24 March 22
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The Biden administration is expanding Donald Trump’s Medicare privatization scheme that is forcing hundreds of thousands of seniors onto for-profit health plans.
The development represents a troubling new dimension in the fight by corporate interests to privatize Medicare, the federal health insurance program for people sixty-five or older. Medicare Advantage, which allows for-profit health insurers to offer privatized benefits through Medicare, already results in unexpected costs for routine procedures and wrongful denials of care. Private plans have cost Medicare an astonishing $143 billion since 2008, and are now driving some health insurers’ record profits.
The new Direct Contracting Entity (DCE) program similarly adds a private sector third party between patients and Medicare services. Medicare allows these intermediary companies to offer unique benefits, like gym membership coverage. But as for-profit operations ranging from private insurers to publicly traded companies to private equity firms, these intermediaries are incentivized to limit the care that patients receive, especially when they are very sick.
While Medicare Advantage patients choose to sign up for private insurance plans, patients are being enrolled in these DCE health care plans without their informed consent. As Representative Pramila Jayapal (D-WA) noted in a January op-ed, “Seniors in traditional Medicare may be ‘auto-aligned’ to a DCE if any primary care physician they’ve visited in the past two years is affiliated with that DCE. That means Medicare automatically searches two years of seniors’ claims history without their full consent to find any visits with a participating DCE provider as the basis for enrollment.”
Among those who unexpectedly found themselves caught up in one of these new DCE plans is Suzanne Gordon, a policy analyst based in Richmond, California. Gordon spent her entire professional career studying the US health care system and advocating for Medicare for All. As a firm opponent of privatization in Medicare, she has never signed up for a for-profit Medicare Advantage plan.
That’s why she was so surprised when she got an email in January from her doctor at One Medical, a for-profit primary care practice on the West Coast backed by the private equity giant Carlyle Group. While the email message wasn’t particularly clear, she eventually realized that she was being enrolled without her informed consent in a new private DCE plan run by Iora Health, a primary care provider One Medical purchased last year.
“I got the email, I clicked on it and began a signing process that didn’t tell me what I was signing,” said Gordon. “You sign, you click in, and they tell you that they want you to sign up for a DCE with Iora Health. I wrote back to my doc and said I won’t do this . . . I felt that a line had been crossed.”
Gordon, a health policy expert, was able to get out of the plan — but others have not been so lucky. Jayapal’s office told the Lever that three hundred fifty thousand seniors were in DCE plans as of January 2022 — none of whom elected to sign up voluntarily.
This latest Medicare privatization scheme was started under the leadership of a Trump official who has since launched his own “entrepreneurial firm focused on building and growing transformational health care companies,” with support from private equity firms. Now, the effort is quietly being expanded by the Biden administration through its new ACO REACH program, under the direction of two former Obama administration officials who have revolved between jobs in government and the corporate health care industry.
The development means that even more of the country’s most vulnerable will be at the mercy of corporate arbiters that they know little or nothing about.
“Seniors and people with disabilities are, without their consent or full knowledge, being put into a program that has as its center the profit of the investment community rather than the health of Medicare members,” said Ed Weisbart, a physician who chairs the Missouri chapter of Physicians for a National Health Program (PNHP), a doctors organization that advocates for single-payer health care. “The investment community has proven that they know how to work around the guardrails of any program that has been set up. They know how to do it.”
Privatizing Medicare
The DCE program was originally launched in April 2019 by Trump’s Centers for Medicare and Medicaid Services (CMS), under the auspices of the CMS Innovation Center, known as CMMI.
CMMI was created under President Barack Obama’s signature health care law, the Affordable Care Act (ACA), to pilot new payment models in Medicare and Medicaid without going through the formal rulemaking process that requires public comment. As a result, the new DCE program, which assigns seniors to a privatized model without their consent, has never been subject to any public scrutiny whatsoever.
“All that DCEs do is privatize traditional Medicare,” said Diane Archer, the CEO of Just Care USA, which works to fight Medicare privatization.
Meanwhile, Adam Boehler, who Trump tapped to run CMS’s Innovation Center, has since formed his own firm, Rubicon Founders. The firm’s website claims it will “architect transformational companies and are deliberate in creating the foundation necessary to lead an industry,” but provides few details on how it will do so. Rubicon did not respond to a request for comment.
Boehler’s firm launched with the backing of longtime private equity executive Annie Lamont, who is married to Connecticut governor Ned Lamont (D), as well as support from the health care–focused private equity firm Welsh, Carson, Anderson … Stowe (WCAS). WCAS is developing a series of primary care centers for Medicare Advantage patients with the help of Humana, a private health insurer that has also launched a DCE program.
For Archer, the evidence is clear: “Adam Boehler . . . launched this [DCE] program to enrich his friends in the private equity world.”
“We Needed to Make Sure That CMS Continues This Journey”
Late last month, critics of DCEs say the Biden administration effectively expanded the DCE effort under a new name — the “ACO REACH” program.
The new program — which stands for Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) Model — allows hospital-led managed care organizations to access the new Medicare privatization scheme, too. ACO REACH similarly assigns patients with little informed consent to for-profit plans that benefit health care profiteers and creates incentives to deny care.
The DCE and ACO REACH programs are being spearheaded in part by CMMI head Liz Fowler, a former Obama administration official who helped write Obama’s signature health care act as the chief health counsel to former US Senate Finance Committee chairman Max Baucus (D-MT). Earlier, she helped write the 2003 Medicare Prescription Drug, Improvement, and Modernization Act, legislation that barred the government from negotiating lower prescription drug prices.
Fowler served as vice president of public policy for the health insurer WellPoint, now part of Anthem, before moving to Baucus’s office. She later became a health care aide in the Obama administration, before spending nearly seven years as a vice president for pharmaceutical giant Johnson … Johnson.
Neither Anthem nor Johnson … Johnson are currently active in the DCE market. But considering other major insurers like Humana are pursuing DCE contracts, and that Anthem already offers Medicare Advantage plans, it is conceivable that these insurance giants could get into the business at some point in the future.
In a February 24 press call announcing ACO REACH, CMS administrator Jonathan Blum said that the Biden administration had always been committed to continuing with the DCE program.
