James Comey described how Donald Trump eats the souls of those who work for him
James Comey wrote a fascinating column (no paywall) in the NY Times four years ago that I seem to have missed. In it, Comey describes in detail how Trump suborns people and leads them astray until they are trapped. Comey concludes:
What happened to these people? [those who have become Trump’s accomplices and supporters – LG]
I don’t know for sure. People are complicated, so the answer is most likely complicated. But I have some idea from four months of working close to Mr. Trump and many more months of watching him shape others.
Amoral leaders have a way of revealing the character of those around them. Sometimes what they reveal is inspiring. For example, James Mattis, the former secretary of defense, resigned over principle, a concept so alien to Mr. Trump that it took days for the president to realize what had happened, before he could start lying about the man.
But more often, proximity to an amoral leader reveals something depressing. I think that’s at least part of what we’ve seen with Bill Barr and Rod Rosenstein. Accomplished people lacking inner strength can’t resist the compromises necessary to survive Mr. Trump and that adds up to something they will never recover from. It takes character like Mr. Mattis’s to avoid the damage, because Mr. Trump eats your soul in small bites.
It starts with your sitting silent while he lies, both in public and private, making you complicit by your silence. In meetings with him, his assertions about what “everyone thinks” and what is “obviously true” wash over you, unchallenged, as they did at our private dinner on Jan. 27, 2017, because he’s the president and he rarely stops talking. As a result, Mr. Trump pulls all of those present into a silent circle of assent.
Speaking rapid-fire with no spot for others to jump into the conversation, Mr. Trump makes everyone a co-conspirator to his preferred set of facts, or delusions. I have felt it — this president building with his words a web of alternative reality and busily wrapping it around all of us in the room.
I must have agreed that he had the largest inauguration crowd in history because I didn’t challenge that. Everyone must agree that he has been treated very unfairly. The web building never stops.
From the private circle of assent, it moves to public displays of personal fealty at places like cabinet meetings. While the entire world is watching, you do what everyone else around the table does — you talk about how amazing the leader is and what an honor it is to be associated with him.
Sure, you notice that Mr. Mattis never actually praises the president, always speaking instead of the honor of representing the men and women of our military. But he’s a special case, right? Former Marine general and all. No way the rest of us could get away with that. So you praise, while the world watches, and the web gets tighter.
Next comes Mr. Trump attacking institutions and values you hold dear — things you have always said must be protected and which you criticized past leaders for not supporting strongly enough. Yet you are silent. Because, after all, what are you supposed to say? He’s the president of the United States.
You feel this happening. It bothers you, at least to some extent. But his outrageous conduct convinces you that you simply must stay, to preserve and protect the people and institutions and values you hold dear. Along with Republican members of Congress, you tell yourself you are too important for this nation to lose, especially now.
You can’t say this out loud — maybe not even to your family — but in a time of emergency, with the nation led by a deeply unethical person, this will be your contribution, your personal sacrifice for America. You are smarter than Donald Trump, and you are playing a long game for your country, so you can pull it off where lesser leaders have failed and gotten fired by tweet.
Of course, to stay, you must be seen as on his team, so you make further compromises. You use his language, praise his leadership, tout his commitment to values.
And then you are lost. He has eaten your soul.
Read the whole thing. (no paywall)
Lessons from Washington State’s New Capital Gains Tax
You’d think that, with Republicans so eager to reduce the deficit, they would endorse getting more tax revenue from those who can easily afford it. However, that’s not the case. One must recognize that Republicans almost always act in bad faith, and their hypocrisy runs deep.
Kamau Chege reports in The Urbanist:
Taxing the rich works like a charm.
Last week we learned that the capital gains tax — which was passed by the state legislature in 2021 to fund much-needed childcare and public education — will bring in nearly $601 million more in state revenue than previously projected in the biennium.
For decades, the wealthiest Washingtonians have gotten out of paying what they truly owe in state and local taxes. It’s worth taking a moment to reflect on this stride toward a more progressive tax system in our state, and the court case that almost rolled it back.
One of the first lessons is that our state’s richest residents are much, much richer than we understood — and they are continuing to get richer at a faster rate than previously assumed.
According to the Department of Revenue, just 1,200 tax returns and 2,500 extensions represent the households paying the new 7% capital gains tax on profits over $250,000 gained from selling stocks and bonds. And despite high interest rates and a stock market that contracted by 25% in 2022, these capital gains tax payers would have had to rake in billions more in passive profits from their stockpile of wealth last year.
Among that group of tax filers were a few individuals who filed a lawsuit in an attempt to roll back the new tax: but in early March, the State Supreme Court ruled that the lawsuit had no merit.
The landmark decision and the case put forward by the tax dodgers lends us our second lesson: the tired arguments used to defend the rich from paying their share of taxes should be put to rest.
The plaintiffs in that case essentially argued that their capital gains were their income, which they alone earned, and therefore should not be subject to the tax.
But working people know that private wealth is built on public infrastructure and public investments paid for by all of us — especially low-income folks who pay more than their share in taxes. The roads and the transportation system corporate executives use to get goods to market, the schools and universities that train their workers, and the regulation and safety systems they rely on build the wealth of the people who live and do business in our state.
