Kristof, Bruni and Collins

In “When Crime Pays: J&J’s Drug Risperdal” Mr. Kristof says marketing the antipsychotic got Johnson & Johnson a criminal record, big settlement costs and penalties — and bigger profits.  Mr. Bruni had “An Overdose of Donald Trump at the G.O.P. Debate,” and says the second meeting of Republican candidates often revolved around the supposedly entertaining billionaire, and that isn’t amusing.  Ms. Collins watched too.  In “At Debate, Republicans Talk the Talk” she says some of the 15 candidates on stage said things to catch viewers’ attention, but it took five long hours to hear them through.  Here’s Mr. Kristof:

Risperdal is a billion-dollar antipsychotic medicine with real benefits — and a few unfortunate side effects.

It can cause strokes among the elderly. And it can cause boys to grow large, pendulous breasts; one boy developed a 46DD bust.

Yet Johnson & Johnson marketed Risperdal aggressively to the elderly and to boys while allegedly manipulating and hiding the data about breast development. J&J got caught, pleaded guilty to a crime and has paid more than $2 billion in penalties and settlements. But that pales next to some $30 billion in sales of Risperdal around the world.

In short, crime pays, if you’re a major corporation.

Oh, and the person who was in charge of marketing the drug in these ways? He is Alex Gorsky, who was rewarded by being elevated to C.E.O. of J&J. He earned $25 million last year.

This tale is told in a devastating 58,000-word epic by Steven Brill that is being serialized on The Huffington Post. Some has already been covered in The Times and other papers, or in Senate investigations and innumerable court decisions, but it’s still wrenching to read the comprehensive account of how a company put profit above everything and then benefited handsomely for doing so.

The story begins when J&J’s previous antipsychotic medicine ended its patent life, so sales plunged as generics gained market share. In 1994, J&J released Risperdal as a successor, but the Food and Drug Administration said it wasn’t necessarily better than the previous version and in any case was effective primarily for schizophrenia in adults. That’s a small market, and J&J was more ambitious. It wanted a blockbuster with annual revenues of at least $1 billion.

So J&J reinvented Risperdal as a drug for a broad range of problems, targeting everyone from seniors with dementia to children with autism.

The company also turned to corporate welfare: It paid doctors and others consulting fees and successfully lobbied for Texas to adopt Risperdal in place of generics. This meant that the state paid $3,000 a year for each Medicaid patient taking it, rather than $250 a year for each, Brill says.

Building on that, J&J reached out to Omnicare, a company that provided pharmaceutical services in nursing homes. The two companies cut a deal so that Omnicare doctors would prescribe Risperdal, and the profits would be shared with Omnicare. (Yes, that’s called a kickback.)

Even though Risperdal wasn’t approved for the elderly, J&J formed a sales force, called ElderCare, with 136 people to market it to seniors. The F.D.A. protested and noted that there were “an excess number of deaths” among the elderly who took the drug.

J&J seems to have shrugged. It was making vast sums, and the F.D.A. didn’t have teeth.

At the same time, J&J was also expanding into another forbidden market: children. The company began peddling the drug to pediatricians, so that by 2000, more than one-fifth of Risperdal was going to children and adolescents.

In 2003, the company had a “back to school” marketing campaign for Risperdal, and a manager discussed including “lollipops and small toys” in sample packages, Brill says.

All this was great for business, and by 2004 Risperdal was a $3-billion-a-year drug.

One challenge was that a J&J study had found that Risperdal led 5.5 percent of boys to develop large breasts, a condition known as gynecomastia. J&J covered this up, Brill says, quoting internal documents.

I asked J&J and Gorsky for comment. In particular, I wanted to understand why an executive who presided for years over conduct that the company conceded was criminal had been elevated to chief executive.

Gorsky declined to comment, and a company spokesman, Ernie Knewitz, didn’t really want to have that conversation. Knewitz did say the company “vehemently” disagrees with Brill’s take, denies a cover-up and considers Risperdal a useful drug with real benefits.

