Who benefits from increasing healthcare costs?

Maureen Walsh, the Washington state Republican who thinks nurses are lazy and don’t deserve humane working conditions, got another royal smackdown from a nurse. Maybe there’s a reason nurses are overworked.

Hospital administrators pull down enormous bonuses- and most are not required to be disclosed to the public. Nonclinical healthcare wages- as in hospital administrators- increased 30% over the last decade to $865 billion (Bryant, 2018). Furthermore, salaries for nonprofit CEOs far eclipsed those for nurses. Over the past decade, salaries for hospital CEOs jumped a whopping 93% (Clinical Orthopedics and Related Research 2018). Average salaries for hospital CEOs skyrocketed from $1.6 million in 2005 to $3.1 million in 2015. In fact, salaries for nonclinical workers are a major factor in skyrocketing national healthcare spending. In 2017, 84 of the largest nonprofit hospital systems boasted total annual profits of $14.4 billion — resulting in a 2.7% operating profit margin (Bryant, 2018). Are you telling me that hospitals can’t afford to hire enough staff to allow nurses to get legally mandated breaks? Please, Senator Walsh, show me that math. Sounds like you’re being played by the lobbyists and that you’ve been too lazy to do your own research. Shame on you.

I do have to wonder what those CEOs are doing to earn $3 million salaries. Do they actually work 50 times harder than I, or one of their nurses, do?

I suspect the CEOs are in turn only a small part of the problem. I wonder how much of the money flowing into hospitals is sucked away by insurance companies?

The authoritarian, profit-seeking people who want to seize the commons are the problem

I confess that I’ve never really thought deeply about the Tragedy of the Commons — it’s a story that we are all told early, and superficially, it seems to make a lot of sense. Sure, we have to worry that a shared resource might be exploited by selfish individuals. We have to be concerned about free riders. But do we really? And why is it that somehow the blame always falls on the weakest, poorest members of society? So I read Garrett Hardin’s original essay from 1968, and realized…it’s dreck. Why has this thing been so influential? It’s entirely about population control, nudging around the edges of eugenics, and yuck, I realized that the people who think this is great stuff tend to be the wealthy and deluded Libertarians. Look at this:

If each human family were dependent only on its own resources; if the children of improvident parents starved to death; if, thus, overbreeding brought its own “punishment” to the germ line–then there would be no public interest in controlling the breeding of families. But our society is deeply committed to the welfare state, and hence is confronted with another aspect of the tragedy of the commons.

In a welfare state, how shall we deal with the family, the religion, the race, or the class (or indeed any distinguishable and cohesive group) that adopts overbreeding as a policy to secure its own aggrandizement? To couple the concept of freedom to breed with the belief that everyone born has an equal right to the commons is to lock the world into a tragic course of action.

Unfortunately this is just the course of action that is being pursued by the United Nations. In late 1967, some 30 nations agreed to the following: “The Universal Declaration of Human Rights describes the family as the natural and fundamental unit of society. It follows that any choice and decision with regard to the size of the family must irrevocably rest with the family itself, and cannot be made by anyone else.”

Oooh, ‘ware the improvident. They might use overbreeding to aggrandize themselves! I’ve never felt that way. It seems to me that those gigantic families are harming themselves, perpetuating self-destructive myths at best, and reducing resources to their own children. Those children aren’t cows, property that they can use to seize an unfair share of the commons; they are independent, educable individuals who, if given the opportunity, could learn to be cooperative members of society and who would see that their own self-interest is not served by dropping a baby every year.

Hardin’s own example of herdsmen overgrazing a shared pasture is full of limiting assumptions — his herdsmen not only fail to cooperate in managing a shared resource, they don’t even talk to each other. And this is a shared myth used to justify privatization and control of basically everything in the world?

What prompted me to dig into the source material was an excellent article on Hardin and his “tragedy” by Matto Mildenberger. Humans actually do not lack cooperative management tools; we don’t need authoritarian intervention to save us from ourselves.

But the facts are not on Hardin’s side. For one, he got the history of the commons wrong. As Susan Cox pointed out, early pastures were well regulated by local institutions. They were not free-for-all grazing sites where people took and took at the expense of everyone else.

Many global commons have been similarly sustained through community institutions. This striking finding was the life’s work of Elinor Ostrom, who won the 2009 Nobel Prize in Economics (technically called the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel). Using the tools of science—rather than the tools of hatred—Ostrom showed the diversity of institutions humans have created to manage our shared environment.