“We want to make sure that we see these programs as continuing to grow . . . we have had many conversations with the public and with stakeholders that started with the new CMS team coming on board,” said Blum. “We have felt from the start that we needed to make sure that CMS continues this journey.”
Blum served as the deputy administrator and later principal deputy administrator of CMS under Obama, before joining CareFirst BlueCross BlueShield as an executive vice president, according to Legistorm.
Fowler and Blum’s boss, CMS administrator Chiquita Brooks-LaSure, is a former health care partner at Manatt, Phelps … Phillips, a lobbying firm that worked to launch Medicare Advantage plans as recently as 2020
Manatt, Phelps … Phillips also played an integral role in reducing fines for nursing home violations in California by as much as 99.9 percent in the middle of the COVID-19 pandemic.
The agency declined requests for comment.
A Dangerous New Stage of Medicare Privatization
Kip Sullivan, an attorney who is active with Physicians for a National Healthcare Program, said that the DCE program relies on ensuring that elderly or disabled patients don’t have an informed choice about enrolling in the private health care plans.
“Seniors have been swept into DCEs without their knowledge,” he said. “Many — probably most — beneficiaries are in traditional Medicare as opposed to Medicare Advantage because they did not want to be in a plan run by an insurer.”
Sullivan pointed out that the publicly traded DCEs, like Oak Street Health, brag in investor filings that between 13 and 30 percent of the money they get from Medicare goes into profits. By comparison, according to Sullivan, traditional Medicare plans have overhead of just 2 percent.
“When Medicare passed in 1965, there was never an intention to enrich the insurance industry,” he said. “But that’s exactly what’s happening.”
Weisbart, from the Missouri chapter of PNHP, is especially concerned that the Medicare and Medicaid agency “does not need to get congressional consent, discussion or approval for any of these programs. They’re able to do it on their own.”
Under Trump, the agency even issued a waiver that exempts DCE programs from anti-kickback rules that normally prohibit doctors from entering their patients into such for-profit plans. As a result, doctors can be compensated for involuntarily entering their patients into DCE programs.
In recent months, advocates have been waging a full-court campaign against the DCE scheme. In January, fifty-four members of the House submitted a letter voicing similar concerns to Health and Human Services secretary Xavier Becerra and CMS administrator Brooks-LaSure.
What, then, explains the Biden administration’s recent decision to expand the program?
As always in our campaign finance system, money could play a role. In 2020, the leadership of DCE contractor Clover Health donated $500,000 to the main super PAC for Senate Democrats, while the company’s financier Chamath Palihapitiya donated $750,000 to the same super PAC plus $250,000 to the Biden Victory Fund.
One Medical — which employed Suzanne Gordon’s doctor and owns Iora Health, the company that tried to enroll her in a DCE — is backed by the Carlyle Group, a prodigious donor to both parties. Biden enjoyed Thanksgiving dinner last year at the $30 million Nantucket home of Carlyle cofounder David Rubenstein.
Bill Kadereit, the president of the National Retiree Legislative Network, said that the DCE program could usher in a dangerous new stage of Medicare privatization.
“Medicare Advantage plans have failed,” he said. “Privatization has failed. The cost of Medicare is doubling every ten years because of the health care sector campaign contributions. We’re seeing the disassembly and destruction of our precious public health system. Every place where the profiteers have stepped in costs have gone up and health outcomes have gone down.”
Hundreds of people fleeing the Russian invasion of Ukraine arrive in Przemysl, Poland, by train, 1 March 2022. (photo: Bruno Thevenin/Shutterstock)
The president is opening avenues for those displaced by war to enter the country. But he’s not considering any major evacuation efforts.
But refugee resettlement organizations, advocates and Democratic lawmakers — all of whom urged the White House to take such swift action — say that the steps being outlined are a start but don’t go far enough in certain cases.
At issue is the resolution of one of the worst humanitarian crises on the European continent since World War II. Roughly 3 million Ukrainians have fled across the border since Russia launched an attack on their country last month, with uncertain futures ahead.
The advocacy community is urging Biden to use this moment to not only demonstrate that the U.S. will share in the responsibility of welcoming those Ukrainians but make good on promises his administration made during its first months in office to rebuild a system dismantled by the prior president and lead in addressing the global refugee crisis.
Some 7,000 or more Ukrainians are already seeking relocation through family reunification or as a persecuted minority through the Lautenberg Amendment, according to resettlement agency estimates. In addition to expediting those cases, advocates are pressing the White House to commit to resettling more Ukrainians.
So far, the White House is looking to expedite Ukrainians seeking reunification with family in the U.S., and faster processing of vulnerable individuals, like LGBTQ people, journalists, dissidents and activists, according to three sources familiar with the conversations. Reuters first reported the new steps to ease the process for Ukrainian refugees.
The administration hasn’t yet given a number for how many refugees would be brought into the U.S. under the new actions. National Security Council staff and other administration officials that met this week with refugee resettlement organizations have not responded to those groups’ recommendations to aid Russians fleeing as a result of their country’s invasion of Ukraine. Sources familiar with the White House’s thinking have also said they are not currently considering any major evacuation efforts, such as airlifts, and are evaluating better ways to utilize the humanitarian parole system to allow for temporary relocation to the U.S.
“This is an emergency situation,” said Rep. Bill Pascrell (D-N.J.), who sent a letter to Biden earlier this month calling for a significant increase in the number of refugees admitted to the U.S. “We’re not doing a very good job. Let’s cut to the chase here and get something done.”
Pascrell said Biden appeared to be moving in the right direction and said he believes the president is genuinely interested in helping Ukrainians fleeing for their lives. But Pascrell wants to see expedited processing of cases deliver real results by the beginning of April.
“If it’s just talk and a photo-op, it doesn’t mean a damn thing,” Pascrell said. “If I don’t think he’s moving fast enough I’m gonna tell some people.”
Krish O’Mara Vignarajah, president of Lutheran Immigration Refugee Service said expediting family reunification applications and ensuring refugees are able to finalize processing after they’re on the U.S. shore is “an important first step.”
“But this is a system that was forged in the crucible of the Cold War and needs to be deployed to welcome refugees fleeing Ukraine,” said Vignarajah.