He’s right: Risperdal is a good drug that helps people. But it was marketed too broadly, and the system failed to protect consumers.

Brill calculates J&J may in the end have to pay a total of $6 billion in settlements for its misconduct. But he estimates the company made $18 billion in profits on Risperdal, just within the United States (on $20 billion in domestic sales, and there was $10 billion more in sales abroad).

Last week the Appeal of Conscience Foundation, an interfaith organization, announced it would honor Gorsky with an award as a “man of integrity” and a “corporate leader with a sense of social responsibility.”

So even though the company was caught, criminality paid off, for the company and for executives.

That’s why we need tougher enforcement of safety regulations, and why white-collar criminals need to be prosecuted (as Attorney General Loretta Lynch has promised will happen).

Risperdal is a cautionary tale: When we allow businesses to profit from crimes, we all lose.

Next up we have Mr. Bruni:

It was a debate that worked almost in spite of itself.

As the hours dragged on, the issues were indeed hashed out: whether a Republican president should immediately tear up the Iran deal or wait and see; whether the federal government should be shut down in the service of defunding Planned Parenthood; whether a wall along the Mexican border is a feasible plan or empty bluster.

But that substance had to muscle its way through the show business, by which I mean Donald Trump’s attempt to turn everything into an adolescent popularity contest and CNN’s willingness to reward that by filtering the entire evening through the prism of the Republican field’s proven ratings magnet: Trump, Trump, Trump.

What did Trump think of something mean that someone else on the stage had said about him? What did someone else think about something nasty that Trump had said about him or her?

Trump had insulted Jeb Bush’s wife: Discuss! Trump had insulted Carly Fiorina’s business career: Respond!

So it went, somewhat tediously and surreally, for many stretches of the debate on Wednesday night and especially for the first half-hour, during which Rand Paul took the precise measure of — and raised the correct question about — the egomaniacal front-runner.

“Do we want someone with that kind of character, that kind of careless language, to be negotiating with Putin?” Paul asked.

“I think really there’s a sophomoric quality that is entertaining about Mr. Trump, but I am worried,” he added, and I nodded so vigorously at the “worried” part that I’m going to need balm and a neck brace tomorrow.

Paul went on to single out Trump’s “visceral response to attack people on their appearance — short, tall, fat, ugly. My goodness, that happened in junior high. Are we not way above that?”

No, we aren’t. Or at least Trump isn’t. And “junior high” is too easy on him, too kind. Trump comes from, and belongs in, the sandbox, as he demonstrated the second that Paul paused and Trump fired back: “I never attacked him on his look, and believe me, there’s plenty of subject matter right there.”

How lovely. And how adult. And less than an hour later, Fiorina had to stand there and try not to squirm as she was asked to react to Trump’s recent comments about her in a Rolling Stone interview: “Look at that face. Would anyone vote for that?”

Fiorina held her head, including her face, high. “I think women all over this country heard very clearly what Mr. Trump said,” she stated tightly, and with more dignity than Trump or the situation deserved.

Trump rushed in: “I think she’s got a beautiful face and I think she’s a beautiful woman.” Watch out, Carly. Next comes an invitation for a private ride in his Trump-i-copter.

I mentioned my nodding, but my real injuries came from shaking my head, over and over, because I couldn’t quite believe the Trump-centric nature of it all. I’m still mystified that he’s done this well in the polls for this long.

I know that Americans have lost faith in institutions — understandably. I know that Americans are turned off by politics as usual — justly.

But have we sunk to a point where we’re prepared to reach for someone so careless with his insinuations, so merrily and irresponsibly ignorant, that he used some of his precious time on Wednesday night to fan irrational, repudiated fears about a link between vaccines and autism?

Are we buoyed by a bully who calls anyone who disagrees with him a “loser,” promises vaguely that his presidency will be “unbelievable” (his favorite adjective, and an unintentionally telling one), and presents little besides his tumescent ego and stagey rage?

The CNN anchor Jake Tapper, who was the debate’s moderator, pressed hard to get Trump to say, with even a scintilla of specificity, why he believes that he’d be more effective in dealing with Vladimir Putin than Obama has been.

