Zadie Smith, Jay-Z, Russell Simmons Occupy Wall Street

This article originally appeared in CounterPunch  on 9/19/2012.

A recent interview with rapper and millionaire Jay-Z in T Magazine of the New York Times has caught fire not for its luminary centerpiece, but rather for his clumsy dismissal of Occupy Wall Street.  While discussing the rise of a new generation of Pitchfork-friendly indie rap e.g. Odd Future, he recognized that “people have a real aversion to what people in power did to this country…so they are lashing out, like: This is the son that you made…look at your son…look at what you’ve done.”

In a way, this is a reasonable, albeit crude, assessment of the Movement from the outsider’s perspective.  However, he soon revealed himself to be awkwardly out of touch.

“I’m not going to a park and picnic, I have no idea what to do, I don’t know what the fight is about. What do we want, do you know?  I think all those things need to really declare themselves a bit more clearly. Because when you just say that ‘the 1 percent is that,’ that’s not true. Yeah, the 1 percent that’s robbing people, and deceiving people, these fixed mortgages and all these things, and then taking their home away from them, that’s criminal, that’s bad. Not being an entrepreneur. This is free enterprise. This is what America is built on.”

The interviewer’s internal response to the mogul’s remark was, simply put, stunning: “It’s so weird watching rappers becoming elder statesmen.”  Such prosaic tact is to be expected given that the interviewer was none other than Zadie Smith, award winning fiction author and professor at NYU.  Her fiction titles include White Teeth and On Beauty.

No one really noticed though, alas.  In fact, most references to Jay’s comment make it seem as if this were an ordinary celebrity interview appearing in NYT.  Smith happens to be luminary herself, though, albeit in obscurer circles namely intellectual-slash-literary ones.  It’s worth noting that the Occupy comment is but a tiny fraction of the 3000-word piece which explores rap and black culture (can the former be discussed without the latter?) as seen through Jay’s eyes, yet filtered through Smith’s pen.

Jay is famous for his ultra-confident style and wit.  However, there are moments when it seems that Smith, as an outsider, understands his persona more than he does.  They are hard to pinpoint; Smith’s writing is apprehended in fleeting moments rather than segments.  She notes that “He likes to order for people” and reflects, “Apparently I look like the fish-sandwich type” with more amusement than sarcasm.  We never discover if she likes fish sandwiches or appreciated the gesture.  I’m confident, however, that Smith is wise enough not to turn down free lunch at a fancy restaurant.

Regardless, most readers found the bulk of the interview superfluous.  Smith, recognizing Jay-Z as more a persona than activist, was able to take the Occupy comment with a grain of salt and move on:

“But still I think “conscious” rap fans hope for something more from him; to see, perhaps, a final severing of this link, in hip-hop, between material riches and true freedom. (Though why we should expect rappers to do this ahead of the rest of America isn’t clear.) It would take real forward thinking. Of his own ambitions for the future, he says: “I don’t want to do anything that isn’t true.” Maybe the next horizon will stretch beyond philanthropy and Maybach collections.”  

The other hip-hop mogul that isn’t Puff Daddy, namely Russell Simmons, founder of Def Jam record company, took it more seriously.  Indeed, Jay’s comment was actually a reference to a conversation he previously had with Simmons, a long-time friend.  In response to Jay’s insensitivity, he noted “As the same man that said he would pay more taxes if it helped educate more children and create affordable healthcare, Jay-Z’s words matter” and thus took it upon himself to clarify things for his friend.  Couldn’t be a better man to do it given Simmons’ active engagement with Occupy.

After listing the 99 problems including healthcare reform, prison-industrial complex, war spending, GMOs, gay rights, immigration reform, the tuition crisis, and wealth inequality and describing the disastrous effects of Citizens United vs. FEC on American franchise, he closes with the bottom line:

“So, Jay, here’s the deal. You’re rich and I’m rich. But, today it’s close to impossible to be you or me and get out of Marcy Projects or Hollis, Queens without changing our government to have our politicians work for the people who elect them and not the special interests and corporations that pay them. Because we know that these special interests are nothing special at all. In fact, they spend millions of dollars destroying the fabric of the black community and make billions of dollars in return.”

