The Supreme Court: Healthcare, Immigrants and Killer Teens

On a recent visit to Boston, Attorney Steve Shapiro (General Counsel to the American Civil Liberties Union) outlined matters before the Supreme Court today, or likely to arise in the coming 2012-2013 session.

I.    Obama – Care

The gorilla in the room is litigation concerning the healthcare law (designated derisively by some as “Obama Care” but we in Massachusetts really know it more by its original name: “Romney Care”).  In an unprecedented move, the Court extended its usual one hour argument time by a factor of six in order to hear arguments on specific issues posed by the Court itself:

  • Is the case ripe to be decided today since most of the provisions, including the requirement to obtain health insurance (the so-called “individual mandate”), don’t take effect until 2014?
  • Since the IRS can collect the penalty for violating the individual mandate only by offsetting tax refunds, and since there is an established rule of law that you can challenge a federal tax provision only after the tax is paid, will it ever be possible to challenge the law from the “tax” standpoint?
  • Can a citizen be forced to buy a commercial product such as insurance?
  • If the Supreme Court strikes the individual mandate, what other parts of the law if any are so inter-related that they must also be stricken?

Why is the Civil Liberties Union interested in the healthcare law, bearing in mind it is not overtly a civil liberties statute and the ACLU has taken no position as to whether the healthcare law is wise legislation?  The reason has to do with Commerce Clause of the Constitution; the ability of the Federal government to pass the healthcare law is dependent upon whether such legislation fits within the constitutional grant of authority to the Federal government to regulate interstate commerce, and a broad reading of the Commerce Clause of the Constitution is necessary in order to support a variety of civil rights legislation which is similarly premised.

Shapiro noted that there is political pressure on the Supreme Court to decide this issue now, regardless of the technicalities as to whether it is “ripe.”  As to the question of whether the case is appropriate for decision where the “tax” has yet to be collected, Shapiro points out that the Administration has firmly taken the position (requisite in the current economic climate) that the IRS-collected penalty is simplynot a tax.  Indeed, its collectability is only as an offset from otherwise government-owed refunds which may never arise.

Whether a citizen can be forced to buy insurance is fascinating.  It seems clear that State governments could in fact impose such a requirement, because it is an exercise of the general police powers.  But the Federal government only has those powers which are expressly afforded to it by enumeration in the Constitution.  All other powers are retained by the people and the States.  Thus for example, the similar Massachusetts Healthcare Law cannot be attacked on the ground of lack of government authority.

In a way it is therefore a shame for the Administration that it has claimed that the penalty is not a tax, since the Federal government clearly is entitled to levy tax pursuant to the Constitution.

Challengers to the law say that the Commerce Clause cannot support the legislation.  It may be true that if an individual chooses to buy health insurance he then participates in the interstate commerce business of the healthcare system.  But, say opponents, the statute is focused on individuals who do not buy health insurance and, consequently, uninsured individuals subject to this law are by definition notinvolved in interstate commerce relative to healthcare, as they do not participate.  The government counters by saying that in fact all Americans participate at some point in time, this is a matter not of “if” but simply “when.”  If someone who is not insured requires healthcare, and he does not have insurance, by law he cannot be denied medical care and ultimately that care is paid for by all Americans as part of the interstate commerce of healthcare.

Shapiro noted that two popular provisions of the healthcare law clearly are within the constitutional powers of the Federal government: that insurers cannot deny coverage for pre-existing conditions, and that insurers cannot increase charges for insurance based upon one individual’s health history.  Since the Constitution grants to the Federal government all other power necessary to effect otherwise constitutional actions, the individual mandate perhaps can be backed into a convenient parking space of constitutionality through this argument, without reference to the Commerce Clause.

Query: let us say it is true that the Federal government can require an individual to buy health insurance because the Federal government supports a national healthcare system which in turn is part of interstate commerce.  Does that also mean the government can require all citizens to buy a General Motors car because we bailed out GM?  Shapiro suggests that the issues are analytically the same but the political ramifications vastly different.

How will the case come out?  As in the past, Justice Kennedy is thought to be the key.  But the general thinking is that if the healthcare law is to be stricken, the vote will be five to four.  If, however, there are in fact five votes to retain all aspects of the law (that is, if Kennedy votes in favor of the law), then the vote is liable to be six to three.  Why is that?  Because at that point the Chief Justice is expected to vote to uphold the statute, because then the Chief Justice will be entitled to write the legal opinion, and he would want to write the legal opinion in the narrowest possible terms.

II.  Immigration

The second leading and as yet undecided case before the Supreme Court is the Arizona “show me your papers” law which requires the police, upon any otherwise permissible detaining of a person (including for example running a red light), if that officer also has a “reasonable suspicion to believe” that a person is in the country illegally, to ask the detainee to prove his legality (green card or some such).  If you cannot, you are to be taken into custody and a call placed to Immigration.

The key question here is the basis for “reason to suspect” that someone is in the U.S. illegally.  Shapiro’s position is that this is an open door in Arizona to racial profiling to accomplish Arizona’s overtly articulated goal: attrition through forced immigration of minorities out of the State.

The fight over the Arizona Immigration Law is the exact reverse of the fight over the healthcare law: the cases are mirror images.  Why is that?  It is again a question of who has authority to take action.  Under the healthcare law the question is whether the Federal government has authority to act under its constitutionally specified powers (the Commerce Clause).  In the Arizona “show me your papers” case, the question is whether the State has the authority to take any action with respect to immigration which is clearly a primary Federal function.

Opponents of the law say that immigration is a Federal matter and the States are preempted from acting upon it.  And here the issue is compounded by history.  Historically, immigration indeed was a Federal prerogative both in terms of articulating the law and enforcing it.  In the last Bush Administration, the President’s legal office stated that the Federal government could share enforcement of Federal policy with the States, and that the States therefore could have concurrent authority.  The Obama Administration, although urged to reverse this position, declined to do so.  Consequently the Obama Administration now cannot maintain that the States have no power whatsoever to enforce in the area of immigration.  Now the Obama Administration is therefore required to take the following position: States cannot enforce Federal immigration laws inconsistently.  The response of the State is obvious and based on the facts:  “we do in fact consistently enforce.”