When I studied accounting in college, I volunteered to help low-income families file their taxes. I sat down with bus drivers, hotel workers, and childcare providers and the rate that they had to pay in taxes astounded me. It was far more than their share, especially when the richest people in our state, like Jeff Bezos and Bill Gates, have armies of accountants working to find tax loopholes and write-offs.
Those accountants don’t have to look too closely, because our tax system has been set up to benefit the very rich. Here in Washington State,
Propaganda rarely looks like this
Caitlin Johnstone has an interesting column in Consortium News, in which the above video appears (along with another very interesting video). I think the video understates the role of good journalism — for example, I have recently read of various legislation passed based on reporting in ProPublica and Judd Legum’s Popular Information. On the other hand, I certainly do not see much reporting on the basic flaws of capitalism — that decisions are made solely on how they affect profits, with clear examples of how that leads to danger to the public and the environment (by long trains, for example, or by not providing paid sick leave for food works — both of which have been reported but not the basic flaw in capitalism that led to those bad outcomes). Nor do journalists talk much about the damage from the ethos of “rugged individualism” and how we fare better with a cooperative community spirit — cf. barn-raising.
Nonetheless, the video is interesting — and this video has more on Chomsky’s ideas of manufacturing consent. When we talk about “manufactured consent,” that does not mean that everyone must conset — just enough people with enough power to determine the country’s direction. One might call it “manufactured effective consent,” with dissenters having no power to affect the decisions. For example, I did not consent to the US invasion of Iraq. In fact, I strongly opposed that invasion. But they did it anyway. James Fallows, who certainly has a greater voice than I, wrote a lengthy article in the Atlantic offer a strongly reasoned argument against the invasion.
But in the meantime, a coterie of newspapers, politicians, and influencers — including the NY Times, which was a big booster of the invasion — were beating the drums to go to war, and go to war we did, and killed hundreds of thousands of innocent people and also instituted systematic torture of suspects as US policy. No one has been held accountable for any of that.
Still, the overall thrust of Johstone’s column is worth your consideration. She writes:
People in the English-speaking world hear the word “propaganda” and might tend to think of something that’s done by the governments of foreign nations that are so totalitarian they won’t let people know what’s true or think for themselves.
Others might understand that propaganda is something that happens in their own nation, but think it only happens to other people in other political parties. If they think of themselves as left-leaning they see those to their right as propagandized by right wing media, and if they think of themselves as right-leaning they see those to their left as propagandized by left-wing media.
A few understand that propaganda is administered in their own nation by their own media, and understand that it’s administered across partisan lines, but they think of it in terms of really egregious examples such as weapons of mass destruction in Iraq or babies being taken from incubators in Kuwait.
In reality, all are inaccurate understandings of what propaganda is and how it works in Western society. Propaganda is administered in Western nations, by Western nations, across the political spectrum — and the really blatant and well-known examples of its existence make up only a small sliver of the propaganda in which our civilization is continuously marinating.
The most common articles of propaganda — and by far the most consequential — are not the glaring, memorable instances that live in infamy among the critically minded. They’re the mundane messages, distortions and lies-by-omission that people are fed day in and day out to normalize the status quo and lay the foundation for more propaganda to be administered in the future.
One of the forms this takes is the way the Western political/media class manipulates the Overton window of acceptable political opinion.
Have you ever noticed how when you look at any mainstream newspaper, broadcast or news website, you never see views from those who oppose the existence of the U.S.-centralized empire? Or those who want to close all foreign U.S. military bases? Or those who want to dismantle capitalism? Or those who want a thorough rollback of the creeping authoritarianism our civilization is being subjected to?
You might see some quibbling about different aspects of the empire, some debate over de-escalating against Russia in order to better escalate against China, but you won’t ever see anyone calling for the end of the empire and its abuses altogether.
That’s propaganda. It’s propaganda in multiple ways: it . . .
One thing that would protect us against propaganda is to teach every citizen, starting at a young age, critical thinking skills. (Edward DeBono developed a good program that begins in first grade and goes through elementary school, and it has proven effective in many schools.) However, I don’t believe that will happen in the US. The US has no national curriculum and the many thousands of school districts have the power to decide many aspects of curriculum (even though states do try to impose some curricular standards. What kills the teaching of critical thinking skills to young children is that, when they learn those skills, they start to practice them, and many parents do not like that. The children begin to question things the parents do not want questioned, and often parental pressure will kill the program.
The Congressional-military-industrial complex costs too much for what it delivers
Kevin Drum writes:
CNN has a remarkable story today about the vast difference in cost between warships built in the US and those built in Japan:
The country’s newest Maya-class destroyers are armed with 96 VLS cells that can fire both anti-ballistic and anti-submarine missiles, while the “quality of its sensors and systems stands at the very top end of the spectrum.”…Those 96 VLS cells put the Mayas on par with the newest of the US Arleigh Burkes, but there’s a crucial difference between them: The Arleigh Burkes cost $2.2 billion; the Mayas cost a billion dollars less.