And all that Trump could muster was: “I would get along with him.”

How? Why? Not a single detail. But Trump doesn’t do details. He just crows that he will know the most, be the best and win. He’s a broken record of grandiose, self-infatuated music.

The most satisfying, encouraging moments of the debate were those when other candidates tried to point that out directly or indirectly. Chris Christie did so several times. During his opening remarks, he asked the camera to move from him to the audience, saying that the election isn’t really about the candidates, who soak up the spotlight, but the people, who deal with the consequences.

He returned to that idea after Trump and Fiorina wrangled over her past performance as the chief executive of Hewlett-Packard, an exchange that followed much tussling over Trump’s business bona fides.

“While I’m as entertained as anyone by this personal back-and-forth about the history of Donald and Carly’s career, for the 55-year-old construction worker out in that audience tonight who doesn’t have a job, who can’t fund his child’s education, I’ve got to tell you the truth — they could care less about your careers,” Christie said to Trump and Fiorina.

“You’re both successful people,” he continued. “Congratulations.” But then he pleaded that there be more discussion of issues and an end to “this childish back-and-forth between the two of you.”

Mike Huckabee built on that, bemoaning “a lot of back-and-forth about ‘I’m the only one who has done this, the only one who has done that, I’ve done great things.’ We’ve all done great things or we wouldn’t be on this stage.”

During the second half of the debate in particular, the conversation moved far enough away from Trump for all of the candidates to strut their stuff, for whatever that stuff was worth.

But because there were eleven of them, those struts were so brief and sporadic that I don’t think anyone’s fortunes will be significantly changed.

Marco Rubio showed great confidence about foreign affairs. Fiorina’s crispness came through. John Kasich seemed to vanish for long chunks but, when present, managed to be both avuncular and authoritative: an effective, appealing combination.

Cruz predictably won the awards for Most Strident and Most Smarmy, talking directly to the camera rather than whoever had asked him a question. Carson was the anti-Trump, as docile as Trump was domineering, and he brilliantly sought to reeducate Trump on vaccines.

Did Bush find some spine and spark? Yes, but he seemed to fumble for it. He picked a fight with Trump about casinos in Florida. He spoke succinctly about his brother’s administration, no longer pantomiming a deer in headlights. He made a marijuana joke and then another joke, about his energy level, saying that he’d want his Secret Service nickname to be “Eveready.” Like the battery.

But there remains something wan about him: In a season of such garish colors, he always looks a little pale.

He’s not enough of a clown, and Trump has done his best to turn this into a circus, erasing the blurry line between entertainment and politics and beckoning commentators and networks toward uncharted summits of breathlessness.

“It is electric,” Anderson Cooper said to Wolf Blitzer in the hours before the debate began, describing the atmosphere.

“It doesn’t get much bigger than this,” Blitzer said to Cooper, and he repeatedly interrupted the pundits around him to provide updates on whether Trump had been spotted yet at the Reagan library, where the debate was held.

“Donald Trump, we’re told, is arriving!” Blitzer trumpeted at one point, minutes later adding: “Hold on! Hold on! . . . He’s walking in right now.” The camera documented it, step after step.

Were we supposed to get goose bumps? I just felt queasy.

Well…  That was much longer than it needed to be.  And now we get to Ms. Collins:

Our national attention span is … short. The Republican presidential primary debate on Wednesday was … long. Really, if you throw in the earlier loser debate, it was the longest ever.

The Lincoln-Douglas debates would go on for three hours. But that was back when in many towns, the most exciting public activity of the year was pole-raising.

Are people going to remember the shallow, sassy Donald Trump from the first half-hour? (“I wrote ‘The Art of the Deal.’ I say not in a braggadocio’s way I’ve made billions and billions of dollars.”)

Or the middle-section Trump who clearly didn’t have a clue about how to critique President Obama’s Syrian policy? (“Somehow he just doesn’t have courage. There’s something missing from our president.”)

