The business model of U.S. health care is fraud

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Wednesday August 15, 2018 · 9:42 AM PDT

2018/08/15 · 09:42

Greed motivates way too many actors in the U.S. health care system.

Fraud is defined as “wrongful or criminal deception intended to result in financial or personal gain.” And the U.S. health care non-system — really a dysfunctional phenomenon of market failure more than a system — is riddled with fraud.

Imagine having a doctor give you a $70 orthopedic boot for a foot injury only to turn around and receive a $30,000 bill — yes, that’s tens of thousands — for “surgery.” But that’s what Brooklyn journalist Kate Arnoff just had happen to her. Note the collusion of parasitic actors — few of which are actually providing health care — in her Twitter thread about the matter. Read it from start to finish.

Love too navigate the Kafkaesque process of being told by my insurance company that I may have to pay $30,000 for a surgery that I did not have!
Ã¢ÂÂ Kate Aronoff (@KateAronoff) August 14, 2018

I suffered a very minor foot injury several weeks ago, for which I've had 3 x-rays and seen the doctor for a total of probably 20 minutes. Can't wait to spend hours on the phone tomorrow sorting this out in our extremely normal and efficient private healthcare system
Ã¢ÂÂ Kate Aronoff (@KateAronoff) August 14, 2018

I called my insurance who called the host network who called the doctor who sent them to the billing co., which is defending the fact that the doctor giving me a $70 orthopedic boot constitutes $30,000 worth of surgery. Now I can file an appeal or start a fraud investigation Ã°ÂÂÂ
Ã¢ÂÂ Kate Aronoff (@KateAronoff) August 14, 2018

I'm trying to reach the billing company myself, and have called the relevant representative four times today and left a message. Tried talking to an operator but nobody picked up the line and the mailbox is full. I love the freedom of choice that markets provide.
Ã¢ÂÂ Kate Aronoff (@KateAronoff) August 14, 2018

I want to point out that it wasn’t Kate’s doctor defending this “surgery” bill, but instead the “billing company” employed by her doctor. A number of doctors and hospitals in the U.S. medical non-system now contract with companies whose sole reason for existence is to game the medical coding system in order to suck as much money as possible from patients. Case in point from a company called MediRevv:

In revenue cycle, payment posting and collections often take the starring role. After all, this is where the money comes in. But, the truth is, the champion of the revenue cycle often gets overlooked — that is, until there is a glaring problem.

In the new era of value-based reimbursements, never before has the process of medical coding had such a powerful impact on revenue cycle performance. Every stage of the healthcare revenue cycle has an impact on the next. This means that what begins as a small problem in one phase has the potential to mature into a costly setback further down the line.

Now, Kate is insured, but do you think her health insurance company really has an incentive to waste time and resources fighting this fraud? Hell no. They pay what they want to pay and then, if that leaves the patient left owing tens of thousands of dollars, and at risk of bankruptcy and destroyed credit — well, good luck.

So, is this an insurance company issue or a doctor issue? Well, it’s clearly not the insurance company demanding $30,000 from Kate, but it’s the insurance-based system that creates the “space” for this kind of fraudulent behavior by providers.

In a singe-payer, Medicare-for-all system, patients are not left in despair to mediate between an insurer whose goal is to spend as little as possible on care and a doctor or hospital whose goal — not all doctors! — is to earn as much money as possible. Rather, if the doctor tried to charge the government $30,000 for a freaking boot, they would be at serious risk of criminal prosecution — and the patient would not be forced to negotiate the crisis. The patient would either be responsible for a small fixed co-pay or nothing at all.

With a single-payer, Medicare-for-all system, patients would be relieved of the tremendous burden of being forced to personally combat financial fraud in the health care system, whether it results from overzealous coding by a provider or, in the example below, a health insurer fraudulently denying payment for something that no reasonable person could have predicted would have happened in advance, a miscarriage.

I spent a few months fighting with my insurance because I didn't get pre-approval to have a miscarriage (which nearly killed me). Every person I talked to, I made them admit that the words coming out of their mouth were absurd.
Ã¢ÂÂ Jessie's Compile Time (@OnyxPlatypus) August 14, 2018

The “job” of patients in a moral and humane health care system should be to follow the directions of their doctors in order to achieve good health. It should not be to stumble through a barbaric financialized non-system of health care with rampant fraud and abuse.

The status quo of U.S. health care is a non-system driven be abuse, fraud and greed — there is a better way.

Atlanta police charge woman hit by tractor-trailer truck in impoverished neighborhood. Yes, really.

james321

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Thursday August 02, 2018 · 6:38 AM PDT

2018/08/02 · 06:38

Walking while poor in metropolitan Atlanta is often a crime.

If you get hit by an 18-wheeler in Atlanta — notorious for its hostile pedestrian environment — the police will make sure you suffer — even more, that is, than the pain of being hit by a giant truck.

On Wednesday, a woman accidentally stepped in front of a tractor-trailer truck in an impoverished southwest Atlanta neighborhood, and while she was stable when taken to the hospital, the Atlanta Police Department is still intent on making things worse, planning to charge her with “misdemeanor pedestrian in the roadway.”

Investigators told AJC.com the woman was injured but seemed to be stable when she was taken to the hospital. She will be charged with misdemeanor pedestrian in the roadway.

The truck driver was not cited, police said.