Of course, humans can deplete finite resources. This often happens when we lack appropriate institutions to manage them. But let’s not credit Hardin for that common insight. Hardin wasn’t making an informed scientific case. Instead, he was using concerns about environmental scarcity to justify racial discrimination.

About that last bit — yeah, Hardin was a nasty character, but his nastiness isn’t the reason we should reject his myth. It’s because he was wrong.

Hardin was a racist, eugenicist, nativist and Islamophobe. He is listed by the Southern Poverty Law Center as a known white nationalist. His writings and political activism helped inspire the anti-immigrant hatred spilling across America today.

And he promoted an idea he called “lifeboat ethics”: since global resources are finite, Hardin believed the rich should throw poor people overboard to keep their boat above water.

People who revisit Hardin’s original essay are in for a surprise. Its six pages are filled with fear-mongering. Subheadings proclaim that “freedom to breed is intolerable.” It opines at length about the benefits if “children of improvident parents starve to death.” A few paragraphs later Hardin writes: “If we love the truth we must openly deny the validity of the Universal Declaration of Human Rights.” And on and on. Hardin practically calls for a fascist state to snuff out unwanted gene pools.

Or build a wall to keep immigrants out. Hardin was a virulent nativist whose ideas inspired some of today’s ugliest anti-immigrant sentiment. He believed that only racially homogenous societies could survive. He was also involved with the Federation for American Immigration Reform (FAIR), a hate group that now cheers President Trump’s racist policies. Today, American neo-Nazis cite Hardin’s theories to justify racial violence.

It’s always useful to the powers-that-be to claim that a crisis is inevitable, and that it’s all due to unavoidable Human Nature, because that obscures where the blame really lies: in the hands of a corrupt, rich few who have used their power and wealth to override the potential of the many.

…rejecting Hardin’s diagnosis requires us to name the true culprit for the climate crisis we now face. Thirty years ago, a different future was available. Gradual climate policies could have slowly steered our economy towards gently declining carbon pollution levels. The costs to most Americans would have been imperceptible.

But that future was stolen from us. It was stolen by powerful, carbon-polluting interests who blocked policy reforms at every turn to preserve their short-term profits. They locked each of us into an economy where fossil fuel consumption continues to be a necessity, not a choice.

You can find more on that anti-corporate perspective in this video from Mexie:

We’re not going to solve climate change or any of the other global problems harming humanity until we claw down the billionaires from their perches and enact laws that control their greed.

American politics has become a sham

There were a bunch of town hall meetings with Democratic presidential candidates last night. I didn’t watch a single one of them, instead retiring to my bed with a book. My wife tuned in to all of them, I think, because I don’t believe she came to bed at all (she’s the fiercely political one in the family nowadays, and I can’t blame her.) I look at the swarm of Democrats that are buzzing around during this premature election cycle, and I’m just tired. All I want is sound policy and coherence at this point. So I detest the young, brash ones like Mayor Pete who has no policy and openly says he’s avoiding it because he’s all about “values” (but what if your values are all about having a rational, sane, competent government?) I detest the old neo-liberal party hacks — I can’t believe that Uncle Joe is going to be running. Do you think he’ll get Anita Hill’s vote?

But worst of all, I detest the Republican party. They’re doing nothing. At a time when eleventy-seven thousand Democrats are plunging madly to the starting gate because they see our current president as weak and hateful and a necessary target for removal, the Republicans cower in fear and none are suggesting that they’ll run against him. Why? Because even the ones who express reservations about the Deplorable-In-Chief know that he is the current apotheosis of Republican policy, and they can’t run against him without repudiating everything the Rethuglican machine and Fox News has built since Reagan. Charles Pierce puts it well.

That there are not at least five Republican candidates challenging El Caudillo del Mar-a-Lago not only is a fine metric for judging the deep internal rot in that political party, but also a good measure of the limits of the Never Trumpers as allies in an election year. Let us stipulate the following two points: 1) It is the responsibility of the Democratic Party to do everything in its power to protect the institutions of our republic, and 2) it is distinctly not the Democratic Party’s responsibility to save the Republican Party from itself, and from the political monster it has created over the past 40 years. For four decades, the party has flattered, and begged, and truckled to the very forces of which it is now terrified. Save yourselves, gang.