Jay-Z’s verse, prose, and life have demonstrated that he is a passionate authority on the subject of poverty, entrepreneurship, and the American dream.  And Zadie Smith’s interview-essay gracefully reveals that the mystery of Shawn Carter aka Jay-Z transcends celebrity and riches.  Simmons has tactfully appealed to his understanding to coax a rebuttal which may never come.

If it does, it will be from the perspective of a man that affirmatively hustled and clawed his way to the top in a society that systematically sought to keep him down and in many ways still does.  He may begrudge the system, but he doesn’t need to answer for it.  It’s worth remembering that he is neither a Princeton academic nor a militant subversive.  He literally beat the system not by lamenting its injustices, but by circumnavigating them and recording the odyssey chapter by chapter.

“No one came to our neighborhoods, with stand-up jobs, and showed us there’s a different way. Maybe had I seen different role models, maybe I’d’ve turned on to that.”

David Brooks on American Capitalism

This article originally appeared in CounterPunch on 5/24/2012.

A recent op-ed by NY Times columnist, David Brooks, asserts that “Forty years ago, corporate America was bloated, sluggish, and losing ground to competitors in Japan and beyond.”  However, the rise of private equity firms and “bare-knuckled corporate executives” contributed to structural changes from which “American businesses emerged leaner, quicker, and more efficient” even though the “process was brutal and involved streamlining and layoffs” (1).

That last part is crucial and it’s likely that the corporate apologist and bobo-expert regrets including it.  The latter term was a reference to his book Bobos in Paradise in which he argues that the modern American yuppie-elite is an amalgamation of the bohemian rebel of the 60s and the wealth-seeking corporate climber of the 80s.  If you read the book, you’ll find that the “bobo” is the primary beneficiary of the vitalized American business that he celebrates.  And he’s quite right that American business emerged leaner and more efficient.

Businesses exist to make profits for the investors and shareholders that own the business.  It’s this incentive that free market fanatics tout as central to the doctrine’s celebrated efficiency.  These businesses operate on the efforts of rented wage labor of both blue and white collars.  However, even though it’s true that American business has experienced booming profits since the 1970s, what Brooks fails to mention is that these benefits have been sharply concentrated at the top alone.

It’s barely news that wealth and income distribution in recent decades has been dramatically lopsided with the top 1% taking in 10% of the nation’s income since 1979 and holding on to about 30% of the nation’s wealth (2) (3).  Being in the top 1% is no easy task, either.  The average salary is $1 million per year (4).  If you care to look closely enough, you’ll find that these figures come right out of the Congressional Budget Office.

Furthermore, the “leaner, quicker, and more efficient” American business indirectly reflects the decline in American manufacturing industry and the rise of multinational institutions that sell no product but continuously engage in complex financial manipulations and specialized transactions.  This process of financialization was set off by the United States’ decision to unilaterally disengage from the Bretton Woods monetary system that it and Britain championed after World War II.  The dollar was no longer accountable to gold convertibility and thus began policies associated with “neoliberalism” (5).

The general trend was that American businesses found it much cheaper to open the door to foreign imports of goods and products from both unskilled and skilled labor.  This crippled the American manufacturing industry by debasing workers in textiles, steel, automobiles, and consumer electronics.  So, even though computers were invented on the college campus using American taxpayer funding throughout the 1950s and 1960s, it became possible to cheaply assemble them abroad in the Third World by foreign workers and subsequently import them (6).

Obviously the effects followed a class-specific distribution.  Manufacturing was where you could find a decent job without a college degree.  The working class mix included poor native-born whites, African-Americans, and southern and eastern European immigrants.  They were dealt with accordingly.  Black life was recriminalized under what Michelle Alexander termed “The New Jim Crow” (7).  With more blacks currently imprisoned than were ever enslaved, black communities can’t even pretend to reap the benefits of Brooks’ celebrations (8) (9).  Those who were able to hold on to their jobs saw their real wages more or less stagnate and working hours increase.  The skilled workers that lost their manufacturing jobs were forced into the menial service economy in competition with Latin American immigrants (10).  This competition was only exacerbated by the devastating effects of the North American Free Trade Agreement that was designed specifically to enrich big business at the expensive the American worker (11).  The growing dispossessed formed the basis of today’s Tea Party Movement (12).

