An End to Human Trafficking

— by Hillary Rodham Clinton, Democratic Party Nominee for U.S. President

human-traffickingElementary students across America are taught that slavery ended in the 19th Century. But, sadly, nearly 150 years later, the fight to end this global scourge is far from over. Today it takes a different form and we call it by a different name — “human trafficking” — but it is still an affront to basic human dignity in the United States and around the world.

The estimates vary widely, but it is likely that somewhere between 12 million and 27 million human beings are suffering in bondage around the world. Men, women and children are trapped in prostitution or labor in fields and factories under brutal bosses who threaten them with violence or jail if they try to escape. Earlier this year, six ”recruiters” were indicted in Hawaii in the largest human trafficking case ever charged in U.S. history. They coerced 400 Thai workers into farm labor by confiscating their passports and threatening to have them deported.

I have seen firsthand the suffering that human trafficking causes. Not only does it result in injury and abuse—it also takes away its victims’ power to control their own destinies. In Thailand I have met teenage girls who had been prostituted as young children and were dying of AIDS. In Eastern Europe I have met mothers who lost sons and daughters to trafficking and had nowhere to turn for help. This is a violation of our fundamental belief that all people everywhere deserve to live free, work with dignity, and pursue their dreams.

For decades, the problem went largely unnoticed. But 10 years ago this week, President Clinton signed the Trafficking Victims’ Protection Act, which gave us more tools to bring traffickers to justice and to provide victims with legal services and other support. Today, police officers, activists, and governments are coordinating their efforts more effectively. Thousands of victims have been liberated around the world and many remain in America with legal status and work permits. Some have even become U.S. citizens and taken up the cause of preventing traffickers from destroying more lives.This modern anti-trafficking movement is not limited to the United States. Almost 150 countries have joined the United Nations’ Trafficking Protocol to protect victims and promote cooperation among countries. More than 116 countries have outlawed human trafficking, and the number of victims identified and traffickers imprisoned is increasing each year.

But we still have a long way to go. Every year, the State Department produces a report on human trafficking in 177 countries, now including our own. The most recent report found that 19 countries have curtailed their anti-trafficking efforts, and 13 countries fail to meet the minimum standards for eliminating trafficking and are not trying to improve.

It is especially important for governments to protect the most vulnerable – women and children – who are more likely to be victims of trafficking. They are not just the targets of sex traffickers, but also labor traffickers, and they make up a majority of those trapped in forced labor: picking cotton, mining rare earth minerals, dancing in nightclubs. The numbers may keep growing, as the global economic crisis has exposed even more women to unscrupulous recruiters.

We need to redouble our efforts to fight modern slavery. I hope that the countries that have not yet acceded to the U.N. Trafficking Protocol will do so. Many other countries can still do more to strengthen their anti-trafficking laws. And all governments can devote more resources to finding victims and punishing human traffickers.

Citizens can help too, by advocating for laws that ban all forms of exploitation and give victims the support they need to recover. They can also volunteer at a local shelter and encourage companies to root out forced labor throughout their supply chains by visiting www.chainstorereaction.com.

The problem of modern trafficking may be entrenched, but it is solvable. By using every tool at our disposal to put pressure on traffickers, we can set ourselves on a course to eradicate modern slavery.

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A Bishop In The Exam Room: When Faith Dictates Health Care Instead Of Science

A number of folks in Humboldt County have expressed complaints about our local hospital, but they should be thankful for the secular hospital we have available to serve our population. Given the merger-mania in corporate America, we could be facing, like so many other communities, a takeover of our hospital by Catholic Hospitals of America and the imposition of OBGYN-lite policies, restricting the availability of reproductive healthcare services to women throughout the hospital’s service area.

Here’s a post an article from ThinkProgress that will walk you through how religious institutions are imposing their religious beliefs on women through the limited care they’re willing to provide, essentially elevating their religious rights at the expense of any patient’s rights.


CREDIT: DYLAN PETROHILOS
CREDIT: DYLAN PETROHILOS

— by Erica Helerstein and Josh Israel

When Rita, a Michigan-based OB-GYN, learned that the hospital where she worked would be switching hands, she was dismayed.

The secular community hospital, Crittenton, had plans to join with Ascension Health, a prominent Catholic nonprofit hospital chain. Rita, who asked that her real name be withheld to protect her identity, knew the transition would profoundly impact her ability to do her job the way she saw fit. The OB-GYN specifically wanted to work at a place where she could practice the full scope of reproductive care, from preventing pregnancy to delivering babies. But now, with the hospital merger looming in the not-so-distant future, that possibility seemed increasingly unlikely.

Rita also understood the change in leadership meant that her patients’ medical options would be limited. That’s because Catholic hospitals follow a set of rules written by the U.S. Conference of Catholic Bishops, which often prohibit doctors from performing basic reproductive services — like contraception, sterilization, in vitro fertilization, abortion — and end-of-life care.

Although Rita knew certain services at the hospital would soon be banned, many of her patients had no idea. They also may not have known that mergers like Crittenton’s are becoming increasingly common.

As hospitals throughout the country struggle with financial woes, many have begun to merge with Catholic systems in order to stay in business. This means a growing number of patients are winding up in institutions guided by religious doctrine. Between 2001 and 2016, the number of hospitals affiliated with the Catholic Church increased by 22 percent. Today, one in six patients in the U.S. is cared for at a Catholic hospital — a troubling trend for health care providers like Rita, who worry that patients are increasingly being placed in centers that provide services based on faith rather than medical necessity.

“I do think as more places are being purchased by Catholic systems it’s going to become more of a problem,” she told ThinkProgress. “To take away the ability to provide services that people need or desire… I think it’s very upsetting both for an OB-GYN and also for a woman. Having those choices gives you the ability to participate in society.”

Rita found another job before the Catholic system moved in. Although she says her decision to leave Crittenton was based on other factors, she admits she probably would have sought employment elsewhere even if those reasons hadn’t come up. Before Rita departed from the hospital, though, she warned her patients about what was to come — and encouraged them to get their tubes tied before it was too late.

As Rita was advising her patients to move forward with their procedures, organizers with the American Civil Liberties Union of Michigan were trying to gin up support for a campaign opposing the Crittenton merger. In June, they arranged an event at a public library in a nearby town to talk about what the shift in leadership would mean for community members. But only six people showed up. “It was so hard for us to connect to anyone who cared,” said Merissa Kovach, a field organizer in charge of the campaign.

The struggle to engage people who could be directly impacted by Crittenton’s transition might not be entirely surprising given the demographic makeup of Rochester, which is predominantly white, conservative-leaning, and upper-middle class. But it suggests another problem that Kovach and others have been struggling to address: A widespread lack of awareness about a conflict that’s quietly brewing in the health care industry. It’s a trend that has managed to accelerate rapidly and yet evade public scrutiny. Because Catholic hospitals aren’t required to disclose their religious affiliation or talk about the limited medical services they may offer, many patients wind up in the dark — and don’t think about the hierarchies that govern their care until it’s too late.