Darin Givens, an Atlanta urbanist and pedestrian advocate, tweeted a picture of the roadway where the woman was hit, which he notes features multiple MARTA bus stops, but no sidewalks, crosswalks or pedestrian lights. Imagine, if you will, attempting to access bus stops on this street — or cross the road to access one in your direction of travel — without entering the roadway.

Here's the spot on Campbellton Rd where a pedestrian was injured after being hit by a truck. No sidewalk, no crosswalk, no light. Several MARTA bus stops nearby

The people who designed the road are not being charged with a crime. But the pedestrian is. https://t.co/SCBp9nGO8s pic.twitter.com/ZksB0Vrt4N
Ã¢ÂÂ Darin Givens (@atlurbanist) August 2, 2018

Georgia has a history of criminalizing pedestrians — often too poor to afford a car — forced to navigate its hostile and dangerous roads. In 2011, a Georgia mother was convicted of vehicular homicide when a drunk driver killed one of her children as she attempted to cross a Marietta road — with few crosswalks — from the bus stop to her apartment complex.

In metropolitan Atlanta, if you’re too poor to afford a car — or even just choose to navigate the sprawling region by foot — expect for the police to punish you for existing.

The future of the United States is in a strong and free North American Union

james321

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Tuesday July 03, 2018 · 11:26 AM PDT

2018/07/03 · 11:26

We need to choose North American integration or choose irrelevance.

Leaders from 16 Asian countries — including Australia, China, India, Japan, and South Korea — met in Tokyo on Sunday to continue working towards the creation of the world’s largest trading bloc, one that would constitute one third of the world’s population and potentially allow for “free movement” of labor between member states.

“The path toward a year-end agreement is now clearer,” said Hiroshige Seko, Japan’s Trade Minister during the joint-press conference held Sunday. “As protectionism concerns increase globally, it’s important that the Asian region flies the flag of free trade.”

If ever fully achieved, the partnership would also include the 10 members of the Association of Southeast Asian Nations as well as South Korea, Australia and New Zealand, and cover one third of the world’s economy and almost half its population.

For most of the world, regional integration and economic cooperation is nothing new. South America has MERCOSUR, Southeast Asia has ASEAN, Russia and some former Soviet states have the Eurasian Economic Union, and, of course, Europe has the European Union, arguably the most advanced project of regional integration.

At the same time as other parts of the world are pursuing economic and political integration, however, the United States is increasingly looking inward: expressing ambivalence about NAFTA and clinging to outdated notions of sovereignty and nationalism.

Given its rapidly declining relative economic and military power even before the horror of the Trump regime, the need for the United States to have serious “adult” conversations about giving up some sovereignty for greater global influence as part of a regional bloc has existed for some time.

These conversations won’t be easy, because even liberals like Hillary Clinton and Michelle Obama engage in a profoundly problematic discourse of extreme nationalism: “America is the greatest country on Earth.”

But these conversations are nevertheless necessary, because absent robust regional integration with Canada and Mexico, the United States will be choosing irrelevance. Adjusted for purchasing power parity, our GDP already trails China and the European Union. Our population is stagnating.

So, what would a North American Union look like? Well, probably something like the European Union, but with the advantage that we can learn from Europe’s process of integration.

To start, we would form a “single market” between the Untied States, Canada and Mexico — all tariffs would be eliminated and North America would speak as a “single voice” when negotiating trade agreements with other blocs and/or countries. The United States wouldn’t negotiate trade agreements with Russia or the European Union — instead, North America would negotiate trade agreements with other international actors.

To start, the United States and Canada would probably become a “border-free” zone — for both free movement of people and labor — similar to Europe’s Schengen Area, with Mexico wrapped into this zone in due course. (Even before being wrapped into a borderless North America, however, Mexicans would immediately enjoy a privileged status as migrants in the United States and Canada.)

Ultimately, far in the future, the North American Union might become something close to — but just short of — a federal North American state, perhaps with governing institutions in a politically neutral city like Toronto, Canada or Monterrey, Mexico.

As the Union evolves, additional countries from the Caribbean and Central America could apply for membership, upon meeting high standards of governance, human rights, and a commitment to open and free markets.

Cooperation on everything from defense to international development to regulatory standards would also increasingly fall under a North American framework. A shared currency would eventually be implemented.

As a compromise for those on the right who would inevitably be concerned about loss of sovereignty and increased migration to the United States, participation in a new North American Union would necessarily mean the construction of a new kind of North American sovereignty with North American borders, ones that would be strong and controlled. Even as migration increases from our historic neighbors of Mexico and Canada, migration from other large countries — China and India, for example — could be expected to decrease and come under additional scrutiny. Such would be a small price to pay for the United States moving beyond nationalism into an exciting globalized and multilateral 21st Century.

Will this project be easy? No. Is it necessary? Yes.

The future is multilateralism and regional cooperation — we ignore it to our peril.

Actually, it's okay for the Democrats to talk about something other than immigration and the border

james321

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Monday June 25, 2018 · 9:05 AM PDT

2018/06/25 · 09:05

Yes, what's happening at the border is bad -- but there are also many other bad things happening in the United States.

Judging from the mainstream media and the social media accounts of most Democratic Party politicians, one would think that the only atrocity of justice currently occurring in the United States is the behavior of the Trump administration and ICE at the border. And the Democrats are right to call Trump out on his treatment of migrants, because ultimately, a country that abuses the rights of migrants will also abuse the rights of citizens.

And, to be clear, I don’t think any Democratic Party outrage on behalf of migrants has been misplaced. Still, migrants can’t vote, and in order to win power in government — providing Democrats with the actual ability to fix things at the border — the Democratic Party must also address the needs of citizen voters.

