Profits Trump Affordable Healthcare

 

When the rest of the developed world was deploying virtually all of their financial resources toward rebuilding WWII -decimated, bombed out cities and infrastructure, the United States was beginning to figure out what to do with millions of returning soldiers, workers who staved off their pay demands in support of the war effort and massive unemployment. We did not have cities that needed rebuilding or infrastructure that needed to be fixed.

Strikes were so rampant that Congress passed the Taft-Hartley Act in 1947 to create economic stability. That combined with the GI Bill, affording returning soldiers with access to government subsidized college or trade school education and home ownership, began to accelerate the United States into a high-growth internally stimulated consumer economy. New homes, cars and modern appliances proliferated. Soon, 60% of Americans became homeowners.

Wages and salaries soared. Americans were earning multiples of their counterparts in other developed nations, who were still struggling to fix war damage. There wasn’t a lot of universal healthcare anywhere (it was still a nascent movement), and lucrative union health plans pushed us ahead of most of the rest of the world. Government workers were accorded comparable benefits, and major employers (where unions were not already mandating their plans) filled out most of the rest. Less affluent Americans were left with little or nothing in the way of healthcare. Those who were working were making a bundle when compared with their foreign counterparts.

Salaries for professionals also took off, and that most definitely included doctors and medical specialists. With generous medical insurance, to cost of virtually every category of medical expense took off like a rocket. Somewhere in the 1960s, the rest of the world seemed to have recovered from the post-WWII rebuild, and government-provided universal healthcare began to accelerate… except in the United States. We were already far and away the country with the most expensive healthcare on earth, double the average cost of the next most expensive nation, and we were spending 20% of our GDP on healthcare (a bit over 17% today), far more than any other country.

That lingering mega-cost of healthcare has never gone away. It has plagued the United States as the rest of the developed world began to equal, and in some cases exceed, our standard of living. And given the political reality that we have become a nation governed by well-heeled special interests with major lobbying power and little in the way of capping their political advertising budgets, incumbent medical constituencies were hell-bent on keeping those medical prices exceptionally high. Congress is addicted to those campaign contributions. When the Affordable Care Act (Obamacare) was passed in 2010, pharmaceutical lobbies were placated by a statutory guarantee that the resulting healthcare exchanges were unable to challenge whatever prices these corporate giants wanted to charge.

Today, Americans pay a serious multiple for prescription drugs over what is charged in any other developed nation (and of course in virtually all developing nations except where price gouging is not curtailed). Pharmas tell us that they need this excess to pay for research and development for new medications, particularly since recent government research cutbacks have seriously impaired government support for that R&D. You only have to look at share prices and the proliferation of advertising for prescription drugs to know where that extra money is really being spent!

Everybody is complaining that without getting the cost of prescription drugs under control, medical care in this country will zoom into a “generally unaffordable” range. Even Medicare, which is substandard when compared with healthcare systems overseas, has a “donut hole,” where prescriptions just fall into an uncovered crack in the system. Supplemental insurance is required, for those elders able to write the checks, to achieve more affordable prescriptions… or elders simply go without. Between exclusions, caps, deductibles and premium costs, even people with healthcare insurance are often forced to file for bankruptcy for uncovered medical costs they are unable to pay. That just does not happen in any other developed nation.

Donald Trump has openly chastised pharmas for what appears to be a pattern in this country of price-gouging pricing structure. He began by ordering pharmas to publish pricing in their marketing materials, immediately challenged in the courts. In mid-September, he expanded the earlier executive order by mandating that Americans not be required to pay more than what the pharmas charge for the same prescription product overseas. Pharmas scoffed at the effort… “President Donald Trump's latest executive order aimed at lowering U.S. drug prices by linking them to those of other nations is ‘light on details’ but ‘surely exceeds’ his authority, [pharmaceutical giant] Roche's top drug executive said on Monday [9/14].

“Trump's plan, which he called a ‘Most Favored Nation’ (MFN) order on Sunday [9/13], would pay a price for a prescription drug that matches the lowest price paid among wealthy foreign governments. Medicare, the U.S. government healthcare program for seniors, is now prohibited from negotiating prices it pays to drugmakers.

“‘This is really not the right way to go,’ Bill Anderson, the Swiss company's pharmaceuticals division CEO, said on a call with investors. ‘The fundamental problem with MFN is it really brings the policies from other countries that don't support innovation, it just brings those into the U.S....The executive order, it's basically one page, it's light on details, but it surely exceeds the authority of an executive order.’” Reuters, September 14^th. Trump was obviously aware that the pharmas were unlikely to comply with his order, but at least it looked as if he were trying.

If you really want to understand how little this executive order means to these pharmaceutical behemoths, let’s look at one of the companies that the federal government blessed with ten figure COVID-development grants: UK pharma AstraZeneca. That company just announced steep increases in just about all of their prescription drugs, including the prospective cost of a coronavirus vaccine if successfully developed.

Noam Levey, writing for the September 15^th Los Angeles Times, fills in the details: “One of the world’s largest drug companies has been aggressively raising prices even as it received hundreds of millions of dollars of U.S. government aid to develop a COVID-19 vaccine… AstraZeneca, which the Trump administration has lauded for its vaccine work, boosted prices despite renewed promises by President Trump this summer to keep drug costs in check.

“The multinational pharmaceutical firm raised prices in a way that stood out even among other big drug companies. It announced not just one set of price hikes in 2020 but two, often on the same drugs, according to an analysis of drug pricing data by The Times and 46brooklyn Research, a nonprofit that studies the pharmaceutical industry.

