Friday, July 14, 2023
Hospice care privatization, Ukraine's NATO aspirations, climate funding, actors on strike, pigeon history, and more!
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STORIES THAT SHOULD BE BIGGER
PRIVATIZATION IS MAKING HOSPICE CARE WORSE
Half of all Americans die in hospice care, which focuses on providing a high quality of life for people with less than six months to live. For-profit providers now make up 70 percent of hospices, up from just 30 percent at the turn of the century. Meanwhile, the number of hospice care companies owned by private equity firms—which buy companies with the goal of cutting costs and selling them for a profit—quadrupled between 2011 and 2019. As hospice care turns into primarily a profit-seeking venture, patient care has suffered. According to Katrina vanden Heuvel in The Nation:
For-profit hospices deliver “substantially worse care experiences” than not-for-profit hospices, one study found. This is unsurprising, given the cost-cutting strategies at play: less staff is hired, often at lower skill levels; visits from nurses, social workers, and therapists are less frequent; fewer community benefits are provided; and medical treatment is outsourced to hospitals and emergency rooms at significantly higher rates—all at the expense of dying patients and their grieving families.
For-profit hospice care gets billions of dollars every year in federal funding from Medicare, but according to an expose by ProPublica, “oversight is scarce.” Ava Kofman writes:
“Regulations require surveyors to inspect hospice operations once every three years, even though complaints about quality of care are widespread. A government review of inspection reports from 2012 to 2016 found that the majority of all hospices had serious deficiencies, such as failures to train staff, manage pain and treat bedsores. Still, regulators rarely punish bad actors. Between 2014 and 2017, according to the Government Accountability Office, only 19 of the more than 4,000 U.S. hospices were cut off from Medicare funding.”
AS THE GLOBE BURNS, REPUBLICANS TRY TO HALT CLIMATE FUNDING
Ted Cruz (a senator awash in donations from the fossil fuel industry) is leading an effort by Republicans to cut climate-change mitigation measures out of the 2024 budget. They are also inserting amendments into spending bills that block funding for electric cars, batteries, and charging stations. They also block money for the Green Climate Fund which helps developing countries meet the goals of the Paris Climate Accord. Cruz’s memo attacking these measures calls them attempts to “micromanage the global temperature…[by] anti-fossil fuel environmentalists.”
Given that more than 112 million Americans currently face heat warnings, the world recently reached its highest temperatures in recorded history, and extreme heat and cold kill more than 5 million people each year worldwide, it seems as if the global temperature could use quite a lot of “micromanaging.” Just to remind you what the situation is already like, and what is going to be faced by even more people around the world soon, here’s a New York Times report on the current situation in Phoenix:
In triple-digit heat, monkey bars singe children’s hands, water bottles warp and seatbelts feel like hot irons. Devoted runners strap on headlamps to go jogging at 4 a.m., when it is still only 90 degrees, come home drenched in sweat and promptly roll down the sun shutters. Neighborhoods feel like ghost towns at midday, with rumbling rooftop air-conditioners offering the only sign of life.
Given this growing peril, it’s disturbing to see that there are still those (like Robert F. Kennedy Jr.) firmly convinced that The Free Market will get us out of this. Alas, no great Invisible Hand is coming to save us—as even the Financial Times points out, capitalism just can’t deliver the energy transition fast enough. Instead, we need the visible hand of climate activists worldwide to push reluctant governments into action. See, for example, the UK Green New Deal activists who recently disrupted a speech by Labour Party Leader Keir Starmer, who has reportedly said “I hate tree-huggers” and is trying to back down on the party’s climate commitments. As we have written in Current Affairs, politicians who refuse to treat this emergency as an emergency are the enemies of humanity. They should not be given peace. Their speeches should be disrupted. Their offices should be picketed. The future of the world, and the lives of millions upon millions of people, depend on what we do now. Do not succumb to climate despair. Take action!
THE BIG STORY
HOLLYWOOD ACTORS JOIN WRITERS IN STRIKING.
The Screen Actors Guild, which represents American film and TV actors announced that they will strike after weeks of failed talks with studios. Film and TV writers have been on strike since May, hoping to receive residuals for streaming (which is how the majority of TV viewing happens these days)and to obtain a guarantee that they will not be replaced with artificial intelligence. According to Fran Drescher, the SAG president (and star of the classic 90s sitcom The Nanny), “The companies have refused to meaningfully engage on some topics and on others completely stonewalled us…They plead poverty… when they’re giving hundreds of millions of dollars to their CEOs...Shame on them. They stand on the wrong side of history.” (Want to learn more about how to support striking writers? Check out this page from the WGA.)