Shapiro suspects the Supreme Court may indeed uphold the “show me your papers” portion of the Arizona Immigration Law (other provisions clearly will fall), but will still leave open the issue of discriminatory application.  And in that regard, there ultimately may be a victory for the opponents of the law; business and agricultural interests in Arizona (and similar States that have adopted similar laws) have realized that clamping down on immigrants is bad for business, and the political will to enforce the law in a discriminatory manner may well have dissipated.

III.    Murderous Children

More consistent with the kinds of cases with which the ACLU generally deals are two pending cases involving whether imposing a criminal sanction of life in prison without parole, in cases of murder, can be applied to a minor.  The contrary argument is that it is cruel and unusual punishment violative of the Constitution’s Eighth Amendment.  The Supreme Court previously has held that a sentence of life without chance of parole constitutes cruel and unusual punishment for a minor in all non-homicide cases.

At this point two cases are pending under an Alabama law against two fourteen year olds (at the time of the crime), one of whom pulled the trigger in a murder and the other of whom was found guilty of murder under the time honored “felony murder rule” (any participant in a criminal act which is a felony, where that criminal act results in someone’s murder, is himself guilty of that murder).

Shapiro expects that the Alabama law will be determined to be unconstitutional because the Alabama lawrequires a life sentence without parole in such a case.  He expects that the Court will say that the judge must be left with some discretion with respect to sentencing.  Query whether the Court will go further?  Query whether the Court will establish an absolute minimum age with respect to which a life without parole sentence will always constitute cruel and unusual punishment.  Conveniently in the argument before the Supreme Court in the two Alabama cases, lawyers for the minors claimed that the appropriate absolute minimum age is fifteen while the State of Alabama claimed it was thirteen, artificial line drawing with respect to two defendants who happened to be fourteen years old.

IV.    Congressional Medal of Honor

Other interesting cases this term include:

United States v. Alverez (a pending case asking whether the statute which criminalizes lying about receiving a military honor such as the Congressional Medal of Honor violates the First Amendment right of free speech); and

Two decided Fourth Amendment search and seizure cases (United States v. Jones asked whether the police with no warrant can put a GPS tracking device on your automobile, answered in the negative by this Court in a rare nine to nothing decision; as compared to Florence v. Board of Freeholders, which asked whether a New Jersey jail can routinely strip search each person held in the jail, no matter how minor the offense and how short the incarceration, an exercise of police power upheld by a five to four vote).  Shapiro suggested that the difference between the decisions in the Jones and Florence cases is one of Court “empathy;” the Justices could imagine, and be shocked by, the government putting a GPS device on their own cars parked in the Supreme Court parking lot (they actually asked the government attorney during argument if the government felt it had the power to do so, and received an affirmative response!) while, it was suggested, the Justices simply could not imagine themselves in a position of being stripped and searched because they ran a red light).

V.  Coming Attractions

What is liable to come up in the next term?  (The Supreme Court operates on what is an academic year, the cases start getting heard in the Fall and all must be decided by the following June 30th.)

There is likely to be another case on whether affirmative action is supportable in university admission settings, re-examining the acceptance of such a criterion in the University of Michigan case several years ago.

There may be a challenge to Section 5 of the 1965 Voting Rights Act, which requires States with a history of voting discrimination to obtain affirmative Department of Justice pre-approval of any change in their voting rules (Obama’s DOJ has struck down two such laws, while allowing a change in Wisconsin voting laws without DOJ review because Wisconsin had no history of voting discrimination).

It is likely that California Proposition 8 (defining legal marriage as only between a man and a woman) will come before the Court (the statute had been stuck down by three judge panel of the Ninth Circuit [California] Court of Appeals).

ACLU hopes to bring up the case of Clapper v. Amnesty International, where ACLU raises the Fourth Amendment protection against unlawful search and seizure in a wire-tapping for national security purposes without judicial oversight.  This case presents an anomalous twist: generally you can only challenge United States Federal surveillance powers if you have standing because you have been under surveillance, but under the national securities regime you may well not know that you are under surveillance, and if you ask you will not be told because it is of course a secret national security matter.  This surveillance right was struck down by a three-judge panel of the Second Circuit [New York] Court of Appeals), but the en banc Second Circuit (a conclave of all the judges who sit on the Circuit) was divided six to six.

Finally, it was asked whether any more litigation was liable to reach the Supreme Court out of the Gitmo detentions.  While there is of course no definitive answer, Shapiro noted that at present all detainee cases go to the Federal District Court for the District of Columbia, which has granted the government broad license to detain a wide variety of suspects, and has determined that although a given detention may in fact be unlawful there is no ready remedy because the detained individuals cannot be set free in the United States and the courts cannot compel deportation.

Knock Your Sox Off

Early in this season, I blogged briefly about the pitiful state of the Boston Red Sox who are, if you are not local to Boston, the nearest thing we have to royalty since most of the Kennedys have moved onward.  My dire predictions of doom were promptly followed by the Sox winning five games in a row, which shows how the blogging gods punish anyone who offers a clear position on anything– immediate discredit by example.

But alas, the Sox have lost again, often and terribly, with horrible pitching and a bunch of guys who are lionized around here for hitting .250.   Indeed we have a few fill-ins, people promoted from the minors, who over the short haul show some promise, but you cannot easily replace the guy who almost won the MVP voting with a rookie and expect to win ball-games.

Today a friend called to my attention a post by Pete Abraham of the Boston Globe staff.  (Blog posts must be brought to my attention; I write but do not read, a set of habits that bodes ill for my journalistic future, but that is another issue.)  Abraham notes that since last September 1, which comprises the equivalent of more than a third of a whole season, our pitching staff has an ERA of about 6.  During this time, the team has won only 19 of its last 56 games.

If you look today, you see that we are in last place in our division.

What to do?  My thought was, wait for the return of our injured players (we have $78M of talent on the DL, including two outfielders, our third baseman and our closer).  But no team can win by giving up 1.50 WHIP (that is, one and a half walks and hits for each inning).  So we need pitching (pretty clever of me, eh?).