“AstraZeneca hiked prices on some of its biggest-selling medicines by as much as 6% this year at a time when the overall inflation rate is hovering around 1%, the analysis shows. The administration has said nothing about the price increases… AstraZeneca’s second round of increases came after it secured a $1.2-billion commitment in May from the U.S. for vaccine development and as the company was reporting more than $3.6 billion in operating profit in the first half of 2020… ‘They clearly made a decision to do their pricing differently, both from their recent past and from their peers, at the same time they were seeking billions of dollars,’ 46brooklyn founder Eric Pachman said…

“The company’s price hikes underscored the persistent inability of U.S. policymakers, including Trump, to rein in drug prices, even during a public health crisis when pharmaceutical companies are getting substantial public assistance… Although the federal government has committed more than $10 billion this year to drug companies to develop a COVID-19 vaccine, the administration hasn’t required any commitments from drugmakers on the price they would charge.

“Thus far, companies receiving government aid have only made vague promises to make any vaccines they develop affordable… AstraZeneca has said it wouldn’t profit from vaccine sales during the pandemic, but it remains unclear how this would be verified and whether the company might raise prices after the worst of the crisis passes.

“Drugmakers for years have pledged to make their products more affordable, assuring U.S. lawmakers, patient groups and others that they are sensitive to the struggles many Americans have paying for their medications… Yet patients in the U.S. are finding it increasingly difficult to afford prescriptions, with 1 in 5 households reporting last year that they were unable to pay for a medicine that a doctor had prescribed in the previous year because of costs.

“Nevertheless, to start this year, most major pharmaceutical companies continued to hike prices at rates far exceeding inflation, The Times and 46brooklyn found… Several of the world’s biggest drugmakers announced hikes of 5%, 6%, even 9% on a host of popular medicines, according to the analysis, which looked at list prices by the 15 largest drug companies using the Elsevier Gold Standard Drug Database, which includes pricing and clinical information on tens of thousands of medications.” Trump’s promised new healthcare plan, intended to replace the Affordable Care Act his administration is attempting to end via a Supreme Court ruling, has never surfaced, and none of his prescription drug containment orders has been implemented. Sound and fury signifying nothing.

            I’m Peter Dekom, and it is time to pass truly complete and meaningful US universal healthcare, battle the pharmas in court as they challenge the effort, and joint the rest of the developed world in providing healthcare as a modern right for all residents.

 

 

 

 

 

The High-Priced Spread

 

So many people around the world simply dismiss the intensity of the pandemic, a factor that is most pronounced in the United States where dealing realistically with the novel coronavirus is a sign of disloyalty to Trump populism. This is especially true of people who do not know many people who are or have been infected, intensified that at any given moment since 40% of those infected by COVID-19 are (and may remain) asymptomatic. Unfortunately, when the virus hits a community, it spreads like wildfire on a hot gusty day. Learning the hard way can be terrifying. And the older you get, the less prepared your immune system is able to counter the virus. As a result, “Covid-19 patients who are 80 or older are hundreds of times more likely to die than those under 40.” New York Times, September 8th. 

If you would like a visual of the rate COVID-19 is spreading now, visit covidspreadingrates.org. Mark Wilson, writing for FastCompany.com (September 15th), puts it this way: “In Burundi, where a new COVID-19 case is found every 17 hours, that dial fills slowly—too slowly to see. But in the U.S., where a person is diagnosed with COVID-19 every 2.5 seconds, the graph is in a constant red spin. Since I loaded the [above web] page as I began writing this article, 339 Americans have tested positive for the virus. (The ticker isn’t displaying real-time diagnoses; it starts by analyzing the total COVID-19 cases tracked in each country during the week of September 7. Then it averages out the rate of those cases evenly through the day to make these ticking graphs. So it’s technically a simulation, but it’s built upon real, recent data.).” 

So younger, asymptomatic carriers – even those whose immune systems can push back against the disease – can infect older persons with devastating consequences, particularly those over 65. “That’s partly because [elders] are more likely to have underlying conditions — like diabetes and lung disease — that seem to make the body more vulnerable to Covid-19. 

“But some scientists suggest another likely, if underappreciated, driver of this increased risk: the aging immune system… When a virus infiltrates the body, cells in the first line of defense act swiftly and violently — sending out alerts and instructions to other cells, and provoking inflammation to start knocking down the virus… The ‘innate’ immune system, as it’s called, also happens to be responsible for cleaning up damaged cells, misfolded proteins and other detritus in the body, even when there’s no infection to fight. 

“In older people, such waste seems to outrun the immune system’s ability to clear it, however, said Dr. Eric Verdin, the chief executive of the Buck Institute for Research on Aging in Novato, Calif. The innate immune system grows overwhelmed, and slides into a constant state of alert and inflammation… At the same time, elderly cells in tissues throughout the body are thought to change with age, releasing inflammatory substances of their own… ‘They are not just benign, like old nice grandparents,’ Dr. [Arne Akbar, a professor of immunology at University College London] said. ‘They’re actually very cantankerous.’ 

“As a result, even perfectly healthy 65-year-olds usually have higher levels of immune proteins, like cytokines, involved in inflammation than younger people do. This heightened state of chronic inflammation, sometimes called ‘inflammaging,’ is linked to frailty — older adults with higher levels of it may be more fragile and less mobile. 

“And it also means that fighting off pathogens becomes more complicated: All of this baseline inflammatory chaos in an aging body makes it harder for the messages sent out by the innate immune system to reach their targets… On top of that, there’s the added danger that the innate immune system may overreact.” NY Times. 

Since the elderly are particularly vulnerable, they are mostly excluded from the clinical trials for most of the vaccines in development. The underlying notion, however, is that older people just might need different dosage or longer sequential treatment of the vaccine, if we do in fact deliver one, than the general population. This brings into question whether one of the most virus-susceptible segments of our population, those who need immunity the most, will even be able to be immunized by the initial wave of approved vaccines. 

The cost in lives and health, well beyond COVID-19 losses, is staggering generally in terms of whatever progress we may have made in improving global standards. “The Bill and Melinda Gates Foundation’s… newest Goalkeepers Report, an annual report that tracks how the world is advancing on the United Nations’ Sustainable Development Goals, the news is now grim: After years of progress, the pandemic is setting the world back on most of the goals. 

