What would single payer health care look like in the US?

You might think it's not possible but I'm here to tell you that it is.  It's just not possible as the thing you are thinking about. Instead it's this. 

The fragmentation of American health care has kept Big Data from being fully harnessed as it is in other industries, like online commerce. But Optum’s acquisition of Change heralds the end of that status quo and the emergence of a new “Big Tech” of health care. With the Change data, Optum/UnitedHealth will own the data, providers, and the network through which people receive care. It’s not a stretch to see an analogy to Amazon, and how that corporation uses data from its platform to undercut third parties while keeping all its consumers in a panopticon of data.

The next step is up to the Department of Justice, which has jurisdiction over the acquisition (through an informal agreement, the DOJ monitors health insurance and other industries, while the FTC handles hospital mergers, pharmaceuticals, and more). The longer the review takes, the more likely it is that the public starts to realize that, as Dartmouth health policy professor Dr. Elliott Fisher said, “the harms are likely to outweigh the benefits.”

It's not politically possible to get the benevolent One Giant Public Health Behemoth controlling costs and care on behalf of patients.  So we will have to settle for the One Giant Private Health Behemoth controlling everything on behalf of executive profits. But at least it will be a "market-driven" solution that gets us there so it must be good. 

And there is the catch

Sorry to say this but the only reason anyone with any power can even imagine taking the Claiborne Expressway down now is the same reason it was erected in the first place. It is because we have reached a point in the cycle where tearing it down can and will benefit wealth.  This is going to be the same point I made ten years ago when the gentrification taking place in Treme first set the planners' sights on gussying up the convenient real estate they had buried under that bridge decades before.  But taking down the expressway, in and of itself is not going to magically restore the neighborhood that was broken apart by its construction. 

The 20th Century was a long time ago.  Other things are happening now and they are not great things for poor and working class people in cities. The political game now is all about moving those people out of the way, isolating them in far flung suburbs, and even taxing them if they try to drive back.  The cities (and especially this city) aren't for poor people anymore. Instead they (especially this one) are playgrounds for rich people and tourists where nobody actually lives. All of the planning and policy decisions made now are intentionally meant to facilitate this.  

For years the Claiborne overpass was a public health and "quality of life" detriment to poor people living near it. Nobody who could do anything about that cared.  But now it is in the way of real estate development so it's apparently time to take that problem seriously. 

Anyway, the Washington Post got in touch with Amy Stelly to for its story on the infrastructure bill that might fund the highway's removal. She's obviously very much aware of the problem.

While activists’ goal, in many cases, is to remove a highway, they say they also want communities most harmed by their construction to enjoy the benefits as their neighborhoods become more desirable. That could mean help for renters to buy their homes or property tax advantages.

“We can’t remove highways in neighborhoods that would otherwise have been very desirable and leave it to the real estate market to govern,” Stelly said. “The people of Tremé should have the right to return when it’s beautiful.”

And, well, that's the catch, isn't it. 

 

Is anything frundamentally changed?

 Mr. Biden should tear down this wall.  Do you think he will even consider it?

With the border still closed for most migrants, a growing number who have no safe way to present their asylum claims have taken desperate and sometimes fatal measures, like climbing the border wall. To countless migrants escaping violence, economic and climate devastation (and in many cases trying to reunite with family and loved ones) the only feasible option for entering the U.S. is to risk injury and death.

That’s not a political mistake; it’s by design. Biden now joins a long tradition of presidents who’ve added to the immigration enforcement strategies of border militarization and prevention through deterrence. Right now, though, Biden must overturn the deadly policies that keep the border shut to asylum seekers. Until that happens, the human casualties of these policies, and in particular title 42, fall on the shoulders of this administration.

The thing about bosses is..

 The bosses always lie.

Rep. Mark Pocan replied via tweet: “Paying workers $15/hr doesn’t make you a progressive workplace when you union-bust & make workers urinate in water bottles,” echoing reports from 2018 that Amazon workers were forced to skip bathroom breaks and pee in bottles. Amazon’s denial was swift: “You don’t really believe the peeing in bottles thing, do you? If that were true, nobody would work for us.”

1/2 You don’t really believe the peeing in bottles thing, do you? If that were true, nobody would work for us. The truth is that we have over a million incredible employees around the world who are proud of what they do, and have great wages and health care from day one.

— Amazon News (@amazonnews) March 25, 2021

But Amazon workers with whom I spoke said that the practice was so widespread due to pressure to meet quotas that managers frequently referenced it during meetings and in formal policy documents and emails, which were provided to The Intercept. The practice, these documents show, was known to management, which identified it as a recurring infraction but did nothing to ease the pressure that caused it. In some cases, employees even defecated in bags.