But that isn’t happening because, for all their brave talk, the Never Trumpers want to keep the political power that base gave them while distancing themselves from its obvious and inevitable product. So, instead of gathering forces behind a primary challenge, many of the Never Trumpers seem to be content with advising the Democratic Party on who it should nominate and what policies it should pursue. This, I believe, in preparation for a campaign to blame the Democratic nominee if the country determines that it wants to live six more years in the current gale-force dungwind.

Let us be clear: if the country re-elects this president*, it’s because modern movement conservatism prepared the ground for it and used the Republican Party to do it. It hangs on all of them like a historical deadweight. They should disenthrall themselves from the policies and tactics that hung it from their necks before presuming to beg the other political party save them from their own monster.

So here I am, disgusted. I am going to vote for whoever wins the Democratic party nomination, and I will say it loud and clear ahead of time, even if it’s a Mayor Pete or an Uncle Joe, because the number one priority for the country is to first get rid of that asshole in the White House, and number two priority is to bury the Republican party. Yet I hate that I’m trapped in this two-party system, and I do not trust the Democratic party to fight for anything other than corporate sponsorship. That means I cannot bear to pay attention to the process, because the process is the problem.

I’ll walk into the primaries and vote my conscience (which at this point whispers “Warren” in my brain; could change), and then when the actual election roles around after a goddamn year and a half of misery, I’ll mark the ballot for whoever is opposite Trump, which means the Democrats could nominate a chimpanzee and they’ll get my vote. Which does not make me happy.

Slap me in the face harder

People who can’t imagine doing good for people are the worst kind of people. Philip Klein is resentful that Elizabeth Warren’s plans might benefit people.

Aside from the cost, which, like her child care proposal, she claims would be covered by her ultra-millionaires tax, the plan would be tremendously unfair to those who have been struggling for years to pay off their student loans.

Yes. It was tremendously unfair to hit a generation of students with excessive costs and dreadful loans. So where were you when those were imposed? Have you been crying out for decades about the unfairness of student debt? Looking at Klein’s usual pro-rich, conservative Republican op-eds, I rather doubt it. But now he’s crying for them.

There are those who may have taken higher-paying jobs they didn’t necessarily want to pay off loans.

Wait, what? They were forced to suffer by taking higher-paying jobs? I don’t think that’s a common problem.

And there are those who have cut expenses to the bare bones to pay off loans while watching their friends with similar salaries eat out and travel and de-prioritize paying off loans. Those who were more responsible will feel justifiably enraged at the idea that those who may have been more profligate will now get a bailout from the government.

Boy, I think this is called projection. Philip Klein is very concerned that slackers and deadbeats might beat the unfairness of the existing system, so we ought to keep that system to punish them. This is how bad systems persist, isn’t it? By this argument that “I suffered through it, so you have to suffer, too” which only perpetuates suffering.

Hey, I guess my vote can be bought

I’m going to vote for a candidate with this plan:

The first step in addressing this crisis is to deal head-on with the outstanding debt that is weighing down millions of families and should never have been required in the first place. That’s why I’m calling for something truly transformational — the cancellation of up to $50,000 in student loan debt for 42 million Americans.

My plan for broad student debt cancellation will:

  • Cancel debt for more than 95% of the nearly 45 million Americans with student loan debt;
  • Wipe out student loan debt entirely for more than 75% of the Americans with that debt;
  • Substantially increase wealth for Black and Latinx families and reduce both the Black-White and Latinx-White wealth gaps; and
  • Provide an enormous middle-class stimulus that will boost economic growth, increase home purchases, and fuel a new wave of small business formation.

Once we’ve cleared out the debt that’s holding down an entire generation of Americans, we must ensure that we never have another student debt crisis again. We can do that by recognizing that a public college education is like a public K-12 education — a basic public good that should be available to everyone with free tuition and zero debt at graduation. My plan for universal free college will:

  • Give every American the opportunity to attend a two-year or four-year public college without paying a dime in tuition or fees;
  • Make free college truly universal — not just in theory, but in practice — by making higher education of all kinds more inclusive and available to every single American, especially lower-income, Black, and Latinx students, without the need to take on debt to cover costs.

Some people will say we can’t afford this plan. That’s nonsense. The entire cost of my broad debt cancellation plan and universal free college is more than covered by my Ultra-Millionaire Tax — a 2% annual tax on the 75,000 families with $50 million or more in wealth. For decades, we’ve allowed the wealthy to pay less while burying tens of millions of working Americans in education debt. It’s time to make different choices.