….And it’s not just the Mayas. Take Japan’s Mogami-class frigates; speedy, stealthy 5,500-ton warships with 16 VLS cells that fire surface-to-air and anti-ship missiles. All done with a crew of 90 and a price tag of about $372 million each. By contrast, the first of the US Navy’s under development Constellation-class frigates are expected to cost three times as much and require twice as many crew.
These Japanese ships, along with others from South Korea, are designed to be very similar to American ships:
All these Japanese and South Korean vessels are designed to incorporate US technology, weapons, spy radars and the Aegis command and control system.
So why the vast difference in cost?
Cost overruns, endemic in US defense contracting, are not common in Japan, Schuster says, because — unlike the US — the country holds manufacturers to their estimates.
“A Japanese shipbuilder’s bid is an absolute. If they finish it below expected cost, they make a larger profit. If they encounter delays and mistakes, the builder has to correct it at their own expense,” Schuster said.
That sounds . . . a little too easy. There has to be more to it than “we won’t pay a nickel more than you bid.” Requirements change, specs change, and timetables change. It’s hardly possible in the real world for a bid to stay frozen in the face of that.
And yet, . . .
Photos from Thursday
When I walked around getting ingredients for my stew-fry, I saw many fine plants. Here are a few.
More signs of the decline of the US: Gov. Reynolds Signs ‘Worst Corruption Bill In Iowa History’
Newshound Ellen reports in Crooks & Liars:
As of July 1, the state auditor will be unable to ask a court to order state agencies and officials under investigation to provide records. Instead, the governor and her cronies will get to decide what gets examined. Iowa Public Radio explains:
It requires a three-member arbitration board to decide if the agency should release the information. One member would be appointed by the governor, one by the agency that’s being investigated (whose director is appointed by the governor), and the third member would be appointed by the auditor.
Iowa Auditor Rob Sand called the law “the worst pro-corruption bill in Iowa history” because it is “akin to letting the defendant decide what evidence the judge and jury are allowed to see.”
Not only that, the law may jeopardize $12 billion in federal funding by preventing the state from complying with federal award requirements and/or requiring more frequent audits, increasing state costs.
In an interview with TPM, Sand said the genesis of the bill is that “in my first term we uncovered more waste, fraud, and abuse than any other state auditor ever had, a record amount.” Some people didn’t like that. That includes $21 million of misspent federal COVID relief funds Reynolds said she’d return in 2020 and, as seen in the video above, $450,000 in late 2021.
“And then, the other piece of it that makes it easy to get other members of the legislature to go along is . . .
Also: video at the link.
Obesogens in Foods
The abstract from an interesting research report from the National Library of Medicine (emphasis added):
Obesogens, as environmental endocrine-disrupting chemicals, are supposed to have had an impact on the prevalence of rising obesity around the world over the last forty years. These chemicals are probably able to contribute not only to the development of obesity and metabolic disturbances in individuals, but also in their progeny, having the capability to epigenetically reprogram genetically inherited set-up points for body weight and body composition control during critical periods of development, such as fetal, early life, and puberty. In individuals, they may act on myriads of neuro-endocrine–immune metabolic regulatory pathways, leading to pathophysiological consequences in adipogenesis, lipogenesis, lipolysis, immunity, the influencing of central appetite and energy expenditure regulations, changes in gut microbiota–intestine functioning, and many other processes. Evidence-based medical data have recently brought much more convincing data about associations of particular chemicals and the probability of the raised risk of developing obesity. Foods are the main source of obesogens. Some obesogens occur naturally in food, but most are environmental chemicals, entering food as a foreign substance, whether in the form of contaminants or additives, and they are used in a large amount in highly processed food. This review article contributes to a better overview of obesogens, their occurrence in foods, and their impact on the human organism.
Why it’s in the public interest to require businesses to provide paid sick leave: Sick Workers Tied to 40% of Food Poisoning Outbreaks, C.D.C. Says
Amanda Holpuch reports in the NY Times (no paywall):
People who showed up to their restaurant jobs while sick were linked to 40 percent of food poisoning outbreaks with a known cause from 2017 to 2019, the Centers for Disease Control and Prevention said in a report released on Tuesday. Paid sick leave and other policies that support sick workers could improve food safety outcomes, according to the report, which was based on a review of 800 food poisoning outbreaks, using data provided by 25 state and local health departments.
Of the 500 outbreaks where investigators identified at least one cause, 205 involved workers showing up sick, the report said. Other common causes included contaminated raw food items, in 88 cases, and cross-contamination of ingredients, in 68 cases.
In 555 of the outbreaks, investigators were able to determine what virus, bacterium, toxin, chemical or parasite was to blame. Most outbreaks were caused by salmonella or norovirus, the report said.
To combat these outbreaks, “comprehensive ill worker policies will likely be necessary,” the report said. It highlighted research that showed that expanded paid sick leave reduced how often food service workers showed up at work sick, and noted that paid sick leave regulations were associated with decreased rates of food-borne illness.