The White House has maintained that most Ukrainians want to remain in European countries in the hopes of eventually returning to their home country. The administration also says that they are helping allied countries with humanitarian assistance to care for Ukrainians who have fled.
For refugee advocates, Biden’s visit to Poland — which has welcomed some 2 million Ukrainian refugees to date — presents an opportunity for the administration to not just address the situation in Ukraine but refugee, migration and immigration policy holistically. Among the policies they’d like to see include fully revoking the Trump-era public health order known as Title 42, that is still being used to expel most migrants and asylum seekers at the border; ramping up refugee intake of vulnerable populations from other parts of the world; granting temporary protective status to more than Ukrainians and Afghans; and clarifying how the U.S. will welcome Russians seeking asylum.
Noah Gottschalk, global policy lead at Oxfam America, and other advocates are quick to acknowledge that the refugee and immigration systems were gutted under the Trump administration. But they say the Biden administration is falling short in rebuilding them.
“The U.S. has the capacity to handle both refugees coming from abroad as well as people through the resettlement program, as well as people coming at the U.S.-Mexico border,” said Gottschalk. “As we’re seeing literally millions of refugees crossing into Central European countries, the U.S. has accepted [some] 7,000 refugees from abroad and is turning away most refugees at the border. We’re punching well below our weight.”
“I just don’t think it’s in the top 20 priorities of the Biden administration and that it shows,” Gottschalk continued.
As of March 22, the U.S. has taken in 7,888 refugees for fiscal year 2022, according to the State Department. Biden set the annual refugee cap at 125,000 last year after backlash from within his own party when he set a lower cap initially. Separately, more than 76,000 Afghan nationals who have arrived through Operation Allies Welcome have now joined their new communities across the United States, according to the Department of Homeland Security. A majority of those Afghans received parole for humanitarian reasons — an avenue that the White House is considering for Ukrainians as well.
Mark Hetfield, president of HIAS, a Jewish American nonprofit that resettles refugees, said he wants the administration to welcome tens of thousands of Ukrainians, referencing the Clinton administration’s effort to take in 20,000 Kosovo refugees in 1999.
“The refugee program was created in 1980 to respond to emergency situations specifically so we wouldn’t have to use humanitarian parole anymore,” said Hetfield. “It’s become such a slow moving program, that it’s like an ambulance that moves at a glacial pace.”
The Refugee Resettlement Act gives Biden all the authority he needs, Hetfield said, to relocate Ukrainians and finish their processing in the United States. “And yet, no administration since the Clinton administration has used it for its original purpose. So I’m really hoping that changes for everybody, not just Ukrainians.”
Despite promising to overhaul an immigration system largely dismantled by his predecessor, increased migrants and vulnerable populations fleeing violence at the border have been met with high expulsions by the Biden administration through use of the Title 42 order. The White House has struggled to combat Republican attacks on their immigration policies and to the dismay of Democrats has shied away from promises to make the system more open and humane.
Republicans have opposed Biden’s efforts to provide undocumented immigrants a pathway to citizenship and are eager to capitalize politically on any crowding at the southern border. Democrats, meanwhile, have pleaded with the White House to welcome as many refugees as possible and make good on citizenship promises for so-called Dreamers, citing polling that it would motivate base voters. During his State of the Union, Biden said the U.S. must “secure our border and fix the immigration system” but devoted less time to the issue than progressives had hoped.
“This administration is scared to death of immigration issues,” said Hetfield.
A White House official did not preview any of the administration’s actions but pointed to comments made by White House press secretary Jen Psaki, who said the White House was in talks with the European Union and the U.N. Refugee Agency about Ukrainian nationals who may not be able to remain safely in Europe.
“[President Biden] will announce further American contributions to a coordinated humanitarian response to ease the suffering of civilians inside Ukraine and to respond to the growing flow of refugees,” national security adviser Jake Sullivan said Tuesday.
Jenny Yang, senior vice president of advocacy and policy at World Relief, credited the White House for engaging on expedited processing options early on in the Ukraine conflict, calling it an “encouraging sign.” But she said streamlined refugee and humanitarian parole processes need “to benefit a broader population than just Ukrainians and Afghans.”
In particular, Yang took issue with a Title 42 exemption being allowed only for Ukrainians. “The fact that they’ve exempted Ukrainians only — when the whole policy is wrongheaded — is another indication that they’re not pursuing equitable protection policies,” said Yang.
A White House official said the Center for Disease Control and Prevention’s Title 42 public health order remains in place for single adults and family units. Exemptions under the order are granted to particularly vulnerable individuals for humanitarian reasons and are made on a case-by-case basis, the official said, adding that the White House would continue to defer to the CDC on how long the order will be in place.
Though advocates support resettling as many Ukrainians as possible, they fear the exemptions provided to them are creating a two-tiered system for people fleeing violence in their home countries.
“Ukrainian refugees absolutely deserve protection,” said Gottschalk. “But [the White House is] basically creating a loophole for them by doing this while leaving mostly black and brown refugees out in the cold.”
'Today, as humanity confronts a looming climate catastrophe, what's needed is a new political-economic project.' (photo: Getty)
It’s always wonderful when, for a contribution to this website of at least $100 ($150 if you live outside the U.S.), I can offer you a personalized, signed copy of a must-read new book. In this case, I’m talking about TomDispatch regular Avi Chomsky’s soon to be published Is Science Enough? Forty Critical Questions About Climate Justice. Of it, TomDispatch contributor Stan Cox, author of The Green New Deal and Beyond, has written: “When reading books or articles purporting to address the climate emergency, I typically find plenty to disagree with. But reading Aviva Chomsky’s Is Science Enough?, I found myself nodding my head all the way through. Dr. Chomsky asks all of the most crucial questions and answers each in clear-eyed, logical, fearless, plain-spoken prose… Every climate bookshelf should include Is Science Enough? in a prime spot.” To contribute much-needed funds to this website and be the first on your block to get a copy of Chomsky’s signed, personalized new book, just check out our donation page. And my thanks in advance to all of you who do! Tom]
Recently, making my way through the New York Times — and yes, at 77 and a creature of habit, I still read its paper version — I found two articles of special interest to me, one above the other, on page 17. These days, I hardly need to say that the front page (and its online equivalent) remains a riot of Ukraine news. That day, four major Ukraine stories were piled atop one another there (plus grim photos) with the overarching headline being: “Survivors Found in Theater Rubble, but Suffering Widens.”
