efforts stalled because China did not have the “technical chops to pull off localization until now, and to a certain extent they still kind of don’t,” said Kendra Schaefer, head of tech policy research at Beijing-based consultancy Trivium China.
FEAR OF DEPENDENCE
SOEs were instructed last year to replace office software systems with domestic products by 2027, the first time such specific deadlines were imposed, according to five brokerage firms that cited a September 2022 order from China’s state asset regulator. Reuters could not independently verify the order.
Domestic replacement projects this year have targeted markedly sensitive infrastructure, the tenders show.
One partially redacted tender for a “certain government department in Gansu province” assigned 4.4 million yuan to replace an intelligence-gathering system’s equipment, without providing specifics.
People’s Liberation Army units in the northeastern city of Harbin and Xiamen in the south last December meanwhile issued tenders to replace foreign-made computers.
Tech researchers such as Mo Jianlei of the Chinese Academy of Sciences, the country’s largest state-run research organization, said the Chinese government was increasingly concerned about Western equipment being hacked by foreign powers.
The state asset regulator did not return a request for comment.
Over the past year, state-linked researchers also called on Beijing to strengthen anti-hacking defences in its financial infrastructure due to geopolitical concerns.
One March research paper highlighted the dependence of China’s UnionPay credit card system on U.S software firm BMC for settlements.
“Beware of security vulnerabilities in hardware and software set by the U.S. side … build a financial security ‘firewall’,” the researchers wrote.
BMC declined to comment.
An article published this year in the journal Cyberspace Security by researchers from the state-run China Telecommunications Corporation concluded the country was overdependent on chips made by U.S. giant Qualcomm for back-end management, as well as on the iOS and Android systems.
“(They) are all firmly controlled by American companies,” the researchers wrote.
As China has not signed World Trade Organization clauses governing public procurement, the substitution effort does not appear to violate international accords, according to the U.S. Treasury. The U.S. has implemented similar rules barring Chinese companies from public sector bids.
Qualcomm, Google and Apple did not immediately return requests for comment.
WINNERS AND LOSERS
China’s effort to build an independent computing system dates back to at least its 2006 five-year plan for science and technology development, which listed the semiconductor and software systems sectors as national priorities.
This effort spawned state-owned companies that are increasingly winning major contracts. Two firms awarded the Harbin tenders were subsidiaries of China Electronics Corporation and China Electronics Technology Group Corporation – both heavily targeted by U.S. sanctions.
The state regulator’s 2022 order pushed SOEs away from U.S. companies such as Microsoft and Adobe, according to an employee of a Beijing-based firm that develops domestic office-processing software
China Tobacco, for example, in July began switching some subsidiaries from Microsoft Windows to Huawei’s EulerOS, according to an employee of a software vendor that services the state-owned manufacturer.
The people spoke on condition of anonymity because they were not authorized to discuss clients and competitors.
For years, Western tech companies have shared their source code and entered into partnerships with domestic firms to address Beijing’s concerns, but prominent computer scientists such as Ni Guangnan of the Chinese Academy of Engineering have said such measures are not sufficient for China’s security needs.
China Tobacco, Microsoft and Adobe did not respond to requests for comment.
In September, Reuters and other outlets reported that some employees of central government agencies were banned from using iPhones at work.
“In certain sectors, customers … are opting for domestic suppliers, with foreign suppliers frequently facing informal barriers,” the European Union Chamber of Commerce in Beijing said in response to Reuters questions.
In a 2023 American Chamber of Commerce (AmCham) in Shanghai report, 89% of the organization’s tech business members named procurement practices favoring domestic competitors as a regulatory obstacle. It was the highest percentage of any sector.
AmCham Shanghai President Eric Zheng acknowledged China’s national security concerns but said he hoped “normal procurement procedures will not be politicized so that US companies can compete fairly and pursue commercial opportunities … to benefit both countries.”
The U.S. Department of Commerce, China Electronics Corporation and China Electronics Technology Group Corporation did not return requests for comment.
HUAWEI PRIZED
Chinese tech conglomerate Huawei has emerged as the leading firm in this replacement cycle, according to three people familiar with China’s enterprise tech industry, who spoke on condition of anonymity given the sensitivity of the issue.
In 2022, Huawei’s enterprise business, which includes software and cloud computing operations, reported 133 billion yuan in sales, up 30% on the previous year.
One of the people said privately-held Huawei was seen as more nimble than state-owned groups in rolling out products and executing projects.
