The Healthy Power of Restraint

Our 33rd president had a penchant for saying what was on his mind, earning him the sobriquet “Give ’em Hell, Harry!”

The authenticity—and, yes, lack of political filter—was appealing to many, and not only to those in his party. As Senator John McCain said last May, “You don’t have to be a Democrat to admire Harry Truman. I’ve always admired him. I admired his honesty and candor, a straight talker by conviction and habit.”

As it turns out, the one-time haberdasher from Missouri was even more blunt in his private correspondence—a fact that Truman historian Monte Poen uncovers in his illuminating collection of the former president’s letters. Truman, for instance, once threatened to blacken the eyes of a Washington Post music critic who had slammed a performance by the president’s daughter. He called one prominent Kansas City citizen “pig-faced” and “lower than the belly of a snake”; dismissed Richard Nixon as a “squirrel head”; and—as Poen discovered—labeled “two Democratic representatives from his hometown’s congressional district ‘double barreled sh*t asses.”

But notably—and, in my view, importantly—the president didn’t send those letters. (Well, he did apparently mail the one to the Post music critic, but buried a more provocative draft in his desk.)

The famed Give ’em Hell Harry, it seems, was often merely Think ’em Hell Harry—a leader who had the good sense to censor himself when appropriate.

This is a fine day to consider that. Today, of course, is the end of one presidential administration and the beginning of a new one—the peaceful, orderly transition of authority that makes this nation so rare and remarkable.

We have a system that, quite heroically, allows for a dramatic change in policy direction without upending the governmental institutions that have served this nation well for 12 score years.

There will be moments, to be sure, in the coming days and months when those on either side of this transfer of power will have their hackles raised. They will take to comment boards and social media and fire off words in passion and outrage. That’s well and good. That’s what a free society engenders. And there’s even evidence to suggest that such liberty is inherently healthy, as three professors from Spain reported not long ago in the medical journal BMJ. (In a study of health indicators in 170 countries, the researchers found that “the highest levels of health were in free countries.”)

But then, there’s also a virtue in voluntarily deciding not to fire off those words of passion and outrage. There’s a reason it’s called “healthy discretion.” So as No. 45 is sworn in to the highest office in the land, let’s consider this unsung lesson from No. 33. Sure, go ahead and write your angry tweet if you must. Maybe just don’t send it.

The day’s news below.

DIGITAL HEALTH

Cyber criminal organization holds Indiana Cancer Agency for ransom. TheDarkOverlord (TDO), a cyber criminal group, successfully hacked the main server and back up drive for Cancer Services of East Central Indiana-Little Red Door, stole the data, and then encrypted it. Now, the hacker group is asking for a 50 bitcoin ransom, which comes out to approximately $43,000, in exchange for not publicly disclosing the information collected. That includes cell phone numbers of and sensitive information about cancer patients and their families. And in a demonstration of just how brazen this particular attack is, TDO actually contacted the cell numbers of various company executives demanding money and threatened to start contacting patients' families and donors, too. The firm's executive director, Aimee Fant, has sworn not to pay the ransom and is currently working with the FBI. And one way they plan to prevent data loss of this kind going forward is to transition the affected server into a cloud-based system.(Healthcare IT News)

Healthcare.gov ads will continue to run under Trump. A scoop from Politico's Dan Diamond and Joanne Kenen: the Centers for Medicare and Medicaid Services (CMS) have already paid for Obamacare advertisements into February, meaning that television and digital ads for Healthcare.gov will keep running even as Donald Trump and a GOP Congress work to dismantle the law (sorry, the Politico article is available by pay subscription only.) This is significant because the deadline for enrolling in a plan is January 31, giving Americans nearly two more weeks to sign up. And past evidence has shown that enrollment tends to surge in the final weeks before the deadline, with an assist from advertisements reminding people that the clock is ticking. Trump's election has led to a veritable surge in Obamacare signups as uncertainty reins over the health law's future.(Politico)