We await the return of Dice-K from Tommy John surgery.  Will that help?  Who knows? Dice-K had a couple of good years and a couple of bad ones; he is stubborn, and also (not that it matters, but…) no fun to watch.  But we cannot expect he will bring iron to the rotation.

Abraham says we ought to trade for good pitching which means trading good position players.  He notes that in 2004, that season of blessed memory, we traded Nomar and shook the team into the World Series.  Let us say that is a good idea; who do you trade?  Assume no one is untouchable.

You have a choice; trade young guys and become the NY Mets of a couple of years ago.  We have a couple of young guys doing great right now.  Sweeney is hitting .360 in 25 games; he actually is not so young, been up in the Show a few years and last year got into over 100 games and hit a mere .265, but he sure looks good today.  Middlebrooks is hitting .409, but that is only over 5 games and while he has had a pretty good minor league career he has had only a handful of AAA games.  Others deep down in the system?  Maybe, but not sure there is gold there; I do not follow our depth charts.  Our much touted shortstop phenom who some in the press wanted to keep with the Big Club and start at short in favor of Aviles in hitting around .200 at Pawtucket and does not seem like much trading bait at this juncture.

Trade older guys on the major league roster?  Maybe not a bad idea. Shakes things up. But who?  Big Papi?  Big nerve to trade him.  Youk?  Popular idea in the press but, in the stands?  And right now he is not in the best position to be traded, some have suggested we put a fork in him (although that is likely an over-aggressive criticism).   Ellsbury?  No doubt high value but frankly he is the most exciting player we have.  Pedroia?  Wow.  Gonzalez?  Hard to say what to do.  Compared to these choices, Nomar was easy.

I think the Sox should forget this year and draw up a “rebuilding plan” that excludes old guys and trades for young pitching talent.  I don’t see them pulling it out of the fire this year.  Not sure, either, that the current management has it in them to rebuilt with the average loge seat costing almost a hundred bucks, guts-wise or skill-wise.

Now why have I taken so pessimistic a view?  I will tell you: it is part of my scheme to have the Sox finish first this year.  As soon as I write that X will happen, we get Y happening.  Having predicted doom, we will no doubt win fifty in a row.  I have tickets for this Saturday and again this coming Monday.  I hope to see my first Fenway-attended win by the Sox since early last August.  I will report.  Well, I will report if we win….

And meanwhile, the Newton South Little League AA Brewers are doing great this season.  This really young catcher is pounding the ball, sets up well with a big target, is learning to get the ball to second base.  Clear the roster for him if you will.  Matthew Honig is his name, and he looks a hell of lot better than the current Sox line-up, and can be had for a few sets of Legos on a long-term contract basis.

US Life Science: Left to our own Devices?

The other day at UMass Boston, MassMEDIC (the trade organization of Massachusetts medical device companies) held its 16th Annual Conference.  It was well attended, and my prior blog post reported Covidien CEO Jose Almeida’s comments for the advancement of the United States medical device industry.

Another speaker, Yair Holtzman, is a director at WTP Advisers of White Plains, New York, where he focuses on business advisory services to the life science industry.  A CPA and MBA, Yair ambitiously traced the current and future states of R&D in device development.  Let me take a stab at summarizing the high points.

In the past, the United States has been dominant in the medical device market through a combination of its head start with a large number people working within the field, deep expertise, entrepreneurial investment, a robust middle class that drove medical device advances, and a group of patients who could afford to be price-insensitive when it came to buying medical services.  A large number of hospitals, and the leadership of the FDA in device safety, didn’t hurt.

International R&D, as many have noted, is greatly increasing.  Reimbursement has become an issue in the United States, creating concern for ROI that can be derived from R&D efforts.  Added pressure was placed on U.S. ROI for many other reasons, as outlined by Covidien’s Almeida (see the May 1st post).  China and India have growing middle classes and growing expertise; they may well develop medical device products and not even bother to have them cleared in the United States.  Approval of devices in Europe takes half the time of FDA review; Brazil, India and China are becoming very entrepreneurial and are attracting substantial investment.  Germany and Israel have substantial medical device expertise.

For these reasons the United States, historically a leader in the production and consumption of medical device advances, may find itself left behind the rest of the world.

Joining the cacophony in criticizing the Affordable Care Act, which in 2013 will assess a 2.3% excise on the gross income of medical device companies regardless of whether or not a profit has been made, Holtzman anticipated that the effect would be “devastating” and urged that the excise be repealed.  Also in order is a reinstatement of the R&D tax credit, which expired at the end of 2011.

What else must be done in the future?  First, greater speed and predictability must become part of the FDA approval process.  Second, a continuation in the trend to reduce R&D costs through joint ventures and through “farming out” R&D functions must continue.  Third, the industry must recognize certain trends in healthcare: mobile health, personalized medicine, economic efficiency demanded by patients and their reimbursers, and the need for disruptive technologies which will create a paradigm shift in costs and outcomes.  Analytics to demonstrate both health and financial outcomes must become part of device development.

Holtzman observed a trend in the United States to develop incremental products, as opposed to developing disruptive technologies through R&D expenditure, with the “disruptive” perhaps more likely to be generated offshore.  This development is not beneficial to U.S. industry, to say the least.

Holtzman also noted that many VCs are establishing offshore presences, including in Israel and Singapore.  Hopefully some of his recommended changes (at the FDA and in tax policy) will again make domestic United States venture investment in medical device companies attractive, but Holtzman added that his firm has success in identifying grants, state credits and local incentives, as well as joint venturing approaches, in order to drive down R&D costs, speed development and thereby improve ROI.

Interestingly, Holtzman’s remarks also reflected an anomaly which was apparent upon analysis of several recent life science conferences (not just medical devices).  On the one hand, the FDA is praised as setting the standard for review of medical technology which is emulated around the world, and which is one basis for historical American primacy in these markets; on the other hand, the FDA now also is criticized as one of the primary causes of the United States slipping behind the rest of the world.

