A little-known pharmaceutical company that made billions selling opioids 'escapes' billions in fines and IRS payments

Endo began in 1920 as "Intravenous Products of America." Its website does not mention opioids;
instead it highlights the company's "past successes and history of expertise." (Endo photo)

A lesser-known pharmaceutical company named Endo made billions of dollars during the U.S. prescription opioid crisis by marketing its flagship opioid, Opana ER, as safe and non-addictive.

Despite whistleblower suits from Endo employees, the U.S. Department of Justice failed to pursue Endo, even as it vigorously prosecuted Purdue Pharma for its part in the opioid crisis, report Bob Fernandez of ProPublica and Craig R. McCoy of The Philadelphia Inquirer. The DOJ's investigative delay and the company's clever bankruptcy exit strategy allowed Endo to "escape $1.5 billion in fines and forfeitures" it owed and billions more "officials said it owed the U.S. government."

When the DOJ finally moved to prosecute Endo for its part in the opioid crisis, the company was bankrupt. "In what amounted to a liability fire sale by the Justice Department, the company’s woes with the federal government would all be resolved by a $200 million payment," Fernandez and McCoy explain. "In sentencing Endo in federal court Judge Linda Parker wondered how the amount paid to the U.S. could be so low. Parker said, 'I just don’t understand how it went from $1 billion to $200 million.' Federal prosecutor Benjamin Cornfeld explained: Endo was broke."

While Endo's 2024 financial troubles were real, a deeper look at the DOJ's delay after winning a criminal case against Endo in 2014, revealed how in those intervening years allowed Endo "vastly expanded its narcotic-pill empire before executing a corporate escape plan," Fernandez and McCoy write. "The plan allowed Endo to restructure its debt to retain control of the company and hand out $95 million in executive bonuses before seeking protection in bankruptcy."

DOJ's settlement with Endo concluded some of the company's financial troubles and "also mostly erased claims of another $1.5 billion for false health care billing and Medicare costs generated by the opioid crisis." In addition, "Endo paid a tiny fraction — three pennies on the dollar — of the $7 billion that officials said it owed the U.S. government, including $4 billion in taxes," Fernandez and McCoy explain. "Hundreds of lawyers, paralegals and financial advisers litigated Endo’s bankruptcy, billing more than $350 million. . . . Individual opioid victims didn’t fare as well. They got just $40 million from Endo — a sum that works out to about $1,000 per victim."

Southern timber owners could benefit from plan to create electricity and carbon credits by burning wood chips

The U.S. Pine Belt is filled with fast-growing Loblolly
pines. (Reddit map)

 

United Kingdom power producer Drax is scouting locations in America's Pine Belt to "build electricity generators fueled by burning wood chips," reports Ryan Dezember of The Wall Street Journal. "The plants’ exhaust will be piped underground instead of out of smokestacks, which generates lucrative carbon credits for which Drax is already lining up buyers." The company plans to sell its electricity to data center companies looking to fuel their artificial intelligence operations.

The plan could be an economic game changer for the U.S. South "where pulp and paper mills have closed and left timber growers without buyers for those trees unfit for making lumber or poles," Dezember explains. "Biomass power has long been dangled before Southern timberland owners as a potential solution to the glut of pine that has depressed prices and complicated harvests."

Drax's UK facility "burns pellets of compressed sawdust in a converted coal-fueled power plant," which fuels roughly 5% of the country's electricity. It already runs several U.S. pellet mills that fuel its UK operation, Dezember writes. The planned U.S. plant will be a BECCS, short for bioenergy with carbon capture and storage. The company plans to provide 24/7 renewable energy for AI data centers.

Drax is pinpointing locations that have all the elements it needs, which include a "confluence of carbon dioxide pipelines, pine plantations and a short wait to connect to the grid," Dezember reports. "It has options on properties and expects to announce a location for the first plant in 2025."