The other two sources highlighted Huawei’s broad product suite – spanning chips to software – as an advantage.
Clients also prize Huawei for its ability to process data on internal company servers and external cloud networks, as well as its wide offering of cybersecurity products, according to the employee of a China Tobacco tech supplier.
Huawei declined to comment.
The replacement drive has re-drawn entire sub-sectors of the software industry. The combined China market share held by five major foreign makers of database management systems – the majority of which are American – dropped from 57.3% in 2018 to 27.3% by the end of 2022, according to industry group IDC.
Despite heavy spending on domestic substitution, however, foreign firms are still dominant suppliers for banking and telecoms database management. Non-Chinese companies held 90% of market share for banking database systems at the end of 2022, according to EqualOcean, a tech consultancy.
Financial institutions are generally reluctant to switch database systems despite government pressure, said one of the industry sources, adding that they have higher stability requirements than many other sectors and local players cannot yet match their needs.
Even for personal computers, banks that switch from an international brand to China’s dominant supplier Lenovo would still be reliant on critical chip components provided by Western firms, one of the industry sources said.
($1 = 7.3165 Chinese yuan)
(Reporting by Beijing newsroom; Editing by Brenda Goh and Katerina Ang)
Column: How Walgreens, CVS and Rite Aid tried to take over healthcare — and failed
Michael Hiltzik – October 25, 2023
Think this will be your new healthcare provider? Not so fast. (Julie Gallant)
There was a time, in the misty, rose-hued past, when the three big drugstore chains look poised to take over the American healthcare system.
Drug retailer CVS and health insurer Aetna announced a $69-billion merger. Walgreens made a $5.2-billion investment in primary care provider VillageMD and took a $330-million stake in home care provider CareCentrix, giving it control of both firms. Rite Aid wasn’t as aggressive, but still built up its national footprint to 5,000 stores before cutting back to about 2,100.
The companies talked about evolving into one-stop medical providers so that “patients discharged from the hospital … will be able to stop at a health hub location to access services such as medication evaluations, home monitoring and use of durable medical equipment, as needed” (according to the merger announcement by CVS and Aetna).
We’re rightsizing the footprint and getting our expenses in the right place. We don’t see the growth coming fast enough in certain markets.
Walgreens executive John Driscoll admits the company’s healthcare ventures have been disappointing
The American Hospital Assn. issued an alarming report listing CVS and Walgreens among companies that had grabbed market share in “primary care, concierge medicine, virtual care, in-home medical services and elsewhere.”
It seemed that this trend might continue, as the pharmacy chains exploited their networks of stores on virtually every American corner.
That wasn’t so long ago. The CVS/Aetna merger was in 2017. Walgreens took over VillageMD in 2021 and CareCentrix just last year.
Now, however, their dream of playing a central role in a restructured nationwide healthcare system seems to be fading.
The pharmacy chains have discovered that taking a larger role in the healthcare system than simply dispensing prescriptions and selling over-the-counter notions is more complicated and costlier than they expected.
“It has taken us longer than anticipated to realize the cost synergies across the combined assets,” John P. Driscoll, the head of Walgreens’ U.S. Healthcare division, told investment analysts at the company’s fourth-quarter earnings conference call on Oct. 12.
He said VillageMD would be focusing on “our highest opportunity markets” — evidently affluent urban areas — by shutting down in five markets and closing 60 VillageMD clinics over the coming year.
“We’re rightsizing the footprint and getting our expenses in the right place,” he said. “We don’t see the growth coming fast enough in certain markets.”
At CVS, executives paint the effort to remake the company into an integrated healthcare provider as very much a work in progress.
“If you think about what’s happening in America relative to healthcare,” Chief Executive Karen Sue Lynch told investment analysts at a Morgan Stanley healthcare conference in September, “it’s … very hard for people to access care.”
She said the company’s goal is “to make sure that people have seamless connected experiences across the spectrum of healthcare. And I would argue that the businesses that we’re creating will enhance the value of consumer experience.”
The tendency of the American healthcare system to confound promises and expectations was underscored in 2021. That’s when billionaires Warren Buffett, Jeff Bezos and Jamie Dimon had to admit that their plan to solve the system’s problems, as if by sheer star power — well, to be fair, through “technology solutions” — had been obliterated.
The trio had announced their venture in 2018 to a blast of worldwide fanfare. If they couldn’t succeed, it was said, no one could. The idea was that there was some magic bullet for reducing healthcare costs that had evaded everyone for years, but that they could discover.