In Rochester, for example, the two systems merged without much of a fuss. But just a few days after Ascension took over the hospital in October 2015, its official website changed ever so slightly. “Tubal ligations” were removed from the list of available services.

CatholicHospitalData-before-after6

The role of Catholics in health care is nothing new — indeed, throughout the Middle Ages, it was the Catholic Church that created hospitals and hospices for the old and ill in an attempt to follow Jesus’ teachings about healing the sick. Many of the earliest hospitals in America were set up by Ursuline sisters and other Catholic orders dedicated to serving the poor. About 75 Catholic hospitals had been established in the U.S. by 1875.

But there has been a particular boom in the number of Catholic hospitals since the beginning of the 21st century, according to a groundbreaking 2013 report on the growth of Catholic hospitals and health systems by MergerWatch, a patients’ rights organization that tracks hospital mergers, and the American Civil Liberties Union (ACLU). In 2001, about 8.2 percent of the nation’s acute care hospitals were Catholic nonprofits. By 2011, that number had jumped to 10.1 percent. This increase coincided with notable drops in the numbers of other nonprofit hospitals and public hospitals.

This trend is accelerating among all hospital chains, too, and not just nonprofits. A recently released 2016 update found that 14.5 percent of all acute care hospitals are now Catholic-owned or affiliated (up from 11.2 percent in 2001) and that four of the nation’s 10 largest hospital systems are Catholic-sponsored. Some of the growth is the result of new Catholic hospitals opening their doors — but many were the result of secular hospitals merging with Catholic systems, bringing them under the Catholic hospitals umbrella.

But while Lois Uttley, MergerWatch’s director, believes Catholic hospitals do deliver “excellent care” in many treatment areas, she and her group are working to shine a light on a major exception. They believe Catholic hospitals prevent many women from getting the reproductive health care they need — even procedures that are medically necessary — ultimately putting them in an untenable situation once they walk through the doors of one of these religious facilities.

Once a hospital elects to merge with the Catholic system, it agrees to obey a set of directives issued by the U.S. Conference of Catholic Bishops. Called the “Ethical and Religious Directives for Catholic Health Care Services” (ERDs), these rules include instructions that Catholic care “should distinguish itself by service to and advocacy for those people whose social condition puts them at the margins of our society and makes them particularly vulnerable to discrimination: the poor; the uninsured and the underinsured; children and the unborn; single parents; the elderly; those with incurable diseases and chemical dependencies; racial minorities; immigrants and refugees.”

Although these large Catholic hospital systems operate in accordance with religious values and doctrine, they aren’t directly funded or controlled by the Catholic Church. As Uttley put it, “they are not being funded by the envelope my mother used to put in the collection basket every Sunday.”

Instead, as tax-exempt nonprofit corporations, they are funded through a combination of private insurance reimbursement, Medicare and Medicaid payments, and sometimes government grants, according to Uttley.

By bringing many hospitals together into large Catholic health systems, they can cut costs through shared administration and joint purchasing, offering protection to hospitals in rural states where isolated health care facilities often struggle. “It’s to their credit, they’ve kept these hospitals operating in very challenging times,” she said.

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CREDIT: DYLAN PETROHILOS

But the directives also include prohibitions on abortion, even when a woman’s health is at risk; assistance with surrogacy; egg and sperm donation; contraception; and temporary or permanent sterilization, with few — if any — exceptions. And the condoning of or participation in euthanasia or assisted suicide “in any way” is expressly verboten for all who work at a Catholic health care institution. MergerWatch, the ACLU, and the handful of other organizations that track this issue believe these directives often mean even procedures needed to mitigate serious health risk to the patient are unavailable at a Catholic hospital.

The groups also pointed to a troubling lack of transparency: Because Catholic hospitals often choose not to disclose which services are not offered, patients don’t always realize they operate any differently from a secular institution.

Proponents of the Catholic hospital system say the distinction should already be obvious to patients given the facilities’ religious presentation. As the attorney for one Catholic hospital in California that refuses to perform tubal ligation argued in a lawsuit earlier this year, “no one is lacking for understanding that this is a Catholic hospital, from the crucifix in the front entrance to everything about it.”

But that’s not necessarily how providers see it. Nancy, a physician who provided services at Rochester’s Crittenton before the merger and continues to do so today, said the now-Catholic hospital is presented to the public as a secular institution with no disclosure of its restrictions. “I think it is incredibly difficult to understand what limits we have available,” said Nancy, who asked that her real name be withheld because she is still practicing in the field, noting that the names of Catholic hospitals don’t always reveal their religious affiliation. “It’s not Saint Crittenton. It’s not Mary of Christ Crittenton. It’s just Crittenton.”

Ascension and Crittenton did not respond to a ThinkProgress inquiry about their practices. A spokesperson for the Catholic Health Association, which represents hundreds of Catholic hospitals and facilities nationwide, said his group “encourages transparency from Catholic hospitals regarding the services they do and do not offer.”

But Brigitte Amiri, senior staff attorney for the ACLU’s Reproductive Freedom Project, says in practice, that transparency is often absent — putting patients in potentially perilous situations when they’re in urgent need of care.

“The hospital closest to you might be Catholic, you might not know it, you might not think to ask these questions until [you’re facing] an emergency situation or far along in a pregnancy,” she said.

Rachel Miller found herself in that exact situation when she was a patient at Mercy hospital in Redding, California in 2015. Miller, who was pregnant with her second child, was certain she didn’t want to have more kids: In 2013, she had an emergency C-section for her first daughter, and knew she would have to repeat the procedure for the birth of her second child. After she discussed her options with her OB-GYN, she decided a tubal ligation made the most sense — she could get it right after delivering her baby and it wouldn’t require an additional hospitalization.

Miller sent a request to Mercy for the procedure, and assumed it would be approved. Instead, she received a letter back stating Mercy would be unable to accommodate her, citing the Catholic bishops’ directives.

Miller had never heard of the directives before — in fact, she had no idea that the standard of care at Mercy would be any different than what was available at a secular hospital. “I guess if someone had asked me at the time, ‘is this a Catholic hospital?’ I would have said yes, because it’s Mercy, normally a Mercy hospital is Catholic,” she told ThinkProgress. “But I had never thought about it. And as far as Catholic hospitals in general and having ERDs, I had never thought about that either.”

Miller was sure she wanted to get her tubes tied, but after Mercy’s rejection, she found that her options were limited. Redding has only one hospital with a labor and delivery department and the nearest hospital Miller could find that took her insurance was some 160 miles away. That was out of the question — Miller knew she would have to stay at the hospital for several days, and she didn’t want to be away from her toddler for that long. Mercy — the largest hospital provider in California — was her only option, and they just wouldn’t budge.

That was especially concerning to Elizabeth Gill, an attorney at the ACLU of Northern California who later took up Miller’s case. “It’s troubling that your access to health care in such a significant degree in a state like California is dictated by the moral code that corporations subscribe to, especially given that these are entities that are largely state and federally funded,” she said.