The company has sought timber managers who will manage forests without stressing their ecosystems, and it "plans to buy wood only from properties managed for timber production, not old-growth stands," Dezember explains. "Nor will the plants need the wood to be ground down to dust and pressed into pellets, which are made to facilitate ocean shipping. The U.S. power plants will only need the wood chipped into small pieces."

Understanding what pharmacy benefit managers are reveals flaws and solutions in U.S. drug pricing and selling system

Not all PBM savings are passed along to members.
(Adobe Stock photo)

Despite a deluge of news information discussing the unfair pricing practices of pharmacy benefit managers, what they are and what they do may still be a mystery. James B. Rebitzer, an economics professor at Boston University, provides some answers in his Q&A for The Conversation.

What are pharmacy benefit managers?
During the 1960s, PBMs "became essential middlemen [companies] between drugmakers and the many insurers, employers and government entities who purchase drugs on behalf of their members. . . . These companies negotiate price, affordability and access to prescription drugs. They do this by operating and designing formularies, which are lists of drugs that insurers cover.

Formularies assign drugs to different tiers that determine what patients must pay out of pocket to access the drug. . . . Tier placement determines how affordable a medication is to consumers and the effective drug price that insurers pay. . . .The price at which the PBM obtains the drug for its clients is the net price – the list price minus the drugmaker’s discount. . . . If a drugmaker increases its rebate, the net price falls, even if the publicly posted list prices remain high. This is why focusing on list prices to determine the cost of a drug can be misleading."

Are PBMs working to decrease their clients' costs or increase their profits?
Both. "If the contest for formulary placement works as it should, competition compels drugmakers to offer substantial discounts off the published list price. As a result, insurers and consumers benefit from a reduced net price for drugs. However, formulary competition can be undermined in various ways. . . . Competition within the formulary can also be distorted when drugmakers post very high list prices. This artificially inflates rebates for PBMs without lowering net prices for insurers and other parties."

How does market competition figure into PBM activity?
"The current regulatory environment in the U.S. tolerates overly large PBMs that engage in anticompetitive practices to accumulate excessive profits. Without strong competitors, dominant PBMs are free to charge their customers high fees and keep a larger portion of drugmaker rebates for themselves. . . . In theory, this problem should be self-correcting. . . . High profits should attract new competitors into the industry." But the chances for scrappy upstarts to survive are also limited by the industry's current PBMs' dominance.

Who are the villians?
The concentration of power is the problem. "If we didn’t have PBMs, we would need to invent them – or something like them – to obtain reasonable prices on patented drugs. But the concentration of market power among a few companies threatens to dissipate the value they create. A more competitive and transparent market for PBM services will help keep that contest fair and transparent – to the benefit of customers and society. . . . In that sense, PBMs aren’t the villain. Too much market power in too few hands is the problem, and that’s something more competition, sensible regulation and vocal consumers might fix."

Leaders and economists worry over what Trump's planned tariffs might do to business profits and consumer wallets

Businesses and U.S. economists are worried about how tariffs
could impact profits and American budgets. (Adobe Stock photo)

World leaders and CEOs are working to convince President-elect Donald Trump to reconsider his hard-line plans for tariffs against the country's biggest trade partners, which could "disrupt global trade and pummel profits," report Andrew Ross Sorkin, Ravi Mattu, Bernhard Warner, Sarah Kessler, Michael J. de la Merced, Lauren Hirsch and Tariq Panja of The New York Times. They "feel they’re making little headway in warning him of the consequences." Meanwhile, if Trump makes good on his threatened levies, U.S. consumers will likely pay higher prices.

Trump's first tariff announcements targeted Canada, Mexico and China. He said "he would impose 25% levies on Canada and Mexico, if they didn’t tighten their borders and stem the flow of illegal migration to the U.S.," The Times reports. "In subsequent social media posts, he went after BRICS countries," which include Brazil, Russia, India, China and South Africa, and other emerging markets.