A Glaxo vet heads over to Genenta to help develop new gene therapy. Carlo Russo, who used to run the rare disease R&D unit over at pharma giant GlaxoSmithKline, is heading over to Italian biotech Genenta Science. His next project: the tough slog to developing a gene therapy that harnesses stem cells to fight tumors. Gene therapies have drawn plenty of interest but have faced tough challenges in the clinic and the market alike. One of the only approved gene therapies in Europe, uniQure's Glybera, has close to zero sales, thanks in large part to its $1 million price tag.(Endpoints)

INDICATIONS

Can Merck's Keytruda be stopped in lung cancer? Merck's Keytruda sure looks like it's destined to be the king of the lung cancer immunotherapy market. On Thursday, Bristol-Myers Squibb abruptly ditched an accelerated approval application for a combo of its rival immunotherapy Opdivo and an older drug called Yervoy. That leaves Merck largely free of competitors in the near-term in its quest to become a go-to, first-line option for lung cancer patients in combination with chemotherapy (Merck recently surprised investors with an early FDA filing for that combination). Just why is the lung cancer space so important? Because it makes up more than 13% of all new cancers and nearly 27% of all cancer deaths in the U.S. Just 17.7% of diagnosed patients are still alive five years out from their diagnosis. Bristol-Myers shares have fallen 10% in Friday trading as Merck gained 4%.

Lilly axes jobs in its ill-fated Alzheimer's unit. Indianapolis-based pharma giant Eli Lilly is slashing 485 jobs, with most of the cuts coming from the Alzheimer's unit that saw high-profile (and expensive) clinical flop last year. Solanezumab's inability to best placebo in a late-stage trial, combined with impending patent expirations for big sellers like the erectile dysfunction drug Cialis and ADHD medication Strattera, are largely driving the cuts. Lilly has previously said that its marketing department would be seeing layoffs as it stops promoting treatments that will soon face competition from generic rivals.(FiercePharma)

THE BIG PICTURE

Collins to stay on as NIH director in early days of Trump administration. An NIH spokesperson tells Endpoints that Dr. Francis Collins, director of the biomedical research agency, will stay on as its head as Donald Trump takes office. "We can confirm that Dr. Collins has been held over by the Trump administration," a spokesperson told Endpoints. "We have no additional details at this time.  Any questions should be directed to the Trump transition team." It's unclear whether or not the hold over will be a permanent one. Although Collins has enjoyed what's widely considered a successful tenure as NIH chief, Trump has reportedly considered candidates such as L.A. billionaire and biotech executive Patrick Soon-Shiong and Republican Congressman Andy Harris for the post.(Endpoints)

California has the first "casualty of the Trump administration." Donald Trump, who took office as the 45th President of the United States at noon today, is already causing California lawmakers to scuttle some ambitious health care plans. The state is withdrawing a government waiver request that would allow undocumented immigrant adults to purchase (unsubsidized) health insurance on its Obamacare marketplace, Covered California. The proposal's sponsor, state Sen. Ricardo Lara, said that he didn't trust a Trump administration to protect undocumented residents' privacy (not to mention the fate of the health law itself is very much up in the air). "California is committed to a healthier future for all, and we will continue to seek ways to expand health coverage even as Republicans in Washington move to take it away," he said in a statement.(Fortune)

Federal judge expected to block Anthem-Cigna merger. The New York Post reported on Thursday that a federal judge is gearing up to block the controversial $54 billion merger between insurance giants Anthem and Cigna. The Obama administration sued to stop Anthem's acquisition, citing competitiveness concerns, seven months ago. The government is also attempting to halt the proposed merger between Aetna and Humana in a trial that began in December. The companies say that consolidation is necessary to keep up with other mergers in the health care space, and the combining forces is the only way for them to gain enough leverage in order to keep costs low for consumers.(Fortune)

REQUIRED READING

Everything You Need to Know About Obamacare Repeal and Replace, by Tory Newmyer

Federal Government Sues Walmart for Firing Employee with Down Syndrome, by Abigail Abrams

Predictions for the New World Order, by Adam Lashinsky

IPOs Are Dwindling, So Are the Number of Private Companies, by Anne VanderMey