The predicament Miller found herself in is becoming increasingly common.

For many patients, Catholic hospitals are now so ubiquitous they may be the closest or only option for care. According to MergerWatch’s most recent report, more than 40 percent of the acute care beds in Alaska, Iowa, Wisconsin, Washington, and South Dakota are in Catholic-owned or affiliated hospitals, and more than 45 Catholic hospitals in the country provide the only acute care in their geographic region. Naturally, this impacts the services available to patients. As Miller experienced, the bishops’ guidelines often prevent doctors from performing tubal ligations after patients deliver, which is the safest time for the procedure.

Moreover, as the National Women’s Law Center noted in a complaint to the Centers for Medicare and Medicaid Services, many Catholic hospitals don’t follow the medical standards of care for what’s known as “miscarriage management,” often by denying services to women experiencing pregnancy complications before viability or in the middle of a miscarriage.

Tamesha Means was 18 weeks pregnant when she showed up at a Mercy hospital in Michigan in December 2010. Her water had broken prematurely. Hospital staff examined Means, but neglected to tell her that the fetus she was carrying had virtually no chance of survival — and in fact posed a risk to her health if she continued to carry it. Means was sent home, but she returned the next day as her bleeding and cramps intensified. Again, she was instructed to go home. Means returned for a third time that night — visibly in pain and showing signs of an infection. The hospital prepared to send her home once again, but stopped when she started delivering. The baby died shortly thereafter, and the hospital staff told Means to prepare funeral arrangements.

The ACLU took on the case, arguing that the directives prevented hospital staff from informing Means of the risk of the pregnancy and directly placed her in harm’s way. “Because of the Directives, MHP did not inform Ms. Means that, due to her condition, the fetus she was carrying had virtually no chance of surviving, and continuing her pregnancy would pose a serious risk to her health,” the lawsuit claimed. As a result, “Ms. Means suffered severe, unnecessary, and foreseeable physical and emotional pain.”
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CREDIT: DYLAN PETROHILOS/SHUTTERSTOCK

The restrictions on care don’t present a burden for patients alone — working within the system can also weigh heavily on providers who are prevented from performing the full range of medical care they expected to practice as an OB-GYN. According to a 2012 national survey, more than 50 percent of OB-GYNs who work at Catholic hospitals said they’ve run into conflicts with their institutions over the directives. Dr. Didi Saint Louis, a physician in the Southeast who completed her medical residency at a Catholic hospital, is familiar with that tension herself. She remembered seeing a patient who fell extremely ill at an early stage in a nonviable pregnancy. Saint Louis was prohibited from terminating the pregnancy — even though the fetus would not survive — and ended up transferring the patient to another hospital.

“I remember our director riding in the ambulance with the patient, she went straight to the operating room, they terminated the pregnancy, and she was fine,” she recalled. “But it could have gone so many different ways. And while the Catholic hospitals strive to give the best standard of care, this is one area where I think they fall short.”

The impact of a hospital merger can be much more profound for people living in geographically isolated regions without easily accessible alternatives. According to MergerWatch, there are 46 hospitals nationally that provide the only short-term acute care for people in their region, leaving people who lack transportation and travel resources with few alternative options.

Nancy, the physician from Michigan who works with Ascension, says she’s fortunate to be in a region with more than one hospital. “I’m in an area in which my patients can commute or get to a different location, so people in more remote areas are stuck without that,” she said. “Which is a really disturbing trend.”

About 2,000 miles west of Rochester, a Catholic hospital merger brought a very different outcome. In Washington, a battle was waged over the fate of Vashon Island’s only health clinic. Vashon, a quirky island community near Seattle, is home to about 11,000 people, 45 miles of shoreline, and an unofficial mayor who was re-elected in 2015 over a goat named Bandit. It is a Democratic bastion: Mitt Romney received a mere 18.6 percent of the vote in the 2012 elections, to Barack Obama’s 77.6 percent.

In 2012, Mark Benedum, the CEO of the island’s health clinic, announced the board had decided that, due to financial struggles, the time had come “to explore the benefits of joining a larger system.” It reached an agreement to become an affiliate of Franciscan Health System, a chain of Catholic health facilities and part of the behemoth Catholic Health Initiatives.

Benedum initially claimed patients’ options would be unaffected by this union, insisting, “it’s not going to change a thing.”

Vashon’s residents weren’t so sure. A group of skeptics, calling itself Vashon HealthWatch, worried that the island’s sole clinic would now be forced to adhere to the bishops’ directives — and that their care would be limited as a result. After consulting with MergerWatch, they organized a massive town hall meeting where members of the community could question Franciscan and Highline leadership.

On April 25, 2013, weeks after the Franciscan’s purchase of the clinic was complete, about two hundred people packed the multipurpose room at one of the the island’s schools, according to Kate Hunter, who helped organized the event. It was a far cry from the sparsely attended event that took place in Michigan. And not only did people show up, but they’d read the directives and were prepared with specific questions.

Benedum and executives from Franciscan Health Services were peppered with two hours of anxious inquiries from community members about the merger’s impact on available reproductive health and end-of-life services.

Margaret Chen, a staff attorney with the ACLU of Washington Foundation, said this level of civic engagement is atypical. “The visibility of concerned citizens was large in the Vashon Island community, maybe in part because of the unique situation [of being so separated from other options].” This response, she suggested, might have been part of the reason the new ownership agreed to continue offering birth control, family planning, and contraception to patients on the island — though a company spokesperson said the directives are “consistently applied” across all of its facilities.

While the executives sought to assure residents that “nothing is going to change at the Vashon medical clinic,” Hunter wasn’t convinced. She recalled one particularly concerning exchange toward the end of the forum: “Does your contract with your doctors specify that they will follow the directives?” a resident asked. “Yes, they do,” the Franciscan representative answered. “Our employment contract does.”

John Jenkel, who is part of the Vashon-Maury Health Collaborative, a community group that works to improve emergency care options on the island, said the relationship between the new ownership and residents was scarred by that early tension. “[T]hose directives and the manner in which the Franciscans communicated with the community caused a rift that never really made for a comfortable working relationship on our small island,” he said. “The initial discussion that the Franciscans had with the community was a rocky one, and the relationship of the directives to the type of care the Franciscans would be providing was never too clear.”

Hunter stopped going to the Vashon clinic. “I just feel so strongly that no one’s religious beliefs should interfere with my health care and I had no confidence that that would not be the case at the clinic anymore,” she said. Instead, she travels to a secular nonprofit facility in Seattle, via ferry and bus — a 60- to 90-minute trip each way.

When ThinkProgress reached out to Franciscan for comment, spokesperson Scott Thompson said that “none of the practice’s women’s reproductive services changed at the clinic after Highline’s affiliation with CHI Franciscan Health.” However, he added that the Vashon Island clinic would be closing in August. The company attributed the decision to the cost of operating the clinic and the fact that visits had declined from about 1,000 a month when they took it over to between 750 and 850 a month today.

