Analysis

Martin Shkreli Is Going to Jail Because He Forgot There Are Consequences For Hurting the Rich

The frat boy of pharmaceuticals, Martin Shkreli, was sentenced to seven years in prison last Friday for securities fraud and conspiracy. After four years of earning millions by controlling the supply of certain medications, he was convicted of defrauding hedge fund investors in a Ponzi scheme.

In many ways Shkreli is a master of American capitalism, but he forgot its cardinal rule: Hurting people with less money than you is part of doing business, but ripping off other rich people is a line you do not cross.

Like most people, I first heard the name Martin Shkreli when he made news for hiking up the price of a drug called Daraprim. The medication is used to treat life-threatening infections that can strike people with compromised immune systems, particularly people with AIDS. After Daraprim was acquired by Shkreli’s company in 2015, the price of a single tablet skyrocketed by 5,000% overnight from $13.50 to $750. It was at least the second time he had used the tactic: A year earlier he encouraged a different company to inflate the price of a kidney stone medicine called Thiola, increasing the daily cost from $30 to $450.

To be fair, he isn’t the only one guilty of this offense. Hundreds of other drug company executives have committed similar deeds to rake in as much profit as possible. But few others have been so blatant about it, reveling with such glee in both the frustration of patients and the rewards of his gluttony. Shkreli seemed to delight in flaunting his wealth. He loved showing off all the pricey toys and trinkets he bought with his drug company profits, including an infamous (and now subject to forfeiture) one-of-a-kind Wu-Tang Clan album. It was the kind of entitled, spoiled-rich-kid behavior that earned him the nickname, “Pharma Bro.”

From all appearances, life was good for Pharma Bro in those glory days of making a lifesaving drug unaffordable to those who desperately needed it. He was universally loathed, but nothing he did was actually illegal.

I had always assumed that somewhere behind the scenes, someone was getting rich

I don’t currently have any family members who take Daraprim, as far as I know. However, my family and I rely on other expensive drugs to stay alive or maintain even just the bare minimum quality of life. My sister is on a host of drugs to treat advanced multiple sclerosis (MS), rheumatoid arthritis, lupus, and severe asthma. Or should I say, she is supposed to be on these drugs. She doesn’t have insurance, so she hasn’t taken any of them in more than a year. Just one of her MS drugs, Rebif, costs more than $5,000 a month. That’s $60,000 per year.

I would go to fill my child’s prescriptions, and then see the staggering price lists on the computer screen.  The clerk or pharmacist would call me over to the side for a private consult. Their expression was always one of either shock or pity, or a combination of both. In whispered tones, they would say something like, “Um, this is pretty expensive, so I just wanted to make sure you were aware of that.” If you were lucky enough to have insurance that would cover any portion of this—usually a relatively small amount—the insurance company would also often get involved at this point. Then you would face the additional experience of insurance companies playing doctor, attempting to make critical decisions about your lifesaving treatments.

Sometimes I’d try to bargain with the pharmacist by asking if they could dole out a one-week supply at a time, so I could pay in smaller increments. There were times when I had little or no money at all, and would break down in tears at the pharmacy counter. In the end, though, you usually would be left to face the inevitable: Come up with the money, or go without it.

Sometimes the prices are justified—the rarer the drug, the more costly the treatment—but a lot of the time it’s not. I had always assumed that somewhere behind the scenes, someone was getting rich off the proceeds of these meds, whose sky-high prices often sent me into an emotional panic. But I never realized how arbitrary it could be until I read the coverage of Shkreli and his Daraprim price hike a few years ago.

Shkreli was famous for his cocky smirk and glib attitude towards anyone who questions his methods, but he reportedly cried when his sentence was announced. He presumably never shed tears for the people who needed his companies’ medications so they wouldn’t die, or the many people like me who have sobbed at a pharmacy counter.

We are left to wonder why justice only appeared when the victims were rich.