Daniel Schneider, a professor of social policy at the Harvard Kennedy School, said the report was “sobering,” and highlighted that the United States is the only wealthy country with no federal paid sick leave.
“Reports like this show the real urgency of it, not just because it’s in workers’ interests, although it is, but because it is in the public interest,” Professor Schneider said.
Of the 725 managers who were interviewed by state and local health departments, 665 said that their business required food workers to tell a supervisor if they were sick, and 620 said that sick employees were either restricted or blocked from working. Fewer than half of the managers — 316 — said their business provided paid sick leave to workers.
Professor Schneider is a director of . . .
Continue reading. (no paywall)
Congress should pass a law requiring businesses with more than (say) 12 employees to provide paid sick leave, just as a public health measure. That would be Congress doing governing, and such a law is the only way to keep the playing level in that respect. That is, without such a law, some businesses will seek a competitive advantage by not providing paid sick leave because capitalism has a single criterion for making a decision: will it increase profit?
The beginning of the end of work
Kevin Drum posts:
When ChatGPT came out last November, Olivia Lipkin, a 25-year-old copywriter in San Francisco, didn’t think too much about it….In April, she was let go without explanation, but when she found managers writing about how using ChatGPT was cheaper than paying a writer, the reason for her layoff seemed clear.
….For some workers, this impact is already here. Those that write marketing and social media content are in the first wave of people being replaced with tools like chatbots, which are seemingly able to produce plausible alternatives to their work.
This is not what people expected when AI first became a topic of conversation years ago. Everyone figured the first victims of job loss would be blue-collar workers doing repetitive tasks: data entry clerks, customer service reps, taxi drivers, retail workers, and so forth. Then in 2017 Google published a paper about how to make Large Language Models work better and within a few years the most common form of AI was suddenly white collar and non-repetitive.
Automation has been taking jobs for years, of course. In that sense there’s nothing unique about Lipkin’s experience. Most likely she’ll get another job, this time at a shop that needs writing skills above the bare minimum that ChatGPT can currently provide.
But there’s still a difference. In the past, . . .
Synthetic v. Silvertip: Round 2 complete
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Continuing the series of testing badger v. synthetic on Declaration Grooming’s bison-tallow soaps, this morning I chose Phoenix Artisan’s Green Ray as the brush. It’s a close cousin of the Solar Flare brush that began this series. Again, the synthetic brush show no sign of “gripping” the soap, unlike the badger brushes. It moved easily over the surface of the soap and, in this case, made a better lather than yesterday’s badger brush did.
Perhaps Declaration Grooming’s Milksteak soaps, like Barrister & Mann’s Reserve soaps, work better with synthetic knots. More experimentation is required. In the meantime, today’s lather was luscious, and I do like this fragrance: “a blend of leather, tobacco flower, cedar, anise, oakmoss, and patchouli.”
The razor today has a RazoRock Lupo head and a Tradere handle. The Lupo is an excellent razor for me: lots of blade feel but still quite comfortable and non-threatening, and highly efficient. Three passes to perfection — and the lather’s consistency made it clump nicely on the razor until rinse (no drooling of lather into the sink).
A splash of Geo. F. Trumper Spanish Leather augmented with a couple of squirts of Grooming Dept’s Aion Hydrating Gel and the weekend is launched.
The coffee this morning is Fantanstico’s Carrizal: “Approachable and Easy Drinking. Full Bodied and Balanced With a Combination of Milk Chocolate, Praline and Caramel.”
More than 800m Amazon trees felled in six years to meet beef demand
Why is the Amazon rainforest being cut down? Profit. Why are more and more fossil fuels being extracted with new fields developed? Profit. Why is the earth becoming uninhabitable? That’s an unfortunate side effect, but look at how much profit was made.
Andrew Wasley, Elisângela Mendonça, Youssr Youssef, and Robert Soutar report in the Guardian:
More than 800m trees have been cut down in the Amazon rainforest in just six years to feed the world’s appetite for Brazilian beef, according to a new investigation, despite dire warnings about the forest’s importance in fighting the climate crisis.
A data-driven investigation by the Bureau of Investigative Journalism (TBIJ), the Guardian, Repórter Brasil and Forbidden Stories shows systematic and vast forest loss linked to cattle farming.
The beef industry in Brazil has consistently pledged to avoid farms linked to deforestation. However, the data suggests that 1.7m hectares (4.2m acres) of the Amazon was destroyed near meat plants exporting beef around the world.
The investigation is part of Forbidden Stories’ Bruno and Dom project. It continues the work of Bruno Pereira, an Indigenous peoples expert, and Dom Phillips, a journalist who was a longtime contributor to the Guardian. The two men were killed in the Amazon last year.
Deforestation across Brazil soared between 2019 and 2022 under the then president, Jair Bolsonaro, with cattle ranching being the number one cause. The new administration of Luiz Inácio Lula da Silva has promised to curb the destruction.
Researchers at the AidEnvironment consultancy used satellite imagery, livestock movement records and other data to calculate estimated forest loss over six years, between 2017 and 2022 on thousands of ranches near more than 20 slaughterhouses. All the meat plants were owned by Brazil’s big three beef operators and exporters – JBS, Marfrig and Minerva.