Kate Hunter laments that with the closing, “there will be no health care clinic on Vashon Island. We’re back to ground zero.”

The bishops’ directives were last updated in 2009 and, according to observers, are due to be revised again in the near future. Reproductive rights advocates say a revision could loosen restrictions on how hospitals that become Catholic through mergers may deal with reproductive decisions — or could put the kibosh on the limited flexibility that Catholic chains have shown in places like Vashon Island.

Sara Hutchinson Ratcliffe, domestic program director for Catholics for Choice, fears it will be the latter. “I think the upcoming regulations are going to close those avenues for alternative provision for those health care services, to make the partnership agreements even more strict on who must/must not do this or that,” she said. “I think it will make it worse.”

MergerWatch’s Lois Uttley is a bit more optimistic. “We hope that they will be realistic about the fact that, in this day and age, Catholic hospitals are serving everyone in the community, not just Catholics. And they are employing doctors and staff that come from a wide background of religious affiliation,” she said. “We hope there will be a recognition that all hospitals, including Catholic ones, are licensed to serve the whole community.”

The press office for the U.S. Conference of Catholic Bishops did not respond to a ThinkProgress inquiry about their timetable for an update. But when and if the directives are updated, they could make a huge difference in terms of whether doctors at hospitals that merge with Catholic hospital system.

In the meantime, several approaches have been contemplated for how to address the topic.

The Center for Inquiry, which advocates for a secular society, thinks that the Medicare and Medicaid funding Catholic hospitals receive could be used as leverage to force Catholic hospitals to provide a full range of reproductive health and end-of-life care. Michael De Dora, who heads the Center’s Office of Public Policy, explained that while he does not believe all individual doctors should be forced to engage in all health care services, all hospitals should. “The responsibility should be with the hospital in any case [if] they’re receiving public funds,” he said. “That is the ideal.”

The ACLU’s Brigitte Amiri noted that some — though not many — states have considered legislation that would shield doctors from punishment, should they choose to provide services forbidden under the directives. After non-discrimination laws and same-sex marriage equality were enacted, several Catholic Charities organizations shelved adoption services rather than serve same-sex couples.

Thus far, the ACLU has concentrated its efforts on the judicial system, threatening and bringing lawsuits under the federal Emergency Medical Treatment and Active Labor Act and state medical laws. Two suits were dismissed at the trial court level, though both are being appealed, and others are still working their way through the courts. In April, for the first time, the 41,000 doctors of the California Medical Association announced they would join an ACLU of Northern California case against a Catholic hospital system that bars its doctors from performing tubal ligation.

Since these and other attempts to force Catholic hospitals to provide services have not yet been met with much success, some activists have focused on making the rules more transparent.

Washington state enacted a requirement that hospitals generally disclose what services they refuse to provide to the state government — which would become public record — but MergerWatch’s advocacy coordinator, Christine Khaikin, observed even that “leaves a lot of room for interpretation to the hospital system,” and few hospitals have reported much of anything.

model-patiens
CREDIT: AMERICAN ATHEISTS

The American Atheists, a group that advocates for a strict separation of government and religion, have circulated a piece of model state legislation called the Patient’s Right to Know Act. The organization’s national legal and public policy director Amanda Knief said it would simply require that providers “inform their patients up front of all services they’re not going to provide, according to their religious, philosophical beliefs.” This “sunshine law” would not require hospitals to provide an explanation or a referral, she added, but simply a disclosure of which services are not provided there “because we’re Catholic affiliated, or we’re Pastafarian affiliated, or we don’t believe in modern medicine.”

The bill has been introduced in Arizona, and Knief is hopeful other states will soon follow. But, she acknowledges, it may have trouble gaining momentum — some progressive groups have been reluctant to back the measure because it lacks a requirement that the hospital refer the patient to a place that performs procedures prohibited by the directives.

In some communities, MergerWatch has partnered with local advocates to utilize state hospital merger laws and galvanize public actions to force accommodations or block the mergers entirely. “Frankly, totally stopping the merger is our fallback position,” Lois Uttley explained. “What we try to do, from the outset, is make sure that community access to needed reproductive health care services is preserved in some way.” She pointed to one case in which a separately funded and staffed reproductive health care center was opened on the second floor of a newly Catholic hospital that could no longer provide all services under the directives. In another, the community got a local hospital to call off its plans to affiliate with a Catholic system.

But, like with Crittenton Hospital in Michigan, these mergers often fly under the radar. Because the hospitals themselves do not highlight that they are going to begin restricting services, MergerWatch, the ACLU, and a small number of other organizations are often the only early-warning system for communities. And, as Sara Hutchison Ratcliffe of Catholics for Choice pointed out, until more people understand what these mergers mean, it can be an uphill battle for them to galvanize community resistance.

“Awareness isn’t the only solution, but it is the first step,” she said. “Until they are aware, the likelihood of something happening is small… The first step is getting those who have the power to change it involved.”

The fate that awaits Rochester, Vashon, and the numerous other communities that have recently experienced hospital mergers is uncertain. Indeed, some may choose to go the path of resistance favored by Washington’s quirky island community, organizing themselves and arranging well-attended town hall meetings. But, as Merissa Kovach and her coworkers at the ACLU of Michigan experienced while organizing their campaign, getting that community buy-in is often an uphill battle.

“One of the biggest issues with this is that it’s just not well-known at all and nobody understands what these hospitals are doing,” Kovach said. “We’re in such a public education step with this, and it’s such an unknown issue. People don’t know why they should care.”

But why did they seem to know and care in the Washington island? At least some portion of the differences between the two community responses can likely be drawn along political lines — Vashon overwhelmingly leans left, Rochester tilts right. But what took place in the Michigan city might be the more standard course of events: A merger takes place in a community that isn’t predisposed to fight it — or isn’t even aware that it might impact the care they expect to receive — and, as was the case with Rochester, a new merger quietly goes into effect. And the cumulative impact of these mergers, critics say, is an overall reduction in available reproductive services.

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CREDIT: DYLAN PETROHILOS

So what are the alternatives to Catholic medical care? In some rural communities, there aren’t any — it’s a Catholic system or nothing at all. That’s a sobering reality for people on all sides of the debate, including reproductive health advocates. They recognize that a singular focus on the expansion of the Catholic health care system ignores the forces that often propelled them to step in in the first place. Public hospitals are struggling, and their Catholic counterparts can provide much-needed care. According to the most recent MergerWatch report, the number of public short-term acute care hospitals in the U.S. dropped an astonishing 34 percent between 2001 and 2016. The number of secular nonprofit hospitals, too, shrunk by 11 percent, while for-profit systems shot up by more than 50 percent. In rural areas, where it is harder to turn a profit, these trends have left tremendous disparities in health care access.

Catholic hospitals help fill some of that gap — but at what cost? The ACLU’s Brigitte Amiri worries that hospitals’ fealty to the directives over the standard of care means that for some, the delta between the services they seek and those that are available is becoming a gulf.