There can be no doubt that the ongoing disaster in Europe and Russia remains a story of major and developing, even world endangering, significance. Still, I wondered whether there shouldn’t also have been a place somewhere far more obvious for those two buried stories on page 17. The smaller one at page bottom was headlined, “Drought Conditions Expected to Worsen, and Spread Farther, Through the Spring.” Just 12 modest paragraphs, it offered the latest news on the climate-change-induced megadrought, the worst in 1,200 years, that’s now struck much of the western half of this country and shows no sign of letting up soon on this ever hotter, more disturbed planet of ours. Above it, taking up a significant part of the page, was a story headlined “Largest Federal Utility Chooses Gas, Undermining Biden’s Climate Goals.” Oh, and like the Postal Service, led by a Trump appointee, that now plans to spend $6 billion purchasing 165,000 new gasoline-powered mail trucks, the Tennessee Valley Authority’s board is “dominated by members nominated by former President Donald J. Trump, who frequently mocked climate science and was an ally of the fossil fuel industry.”
At the heart of both those stories lies a human inability at least as devastating as the one in Ukraine to deal with a peril of world-endangering significance. It seems to me that it should now be eternally in our sight lines, but anyone who watches TV news or checks out major mainstream websites knows that it seldom is. Yes, we can live 24/7 with horrifying news of the developing disaster that is Ukraine, but not the one that increasingly is our entire planet.
As you may have noticed, however, TomDispatch does consider the climate emergency an ongoing top-of-the-news story, not just a page 17 item, which is why today it’s publishing the latest piece by TomDispatch regular Aviva Chomsky, author of the new book Is Science Enough? Forty Critical Questions About Climate Justice, who focuses on the way the very organization of this planet in terms of our well-being or lack of it (think, for instance, about the 700 American billionaires whose wealth only grew by $1.7 trillion in the pandemic years) has helped heat this planet to what increasingly looks like the boiling point. Then think with Chomsky about just how this world of ours is organized at present. Believe me, it’s a headline story or at least it should be.
-Tom Engelhardt, TomDispatch
“We have about 50% of the world’s wealth, but only 6.3% of its population. In this situation, we cannot fail to be the object of envy and resentment. Our real task in the coming period is to devise a pattern of relationships which will permit us to maintain this position of disparity without positive detriment to our national security.”
That, in a nutshell, was the postwar version of U.S. exceptionalism and Washington was then planning to manage the world in such a way as to maintain that remarkably grotesque disparity. The only obstacle Kennan saw was poor people demanding a share of the wealth.
Today, as humanity confronts a looming climate catastrophe, what’s needed is a new political-economic project. Its aim would be to replace such exceptionalism and the hoarding of the earth’s resources with what’s been called “a good life for all within planetary boundaries.”
Back in 1948, few if any here were thinking about the environmental effects of the over-consumption of available resources. Yet even then, however unknown, this country’s growing wealth had a dark underside: the slow-brewing crisis of climate change. Wealth all too literally meant the intensified extraction of resources and the production of goods. As it happened, fossil fuels (and the greenhouse gases that went with their burning) were essential to every step in the process.
Today, the situation has shifted — at least a bit. With approximately 4% of the world’s population, the United States still holds about 30% of its wealth, while its commitment to over-consumption and maintaining global dominance remains remarkably unshaken. To grasp that, all you have to do is consider the Biden White House’s recent Indo-Pacific Strategy policy brief, which begins in this telling way: “The United States is an Indo-Pacific power.” Indeed.
In 2022, the relationship between wealth, emissions, and climate catastrophe has become ever clearer. In the crucial years between 1990 and 2015, the global economy expanded from $47 trillion to $108 trillion. During that same period, global annual greenhouse-gas emissions grew by more than 60%. Mind you, 1990 was the year in which atmospheric levels of carbon dioxide (CO2) first surpassed what many scientists believed was the level of safety — 350 parts per million, or ppm. Yet in the 22 years since then, more CO2 and other greenhouse gases have been emitted into the atmosphere than in all of history prior to that date, as atmospheric CO2 careened past 400 ppm in 2016 with 420 ppm now fast approaching.
Inequality and Emissions
Growing global wealth is closely associated with growing emissions. But the wealth and responsibility for those emissions are not shared equally among the planet’s population. On an individual level, the wealthiest people on Earth consume — and emit — far more than their poorer counterparts. The richest 10% of the world’s population, or about 630 million people, were responsible for more than half of the increase in greenhouse-gas emissions over the last quarter-century. On a national level, rich countries are, of course, home to far more people with high levels of consumption, which means that the larger and wealthier the country, the greater its emissions.
In terms of per capita income, the United States ranks 13th in the world. But the countries above it on the list are mostly tiny, including some of the Persian Gulf states, Ireland, Luxembourg, Singapore, and Switzerland. So, despite their high per-capita emissions, their overall contribution isn’t that big. As the third largest country on this planet, our soaring per-capita emissions have, on the other hand, had a devastating effect.
With a population of around 330 million, the United States today has less than a quarter of either China’s population of more than 1.4 billion or India’s, which is just under that figure. Four other countries — Brazil, Indonesia, Nigeria, and Pakistan — fall into the population range of 200 to 300 million, but their per-capita gross domestic products (GDPs) and their per-capita emissions are far below ours. In fact, the total U.S. GDP of more than $19 trillion far exceeds that of any other country, followed by China at $12 trillion and Japan at $5 trillion.
In sum, the United States is exceptional when it comes to both its size and wealth. I’m sure you won’t be surprised to learn then that, until 2006, it was also by far the world’s top CO2 emitter. After that, it was surpassed by a fast-developing China (though that country’s per capita emissions remain less than half of ours) and no other country’s greenhouse gas emissions come close to either of those two.