And when they aren't lying about the problems they cause for their own workers, they are shaming the workers for them. 

An email that Brown received from her manager this past August has a section titled “Urine bottle” and states: “In the morning, you must check your van thoroughly for garbage and urine bottle. If you find urine bottle (s) please report to your lead, supporting staff or me. Vans will be inspected by Amazon during debrief, if urine bottle (s) are found, you will be issue an infraction tier 1 for immediate offboarding.”

While Amazon technically prohibits the practice — documents characterize it as a “Tier 1” infraction, which employees say can lead to termination — drivers said that this was disingenuous since they can’t meet their quotas otherwise. “They give us 30 minutes of paid breaks, but you will not finish your work if you take it, no matter how fast you are,” one Amazon delivery employee based in Massachusetts told me.

Asked if management eased up on the quotas in light of the practice, Brown said, “Not at all. In fact, over the course of my time there, our package and stop counts actually increased substantially.”

The Bessemer Amazon workers are currently voting to unionize. That election period ends on Monday. The US Senate is able to give American workers their best path to organizing they will have had in decades if it just passes the PRO Act.  They're close but...

With Democrats holding a slim majority in the Senate, passing the PRO Act would require reforming the filibuster, as the prospect of 10 Republican votes for labor reform is beyond a fantasy. The number of high-profile Democrats joining the push to reform the filibuster has steadily grown, with Biden and Sen. Joe Manchin, D-W.Va., endorsing unspecified changes to filibuster rules earlier this month.

The Democrats can choose to deliver this essential and potentially transformative piece of legislation which they claim to support.  But, you know, Democrats are a lot like bosses in certain regards so, stay tuned. 

The pump uprising

The pumps have had enough of our abuse and are starting to turn against us. 

Part of the West End area of Lakeview flooded Wednesday when a Sewerage & Water Board pump worked in reverse, sucking water from Lake Pontchartrain and pumping it into the streets of the residential area, according to our news partners at WWL-TV.

The pump was working in reverse for nearly an hour before it was fixed, WWL-TV reported, citing information from S&WB officials.

We always suspected this day would come.

Why lie when the facts are bad enough

Every year Joe Bouie tries to nudge us ever so slightly in the direction of untangling the corrupt nightmare system that runs our public schools "like a business."  Every year it fails.  No reason to stop trying, though. 

A state legislator who has a history of criticizing the way New Orleans schools are governed is pushing a bill in the upcoming session that would strip NOLA Public Schools Superintendent Henderson Lewis Jr. of his power to close or renew charter schools without an Orleans Parish School Board vote.

State Senator Joseph Bouie Jr. spoke briefly with board members during their meeting Tuesday about the bill, which he has prefiled for the 2021 legislative session beginning next month. Bouie’s bill aims to undo the charter school renewal system established by a state law passed in 2016 that brought the city’s charter schools — most of which had been overseen by the state-run Recovery School District after Hurricane Katrina — back under local control. 

That law, Act 91, gives near unilateral power to the superintendent to decide which nonprofit-run charter schools up for contract renewal with the district will remain open and which ones will close. Under the current system, the board can only overturn Lewis’ recommendation with a two-thirds supermajority vote within one month of a recommendation’s presentation. 

Bouie’s proposal would require board votes on all charter renewals.

One of the principal authors of Act 91 is congressional candidate Karen Carter Peterson who, over the weekend, (just barely) slipped into a runoff against Troy Carter.  During the primary, Carter tried to make hay out of Peterson's relationship with the charter school movement. Those links do exist and voters should consider them during the runoff.  They should also, consider, however, that Troy Carter also supported Act 91 and does not appear to have taken a stand against the charter movement that meaningfully distinguishes him from Peterson. 

On the other hand, at least his attack ad acknowledged the devastating effect the charter movement has had on teachers. Leaving aside the question of his sincerity about that, it matters that it's something Peterson does not talk about unless she is refuting an opponent's accusations. Which is what happens in this article. 

Only days before Saturday’s primary, Karen Carter Peterson is calling foul on Troy Carter for a television ad that slams her and her husband on education matters.

“Troy Carter’s latest attack is a lie,” Peterson, who like Carter is a state senator from New Orleans, said in a statement.

She is correct.  Carter's ad does lie. It cherry picks certain events and compresses their timeline to imply a stronger causal relationship than the viewer would otherwise infer. I'll try to summarize this as clearly as I can.  