To find the farms that were most likely to have supplied each slaughterhouse, the researchers looked at . . .
Avoid artificial sweeteners (and refined sugar)
If you want something sweet, eat a piece of fruit. Artificial sweeteners in general are bad, and Lisa O’Mary discusses in Medscape a particular problem with sucralose (Splenda):
A new study reveals health concerns about the sugar substitute sucralose so alarming that researchers said people should stop eating it and the government should regulate it more.
Sucralose is sold under the brand name Splenda and is also used as an ingredient in packaged foods and beverages.
The findings were published this week in the Journal of Toxicology and Environmental Health, Part B. The researchers conducted a series of laboratory experiments exposing human blood cells and gut tissue to sucralose-6-acetate. The findings build on previous research that linked sucralose to gut health problems.
The researchers found that sucralose causes DNA to break apart, putting people at risk for disease. They also linked sucralose to leaky gut syndrome, which means the lining of the intestines are worn down and become permeable. Symptoms are a burning sensation, painful digestion, diarrhea, gas, and bloating.
When a substance damages DNA, it is called genotoxic. Researchers have found that eating sucralose results in the body producing a substance called sucralose-6-acetate, which the new study now shows is genotoxic. The researchers also found sucralose-6-acetate in trace amounts in off-the-shelf products that are so high, they would exceed the safety levels currently allowed in Europe.
“It’s time to revisit the safety and regulatory status of sucralose because the evidence is mounting that it carries significant risks. If nothing else, I encourage people to avoid products containing sucralose,” said researcher Susan Schiffman, PhD, adjunct professor of biomedical engineering at North Carolina State University, in a statement. “It’s something you should not be eating.”
The FDA says sucralose is safe, describing it as 600 times sweeter than table sugar and used in “baked goods, beverages, chewing gum, gelatins, and frozen dairy desserts.” . . .
What goes around, comes around: School district bans Bible after “indecent” materials complaint
Interesting report by John Russell in LGBTQ Nation. From the report:
. . . Last year, Utah lawmakers passed H.B. 374, which requires public K–12 schools to remove books containing “pornographic or indecent material.” Critics say the law has been used to remove books by mostly LGBTQ+ and Black authors from shelves.
In their December 2022 Bible challenge, a parent whose name and address were redacted suggested that H.B. 374 makes the “bad faith process” of removing books from school libraries “much easier and way more efficient.” They described the Bible as “one of the most sex-ridden books around” and included an eight-page list of passages they said should be considered unacceptable under the law.
“Incest, onanism, bestiality, prostitution, genital mutilation, fellatio, dildos, rape, and even infanticide,” the parent, who noted that they have actually read the Bible, wrote. “You’ll no doubt find that the Bible, under Utah Code Ann. § 76-10-1227, has ‘no serious values for minors’ because it’s pornographic by our new definition.”
“Get this PORN out of our schools,” they continued. “If the books that have been banned so far are any indication for way lesser offenses, this should be a slam dunk.” . . .
Three ‘Forever Chemicals’ Makers Settle Public Water Lawsuits
I blogged earlier about how the US cannot keep its citizens alive, and the previous post gave part of the reason: hypercapitalism has infected US healthcare, with one result being that people are denied treatment if they have “medical debt,” which doesn’t exist in advanced countries that see a healthy (and educated) citizenry as 1) a government obligation, and 2) an important component of national prosperity and security. I say “one result” because there are other effects, such as understaffing hospitals (cutting payroll saves money), underserved rural areas (not enough profit to be gained), a weak public health system, and so on.
Now three companies have paid fines after having contaminated drinking water with chemicals that cause illness. I feel certain that the companies agreed to the fines because they still made a net profit. Corporations view fines just as a cost of doing business. If the law stands in the way of profits, break the law if the fine is less than the profit to be gained.
Ben Casselman, Ivan Penn and Matthew Goldstein report in the NY Times:
Three major chemical companies on Friday said they would pay more than $1 billion to settle the first in a wave of claims that they and other companies contaminated drinking water across the country with so-called forever chemicals that have been linked to cancer and other illnesses.
The companies – Chemours, DuPont and Corteva – said they had reached an agreement in principle to set up a $1.19 billion fund to help remove toxic perfluoroalkyl and polyfluoroalkyl substances, or PFAS, from public drinking water systems. PFAS have been linked to liver damage, weakened immune systems and several forms of cancer, among other harms, and are referred to as forever chemicals because they linger in the human body and the environment.
Bloomberg News also reported on Friday that 3M had reached a tentative deal worth “at least $10 billion” with U.S. cities and towns to resolve related PFAS claims. Sean Lynch, a spokesman for 3M, declined to comment on the report, which cited people familiar with the deal without naming them. . .