Even though many Americans list high inflation, particularly on groceries and household staples, as a primary concern, "Trump conceded that he 'can’t guarantee tariffs won’t hit consumers hard," the Times reports. "That’s a concern among economists and big companies such as Walmart and Costco, who fear that levies could lead to price rises."

An estimate from The Budget Lab at Yale "found that the cost to consumers from Trump’s proposed tariffs could reach as much as $1,200 in lost purchasing power on average based on 2023 incomes, assuming retaliatory duties on U.S. exports are put into place," reports Rob Wile of NBC News. "While Trump has insisted other countries end up paying the cost of tariffs, most economists agree those costs wind up getting passed on to shoppers."

The National Retail Federation warned about "the impact of tariffs to everyday households," Wile writes. "Some Trump allies suggested the president-elect doesn’t actually plan to follow through with the proposed tariffs. . . . Rep. Dan Crenshaw, R-Texas, conceded, 'Tariffs will hurt the American consumer, that’s true. But they also make for good negotiation tools.'"

An Rx for American anger: Imagination, courageous peace-seeking and a collective will for something better for all

Graphic via MedPage

One look at social media posts or comments on newspaper stories, and it's easy to see why some Americans believe the mood of the country can be described as angry.

"This goes beyond malaise," writes psychiatrist Arthur Lazarus in his opinion for MedPage. This mood "signals something deeper. . . It isn't just dissatisfaction or unrest; it's a simmering anger, a wellspring of cynicism so powerful it spills over. . . . Our collective capacity for hope, patience, and even basic kindness seems to be eroding."

Why are Americans so angry? Lazarus writes, "At the heart of this phenomenon is a growing sense of betrayal -- by leaders, by institutions, by systems that promised stability, fairness, and opportunity. For decades, Americans have been sold visions of progress. . . But for many, these promises have proven illusory. . . . When a society feels full of "pervasive negativity," it's natural for humans to "armor up with cynicism" versus exposing feelings of hopelessness.

To make a way forward, we need to "go beyond anger," Lazarus explains. "Beneath the surface lies a yearning for something better -- a system that doesn't exploit, leaders who don't betray, and communities that support rather than divide. . . . Hope isn't naïve, nor is kindness. These qualities are necessary for the repair work ahead."

Reinvigorating courage and peace as American values can help change how we respond to adversity. Lazarus adds, "During the Civil Rights Movement, Martin Luther King Jr. championed peaceful protest and non-violent resistance as a form of courage. Sit-ins, marches, and boycotts challenged segregation and systemic racism without resorting to violence, even in the face of brutality."

Using current frustration as an energy to power change and innovation in U.S. health care models could also help. "Imagination in health care is often about seeing beyond immediate limitations to create systems that better serve humanity," Lazarus writes. "A compelling example is the transformation of Rwanda's health system."

A collective will to persevere together to make things better is an American ideal from the colonial period that can course-correct some of today's pessimism. Lazarus add, "In moments of crisis, it is tempting to retreat into cynicism or inaction. But previous challenges remind us that courage, imagination, and the will to rebuild are antidotes to despair."

Arthur Lazarus, MD is an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine, including Medicine on Fire: A Narrative Travelogueopens and Story Treasures: Medical Essays and Insights in the Narrative Tradition.

Rural journalists can receive funding for computer-assisted reporting training

Journalists who work at smaller news organizations with a significant rural audience can apply for fellowships that cover much of the cost of attending an IRE training bootcamp for computer-assisted reporting. The goal of the fellowships is to help journalists at these organizations learn how to do important investigative stories that provide a public service for people in rural communities.

The deadline is Jan. 6 to apply for the March 24-28 bootcamp, which will be held at the University of Missouri’s School of Journalism in Columbia, Mo. That bootcamp is meant for beginners in data-driven journalism or journalists with minimal data experience.