“We don’t want to take away health care services from a community that desperately needs them,” she acknowledged. “But I don’t think we can be so timid about our work that we don’t push them to provide health and lifesaving care to women.”

Kiley Kroh and Tara Culp-Ressler edited this piece. Cory Herro provided research assistance. Videos by Victoria Fleischer, graphics by Dylan Petrohilos, and illustrations by Laurel Raymond.


This material [the article above] was created by the Center for American Progress Action Fund. It was created for the Progress Report, the daily e-mail publication of the Center for American Progress Action Fund. Click here to subscribe. ‘Like’ CAP Action on Facebook and ‘follow’ us on Twitter

Supreme Court Takes Up ‘Fundamental Concept of Democracy’ in Voting Case

Supreme Court to decide if states should be required to draw legislative districts based on eligible voters or total populations

— by Nadia Prupis, CommonDreams staff writer

The U.S. Supreme Court is taking up the decades-old issue of “one person, one vote.” The main question is, what does “person” mean? (Photo: Jeff Kubina/flickr/cc)

The U.S. Supreme Court on Tuesday heard a case on redistricting that could have a profound impact on voting and representation nationwide, as it considered the dynamics of the “one person, one vote” principle.

It’s a case that is poised to upend the U.S. voting process and, some critics warn, “make millions of people who live in our communities invisible in our democracy.”

In Evenwel v. Abbott (pdf), a case that emerged from a redistricting debate in Texas, the plaintiffs argue that states should only count eligible voters when drawing legislative district lines, rather than entire populations—an approach that would strengthen Republican strongholds in rural areas, while thinning out representation in urban centers, which have a higher proportion of non-eligible voters, such as non-citizen immigrants, children, and those disenfranchised through felony convictions.

“Everyone deserves fair and equal representation regardless of voting status or age. A ruling in favor of Evenwel would deny us fair representation in government and leave approximately 55 percent of Latinos unrepresented and affect many other groups—eroding Latinos’, Asian-Americans’, and African-Americans’ political power,” said Cristóbal J. Alex, President of Latino Victory Project. “We hope the Supreme Court will uphold the principle of one person, one vote. We should not create a second class of individuals who are subject to laws written by those who are not accountable or truly representative of the people.”

Because the decision in the case could impact nationwide redistricting rules, a ruling in favor of the plaintiffs has the potential to “shift political power from larger areas that are more ethnically diverse and shift them more over to rural areas,” ACLU-Texas staff attorney Satinder Singh told Common Dreams on Monday.

That concern extends to numerous states with large minority populations.

“If changed, we will be moving from a standard that includes all people in the representation process to a scheme that excludes minors, undocumented veterans, and takes away the power given to communities to elect one of their own,” said Chuy Garcia, Illinois’ Cook County commissioner and populist icon.

In a city like Chicago, said Alderman Joe Moore, a ruling in favor of the plaintiffs could “make millions of people who live in our communities invisible in our democracy.”

The Supreme Court first imposed “one person, one vote” in 1964, when it ruled in Reynolds v Sims that the equal protection clause of the 14th Amendment requires state legislative districts to be comprised of roughly equal populations, though it gave individual states the power to decide on how they would determine “populations.” Most states leaned toward counting total residents, but a small handful of others only refer to voters.

But through decades of precedent, the court “never clarified what they mean by one person,” Singh said.

Justices have historically used “person” and “voters” interchangeably, he continued. “It’s a fundamental concept of democracy. Ultimately the question they’re going to be deciding is, what does this principle mean?”

It’s a question of representation that has been rejected by Texas Governor Greg Abbott, a state federal district court, the U.S. Department of Justice, and ACLU-Texas, among other organizations. In fact, as Richard Hasen writes for SCOTUSblog, the case could be seen as nothing more than an attempt at “taking power away from the states and having the Supreme Court overturn precedent by imposing through judicial fiat a one-size-fits-all version of democratic theory unsupported by the text of the Constitution or historical practice.”

In fact, Hasen writes, the plaintiffs “are seeking to impose a standard which is not supported by the text of the Constitution.”

But the lawsuit has nonetheless climbed the judicial ladder. The plaintiffs, Titus County Republican Party chairperson Sue Evenwel and Montgomery County “party stalwart” Edward Pfenninger maintain that current standards weaken the influence of voices from areas with more registered voters, but smaller populations. Opponents, including Democratic Texas Rep. Marc Veasey and Mexican American Legislative Caucus voting rights counsel Joe Garza, say a redistricting policy that values registered voters over total residents would shut out large chunks of minorities, particularly those who are black or Latino.

“This legal challenge would do great harm to the state of Texas and potentially to other states that have very young populations and a significant number of noncitizen residents,” Veasey told McClatchy on Monday. “For Tarrant County in particular, this could mean that over 100,000 noncitizens would no longer be counted when assigning representation, according to a 2015 Migration Policy Institute report, and 27 percent of the county would be discounted due to be their age, according to the 2014 U.S. Census.”

Garza added, “We would lose seats in Texas—we would lose two districts in the Senate. It is an advantage for the white population.”

The implications of such a decision are far-reaching. In a state like Texas with a high population of Latino and minority voters, strengthening rural votes at their expense could lead to older, white constituents having “an outsize voice at the legislature,” Singh told Common Dreams. “A very small number of people would have a very large voice and would be able to decide things for a state with 30 million people.”

That “would certainly cause some representative issues and is a troubling notion of what democracy is,” he said.


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NOT Good Enough for the Fearful?

Homeland Security Secretary Jeh Johnson explains the Syrian refugee screening process

In the days since the terrorist attack in Paris, there has been a huge debate in the United States over Syrian refugees. While the U.S. has committed to taking 10,000 people fleeing the Syrian civil war, some have argued that there is no way to ensure that terrorists won’t enter the country posing as refugees. The Obama administration has responded by saying that the vetting process is extremely rigorous.

So, putting aside emotional rhetoric about this issue, what exactly is that process?

According to Secretary Jeh Johnson, more than 23,000 potential refugees have been referred to the U.S. and that only 2,000 have made it past the screening. But according to the GOP fearmongers, our process isn’t good enough for them.  Is that because 2,000 worthy souls actually made it through the process?

Head more …. HERE

An Open Letter to Paul Ryan

AnnWernerAs a nation, we must stand up and call out those who betray what it means to be an American.

Dear Paul Ryan,

Shame on you. Shame on your Party for succumbing to the absolute worst in human nature. Shame on you for wanting to legislate turning our back on people who are fleeing for their lives. Shame on you for fomenting fear and hatred. Shame on you for accusing our president of politicizing the refugee crisis.

What has he said? He said he will veto the bill Republicans have cooked up to stop us from accepting a mere handful of Syrian refugees. Because he is abiding by our constitution, President Obama is politicizing this crisis? Is that what you’re saying? His statement “this is not who we are” is politicizing this crisis? This is “remarkably unpresidential?”