How Covidien Sees the Med Device World

In conjunction with Mass MEDIC’s 16th Annual Conference, Jose Almeida, who is chairman and president and CEO of Covidien, today put forward a roadmap for what has to be done to retain the United States’ primacy in the medical device field.  Apparently Almeida spends a lot of time thinking about this; he views the role of a CEO as planning what is going to happen ten years down the road (leaving the operation of “today” to others).

His brief shopping list for things that the United States must do:

Expand the coverage of healthcare, but not pay for it by instituting the 2.3% excise tax on gross revenues which will be collected from device companies starting in 2013 under the Affordable Care Act.  Tax burdens reduce R&D expenditures, and it is not logical to tax companies that just happen to operate in the medical field in order to pay for universal healthcare.  One of the effects of this tax burden is to drive companies such as Covidien to undertake hiring not only in the United States but also in China, India and Singapore.

Improve the speed with which the FDA approves products, which now often go to Europe first because of the efficiency of the approval process there.  Slow approval also impacts the economics of VC investments, because it disincentivizes such investments and drives capital offshore.

Address Marketing:  growth overseas of the middle class will drive the need for medical devices, and also require medical device companies to look in detail at their marketing strategies (noting in passing that Covidien is in the process of adding 1,000 sales representatives for its products just in Asia).

Simplify products for sale to lower tier hospitals overseas (interestingly, to achieve this within Covidien, these tasks had to be given to a different team, as the regular R&D team was much more interested in state of the art complexities).

While Almeida reiterated much of what you hear from all large life science companies (and many small companies also) both in the biotech and medical device fields, he makes a powerful case for the necessity of dealing with the Federal government at a granular level in order to maintain United States supremacy in these fields.  With the Affordable Care Act giving rise to (per Almeida) seventeen new federal agencies and their attendant bureaucracies, with the life sciences driving an increase in the number of people at the FDA and the need to increase their pay scale so that turnover at that agency is reduced, and with the negative effects of the upcoming device excise tax, there is a cogent case for substantial realignment of thinking at the Federal level.

And in one area the argument seems absolutely irrefutable: if we are expanding healthcare coverage for the benefit of all, why is the cost to be paid for by an excise only upon an industry that happens to operate within the healthcare system (not to mention that such excise will reduce R&D expenditures and increase the cost of medical devices, two results that are inconsistent with health care policy)?

Red Sox Victorious

The Boston Red Sox scored a major victory last night when their 8pm game against the Yankees was drowned out by torrents of wind-driven rain.  Any game the Sox don’t play these days is counted as a victory.  The team lacks two outfielders, a credible short-stop, predictable starters and any hope at all from the bull-pen.

But failure on the field is not unknown to Red Sox Nation; recent World Series wins set off insane celebration just because everyone knew the Sox were woeful as a general proposition.  Why, now, has the slow start caused such angst among the faithful?  The folks with whom I share season seats have been emailing about this, and there is no shortage of theories.

First, when you expect a lot and don’t get it, you are angry.  For the first time, Sox fans have expectations.

Second, we pay the highest or second highest tariff in the Big Leagues.  At this price point, one can go to a Patriots game and see true brain trauma, so why waste the bucks on so tame a sport as baseball.

Third, there is the carpetbagger syndrome.  We are owned by non-Boston people, and they are not very sympathetic folks at that.  (Principal owner John Henry ties his yacht up at the Boston Harbor Hotel in the summer, and there is something about the winding staircase sweeping up the front of the salon that is, shall we say, lacking in New England frugality.)  Henry’s Boston-based mouthpiece sounds smarmy so the overall feeling is one of, well, invasion.

Just the other day, management invited all true fans to come to the ballpark (America’s most beloved ballpark, they call it; must be true, as it sells out even though half the seats are obstructed view and you take your private parts in your hands if you try to sit on a toilet after the first beer dumping – whoops, I mean the second inning).  Come on over free and have the run of the park.  Morning to night.  People flocked.  Of course, there was no ball game that day.  The idea of a free ballgame would cause management cardiac arrest.  You poor folk can walk the by-ways of Fenway to see how it might feel if you could afford a ticket; noblesse oblige I think the French call it.

Which brings us, fourth, to soccer.  Any true member of Sox Nation knows that soccer is that effete European low-scoring, high-boring, foreign thing that the rest of the world erroneously chooses to call a spectator sport to the detriment of the beautiful symmetry of baseball.  SO —  HOW MUCH did that non-Boston owner (the guy pronounces his Rs in his words, fagodzakes, what the hell is THAT all about) pay to buy a soccer team?  In Europe?  Do you have any idea how many starting pitchers we could have bought with that kind of money spent here in the US of A?  We couldda had Verlander in the bull-pen, facryinoutloud‼

There is still time for the Sox to turn it around.  This year I hear the Major Leagues have added another wild card team to post-season play (MLB is beginning to look like my kid’s Little League: every team gets a trophy, every player an award, there are no losers in the new Valhalla).  But, and this is the shocker, no one cares.  We are watching the Bruins, the Celts, the NFL draft, Nadal playing tennis, Tiger imploding for the umpteenth time (this is really too much punishment for just wandering off the reservation a few times, why take it out on his putts?)….

I hope this is not the end of Red Sox Nation; that powerful marketing combine that posts the number of days of consecutive sell-outs with the breathless fervor of reporting a real score in a real ballgame.  I hope to see the continuing traffic of visitors to Boston who just want to see Fenway Park and don’t care whether the Sox win that particularly game.  I hope Senator Scott Brown, who once urged a Sox move to Foxboro and now advertises the singular grace of a rehabbed Fenway, continues to get seated in one of the eight seats that has both no poles and a visual orientation onto the playing diamond.

So I have a few tickets for games that I cannot use.  Interested?  No scalping, I can give them to you for face value because, well, you’re a true member of the Nation.   … What, no takers?  Hey, these are SOX tickets, ya hear?  SOX SOX SOX, get em while you can, this won’t last forever.

Wait til May, you’ll see.  Then there is always next year….

Public Company Comp in 2012

At the April Breakfast Meeting of the New England Chapter of the National Association of Corporate Directors, a panel of public company directors faced “the Enemy” in the person of Pat McGurn, who represents the ISS.  For the uninitiated, ISS stands for Institutional Shareholder Services, the company that advises institutional shareholders in public companies as to how they might want to vote on director elections and other proxy issues.