In other words, the Democratic Party needs to do two things at once. They need to do that which is probably pretty politically easy for them — defending the rights of migrants who (correctly!) enjoy support from America’s billionaires and oligarchs — and also that which is probably politically hard for them — attacking the gross inequality and poverty that has destroyed the lives of so many in the Democratic Party’s base.

So, please do talk about the obscenity that is Trump’s separation of children from their parents at the border, but also please talk about the obscenity that is the U.S. health care system and declining life expectancy. Talk about ways to halt the atrocities on the border — abolishing ICE and fixing the wildly incompetent Office of Refugee Resettlement at Health and Human Services — and also talk about America’s entirely inadequate welfare state — calling for policies like Medicare-for-all and social protection for “gig economy” workers like the European Union has been doing. They could even talk more about how Trump’s trade war will destroy the U.S. cheese industry, because who doesn’t like cheese (and also because Wisconsin)?

I totally get that it’s easier for the Democratic Party to focus on migrants and “identity” issues than it is to attack powerful financial and corporate interests, but unfortunately doing that alone is not going to help them win in 2018 at a time when many Americans — voters -- are literally killing themselves from despair due to the disruptions caused by post-industrial late capitalism.

In short, yes, continue highlighting Trump’s maltreatment of migrants and refugees, but also advance a concrete policy agenda with popular proposals — like true universal health care — that will inspire the Democrats’ core electorate.

If the Democrats don’t win — and lots of evidence is pointing to the fact that 2018 is going to look like 2016 — the atrocities at the border will continue. So, if the Democrats need to “steal some minutes” from the migration issue to talk domestic social and labor policy for citizens who can vote, it’s fine, and shouldn’t be treated as dismissing the plight of migrants.

I wrote the diary for why a "Jon Ossoff" would lose last summer. He lost. We must change course.

james321

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Wednesday June 21, 2017 · 5:48 AM PDT

2017/06/21 · 05:48

You don't get to come here if you don't give voters a reason to send you here.

Last summer, after Hillary’s campaign released one of their first adverts — kids watching Trump say mean stuff — I wrote that simply attacking Trump as “being an asshole” would lead to a big Hillary loss in November. With very little joy, I found myself proven correct.

Here’s the most important part of my diary:

Thanks to some nudging from one Bernie Sanders, Hillary has recently announced a lot of really, really popular ideas: like support for a public option and ending college tuition for all but the wealthiest Americans.

Americans — a massive number of independents — flocked to Bernie Sanders, because he was crystal clear about what politics should be about: making good public policy happen. The public craves good policy in a country where the trains don’t run on time, bridges are collapsing, health care is an expensive bureaucratic nightmare, and earning a bachelor’s degree is more expensive than buying an Italian sports car.

Hillary will not win if she makes this campaign about Trump being an asshole. She will win if she makes this campaign about celebrating good public policy for the public good.

I beg of you, Team Hillary, please change course...before it’s too late.

As we saw with the Ossoff campaign, not only did he not even aggressively attack Trump — he promised to work with the president on anything related to his district — he failed to articulate a clear vision for what he wanted to achieve in Congress: how would he fix health care? How would he get more people in good jobs? How would he resolve the intractable conflict in the occupied Palestinian territories?

I’m hardly a fan of Matthew Yglesias’ work, but he’s right on Ossoff, especially when he notes how Corbyn achieved significant success in the recent UK election, because he articulated an inspiring policy vision:

But perhaps most of all, running on a bold policy agenda helped focus voters’ minds on policy rather than on the (extremely long) list of controversial Corbyn statements and associations from past years. Pundits had long expected Corbyn to get crushed at the polls, and had Theresa May succeeded in running an election focused on the Falklands War, the Irish Republican Army, and unilateral nuclear disarmament, she would have won. But instead, the UK ended up with a campaign about promises to nationalize utilities, eliminate university tuition, and raise taxes.

In contrast, look at Ossoff saying almost nothing in this advertisement:

YouTube Video

I will say this again, in simple language: if the Democrats want to stop losing and start winning, they must begin articulating a bold and inspiring vision of good public policy for the public good.

Medicare-for-all polls at about 73 percent for Democrats, perhaps that’s a good place to start? Or free college tuition? Or a concrete infrastructure plan? Or a pathway to untangling the United States from its problematic — and one-sided — relationships with Israel and Saudi Arabia?

(Republican policy proposals are vile, disgusting, backwards, positively medieval — but at least they articulate something for their voters to get excited about during campaigns.)

Americans aren’t stupid — they can handle policy details.

At this point, I think we are going to be woefully disappointed by the performance of Democrats — in both 2018 and 2020 — if the party doesn’t change course fast.

Sorry, Hillary Fans, the Lesson of Macron's Epic Success is More Bernie 2020 than Hillary 2020

james321

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Monday June 19, 2017 · 6:01 AM PDT

2017/06/19 · 06:01

640px-Vladimir_Putin_and_Emmanuel_Macron_(2017-05-29)_06.jpg — If you look at Macron and see a more successful version of Clinton, try looking deeper.

Update: As expected, I’m being attacked as an idiot and told that I don’t understand anything about either U.S. or French politics. I’m also being told it’s unfair to compare French politics to U.S. politics, because, I don’t know. I guess it’s OK when “Very Serious” Neera writes a Washington Post Op-Ed making comparisons to our centrists, but not okay when I write, “Well, actually, Macron is more “Our Revolution” than he is “Center for American Progress.” Thanks to those who are substantively engaging my piece rather than dishing personal attacks. FWIW, I don’t care about Hillary or Bernie — I care about good public policy for the public good. This diary isn’t about Hillary and Bernie — it’s about public policy and ideology.