Those that could not find employment at all watched lifelines slip away for themselves and their families with the decline of the United States welfare system under Reagan, Bush I, and Clinton (13).  20 million Americans currently live in extreme poverty with incomes below half of the poverty line.  For 6 million Americans, the only source of income is food stamps (14).  What’s rarely mentioned is that with conservative reforms of programs such as Temporary Assistance to Needy Families and what used to be Aid to Families with Dependent Children, the core issue remains single mothers and impoverished children.  Jason DeParle described the recession-era trend of food stamp users skyrocketing while welfare cash payouts remained on the decline in a recent NY times article.  He noted that the 90s economic boom, no doubt the kind that Brooks had it mind, was accompanied aggressively by the drive to “end welfare as we know it” (15).  However, according to Brooks, “Many voters have come to regard their desires as entitlements” and “they become incensed when their leaders are not responsive to their needs.”  He asserts that “like any set of human begins, they command their politicians to give them benefits without asking them to pay” (16).  I suppose you have to hand it to him for finding it so easy to categorize a “set of human beings.”

“Successful” middle class citizens including myself sometimes found their way through institutions of higher learning which were often touted as the means to personal enlightenment and economic prosperity.  College was central to the American dream.  However, one peak behind the curtain reveals that tuition only imposes a new set of chains in the form of debt burden as the New York Times recently described (17).  The trillion dollar debt bubble in the United States drives the population further into the pockets of the 1%.  The rest, I suppose, rent themselves to the military.

So Mr. Brooks was certainly right.  Without question, the neoliberal agenda has dramatically invigorated American businesses from “sluggish” to “leaner, quicker, and more efficient.”  It accomplished this by adopting a simple strategy that came right out of the UChicago economics department: protect domestic business interests but open the labor force to market pressures.  This entailed subsidizing American exports using tax payer funding, but simultaneously pulling the rug right out from underneath the very same taxpayer.  The highly respected American economist Richard Wolff summed it up perfectly (18):

“Since the 1970s, most US workers postponed facing up to what capitalism had come to mean for them.  They sent more family members to do more hours of paid labour, and they borrowed huge amounts.  By exhausting themselves, stressing family life to the breaking point in many households, and by taking on unsustainable levels of debt, the US working class delayed the end of American exceptionalism – until the global crisis hit in 2007.  By then, their buying power could no longer grow: rising unemployment kept wages flat, no more hours of work, nor more borrowing, were possible.  Reckoning time had arrived.  A US capitalism built on expanding mass consumption lost its foundation.”

Notes.

(1)    http://www.nytimes.com/2012/05/22/opinion/brooks-how-change-happens.html?ref=davidbrooks

(2)    http://www.motherjones.com/kevin-drum/2010/09/simple-look-income-inequality

(3)    http://economix.blogs.nytimes.com/2011/03/30/inequality-is-most-extreme-in-wealth-not-income/

(4)    http://www.motherjones.com/politics/2011/02/income-inequality-in-america-chart-graph

(5)    http://business.pages.tcnj.edu/files/2011/07/VanArnum.Thesis.pdf

(6)    http://www.brookings.edu/research/papers/2011/01/china-challenge-baily

(7)    http://www.huffingtonpost.com/michelle-alexander/the-new-jim-crow_b_454469.html

(8)    http://pbstandards.org/news/article/221?newstype=1

(9)    http://www.huffingtonpost.com/inimai-chettiar/prison-system-jim-crow_b_1297413.html

(10)http://economyincrisis.org/content/service-economy-taking-over-us

(11)http://www.huffingtonpost.com/ellen-r-shaffer/immigration-is-a-nafta-pr_b_642484.html

(12)http://www.usnews.com/opinion/blogs/peter-roff/2010/10/07/the-tea-party-movement-is-a-middle-class-revolt

(13)http://www.nber.org/papers/w5774.pdf?new_window=1

(14)http://www.democracynow.org/2012/5/23/so_rich_so_poor_peter_edelman#transcript

(15)http://www.nytimes.com/2012/04/08/us/welfare-limits-left-poor-adrift-as-recession-hit.html?_r=1&pagewanted=all

(16)http://www.nytimes.com/2012/05/18/opinion/the-age-of-innocence.html?_r=3&ref=opinion

(17)http://www.nytimes.com/2012/05/13/business/student-loans-weighing-down-a-generation-with-heavy-debt.html?ref=tuition&gwh=A192E2C120C487DF2288577E2C662C39

(18)http://www.guardian.co.uk/commentisfree/cifamerica/2011/jan/17/economics-globalrecession

The real joke: oppression through marginalization

This article originally appeared in CounterPunch on 5/4/2012.