McGurn noted that in 2011 the ISS made a favorable recommendation on “say-on-pay” votes in 88% of public companies (that is, ISS recommended that in 7 out of every 8 public companies the shareholders vote in favor of the compensation arrangements proposed by management and the board of directors in the advisory, non-binding shareholder votes mandated by Dodd-Frank).  Although it is early in the current proxy season for 2012, he noted that so far ISS has recommended favorably in 86% of the companies that have come before them.

It should also be noted that historically most companies pass the say-on-pay test with an average positive approval of over 90% of the shareholder votes; in 2011 only 41 companies, or less than 2% of the Russell 3000 Index, actually failed.  Early indications indicate that similar results will obtain in 2012.

McGurn noted that in 2013 the Dodd-Frank Act say-on-pay provisions become applicable to low cap companies for the first time, which may result in different statistics.  That is, if there is no change in the Federal administration, the suggestion being that a Republican victory might lead to a delay in implementation.  He noted that the April 5th JOBS Act signed by the President delayed many otherwise mandated compensation disclosures for newly registered companies with sales below $1,000,000,000 which is, after all, most of them.

What was the effect of a negative ISS recommendation in 2011?  According to McGurn, all but a small handful of boards receiving negative ISS recommendations, whether or not they received negative shareholder votes, responded in some fashion.  Almost all companies changed their compensation to link it better to actual performance.  Each of the three companies who received negative votes in 2011 and who have already had their 2012 annual meetings have received over 90% approval in their 2012 say-on-pay votes by the shareholders.

The key is not only changing compensation to link it to company performance; the key is also outreach to investors to understand and meet their reactions.  Disclosure is much better of course, and this facilitates communication, but some companies also have been doing formal compensation roadshows.

The problems with compensation are no longer extra perks, severance and the like, which McGurn described merely as “irritants.”  The issues now are actually tying compensation to performance, and addressing executive compensation which is a multiple of peer group mean compensation.

There is something of a contrast between this relatively self-satisfied ISS report, on the one hand, and the extensive article in this past Sunday’s New York Times Business Section concerning executive pay.  Discussing pay for the top fifty public company executives whose information has already been reported in this proxy season, the Times article concludes that while executive compensation growth may have leveled off, it has leveled off at an extremely high point in terms of absolute dollars.  Even taking Apple’s CEO out of the equation (earning something in excess of $378,000,000, although most of it was indeed in stock and not cash), CEO compensation in numerous business sectors was significant.

The panelists, chairs of compensation committees of public companies, had differing reactions.  One panelist noted that, in a highly successful company where compensation was discretionary (but it turns out not above mean), there was resistance to having ISS force mathematical metrics into the equation in order to define and calculate appropriate compensation.  There was also criticism of an over-emphasis on “total shareholder return” which is an important ISS metric; in technology companies with high potential volatility, an executive can be doing an excellent job and yet profitability can take a short term beating because of the realities of the marketplace.

The ISS response was that they have lengthened their time horizon by which they are comfortable in measuring corporate performance, to take pressure off the very short term, but McGurn did note that his clients (ISS’s clients) are long-term investors, and at some point total shareholder return on investment becomes “the” metric in which his clients have an interest.

There was also discussion of the somewhat opaque selection of peer groups in which ISS places each company (so that compensation can be measured against what are putatively the company’s peers).  McGurn noted that each company is placed in a peer group wherein that company is placed near the mean in terms of size, further noting that one of the largest determinants of absolute compensation is indeed the size of enterprise.

In 2012, ISS sees as its hot spot the payment of executive compensation above the peer mean by companies showing mediocre performance, although McGurn assured the group that ISS has no particular performance metric and that each company is entitled to have its own metrics; what he is looking for, he says, is “evidence of intelligent design” as opposed to a rote set of numbers.

Finally, the panel noted that an effort was being made to address the ratio of CEO compensation to the compensation paid to the rest of the executive team; they declared an end to “the rock star CEO.”  That announcement may come as a surprise to readers of the New York Times CEO survey.

Bentham Meets Obama (or, when Courts should shut up)

Jeffrey Toobin’s lead article in the April 9 New Yorker is a clear and convincing argument for the liberal viewpoint on the Supreme Court’s role in evaluating Romneycare – whoops, I mean Obamacare.  As befits a graduate of THE Law School, Toobin applies the power of court precedent to the debate, finds that the law should be sustained, and excoriates Court conservatives for replacing judicial process with personal bias and a lack or respect for the elected representatives of the people.

We should pause to note that Toobin, for about twenty years the legal guru at New Yorker and more recently at CNN, writes with convincing clarity and hits from the left side of the plate.  Neither of these facts make him wrong —  but neither guarantees that he is correct, either.

Toobin notes extrinsic pressures on the Court deliberations: politics.  It is hard to know the degree to which the Justices will internalize political realities in their judgments.  His analogy to the Roosevelt Supreme Court reversing in 1937 its conservative bias (most importantly expressed by the Court striking down the NRA in the 1935 “sick chicken case”), thereby reflecting an appropriate appreciation for the presumed validity of Congressional Acts passed by elected officials, seems misguided; likely, fear of Roosevelt packing the Court was a greater driver of the Supreme Court changing direction.

What is not discussed by Toobin is the role of social values underlying the debate.  The article’s suggestion that the conservatives on the Court are applying not only unprecedented standards but also their own sense of our Social Compact to the detriment of “THE LAW,” is implicit and not stated but, I suspect, can be found one layer deeper in the Toobin onion.

For example, his moral outrage over this same Court declaring corporations to be people in Citizens United is echoed in Toobin’s clear moral contempt for questions directed from conservative Justices to the Solicitor General that suggest sympathy for the insurance companies which are subject to Romney/Obamacare.