“The number of people getting vaccinated, for example, has dropped to levels not seen since the 1990s. ‘In other words, we’ve been set back about 25 years in about 25 weeks,’ Bill and Melinda Gates write in the report. Disruptions in healthcare mean that people with diseases such as HIV or TB are less likely to get treatment. The economic catastrophe caused by the virus means that people are struggling to afford food or keep a roof over their heads. Developing countries are finding innovative ways to help—India sent digital cash transfers to 200 million women soon after the pandemic began—but are still limited by budgets. As part of the report, the Institute for Health Metrics and Evaluation, a Gates-backed program at the University of Washington, calculated that so far this year, nearly 37 million people globally have fallen below the extreme poverty line of $1.90 a day… The situation can’t improve until the pandemic is under control, something that’s still far from happening.” FastCompany.com, September 15th. 

In the end, the quality of national and international leadership is determinative. Allocation of resources, a staunch reliance on scientific facts without politization and a willingness to make tough short-term choices for long-term survival are critical. There are no magic bullets, and as the above information illustrates, even a viable vaccine (if and when developed) has its own risks and limitations. If governments cannot garner popular support, even properly framed policies will simply fail. In particular, the United States needs to do so much more. Testing, contact tracing, containment and deploying effective rules to limit the most obvious risks of spreading the contagion. Whether we like it or not. 

I’m Peter Dekom, and expecting a short time to full recovery is without doubt most unrealistic, but failed leadership can drag this litany of COVID horribles on for so much longer.

 

 

 

 

 

Stopgap Climate Change Efforts

 

We are so far from achieving any semblance of a unified global effort to halt, much less reverse, the ravages of climate change. Too many people unwilling to take personal steps, governments prioritizing “economic” growth over what it takes to stop the devastation, rogue nations (like Brazil and the United States) simply opting out of the process and embracing blame over solutions. Nature is escalating culling the human herd that caused this environmental catastrophe. COVID is just one step.

As floods, mega-storms, coastal erosion, droughts and severe wildfires rage, there appears to be a blind eye turned to the trillions and trillions of dollars, millions of lives lost or becoming health impaired, and the vast multiple of measurable damage above and beyond the aggregate value of economic displacement (with concomitant economic opportunities) that might be inflicted on the incumbent holders of the earth’s wealth. It’s really those economic elites who have led the resistance, when they could have benefitted economically by leading the solution.

Our own US legal system, basic state and federal corporate and tax law, is an example of this environmental anomaly. Corporate officers and directors have one overriding duty, as long as they are otherwise legally compliant: the economic betterment of shareholders and no one else. Every decision, even to donate to charities, stop polluting or pay employees a fair wage, has to be justified in terms of how that choice would ultimately create economic value to shareholders. The environment, the community, the employees and the nation as a whole are not stakeholders in American corporations. Other nations have expanded that list of stakeholders. We have not.

The way to sell this lackadaisical approach to the masses is in terms of “inconvenience,” higher consumer costs (“we’ll just pass it on to you”) and job loss. We have so embedded the notion that success is based on hard dollar growth – there are no globally accepted comparative standards of quality of life or health, just GDP and employment numbers – that any decision that might transition our metrics to something else are almost an impossible sell. This flies in the face of the huge costs to taxpayers and victims of natural disasters and permanent climate change. The desertification of agricultural lands. The spread of insect-born disease. The decimation caused by wildfires, floods and unprecedented mega-storms. The displacement of millions of environmental migrants. The resulting wars and battles over the remaining pockets of natural resources.

“Job loss” should be just “job transition.” High costs can be mitigated with a smaller footprint. Here’s a simple visual example. Remember how much space CD or record collections used to consume? How big television sets used to be? If you are old enough. Simply, we can live better with less. Economic costs cannot accurately be measured by just GDP and employment statistics, since we are all paying dramatically more (hard dollars) for health and ecological damage that simply is not reflected in existing metrics. We react to what we measure. So we need to measure real costs and real damage. Our policymaking is driven by those corporate interests, at the expense of everyone else. “A new analysis by the RAND Corporation examines what rising inequality has cost Americans in lost income—and the results are stunning.

“A full-time worker whose taxable income is at the median—with half the population making more and half making less—now pulls in about $50,000 a year. Yet had the fruits of the nation’s economic output been shared over the past 45 years as broadly as they were from the end of World War II until the early 1970s, that worker would instead be making $92,000 to $102,000. (The exact figures vary slightly depending on how inflation is calculated.)… The findings, which land amid a global pandemic, help to illuminate the paradoxes of an economy in which so-called essential workers are struggling to make ends meet while the rich keep getting richer.” Rick Wartzman, FastCompany.com, September 14^th.

In the meantime, we continue to deal with the symptoms, and not the disease. We are reactive, not proactive. Like this example motivated by the super-devastating California wildfires. “If you zoom in on a new map of California, you’ll start to see that the fields of green that represent the forest are actually made up of individual green points, and each point represents a real, individual tree. The tool, called the California Forest Observatory, uses AI and satellite images to create an ultradetailed view of the state’s forests—aiding work to prevent the type of catastrophic megafires that the state is experiencing now.

“Scientists at Salo Sciences, a startup that works on technology for natural climate solutions, began creating the tool after interviewing dozens of experts in California about the state’s challenges with wildfires: They need more detailed, up-to-date information about the forests so they can better predict how fast and in what direction fires will spread, and remove the most hazardous fuels. Even the rough satellite maps that exist now are often three years out of date, making it hard for agencies to plan their work.

“The new tool will be updated annually after the fire season ends, if not more often. Firefighters can use the tool to predict how current fires may spread as they’re burning. But just as critically, the state can also use the map to plan forest management to prevent future megafires. ‘What we really found was California more than anything has a vegetation and fuel load problem,’ says David Marvin, cofounder and CEO of Salo Sciences. ‘This has occurred because, for the last century, we’ve been suppressing wildfire, and we’ve gotten really good at doing so. CalFire, the state fire agency, puts out something like 96% of fires, and we have thousands of them every year.’” Adele Peters, FastCompany.com.