UKRAINE WANTS NATO MEMBERSHIP ASAP
NATO’s member nations gathered this week in Lithuania to discuss when and if Ukraine, which is currently besieged by a nightmarish Russian invasion, will be allowed to join the military alliance. Western leaders, including President Joe Biden, made emphatic, if vague, proclamations about Ukraine’s future in the organization: “Ukraine’s future is in NATO,” he and other NATO members declared on Wednesday, while also promising to “provide security to Ukraine for its needs and against any aggression that may occur.” This “security,” we have learned recently, goes as far as providing the nation with dangerous and illegal cluster munitions. Biden has also activated 3,000 more reservists to be deployed to Europe to join the 80,000 U.S. troops already there.
Critically Biden and other members clarified that Ukraine’s membership would have to wait until the end of the war, which left Ukrainian President Volodymyr Zelensky nonplussed. He tweeted about the demands of world leaders that “conditions”—such as democratic and military reforms—need to be met before Ukraine could be allowed to join the alliance:
“It's unprecedented and absurd when a time frame is set neither for the invitation nor for Ukraine's membership…While at the same time, vague wording about ‘conditions’ is added even for inviting Ukraine. It seems there is no readiness to invite Ukraine to NATO or to make it a member of the Alliance.”
While it’s understandable that Zelensky wants as much help to repel the Russian invasion as possible, he has to understand the potentially catastrophic consequences of bringing Ukraine into NATO. Article 5 of the organization’s founding treaty states clearly that “an armed attack against one or more [members] in Europe or North America shall be considered an attack against them all.” This would mean that all of the alliance’s nuclear powers would formally be at war with Russia. As Justin Logan and Joshua Shifrinson argue in Foreign Affairs:
The stakes could not be higher. Membership in NATO encompasses a commitment by the allies to fight and die for one another. Partly for this very reason, its members worked throughout the post–Cold War era to avoid expanding the alliance to states that faced a near-term risk of being attacked. NATO leaders have also long understood that admitting Ukraine involves a very real possibility of war (including nuclear war) with Russia…Kyiv’s resistance to Russian aggression has been heroic, but…the security benefits to the United States of Ukrainian accession pale in comparison with the risks of bringing it into the alliance.
CROOKS vs. SICKOS (or, “What’s going on with electoral politics?”)
Joe Biden is not terribly “folksy” in private. According to Axios, the president, who often appears mellowed out (or just straight-up confused) in public, actually has a red-hot temper and a sailor’s vocabulary:
“Behind closed doors, Biden has such a quick-trigger temper that some aides try to avoid meeting alone with him. Some take a colleague, almost as a shield against a solo blast. The president's admonitions include: ‘God dammit, how the f**k don't you know this?!,’ ‘Don't f**king bullsh*t me!’ and ‘Get the f**k out of here!’ — according to current and former Biden aides who have witnessed and been on the receiving end of such outbursts.”
Doug Burgum is paying voters to donate to him. In exchange for $1 donations, the North Dakota governor is giving away $20 gift cards. This may sound wildly counterintuitive (and a bit like a phone scam your grandmother might fall for), but Burgum is actually exploiting a rule in the GOP primary allowing candidates onto the debate stage if they receive a minimum number of individual donors…and it might actually be legal! We've previously scoffed at FiveThirtyEight’s suggestion that a nobody like Burgum “could surprise” in 2024. But if he keeps showing this kind of ingenuity, the nation could soon find itself trembling before an unstoppable Burgum juggernaut.
LONG READ: By now, you’ve probably heard about this freakish ad put out by the Ron DeSantis campaign on Twitter. In case you haven’t, here it is:
[CONTENT WARNING: Homophobia, transphobia, and terrible memes]
The since-deleted ad is one of the weirdest pieces of political communication we’ve ever seen—so intent on demonstrating DeSantis’ outright sadism towards the LGBTQ community that it compares him to fictional serial killer Patrick Bateman!
How did we get here? What kind of terminally online weirdo was meant to find this appealing? And what’s up with all those shots of oiled bodybuilders? Ian Ward of Politico investigated “the deepest darkest corners of the internet” to find out:
“To the average voter, this rapid-fire mishmash of images might seem like a political fever dream. But the video fits squarely within an emergent strain of an online conservative subset that focuses on LGBTQ issues and masculinity. This discourse, which emerged from an obscure corner of the internet sometimes called the “manosphere,” relies on a heavily self-referential set of memes to convey its message, a message that is almost always drenched in irony…Yet beneath the irony lies a coherent — if deeply intolerant — argument: The embrace of LGBTQ people is part of a broader plot in society to destroy traditional masculinity.”