I’ll tell you who is politicizing it. You, and the people in that sorry excuse for an American political party, the GOP. The people who are always yelling about the Constitution and upholding the principles in it.

Donald Trump is on TV calling for shutting down every mosque in the United States. He has gone so far to say we should require all Muslims carry identification. What’s next? Making them wear star and crescent patches in a replay of what the Nazis did to Jews in Hitler’s Germany? Members of your party are calling for a religious litmus test: Christians only. Members of your Party want to round up Muslims in this country and put them into internment camps. Members of the GOP would have us believe that 5-year-old children and their mothers pose a threat and that every male Muslim is a terrorist. If left to your own devices, you would build a wall around this entire country and throw out everyone who doesn’t look like you, think like you and hate like you. One of the most hurled around “insults” of our president from your irrational, xenophobic, lying brethren is that Obama is a Kenyan Muslim and a secret member of the Muslim Brotherhood, bent on destroying America.

How dare you accuse the president of politicizing this crisis when that is all members of the Republican Party have done since the onset of the worst refugee situation since World War II? How dare you impugn his patriotism? I don’t even want to hear the word Constitution coming out of your mouth. You and the members of your backwards Party have betrayed every single value our country was built upon. I will remind you of the symbol that stands in New York Harbor. It’s a damned shame that I have to remind you. You, after all, are Speaker of the House, and one would think you would remember what we stand for, but since you don’t here is a refresher course:

Not like the brazen giant of Greek fame,
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame

Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.
‘Keep, ancient lands, your storied pomp!’ cries she
With silent lips. ‘Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tossed to me,
I lift my lamp beside the golden door!’”

For once in your stingy, privileged, Ayn Rand worshipping life, think about what you are doing and saying. You have forgotten what it means to be an American. You have betrayed the values Republicans used to respect. You have betrayed the values that made this country great. You and those like you are spitting on the Constitution you claim to want to uphold. You and the right wing members of your Party are a national embarrassment. More than that, you are a national disgrace.

Sincerely,
Ann Werner


Ann Werner is the author of thrillers and other things. Visit her at Ann Werner on the Web

Follow Ann Werner on Facebook and Twitter

This letter was originally posted at LiberalsUnite

What’s next? Dismantling Lady Liberty?

CAKyOt4UgAAfIzLOur three Teapublican congressmen from Nevada, Mark Amodei, Joe Heck and Cresant Hardy locked arms in antipathy and voted to deny Syrian refugees entrance to American shores (Roll Call Vote 643: HR 4038) just as their ancestors denied access to German Jewish refugees during WWII, half of whom died during the Holocaust.  Surprisingly, they didn’t amend the bill so they could dismantle Lady Liberty as well.

Lady Liberty was officially presented to America in 1886 as a gift of the French to the American people.  Her French sculptor Frederic Auguste Bartholdi had originally drawn up plans to create a monumental statue in the form of an Egyptian fellah, or a peasant women, which means she would have been a “Muslim” woman. He wanted to place her at the Suez Canal’s Port, but couldn’t find the financing.  Instead, he reworked everything and she was presented to us instead.  I’m sure if the cowardly Republimen realized this, they’d be more than happy to completely dismantle her and send her packing as it’s clear that they no longer believe in the motto inbscribed at her base:

“Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tossed to me,
I lift my lamp beside the golden door!”

It was an egregious American President and his Administration that created this mess, by lying us into starting a pre-emptive war in Iraq, that destabilized the entirety of the middle east, spawning ISIS and the carnage they’ve created.  Still, the Republimen in Congress feel absolutely NO ownership of their savage carnage nor for the resultant refugees fleeing for native country for their lives.  And now, Republican despots are touting how terrified they are of widows and 3-5 year old orphaned Syrian Refugees.

Personally, I’m ashamed of the action our representatives in the Congress took today.  It’s their jobs to lead this nation and to make things work.  Instead, all they can do is cast doubt on anything and everything, vote to do nothing, and then crawl back under their favorite rock in fear.

Obama Issues Veto Threat for GOP’s Syrian Refugee Gum Up the Works Bill

President Obama has issues yet another veto threat to the House Republimen regarding their Syrian refugee bill (aka, H.R. 4038 – American SAFE Act of 2015).

NoRoom

In a statement of administration policy, the White House made the president’s veto threat clear:

The Administration’s highest priority is to ensure the safety and security of the American people. That is why refugees of all nationalities, including Syrians and Iraqis, considered for admission to the United States undergo the most rigorous and thorough security screening of anyone admitted into the United States. This legislation would introduce unnecessary and impractical requirements that would unacceptably hamper our efforts to assist some of the most vulnerable people in the world, many of whom are victims of terrorism, and would undermine our partners in the Middle East and Europe in addressing the Syrian refugee crisis. The Administration therefore strongly opposes H.R. 4038.

The current screening process involves multiple Federal intelligence, security, and law enforcement agencies, including the National Counterterrorism Center, the Federal Bureau of Investigation, and the Departments of Homeland Security (DHS), State, and Defense, all aimed at ensuring that those admitted do not pose a threat to our country. These safeguards include biometric (fingerprint) and biographic checks, medical screenings, and a lengthy interview by specially trained DHS officers who scrutinize the applicant’s explanation of individual circumstances to assess whether the applicant meets statutory requirements to qualify as a refugee and that he or she does not present security concerns to the United States. Mindful of the particular conditions of the Syria crisis, Syrian refugees – who have had their lives uprooted by conflict and continue to live amid conditions so harsh that many set out on dangerous, often deadly, journeys seeking new places of refuge – go through additional forms of security screening, including a thorough pre-interview analysis of each individual’s refugee application. Additionally, DHS interviewers receive extensive, Syria-specific training before meeting with refugee applicants. Of the 2,174 Syrian refugees admitted to the United States since September 11, 2001, not a single one has been arrested or deported on terrorism-related grounds.

No Room at the InnThe certification requirement at the core of H.R. 4038 is untenable and would provide no meaningful additional security for the American people, instead serving only to create significant delays and obstacles in the fulfillment of a vital program that satisfies both humanitarian and national security objectives. No refugee is approved for travel to the United States under the current system until the full array of required security vetting measures have been completed. Thus, the substantive result sought through this draft legislation is already embedded into the program. The Administration recognizes the importance of a strong, evolving security screening in our refugee admissions program and devotes considerable resources to continually improving the Nation’s robust security screening protocols. The measures called for in this bill would divert resources from these effortsiven the lives at stake and the critical importance to our partners in the Middle East and Europe of American leadership in addressing the Syrian refugee crisis, if the President were presented with H.R. 4038, he would veto the bill.

The House of #Republimen are slated to vote TOMORROW on this wasteful showboat legislation. Instead of helping to resolve the crisis before Syrian refugees, H.R. 4038 is nothing but dreadful political grandstanding that directly enhances ISIS recruitment efforts worldwide.