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First Person

For Domestic Violence Survivors, Courts Can Be Another Abuse

My abuser’s father was the one who delivered the court’s petition to my slummy apartment.   Because I had a protection order in place, my abuser couldn’t do it himself. I was in the bathroom, getting ready for bed—I had an interview the next day for a job as a paid fundraiser for a local arts program—so my husband accepted the paperwork in my stead. It was a request for genetic testing to establish paternity of the child my abuser had forced me to birth when I was 19 years old.

The first day I stood in the courtroom, all I had was my story. I prepared to tell the judge that I had been groomed by the man seven years my senior since I was 14; that I had been kidnapped, drugged, beaten, bitten, strangled, and raped. I prepared to tell her that the last time we were alone together, the petitioner strangled me while I was holding my infant son until I had a seizure and dropped my baby. I prepared to tell the judge that my son was now an eight-year-old boy who still wore diapers and could not speak, while I was in recovery from a heroin addiction that had, for many years, been my only means of coping with the PTSD.

My abuser came to court equipped with an attorney. His lawyer was a tall man with an olive complexion and an easy self-confidence that he showcased by strolling through the courtroom, addressing the clerks by name and punctuating their interactions with a rolling belly laugh. My abuser’s attorney had all the papers in order. I, attorneyless, did not.

When the judge entered she told me I needed a lawyer, and offered me a continuance I didn’t know I could request. I took it, thinking it would give me a little more time before my son would officially belong to the man who had terrorized me when I was little more than a child myself. I knew the continuance would ultimately make no difference; there was no attorney I could afford.

This type of legal divide is not uncommon. According to the American Psychological Association, abusive fathers file for sole custody more often than fathers who have no history of domestic violence. Since 99 percent of domestic violence victims also face some form of financial abuse, abusers tend to have more money and thus more access to legal resources than the women fleeing their abuse. That gives them an advantage in the courts that makes them just as likely, or even more likely, to gain custody.

Litigation gave him freedom to pick at the most private things about me.

These prolonged legal battles can turn into an abuse of their own. Court-related abuse—sometimes called litigation abuse—is a widely under-recognized phenomenon in which a perpetrator of intimate partner violence will use family law court as a means of maintaining contact with their victims, even when legal protections would otherwise forbid it. Women and their children who have endured horrific abuses, including sexual molestation and rape, can be forced to interact repeatedly with their assailants in the courtroom upon escaping the relationships.

My abuser discovered his judicial advantage in 2016. I had a five-year protective order against him, a length of time I was told is rarely granted except in cases of extreme violence. But even that did not stop my abuser from dragging me to court.

Unlike many women, I got lucky. I won a lottery for a pro bono attorney through a program offered by my county that mentors licensed lawyers hoping to switch from their previous specialty to family law. These lawyers are only available—in limited quantity—to domestic violence survivors involved in custody cases where a child faces significant danger should the outcome favor the opponent. My attorney’s previous specialty was personal injury law. My abuser’s attorney had been practicing family law for decades. He filed claim after claim trying to dispute my testimonies, forcing me to recount abuses I hadn’t even yet addressed in therapy, and painting me as the negligent junkie who abandoned my son and couldn’t even keep a home clean.

When the case was over, I asked my attorney if she still planned to pursue family law. She said no.

After a year of litigation that included a comprehensive assessment by a child’s advocate, threats of Child Protective Services involvement, numerous courtroom proceedings that placed me side-by-side with my abuser, and an attempt at mediation, my abuser got bored and gave up his parental rights. Or maybe his new girlfriend became angry that he was giving me so much attention. Or maybe he litigated himself out of money, though that’s extremely rare in these types of cases. I don’t know. What I do know is that my son’s biological father now gets to put his name on the birth certificate. I know that I still have a domestic violence protection order, but it no longer covers my now-10 year old son, who is nonverbal and cannot call for help or tell anyone if he is harmed.

