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Where the City Ends: At the Frontier of the District of Columbia

Hot Topics | July 16th, 2021

The oldest federal monument in the country is not a stately building nor a grand memorial. Rather, the oldest federal monument(s) in the United States are the humble boundary stones that ring the District of Columbia.

Once President Washington chose Jones Point, Alexandria, as the southernmost point of the District of Columbia, the hard work of demarcating the boundaries of the new federal district fell to Major Andrew Ellicott, Benjamin Banneker and a team of other surveyors. Starting at Jones Point, the men embarked on a forty-mile journey to survey the four, ten-mile sides of the District of Columbia. (From 1791 until 1846 when land west of the Potomac was returned to Virginia, the District of Columbia was shaped like a rhombus.) With the boundaries surveyed, 20 feet of land was cleared on each side of the border and 40 sandstone boundary markers were placed around the perimeter of the District of Columbia at one-mile intervals.

Today 36 of the original 40 stones are still standing along highways, in parks, behind private residences and next to businesses. Though perhaps a relic of a bygone era in the age of GPS, the boundary stones continue to inform wanders and explorers whether they are in the District of Columbia, Maryland or Virginia. 

With this knowledge you could go on a ~60 mile tour of the boundary stones like this guy did in May 2020, or you can stick with us and catch up on the latest healthcare public policy news:

 Pricing policy at the stroke of the president’s pen

  • Last Friday, President Biden signed a broad executive order that aims to lower drug prices by: 1.) Ordering the Department of Health and Human Services to develop a “comprehensive” plan to lower drug prices within 45 days 2.) Allowing a Trump-era policy on the importation of drugs from Canada to stand and 3.) Pausing a rule that would prevent the government from using the 1980 Bayh-Dole Act to lower drug prices. (STAT) Known as “march-in rights,” the Bayh-Dole Act allows a government agency that funds private research to require a company to license its patents if the needs of the public’s health are not “reasonably satisfied” and if a medicine is not available on “reasonable terms.” (STAT)
    • Read more: Who is going to write President Biden’s drug pricing plan? (STAT)

Drug pricing wheeling and dealing in the Senate

  • Some Senate Democrats want to lower drug prices to help pay for a massive $3.5 trillion partisan spending bill that would enact many of the party’s legislative priorities from child care to climate change. Though details are vague, draft legislation does include a provision repealing a Trump-era policy that eliminates drug rebates between pharmacy benefit managers and insurance companies. Democrats are also discussing the prospect of allowing Medicare to negotiate drug prices. Expect more details to emerge in the coming weeks as details are finalized. (STAT, Axios, The Hill

Medicare for more than just medical care

  • Democrats have agreed on one provision of their proposed $3.5 trillion spending bill: expanding Medicare to include coverage for dental, vision and hearing care. Currently the traditional Medicare program, which covers about 75% of senior citizens, provides only limited coverage for these services. The Congressional Budget Office estimates this policy would cost the federal government $358 billion over the next decade, and some centrist senators including Joe Manchin (D-W. Va.) are questioning how the policy will be paid for. (The Washington Post, The Hill, Axios)

 FDA cracks down on marketing malpractice

  • The Food and Drug Administration (FDA) issued a stern letter to Amgen after the company released an advertisement for Neulasta, a bone marrow stimulant, that cited a study purporting a statistically significant higher risk of developing febrile neutropenia when using a pre-filled syringe versus an injector. Amgen markets the “OnPro” injector kit which was promoted in the advertisement. The FDA’s letter said the study had “multiple limitations” and the ad was “concerning from a public health perspective.” (STAT)

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