-------------------------------------------------------------------------------------------------------------

I’ve noticed that the lesson “Very Serious DC and NYC Liberals” seem to be taking from the incredible success of Emmanuel Macron in France is that the path to victory for “The Party” in 2020 is centrism, centrism, centrism and personality, personality, personality. Basically, Hillary Clinton, but a tiny bit more likable than just likable enough.

From New York:

To defeat populism, America needs its own Macron--a charismatic leader who can make centrism cool. My take: https://t.co/AAF1YwTnqb
Ã¢ÂÂ Max Boot (@MaxBoot) June 15, 2017

From Washington, D.C. (where Center for American Progress President Neera Tanden has not held back with her Macron adoration):

I really can't improve on this tweet. Other than to say how weird it is that no one focuses on actual winners like Trudeau and Macron. https://t.co/DKLaW8jhGh
Ã¢ÂÂ Neera Tanden (@neeratanden) June 9, 2017

In addition to tweeting lots of Macron love, Neera even wrote an entire column in the Washington Post on the topic. The problem is that her love letter (and I’d submit the same critique of Max Boot’s work) to obscure institutional reforms in France ignored the most substantive part of Macron’s campaign: importing the wildly successful Nordic model to France, which in the case of France means making the country’s already very generous social model a tiny bit more generous, and making the country’s extremely rigid labor laws (i.e. it’s really, really, really hard to fire someone for incompetence in France) a bit more liberal (liberal in the European free market sense of the word).

Please read this carefully:

Macron’s policy is entirely in line with this model. He does not share the French Socialist Party’s (and now also its British sister party’s) strong anti-market ideology. But he is not a neo-liberal who wants to scrap France’s social policy system. On the contrary, he wants to invest in a labor market policy on typically Nordic lines, where one wants to give a second chance to those who lose their jobs due to globalization. He also wants to increase political efforts in areas such as health care, climate change and culture.

The Nordic model is also known as “flexicurity,” which is a more technical term for a social and labor contract defined by extensive universal welfare institutions, but also a liberal labor market. (Nevertheless, labor rights in Nordic countries are generally still stronger than those provided American workers.)

Furthermore, Macron’s support for free trade is surprisingly measured. He is in favor of some protectionism to defend French (and European) workers.

Macron’s proposals include a “buy European act” that would make it harder for non-EU companies to get public contracts in Europe. And when he visited German Chancellor Angela Merkel in May, Macron urged her to strengthen EU laws to stop “dumping,” wherein a non-EU company exports a product to Europe at prices lower than market value.

So, hmmm, help me think about this, my dear friends: who is the Democratic candidate from 2016 that supported both the Nordic social model and light protectionism? Was it Hillary Clinton?

Hillary Clinton: "We are not Denmark. I love Denmark, we are the United States of America." http://t.co/h9qJs2sHQ6 pic.twitter.com/dmhJbVsrxm
Ã¢ÂÂ NYT Politics (@nytpolitics) October 14, 2015

Ummm, no, it was not.

Emmanuel Macron supports a social welfare infrastructure that Hillary — and the “Very Serious Wonks” at the Center for American Progress — would never even begin to consider as acceptable for the United States.

Ok, but what about the labor law reforms? Don’t those make Macron a “centrist” closer to Hillary than Bernie?

Ummm, no. When people like Neera and Max praise Macron and ponder why he could be so successful, and try and attribute all of that success to personality and institutional tinkering rather than a bold vision for human welfare, they display great ignorance of the national context that elected Macron. (I do think a lot “Very Serious DC and NYC Wonks” are well-meaning people, but when they try to draw lessons from European politics for American politics, they often display a breathtakingly poor understanding of European political economy, and, in particular, the nuance required to understand the differences between Nordic and French labor and social policy.)

Unlike the United States, France’s problem isn’t a deficit of public goods — France has great universal health care, outstanding public transportation, excellent public schools for both the rich and poor, good (albeit imperfect) social housing — but it does suffer from wage stagnation and a labor market that can be tough for young people and non-French European migrants and entrepreneurs to enter. So, Macron’s plan to reform the French labor market is not draconian cruelty — “French GOP” — but an earnest attempt to provide decent and respectful work for more French and European citizens.

So, in short, if you look at Macron on a thoughtful and substantive level — with appropriate French and European context — you see that Macron is, without a doubt, much, much, much closer to Bernie Sanders in terms of policy preferences than he is to a Hillary Clinton or Cory Booker.

YouTube Video

It profoundly depresses me to say this, but when we talk about social and economic “centrists” in the U.S. context, we’re really talking about a very far-right approach to political economy and social policy in the rest of the rich world. (I suspect “progressives” like Neera would rather just ignore how cruel, extreme and severe the status quo of U.S. social and labor and policy is, because it does serve economic and political elites quite well, even if the bottom 80 percent of Americans suffer as a result.)

In a nutshell, if you’re a Democrat excited by the success of Macron in France, try to look at him on a deeper level than just “he’s energetic,” “young,” and “believes that climate change is real.” That’s all great, but substantively, if you really want to get on board the “Macron train (errr...TGV),” you must admit — unless you are choosing to be intellectually dishonest and ignore facts — that Macron and the En Marche movement, with its Nordic orientation, is dramatically closer to the Bernie Sanders/Keith Ellison wing of the Democratic Party than it is to the Hillary Clinton/Cory Booker wing.