According to IRE, a “Data Journalism Bootcamp equips journalists across all beats and media platforms with essential data skills. These weeklong, intensive sessions are designed to make data analysis accessible — even for beginners. If you’re new to data journalism, our March and August bootcamps are perfect, as they focus on Google Sheets.”

The deadline to apply for fellowships to attend the Aug. 4-8 bootcamp is May 6.

The Rural Computer-Assisted Reporting fellowships (R-CAR) are provided through a fund created by journalist Daniel Gilbert, who won the 2010 Pulitzer Prize for public service and a Scripps Howard Foundation National Journalism Award for community journalism for a series of stories about the mismanagement of natural gas royalties in southwest Virginia.

His donation of the $10,000 prize for the National Journalism Award was matched by the Scripps Howard Foundation and funds through a Kentucky state program. The funds are housed in an endowment as part of the Institute for Rural Journalism and Community Issues at the University of Kentucky.

The R-CAR fellowships cover registration costs for the bootcamp (up to $1,250 value), a one-year IRE membership or renewal, and a travel stipend of up to $500.

For more information or to apply, go to https://www.ire.org/training/fellowships-and-scholarships/r-car-fellowship/

AI news: Humans write the news only to have bots steal and repost it 'under stolen or assumed identities'

AI "reporters" plagiarize stories from real publications
written by humans. (Graphic by AI robot, Adobe Stock)

Artificial intelligence bots revived a closed small-town newspaper site using culled stories and stolen reporters' names. "The defunct Daily Tidings was alive and kicking, sending out fresh stories again," reports Danny Westneat of The Seattle Times. "The site’s masthead showed eight reporters — a ton for tiny Ashland, Oregon. . . . As Oregon Public Broadcasting revealed this past week in an investigation, the entire site now is reported and written by artificial intelligence bots, under stolen or assumed identities."

"One 'reporter' they tracked down actually lives in the United Kingdom and had no clue he was practicing journalism in southern Oregon," Westneat explains. "The site pumps out about five stories a day — most of them cribbed from real publications, such as Ashland News or The Oregonian, and rewritten by AI programs." The site boasts ads and videos from "big ad-streaming companies such as Google."

The Daily Tidings past owner "told OPB he looked into suing the AI operation — whoever or whatever it is," Westneat reports. "His lawyers though said it’s coming from outside the United States, likely China. It would be 'pursuing a phantom.'"

Ashland's robot news spot isn't unique. "Sites are popping up everywhere using AI bots to create the vague appearance of journalism, usually by rewriting or repurposing articles culled from the real local media," Westneat reports. "AI tools have been developed, such as one depressingly called Spin Rewriter, that can digest an article and convert it into 1,000 'human-quality' facsimile articles."

In Seattle, the "Hoodline" news site produces stories by bots. A former human Hoodline employee, who lost her job to AI, told Westneat, "Old-fashioned shoe-leather reporting has been replaced by fake people who’ve never set foot in any of the neighborhoods they write about — because they don’t have feet."

The editor of the Ashland News, Bert Etling, "says that in Ashland, the scam journalism has been mostly just annoying," Westneat reports. "It’s a plagiarism operation, so the real town news source, his Ashland News, isn’t at much risk of getting scooped. . . . But it isn’t helping that gnawing sense that nobody believes anything anymore."

Opinion: No American should go hungry. Supporting food banks and policy changes are part of the solution.

The U.S. exported 2.26 billion bushels of soybeans
in 2022. (Adobe Stock photo)

The United States is a top global producer of corn, wheat, soybeans, sugarcane, potatoes and rice. In terms of exports, it exceeds all other countries by trading more than 20% of what it grows. With all the food grown and exported, why do so many Americans live with food insecurity? They shouldn't, writes The New York Times editorial board.

One measure of how many Americans go hungry is the number of meals served by Feeding America in 2023: an astonishing 5.3 billion. "In a country of more than 330 million people, it is evidence of how widespread and persistent food insecurity remains," they write. "Food insecurity is defined by the Department of Agriculture as the lack of access to enough food for an active and healthy life. . . . In some of the poorest regions of America, mostly rural areas in the South, food insecurity among children is as high as 48%. But it is present in every county in the country."

