UK PM Theresa May loses historic Brexit vote

British Prime Minister Theresa May on Tuesday urged MPs to vote in favour of the Brexit deal she has struck with the EU. (AFP/Screenshot)
Updated 16 January 2019
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UK PM Theresa May loses historic Brexit vote

  • Defeat now raises the question about whether she will try again, is removed from office, delays Brexit -- or if Brexit even happens at all
  • Labour leader Jeremy Corbyn tables a motion of no confidence in May's government

LONDON: Britain’s parliament on Tuesday resoundingly rejected Prime Minister Theresa May’s Brexit deal, triggering a no-confidence vote in her government and plunging its plans to leave the EU into further chaos.
MPs voted 432 to 202 against May’s plan for taking Britain out of the European Union, the biggest parliamentary defeat for a government in modern British political history.
With a deal that took nearly two years to craft in tatters and her government’s future hanging in the balance, EU leaders sounded a note of exasperation, urging Britain to come out and say what it actually wants.
“If a deal is impossible, and no one wants no deal, then who will finally have the courage to say what the only positive solution is?” EU president Donald Tusk tweeted.
Jean-Claude Juncker, the European Commission president, warned of a heightened risk of a “no deal” Brexit — an outcome that could disrupt trade, slow down the UK economy, and wreak havoc on the financial markets.
The government of Ireland — the only EU member state with a land border with Britain — said it would now intensify preparations to cope with a “disorderly Brexit.”
And German Finance Minister Olaf Scholz, representing the EU’s most dominant economy and leading political voice, called the vote “a bitter day for Europe.”
Most lawmakers have always opposed Brexit, as have some leading members of the government, creating a contradiction that has been tearing apart Britain ever since a June 2016 referendum began its divorce from the other 27 EU states.
Moments after Tuesday’s outcome, which was met with huge cheers by hundreds of anti-Brexit campaigners who watched the vote on big screens, opposition Labour leader Jeremy Corbyn submitted a motion of no-confidence in May’s government, calling her defeat “catastrophic.”
The vote is expected on Wednesday at 1900 GMT.
May sought to strike a conciliatory tone, telling MPs they had the right to challenge her leadership and promising to hold more talks to salvage a workable solution by the rapidly approaching March 29 Brexit deadline.
She promised to hold discussions with MPs from across parliament to identify ideas “that are genuinely negotiable and have sufficient support in this House.”
“If these meetings yield such ideas, the government will then explore them with the European Union.”
Downing Street said May will then return to parliament with a new Brexit proposal on Monday.
With their nation again in turmoil, noisy supporters and opponents of Brexit, rallied outside the ancient parliament building in London.
“It could end up being the day that will lead to us leaving with no deal!” said 25-year-old Simon Fisher, who backs a swift and sharp break with the EU.
A much larger rally nearby in support of a second referendum turned Parliament Square, dotted with statues of past UK leaders, into a sea of EU flags.
Economists said the scale of May’s defeat — on the upper end of most predictions — now also put pressure on Brussels to make more meaningful compromises.
The pound surged higher against the dollar and euro after the vote, seemingly buoyed by May’s promise to seek a compromise with her opponents.
“Markets project beliefs and the underlying belief is that nobody’s going to be committing economic suicide,” BK Asset Management’s Boris Schlossberg said.
But businesses voiced alarm about the outcome, which does nothing to resolve uncertainty that has been dampening the UK investment climate for months.
“Financial stability must not be jeopardized in a game of high-stakes political poker,” warned Catherine McGuinness, policy chair at the City of London Corporation, the body governing the British capital’s massive financial district.
May made it her mission to carry out the wishes of voters after she became prime minister a month after the referendum, putting aside her own initial misgivings and stating repeatedly that “Brexit means Brexit.”
But her deal raised concern that Britain could end up locked in an unfavorable trading relationship with the EU.
Criticism of the deal was focused on an arrangement to keep open the border with Ireland by aligning Britain with some EU trade rules, if and until London and Brussels sign a new economic partnership — a tortuous process that could take several years.
Arlene Foster, head of Northern Ireland’s Democratic Unionist Party upon which May relies for her parliamentary majority, said May needed to win binding concessions from Brussels to secure her vote.
“Reassurances whether in the form of letters or warm words, will not be enough,” said Foster.
“The prime minister must now go back to the European Union and seek fundamental change to the Withdrawal Agreement.”
Speculation is growing on both sides of the Channel that May could ask to delay Britain’s divorce from the EU after almost half a century of membership.
But a diplomatic source told AFP any extension would not be possible beyond June 30, when the new European Parliament will be formed.