Less than three years later, they had been subjected to a ritual mortification. Their joint venture, christened Haven, shut down. For all their efforts, primary care had not become easier for millions of Americans to access, insurance benefits were as opaque and arcane as ever, and prescription drug pricing was still a public scandal.
The drug chains’ expansion strategies have exposed them to complexities in American healthcare — political controversies, Medicare regulations, issues of prescription drug pricing — that they had not faced in the their core businesses and have led to a string of unpleasant surprises.
Walgreens became embroiled in abortion politics in March, when it said it would not distribute or ship a drug used for medication abortions in at least 21 red states, including at least four where abortions were still legal.
The company made the announcement after a group of red state attorneys general threatened it with unspecified “consequences” for shipping the drug, mifepristone, the long-assumed legality of which had been challenged in federal court.
Walgreens’ national footprint made it vulnerable to the threat — and to a backlash from blue states such as California, where Gov. Gavin Newsom said he would stop the state from doing business with the company, or any other “that cowers to the extremists and puts women’s lives at risk.”
CVS ran into the buzzsaw of Medicare politics in August, when a New York state judge blocked the transfer of 250,000 Medicare patients to Aetna’s Medicare Advantage plan. The transfer was part of a contract worth $15 billion to Aetna over five years. Medicare Advantage plans provide more benefits to enrollees than traditional Medicare but have come under fire for costing the government too much for too scanty patient gains.
The company also disclosed a potential hit of $800 million to $1 billion in its 2024 operating income from a downgrade by government authorities in its Medicare quality rankings, known as “star ratings.”
The move of CVS into the pharmacy benefit manager business through its $24-billion acquisition of the Caremark PBM in 2007 also may not have worked out as it expected.
PBMs originated as middlemen to help health insurance plans process prescription claims, steer doctors and hospitals to the cheapest drug alternatives, and allow insurers to combine their customer bases for greater leverage in negotiations with drug manufacturers. Eventually they got blamed for driving up drug costs by extracting their own profits without producing sufficient discounts for their clients.
In August, Blue Shield of California rattled Caremark by cutting most of its ties with the PBM and turning over most of its responsibilities to four competitors, in a strategy aimed at cutting its prescription costs, which come to more than $600 billion annually, by as much as $500 million a year.
That was the second blow to Caremark in a year; in November managed care insurer Centene said it was turning pharmacy benefits for its 20 million enrollees over to Express Scripts starting next year, on a $35-billion contract.
The Blue Shield announcement drove the CVS stock price down by about 9%, a reaction that CEO Lynch called “overblown” at the Morgan Stanley conference. She also cast doubt on Blue Shield’s assertion that the PBM change would save it $500 million. “We’re not earning that kind of money on that account,” she said.
As for Rite Aid, that chain has problems all its own. The firm filed for bankruptcy protection on Oct. 16, citing a crushing debt load and excessive rent for underperforming stores. The company subsequently announced plans to close 154 stores, including 31 in California.
Rite Aid is also facing a federal lawsuit for allegedly filling unlawful prescriptions, mostly for opioids. It isn’t alone in being accused of complicity in the opioid crisis: In a 2022 legal settlement with state attorneys general, CVS agreed to pay as much as $4.9 billion over 10 years, Walgreens up to $5.52 billion over 15 years, and Walmart, which has become a major competitor in the pharmacy business, up to $2.74 billion within six years.
At this moment, it’s clear that pharmacy services remain overwhelmingly the drivers of revenue and profit for the drugstore chains. At CVS last year, pharmacy services and other retail sales provided $14 billion in operating profit on $275.8 billion in revenue, versus $6 billion in operating profit on $91.4 billion in revenue from healthcare benefits.
At Walgreens, retail pharmacy sales provided $3.7 billion in operating profit on $110.3 billion in revenue in the fiscal year ended Aug. 31, 2023, while U.S. healthcare generated a loss of $556 million on $6.6 billion in revenue.
One other factor stands between the drugstore chains and their ambitions to cast a wider net over American healthcare: The presence of well-heeled rivals with ideas of their own. Walmart, the nation’s largest retailer, offers customers low-priced prescriptions and telehealth services, and has been opening walk-in clinics around the country.
Then there’s Amazon, which may have felt burned by the failure of Haven, but acquired concierge care provider One Medical in February for $3.9 billion and offers its Amazon Prime members access to scores of generic medicines for a monthly fee.