To fully understand different countries’ responsibility, it’s necessary to go past yearly numbers and look at how much they’ve emitted over time, since the greenhouse gases we put in the atmosphere don’t disappear at the end of the year. Here again, one country stands out above all the others: the United States, whose cumulative emissions reached 416 billion tons by the end of 2020. China’s, which didn’t start rising rapidly until the 1980s, reached 235 billion tons in that year, while India trailed at 54 billion.
Having first hit 20 billion tons in 1910, U.S. cumulative emissions have only shot up ever since, while China’s didn’t hit that 20 billion mark until 1979. So the U.S. got a big head start and, cumulatively speaking, is still way ahead when it comes to taking down this planet.
The U.S. Climate Action Network (USCAN) argues that excessive emitters like the United States have already used up far more than their “fair share” of this planet’s carbon budget and so, in fact, owe a huge carbon debt to the rest of the world to make up for their outsized contribution to the problem of climate change over the past two centuries. Unfortunately, the 2015 Paris Agreement’s voluntary, non-enforceable, and nationally determined limits on emissions functionally let rich countries continue on their damaging ways.
In fact, nations should be held responsible for repaying their carbon debt. The world’s poorest people, who have contributed practically nothing to the problem, deserve access to a portion of the remaining budget and to the sort of aid that would enable them to develop alternative forms of energy to meet their basic needs.
Under the fair-share proposal, it’s not enough for the United States just to stop adding emissions. This country needs to repay the climate debt it’s already incurred. USCAN calculates that to pay back its fair share the United States must cut its emissions by 70% by 2030, while contributing the cash equivalent of another 125% of its current emissions every year through technical and financial support to energy-poor nations.
Bernie Sanders’s Green New Deal proposal adopted the concept of the “fair share.” True leadership in the global climate fight, Sanders has argued, means recognizing that “the United States has for over a century spewed carbon pollution emissions into the atmosphere in order to gain economic standing in the world. Therefore, we have an outsized obligation to help less industrialized nations meet their targets while improving quality of life.”
On this subject, however, his voice and others like it sadly remain far outside the all-too-right-wing mainstream. (And if you doubt that, just check Joe Manchin’s recent voting record.)
Are We Making Progress Thanks to New Technologies?
In 2018, the U.N.’s Intergovernmental Panel on Climate Change (IPCC) issued a special report on our chances of limiting global warming to 1.5 degrees centigrade — the goal that the countries involved in the Paris Agreement, including the United States, accepted as their baseline for action. It concluded that, to have a 50% chance of staying below that temperature increase, our future collective emissions couldn’t exceed 480 gigatons (or 480 billion tons). That, in other words, was humanity’s remaining carbon budget.
Unfortunately, as of 2018, global emissions were exceeding 40 gigatons a year, which meant that even if they were flattened almost immediately (not exactly a likelihood), we would use up that budget in a mere dozen years or so. Worse yet, despite a Covid-induced decline in 2020, global emissions actually rebounded sharply in 2021.
Most scenarios for emission reductions, including those proposed by the IPCC, rely optimistically on new technologies to enable us to get there without making substantive changes in the global economy or in the excessive consumption of the world’s richest people and countries. Such technological advances, it’s hoped, would allow us to produce as much, or possibly more energy from renewable sources and even possibly begin removing CO2 from the atmosphere.
Unfortunately, there’s little evidence to support the likelihood of such progress, especially in the time we have left. No matter how much new technology we develop, there seems to be no completely “clean” form of energy. All of them — nuclear, wind, solar, hydropower, geothermal, biomass, and perhaps others still to be developed — rely on massive industrial operations to extract finite resources from the earth; factories to process them; facilities to create, store, and transmit energy; and, in the end, some form of waste (think batteries, solar panels, old electric cars, and so on). Every form of energy will have multiple dangerous environmental impacts. Meanwhile, as the use of alternative forms of energy production increases worldwide, it hasn’t yet reduced fossil-fuel use. Instead, it’s just added to our growing energy consumption.
It’s true that the world’s wealthiest countries have achieved some gains in decoupling economic growth from rising emissions. But much of this relatively minor decoupling is attributable to a shift from the use of coal to natural gas, along with the outsourcing of particularly dirty industries. Decoupling has, as yet, made no dent in global greenhouse gas emissions and seems unlikely to accelerate or even continue at a meaningful enough pace after these first and easiest steps have been taken. So almost all climate modeling, like that of the IPCC, suggests that new technologies to remove CO2 from the atmosphere will also be needed to counter rising emissions.
But negative emissions technologies are largely aspirational at this point. Instead of counting on what still to a significant extent remain technological fantasies, while the wealthy continue their profligacy, it’s time to shift our thinking more radically and focus, as I do in my new book Is Science Enough? Forty Critical Questions About Climate Justice, on how to reduce extraction, production, and consumption in far more socially just ways, so that we can indeed begin to live within our planet’s means. Call it “post-growth” or “degrowth” thinking.
Make no mistake: we can’t live without energy and we desperately do need to turn to alternatives to fossil fuels. But alternative energies are only going to be truly viable if we can also greatly reduce our energy needs, which means reconfiguring the global economy. If energy is a scarce and precious resource, then ways must be found to prioritize its use to meet the urgent needs of the world’s poor, rather than endlessly expanding the luxuries of the wealthiest among us. And that’s precisely what degrowth thinking is all about: scaling back the mindless pursuit of production, consumption, and profit in favor of “human wellbeing and ecological stability.”
Abandoning Exceptionalism
In April 2021, President Biden made a dramatic announcement, setting a new goal for U.S. greenhouse-gas emissions — to reduce them 50% from 2005 levels by 2030 and reach net-zero by 2050. Sounds pretty good, right?
But given that this country’s CO2 emissions had hit a high of 6.13 billion tons in 2005, that means by 2030 we’d still be emitting three billion tons of CO2 a year. Even if we could reach net-zero by 2050, our country alone would, by then, have used up one quarter of the entire remaining carbon budget for the planet. And right now, given the state of the American political system, there’s neither a genuine plan nor an obvious way to reach Biden’s goal. If we stay on our current path — and don’t count on that if the Republicans take Congress in 2022 and the White House again in 2024 — we would barely achieve a 30% reduction by 2030.