This Nonprofit Health System Cuts Off Patients With Medical Debt
I just blogged about how the US is failing to keep its citizens alive and healthy. One reason for that is that the US has chosen to make profit a higher priority than citizens’ health and lives — “medical debt” is not a thing in other wealthy countries. Sarah Kliff and Jessica Silver-Greenberg report a clear example of that in the NY Times. What they describe is a situation that does not exist in any other wealthy country. They write (no paywall):
Many hospitals in the United States use aggressive tactics to collect medical debt. They flood local courts with collections lawsuits. They garnish patients’ wages. They seize their tax refunds.
But a wealthy nonprofit health system in the Midwest is among those taking things a step further: withholding care from patients who have unpaid medical bills.
Allina Health System, which runs more than 100 hospitals and clinics in Minnesota and Wisconsin and brings in $4 billion a year in revenue, sometimes rejects patients who are deep in debt, according to internal documents and interviews with doctors, nurses and patients.
Although Allina’s hospitals will treat anyone in emergency rooms, other services can be cut off for indebted patients, including children and those with chronic illnesses like diabetes and depression. Patients aren’t allowed back until they pay off their debt entirely.
Nonprofit hospitals like Allina get enormous tax breaks in exchange for providing care for the poorest people in their communities. But a New York Times investigation last year found that over the past several decades, nonprofits have fallen short of their charitable missions, with few consequences.
Allina has an explicit policy for cutting off patients who owe money for services they received at the health system’s 90 clinics. A 12-page document reviewed by The Times instructs Allina’s staff on how to cancel appointments for patients with at least $4,500 of unpaid debt. The policy walks through how to lock their electronic health records so that staff cannot schedule future appointments.
“These are the poorest patients who have the most severe medical problems,” said Matt Hoffman, an Allina primary care doctor in Vadnais Heights, Minn. “These are the patients that need our care the most.”
Allina Health said it has a robust financial assistance program that in an average year helps over 12,000 of its 1.9 million patients with medical bills. The hospital system cuts off patients only if they have racked up at least $1,500 of unpaid debt three separate times. It contacts them by phone and with repeated letters that include information about applying for financial help, said Conny Bergerson, a hospital spokeswoman.
“Allina Health’s goal is, and will always be, to have zero patients go without services for financial reasons,” Ms. Bergerson said. She said cutting off services was “rare” but declined to provide information on how often it happens.
Allina suspended its policy of cutting off patients in March 2020, at the onset of the coronavirus pandemic, before reinstating it in April 2021.
An estimated 100 million Americans have medical debts. Their bills make up about half of all outstanding debt in the country.
About 20 percent of hospitals nationwide have debt-collection policies that allow them to cancel care, according to an investigation last year by KFF Health News. Many of those are nonprofits. The government does not track how often hospitals withhold care.
Under federal law, hospitals are required to treat everyone who comes to the emergency room, regardless of the person’s ability to pay. But the law — called the Emergency Medical Treatment and Labor Act — is silent on how health systems should treat patients who need other kinds of lifesaving care, like those with aggressive cancers or diabetes.
In 2020, thanks to its nonprofit status, Allina avoided roughly $266 million in state, local and federal taxes, according to the Lown Institute, a think tank that studies health care.
In exchange, the Internal Revenue Service requires Allina and thousands of other nonprofit hospital systems to benefit their local communities, including by providing free or reduced-cost care to patients with low incomes.
But the federal rules do not dictate how poor a patient needs to be to qualify for free care. In 2020, Allina spent less than half of 1 percent of its expenses on charity care, well below the nationwide average of about 2 percent for nonprofit hospitals, according to an analysis of hospital financial filings by Ge Bai, a professor at the Johns Hopkins Bloomberg School of Public Health.
Allina is one of Minnesota’s largest health systems, having largely . . .
Continue reading. (no paywall)
The US is failing to meet its mission statement in the preamble to the Constitution: to improve the general welfare.
When a government agency is asleep at the switch
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Bad lapse. Jason Koebler reports in Vice:
Roughly 800,000 Maryland drivers with license plates designed to commemorate the War of 1812 are now inadvertently advertising a website for an online casino based in the Philippines.
In 2012, to celebrate the 200th anniversary of the War of 1812, Maryland redesigned its standard license plate to read “MARYLAND WAR OF 1812.” The license plates, which were the default between 2012 and 2016, have the URL www.starspangled200.org printed at the bottom.
Sometime within the last year, http://www.starspangled200.org stopped telling people about how Marylander Francis Scott Key was inspired to write the national anthem “The Star Spangled Banner” after watching British ships bombard Fort McHenry in Baltimore during the War of 1812 and started instead redirecting to a site called globeinternational.info, in which a blinking, bikini-clad woman advertises “Philippines Best Betting Site, Deposit 100 Receive 250.”
The issue was spotted by a Redditor who said “I was never a fan of having a plate celebrating the War of 1812, but I’m even more upset now that I (and tons of other Marylanders) are driving advertisements for international online gambling.”
Domain registration information shows that starspangled200.org has been re-registered and transferred a handful of times within the last few years. It is not exactly clear when it stopped being a website about American history. The Internet Archive shows that as recently as December 2022, the website explained that “the young United States was embroiled in the War of 1812 and the Chesapeake Bay region felt the brunt of it.” A snapshot from today, however, explains that “Extremely lenient laws govern gaming,” in the Philippines. “This is a result of the growing popularity of gambling among tourists and the enormous casino resorts that have recently been built.”