During the proceedings, I lost my job as a fundraiser. I began hallucinating the face of my abuser over the faces of men who resembled him, which made me afraid to leave my home. I had to start taking medication for trauma nightmares that made me dizzy if I stood up too quickly in the morning. I also relapsed on heroin, briefly, and take medication now for that too. Before the case began, my PTSD centered on events in the past. Now I have to be scared of the future: of the possibility that my abuser will come after my son and me again.

Litigation gave him freedom to pick at the most private things about me. I had to defend the reasons why my son didn’t live with me. I had to defend how and why I have PTSD. I had to reveal my addiction and treatment history, and then defend that too. On the other hand, I learned very little about my abuser. What I did learn was that he has a new girlfriend. She is not yet fully fluent in English, which fits his pattern of bouncing between underage girls and women who are new to the country and language. I learned that he lives with his girlfriend on a small piece of land outside of the city. I heard they raise chickens, and that on some weekends his girlfriend’s daughter—a young girl who has begun experimenting with hair dye—stays overnight.

Editor’s note: To protect the privacy of certain individuals, identifying details have been changed. 

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First Person

The Bill That Would Legalize Discrimination Against My Daughter

My daughter was born 26 weeks into my pregnancy. When Charlie arrived she weighed one pound and 12 ounces, and she was just as long as my finger. During the first few weeks of her life, I watched her overcome what felt like insurmountable obstacles. She struggled to breathe, her stomach wasn’t mature enough to digest food, and her skin was so thin it was agony for her to be held. I worried that we were asking too much of her, but she fought to survive. Today, she is a joyous 5-year-old, though she has residual effects of her significantly premature birth. Charlie was incredibly susceptible to infections, and she has delays in speech and fine motor development. She will go through life with a disability: she needs help tying her shoes, using scissors, and opening her lunch.

Throughout 2017, my family and I have fought constantly for Charlie’s health care. I have marched, spoken at press conferences, and met with more representatives than I can count to try to explain what Congressional Republican attempts to repeal Obamacare and slash Medicaid funding would do to my family. I’ve spent days, hours, and weeks travelling back and forth between my home in Charlottesville, Virginia, and Washington, D.C., because I knew fighting for Charlie’s life meant fighting for affordable, accessible, and comprehensive health care.

When Charlie was an infant, I would often sit and watch her. Sometimes, she would forget to breathe and I would gently remind her with a nudge. When we defeated Graham-Cassidy, the last attempt to overturn the Affordable Care Act, it finally felt like we could both breathe more easily.

But now there is a new threat on the horizon: HR 620, the ADA Education and Reform Act, has already passed the House and is at risk of being taken up in the Senate. If it’s passed, the bill will change key provisions of the Americans with Disabilities Act (ADA), shifting the burden of accessibility from businesses to people with disabilities.

Sometimes, Charlie would forget to breathe and I would gently remind her with a nudge

For 28 years now, the ADA has given people like Charlie the unassailable right to be part of public life: They cannot be discriminated against at work or in school, and businesses have to be accessible by including things like curb cuts and accessible bathroom stalls. Over the years, people with disabilities have needed to pursue litigation under the ADA when businesses refuse to become accessible. And it’s worked. Our society is much more accessible today than it was nearly three decades ago when disabled activists had to climb up the steps of the Capitol to get attention. But HR 620 threatens to send us back to that time—a time when people with disabilities were excluded from public life.

Under HR 620, people with disabilities will have to notify businesses that they are violating the ADA, citing very specific details regarding the provisions of the statute that apply to their particular situation. Business owners would then have up to six months to make “substantial progress” toward fixing the issue, but they don’t have to be fully accessible. That is at least six months before the person filing the complaint can access a restaurant, or a movie theater, or a book store that’s effectively barred its doors to people with disabilities—even though accessibility has been the law for almost 30 years.

No other marginalized community needs to demonstrate why they deserve to access a public space, let alone cite specific legal provisions, in order to be able to access that space. Why should Charlie have to?

The ADA made the American Dream possible for a generation of people with disabilities. Now my child is being told the American Dream is no longer available to her. This isn’t the United States of America I know, and it isn’t the society I want to live in.