It’s not easy to get the President of the United States to provide meaningful answers to questions regarding issues of serious concern to the population.  During a Q&A session with Obama put together by YouTube in January, a woman pressed him about her husband’s extended unemployment to which he responded: “send me your husband’s resume” (1) (2).  Dodging questions is pretty standard especially when the truth is not going to make you very popular.  The jobs issue is central to Obama’s presidency so it’s likely that he could have provided a meaningful albeit depressing answer.  Unfortunately, the show has to go on and it did so by ignoring the most popular questions which—remarkably enough—did not have to do with his wedding anniversary or the midnight snacking habits that were discussed, but rather with the War on Drugs (3) (4).

Given his role as the President, one would hope that his public appearances and remarks would serve useful purposes such as providing substantive and honest information regarding policy positions and government activity.  His responses during the YouTube Q&A were not totally egregious, but the superficial behavior at these Correspondents’ Dinners is just depressing.  Performing skits and telling jokes was the top priority last year while Operation Neptune Spear was being carried out.  Again, the show had to go on.  The subjects tackled during this year’s Dinner included eating dogs, Young Jeezy, and casual homophobia.  The funniest bit, however, was the greasy comment on what he declared to be a great American tradition: “a free press that isn’t afraid to ask questions, to examine and to criticize” (5).

Whether or not those questions get answered, the free press he was referring to is far from traditional.  For one thing the spectrum of representative interest is sharply polarized.  For example, there are blogs and there are media conglomerates much like there are local coffee shops and there are Starbuckses.  Even though both provide similar commodities, the two sides operate in different ways because they exist for different reasons.  So even though neither ThinkProgress nor The Wall Street Journal is under any coercion, the latter is still owned by the multibillion dollar News Corporation which exists to make profits for investors.   This has two major implications for an outlet like WSJ.  Firstly, as a corporate subordinate, its terminal function is to contribute to wealth consolidation.  It may not accomplish this explicitly (e.g. “playing politics”), but it would not have been absorbed if it did not contribute to Rupert Murdoch’s bottom line (6).  Secondly, its massive financial backing inexorably enables it be ultra-prominent and consequently ultra-powerful.  Its elite status will obviously influence its content by filtering out writers with non- or anti-elite sentiments.  These principles generalize to other dominant media such as The New York Times and The Washington Post.

So just whose views are the big three free press outlets representing?   An April report published by FAIR looked into which perspectives were being represented on their op-ed pages during September and October 2011 when the Occupy movement was in full swing: the movement which is now recognized to have dramatically shifted political discourse in the U.S. as recent articles in the Post and in Rolling Stone make clear (7) (8).  The report revealed that elites from academia, think tanks, big business, and government institutions made up 84%, 84%, and 73% of the guest column bylines in the Times, the Journal, and the Post respectively.  Those proportions aren’t surprising because they’re pretty much taken for granted: you wouldn’t expect anyone else’s opinion to be important enough to be featured.  The study also found that op-ed writers were overwhelmingly white males: 80-90%.  Furthermore, the Occupy movement was barely discussed in the opinion pages of all three papers.  Again, given the structure of American society, it’s not that surprising.  However, the connection you’re not supposed to make is the obvious one that contradicts principles of a “free press” (9).

To make this connection, we can start by acknowledging some major domestic concerns which, unsurprisingly, include job creation, Social Security, education, and Medicare (10).  The problem is that elites from academia, think tanks, big business, and government are the least burdened by these concerns.  The fact remains that there are people that depend on Social Security for survival (11).