Peters also discusses this rather bizarre thought about containing the explosion of intense hurricanes and typhoons: “Climate change is making hurricanes more violent, and one of the reasons is that warmer oceans make storms gain more speed: A one-degree rise in the surface temperature of the water can increase wind speed as much as 20 miles an hour. But what if technology could cool the water down? Could it help prevent catastrophes?

“That’s the theory behind the still-unproven tech from a Norwegian startup called OceanTherm. In hurricane season, ships would deploy large pipes with holes deep under water, where the water is colder, and then pump in air, which would push cold water bubbles up to the surface. As a storm passed over the cooler water, the change in temperature could prevent a more intense storm.” Lots of ideas. Reactive, stopgap band aids when we all know that so much more is necessary.

I’m Peter Dekom, and you really don’t have to wonder why Millennials and younger are terrified of the climate damaged environment of their future; they are beginning to question the very notion of whether “growth” is either good or even a metric for success.

When Clinical Tests Reveal Hidden Risks

 

As the President has forced a pre-order of a vaccine (over 100 million units) way before any semblance of adequate clinical tests have been completed – under the catchy name of Operation Warp Speed – he has put pressure on theoretically neutral federal protectors of the health and safety of a nation to waive normal testing requirements. With the Food and Drug Administration and Centers for Disease Control kowtowing to the President’s direct political interference, in abrogation of their statutory mandate, we could face a litany of risks and unintended consequences should that vaccine be released too soon. Think that’s out of the question?

So far clinical testing of the leading vaccine contenders here in the United States has still failed to generate sufficient tests, particularly with certain segments of the population including different racial and ethnic groups or the very young or elderly.  The consequences of those missing test subjects pose a very serious risk. Would our government really allow that risk to happen? The obvious answer is resounding yes. This has become a political and not a medical or scientific decision process. It’s no coincidence that the announced target release date, which experts (including in the federal government) tell us is exceptionally unlikely, is two days before the November 3^rd election.

In an administration that often operates under falsely represented agendas shrouded in secrecy, we are unlikely to see a full and transparent release of the clinical process and test results. We are forced to generate a common sense of the risk here in the United States by looking at comparable studies of other advanced vaccine development in other high credibility countries that parallel our own. Like the United Kingdom.

“Final clinical trials for a coronavirus vaccine, developed by AstraZeneca and Oxford University, have been put on hold after a participant had a suspected adverse reaction in the UK… AstraZeneca described it as a ‘routine’ pause in the case of ‘an unexplained illness.’… The outcome of vaccine trials is being closely watched around the world.

“The AstraZeneca-Oxford University vaccine is seen as a strong contender among dozens being developed globally… Hopes have been high that the vaccine might be one of the first to come on the market, following successful phase 1 and 2 testing… Its move to Phase 3 testing in recent weeks has involved some 30,000 participants in the US as well as in the UK, Brazil and South Africa. Phase 3 trials in vaccines often involve thousands of participants and can last several years.

“The New York Times is reporting a volunteer in the UK trial has been diagnosed with transverse myelitis, an inflammatory syndrome that affects the spinal cord and can be caused by viral infections… However, the cause of the illness has not been confirmed and an independent investigation will now work out if there was any link to the vaccine.

“At first glance this may seem alarming. A vaccine trial - and not just any vaccine, but one receiving massive global attention - is put on hold due to a suspected serious adverse reaction. But such events are not unheard of. Indeed the Oxford team describe it as ‘routine.’ Any time a volunteer is admitted to hospital and the cause of their illness is not immediately apparent it triggers a study to be put on hold.

“This is actually the second time it has happened with the Oxford University/AstraZeneca coronavirus vaccine trial since the first volunteers were immunised in April. An Oxford University spokesperson said: ‘In large trials, illnesses will happen by chance but must be independently reviewed to check this carefully.’

“A final decision on restarting the trial will be taken by the medical regulator the MHRA [the Medicines and Healthcare products Regulatory Agency, the UK equivalent of the US’ FDA], which could take only days. But until then all international vaccination sites, in the UK, Brazil, South Africa and the USA are on hold… The Oxford University team believe this process illustrates that they are committed to the safety of their volunteers and the highest standards of conduct in their studies…

“US President Donald Trump has said he wants a vaccine available in the US before 3 November's election, but his comments have raised fears that politics may be prioritised over safety in the rush for a vaccine… [To try and counter global skepticism of US efforts, on] Tuesday [9/8], a group of nine Covid-19 vaccine developers sought to reassure the public by announcing a ‘historic pledge’ to uphold scientific and ethical standards in the search for a vaccine.” BBC.com, September 9^th.

The pressure to skip over vital testing is coming from the same Donald Trump who suggested the internal use of bleach and use of hydroxychloroquine as possible cures for COVID-19… the same Donald Trump who has pressured all of those in his administration to talk about the pandemic in the past tense, even as the outbreak continues unchecked. As well north of fifty thousand college students, just having arrived on campus, have already tested positive for the virus. The pandemic is actually going in the opposite direction in many US regions. This, just before the Labor Day weekend:

“Covid-19 cases are on the rise in 22 states, causing health officials to worry that a long holiday weekend of travel and social events could led to a surge in infections similar to what happened during July and August in the wake of Memorial Day. That explosion in cases was concentrated across the Sunbelt in the South and West, but now, the rise is located in less-populated states in the Midwest and Plains.” Barron’s, September 6^th.

So, in the United States, “Skepticism about getting a coronavirus vaccine has grown since earlier this summer, and most voters say if a vaccine were made available this year, their first thought would be that it was rushed through without enough testing… Just 21% of voters nationwide now say they would get a vaccine as soon as possible if one became available at no cost, down from 32% in late July. Most would consider it but would wait to see what happens to others before getting one. 