Every branch of our government reflects the sense of the electorate (that part which votes) as to the current nature of our Social Compact.  We, or some of us, elect two branches and one branch names the third; to say that Justices are not elected is true only in the technical sense.  And to suggest as does Toobin that conservative social thinking is polluting the judgment of conservative Justices is just another way of saying that people are messing with the liberal social thinking that for several decades of the 20th Century in fact dominated the content of our legal precedent.  It is not that improper social thoughts are taking over our Courts; rather, it is that social thoughts that liberals do not share are taking over our Courts.

Enter another way to think about the debate; it is a way that is not Constitutionally premised, but rather is reflective of what underlies our governance and what is (imperfectly) reflected in our voting.  What would Jeremy Bentham and John Stewart Mill, the utilitarian philosophers, do if they were on the Court?

Likely they would be blind to the Constitutional arguments although that would be a shame; the primacy of the rule of precedential law is pretty important and not often shared outside the legal profession.  I am sure they would ignore the pressure of the election.  But they would, as all people must, bring their understanding of our society’s “Deal” with itself to the deliberations.  And their understanding is neither conservative nor liberal, it is utilitarian.

Now there are various schools of utilitarianism and I am going to do disservice to all of them (and reveal no doubt a lack of deep knowledge) by reducing the whole lot to a simple proposition: best governmental decisions provide the greatest good and happiness to the greatest number.  Put another way – my way  —  we should look to weight benefit and burden.  That mathematics multiples the number of benefited by the amount of benefit, and balances it against the number of burdened multiplied by the amount of burden.  The best answer is told by the way in which the balance tips.

So who is benefited by Romney/Obamacare?  Arguably most people.  Those without current coverage?  Yes.  Those with existing coverage?  Likely so; I know that when I pay my horrendous premiums I am already paying for many who are not covered; it is implicit in the costs of the care I receive that I am covering the uninsured who by and large are being treated anyway at hospitals and by doctors that I, and others like me, do already pay for. The insurance companies?  As regulated entities, which particularly under Romney/Obamacare cannot be allowed to fail, they will get funded by premiums and governments.

Who is burdened?  Everyone who pays taxes certainly.  But query if they are paying in the long run more than they are paying now by reason of presently paying for their own care and (in an inefficient way) the care of the “uninsured.”  Individuals whose freedom is infringed by being forced to buy a product they do not want?  I find that a facially logical proposition that plays to our legitimate sense of freedom but is unconvincing.  We already are forced to “buy” an infinity of things that we may not want.  How about certain military adventures?  Farm subsidies? Pork barrel? Pick your pet peeve that your tax dollars go to.  Would Bentham much care about the argument that the government could fund universal health care by tax but cannot do so by Romney/Obamacare, when the functional result and economic costs seem roughly the same?

Our “freedoms” are impinged mightily every single day by government, and that is a wholly separate and legitimate discussion, but is not significantly addressed by saying that Romney/Obamacare should be stricken because government is forcing us to buy a commercial product.

None of the above of course reflects an independent moral judgment, which is the degree to which our society should afford medical care to people not receiving it.  There are two flavors of what is now happening in medical care: many receive it free and we are paying for it anyway and inefficiently to boot; or, some do not receive it at all, which ought to present a moral conundrum to many.   (Indeed, some people from whom I hear the argument against the law apply the moral standard privately in their charity but do not see the government as the mechanism to bring moral judgment to medical care, although our government does and must bring moral judgment to almost anything it does do, and by definition).

We will have our answers by the end of June when the Court concludes its current session and must report out its decisions on all cases it has heard.  The Court spent three days hearing arguments that I submit will not drive the decision.  The decision will be decided by preconceived notions of the Social Compact on the part of eight Justices, and some unknowable tortured process undertaken by Justice Kennedy, who so often is the “swingman” between the entrenched personal philosophies of the others.

We as observers are so politicized in the way we see things that we may miss the real battle here, but that battle also may not be express in what is expected to be multiple written decisions of the Court, as it is not express in Toobin’s New Yorker article.

And the Justices will decide,  based on whatever has happened to each of them beforehand, and which brought them to the legal, intellectual and emotional place which each now occupies.  Perhaps, as in Bob Dylan’s words, “A man hears what he wants to hear and disregards the rest.”

Jeffrey Toobin’s lead article in the April 9 New Yorker is a clear and convincing argument for the liberal viewpoint on the Supreme Court’s role in evaluating Romneycare – whoops, I mean Obamacare.  As befits a graduate of THE Law School, Toobin applies the power of court precedent to the debate, finds that the law should be sustained, and excoriates Court conservatives for replacing judicial process with personal bias and a lack or respect for the elected representatives of the people.

We should pause to note that Toobin, for about twenty years the legal guru at New Yorker and more recently at CNN, writes with convincing clarity and hits from the left side of the plate.  Neither of these facts make him wrong —  but neither guarantees that he is correct, either.

Toobin notes extrinsic pressures on the Court deliberations: politics.  It is hard to know the degree to which the Justices will internalize political realities in their judgments.  His analogy to the Roosevelt Supreme Court reversing in 1937 its conservative bias (most importantly expressed by the Court striking down the NRA in the 1935 “sick chicken case”), thereby reflecting an appropriate appreciation for the presumed validity of Congressional Acts passed by elected officials, seems misguided; likely, fear of Roosevelt packing the Court was a greater driver of the Supreme Court changing direction.

What is not discussed by Toobin is the role of social values underlying the debate.  The article’s suggestion that the conservatives on the Court are applying not only unprecedented standards but also their own sense of our Social Compact to the detriment of “THE LAW,” is implicit and not stated but, I suspect, can be found one layer deeper in the Toobin onion.

For example, his moral outrage over this same Court declaring corporations to be people in Citizens United is echoed in Toobin’s clear moral contempt for questions directed from conservative Justices to the Solicitor General that suggest sympathy for the insurance companies which are subject to Romney/Obamacare.

Every branch of our government reflects the sense of the electorate (that part which votes) as to the current nature of our Social Compact.  We, or some of us, elect two branches and one branch names the third; to say that Justices are not elected is true only in the technical sense.  And to suggest as does Toobin that conservative social thinking is polluting the judgment of conservative Justices is just another way of saying that people are messing with the liberal social thinking that for several decades of the 20th Century in fact dominated the content of our legal precedent.  It is not that improper social thoughts are taking over our Courts; rather, it is that social thoughts that liberals do not share are taking over our Courts.