Another hot issue involves reproductive rights and the War on Women (12).  Male op-ed writers comprised 80%, 84%, and 87% of the NYT, the Post, and the Journal respectively.  When the topics include obstetrical sonograms, contraception, abortion, and equal pay/benefits for women, the integrity of the discussion is going to suffer when male perspectives dominate.

The same logic applies to race issues.  Latinos make up 16% of the U.S. population, but their voice was confined to less than half a percent of the op-ed bylines which might not bode well for discussions on immigrant rights or border control.  Blacks were under-represented too which has frightening implications.  Michelle Alexander’s newly popular book The New Jim Crow discusses the scandalous incarceration rate in the United States (highest in the world) that disproportionately targets the black population and supplements a growing “undercaste” (14).  She traces it back to the Nixon and Reagan administrations’ schemes to exploit white working class racism and fear to gain political power.  It’s a national horror that just so happens to not really involve white elites from academia, business, think tanks, and government or their friends or their families.

The race issue is particularly egregious.  Blacks are incarcerated at a rate that is comparatively appalling and often for petty drug crimes such as marijuana possession.  In prison, they’re basically free (slave) labor.  When they get out they are disenfranchised, barred from juries, and struggle to find employment and therefore healthcare.  The fiscal consequences of the War on Drugs or the ethics of incarceration versus treatment are topics that are usually discussed in the papers (15) (16).  Lucid commentary on the grave human damage does come out, but infrequently (17) which is remarkable because the issue is so deeply offensive to principles of compassion and liberty that it ought to be making headlines.

Incidentally the major assertions made by Michelle Alexander in The New Jim Crow are not groundbreaking or radical.  The trajectory of the War on Drugs and its disproportionate affect on the black population had already been figured out by the mid-90s but mainstream discourse was just not ready for that kind of information (18) (19).  Alexander’s study, which is deeply researched and excellently delivered, just came out at the right time.  (Actually it took two years for it to get popular).  This reveals a great deal about the nature of our press.

Well if the press’ function is to inform the public mind so as to facilitate democratic participation and influence political discourse, what can we expect to hear from elected and appointed officials?  Gil Kerlikowske, the Director of the Office of National Drug Control Policy gave a talk a few days ago on drug policy reform at the Center for American Progress (20).  I work in the same building and I happened to walk by him on the way in: I wouldn’t have known about it otherwise.  Even with prodding by the Center’s president Neera Tanden to address incarceration, Kerlikowske managed to avoid talking about drug war casualties by focusing strictly on drug abuse treatment.  In this capacity, he labeled the Affordable Care Act “revolutionary” for its requiring insurers to treat drug addiction like any other disease.  There was barely any mention of the incarceration disaster and absolutely no mention of the effects on the black population.

His lauding of the AFA, however, is interesting.  Obama’s health plan and his drug control strategy are similar in their ostensibly liberal motivations.  Furthermore, these superficialities are reinforced by the White House and the press.  Obamacare expands coverage which helps the poor and sick so therefore it must be populist, liberal, and benign and so on (21) (22).  Similarly, the drug control strategy will treat addiction and help ex-convicts find housing and not relapse so therefore it’s humane and progressive (23).

Unfortunately, the sinister and anemic properties of either are rarely addressed.  Obamacare’s expanded coverage is a blessing to the very entities that are responsible for the health crisis: it funnels billions to private insurers and pharmaceutical companies (24).  Similarly, targeting addiction is not an answer to the incarceration problem nor does it confront the damage to black communities (25).

But for the White House to highlight the hidden problems would irritate investors that influence campaigns through lobbying.  Private correction corporations such as CCA and GEO profit off of taxpayer funded incarceration.  Studies have shown private prison population grew in the last decade as their lobbying dollars increased (26).  A Boston Phoenix article reads: “Despite clear racial, economic, and cultural disparities, cries from constituents fell on deaf ears while law-enforcement lobbyists successfully cajoled and frightened congressional leaders” (27).  Operating through outfits like ALEC, they push for legislation that harshen sentencing for crimes (28).

Health insurance and pharmaceutical companies similarly influence the Affordable Care Act and thus the rhetoric available to Obama.  (29) (30).