The drugstore chains aren’t signaling that they’re giving up on their long-term goals — but warn investors that they may incur losses for years before the long term becomes the here and now.
They and their rivals in retailing and clinical services may well change the course of American healthcare in the future, but it should not be forgotten that they’re all fundamentally in it for the money. Their promises of cheaper, more efficient and more effective healthcare for the average American should be treated with the all-purpose medicine of a healthy skepticism.
Amazon Injuries More Widespread Than Thought, Study Says
Matt Day – October 25, 2023
In this article
(Bloomberg) — More than two-thirds of Amazon.com Inc. US warehouse workers surveyed by researchers reported that they took unpaid time off to recover from pain or exhaustion sustained on the job.
The new national study, published Wednesday by the University of Illinois Chicago’s Center for Urban Economic Development, found that 69% of workers surveyed stayed home without pay to recover, including 34% who did so three or more times.
The data suggest “injury and pain at Amazon are far more widespread” than previously known, said Beth Gutelius, research director at the center and a leading expert on logistics and warehouse work.
The report is based on a 98-question online survey that gathered responses from 1,484 warehouse workers in 451 facilities across 42 states, the researchers said. It was conducted between April and August and measured the percentage of workers who took time off during the previous month. Amazon employs hundreds of thousands of warehouse workers in the US.
Researchers found their subjects using ads on Meta Platforms Inc. apps, targeting people who listed Amazon as their employer or lived in areas where the company operates. The project received funding from the Ford Foundation, Oxfam America and the pro-labor nonprofit National Employment Law Project.
Amazon spokesperson Maureen Lynch Vogel said the report was “not a ‘study’ — it’s a survey done on social media, by groups with an ulterior motive.” She recommended that people read the safety data Amazon submits each year to the Occupational Safety and Health Administration, “which shows that rates in our buildings have improved significantly, and we’re slightly above the average in some areas and slightly below the average in others.”
Lynch Vogel acknowledged there is work to be done but that worker safety is a top priority and that Amazon continues to invest in safety throughout its operations.
The report, the broadest academic survey of Amazon workers to date, adds to the growing scrutiny of the company’s sprawling logistics operation. Amazon is the second-largest private-sector employer behind Walmart Inc., and employs about 29% of the country’s warehousing workers, the researchers estimate. That gives the company outsize influence over the industry’s working conditions and compensation.
Critics say Amazon pushes employees to work too hard and too quickly, leading to avoidable injuries. Workplace safety regulators in Amazon’s home state of Washington allege a direct connection between employee monitoring and discipline and musculoskeletal disorders suffered by its workers. The federal Occupational Safety and Health Administration, meanwhile, has cited Amazon for exposing workers to ergonomic risks at several facilities across the country.
Amazon says the regulators’ allegations are inaccurate and is challenging them, including during weeks of hearings held recently on the Washington state citations. The company says its investments in worker safety, including a push to automate repetitive and arduous tasks, are helping reduce the injury rate.
Gutelius and co-author Sanjay Pinto say 63% of workers acknowledged that Amazon has made safety a high priority. But many suffer injuries anyway, and workers who say they have trouble keeping up are more likely to be hurt on the job, according to Gutelius.
“The harder it is for a worker to maintain the pace of work, the more likely it is that they are injured,” she said.
Employees also suffered work-related mental health issues. More than half of those surveyed reported feeling burned out. The portion of workers reporting burnout increases with job tenure, the researchers say.
The researchers excluded results that didn’t take the questions seriously or appeared to feign employment with Amazon. Managers and drivers were also excluded. Responses were weighted to align demographically with Amazon’s own published statistics on the racial and gender breakdowns of its workforce.
Overall, 41% of workers reported being injured while working at an Amazon warehouse. The share rises to 51% for people who have worked at the company for more than three years.
“They are taking some steps, but tinkering around the margins isn’t going to work,” Pinto said of Amazon’s attempts to reduce injuries within its ranks. “There’s something fundamental about the system that needs to change.”
(Updates with Amazon comment, details on project funders, starting in the fifth paragraph. A previous version of this story was corrected to remove Princeton as a study funder in penultimate paragraph.)
Editorial: Fla. attorney general moves to silence voters once again
Sun Sentinel Editorial Board – October 24, 2023
Joe Raedle/Getty Images North America/TNS
Attorney General Ashley Moody won’t be satisfied with simply banning abortion in Florida, at which she appears close to success. She also intends to prevent voters from doing anything about it.