“Two-thirds of voters think if a vaccine were announced as soon as this year, their initial thought would be that it was rushed through without enough testing, rather than a scientific achievement that happened quickly. Among those who feel it would have been rushed, just 13% say they would get a vaccine for the coronavirus as soon as possible if one were available.” CBS News, September 6^th. One wag has suggested that the vaccine first be tested on members of the Trump administration and their supporters in Congress. No matter the result, they say, the nation would be better off. And remember, without widespread deployment of an effective vaccine, herd immunity is just not happening.

            I’m Peter Dekom, and that federal health agency leaders are willing to accept the political dictates of a science-denying president over their sworn duty to protect the health of a nation should result in their criminal prosecution.

 

 

 

Forcing Homelessness, Pressuring to Bankruptcy

 

Virtually the entire body of developed democracies, except the United States, have social safety nets that were in place well before the pandemic struck. Their people are markedly better off than so many middle- and lower-income Americans. Conservative politicians call such safety nets “socialism,” a word that actually means government ownership of the assets of production (often including residential structures); it should not be conflated with “social programs” like public schools, Social Security, Medicare, SNAP, unemployment insurance, universal healthcare, etc.

But it is convenient to pretend these concepts are one and the same, because so many older voters  grew up in an era where anti-socialist (and anti-communist) slogans proliferated and justified our support of right wing dictators (particularly in Latin America), fighting the Vietnam War (which we lost) and similar efforts. Concepts like the “domino theory” (allowing one communist nation would begin a unstoppable flow of other communist takeovers), the “red scare” (McCarthyism from the 1950s) and a belief that it is an “either/or” choice to have capitalism or government-provided social programs. Politicians used this confusion, these made-up theories, to get elected.

Millennials and younger were not raised with any bugaboo over “socialism.” The face a tight entry level/early years job market, massive student debt, unaffordable housing and open government hostility to universal healthcare. While there are radical right components to these rising generations, a majority of them they have or will have some meaningful post-secondary education and fewer of them will live in rural communities. They tilt the other way; the majority of these younger Americans are clearly not looking at the United States the way their elders have.

History also provides proof that without social programs – like public education and in desperate times, the New Deal which provided millions of jobs, many building infrastructure which continues to this day to generate hard economic returns – the United States just might not be the success story it became. Where would we be, for example, without free public education? Betsy DeVos, our Secretary of Education, openly believes that public schools should be closed and replaced with a voucher system (isn’t that also a conservative no-no?) to enable much more religious education not permitted in public schools (under the separation of church and state in the First Amendment). That helps us compete on a global stage?

Arguments calling for a free market are predicated on the notion that the United States’ brand of capitalism embraces that concept. But when there are tax loopholes – from the “carried interest rule” to massive tax cuts that only benefit the rich – government subsidies (farm subsidies, bailouts to big failing industrial or financial institutions, etc.) and laws and regulations that create unique access to risk capital and cheap debt only to large companies and rich investors, the United States appears to be a nation driven by “corporate socialism.” It is anything but a free market. We have no problem incurring massive deficits to relieve rich companies of a tax burden, widely supported by the GOP, but struggle with deficits that are absolutely necessary to support working Americans and small businesses trying to get through this pandemic and its economic consequences.

No, the answer is not sending people back to close-knit workplaces to “reignite” the economy. That actually spreads the contagion which only inflicts more long-term damage to our national financial well-being. The Republican Senate refuses to continue the support checks to individuals and small business, a bulwark of our economy. 57% of the private work force and over 39% of our GDP is generated by small businesses. But hundreds of thousands, probably rising to millions (there are over 20 million small businesses in the US) of small businesses, are closing or dying in bankruptcy. If we do not re-prime the pump, if we do not continue support to individual workers struggling through a crisis made so much worse by government misfeasance, we are dooming ourselves to a really tough decade or more to recover, assuming recovery at all.

Deficits are not to be taken lightly, but we did not have the luxury of avoid deficits in WWII. We faced rationing, sold “war bonds” (deficit builders) and simply appropriated what we needed to win that war. Nobody knows exactly how many Americans lost their lives in that war, “but it is estimated that around the U.S. counted around 407,000 military deaths and around 12,000 civilian deaths (due to crimes of war and military activity such as bombings.) The total death count for all Americans amounted up to 420,000.” HistoryOnTheNet.com. Numbers that look a whole lot like the impact of the novel coronavirus that plagues us today. What’s worse, the pandemic’s toll is generated here… not in distant battlefields scattered around the world.

In short, if we do not understand the necessity of incurring big deficits in this time of extreme crisis, which we can afford and which we have incurred before in parallel crises, we will suffer a much worse economic chaos for a very long time. Those lost businesses will not be there to rehire. And individual workers will be forced to downsize their expectations based on a lower earning base in future years, one made worse by increasing levels of artificial intelligence-driven, job-replacing automation. A solid stock market does not reflect a better life for most of us!

Nothing screams of the balloon of pain that is about to burst like the eviction issue. Aside from the escalation of medical bankruptcies as healthcare option continue to contract, the world is about to turn even more cruel as the moratorium, where is applies, on evictions expires. Virtually all of the government-imposed bans on evictions during this pandemic simply accrue and defer rent until some future date. Renters are amassing huge levels of debt that most certainly cannot be repaid when the bans are lifted, even in going-forward adjusted installments.

“The evolving patchwork of pandemic-related policy that’s swept the United States housing market has left tenants and renters across the country in similar states of uncertainty as experts warn of a pending eviction crisis that will increase homelessness everywhere. Pandemic-related restrictions change frequently and sometimes differ greatly by jurisdictions, but the long-term effects of an eviction are largely universal: An eviction record can make it much more difficult to secure new housing.

“‘Eviction is an incredibly traumatizing event that affects every area of a family’s life and livelihood and well-being,’ says Emily A. Benfer, director of the Health Justice Advocacy Clinic at Columbia Law School and chair of the American Bar Association’s COVID-19 Task Force Committee on Eviction…

“The new federal order from the CDC, effective Sept. 4 through Dec. 31, prohibits payment-related evictions of tenants who declare—under penalty of perjury—an income of less than $99,000 for singles and $198,00 for couples, financial harm from COVID-19, and a susceptibility to homelessness or crowded shelters if evicted. They also must demonstrate they’ve sought governmental help paying rent.