In 2004 Peterson sponsored a bill called Act 193 which empowered the state controlled Recovery School District (RSD) to take over so-called failing schools in Orleans Parish. Shortly after Katrina, a second bill (Act 35) enabled the RSD to take all of the schools in Orleans Parish. Peterson voted against this bill. RSD took over 102 of 117 schools and immediately fired 7000 teachers and support staff. This move effectively destroyed the teachers union and gutted what most people considered a core piece of the city's Black middle class at a critical moment. Those teachers, their union, and in many ways the whole city has never really recovered from that. The state then re-made the New Orleans Public Schools according to an experimental model of privatized autonomous charters working with largely non-union labor (although a very small number of charter school staffs have since been organized.) In 2016, Act 91, again, authored by Peterson, returned this reconfigured system to local school board's nominal control but locked the RSD's changes into place.  

Carter's ad presents this story as 1) Peterson voted for Act 193 and then 2) All of the teachers were fired. Obviously that isn't how it happened. In between those events there was a hurricane, a flood, and a thorough takeover of the schools that Peterson voted against. However, it does not get her off the hook for writing and supporting Act 91 which we can see as a validation of all of those events after the fact. She is further implicated by the close involvement of her husband and brother-in-law in the leadership of RSD and Orleans charter schools during this period although Carter's ad also fudges the facts on this so as to make it appear even more sinister. 

Which, again, causes us to question Carter's integrity as much as Peterson's.  The facts are bad enough.  But Carter is as culpable as Peterson for much of the situation being what it is so he has to lie to make it sound even worse. 

Anyway, I'm not sure when Bouie's bill is due up in the session or if Senators Carter and Peterson will be available to vote on it when it does.  The legislative session begins on April 12 and the runoff election is April 24 so it's a real tight window. Which is a shame because we might miss a key moment of truth for both of them.

Ah they brought in a ringer

For those who were curious about what sort of gimmick could possibly breathe new life into the many-failures-over Six Flags redevelopment saga, well, here you go. 

Mayor LaToya Cantrell's administration announced that a partnership that included Brees was among the three finalists chosen to redevelop the derelict Six Flags site in New Orleans East, advancing a highly-anticipated effort to breathe life into the 227-acre park that has been abandoned for almost 16 years. 

After a selection committee scored six proposals based on developers' qualifications, financial resources and other factors, the highest scoring contender was a partnership between Kiernan West LLC of Colorado and S.H.I.E.L.D., a foundation launched by Brees, Saints linebacker Demario Davis and Buffalo Bills cornerback Joshua Norman.

That group wants to turn the park into multiple facilities, including an agriculture innovation center that helps young people learn about urban farming.

The actual developer is Kiernan-West which is a corporate real estate firm that has dotted the US map with logistics centers so we can logically conclude that is at least one of the "multiple facilities" in the proposal, if not the main one.  The rest of it is just branding.  And by that we mean they just grabbed a bunch of progressive-sounding twee business buzzwords and mashed them all into one thing for the professional athletes to pitch.

The nonprofit portion, managed by the SHIELD group, would include a facility for urban farming and aquaponics; a “discovery lab” that would provide science, technology, engineering, arts, and mathematics programming for New Orleans students; a natural healing center, and a food cultural center that would serve as a lecture hall for culinary arts education. The site would also feature a restaurant. 

Future development phases could include a ghost kitchen that would deliver meals to people in need, and a food truck park.

There are so many half-baked ideas going on there it literally reads as though it were being made up as it was dictated. Either that or they were just trying to make sure they hit whatever sweet spot the consultant's report laid out for them. 

A firm the city hired to study the best use for the park said in 2019 that it would work best as a transportation and distribution hub, though that team ended up recommending an “education destination” that could focus on themes such as resiliency and climate change, after talking with residents.

I'm glad they clarified which consultant's report we're working from here because there have been several.  This is the 2019 report by  TIP Strategies and Perkins & Will.  The purpose of glossy papers like this is always to give the developers a paint-by-number scheme for making their project appear to fit the needs of whatever community they are taking advantage of.   I'm disappointed to see that Brees's group did not throw a zipline in with their proposal as the consultants suggested.  But we got the healing center and that always seems to be the key. 

Anyway, between the pro athletes involvement and the jamming in of all the shiny objects, this seems like the proposal that is going to be selected.  And Brees sure does know how to spit out the jargon. 

“I am excited about the ability to present this transformational proposal to the city,” Brees said in a statement about the plan. “It is a vision that we have been working on for more than a year, actively looking for the right site and the right public/private Partnership to launch our non-profit concept. I believe this is it.”

If this means he and this giant real estate firm he's shilling for are going to get their hands on one cent of the city's stimulus allocation for any of this, then it's all the same to us if the whole site just sinks back into the swamp. 

On the other hand,  we do see Troy Henry involved with one of the competing groups so maybe let's wait and see. They're expecting to decide within in the next two or three months.