Potential refugees ARE already vetted. But, hypocritical #Republimen, who claim to hate wasteful spending and bureaucracy, are once again wasting what limited legislative time that is available for critical legislative action, taking a showboat vote on a useless, and truly wasteful bill that will seriously add to the bureaucracy and increase costs.  So much for being the small government fiscally responsible crowd.

H.R. 4038 is one bill that President Obama can’t veto fast enough.

How Democratic presidential candidates propose to handle terror threats at home and abroad, in light of the Paris attacks and the shifting threat of the Islamic State:

Senator Bernie Sanders on PBS News Hour with Gwen Ifill:

Secretary Hillary Clinton on the campaign trail today:

(I couldn’t find any YouTube video from Gov. Martin O’Malley subsequent to the debate and the Paris attack on this issue at the time of this post.)

TPP—A Means of Surrendering Our National Sovereignty

The details are out on the the Trans-Pacific Partnership, and critics say the trade deal is worse than they feared. The TPP’s full text was released Thursday, weeks after the United States and 11 other Pacific Rim nations—a group representing 40 percent of the world’s economy—reached an agreement. Activists around the world have opposed the TPP, warning it will benefit corporations at the expense of health, the environment, free speech and labor rights. Congress now has 90 days to review the TPP before President Obama can ask for an up-or-down vote.  Take the time to learn more about this treaty and then weigh in with your representation in the Congress (both Houses) as to your thoughts.  You can find a PDF version of the actual text of the various chapters here, and a slightly more Internet-friendly glossed over-version of what proponents of the TPP want you to know on Medium.

More video:

Victims File Suit Against CIA Torture Architects for ‘Systemic Brutality’

Psychologists James Mitchell and Bruce Jessen, who thus far escaped accountability, face charges of ‘cruel, inhuman, and degrading treatment; non-consensual human experimentation; and war crimes.’

— by Lauren McCauley, staff writer

Suleiman Abdullah Salim, who survived the CIA’s brutal torture regime, was released after five years of being held without charge. (Photo via ACLU)

The two psychologists credited with creating the brutal, post-9/11 Central Intelligence Agency (CIA) torture regime are being sued by three victims of their program on charges that include “human experimentation” and “war crimes.”

The American Civil Liberties Union (ACLU) on Tuesday filed the suit against CIA contractors James Mitchell and Bruce Jessen, on behalf of torture survivors Suleiman Abdullah Salim and Mohamed Ahmed Ben Soud, as well as the family of Gul Rahman, who died of hypothermia in his cell as result of the torture he endured.

The suit, which is the first to rely on the findings of the Senate Intelligence Committee report on CIA torture, charges Mitchell and Jessen under the Alien Tort Statute for “their commission of torture, cruel, inhuman, and degrading treatment; non-consensual human experimentation; and war crimes,” all of which violate international law.

The pair, both former U.S. military psychologists, earned more than $80 million for “designing, implementing, and personally administering” the program, which employed “a pseudo-scientific theory of countering resistance that justified the use of torture,” that was based on studies in which researchers “taught dogs ‘helplessness’ by subjecting them to uncontrollable pain,” according to the suit.

“These psychologists devised and supervised an experiment to degrade human beings and break their bodies and minds,” said Dror Ladin, a staff attorney with the ACLU National Security Project. “It was cruel and unethical, and it violated a prohibition against human experimentation that has been in place since World War II.”

In a lengthy report, the ACLU describes each plaintiff’s journey.

After being abducted by CIA and Kenyan agents in Somalia, Suleiman Abdullah, a newly wed fisherman from Tanzania, was subjected to “an incessant barrage of torture techniques,” including being forced to listen to pounding music, doused with ice-cold water, beaten, hung from a metal rod, chained into stress positions “for days at a time,” starved, and sleep deprived. This went on for over a month, and was continually interspersed with “terrifying interrogation sessions in which he was grilled about what he was doing in Somalia and the names of people, all but one of whom he’d never heard of.”

Held for over five years without charge and moved numerous times, Abdullah was eventually sent home to Zanzibar “‘with a document confirming he posed no threat to the United States.” He continues to suffer from flashbacks, physical pain, and has “become a shell of himself.”

Mohamed Ben Soud was captured in April 2003 during a joint U.S.-Pakistani raid on his home in Pakistan, where he and his wife moved after fleeing the Gaddafi regime in Libya. Ben Soud said that Mitchell even “supervised the proceedings” at one of his water torture sessions.

Describing Ben Soud’s ordeal, the ACLU writes:

The course of Mohamed’s torture adhered closely to the “procedures” the CIA laid out in a 2004 memo to the Justice Department. Even before arriving at COBALT, [a CIA prison in Afghanistan] Mohamed was subjected to “conditioning” procedures designed to cause terror and vulnerability. He was rendered to COBALT hooded, handcuffed, and shackled. When he arrived, an American woman told him he was a prisoner of the CIA, that human rights ended on September 11, and that no laws applied in the prison.

Quickly, his torture escalated. For much of the next year, CIA personnel kept Mohamed naked and chained to the wall in one of three painful stress positions designed to keep him awake. He was held in complete isolation in a dungeon-like cell, starved, with no bed, blanket, or light. A bucket served as his toilet. Ear-splitting music pounded constantly. The stench was unbearable. He was kept naked for weeks. He wasn’t permitted to wash for five months.

According to the report, the torture regime designed and implemented by Mitchell and Jessen “ensnared at least 119 men, and killed at least one—a man named Gul Rahman who died in November 2002 of hypothermia after being tortured and left half naked, chained to the wall of a freezing-cold cell.”

Gul’s family has never been formally notified of his death, nor has his body been returned to them for a dignified burial, the ACLU states. Further, no one has been held accountable for his murder. But the report notes, “An unnamed CIA officer who was trained by Jessen and who tortured Rahman up until the day before he was found dead, however, later received a $2,500 bonus for ‘consistently superior work.'”

The ACLU charges that the theories devised by Mitchell and Jessen and employed by the CIA, “had never been scientifically tested because such trials would violate human experimentation bans established after Nazi experiments and atrocities during World War II.” Yet, they were the basis of “some of the worst systematic brutality ever inflicted on detainees in modern American history.”

Despite last year’s release of the Senate Torture Report, the government has prosecuted only a handful of low-level soldiers and one CIA contractor for prisoner abuse. Meanwhile, the architects of the CIA’s torture program, which include Mitchell and Jessen, have escaped any form of accountability.

Physicians for Human Rights (PHR) issued a statement saying they welcomed the federal lawsuit as “a landmark step toward accountability,” and urged the U.S. Department to follow suit and criminally “investigate and prosecute all those responsible for torture, including health professionals.”

In the wake of the Senate report, the group strongly criticized Mitchell and Jessen for betraying “the most fundamental duty of the healing professions.”

In Tuesday’s statement, Donna McKay, PHR’s executive director, said: “Psychologists have an ethical responsibility to ‘do no harm,’ but Mitchell and Jessen’s actions rank among the worst medical crimes in U.S. history.”