Even as local, state and federal governments work to address how to feed everyone adequately, "Feeding America, a network of roughly 200 food banks and 60,000 food pantries and meal programs, is filling the void every day for tens of millions of Americans," they write. "Feeding America needs help to continue this essential frontline work. The average cost of a single meal may be only $3.99, but when that is multiplied by the millions of meals required, it adds up to $33 billion that families need and don’t have for groceries."

Hunger is more prevalent in minority communities. The editorial board reports, "Roughly one-quarter of Black Americans experience food insecurity, as compared with 10 percent of white non-Hispanic Americans, according to a report by Feeding America. In some parts of the rural American South, roughly two-thirds of Black people are experiencing food insecurity."

Meanwhile, U.S. policy changes could address ongoing food insecurity by allowing more Americans to qualify for the Supplemental Nutrition Assistance Program. The editorial board adds, "Most families of four that receive SNAP benefits have incomes below $40,560. Feeding America estimates that that leaves around 20 million people in a no man’s land, where they can neither afford sufficient food nor qualify for help to pay for it."

Rural communities struggle to find ways to communicate with growing non-native English-speaking population

Despite the ongoing growth of non-native English-speaking populations in rural communities, people in many counties and towns have failed to find effective ways to communicate with residents still learning English. The small town of Elko, Nevada, serves as an example. The town's "Hispanic or Latino population has grown to about 26%," reports Jazmin Orozco Rodriguez of KFF Health News. "The share of people age 5 or older who speak a language other than English at home increased to 18% as of 2022, while Spanish is the language spoken in nearly 15% of households."

With Elko's number of non-native English-speaking residents, the area needs translation support to ensure all residents understand vital information. Unfortunately, "state lawmakers in Nevada left out smaller counties from a recently enacted statewide language-access law," Rodriguez writes. "Not providing language access to people who need it is not only a violation of civil rights protected by Title VI of the Civil Rights Act, but it also can create public health and safety concerns said Jake Hofstetter, a policy analyst for the Migration Policy Institute, a think tank focused on immigration policy and research."

While much of rural America is white and English-speaking, its population has diversified, leaving smaller communities struggling to adapt to residents who aren't proficient in English. Rodriguez explains, "Implementing state and local language-access laws, however, is a challenge, researchers say, given standards can vary across state agencies and localities, making it difficult to ensure high-quality assistance is provided to speakers of various non-English languages."

The language-access challenges rural communities now face will continue to grow. "The number of white residents in rural parts of the nation decreased by about 2 million from 2010 to 2020, according to an analysis by the Carsey School of Public Policy at the University of New Hampshire," Rodriguez reports. "And the percentage of people who are members of a racial or ethnic minority living in rural areas increased from 20% in 2010 to 24% in 2020, with the largest share being Hispanic."

Language access services in metro and urban settings have grown; however, "Hofstetter said he doesn’t see many local policies that focus on the issue in rural areas," Rodriguez writes. "People living in rural areas may still benefit from a patchwork of resources through state agencies that provide services in their counties or local programs required to address language access because of federal funding."

Nonetheless, language barriers put non-native English speakers at a disadvantage. Rodriquez adds, "The degree to which local governments offer communications in languages other than English varies for several reasons, including enforcement of civil rights protections. That enforcement relies on civil rights complaints, which often must be filed by residents who may not know their rights related to language access."