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First Person

Trump Wants to Get Rid of the Heating Support that Kept Me Safe

For the second year in a row, President Trump’s budget plan eliminates the program that provides heating and cooling support for to 6 million households in the United States. To justify the cut to the Low Income Home Energy Assistance Program (LIHEAP), Trump claimed it is “low-performing,” “ineffective,” and has “difficulty demonstrating effective outcomes.”

I’m here to offer an effective outcome: Me.

I grew up in a rural Western Massachusetts town surrounded by forest, farms, and shuttered mills, where it was a 30 minute drive to the nearest grocery store. Winters were a wonderland filled with snow days, cross-country skiing, roaring fires, and sledding. However, when I was 12 years old, my dad left and took our financial stability with him. After 21 years of marriage, my suddenly single-income mum had to find a way to pay the mortgage, keep food in the fridge, put gas in the car, and—in a town where snowfall is measured in feet rather than inches— heat a drafty home through the New England winters.

The original 1970s heating system was intended for a single floor house. Despite its best efforts, the heat would be sucked into the large, dank cement basement, and never reach the second floor that my crafty grandpa added himself. When the temperatures dropped outside, regularly into the single digits, the painful damp cold seeped through the walls and into my bones. I would layer socks with slippers and pair flannel pajamas with sweaters and thick robes. I walked around the house wrapped in blankets, gripped with a constant panic because I could not get warm. Then, when I looked at the thermostat, I would find the already-inadequate heating system was only set to 55—nowhere near the temperature that could have forced the heat up from the basement and into the termite-riddled corners of our house.

But my mum was rationing the heat.

We staged silent, passive-aggressive battles over the temperature for years. I could not understand why we didn’t set the heat to 70 or 72 like my friends’ warm, comfortable houses. So, as the temperatures went down, I would tip-toe to the thermostat at the top of the basement stairs and crank the heat up twenty degrees. Then, when I was caught—and I always got caught—conflict would erupt.

During one particularly tense argument, my mum snapped and told me that the only reason we could even afford to keep the heat in the 50s was the government assistance that helped pay for the oil that heated the house. She was still paying for heat, but the program helped shave a few dollars off each gallon. If I kept turning up the thermostat to more bearable temperatures, we would run out of oil for the month.

Our family only talked about finances during arguments like that: Once someone had been pushed too far, the truth would come rushing out. I pieced together my understanding of money, and adulthood, and class from my memories of those moments. But during the winters when I was still a teenager, I couldn’t get past the disbelief. How could turning the dial to 70 mean we would be without heat in the heart of a Massachusetts winter? How could regions with extreme cold allow residents to live without a basic need like heat?

It took years for me to realize my mum was hiding our financial problems because she was trying to protect me. She was working hard to help our family recover after we lost our only source of income. My mom had stayed home to raise me, so when my dad left, she didn’t have a career to fall back on. She paid the bills by begging friends and the family priest to let her clean their houses and edged her way up to juggling a variety of part-time jobs: temping in offices, restocking clothes at TJ Maxx, and working the night-shift as a receptionist in the emergency room. During this time, LIHEAP was a short-term resource that helped pull us out of a terrifying financial black hole.

When my mom finally secured a full-time receptionist position, she immediately donated to fuel assistance programs because she was so grateful that LIHEAP had given us a chance to stabilize financially. It didn’t keep my house luxuriously warm, but it kept us safe and alive in dangerously cold weather.

Today, only 20 percent of all the households in the US that qualify for LIHEAP actually receive assistance paying for heat or weatherizing their houses. That means for the 6 million families who receive help, there are another 24 million families who are eligible but go without. The program has a brutal, “first come, first serve” policy: When each state’s LIHEAP money runs out, agencies stop accepting applications for assistance—often before winter ends. The families lucky enough to receive LIHEAP can find themselves exhausting their funds before winter is over. The remaining families are left with impossible choices: whether to pay for the heat or the mortgage, whether to live with the cold or to put kerosene heaters in the house.

Trump’s budget would make that a reality for everyone.