Given that vast sectors of the American population hang in the balance in all of these issues, you might assume that the “great American free press” that isn’t afraid to question or criticize would actually ask questions or speak critically in regards to these discrepancies.  But the lives and careers of politicians, business executives, and elite journalists are so intertwined and symbiotic that the public has to be marginalized.  The reason is simple, their interests are opposed.  Furthermore, the public mind is clouded by superficial dichotomies such as Democrats vs. Republicans, pro-life vs. pro-choice, drug treatment vs. overpolicing, etc.  For an elite journalist, these topics are perfectly valid on intellectual and professional levels.  For a politician, they serve invaluable rhetorical purposes.  Forgotten, suppressed, and marginalized, however, are the issues pertinent to the millions that personally have to worry about food, rent, healthcare, education, transportation, debt, and retirement.  That’s the real skit.  That’s the funniest joke.

(1)    http://www.youtube.com/watch?v=eeTj5qMGTAI

(2)    http://www.washingtonpost.com/blogs/44/post/obama-offers-to-find-woman-a-job-during-google-chat/2012/01/31/gIQAckhbeQ_blog.html

(3)    http://www.huffingtonpost.com/2012/01/30/obamas-pot-question-will-_n_1242008.html

(4)    http://www.theatlantic.com/politics/archive/2012/01/retired-lapd-brass-challenges-obama-on-drug-policy/252187/

(5)    http://www.youtube.com/watch?v=GfG8Btb0l3g

(6)    http://www.guardian.co.uk/media/2009/dec/14/rupert-murdoch-wall-street-journal

(7)    http://www.washingtonpost.com/blogs/ezra-klein/post/occupy-the-regulatory-system/2012/04/27/gIQAjo21lT_blog.html

(8)    http://www.rollingstone.com/politics/news/ready-for-the-fight-rolling-stone-interview-with-barack-obama-20120425

(9)    http://www.fair.org/index.php?page=4513

(10)http://www.people-press.org/2012/01/23/public-priorities-deficit-rising-terrorism-slipping/

(11)http://www.cbpp.org/cms/index.cfm?fa=view&id=3260

(12)http://www.salon.com/2012/04/30/war_on_women_isnt_over/singleton/

(13)http://www.washingtonpost.com/blogs/blogpost/post/trayvon-martin-death-has-echoes/2012/04/02/gIQAVievqS_blog.html

(14)http://www.huffingtonpost.com/michelle-alexander/the-new-jim-crow_b_454469.html

(15)http://online.wsj.com/article/SB10001424052702303425504577353754196169014.html

(16)http://online.wsj.com/article/SB10001424052702303592404577364313277369518.html

(17)http://www.nytimes.com/roomfordebate/2012/03/12/young-black-and-male-in-america/spend-money-on-schools-instead-of-the-war-on-drugs

(18)http://www.commondreams.org/views/041200-104.htm

(19)http://www.mendeley.com/research/race-criminalization-black-americans-punishment-industry/

(20)http://www.americanprogress.org/events/2012/05/drugs.html

(21)http://www.thenation.com/article/167256/how-affordable-care-act-saves-lives

(22) http://www.whitehouse.gov/blog/2012/03/21/affordable-care-act-saving-lives

(23)http://www.huffingtonpost.com/r-gil-kerlikowske/white-house-drug-policy_b_1432966.html

(24)http://pnhp.org/news/2010/march/pro-single-payer-doctors-health-bill-leaves-23-million-uninsured

(25)http://www.nytimes.com/2012/04/10/nyregion/reducing-crime-squandering-good-will.html

(26)http://thinkprogress.org/justice/2011/09/26/328486/us-private-prison-population-lobbying/

(27)http://thephoenix.com/Boston/News/73092-Freedom-watch-Jailhouse-bloc/?page=3#TOPCONTENT

(28)http://diversityinc.com/investigative-series/who-profits-from-the-prison-boom/

(29)http://floridaindependent.com/10163/how-the-american-legislative-exchange-council-turned-health-care-repeal-into-a-national-wave

(30)http://thinkprogress.org/economy/2009/12/05/72376/bcbs-alec-health/

Healthcare considerations of the American decline

This article originally appeared in CounterPunch on 4/17/2012.

“A heart that’s full up like a landfill.  A job that slowly kills you.  Bruises that won’t heal.  You look so tired, unhappy.  Bring down the government, they don’t speak for us.  I’ll take a quiet life, a handshake of carbon monoxide.”