Enter another way to think about the debate; it is a way that is not Constitutionally premised, but rather is reflective of what underlies our governance and what is (imperfectly) reflected in our voting.  What would Jeremy Bentham and John Stewart Mill, the utilitarian philosophers, do if they were on the Court?

Likely they would be blind to the Constitutional arguments although that would be a shame; the primacy of the rule of precedential law is pretty important and not often shared outside the legal profession.  I am sure they would ignore the pressure of the election.  But they would, as all people must, bring their understanding of our society’s “Deal” with itself to the deliberations.  And their understanding is neither conservative nor liberal, it is utilitarian.

Now there are various schools of utilitarianism and I am going to do disservice to all of them (and reveal no doubt a lack of deep knowledge) by reducing the whole lot to a simple proposition: best governmental decisions provide the greatest good and happiness to the greatest number.  Put another way – my way  —  we should look to weight benefit and burden.  That mathematics multiples the number of benefited by the amount of benefit, and balances it against the number of burdened multiplied by the amount of burden.  The best answer is told by the way in which the balance tips.

So who is benefited by Romney/Obamacare?  Arguably most people.  Those without current coverage?  Yes.  Those with existing coverage?  Likely so; I know that when I pay my horrendous premiums I am already paying for many who are not covered; it is implicit in the costs of the care I receive that I am covering the uninsured who by and large are being treated anyway at hospitals and by doctors that I, and others like me, do already pay for. The insurance companies?  As regulated entities, which particularly under Romney/Obamacare cannot be allowed to fail, they will get funded by premiums and governments.

Who is burdened?  Everyone who pays taxes certainly.  But query if they are paying in the long run more than they are paying now by reason of presently paying for their own care and (in an inefficient way) the care of the “uninsured.”  Individuals whose freedom is infringed by being forced to buy a product they do not want?  I find that a facially logical proposition that plays to our legitimate sense of freedom but is unconvincing.  We already are forced to “buy” an infinity of things that we may not want.  How about certain military adventures?  Farm subsidies? Pork barrel? Pick your pet peeve that your tax dollars go to.  Would Bentham much care about the argument that the government could fund universal health care by tax but cannot do so by Romney/Obamacare, when the functional result and economic costs seem roughly the same?

Our “freedoms” are impinged mightily every single day by government, and that is a wholly separate and legitimate discussion, but is not significantly addressed by saying that Romney/Obamacare should be stricken because government is forcing us to buy a commercial product.

None of the above of course reflects an independent moral judgment, which is the degree to which our society should afford medical care to people not receiving it.  There are two flavors of what is now happening in medical care: many receive it free and we are paying for it anyway and inefficiently to boot; or, some do not receive it at all, which ought to present a moral conundrum to many.   (Indeed, some people from whom I hear the argument against the law apply the moral standard privately in their charity but do not see the government as the mechanism to bring moral judgment to medical care, although our government does and must bring moral judgment to almost anything it does do, and by definition).

We will have our answers by the end of June when the Court concludes its current session and must report out its decisions on all cases it has heard.  The Court spent three days hearing arguments that I submit will not drive the decision.  The decision will be decided by preconceived notions of the Social Compact on the part of eight Justices, and some unknowable tortured process undertaken by Justice Kennedy, who so often is the “swingman” between the entrenched personal philosophies of the others.

We as observers are so politicized in the way we see things that we may miss the real battle here, but that battle also may not be express in what is expected to be multiple written decisions of the Court, as it is not express in Toobin’s New Yorker article.

And the Justices will decide,  based on whatever has happened to each of them beforehand, and which brought them to the legal, intellectual and emotional place which each now occupies.  Perhaps, as in Bob Dylan’s words, “A man hears what he wants to hear and disregards the rest.”

Impediments to Bio Industry Expansion

The Massachusetts Biotechnology Council meeting on The Business of Science concluded March 27, as it began: lots of discussion of the technology, interspersed with programs about the business and financial aspects of bio which all had the same themes: bio is the great wave of the future, Massachusetts is at the forefront, but other geographic bio clusters are hot on our heels and there are many ways we in Massachusetts can be overtaken and surpassed.

One interesting counterpoint came from an Indian panelist who noted that the suppositions that FDA was too slow and too conservative to the detriment of US bio in general, are simply inaccurate.  Notwithstanding the oft-recited tales of horrible delay in FDA, the timing of drug approval overseas in not faster and will not become faster because other countries rely on FDA to set the tone and the standard of review.  This assertion was not directly challenged but was, alas, simply ignored; the final speaker, who was from FDA, was asked in several ways why the FDA moved so slowly.

The FDA position, by the way, articulated by  Dr. Eric Perakslis (Informatics chief), is that they DO hurry when there is a clear unmet medical need; the FDA will be willing to incur risk if the benefit seems to balance it.  The biggest problem the FDA has these days, he noted, was in their newly established regulatory function over tobacco, where he wondered how to measure benefits against risks for a product having no benefits at all.  (My best guess is that Eric is not a big smoker.)

What is impeding Mass bio?  The state gifts ban (which kills interaction that leads to innovation); the unique Massachusetts ban on co-payment assistance which thereby imperils the payment stream; the failure of schools from elementary to Community colleges to train workers in requisite skill sets; anti-immigration laws that now overly restrict special visas; a lack of language skills among our workforce members; lack of government  funded apprenticeships in private industry thereby impeding hiring of skilled and experienced workers; the growth of viable bio clusters elsewhere with governmental support superior to that afforded in Massachusetts (citing particularly Germany and Singapore).

The attendees are all “bio people” and it is hard to separate their valid but survivable complaints from the truly existential threats to Massachusetts biotech companies; every industry has its burdens to bear, and bio is not the only industry that fairly can say that it is over-regulated, under-served by government, not supported by the educational system and, these days, denied essential capital.