A spokesperson for the Maryland Department of Transportation’s Motor Vehicle Administration told Motherboard that “there are currently 798,000 active War of 1812 license plates.”
“The website printed on the plates is not owned by the Motor Vehicle Administration. The plates’ design and content originated from the War of 1812 Bicentennial Commission created in 2007. . .
Former Gun Company Executive Explains Roots of America’s Gun Violence Epidemic
In an earlier post, I blogged an NPR interview with Ryan Busse, the subject of a ProPublica article by Corey G. Johnson:
From the movie theater to the shopping mall, inside a church and a synagogue, through the grocery aisle and into the classroom, gun violence has invaded every corner of American life. It is a social epidemic no vaccine can stem, a crisis with no apparent end. Visual evidence of the carnage spills with numbing frequency onto TV shows and floods the internet. Each new shooting brings the lists of loved ones lost, the galleries of their smiling photos and the videos of the police response. And each mass shooting brings another surge of national outrage.
According to the Centers for Disease Control and Prevention, guns became the leading killer of children in 2020, overtaking car crashes, drug overdoses and disease for the first time in the nation’s history. Yet as the one-year anniversary of the massacre at an elementary school in Uvalde, Texas, passes, nagging questions loom.
Why haven’t lawmakers acted with forceful correctives? What will it take to regain a sense of safety? When will change happen? And how, exactly, did America end up here?
Ryan Busse, former executive at Kimber America, a major gun manufacturer, recently shared his thoughts on these questions with ProPublica. He was vice president of sales at Kimber America from 1995 to 2020 but broke with the industry and has become a gun safety advocate. He testified about mass shootings and irresponsible marketing last July in front of the House Committee on Oversight and Reform and authored the book “Gunfight: My Battle Against the Industry That Radicalized America.”
In June 2021, he became a senior adviser for Giffords, a gun violence prevention group led by Gabrielle Giffords, the former Arizona congresswoman gravely injured in 2011 during a mass shooting. This conversation has been edited for length and clarity.
Where are we, as a nation, on guns? And where do you think we need to go?
I think we might be on the precipice of things getting much worse. I think this Bruen decision, the Supreme Court ruling, quite possibly will unleash so many lawsuits against so many counted-upon regulations that citizens may wake up to the equivalent of, like, no stop signs in their town anymore, except for it’ll be on gun regulation. [The Bruen decision has been called one of the court’s most significant rulings on guns in decades. It struck down New York’s concealed carry law as unconstitutional, saying it conflicted with the Second Amendment.]
What do you attribute this trend to?
As I write in my book, there was a time not that long ago, maybe about 15 to 20 years ago, when the industry understood a sort of fragile social contract needed to be maintained on something as immensely powerful as the freedom to own guns. And so the industry didn’t do certain things. It didn’t advertise in egregiously irresponsible ways. It didn’t put, you know, growth, company growth, above all other things. There were just these unspoken codes of conduct the industry knew not to violate. And those seem to have broken down. And now it’s kind of a victory at all costs. And sadly, I think there’s a lot of cost.
What do you say to people who make the argument that guns are protected by the Second Amendment and that yes, a deranged person here or there may do something bad, but is it fair to punish or penalize law-abiding gun owners with unnecessary or extra government intervention?
I am a gun owner. I hunt and shoot with my boys. I want to continue doing that. I believe and I think that I have a right to do those things. On the other hand, I do not believe that . . .
101 Simple Salads for the Season, from the NY Times
An archived page from the NY Times has a great collection of salad recipe ideas. It begins:
1. Cube watermelon and combine with tomato chunks, basil and basic vinaigrette. You can substitute peach for the watermelon or the tomato (but not both, O.K.?). You can also add bacon or feta, but there goes the vegan-ness.
2. Mix wedges of tomatoes and peaches, add slivers of red onion, a few red-pepper flakes and cilantro. Dress with olive oil and lime or lemon juice. Astonishing.
3. A nice cucumber salad: Slice cucumbers thin (if they’re fat and old, peel and seed them first), toss with red onions and salt, then let sit for 20 to 60 minutes. Rinse, dry, dress with cider vinegar mixed with Dijon mustard; no oil necessary.
4. Shave raw asparagus stalks with a vegetable peeler. Discard the tough first pass of the peeler — i.e., the peel — but do use the tips, whole. Dress with lemon vinaigrette and coarse salt. (Chopped hard-boiled eggs optional but good.)
5. Grate or very thinly slice Jerusalem artichokes; mix with pitted and chopped oil-cured olives, olive oil, lemon juice and a sprinkling of coarsely ground cumin. Unusual and wonderful.
6. Sichuan slaw: Toss bean sprouts, shredded carrots and celery, minced fresh chili, soy sauce, sesame oil and a bit of sugar. Top with chopped peanuts and chopped basil, mint and/or cilantro. (The full trio is best.)