As medical costs mount, Japan to weigh cost-effectiveness in setting drug prices

Updated 2 min 21 sec ago
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As medical costs mount, Japan to weigh cost-effectiveness in setting drug prices

  • The Japanese government estimates that public medical spending could surge 75 percent to 68.5 trillion yen ($624 billion) by 2040
TOKYO: Japanese doctor Yasushi Goto remembers prescribing the cancer drug Opdivo to an octogenarian and wondering whether taxpayers might object to helping fund treatment, which at the time cost hundreds of thousands of dollars, for patients in their twilight years.
Japanese have easy access to new medicines, whose prices are decided by the government and subsidised by the country’s public health insurance system.
But that may change. Japan, confronted with the ballooning cost of caring for an aging population, is introducing a cost-effectiveness test for drugs as a means of capping prices.
There are no plans to deny care for patients of any age. But limiting the prices of innovative but costly treatments might chase new drugs out of the $86 billion Japanese market, drugmakers say.
“If you ask whether it’s worth prescribing an 85-year-old patient Opdivo, a lot of people will say no. But patients and family members are going to say yes,” said Goto, who works at the National Cancer Center Hospital.
Patients also fear more drastic changes, such as denying access to new medicines; Prime Minister Shinzo Abe’s economic council in December proposed considering cost in determining whether to approve treatments.
“For cancer patients like us, it’s not acceptable if the government applies a cost-effective analysis in determining whether to approve treatments,” said Yoshiyuki Majima, a director of patient advocacy group Rare Cancers Japan.

SUSTAINABILITY OR ACCESS
The Japanese government estimates that public medical spending could surge 75 percent to 68.5 trillion yen ($624 billion) by 2040.
“It is obvious that Japan will face difficulties in providing social security service,” said a government official involved in the discussions, declining to be named because he is not authorized to speak to media. “The cost-effectiveness analysis is a means to secure sustainability.”
The system that will be adopted in April, according to a draft published on the health ministry’s website, compares the cost to the effectiveness of new treatments using an “incremental cost-effectiveness ratio,” or ICER.
ICER, already used in countries such as Britain, considers how much it costs to give a patient one additional year of healthy life compared with existing alternatives. If that exceeds 5 million yen, for example, the government may insist on a lower price, according the policy draft.
There has been little public discussion; weekly meetings so far have involved mostly Health Ministry officials, doctors, academics and drugmaker executives.
“If I have rheumatoid arthritis and I can’t write or type, but then I get a treatment that enables me to go back to work, pay taxes, and take care of my family, that benefit is not going to be captured by the ICER,” said Kevin Haninger, a vice president of Pharmaceutical Research and Manufacturers of America, a lobbying group.
In an interview with Reuters, he insisted Japan should carefully consider an impact on the industry when introducing such analysis to reduce drug prices.
“If Japan is going to cut prices so much, I think Japan will really run a risk of losing its current position,” he said.

LUCRATIVE MARKET NO MORE?
Drugmakers have been complaining about price cuts since 2017, when the government decided to review costs more frequently.
Japan has slashed the price of Opdivo, developed by Ono Pharmaceutical Co. Ltd. and Bristol-Myers Squibb, by more than 75 percent in the last two years. It has also lowered Gilead Science’s hepatitis C drug Sovaldi by 32 percent since 2016.
But while drugmakers threaten to pull back from Japan, the government is prepared to call the industry’s bluff, saying Japan is too lucrative a market for companies to ignore, according to two government officials, who declined to be named because they are not authorized to speak to the media.
Unlike the United States, where insurers may deny claims, or the UK, where patients can be denied costly drugs, Japan is seen as a relatively predictable market because of its social insurance system.
For example, Novartis’ Kymriah, a type of therapy in which a patient’s T-cells are modified to attack cancer cells, is expected to be approved in Japan this year.
The price for paediatric leukaemia patients, to be set by a government panel after approval, is expected to start at about $475,000, similar to US prices. With an estimated 250 Japanese eligible for treatment with Kymriah, sales in Japan are a potentially lucrative addition to Novartis’ bottom line.
Novartis declined to comment on potential effects of a new pricing policy.
Goto said the government should focus on reducing prescriptions for illnesses that are not serious, rather than costly but possibly life-saving treatments for a small number of patients.
“Flu medicines, for example, can be seen to have very low cost-effectiveness because they don’t save people’s lives, except those of infants or pregnant women, compared with cancer drugs that are critical for some patients,” he said. ($1 = 109.6800 yen)