The one extremely positive message that came out of the meeting, however, and one message shared by attendees from within and outside  Massachusetts, is that everyone today believes that Massachusetts has innate advantages in Higher Education and entrepreneurship and that therefore, given appropriate nurturing, bio will be an economic and social engine for the region for a very long time.

Risk, Regulation, and the American Economy: Dialogue with a Professional Director

Ernie Godshalk is a professional director currently sitting on two public boards; a director of the National Association of Corporate Directors/New England, Ernie is well known to the local director community as a thoughtful commentator on board service.

His current view of the world economy is that it is recovering slowly but subject to substantial risks, and heading the list are the precarious nature of the Euro (I parenthetically note today’s report of further weakening in the Euro countries’ employment) and the international risks created by Iran and perhaps Pakistan.  In light of this view, I asked how a board should go about enterprise risk management.

Godshalk’s view is that, while his boards discuss risk virtually every meeting and care is given to identifying who is responsible for watching which risks, there are indeed some existential exposures which cannot be controlled by the company and consequently cannot really be monitored.

Ernie expressed concern as to the impact of any Euro failure on the highly leveraged Deutsche Bank, and rejected the view that a Euro failure in the long run would not represent a substantial risk for United States businesses.  Certainly, identifying non-European markets for the purchase of parts or the sale of goods, and the shortening of lead times, can mediate the Euro risk to some extent, but substantial risk will remain given the international nature of United States business.

What are the problems most plaguing our economy, aside from major geopolitical risks?  We discussed excessive US regulation; we further debated whether over-regulation was an annoyance and a marginal expense but not an ultimate depressor of United States business.  Godshalk noted two factors in the American environment that he thought were significant: first, our high tax rate and, second, our immigration policy.

Noting the internationalization of business in general, even domestic United States companies have substantial opportunity to relocate operations and profits overseas.  Higher United States tax rates drive that flight abroad.

Immigration is an oft-cited problem, as it has become difficult to obtain visa approval for persons with requisite skills to drive technology businesses.  Even more anomalously, I suggested that we are now bringing foreign students to the United States and transferring our own sophisticated technology to them and, then, refusing to allow them to stay; it is the forced exportation of our technological advantage.

Asked about the biggest problems in serving as a director these days, Godshalk noted two: first, failure of boards properly to address CEO succession; and, second, the inordinate time which boards must apply to risk assessment, say-on-pay, proxy solicitation and the like, which diverts the board from its strategic mission of “adding value” and making the company business better.

Finally, I asked Ernie about the current state of the M&A market.  From a strategic acquisition standpoint, he believes that good deals are available.  The strategic advantage should be in either technology or in sales (for example, efficiency in marketing multiple lines).  In response to the suggestion that an improving M&A market has caused an increase in EBITDA multiples, particularly for strategic acquirors, Ernie noted that there are many companies that are for sale, there is pent up sales demand, and many enterprises with VC and PE money remain well “behind plan” by reason of the recent business recession, and consequently are favorably priced.

The issue of over-regulation of United States business is and will remain a significant discussion.  Two days before our meeting, the Congress passed and sent to the President the JOBS Act, which rolls back some of the Dodd-Frank regulatory requirements at least for businesses that are now going public with sales less than $1,000,000,000 (which is not all of them, but surely most of them).  Now that the Federal Administration identifies relationship between regulation and employment, it is possible that bi-partisan efforts (so hard to achieve in so many areas) will nonetheless continue to address these issues of over-regulation which Godshalk believes drive companies abroad and waste director time in boardrooms.

Funding Bio– MassBio Conference doesn’t know how to do it

The Massachusetts Biotechnology Council’s program entitled “2012 Annual Meeting – the Business of Science” is underway, and the kick-off keynote speech and first panel spent a good deal of time exploring why the business approach to funding bio is not working so well.

Francis Collins is the Director of the National Institutes of Health and thus a major player in the business of bio; this year he will give out $25.7  billion to about 325,000 scientists.  His speech was sprinkled with insights and great factoids, but the bottom line is that bio is in financial trouble and he is driving NIH to help meet the issues.  Only about one in every six applicants gets funded these days, and the NIH budget has declined about 20% in buying power over the last decade even though the absolute number of dollars has increased.

Most telling: a 60-year longitudinal chart showing that over that period the number of successful drugs reaching market for each $1 billion of investment has fallen 100-fold.  Although expressing himself as optimistic, citing great advances in the genomic sphere which  will speed diagnosis and specific targeted treatment of cancer and other diseases, he conceded that bio contributes wealth (as well as wellness) to our nation, and that competition in China, India, Russia and now Europe is heating up.  He intends on Wednesday to make these points to the Senate in discussing NIH funding.

(I found myself seated at a table with a representative of the UK government, who listed the UK funds established in the last few months, with many hundreds of millions of pounds to invest in bio, including a 200,000,000 government fund;  you could almost feel the breath of John Bull down the necks of the attendees.)

How to fight for U.S. supremacy in bio?  Efficient use of genomic analysis to speed drug targeting and testing, a study of failed or seldom used drugs to see if they have different applications, effective use of iPS cells which can be differentiated and then studied specifically.  And, continued NIH funding, and an additional federal fund to supplement NIH and to target major needs such as Alzheimer’s.

The panel that followed was a bit more harsh in its analysis; moderated by Juan Enriquez, Managing Director of Excel Venture Management, the panel blamed the by-now usual suspects: the FDA, the non-economic models for drug development which turn off VC investment, the greater ease to acquire drugs as compared to spending 15 years developing and testing them.  Some compared drug companies today to Procter and Gamble: more interested in marketing than in science.

One panelist noted that it is worse than feared: not only do few drugs get approved, but only 3 in 10 which are approved ever earn enough money to provide a return on investment.  Drugs being proposed these days need have not only a scientific story but also a consideration as to pricing and reimbursement issues before investors will consider them.

Growth by acquisition cannot continue, as “pharma is running out of merger partners.”  The benefits of scale will no longer be available.  Schools bear blame also, by restricting doctors from serving on company boards or taking stock.

One final question hung over the room at the end: if drugs can come to market overseas for less money and in four years, what is the future of bio in the U.S.  (There being no ready response, the program moved on to simpler things, like the cure for cancer….)