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The Five-Step Process to Privatize Everything

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‘The heart of privatization,’ writes Buchheit, ‘is a disdain for government and a distrust of society, and a mindless individualism that leaves little room for cooperation.’ (Image: stock/public domain)

— by Paul Buchheit
Law enforcement, education, health care, water management, government itself — all have been or are being privatized. People with money get the best of each service.

At the heart of privatization is a disdain for government and a distrust of society, and a mindless individualism that leaves little room for cooperation. Adherents of privatization demand ‘freedom’ unless they need the government to intervene on their behalf.

These privatizers have a system:

1. Convince Yourself that “I Did It On My Own”

The people in position to take from society seek to rationalize their actions, and many have accomplished this through the philosophy of Ayn Rand, the author of The Virtue of Selfishness. She rejected community values, saying “Any group…is only a number of individuals…If any civilization is to survive, it is the morality of altruism that men have to reject.”

Post-Ayn-Rand, in the growing era of neoliberalism, with Ronald Reagan blurting “government is the problem” and Margaret Thatcher proclaiming “There is no such thing as society,” once-respected institutions like public education and public transportation were demonized as “socialist” and “Soviet-style.” The message has been repeated so often by the business-backed media that the general public began to believe it. Said The Economist with regard to product development, “Governments have always been lousy at picking winners, and they are likely to become more so, as legions of entrepreneurs and tinkerers swap designs online, turn them into products at home and market them globally from a garage. As the revolution rages, governments should stick to the basics…Leave the rest to the revolutionaries.”

But as Mariana Mazzucato points out in The Entrepreneurial State, “In reality it is the State that has been engaged on a massive scale in entrepreneurial risk taking to spur innovation.” There is much evidence for this, in a multitude of disciplines, especially in technology and pharmaceuticals, both of which have seen corporate research labs diminishing if not entirely disappearing.

In the burgeoning new field of nanotechnology, says Mazzucato, industry cannot justify applications that require 10 to 20 years of development and which demand a coordination of physics, chemistry, biology, medicine, engineering, and computer science.

2. Insist that the Removal of Government Will Benefit All People

The removal of government is equated to a vague demand for “freedom” which is hyperbolic if not meaningless. It gained momentum with Milton Friedman, who said: “Underlying most arguments against the free market is a lack of belief in freedom itself.” The Cato Institute went on to preach that “Free markets create a future promoting integrity and trust.” And Forbes Magazine founder Steve Forbes blustered: “You can’t create prosperity without freedom!”

Despite the fact that this ‘freedom’ has generated the greatest inequality in nearly 100 years, apologists try to convince us that somehow we’re all prospering. From the Wall Street Journal: The U.S. economy is on a tear. From a Moody’s analyst: Our economy is firing on most cylinders.

Some libertarian “lovers of freedom” go to even greater extremes to defend the benefits of inequality for all of us, claiming that income inequality is Good For The Poor, and even that “Income inequality in a capitalist system is truly beautiful.”

3. Ensure that Government Isn’t Removed Until You Get Rich

As the well-to-do have complained about government, they’ve also made sure that government has continued to help them, with a mind-boggling array of deductions, exemptions, exclusions, and loopholes.

At least $2.2 trillion per year in tax expenditures, tax underpayments, tax havens, and corporate nonpayment go mostly to the very rich, the most brazen of whom make the astonishing claim that their hedge fund income should be taxed at a much lower rate than a teacher’s income.

Their tax breaks are augmented by the payroll tax rate limit, which allows multi-millionaires to pay a tiny percentage compared to middle-income earners; by high-risk derivatives that are the first to be paid off in a bank collapse; and by a bankruptcy law that allows businesses, but not students, to get out of debt.

4. Defund Government Until Privatization Seems Like the Only Option

This has happened most notably in education, with a simple formula, according to The Nation: “Use standardized tests to declare dozens of poor schools ‘persistently failing’; put these under the control of a special unelected authority; and then have that authority replace the public schools with charters.” And, of course, cut funding. According to the Center on Budget and Policy Priorities, forty-eight states — all except Alaska and North Dakota — were spending less per student in 2014 than they did before the recession.

It’s happening to Social Security, perhaps the most efficiently run system, public or private, in our nation’s history. As Richard Eskow notes, “Congress has cut 14 out of the last 16 SSA budget requests. There’s only one rational explanation for that: a hostility toward government itself, combined with the determination to place more public resources in corporate hands through ‘privatization.’”

It’s happening to police forces, which are going private in neighborhoods and on corporate campuses as public money is disappearing.

5. Remain Ignorant of Any Troublesome Facts

Facts abound of failing private systems, including:

Education: A private system that pays a charter CEO 350 times more per student than the corresponding public school chancellor.

Health Care: The most expensive system in the developed world, with the price of common surgeries anywhere from three to ten times higher than in much of Europe, and with 43 percent of sick Americans skipping doctor’s visits and/or medication purchases in 2011 because of excessive costs. Medicare, on the other hand, which is largely without the profit motive and the competing sources of billing, is efficiently run, for all eligible Americans.

Banking: Thanks to private banks, interest claims one out of every three dollars that we spend, and by the time we retire with a 401(k), nearly half of our money is lost to the banks. But the public bank of North Dakota (BND) had an equity return of 23.4% before the state’s oil boom. The normally privatization-minded Wall Street Journal admits that the BND “is more profitable than Goldman Sachs Group Inc., has a better credit rating than J.P. Morgan Chase & Co. and hasn’t seen profit growth drop since 2003.”

Law Enforcement: As public money for police protection is depleted, our communities are being subjected to law enforcement officers who are insufficiently trained, poorly regulated, and often unaccountable to the public for their actions.

Water Management: A water security expert suggested that “One promising solution is to create water markets that allow people to buy and sell rights to use water.” But a 2009 analysis of water and sewer utilities by Food and Water Watch found that private companies charge up to 80 percent more for water and 100 percent more for sewer services.

The Environment: According to former World Bank Chief Economist Nicholas Stern, climate change is “the greatest market failure the world has seen.” Yet Bloomberg reports that “Wall Street firms are investing in businesses that will profit as the planet gets hotter.”

Government Itself: In a study of outsourcing, the Project on Government Oversight found that in 33 out of 35 cases “the average annual contractor billing rate was much more than the average annual full compensation for federal employees.”

Great Individuals Emerge from Cooperative Efforts

Privatization is closely connected to the demand for individualism over cooperation. But the belief that self-centeredness will benefit everyone is backwards. As George Lakoff summarizes: “The Public provides freedom…Individualism begins after the roads are built, after individualists have had an education, after medical research has cured their diseases…”

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Paul Buchheit is a college teacher, an active member of US Uncut Chicago, founder and developer of social justice and educational websites (UsAgainstGreed.org, PayUpNow.org, RappingHistory.org), and the editor and main author of “American Wars: Illusions and Realities” (Clarity Press). He can be reached at paul@UsAgainstGreed.org.