No, LePen isn't going to win in France. Because France already has excellent public goods. A lesson!

james321

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Sunday March 05, 2017 · 3:20 PM PST

2017/03/05 · 15:20

France is already great (at least in terms of social welfare and cheese) -- and that's why LePen isn't going to win.

I’ve seen a lot of handwringing around France’s upcoming presidential election. Will LePen win and put a final nail in the coffin of the so-called “West”?

I doubt it.

Of course, the “centrist” pundits — people like Josh Barro and Matthew Yglesias — are confused why Emmanuel Macron — who is pledging to cut billions from government and weaken labor regulations — is doing so well in France, while Hillary failed to win over here. So, they invent silly ideas — cute!

Maybe some shadowy foreign actor who's in favor of global stability has been secretly undermining Macron's opponents. Sweden, or something.
Ã¢ÂÂ Josh Barro (@jbarro) March 4, 2017

The reason is pretty simple: unlike in the United States, a vaguely “neoliberal” center-left/centrist candidate can propose major reforms in France (and still win big, as polls suggest he will), because France already has a solid assortment of universal public goods for the public good. You know, stuff like strong workers’ rights, robust rent control in major cities, paid vacation, paid sick leave, maternity and paternity benefits, public child care, (almost) free-at-use universal health care, outstanding — and, by U.S. standards, incredibly cheap — public transit, and, well, you get the idea.

When you already have a country with these awesome public goods, voters won’t care if you tinker around the edges to put a little more “free market” into your political economy. Case in point, there’s very little room for a conman, right-wing demagogue to do as Trump did last year in Michigan and Ohio: hit the Democrats from the Left on health care, by promising lower deductibles and more affordable health care for more people.

Also, what Macron is to balance liberalization of France’s stiff labor market with more robust universal public goods: in other words, the introduction of Nordic-style flexicurity to France. Workers will have a bit less protection from being fired, but they’ll also have a lot more support if it does happen — retraining for a new opportunity, universal welfare programs to ensure they don’t lose their health care and home. It’s all pretty cool — take a look:

YouTube Video

Now, what did Hillary Clinton think would help her win here? Attacking real universal health care, despite the majority of Americans wishing to replace the Affordable Care Act with a single-payer, Medicare-for-all program.

YouTube Video

I’m sorry, I’m sorry for dredging up this video again. I’m sure it won’t win me too many fans here. But I don’t care about popularity, I care about the Democrats — and progressives — winning elections. (I was attacked for a diary I wrote in July that argued Hillary needed to focus on progressive policy — free college, public option, etc. — instead of Trump’s crude language, but I still left the diary up, and defended its thesis, because I wanted Hillary to win.)

And for Democrats to win elections again, they must commit to building universal public goods for the public good. Without universal welfare programs, the working class will always be truly fucked by globalization in the “Uber Economy.”

So the Macron phenomenon offers a couple of lessons for Democrats and American politics more generally:

1.) Our politics are going to be incredibly vulnerable to right-wing demagogues, as long as we fail to ensure a basic level of universal security — health care, housing, cash benefits — for all citizens.

2.) If Democrats want to have a prayer of winning, they need to stand up and demand universal public goods for the public good at the same time as they pursue their neoliberal vision for the labor market.

Macron is winning in France, despite the stresses of globalization, migration, and terrorism, because the country already has such robust public goods and social welfare programs, that a bit of tinkering with them to drive economic growth and employment won’t be a catastrophe for the most vulnerable, or the middle class.

Macron is not winning, because he’s using the “Clinton playbook” and Canadian or Swedish intelligence is stepping in to help him win the election: LOL. He is winning because France already has great public goods, so he has some “space” to argue for adjusting them, and because, well, unlike so many Democrats in the United States, he truly understands that are universal welfare programs are not socialist extremism or optional, but truly necessary to build a stable, sustainable and economically prosperous society.

Democratic Party politicians need to stop calling America the "greatest nation on Earth"

james321

Community (This content is not subject to review by Daily Kos staff prior to publication.)

Sunday February 19, 2017 · 4:18 PM PST

2017/02/19 · 16:18

We have a pretty capitol building, but many nations on this planet have pretty capitol buildings.

This diary starts with the United States Tennis Association. Yes, you read that right. A few weeks ago, they accidentally played Germany’s Nazi-era anthem before a U.S.-Germany match and, as you might expect, the German players were horrified.

The German team member Andrea Petkovic was disturbed by Saturday’s performance, saying on the German federation’s website: “It was the worst experience that has ever happened to me – horrifying and shocking.”

She added, according to Bild: “This is the year 2017 – that something like this happens in America, it can’t happen. It’s embarrassing and speaks of ignorance.”

Why so much horror over a song? Well, the first verse of Germany’s anthem in its original form is the following:

A male soloist at the match on the Hawaiian island of Maui sang the verse beginning with the lines “Deutschland, Deutschland uber alles, uber alles in der Welt”, which translates as “Germany, Germany, above all, above all in the world”.

After two horrible World Wars, Germans are understandably no longer comfortable with labeling their country the “greatest country in the world.” And, really, no other Western highly-developed liberal country calls itself the “greatest country in the world” or the “greatest country on Earth” or believes that God blesses their country before all other countries. (I know, I know — but if there’s only one God and she or he or it is being asked to bless America, it logically follows that God is blessing the United States before other countries, as has been pointed out in film.) Could you ever imagine the president of the European Commission declaring, “God Bless the European Union”?