The existential sorrow in Thom Yorke’s voice has never sounded as poignant as it does today in “No Surprises”, a track of lonely capitulation on Radiohead’s monolithic OK Computer.  The song evokes images of helplessness and retreat in the face of globalization and corporate capitalism.  The accompanying music video features Yorke’s head in a bubble helmet that slowly fills up with water (1).  The symbolism in both the lyrics and the video has become increasingly relevant since the record’s release fifteen years ago.

Some call it America in Decline and it’s a theme that has been explored extensively over the recent years, months, and weeks (2) (3) (4).  The idea is obviously met with skepticism.  In order to understand it, we have to put it in perspective and define a context.  What exactly is America and what’s in decline?

It remains the richest country in the history of modern civilization.  It controls the most powerful and comparatively advanced military machine ever assembled: a likely result of spending more than the rest of the world combined (5).  The two characteristics are intimately related.

Indeed, the idea that the accumulation of wealth inculcates suspicion and the need to defend it has even been discussed by 6^th century philosopher Boethius in The Consolation of Philosophy: “the wealth which was thought to make a man independent rather puts him in need of further protection” (6).  In fact, the need for institutional protection of private property is one of the most heavily explored topics of classical liberalist thought and framed much of the debate during the United States’ formative period.  We like to think that the nation was founded on principles of total equality and personal liberty.  But the chief concern among the framers was how to create a system where landowners can remain landowners without having to worry about greedy peasants.

The concept rapidly generalizes to capital accumulation today.  Wealthy and privileged members of society want the government to perform its intended function which is to protect their assets.  What would have previously been labeled agrarian reform is basically equivalent to progressive taxation.  However, any rational politician will cater to privileged interests especially when legislative positions are virtually bought in the current system.   The collection of votes is now regarding as a secondary consequence of properly financing an electoral campaign.

Social reforms that benefit the overwhelming majority of the population—where political power is least concentrated—are marginal issues that require populist demonstration in order to enter the political arena.  The civil rights movement, the feminist movement, and the AIDS movement are just a few examples.  That these were issues that could not be influenced by voting highlights a particularly sinister illusion of franchise.  We vote for politicians that seem relatable given their stance on satellite issues.  Presidential candidates will resort to tactics such as showing up on MTV discussing underwear in order to the exploit youth culture.  In other venues he’ll discuss how to be tougher on crime or how to withdraw from some foreign conflict in some vague number of years.

But where’s the candidate that speaks to immediately relevant issues such as access to health care or proper retirement benefits?  The former example is pretty striking, actually.  Government sponsored medical coverage has been a prominent domestic concern for almost 40 years (7) (8).  Even a recent 2009 NY Times/CBS News poll suggested that 72% of the population were in favor of a government administered health insurance program that would compete with current private plans (9).

Furthermore, there’s no longer any doubt that a public option would drastically reduce health costs and thus relieving some of the burden on consumers.  A 2003 study published in the New England Journal of Medicine concluded that health care administration costs account for 31% of health expenditures in the U.S. which comes out to almost $300 billion.  Canada’s administration costs, on the other hand, makes up 16.7% of their total health expenditures (10).  The high costs of U.S. health administration are a direct result of having to navigate the extreme complex channels of billing and reimbursement through private insurers.  As one would expect, the system’s complexities are tailored to minimize payouts to consumers and simultaneously maximize profits.

The U.S. has very little to show for its insanely expensive health arrangement.  Its per capita costs are twice those of other advanced OECD nations (11).  However, it ranks pretty low in health outcomes such as infant mortality and and life expectancy (12).

And the burden on the general population is, indeed, quite severe.   Two landmark 2009 studies by Harvard physicians David Himmelstein and Steffie Woolhandler were able to show that the extraordinary costs of healthcare and insurance impose crushing financial burdens and leave many who cannot afford insurance to die.  They found that 62.1% of bankruptcies filed in the United States in 2007 had medical causes.  This value is sharply contrasted with an estimated 8% in 1981 and 46.2% in 2001.  80% of the 2007 figure had health insurance and most were well-educated and middle-class (13).  Furthermore, the researchers were able to link the lack of health insurance to 45,000 working-age deaths per year in the U.S. and conclude that the uninsured are 40% more likely to die than those with private insurance (14).  This figure, too, is in sharp contrast with a 1993 estimate of 25% (15).  The spectrum of health outcomes parallels socioeconomic status as one would expect, but the worsening trends and sheer quantity of deaths are so morally alarming that they cannot be ignored.