Moody has notified the Florida Supreme Court that she will ask it to rule against placing a constitutional initiative guaranteeing abortion rights on the November 2024 ballot.
The drive has collected signatures from more than 400,000 voters toward a required goal of nearly 900,000. Sponsors and supporters have spent more than $9.7 million in anticipation of Florida Supreme Court rulings that would effectively abolish abortion in Florida.
The initiative would change the constitution to say that “No law shall prohibit, penalize, delay, or restrict abortion before viability or when necessary to protect the patient’s health, as determined by the patient’s healthcare providers.” It would not affect an existing provision dealing with parental notification.
A focus on ‘viability’
Moody telegraphed her strategy in an opinion essay to Florida newspapers, arguing that the language of the ballot summary and the amendment is ambiguous and would mislead voters.
“As any mother knows, ‘viability’ has two meanings when it comes to pregnancy,” Moody wrote.
Some women, according to Moody, relate viability to the risk of miscarriage, while others take it to mean when a fetus can survive outside the womb.
She wrote that the American College of Obstetricians and Gynecologists, which supports abortion rights, “notes the two medical definitions.”
What’s misleading is Moody’s misrepresentation of where the American College actually stands on that definition. There is nothing misleading about the term viability so long as doctors are defining it — and they are the only ones who should.
The full definition
This is precisely how doctors define it: “Viability is the capacity of the fetus to survive outside the mother’s uterus. Whether or not this capacity exists is a medical determination, may vary with each pregnancy, and is a matter for the judgment of the responsible attending physician.” (Emphasis added).
Moody did not quote that.
Most commonly, viability is calculated at 23 or 24 weeks of gestation. It is not, and never should be, a matter for meddling or ambitious politicians like Moody.
Moody has consistently been on the wrong side of a woman’s right to her own body. In a pending case being watched nationally, she has urged the court to repeal its historic 1989 decision that Florida’s constitutional right of privacy protects abortion rights.
Were the court to do that, it would effectively limit privacy protection to the release of public records — a faint shred of how the court defined it in 1989.
The court, then and now
“Florida’s privacy provision is clearly implicated in a woman’s decision of whether or not to continue her pregnancy,” Justice Leander Shaw wrote at the time. “We can conceive of few more personal or private decisions concerning one’s body that one can make in the course of a lifetime.”
Restricting the provision, as Moody and the Legislature want the court to do, would expose almost any personal conduct to political control, from end-of-life decisions to the availability of contraception. Parental rights could, and likely would, be subject to unlimited interference by the state.
The pending case involves the constitutionality of Florida’s current ban on abortions past 15 weeks, but a law the Legislature passed this spring automatically caps the procedure at six weeks, a time when many women don’t know they are pregnant, if the court upholds the 15-week ban.
In what appears to be a clear breach of judicial ethics, Justice Charles Canady has been participating in the case despite the interest of his wife, state Rep. Jennifer Canady, R-Lakeland, as a co-sponsor of the six-week abortion ban, which passed as SB 300.
Moody and the Legislature are contemptuous of how the voters spoke nine years ago on a ballot proposal by lawmakers that would have expressly overruled the 1989 precedent. It would have narrowed privacy rights to those determined by the U.S. Supreme Court under the federal constitution. The vote was 4.3 million against and 3.5 million in favor. Had it passed, there would be no privacy rights in Florida because of the high court’s subsequent decision repealing Roe v. Wade.
Hostility toward voters
Moody’s quibbling over “viability” is in line with her hostility to giving voters a voice on other controversial citizen-sponsored amendments. She opposes those dealing with marijuana. Even after Parkland, she sided with the gun lobby in persuading the court to not allow a statewide vote on banning assault weapons.
The attorney general is required to petition the court to rule on proposed initiatives when they hit a threshold of verified signatures. The abortion question qualified with 222,881. Moody is not required to oppose them. It is difficult to conceive of any dealing with abortion rights, marijuana legalization or guns to which she would not manufacture an objection.
The job of Florida attorney general has long been called “the people’s lawyer.” Moody is not.
The Sun Sentinel Editorial Board consists of Editorial Page Editor Steve Bousquet, Deputy Editorial Page Editor Dan Sweeney, editorial writer Martin Dyckman and Editor-in-Chief Julie Anderson. Editorials are the opinion of the Board and written by one of its members or a designee. To contact us, email atletters@sun-sentinel.com.