Correction: An earlier version of this article misstated the reason the author’s mother’s career history. 

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Interview

The Leaked Rule That Could Ban Immigrants Based on Income, Explained by Experts

Earlier this month, leaked documents revealed that the Trump administration is preparing new rules that would effectively end the United States’ family-based immigration system. If implemented, the regulation would prevent low-income and working-class immigrants from entering the country by denying legal status to immigrants considered “likely” to become a so-called “public charge.”

Currently, immigration officials can only consider the use of cash assistance, such as Temporary Assistance for Needy Families—a program that serves very few people—in determining whether someone is likely to become a “public charge.” But under Trump’s new rules, immigrants could be barred from legal status for turning to a whole range of public programs that millions of families rely on, including Head Start, the Supplemental Nutrition Assistance Program (SNAP), nutrition assistance for Women Infants and Children (WIC), housing assistance, home heating assistance—even the Children’s Health Insurance Program and subsidies under the Affordable Care Act.

To understand what this new policy will mean for immigrant families if it goes into effect, I spoke with Shawn Fremstad, a senior fellow at the Center for American Progress, and Hidetaka Hirota, professor of history at the City College of New York and author of Expelling the Poor, which examines the United States’ long history of keeping out immigrants who come from poverty.

Rebecca Vallas: What is the Trump administration considering in this moment, and what do we know about the rules they’re working on from the leaks?

Shawn Fremstad: So, as we all know, this is not a very pro-immigrant administration. Just this week they’ve taken out the “nation of immigrants” language from the actual motto of the United States Citizenship and Immigration Services (USCIS), what used to be known as the INS [Immigration and Naturalization Service]. But now we know the administration is doing a stealth campaign using this longstanding “public charge” provision in immigration law. It’s a way to undermine the family-based immigration system we have and target working-class immigrants from low-income countries, from Mexico, from countries that Trump called “shithole countries.”

RV: I was going to say it if you didn’t.

SF: At its core, it’s about keeping out poor immigrants. This is a rewriting of a longstanding rule. What it meant historically is that you’re a “public charge” if you’re basically going to become completely dependent on welfare-cash type benefits, or institutionalized for long-term care with Medicaid. So it’s really someone who is not working, not able to work, and doesn’t have anybody else supporting them and they’re primarily dependent on benefits. So it’s a very limited thing.

But what the administration is saying is that it’s no longer going to be about whether you’re primarily dependent and not working; it’s are you going to be low-income? Are you going to be below median income? What they say is they’ll weigh it heavily in your favor if you have 250 percent of the poverty line as an income, which is basically around median earnings for a white male worker in the United States.

They also have a long list of benefits that if you’re likely to access them after being admitted to the United States as a green card, as a lawful immigrant, those are the kind of things that will be held against you. This is quite radical. It includes things like the Premium Tax Credit that was part of the ACA, which goes up to 400 percent of poverty. For many families that’s a middle-class benefit. That would not be something that “makes you a public charge.” You could be working full time, making a good salary, and the only issue is you’re not getting health care from an employer, so you need to access this.

They also include things like Head Start, Pell grants—it’s an extraordinary list.

RV: Even the Children’s Health Insurance Program.

SF: Yes. It’s a long list of programs that legal immigrants are often eligible for in the United States.

RV: Help us understand how this is actually going to look in practice.

SF: This public charge test comes up in two broad scenarios. One is you’re a family member here in the United States, you want to bring over a family member and get a family-based visa for them. They are subject to this public charge test so they have to meet that before they can get the visa. So if that person looks like somebody who might get any of these benefits, then the public charge test could be used to exclude them.

The other situation is there are a lot of people in the United States—some undocumented, some under different lawful statuses—who have children in the household who are U.S. citizens, and the child is getting Medicaid because they’re eligible as U.S. citizens. The child is getting SNAP or WIC. Now the test can be applied to the parents simply because they got food stamps or Medicaid or other benefits for that child. So there’s a potential to keep people out who haven’t come to the United States and to penalize people who are here now. It’ll make people much less likely to turn to programs that could help their child’s healthy development, education, et. cetera.