AROUND THE STATES
Multiple state laws banning drag performance and gender-affirming healthcare have been struck down on free speech and equal protection grounds over the last month:
Tennessee: A law outlawing “adult entertainment” featuring “male and female impersonators” was halted, with the judge saying it “reeks with constitutional maladies of vagueness and overbreadth fatal to statutes that regulate First Amendment rights.”
Utah: A judge ordered that the city of St. George acted in a discriminatory manner when it refused to provide a legal permit to a family-friendly drag show.
Arkansas: The state’s law banning gender-affirming care for minors, including hormones and puberty blockers, was ruled to violate the Equal Protection Clause of the Fourteenth Amendment by discriminating based on sex. It also violated the First Amendment rights of doctors to issue referrals for such treatments.
Florida and Indiana: Judges have granted temporary injunctions on similar laws restricting trans rights—they cannot be enforced until a judge determines that they are constitutional.
It remains to be seen if these rulings could be reversed by higher courts and whether some of the other nearly 500 anti-LGBTQ laws proposed in 2023 could fall under similar legal scrutiny.
Utah’s Supreme Court is considering whether to uphold a Congressional map drawn in 2021 to dilute the power of Democratic voters by splitting Salt Lake County into four districts. In 2018, Utah voters gave redistricting powers to an independent commission with the goal of avoiding such partisan gerrymanders. But the state’s Republican legislature has instead chosen to overrule the commission’s maps and pass their own. One of the questions before the court is whether the state legislature has the power to defy the will of a commission people voted for.
Utah’s congressional map splits the blue-leaning Salt Lake County into four Congressional districts A Nebraska mother, Jessica Burgess, will spend two years in prison after pleading guilty to ordering abortion pills for her 17-year-old daughter (who was 24 weeks pregnant). The daughter will also spend two years in prison after being tried as an adult and pleading guilty in May. This has happened before: Another mother was tried back in 2012 for giving her sixteen-year-old abortion pills that could not be accessed in her home state of Pennsylvania. While more women are facing legal threats since the overturn of Roe v. Wade (including for miscarriages), nationwide, there were 1,331 arrests or detentions of women for crimes related to their pregnancy from 2006 to 2020, according to the group National Advocates for Pregnant Women. (You can donate to the Repro Defense Fund which provides bail and legal help to those criminalized for something that happens during a pregnancy.)
If you live in Vermont, Delaware, Connecticut, Hawaii, or Rhode Island, your driver’s license might now be invalid in Florida. A new law signed by Governor Ron DeSantis now requires police to write a ticket for anyone who shows a license from one of these states without an alternate form of identification, because they can be issued without proof of legal residence. The law cracks down on undocumented immigrants in other ways too: it’s now a felony to apply for them to apply for jobs and employers who hire them can be fined or have licenses revoked. Unsurprisingly, thousands of migrant workers left the state when the law was announced, leaving many businesses in shambles.
At the same time, Florida is fining voter registration groups using its new office of election crimes and security, The Guardian reports. Twenty-six groups have cumulatively been fined more than $100,000 since last September. Many of the fines have been for very minor mistakes that the organizations have little control over. For example, one group was fined $7,500 because 15 out of more than 16,500 registration forms were submitted to the wrong county’s office (in many of these cases, the voters themselves incorrectly listed their county). More than 63,000 people registered to vote through third-party registration organizations in 2019. That number has plummeted to just over 2,400 so far this year. Voters of color are five times more likely to use these organizations.
(From Issue 41 of Current Affairs magazine, March/April 2023) LONG READ: Matthew Cunningham-Cook of The Lever explains how Medicare Advantage—a for-profit alternative to the government-funded program—is increasingly leading patients to be denied critical care:
“As total Medicare Advantage enrollment increased from 22 million to 27 million, such denials have reportedly skyrocketed. A February report from the Kaiser Family Foundation found that two million prior authorization requests had been denied by Medicare Advantage in 2021, more than triple the 640,000 prior authorization requests these plans denied in 2019, according to an estimate in the Inspector General’s report…These care denials are helping to drive record insurer profits — Coffey’s insurer, UnitedHealth Group, made more than $14 billion in profits in 2022, and the other three largest for-profit Medicare Advantage insurers pulled in an additional $10 billion. But these denials have disastrous impacts for ordinary people’s lives, as detailed in numerous patient stories shared with The Lever. And the total instances of denied care are likely vastly understated.”