“The new restrictions were unveiled about a week after the CARES Act’s post-expiration waiting period expired, and they don’t apply to jurisdictions that have their own (at least equivalent) requirements, such as California…

“The individual stories represent a much larger problem, says Stacy Butler, director of the Innovation for Justice Program at the University of Arizona James E. Rogers College of Law… ‘The truly terrifying story here is the magnitude of the impending eviction crisis—10 times our historic rate of eviction. People do not understand the ripple effect this eviction crisis is going to have. It is so much greater than individuals losing homes,” Butler says. “It is going to upend the housing market and devastate entire communities. Decision-makers need to be thinking about massive rent relief strategies.’

“The new CDC [anti-eviction] order ‘is an immediate stopgap measure,’ Butler adds… ‘It does keep people housed during the pandemic, but tenants will continue to accrue late rent, fines and costs associated with failure to pay rent. When the moratorium is lifted, tenants will still be financially responsible for those accrued costs’ she says. ‘Eviction moratoriums need to be coupled with rental assistance and mortgage forbearance to stabilize the housing market. The CDC decision does not lessen pending evictions, it merely delays them.’… The CDC order allows for evictions for reasons other than lack of payment, which attorneys say can be easily abused.” Meghann Cuniff writing for the September 10^th Journal of the American Bar Association.

The catastrophe that looms by failing to address the “little guy” (tens of millions of “little guys”) and that stubborn and profoundly false GOP narrative that government support disincentives people from going back to work (even where there isn’t any or it’s still too dangerous for many jobs), could just take this nation into an economic calamity that dwarfs the damage inflicted by the Great Depression of the 1930s. That has to be so much worse than incurring a much greater federal deficit.

For those who argue that the US would slip in value if our deficit grows significantly, I point out that the rest of the world is also laboring under the economic stress of this pandemic. We are still relatively stronger. Additionally, if for some reason we are not able widely to deploy a safe vaccine against this virus within the immediate future, the economic damage would be even more devastating. We need to take care of all Americans! Not just those at the top.

            I’m Peter Dekom, and exactly what does the federal government, whose failure timely to act and contain this viral outbreak – a nation which accounts for 4% of the earth’s population but a quarter of its COVID infections and a fifth of its COVID deaths – owe to its people?

 

Is the Plunge in Global Wildlife a Warning to Humans Too?

 

The emergence of antimicrobial resistance (AMR), including drug-resistant bacteria, or “superbugs”, pose far greater risks to human health than Covid-19, threatening to put modern medicine “back into the dark ages”, an Australian scientist has warned, ahead of a three-year study into drug-resistant bacteria in Fiji.

The Guardian UK, September 9^th.

The coronavirus appears to be nature’s efforts to contain the Malthusian explosion of people on planet with at least twice the number of human beings as it appears to be able to support. We consume, we waste, we pollute, and we destroy ecosystem after ecosystem. We rationalize. Evangelicals tell us that the Bible encourages mankind to use nature’s resources without concern, that God has pledged not to repeat global catastrophes like the Great Flood that Noah survived. Other Christian faiths preach responsibility. Politicians tell us that expanding agricultural land to feed expanding populations and allowing job-creating industries to grow even at the expense of global warming and toxic pollution are simple pragmatic necessities. Economists warn that environmental regulations will crush economic growth and job creation. 

Have we reached critical mass? Do floods, droughts, wildfires, increasingly severe mega-storms, ice melts and coastal erosion mean anything to most of us? Why exactly do leaders all across the world continue to do too little, too late (if anything) to address the combination of “all of the above”? That they hold office only for a limited time, so their focus is only on the here and now? That their constituents do not want to change or hamper growth? That rich and powerful corporations throw everything they can against regulations of any kind, financial or environmental… and money always gets it way? Even as the hard cash damage has now reached into the trillions and trillions of dollars? Even as death and destruction have exploded? 

We tend to be a reactive planet, struggle mightily with obvious longer term ameliorative solutions, and seem to focus on the immediate crises before us… and little else. Fires here. Floods there. Pandemic now. Drought and severe hurricanes and typhoons. Etc. But there is a unifying totality that we seem to be able to ignore. Still, the earth seems filled with so many “canaries in the coal mine” – clear existential peril – that we just continue to ignore. 

Where we can see how life is extinguished by man’s arrogant devastation of his own planet is contained in the World Wildlife Fund’s Living Planet Report 2020, issued on September 10th, which examines exactly how man has impacted the earth and its living creatures. It begins with this admonition: “Living Planet Report 2020 shows that our relationship with nature is broken – but we know what needs to be done if we’re going to turn it around. There’s no time to waste. We must take action now if nature is going to recover.” 

NBC News (September 10th) summarizes the findings: “Humans are wiping out wildlife at a ‘unprecedented’ rate with wildlife populations down by 68 percent on average since 1970… Unsustainable agriculture and deforestation are two of the main drivers, and urgent action is required to reverse the trend… 

‘Our planet is flashing red warning signs,’ said Marco Lambertini, Director General of WWF International, an NGO that focuses on preserving nature… ‘From the fish in our oceans and rivers to bees which play a crucial role in our agricultural production, the decline of wildlife affects directly nutrition, food security and the livelihoods of billions of people… 

“The situation is most stark in the tropics of Latin American where species have declined on average by 94 percent following massive deforestation and the conversion of wild spaces for agriculture… Land clearance and deforestation has hit record levels in Brazil in recent years as farmers seek to convert forest and grasslands for agriculture. Cattle grazing and soy farming — mostly used as animal feed for the meat industry — are the primary drivers. 

“Three quarters of the earth’s non-ice surface have been altered and no longer contain wilderness, the report states, while most of the oceans are now polluted and more than 85 percent of the planet's wetlands have been lost. 