Quick hits: He's not Santa, he's Belsnickel; 'phantom' towns; how music can reframe memories; going out for a walk

A local constabulary lends the town's Belsnickel
a hand. (Photo via Lancaster Farming)

Belsnickel may not be as famous as Santa (or as clean), but he gives Christmas gifts to children in Manheim, Pennsylvania. A Belsnickel is "a crotchety, fur-clad gift giver related to other companions of St. Nicholas in the folklore of southwestern Germany," reports Dan Sullivan of Lancaster Farming. A Belsnickel is tasked "to carry out duties somewhat similar to Santa, ferreting out the naughty and nice and dispensing just punishment or reward. Traditionally, Belsnickel carried a switch in one hand as corporal punishment for the bad kids and a pocketful of treats for the good ones."

When financial times are tight, not as many Americans buy new cars or repair the vehicles they have. "Pinched by inflation, higher interest rates, and supply-chain woes, Americans just haven’t been buying as many new vehicles lately," reports Spencer Jakob of The Wall Street Journal. U.S. consumers choosing to keep aging autos may sound "like great news for auto parts and repair companies. . . . [but] there are some surprising signs that Americans are choosing cheaper options or even deferring purchases of the goods and services that keep them running. . . . Skimping has rarely made less sense, though. . ."

Cartographic 'phantoms' are mapped towns where there isn't a town. (Illustration by Piper Olsen, L&S)

Most mapped towns exist but not all. "The Wisconsin state map is full of phantoms," reports Alli Watters of Letters & Science at the University of Wisconsin. Cartographer Howard Veregin spends his days scouting possible phantom towns, which includes exploring some of the state's most rural places. On one phantom sleuthing day, Veregin works to verify a mapped town called "Walker." He comes upon a friendly cranberry truck driver and this conversation ensues:

Truck driver: Good morning. Looking for something in particular?
Veregin: Well, I’m looking for cartographic phantoms.
Truck driver: What’s a cartographic phantom?
Veregin: It’s a community that is listed on a map, but it doesn’t exist on the ground.
Truck driver: This place exists.
Veregin: Sure, but it doesn’t really look like a community. What is it?
Truck driver: Well, this is our family cranberry farm. We’ve been farming cranberries here for 125 years. I’m a fifth-generation cranberry grower. Most of this area is private property. . .

"Veregin’s suspicions were confirmed. . . . He had found yet another cartographic phantom."

Beginning the new year a little wiser never hurts. In simplest terms, surviving 2025 is the first goal. Field & Stream experts "weighed in on four survival myths that could get you killed," reports Jim Baird. Many people think humans can live off nature's food and survive -- that's not true. "The myth here is that you can survive off them for an extended length of time. But the reality is if you are only eating 'survival foods,' you’ll start feeling sick and weak after a day or two." Another myth is if you kill large game "you're set" because you'll have all the protein you need. Not true, you can also get sick and die from eating too much protein without adequate fat. Read four debunked survival myths here.

Music may subtly shift emotional memories.
(Adobe Stock photo)

As a new year begins, people often reflect on how life has gone over the past year or years. Sometimes there are memories people wish they could change, and while history isn't alterable, music can help shift how people feel about past experiences. "Listening to music can change how you feel about what you remember – potentially offering new ways to help people cope with difficult memories, writes Yiren Ren, a cognitive brain science researcher at the Georgia Institute of Technology for The Conversation. "Our [research] results suggest that music acts as an emotional lure, becoming intertwined with memories and subtly altering their emotional tone. Memories may also be more flexible than previously thought and could be influenced by external auditory cues during recall."

Walking alone or with a buddy can be great exercise. 
(Adobe Stock photo)

Ernest Tubb twanged about "Walking the Floor over You." Johnny Cash confessed, "I Walk the Line." Aerosmith cranked the amps to "Walk this Way." Besides belting out catchy tracks, these musicians were onto something -- walking is an outstanding activity. "Walking can help meet the U.S. surgeon general’s recommendation that adults get at least 2 1/2 hours of moderate-intensity physical activity every week," reports Laura Ungar of The Associated Press. "This helps lower the risk of heart disease, high blood pressure, dementia, depression and many types of cancer. . . .While it’s not the only sort of exercise people should do, it’s a great first step toward a healthy life."