At this point, there’s no guarantee we’ll stay on that path, no matter the political party in power. After all, consider just this:
- In 2010, about half of the new vehicles sold in the United States were cars and half were SUVs or trucks. By 2021, close to 80% were SUVs or trucks.
- In 2020, more than 900,000 new houses were built in this country, their median size, 2,261 square feet. Most of them had four or more bedrooms and 870,000 had central air conditioning.
- President Biden’s infrastructure bill, signed in November 2021, included $763 billion for new highways.
And let’s not even talk about the military-industrial-congressional complex and war. After all, the Department of Defense is the single largest institutional consumer of fossil fuels and emitter of CO2 in the world. Between its worldwide bases, promotion of the arms industry, and ongoing global wars, our military alone produces annual emissions greater than those of wealthy countries like Sweden and Denmark.
Meanwhile, in the run-up to the climate-change meeting in Glasgow, Scotland, in the fall of 2021, Special Presidential Envoy for Climate John Kerry insisted repeatedly that the United States must work to bring China on board. Joe Biden too kept his attention focused on China. And indeed, given its greenhouse gas emissions and still-expanding use of coal, China does have a big role to play. But to the rest of the world, such an insistence on diverting attention from our own role in the climate crisis rings hollow indeed.
A 2021 study shows that almost all of the world’s remaining coal, not to speak of most of its gas and oil reserves, will need to stay in the ground if global warming is to be kept below 1.5 degrees centigrade. Back in 2018, another study found that even to meet a 2-degree centigrade goal, which it’s now all too clear would be catastrophic in climate-change terms, humanity would have to halt all new fossil-fuel-based infrastructure and immediately start decommissioning fossil-fuel-burning plants. Instead, such new facilities continue to be built in a relentless fashion globally. Unless the United States, which bears by far the greatest responsibility for our climate emergency, is ready to radically change course, how can it demand that others do so?
But to change course would mean to abandon exceptionalism.
Degrowth scholars argue that, rather than risking all of our futures on as-yet-unproven technologies in order to cling to economic growth, we should seek social and political solutions that would involve redistributing the planet’s wealth, its scarce resources, and its carbon budget in ways that prioritize basic needs and social wellbeing globally.
That, however, would require the United States to acknowledge the dark side of its exceptionalism and agree to relinquish it, something that, in March 2022, still seems highly unlikely.
Follow TomDispatch on Twitter and join us on Facebook. Check out the newest Dispatch Books, John Feffer’s new dystopian novel, Songlands (the final one in his Splinterlands series), Beverly Gologorsky’s novel Every Body Has a Story, and Tom Engelhardt’s A Nation Unmade by War, as well as Alfred McCoy’s In the Shadows of the American Century: The Rise and Decline of U.S. Global Power and John Dower’s The Violent American Century: War and Terror Since World War II.
Aviva Chomsky, a TomDispatch regular, is professor of history and coordinator of Latin American studies at Salem State University in Massachusetts. Her latest book, Is Science Enough? Forty Critical Questions about Climate Justice, is just about to be published.
Pittsburgh Mayor Ed Gainey announced the five officers involved in the death of Jim Rogers, 54, have been terminated. (photo: Andrew Rush/AP)
The officers have the option to retire and three of them will be allowed to work but require retraining.
Rogers, who was a suspect in the theft of a bicycle, died while in custody of Pittsburgh Bureau of Police October 13. According to CNN’s report, police said they used a Taser on Rogers because he was not “complying with their orders.” Rogers was tased 10 times resulting in him being taken to Mercy Hospital where he died the next day.
The medical examiner ruled his death as an accident due to lack of oxygen to the brain, per WTAE.
From CNN:
The five officers, who were not identified, have 14 days to challenge the firings in arbitration, Public Safety Director Lee Schmidt said at a news conference with Mayor Ed Gainey. The officers will have the option to retire. Three other officers will be allowed to keep their jobs but, according to CNN affiliate KDKA-TV, they will have to be retrained.
Eight officers, including two supervisors, were suspended with pay after the incident, CNN affiliate KDKA-TV reported.
The internal review board found “a series of procedural failures” contributed to Roger’s death, reported CNN. The Allegheny County grand jury is deciding whether the eight officers involved could face criminal charges.
An internal Critical Incident Review Board examined the incident and the police bureau’s trainings and recommended a supervisor be present during a use of force situation and that an EMS be allowed to assess patients after the use of Tasers, per CNN.
“Mr. Rogers deserved to live ... a long life. And he didn’t deserve to lose his life at the hands of police officers. What his life could have been will stay with me for as long as I am the mayor of this city,” said Gainey via CNN.
Alex Jones, host of Infowars, is pictured on Capitol Hill in Washington in September 2018. (photo: Jose Luis Magana/AP)
It was the second straight day that Jones did not appear for the deposition in Austin, which was scheduled to be held Wednesday and Thursday. It wasn't immediately clear what penalties he may face.
Jones' lawyer, Norman Pattis, said Thursday that Jones was following his doctor's guidance to not attend court proceedings because of undisclosed medical conditions.
"Mr. Jones was given conflicting imperatives: his physician told him to stay home; a judge told him to go to a deposition," Pattis wrote in an email to The Associated Press. "He is following his doctor's advice. I suspect most people sensible would do as Mr. Jones has done."
But Connecticut Judge Barbara Bellis on Wednesday denied Pattis' request to delay the proceeding and ordered Jones to appear Thursday. Bellis wrote in a ruling that letters from Jones' doctors indicate his medical conditions aren't serious enough to prevent him from attending the deposition. Bellis noted Jones wasn't hospitalized and appeared on his web show earlier this week.
Bellis warned Jones that he would be in contempt of her order if he failed to show Thursday, and said the families' lawyers could request sanctions against him and try to subpoena him in Texas.
Bellis found Jones liable for damages in November. A trial on how much he should pay the families is set to begin in August.
Twenty first graders and six educators were killed in the 2012 shooting. The families of eight of the victims and an FBI agent who responded to school sued Jones, Infowars and others, saying they have been subjected to harassment and death threats from Jones' followers because of the hoax conspiracy. Jones has since said he believes the shooting did occur.