“The report calls for the world to reform the unsustainable food system, increase protected areas for wildlife and for people in high meat consuming countries — like the U.S. — to shift their diets to a ‘lower share of animal calories.’” 

But the subtext, a most ominous subtext, is that we are both killing ourselves and mandating that nature is beginning to move the human overpopulation problem to her center focus. To kill as many people as she can. Good for the planet. Bad for people. Drought causes migration causes conflict results in war which kills people. Climate change moves disease-carrying insects to new human environments, unprepared for new strains of ailments. And then there are new strains of people-killing viruses. Ebola, SARS, MERS, Spanish Flu, cholera, COVID-19 and whatever nature has planned next (see above).

I’m Peter Dekom, and if we haven’t figured it out by now, nature started with nothing, cares little for what we value or economic worth, is unimpacted by politics or ranting leaders and lobbying industrialists and is simply out to rebalance the earth against mankind’s arrogant distortions.

 

 

 

Men, Machismo & Masks

 

“Preventing disease is like fishing. Only you never actually catch anything.” 

From one of a series of “wear a mask in public” ads appealing to male machismo.

We know that men, particularly as the get older – per my recent Man, Oh Man, Is that Virus Bad?! blog – are more likely than women to have a more serious infection/long-term impairments from COVID-19. The number doubles after age 60. Yet men tend to wear coronavirus masks less than women. Even when they “wear” masks, many sort of don’t. In New York City, for example, “Men were also considerably more likely than women to be wearing their masks in a kinda-sorta way — nostrils peeking over, mask under chin, mask dangling from one ear strap.

“Setting aside these partial mask-wearers, and those holding masks in hand — all of whom arguably deserve some credit if they mask up fully when approaching a crowd — the numbers boiled down to this: Nearly one in three men were walking around unmasked, while only about one in six women were.” New York Times, August 20th. These characteristics are more about the American experience than what is happening in Europe, for example. American pioneer spirit? That many American men do not respond well to authority? Or “risk” is just what a man’s man “does”?

“Much debate and speculation over why some men just won’t wear masks has focused on past research, which shows that men who identify with a certain brand of traditional masculinity tend to engage in expressly unhealthy behavior like eating junk food or avoiding annual doctor’s visits. A more recent survey from June found men were more likely than women to think masks were uncool or signaled weakness.

“Preliminary research from Boston College Developmental Educational Psychology professor James Mahalik and doctoral students Michael Di Bianca and Michael Harris confirms the concept that men who identify with certain macho qualities are less likely to wear a mask. More specifically, their work suggests that a penchant for individualism and skepticism towards science may more directly correlate to one’s decision to don a mask. If the findings hold true, they could provide deeper insight into how to get more men to protect themselves and others against COVID-19.

“To understand why some men don’t wear masks, Mahalik surveyed 596 men across 49 states, the vast majority of whom identify as heterosexual. The survey went out to men across a spectrum of ages and incomes, the latter of which varied from less than $10,000 a year to over $200,000 a year. Roughly a third of the participants were men of color. The survey asked men to rate whether they identified with certain masculine norms and indicate what they thought about the Center for Disease Control and Prevention’s recommendations for mitigating the spread of COVID-19. On whole, respondents felt positively about the guidelines around COVID-19 and said they complied with them (because this is self-reported data, researchers cannot confirm that men were actually or consistently wearing masks). Unsurprisingly, men who felt negatively about public health recommendations like social distancing and mask wearing, also held traditional masculine ideals around emotional self-control, self-reliance, dominance, winning, power over women, and heterosexual self presentation. But what was more interesting to Mahalik, was a separate finding:

“‘What we found was that more traditional masculine men found fewer benefits to following the CDC guidelines,’ Mahalik says. ‘They saw more barriers in their way to following those guidelines. They had less confidence in science and they had less empathy towards people who are vulnerable or in high risk categories.’ Mahalik and his colleagues posited these other prevalent ideas seem to be more directly related to men not wearing masks than traditional masculinity itself.

“Up until this point, research seemed to indicate that a particular brand of hypermasculinity was closely related to whether men chose to lead healthy lives. It is well established that men who prize traditional masculine norms like toughness engage in more risky behavior and use preventative health services less. But this research suggests that these ancillary ideas around science and community may be more responsible for how traditionally masculine men think about wearing a mask. That finding has implications for how public health officials can appeal to these men. Rather than trying to convince uber-masculine men to change core elements of their identity, public health officials could instead focus on dismantling certain beliefs that may be leading them to be less healthy. In the case of COVID-19, public health officials might consider chipping away at the individualism that may keep men from wearing a mask by focusing on the more pro-social aspects of traditional masculinity.

“‘Instead of this notion of being dominant and controlling your emotions and being self-reliant, how about being a guardian, being a protector? Those are very traditional masculine messages,’ Mahalik says. Rather than a total rebranding of what it means to be masculine, this approach suggests refocusing the lens around traditional masculinity’s more positive aspects. A protector wears a mask, because they care about their community and their families; a guardian wants people to be safe.” FastCompany.com, September 2nd. On the other hand, you can ask women why they think men resist wearing masks. You just might get a vocabulary lesson.

              I’m Peter Dekom, and when you ask yourself why American men “sew their wild oats” and why “boys will be boys” – while women still don’t get that “free pass” in what is supposed to be an egalitarian society, you get 

Minds Are Already Made Up – No Changes Expected

 

Millions, no billions, of dollars are pouring into media of all sorts with a hope that a good campaign will deliver that November 2020 margin of victory candidates need against their opponents. As Russians deploy their Trump-flavored malware, as each party desperately solicits contributions, touting the efforts of their other party, as campaigning candidates desperately attempt to rise above the clutter, there is a real question as to the efficacy of these efforts. Perhaps the sheer volume of ad campaigns has a much greater impact than the messages they convey. Are such ads a colossal waste of money? They do help fill the gap in lost ad revenue from commercial sponsors impacted by the drop in consumer spending due to the pandemic, but that’s a benefit for media companies.