And then there was the completely, unbelievably irresponsible Trump of the finale who claimed he knew people whose daughter got autism from a vaccine shot. (This happened, he said, to “people that work for me just the other day.”)

Remember when the vaccination issue destroyed Michele Bachmann’s political career? One can only hope.

Of course everyone wanted to hear Jeb Bush take on the front-runner. Smackdown! Bush got his opportunity very early. Where would he go? Immigration? Taxes? Foreign affairs?

Bush accused Trump of giving him campaign donations in order to get casino gambling in Florida.

“Totally false,” said Trump. “I promise if I wanted it, I would have gotten it.”

Do you think that’s what Bush was practicing over the last couple of weeks? There were six or seven people on the stage who sounded more forceful than he did. A recent poll in Florida suggested that only 52 percent of Florida Republicans want their former governor to continue running for president. At times on Wednesday, that seemed like overenthusiasm.

Bush perked up a little in the middle, when he volunteered that he’d smoked marijuana in his youth. Then at the end, when he was asked what woman he’d like to see on the 10-dollar bill, he said … Margaret Thatcher.

Nobody wanted to deal with the global warming issue. Virtually everybody made up a Planned Parenthood scenario that never existed. Ah, Republicans …

And in other activities, Carly Fiorina managed to yet again drop the name “my good friend … Bibi Netanyahu.” Gov. Scott Walker of Wisconsin repeated his previous debate trick of vanishing entirely into the scenery. Walker’s poll numbers are vanishing, too, and it appears his only playing card is to remind people that he fought against public employee unions. Lately he’s been desperately upping the anti-union ante so much that his next step would have to be demanding that federal employees be prohibited from talking with one another outside of work.

Marco Rubio — remember Marco Rubio? The senator who vanished all summer except the time he hit the kid in the head with a football? He definitely looked rested.

Ben Carson, at one point, appeared to be accusing Trump of socialism.

Chris Christie did pretty well. Too bad he’s such a terrible governor. New Jersey would rather have another traffic crisis at the George Washington Bridge than vote again for Chris Christie.

What do you think it is about governors in this race? Florida is deeply unenthusiastic about Jeb Bush, Wisconsin seems to hate Scott Walker, and if Louisiana had a chance to get its hands on Bobby Jindal, God knows what would happen.

The debate went on for so long it was a wonder no one fainted. And think about the viewers who made it all the way from the first segment — the one where the CNN preview featured a zipper at the bottom of the screen announcing, “PATAKI ARRIVES AT DEBATE HALL.”

“The first four questions are about Donald Trump!” former Gov. George Pataki complained. Senator Lindsey Graham repeatedly slid in the fact that his parents ran a bar and a poolroom. Graham insists he’s really enjoying himself, although when someone keeps saying “I’m running because I think the world is falling apart,” it’s sort of a downer.

Former Senator Rick Santorum and Governor Jindal tried so hard to break through the barrier of national indifference they sounded like rabid otters.

Yes, some political junkies watched Republicans debating for almost five hours Wednesday. This should be a message to the Democrats. Right now the party is engaged in a fight about whether its schedule of three debates in 2015 is too puny. There are a number of democratic nations in the world where you could easily overcome this argument by pointing out that the election is not until 2016.

But the American people are fine with more debates. Honest, there can be one every night as long as the American people are not actually forced to watch them. It could be a kind of endurance contest. Last person standing gets the nomination.

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One Response to “Kristof, Bruni and Collins”

  1. The Wizard Says:

    Get the glue sticks kids we’re about to bust open the political story of the year. Big Pharma lobbies. Presidential candidates dote on about themselves. Never mind that Bush refers to the void in Syria as a manageable operation. I’m waiting to exhale how democracy worked in Iraq and Egypt. How the Afghan forces are on their own. The worst news is one of these doobies is about to be crowned and there isn’t anyone who can beat them. Bernie Sanders? U R Kidding right? Hillary? Hated. Feingold? Not ready for prime time. We’re stuck with lobbyists and toddlers. And the CEO made what, twenty-five mill. Brady makes more than that. Jon Stewart reportedly got paid 30 by CC!!

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