Right now that candidate is Elizabeth Warren, but I’m open to others adopting this idea. In fact, I think it ought to be on the Democratic party platform, and that any candidate who wants to represent the will of the American people ought to be promoting it.

Note: I have no student loan debt — I only had a small debt to begin with, and paid it off years ago — I’m not planning to attend college in the future, and my kids have all completed undergraduate education, and I’m not really going to acquire any personal gain from this (although I sure wish somebody’d put this in place round about 2000, before my trio of offspring started marching off to university and broke us). So I’m not really being “bought”. This is a change that would be good for the country. Let’s build up our human infrastructure!

Also note that her plan specifically covers 2-year public colleges, which is just as important as our ivory tower institutions, and that she has specific plans for HBCUs and MSIs. Warren knows her stuff.

Why isn’t every candidate immediately recognizing a good idea and jumping on the bandwagon? Even the Republicans should be able to see the virtues.

Nurses play cards, cops eat donuts, and other stereotypes

You’ll have to excuse my home state. Walla Walla is a lovely town in a beautiful part of the country, but it is in the eastern half of Washington, which has more than its fair share of rural ignoramuses.

I understand… making sure that we have ‘rest breaks’ and things like that. But I also understand that we need to care for patients first and foremost… I would submit to you that those [critical access hospital] nurses probably do get breaks! They probably play cards for a considerable amount of the day!

Sen. Maureen Walsh (R), Walla Walla

I’ve known a few nurses in my time. What I don’t get is why, if they’re spending most of their time playing cards all day, they come home with aching backs and sore feet all the time? I’ve been in hospitals before, and I’m the one who is lying in bed the whole time, while the nurses are all hustling about on tight schedules, getting the work done. What card game is this that can be done in short bursts and is physically demanding?

I must also beg to differ. This Republican is defending an exemption that benefits hospitals, allowing them to demand mandatory overtime from the nursing staff rather than hiring enough nurses to do the job without overworking them, and that means that care for patients is not first and foremost — hospital profits are. Understandably, that is a very Republican position to take.

Damn, but American health care is such a chaotic mess, thanks to capitalism.

Žižek vs Peterson: A nothingburger.

I guess Jordan Peterson and Slavoj Žižek had their great debate in Toronto yesterday. You know how I feel about debate and Jordan Peterson, while Žižek is simply someone I don’t read and have no interest in, so you can guess how enthusiastic I was about this event. Fine, you like to watch a couple of gomers share a tureen of warm spit on a stage — knock yourself out, have a grand time, I’m not going to tell you you can’t. I’m more interested in Nathan Robinson’s commentary on it.

I didn’t get far in that, even. The debate started an hour late, and practically the first thing out of Peterson’s mouth is that he didn’t have time to read any of Žižek’s work (neither have I, but I’m not the one challenged to debate him), and even more surprisingly, he admits that he, voluble scourge of Postmodernist Communists, studied up by reading the Communist Manifesto … for the first time ever.

Oh, come on. It’s a long pamphlet, a summary of the ideas for the proletariat. This is the minimal amount of effort you put into preparing for a debate that some of your fans are paying $1500 to see? After you’ve spent years damning an ideology that you haven’t read?

It sounds like Žižek’s performance wasn’t much better.

I hope all the attendees got their money’s worth.

Invade Africa — all of Africa — to punish “woke Twitter” for the Notre Dame fire

Andy Ngo, always a reliable source of hypocrisy, started a Twitter thread to document all the wicked Leftists who expressed joy at the burning of Notre Dame. It’s bizarre, because many of those Leftists are making legitimate points. France led a colonial empire, but we don’t see as much grief for the murdered and exploited peoples. Jerusalem’s Al-Aqsa mosque was burning at the same time, and got only a tiny fraction of the attention. Notre Dame is the responsibility of the French state, and there has been bickering for years about the cost of maintenance with the Catholic Church, yet the church still uses it for religious services. Catholicism is an odious cult, yet it gets treated with unwarranted respect (again, Notre Dame’s historical value is preserved by the French Republic, yet this is treated as a loss for Catholicism). Americans demolish Indian lands to build ugly monuments or dig mines, but there’s rarely an outcry about disrespecting their history (well, Indians cry out; we rarely pay any attention).