AROUND THE WORLD
U.N. Secretary-General Antonio Guterres warns that Sudan could be on the brink of a “full-scale civil war,” between rival generals. Nearly 3 million people have already fled their homes to avoid the conflict, which has killed more than 3,000 people. The country’s warring military leaders have received little pushback from Western governments, which attempted to broker peace by backing a fragile power-sharing agreement that broke down earlier this year. This was despite widespread protests from the people of Sudan, which led to violent crackdowns on pro-democracy dissent.
Hundreds of Amazon workers went on strike in Germany and the U.K. during the company’s “Prime Day” sales event earlier this week. The German union Verdi called on workers at nine distribution centers to walk off the job. Meanwhile, 900 workers at the U.K.’s Coventry site did the same. Their complaints surround the company’s meager pay increases (effectively pay cuts when compared with national inflation rates), its high-pressure work environment, and extreme surveillance. U.K. workers, meanwhile, have not had their union efforts recognized by Amazon at all.
A realistic portrait of Jeff Bezos by C.M. Duffy, from Issue 23 of Current Affairs magazine Jan/Feb 2020 Canada is expanding its Medical Assistance in Death Program to allow people with mental illnesses to voluntarily end their own lives if their conditions are deemed “grievous and irredeemable.” Parliament is also considering opening up the program for minors. Though the program began to allow people facing imminent death to depart with dignity, it is increasingly being used by Canadians with disabilities who cannot obtain state funding for the care that would allow them to have a decent standard of living—many of whom are stuck on waitlists. According to The Nation, less than 7 percent of Canada’s healthcare funding goes towards mental health resources, while a recent funding package did very little to expand care for the disabled.
Robots are speaking at the U.N. One of its tech agencies held a rather unnerving news conference in Geneva, Switzerland, where multiple humanoid androids took questions from reporters about the ability of A.I. to contribute to global sustainability goals. We also got a definitive answer to the question of whether the robots plan to take our jobs or rise up in rebellion against humanity. We can rest easy knowing that they do not:
LONG READ: With support from the U.S. and its Gulf allies, Israel is selling drones to Morocco to help them wage colonial war in Western Sahara. According to Pesha Magid & Andrea Prada Bianchi in The Intercept:
“In December 2020, a month after the end of the ceasefire between Morocco and the Polisario, then-President Donald Trump declared U.S. support for Morocco’s sovereignty over Western Sahara. The recognition contravened the United Nations’ position, which considers Western Sahara a “non-self governing territory,” a euphemism for a colony. In return for U.S. support on Western Sahara, Morocco joined the Abraham Accords, a series of diplomatic deals brokered by Trump and his son-in-law, Jared Kushner, that resulted in the United Arab Emirates, Sudan, Bahrain, and Morocco normalizing relations with Israel. Since then, Rabat has gone from having covert ties with Tel Aviv to becoming its open ally, and Israel has sold at least 150 drones to Morocco.”
PIGEON FACT OF THE WEEK (NEW ORLEANS EDITION!)
New Orleans newspapers once used carrier pigeons to deliver the day’s photos up to the newsroom.
Here is a photo of photographer Edward Agnelly from The Times-Picayune sending a pigeon off with photos he took of a Tulane University football game. According to NOLA.com, the newspaper’s plant machinist was a pigeon fanatic who cared for a group of nearly 60 from atop the Times-Picayune building. He named them after characters in the newspaper’s comic section—including “Joe Palooka,” “Tarzan,” and “Alley Oop.” Pigeons were first employed by newspapers in New York as far back as the 19th century. They were also used extensively during the First World War to carry messages. Two “Pigeon Corps” were established by the Entente Powers on the Western Front. According to The Kashmir Observer: “Messages would be put into a small canister and then attached to the pigeon’s leg. The bird would be released and would return to its loft behind allied lines, sounding a bell to confirm that it had landed…Bomber crews usually carried a pair of pigeons so that in the event that the plane was shot down, the birds could be released with details of the crash site.” By the war’s end, more than 22,000 pigeons served in the corps. We are, of course, now deliberating on ways to incorporate pigeons into this magazine’s own workflow.
Writing and research by Stephen Prager. Editing and additional material by Nathan J. Robinson and Lily Sánchez. Fact-checking by Justin Ward. This news briefing is a product of Current Affairs Magazine. Subscribe to our gorgeous and informative print edition here, and our delightful podcast here. Current Affairs is 100% reader supported and depends on your subscriptions and donations.