This is because nationalism — like many other -isms, including racism and sexism and fascism — is a really bad thing. It leads to bloodshed, xenophobia, wars, chaos.

And, well, sorry to break it everyone, calling your country “the greatest nation on Earth” — even in the “uniquely American” way that many folks here might argue Democrats do it — is about as nationalistic as you can get.

So why do U.S. politicians — even members of the so-called “center-left” Democratic Party, which would reject nationalism in any other liberal Western country -- say this very thing about our country’s place in the world? Why do they unapologetically and without irony declare that we live the “greatest country on Earth”?

Hillary Clinton does it:

Ã¢ÂÂI donÃ¢ÂÂt understand people who trash talk about AmericaÃ¢ÂÂ¦who act as if we are not yet the greatest country that has ever been created.Ã¢ÂÂ
Ã¢ÂÂ Hillary Clinton (@HillaryClinton) July 25, 2016

Michelle Obama does it:

FLOTUS: "Don't let anybody ever tell you this country isn't great...this right now is the greatest country on Earth" https://t.co/oRf6y6bhmm
Ã¢ÂÂ ABC News (@ABC) July 26, 2016

And, of course, Barack Obama said the same thing many times.

And, I get it — Democrats think it’s a political liability not to engage with the concept of “American exceptionalism” and publicly declare our nation to be better than every other nation on the planet, despite, of course, many statistics suggesting otherwise.

The problem is that this nationalistic rhetoric is not uttered in isolation — it’s articulated by public figures representing every single person in this nation. And nationalism — as the formerly war-hungry countries of the European Union that have rejected it can tell you — is a really dangerous thing. This is why the German tennis players got so pissed when their anthem was screwed up at the match.

Whether we want to admit it or not, progressives using this extreme nationalistic language — “greatest country on Earth” — do create openings for extremists, people like Donald J. Trump and Steve Bannon, to push things even further.

What we’re witnessing now — the horrific Trump regime with its “America First” policy — is an avowedly nationalist government, unlike any the U.S. has ever seen before.

And Democrats are right to attack an “America First” policy platform as morally and practically abhorrent. I join them in doing so.

Having said that, Democrats who attack “America First” also need to reflect upon their own rhetoric in the past — “America is the greatest country on Earth” is no different than saying “America First” — and, now that extreme nationalism has occupied the White House, reflect on if their own usage of this nationalistic rhetoric is helpful or hurtful when it comes to healing our broken politics and broken nation.

There are many “great” countries on this “great” planet that we share — the United States of America is just one of many. I know Democrats understand this point, but they need to make sure their public rhetoric reflects this understanding moving forward. It’s pretty simple.

Study finds U.S. teens increasingly turning to sex work in order to combat going hungry

james321

Community (This content is not subject to review by Daily Kos staff prior to publication.)

Monday September 12, 2016 · 6:51 PM PDT

2016/09/12 · 18:51

Sex work is one way to earn enough market income to be able to afford food in the United States of America.

Teenagers in the United States are increasingly turning to sex work in order to be able to acquire enough food to eat, according to a new study from Washington D.C.’s Urban Institute, the Guardian reported today. (Yes, this is true.)

Teenagers in America are resorting to sex work because they cannot afford food, according to a study that suggests widespread hunger in the world’s wealthiest country.

Focus groups in all 10 communities analysed by the Urban Institute, a Washington-based thinktank, described girls “selling their body” or “sex for money” as a strategy to make ends meet. Boys desperate for food were said to go to extremes such as shoplifting and selling drugs.

Welcome to the United States, 2016.

According to the author’s lead report, food insecurity is getting worse in the United States, despite the “economic recovery.”

“Even for me, who has been paying attention to this and has heard women tell their stories for a long time, the extent to which we were hearing about food being related to this vulnerability was new and shocking to me, and the level of desperation that it implies was really shocking to me. It’s a situation I think is just getting worse over time.”

The reason for this is pretty simple: teenagers are living in homes lacking adequate income to buy food. Poverty, of course, despite attempts by many scholars to argue otherwise, is ultimately about not having enough money.

Study authors believe that 1990s welfare reform policy — supported by the GOP Congress and President Bill Clinton — may be partly responsible for this appalling state of affairs, in addition to anti-poor U.S. social policy and slow wage growth for workers.

The findings raise questions over the legacy of Bill Clinton’s landmark welfare-reform legislation 20 years ago as well as the spending priorities of Congress and the impact of slow wage growth. Evidence of teenage girls turning to “transactional dating” with older men is likely to cause particular alarm.

Again, let me be clear. Children — and, yes, teenagers are children — are quite literally selling their bodies for food in the United States of America. in 2016.

Many prefer to rationalise what they are doing as dating of sorts. A boy in rural North Carolina said: “When you’re selling your body, it’s more in disguise. Like if I had sex with you, you have to buy me dinner tonight … that’s how girls deal with the struggle … That’s better than taking money because if they take money, they will be labeled a prostitute.”

Many children are even quitting school, as a result of the poverty in their homes.

In seven of the 10 communities, teenagers told stories of girls exchanging sexual favours with strangers or stripping for money in abandoned houses, at flea markets and on the street. A girl in San Diego, California, said: “Someone I knew dropped out of high school to make money for the family. She felt the need to step up. She started selling herself.”