RV: Professor Hirota, effectively barring entry to immigrants who come from poor or low- income backgrounds is something that you’ve called “poverty-based immigration control.” Tell us about the history of this public charge provision that Shawn’s been describing and how it fits into the country’s broader history of keeping out immigrants for economic reasons.

Hidetaka Hirota: The public charge clause has a really long history in the United States, with origins in the colonial period. British settlers essentially brought their mother country’s poor law, which banished the “transient beggar”—that is, the poor people who did not belong to the community beyond the boundary of the community. This kind of poor law was eventually inherited by states after the American Revolution, and when a large number of impoverished Irish immigrants arrived in the US over the first half of the 19th century, these laws eventually developed into immigration laws. So America’s first immigration law really originated from poor law, and the primary purpose of the law was the deportation back to Europe of the destitute Irish immigrants already in the US.

In the late 19th century these poor laws developed into the nation’s first national immigration law—the Immigration Act of 1882. This law, along with the Chinese exclusion law of 1882, laid the foundation for subsequent national immigration law. And the anti-poverty clause, or likely to become “public charge” laws, remained in national immigration laws. So anti-poverty sentiment was really deeply integrated into the American system of selecting immigrants and this has a longer history than we think.

In the 1930s refugees from Nazi Germany became targeted

SF: In different nativist periods this has been interpreted in different ways to target different communities. So in the 1930s refugees from Nazi Germany became targeted. In some periods it’s been so-called “degenerates,” denying people based on sexual orientation. Nobody says public charge in real language today. It’s an archaic, ancient term and it gets filled with whatever the animus is today.

HH: I would add that a central feature of this “likely to become public charge” law is massive discretionary power of the inspecting officer. They have tremendous power to determine who could be enter and who should be expelled thanks to this vague clause.

In the mid 19th century, when there were Anglo-American officers, Irish people suffered disproportionately because of this clause compared to other immigrant groups like Germans. And in the early 20th century, Asian immigrants like Japanese and South Asians were targeted for this clause. There were middle class Japanese immigrants with some cash, and they did not appear likely to become a “public charge” from an economic point of view. But the officers excluded them as potential paupers on the grounds that in America, racism was too strong, so these immigrants wouldn’t gain employment. Despite the possession of potential cash and middle-class appearance, they were deemed likely to become public charge.

The whole clause can operate with very strong racist dimensions, and this also applies to the Trump administration’s proposed new rule. The new rule would not apply to immigrants equally. The officers could have very strong discretionary power in deciding whose visas can be renewable by simply manipulating this “likely to become public charge” rule.

RV: Shawn, how do we expect this to move forward in the weeks ahead and how should folks get involved if they want to try to stop this from becoming the policy of the land?

SF: Right now it’s still in a draft form but we think it will get published in what’s called the Federal Register as a proposed rule probably in the next 30 to 60 days. And this will be an opportunity to formerly comment and an important point to really lift this up and focus. I think it’s been very under the radar so far because it isn’t out there officially and there’s so much else going on right now.

RV: And we’re seeing chilling effects playing out in communities across this country with immigrant families, actually going into social services office and saying stop my food stamps, stop my kid’s Headstart, because I’m afraid this is exposing my family to danger and perhaps the risk of being split up.

SF: I think at this point people should not panic, one important thing to know is that the draft version of the rule says it will be prospective so it’s looking forward; if you had received these benefits in the past we’re not going to count that. So making sure you’re in touch with immigrant advocacy organizations who can tell you more about this is important.

RV: As the National Immigration Law Center has put it, and I think these are probably the right words to end on with a heavy and truly demoralizing topic: if this policy goes into effect, “no longer would we be the country that serves as a beacon for the world’s dreamers and strivers. Instead America’s doors would be open only the highest bidder.”

This interview was conducted for Off-Kilter and aired as part of a complete episode on February 23. It was edited for length and clarity.

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