7. Grate carrots, toast some sunflower seeds, and toss with blueberries, olive oil, lemon juice and plenty of black pepper. Sweet, sour, crunchy, soft.
8. Chop or slice radishes (or jicama, or the ever-surprising kohlrabi) and combine with chopped or sliced unripe (i.e., still crunchy) mango, lime juice and mint or cilantro.
9. Chop or slice jicama (or radishes or kohlrabi) and mango and mix with coconut milk, lime juice, curry powder and cilantro or mint.
10. Cook whole grape tomatoes in olive oil over high heat until they brown lightly, sprinkling with curry powder. Cool a bit, then toss with chopped arugula, loads of chopped mint and lime juice.
11. . . .
In comparison to other wealthy countries, the US fails in keeping its citizens alive
A country that does a poor job of ensuring that its citizens live is not a successful country on this basic and essential measure. In the Washington Post, Steven H. Woolf, professor of family medicine and population health at Virginia Commonwealth University, and Laudan Aron, a senior fellow in the Health Policy Center at the Urban Institute in D.C., write (gift link, no paywall):
Last fall, when federal statistics showed life expectancy had fallen for Americans in 2021 for a second year in a row, it was clear that the devastating covid-19 pandemic was the immediate cause. The coronavirus took the lives of more than 1 million Americans. Life expectancy fell by more than two years — and by twice as much among Hispanic, Black and Native Americans — setting the country back by two decades and producing the most abrupt decline in life expectancy since World War II.
But plotting life expectancy in the United States against that of other wealthy countries reveals three dark insights: Our life spans lag behind those of our peers; our life expectancy was already more or less flat, not growing; and most other countries bounced back from covid-19 in the second year of the pandemic, while we went into further decline.
Ten years ago, long before the world was hit by covid-19, we served as the chair and study director for a landmark report that warned about the “U.S. health disadvantage,” a gap in the health and survival of Americans relative to residents of other high-income countries. Released by a committee convened by the National Research Council and Institute of Medicine, the report showed the United States had the lowest life expectancy among peer countries, and higher morbidity and mortality rates for dozens of causes. The disparity had been growing since the 1950s, by some measures, and was pervasive — affecting both sexes, young and old, rich and poor, and Americans of all races and ethnicities.
The committee examined five areas of relative deficiency that are likely contributing to the U.S. health disadvantage: (1) unhealthy behaviors, such as our diets and use of firearms; (2) inadequate health care and public health systems; (3) poor socioeconomic conditions; (4) unhealthy and unsafe environments; and (5) deficient public policies. The last category especially exerts a powerful influence on the other domains — and helps explain why other advanced democracies are outperforming the United States on almost every measure of health and well-being.
In the years before the covid-19 pandemic, as life expectancy continued to increase in other countries, U.S. life expectancy plateaued and then decreased for three consecutive years. Researchers identified a key reason: U.S. mortality in midlife (ages 25 to 64) was increasing, a phenomenon not occurring in peer countries. This, too, became the subject of a landmark report, which cited drug overdoses, alcohol use, suicides and cardiometabolic diseases (e.g., obesity, diabetes, hypertensive heart disease) as leading causes. Enduring systemic racism and health inequities means that the U.S. health disadvantage is particularly acute among people of color, especially Native and Black Americans, whose life expectancy is far lower than that of White Americans.
With the arrival of the covid-19 pandemic in 2020, the long-standing U.S. health disadvantage only worsened. In 2020 and 2021, U.S. deaths were the highest of any country and among the highest per capita. All five domains we identified in the “Shorter Lives, Poorer Health” report contributed to the death toll: Health behaviors (e.g., resistance to masking and vaccinations) facilitated viral transmission and limited vaccine uptake; health-care and public health services were unprepared and rapidly overwhelmed; socioeconomic conditions further deteriorated, especially for poorer Americans, as the economy imploded; aspects of the physical environment heightened viral exposure; and the policy response to the pandemic was deeply flawed and highly politicized. Once again, people of color paid the highest price, with Native, Hispanic/Latino and Black Americans experiencing devastating losses in life expectancy, despite an interesting twist: In 2021, declines were higher among White Americans than in most other groups, perhaps because of greater resistance to vaccination and masking in conservative communities. . .
Continue reading. (gift link, no paywall)
And read the comments. Here’s one:
Notice that all the other countries that have surpassed the US in life expectancy have nationalized healthcare. We have a healthcare system grounded in pathological capitalism where it is more profitable to keep people in treatment than prevent or cure their illnesses. This happens in a fee-for-service system where more treatment means more profit and more testing means less likely litigation (defensive medicine). The US healthcare system itself is responsible for over 250,000 deaths a year as a result of iatrogenic mistakes and adverse reactions and the US is one of only two countries that allow prescription medicine to be advertised on TV. So if you aren’t one of the 45,000 people who die each year because you have no access to healthcare, you might be one of the 250,000 who do. America spends apron. $4 trillion annually on healthcare which is about 18% of the GDP, far more than any other industrialized country. We are not getting our money’s worth but the large corporations are!
Barkleydog
Later On 