Another girl in Chicago told researchers of an 11-year-old girl who dropped out of sixth grade to work in the sex trade, while boys in Los Angeles described how middle school girls put up flyers in public places to advertise their services.

In the communities with the highest poverty rates, both girls and boys steal food and other basics from local stores for themselves or their families. A male teenager in Chicago said: “I ain’t talking about robbing nobody. I’m just talking like going there and get what you need, just hurry up and walk out, which I do … They didn’t even know. If you need to do that, that’s what you got to do, that’s what you got to do.”

Of course, engaging in sex work and theft to acquire food — illegal acts — leads to kids facing the prison-industrial complex, because unlike in Italy, stealing food to meet basic nutritional needs is a crime in the United States.

Shameful.

Sorry, Hillary and Michelle, America still sucks for a lot of people.

james321

Community (This content is not subject to review by Daily Kos staff prior to publication.)

Thursday July 28, 2016 · 7:25 AM PDT

2016/07/28 · 07:25

For many United States citizens, the so-called "American dream" has always felt something like a cruel joke.

Because I’m not a big fan of racist reality television stars leading a country of 320 million (mostly) decent people, this tweet from Hillary made me cringe:

Ã¢ÂÂI donÃ¢ÂÂt understand people who trash talk about AmericaÃ¢ÂÂ¦who act as if we are not yet the greatest country that has ever been created.Ã¢ÂÂ
Ã¢ÂÂ Hillary Clinton (@HillaryClinton) July 25, 2016

So, too, did these words from Michelle:

FLOTUS: "Don't let anybody ever tell you this country isn't great...this right now is the greatest country on Earth" https://t.co/oRf6y6bhmm
Ã¢ÂÂ ABC News (@ABC) July 26, 2016

Now, I’m not saying that the United States isn’t a pretty great place. Billions and billions of people on this planet would probably give their left and right arms to be a citizen of our nation. That said, when millions and millions of Americans are suffering — from lack of health care, from student debt, from gun violence, from police brutality — it’s incredibly problematic for the people charged with solving big problems — politicians, our leaders — to declare we’re already living in the “greatest country on Earth” or the “greatest country that has ever been created.”

Whether from a Democrat, a Republican or an Independent, American exceptionalism is deeply, deeply problematic — dare, I say, illiberal, insofar as it stigmatizes the most vocal critics of the nation state.

But, you argue, “Isn’t this something that all American politicians have to say?”

Well, I guess, in the past. But, as so many others have said, this year is different.

Why has Donald gotten so much support? Why has Bernie gotten so much support? Neither of them have said “the United States is — at this moment in time — the greatest nation on Earth.” Instead, they’ve both given our great nation quite a few rhetorical spankings — whether it’s Donald bemoaning our slow trains and crumbling roads or Bernie lamenting that we are the only “major country on Earth that doesn’t guarantee health care as a right.”

And, despite attempts by Very Serious Journalists to argue to the contrary, many, many Americans agree that we have a lot of problems — and believe our past leaders have failed to solve them.

I’m not going to exhaust you with evidence that, well, the United States is far, far, far from the “greatest country on Earth,” but I will ask you to consider the following.

Are we the “greatest” at taking care of our kids?

No, we’re not.

The United States has the largest economy in the world, but its children aren't reaping the benefits, according to a new report.

On Friday, the non-profit Save The Children released its annual "Child Prosperity Index" report, which evaluates 19 developed nations on a number of criteria to determine whether they are good environments for raising children. Despite being the wealthiest country, the United States ranked ninth, trailing behind Germany, Canada, and Italy, among others.

Are we the “greatest” at providing health care in an efficient and effective way?

No, we’re not.

Though the system fosters excellence and innovation in places, the messy combination of underinsurance and overinsurance has left the US with the highest healthcare costs in the developed world and some of the worst overall health outcomes.

Are we the “greatest” at providing basic physical security in our towns and cities?

No, we’re not.

Americans are 10 times more likely to be killed by guns than people in other developed countries, a new study finds.

Compared to 22 other high-income nations, the United States' gun-related murder rate is 25 times higher. And, even though the United States' suicide rate is similar to other countries, the nation's gun-related suicide rate is eight times higher than other high-income countries, researchers said.

Look, I’m not going to beat you over the head with any more of these links: you know — compared to Europe, Canada, Australia and high-income Asia — that we, relatively speaking, struggle to provide the vast majority of our citizens with excellent public goods.

Nevertheless, still, compared to many, many other countries, the United States does pretty well. We’re still a beacon of hope for millions around the world, as evidenced by the demand for green cards, even from people in super-awesome countries like Australia.

And, so, it’s fine to say “we’re a really great country.”

But I want to ask: is it really “great politics” to respond to the critical tone of Donald and Bernie with a vapid “America Is Already Great” argument?

In my humble opinion, it’s not.

So, if Hillary is going to win, and I hope she does, she’s going to need to — and her surrogates, too — acknowledge that a lot of people in the United States aren’t doing so great right now. Victims of police brutality? Those continuing to struggle with massive health care expenses? The underemployed? OK? Get my point?

This is not the election for Democrats to respond to Republicans with “rah, rah, USA! USA!”

This is the election for Democrats to respond to Republicans — Trump, included — with attractive public policy proposals capable of, when implemented, making concrete improvements to the lives of regular people, many of which are struggling right now in the so-called “greatest country on Earth.”

james321

Community (This content is not subject to review by Daily Kos staff prior to publication.)