Christopher Mattei, a lawyer for the Sandy Hook families, said Jones did not show up for the deposition Thursday. He did not immediately say what the families' next legal steps were. He previously said the families would seek a subpoena to compel Jones to appear at his deposition.
Also Wednesday, Bellis denied the families' request to have Jones arrested and brought to the deposition if he failed to appear Thursday.
Pattis filed new court documents Wednesday that included letters from two doctors who said they advised Jones not to attend the deposition because of his medical conditions. Pattis wrote Jones' doctor was so alarmed by his observations of Jones on Monday that he advised him to go to an emergency room or call 911. Jones refused and his doctor advised him to stay home, Pattis said.
On Tuesday, however, Jones broadcasted his daily website show at the Infowars studio in Austin, his lawyers said. He did not appear in person on the show Wednesday, but he provided commentary by phone including pre-recorded segments for portions of the program.
Jones underwent an exam by another doctor and medical testing Wednesday, Pattis said. The doctor, Amy Offutt, wrote in a letter that she examined Jones for "acute medical issues that were time-sensitive and potentially serious" and lab tests were pending.
Sudan's deputy leader Mohamed Hamdan Dagalo speaks in Khartoum on 2 March 2022. (photo: AFP)
While Burhan and Hemeti grapple for power and the UN issues yet another empty report, civilians are struggling to put food on the table
Dagalo, commonly known as Hemeti, dressed in a fine suit and reading from a prepared statement, said he was exasperated by the terrible state of affairs in the country: “The people are tired, the people are suffering, the people have reached a hopeless stage. We are a disgrace in the world; our students are stranded, our embassies have stopped working.”
Nearly five months have passed since the 25 October military coup that cut short Sudan’s transitional period, once lauded by former Prime Minister Abdalla Hamdok as a unique civilian-military partnership.
After being ousted in the coup, Hamdok was initially placed under house arrest, then reinstated as prime minister under a short-lived deal with military leaders, before resigning in January. He is now believed to be in Dubai.
Sudan’s future now lies in the hands of an assortment of military officers, security forces and former rebels, with no unifying structure or publicly identifiable decision-making process to mediate their conflicting interests.
Last month, as Hemeti left Khartoum for a visit to Moscow, General Abdel Fattah al-Burhan, Sudan’s formal head of state, reportedly complained to Egyptian officials about the manoeuvring of his deputy, expressing concerns that Hemeti could be plotting to overthrow him with the aid of foreign parties. A few days earlier, the militia leader had been warmly received by Abu Dhabi Crown Prince Mohammed bin Zayed.
The day his deputy flew to Moscow, Burhan toured a military camp south of Khartoum, and stressed that the army would only hand over power to a government formed through “national consensus” or transparent elections.
Assuming a new role
Reaching such a consensus is a task that involves Volker Perthes, head of the United Nations Integrated Transition Assistance Mission in Sudan (UNITAMS). Established in June 2020, the mandate of this special mission was initially to provide support for Sudan during its political transition to democratic rule, including through the promotion of human rights and mobilisation of economic aid.
During the short duration of the "model" civilian-military partnership, the mission operated mostly in the background, although Perthes has spoken publicly about the need to speed up the pace of reforms. But with the coup last October, UNITAMS effectively lost its raison d’etre.
Since then, Perthes has assumed the role of mediator-at-large, rapidly becoming one of the most engaged political voices in the country. After launching a series of consultations on Sudan’s political process, he issued a summary paper last month, which he said was the product of more than 110 meetings attended by 800 people, alongside more than 80 written submissions.
One immediate takeaway is the narrow scope of these meetings, considering that Sudan’s total population exceeds 45 million.
Unsurprisingly, the report ultimately reads like a wish list. The outcomes of the consultation sessions, highlighted throughout the text, amount to performative demands, such as to stop the killing of protesters, to lift the state of emergency, to guarantee accountability for human rights violations, to modify the effectively defunct 2019 constitutional document, and to urgently form a transitional legislative council and a unified, non-partisan army.
Based on the above, the report suggested that the next steps should include “(i) prioritisation of critical steps; (ii) inclusivity and national ownership; (iii) comprehensive solutions; (iv) and effective facilitation and accompaniment”. What these items actually mean is anybody’s guess, but they come across as clinical rather than political, seemingly plucked straight out of a management handbook.
Harsh months ahead
What the UNITAMS report fails to acknowledge are the brute facts of power on the ground. Since the coup, more than 80 Sudanese protesters have been killed and dozens more arrested, amid regular demonstrations against military rule.
At the same time, almost two third of Sudan's population, more than 18 million people, are expected to face acute levels of hunger by September, according to the World Food Programme. In a recent report, the WFP cites armed conflict, economic crisis and a poor harvest as the reasons behind its predictions.
The report notes: “Across the country, an average of 13.6 percent of children under five years suffer from malnutrition. In some areas, the prevalence of global acute malnutrition is as high as 30 percent or above - catastrophic levels.”
At the same time, food costs are rising, and the government - unable to fund its own embassies - has resorted to hiking taxes and slashing subsidies for fuel, electricity and bread. The 2022 budget reportedly aims for a 145 percent increase in tax revenues and a 140 percent increase in revenues from commodities and services.
Compounding matters, Sudan relies considerably on Russian wheat to feed its population. This past January, Sudan, Egypt and Iran received two-thirds of Russia’s wheat exports. But the Russian invasion of Ukraine - together, the two countries account for 29 percent of global wheat exports - threatens to bring supply disruptions, higher wheat prices and increased levels of hunger to the shanties of Khartoum.
Hemeti, ever the merchant, apparently believes he can endure the harsh months ahead by auctioning off Sudan’s coastline to his Russian hosts, or higher bidders. And Perthes, with his report done and dusted, may be looking for a promotion.
Tests by Consumer Reports found PFAS in all kinds of food packaging, even from companies that say they've phased out the chemicals. (photo: iStock)
Tests by Consumer Reports found PFAS in all kinds of food packaging, even from companies that say they’ve phased out the chemicals
The potentially dangerous “forever chemicals“were found in food packaging including paper bags for french fries, wrappers for hamburgers, molded fiber salad bowls and single-use paper plates.