It’s complicated. I think it’s important to preserve European historical sites, but I feel the same about Native American sacred sites and the Sultan Ahmed Mosque and Jagannath Temple and Borobudur and a thousand other places, even when I have little cultural connection to them and may even detest the religion that drove their construction. Human history is full of majestic accomplishments, but they’ve all got warts on them. We’ve got to appreciate the good behind them, but never forget the warts. A tragedy like the Notre Dame fire occurs, and people rush to both deify and demonize the building — let’s try to have some perspective, OK?

I sympathize with the people who feel some schadenfreude at the destruction of one artifact that represents crimes against humanity at the same time that it represents a great human achievement. I don’t mind them reminding us all of the badness that lurks within that monument — I’d do the same. As long as you’re tolerant, no matter how angry you are, and not plotting active destruction yourself, I can respect that.

The interesting thing about Ngo’s thread, though, is that, as you might expect, it’s drawn out the right-wing hypocrites. They’re all deploring how hateful the Left is for expressing a personal dislike of Catholicism, or French imperialism, or thinking it’s only fair that France feel the kind of loss other nations have felt. But they’ve got their own rabid bigotry that they overlook.

There’s the usual call to destroy Islamic holy sites.

You know, Al-Masjid Al-Haram is even older than Notre Dame. If you’re calling for its destruction, you aren’t motivated by an appreciation of history or art, but by simple ideological vengeance. Then you don’t get to complain when people have an ideological contempt for Notre Dame.

Or how about this delusional threat?

He, personally, is going to invade Africa. All of Africa. This vast continent, with a deep history and thousands of complex cultures, is responsible for burning European cathedrals, and he is going to march over there and spank everyone. His reason? To spite people on Twitter he doesn’t like.

Mr Ngo wanted to expose wicked Leftists, but ended up holding a mirror to his own clique.

Tangled web, check. Woven, check. Deceived…uh, not check.

There’s a newspaper in Alabama that has a reputation for promoting some incredibly racist garbage, the Democrat-Reporter, which was run by a good ol’ boy named Goodloe Sutton. “Was”. It’s been sold.

Maybe.

The new owners are CT Harless and Sabrina McMahan, nominally. The story has to be read to be believed. They are incapable of saying any word of truth, and lead a reporter who asked a few simple questions about their background on an amazing runaround. “Are you the CT Harless who said he was an Imperial Wizard of the American White Knights?” “No, that was my brother.” “Your name is Chuck Harless?” “No, Chris, my brother is Chuck, we were both called CT.” (sounds confusing.) “But you bought the paper?” “No, I don’t own it. I’m just helping out the owner.”

It goes around and around, and there’s a transparent charade where CT has a friend call up the reporter posing as “Chuck” of the KKK to disavow any connection. It’s so stupid, with constantly changing excuses, that it’s hilarious. And of course CT/Chuck/Chris/Sabrina are threatening to sue the reporter if he publishes any of it. I still don’t understand why they’re being so evasive, unless it’s just that they have the habit of lying.

I don’t think the KKK/American White Knights are recruiting the very best.

Would you vote for this dead-eyed ignorant wanker?

Then you’re in luck! Carl Benjamin, anti-immigrant, anti-European Union, anti-feminist, all-around bigot, is running for a seat in the European parliament, on a platform of undermining the European Union. It’s a bit like those tea party fanatics who want to eliminate the federal government running for congress all the time, so it’s not that crazy.

Oh, wait…yes it is.

Anyway, his argument for why he should be elected is that he’s extremely popular with alt-right trolls on YouTube, so he has already succeeded in cultivating an electorate, which is, I guess, true.

He’s better known on YouTube as Sargon of Akkad, for reasons unknown. I asked around about why he uses that moniker, since he never talks about the ancient history of Mesopotamia, doesn’t have any credentials in history, and doesn’t even seem to like people from the Middle East, and no one gave me an answer. I think I’ve figured it out, though. There are a great many people with largely right-wing views who got their start on YouTube hiding behind cartoon avatars: a knight in a tuxedo, an angry kangaroo, etc., and pretending to be an Akkadian king fits right in, and also has a bit of pretension. I think it’s like the masks of television wrestling. They’re all playing a simple-to-understand cartoon persona. They think they’re all luchadors.

Which, they think, is another reason to vote for them.