Thursday July 14, 2016 · 7:02 AM PDT

2016/07/14 · 07:02

640px-Donald_Trump_Laconia_Rally__Laconia__NH_4_by_Michael_Vadon_July_16_2015_08.jpg — Please, Hillary, don't make this election about Donald J. Trump.

(I wish I didn’t need to qualify my diary, but as a former Bernie partisan in this community, and based on the first comments I’m seeing below, I suppose it’s necessary. No, this diary is not “Bernie daydreaming disguised as concern-trolling.” Yes, I would prefer Hillary as POTUS to Trump. Yes, I have very real concerns about Hillary focusing too much on Trump being a jerk, and not enough on the impressive (popular) public policy ideas she has announced.)

Hillary Clinton is tied with Donald J. Trump, so on this day when a buffoon has become foreign secretary of the United Kingdom of Great Britain and Northern Ireland, let’s remember that anything is possible come November.

And, yes, that means Trump taking the White House.

I find it troublesome, then, to see Very Serious Wonks praising Hillary for this new television advertisement.

YouTube Video

There are a few things wrong with this advertisement.

First, Trump is a dangerous attention-seeking individual. And the first rule when dealing with attention-seeking individuals — think of the class clown in elementary school — is to ignore the antics of the attention-seeking individual. In this advertisement, Hillary plays “Trump’s greatest hits,” which, for better or worse, some Americans find appealing as “real talk,” while others find them offensive, but funny. And, of course, humor can be disarming.

Second, this is a crappy advertisement that makes the election about Donald J. Trump — and not about Hillary’s “progressive who likes to get things done” vision for the future.

Thanks to some nudging from one Bernie Sanders, Hillary has recently announced a lot of really, really popular ideas: like support for a public option and ending college tuition for all but the wealthiest Americans.

Americans — a massive number of independents — flocked to Bernie Sanders, because he was crystal clear about what politics should be about: making good public policy happen. The public craves good policy in a country where the trains don’t run on time, bridges are collapsing, health care is an expensive bureaucratic nightmare, and earning a bachelor’s degree is more expensive than buying an Italian sports car.

Hillary will not win if she makes this campaign about Trump being an asshole. She will win if she makes this campaign about celebrating good public policy for the public good.

I beg of you, Team Hillary, please change course...before it’s too late.

Baton Rouge Police: Property Rights Are Only For White People (Videos)

james321

Community (This content is not subject to review by Daily Kos staff prior to publication.)

Monday July 11, 2016 · 3:04 AM PDT

2016/07/11 · 03:04

No, we're not here to protect your rights.

Property rights are fundamental to the “American Dream” — indeed, the “right to pursue happiness” actually refers to one’s right to own property. (Of course, originally, that also meant the right for white people to own black human beings as property.) That said, in 2016, property rights are supposedly a universal right in America — for black, white, brown, purple, and green people.

In Baton Rouge last night, however, the police — tasked with protecting and defending the constitutional rights of American citizens — were taking a decidedly un-American approach to their work.

Check out this series of videos, the last of which is the flabbergasted homeowner whose rights were violated:

this is currently going on in baton rouge, this is terrifying. #BatonRouge #BlackLivesMatter #AltonSterling pic.twitter.com/sYvrQzSteW
Ã¢ÂÂ greg (@n9viv) July 11, 2016

Only afterwards I realized that I filmed how police threw young woman out of her own home in #BatonRouge today. pic.twitter.com/rAJf0pOt5N
Ã¢ÂÂ Tuomas RimpilÃÂ¤inen (@TRimpilainen) July 11, 2016

A tank, really? Have these police learned nothing from Ferguson? And, now, the homeowner:

Baton Rouge home owner "very upset" after police storm her yard arresting protesters who had permission to be there pic.twitter.com/gwE8aRGKfL
Ã¢ÂÂ David Begnaud (@DavidBegnaud) July 11, 2016

“And I said, this is my property, please do not do that — I live here.”

…

“And they just looked at me and ignored the things that I was saying.”

This woman had her constitutional rights violated — her “right to pursue happiness” in her own home was violated by out-of-control police officers, who appeared as if they were conducting urban warfare in Fallujah, Iraq.

And, let’s be clear, the homeowner was committing no crimes.

Can you imagine this kind of police response to an out-of-control pool party in a wealthy white suburb — with underage drinking, weed smoking and coke snorting, and prodigious noise violations? Nope!

I want to be crystal clear: American police officers are absolutely out-of-control.

Even when hundreds — thousands? — of people were engaging in violent behavior in Marseille, France following a football game, the French police showed more restraint than American police — in Ferguson, Baton Rouge, and New York City — show when confronted by a peaceful protest, where the only “crime” committed is blocking traffic for a few hours.

I truly believe, having traveled all over the world, including in a number of post-conflict countries, that American police are some of the world’s least restrained.

And, in communities like Baton Rouge with a history of social exclusion, racism, segregation and slavery, I suspect the police response is pathological: racist officers triggered to commit acts of violence against black people refusing to “know their place.”

Ironically, though, it’s American police officers that must “know their place.” Until the Justice Department starts dropping the hammer on local police departments, we’ll continue to see the basic constitutional rights of minority citizens violated, and we’ll continue to see execution-style deaths of black men and women, boys and girls.

The job of a police officer is to protect the constitutional rights of citizens — life, free speech, property. The job of a police officer is not to demand obedience. I truly believe many, many American officers fail to understand this crucial distinction.

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