If the metrics of a significant university study on the power of these political ads are correct, there’s real question as to whether or not such marketing efforts are worth the cost. The study: The small effects of political advertising are small regardless of context, message, sender, or receiver: Evidence from 59 real-time randomized experiments by Alexander Coppock (Department of Political Science, Yale University), Seth Hill (Department of Political Science, UC San Diego), and Lynn Vavreck (Department of Political Science, UCLA) published in ScienceAdvances, September 2^nd.  Here’s the abstract:

Evidence across social science indicates that average effects of persuasive messages are small. One commonly offered explanation for these small effects is heterogeneity: Persuasion may only work well in specific circumstances. To evaluate heterogeneity, we repeated an experiment weekly in real time using 2016 U.S. presidential election campaign advertisements. We tested 49 political advertisements in 59 unique experiments on 34,000 people. We investigate heterogeneous effects by sender (candidates or groups), receiver (subject partisanship), content (attack or promotional), and context (battleground versus non-battleground, primary versus general election, and early versus late). We find small average effects on candidate favorability and vote. These small effects, however, do not mask substantial heterogeneity even where theory from political science suggests that we should find it. During the primary and general election, in battleground states, for Democrats, Republicans, and Independents, effects are similarly small. Heterogeneity with large offsetting effects is not the source of small average effects.

In short, as a general rule people are not persuaded by the messages in political ads. The above study found there is an impact, but it is not what folks think. “The summary finding from our study is that, at least in hard-fought campaigns for the presidency, substantial heterogeneities in the size of treatment effects are not hiding behind small average effects. Attack and promotional advertisements appear to work similarly well. Effects are not substantially different depending on which campaign produced the advertisements or in what electoral context they were presented. Subjects living in different states or who hold different partisan attachments appear to respond to the advertisements by similar degrees.” Are just overthinking our cleverness? Or maybe in tight elections, even that small difference just might be determinative:

“First, the marginal effect of advertising is small but detectable; thus, candidates and campaigns may not be wrong to allocate scarce resources to television advertising because, in a close election, these small effects could be the difference between winning and losing. Second, the expensive efforts to target or tailor advertisements to specific audiences require careful consideration. The evidence from our study shows that the effectiveness of advertisements does not vary greatly from person to person or from advertisement to advertisement.” The study.

One of the study’s authors, Alexander Coppock, had this comment to his study: “‘There’s an idea that a really good ad, or one delivered in just the right context to a targeted audience, can influence voters, but we found that political ads have consistently small persuasive effects across a range of characteristics,’ said Coppock, an assistant professor of political science in the [Yale] Faculty of Arts and Sciences. ‘Positive ads work no better than attack ads. Republicans, Democrats, and independents respond to ads similarly. Ads aired in battleground states aren’t substantially more effective than those broadcast in non-swing states.’” YaleNews, September 2^nd, which continues:

“The researchers selected ads using real-time, ad-buy data and news coverage of each week’s most important ads. They tested ads attacking or promoting Republican candidate Donald Trump and Democratic candidate Hillary Clinton as well as commercials concerning primary candidates, such as Republican Ted Cruz and Democrat Bernie Sanders. They analyzed the ads’ effects on survey respondents across several variables, including the candidate, party, or political action committee that sponsored them; whether they were positive or negative in tone; the partisanship of those viewing the ads; the time to Election Day when they aired; whether they were viewed in a battleground state or not; and whether they aired during the primary or general election. 

“They found that, on average and across all variables, the ads moved a candidate’s favorability rating among respondents only .05 of a point on the survey’s five-point scale, which is small but statistically significant given the study’s large size, note the researchers. The ads’ effect on whom individuals intended to vote for was smaller still — a statistically insignificant 0.007 of a percentage point. 

“Campaigns should carefully consider efforts to tailor advertisements to specific audiences given that the evidence shows that ads’ persuasive effects vary little from person to person or from commercial to commercial, the researchers concluded… The findings do not demonstrate that political advertising is always ineffective, Coppock said, noting that the study didn’t analyze the influence of an entire advertising campaign…  ‘TV ads help candidates increase their name recognition among the public, which is extremely important,’ said Coppock, a resident fellow at Yale’s Institution for Social Policy Studies and the Center for the Study of American Politics. ‘Moreover, the effects we demonstrated were small but detectable and could make the difference between winning and losing a close election.’”  

The dollar flow of money for this 2020 effort is staggering. The September 3^rd Forbes presents various expert analyses on the aggregate expected costs: “Kantar Media CMAG group estimates that political ads for the 2020 election could reach $6 billion. Group M, a prominent ad agency, estimates spending for political ads will reach $10 billion, an increase of 59% from the 2016 election year when an estimated $6.3 billion was  spent.

“BIA Advisory Service estimates $6.55 billion will be spent on local political advertising in 2020, with over-the-air TV receiving the largest share of $3.08 billion – 47% of total political spend in 2020. This represents a potential 16.5% of total local broadcast TV advertising revenue for 2020. Digital media is forecast for 21% of political ads, cable TV 14% and radio nearly 5%.

“Cross Screen Media and Advertising Analytics estimates the video ad market for politics will grow by 50% from 2018 to 2020, reaching a projected $6 billion. The study estimates political advertising will account for 4-5% of the total video ad dollars and account for 17% of total growth. Local broadcast TV is expected to get a lion share of the political ad dollars with stronger ad growth from digital media and local cable.” Whew!

We are unlikely to see any significant reduction in campaign spending. Which candidate is willing to take the leap of faith and say, “Hey, I can win without that”? What’s more, the sheer volume of ads suggests a tsunami of power and support, regardless of the message. Name recognition alone, particularly in local races where challengers are rising to attack incumbents, might be worth the effort. But for those big races, actual events – obvious successes and failures – seem to have more of an impact than political ads about either. And for diehards in each major party, the die appears to be cast.

              I’m Peter Dekom, the political soil all around us appears to be pockmarked by the indentation of well-dug-in heels.