They were found in the packaging from every retailer CR looked at, including fast-food chains – such as Burger King and McDonald’s – and places that promote healthier fare, such as Cava and Trader Joe’s.
CR tested multiple samples of 118 food packaging products and found evidence of PFAS in more than half of those tested, while almost a third had levels beyond a threshold supported by CR experts and others.
In recent decades, PFAS exposure has been linked to a growing list of health problems, including immune system suppression, lower birth weight and increased risk for some cancers.
PFAS can be found not only in nonstick pans and waterproof gear but also in the grease-resistant packaging that holds food from takeout chains and supermarkets. A seemingly virtuous alternative to plastic, packaging made with PFAS often resembles paper or cardboard but salad dressing and fry oil do not leak through.
“We know that these substances migrate into food you eat,” said Justin Boucher, an environmental engineer at the Food Packaging Forum, a non-profit research organization based in Switzerland. “It’s clear, direct exposure.”
That’s especially likely when food is fatty, salty or acidic, according to a 2021 review in the journal Foods. Some research even suggests that PFAS levels are higher in people who regularly eat out.
Another concern: when packaging is tossed into the trash it can end up in landfills, and PFAS can contaminate water and soil, or it is incinerated, and PFAS can spread through the air.
Health and environmental advocates have been pushing for PFAS use to be restricted, especially in items such as food packaging. In response, some fast-food and fast-casual restaurants, as well as several grocery stores, say that they have taken steps to limit PFAS in their food packaging or that they plan to phase it out.
In CR’s tests the chemicals were also found in packaging from places that claimed to be moving away from PFAS, though those levels were often lower than at other retailers. “We know from our testing that it is feasible for retailers to use packaging with very low PFAS levels,” said Brian Ronholm, director of food policy at CR. “So the good news is there are steps that companies can take now to reduce their use of these dangerous chemicals.”
Searching for PFAS
The first known PFAS in the US was accidentally discovered in 1938 by a 27-year-old chemist named Roy Plunkett and in the decades since it and related chemicals have been added to a wide variety of products to make them resistant to heat, water, oil and corrosion.
Today, these practically unbreakable compounds, created when the elements carbon and fluorine are fused, can be found in the air and the water, as well as in our bodies, our food, and our homes.
Identifying the exact type of PFAS in a product is complex: there are more than 9,000 known PFAS, yet common testing methods can identify only a couple dozen.
So CR tested products for their total organic fluorine content, which is considered the simplest way to assess a material’s total PFAS content. That’s because all PFAS contain organic fluorine, and there are few other sources of the compound, says Graham Peaslee, PhD, a professor of physics, chemistry and biochemistry at the University of Notre Dame in Indiana, who has studied PFAS in food packaging.
Another complication: PFAS is used so widely – found in ink on food containers, recycled paper, machines that make packaging and more – that it often shows up in products unintentionally.
Scientists and regulators are still debating what level of organic fluorine indicates intentional use. California has banned intentionally added PFAS; starting in January 2023, paper food packaging must have less than 100 parts per million organic fluorine. Denmark has settled on 20ppm as that threshold, a limit supported by CR’s experts as well.
“If they can get to 100ppm, they should be able to get to 20ppm,” Peaslee says. “Lower is always the ultimate goal.”
CR tested multiple samples of 118 products and calculated average organic fluorine levels for each. Overall, CR detected that element in more than half the food packaging tested. Almost a third – 37 products – had organic fluorine levels above 20ppm, and 22 were above 100ppm.
Among the 24 retailers CR looked at, nearly half had at least one product above that level, and most had one or more above 20ppm. But almost all also had products below that amount. For example, while the two products with the highest average levels came from Nathan’s, the chain also had four products below 20ppm. Nathan’s told CR that it was redoing its packaging and had eliminated the high-level items, as did Chick-fil-A, which had the item with the next highest level in CR’s tests.
The results of the tests are not representative of all the packaging from a retailer, and packaging may have changed since CR conducted them.
Putting PFAS claims to the test
CR looked at retailers that claimed to be phasing out PFAS, including Cava, Chipotle, Panera Bread, Sweetgreen, and Whole Foods Market.
All 13 of the products the companies said had reduced PFAS still had some detectable organic fluorine, and seven were above 20ppm. They ranged from a Whole Foods soup container with 21ppm organic fluorine – the only Whole Foods item to exceed the 20ppm limit – to a paper bag for pita chips from Cava with 260ppm.
In response to questions from CR, companies stressed that with PFAS so common in the environment, it’s almost impossible to eliminate them entirely. Sweetgreen, for example, said, “We may have trace amounts of fluorine in our bowls. Unfortunately, PFAS are a widespread problem and are present in everyday life from tap water to air to soil.” Whole Foods said the company “does not make PFAS-free claims but has strived to prevent intentionally added PFAS in packaging.” Panera and Chipotle also said their goal was to avoid packaging with intentionally added PFAS.
Cava said that supply chain problems had slowed its “transition to eliminating added PFAS.” The company said that it hoped to complete that process by the end of 2022 and that it had updated its public statements to reflect the new timeline.
Michael Hansen, senior scientist at CR, acknowledges that trace amounts of PFAS in food packaging may be inevitable. And that’s why he says that “no company should tell consumers that their products are 100% free of PFAS.” But he also says CR’s tests show that getting to very low levels is possible and should be a goal for every company.
Protecting the next generation
Brian Ronholm, director of food policy at CR, and others say the federal government should regulate PFAS as a group. “Trying to ban individual PFAS is an impossible game of whack-a-mole,” he says. “As soon as one is addressed, industry comes up with another.”
The Environmental Protection Agency now has guidance levels on just two PFAS – PFOS and PFOA – and just in drinking water. And even those are too high, says Philippe Grandjean, a professor of Environmental Medicine at the University of Southern Denmark and an expert on PFAS health risks.
In addition, research from the EPA and elsewhere confirms that many newer PFAS chemicals, like their older cousins, will probably remain in the environment almost indefinitely and will pose health risks, especially to infants.
“The next generation is being exposed to these toxic compounds at the most vulnerable time period in their development,” Grandjean says.
Says Ronholm: “It’s long past time we got PFAS out of products, our water, and our food.”
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