The outlook is even more depressing when we examine a recent U.S. Census Bureau report which revealed a striking racial distribution of uninsurance.  21% of blacks and 31% of Hispanics in the U.S. are uninsured compared to 11.7% of whites (16).  This, too, is not that surprising.  The proportions are probably similar for those who drive Range Rovers, but we have to remain cognizant of the fundamental difference between the two commodities.

The consequences of private administration of healthcare are fairly predictable.  A corporation’s chief concern will always be self-sustenance and growth.  Consumer benefit is only a priority when it contributes to the two main goals.  The touted virtue of free market efficiency is based on the symbiotic relationship between consumer benefit and corporate profit.  Unfortunately, it’s not really a free market.  The government is continually prohibited from acting as a significant competitor even though most of the population agrees that it should be.  Because of the fundamental difference between health and Range Rovers as commodities, consumers do not have the option of simply boycotting the product or choosing a competitor and thereby placing downward pressure on costs.  Saying no to healthcare is simply anti-human.

Furthermore, patent-protected pharmaceuticals will sell at premiums with markups sometimes up to a thousand percent.  It’s often argued that patent protection and value markup are required in order to fund research and development.  However, we cannot ignore the costs of advertising, marketing, lobbying, and profit margins.   The economist Dean Baker has done significant work in exposing the inefficiencies and deceitful practices of the pharmaceutical industry that ultimately harshen the financial burden on the general public (17).  He has argued for several years that publicly funded research for the development and distribution of patent-free drugs would be far more advantageous than the current system that spends an estimated $300 billion per year on prescription drugs.

The prospects for change are pretty bleak given the virtual disenfranchisement of the general population which brings us back to American decline.  Media-propagated illusions are partially responsible.  The current debate surrounding Obamacare is a ripe example.  Government-sponsored insurance is not even on the agenda and the public is led to believe that the Affordable Care Act and its guaranteed coverage is the solution we have long waited for.  This illusion is based on the false dichotomy between Democrats and Republicans.  It’s a bad joke, really.  Obamacare is modeled on the Massachusetts health plan the origins of which trace back to the Heritage Foundation (18) (19).  It was implemented by then-Governor Mitt Romney.  I’ll spare the irony.

The bottom line is that the individual mandate would require everyone to buy in to private insurance risk pools to decrease medical premiums.  It will funnel hundreds of billions of dollars to private insurers and Big Pharma and further inflate their political clout.  Even if it passes, an estimated 23 million of the current 50 million Americans will remain uninsured (20).  Alternatives such as a single-payer system or at least a public option are completely missing from the debate even though majority of the population is in favor of them.  Of course, with these alternatives, private insurance companies would stand to lose.  Corporate executives would lose money and perhaps workers would be laid off, but that overall human suffering would be less is an obvious conclusion of alternatives that are marginalized by the media and our politicians.

Thus, the current trend can be visualized as a hollowing out of the American identity.  The military and financial prowess of the United States makes it an undeniable juggernaut in the global theater, but it has very little advantage for most of the population.  Unemployment and healthcare are the two most pressing concerns for most Americans, but there’s very little that can be done via the electoral system due to its deeply financial nature.  Those that do climb the socioeconomic ladder are driven into virtual fiefdom via debt burdens that are owed in part to the absurd costs of tuition for higher education (21).  Crushing debt burdens discourage social activism and inculcate profit-seeking values.  Those that cannot afford to climb the ladder or choose not to will have to confront the depressing avenues of uninsurance and poverty which only exacerbates the vicious cycle of decline.

1)      http://www.youtube.com/watch?v=u5CVsCnxyXg&ob=av3e

2)      http://www.hoover.org/publications/defining-ideas/article/82581

3)      http://www.truthdig.com/report/item/american_decline_debated_contested_obvious_20120410/

4)      http://www.tomdispatch.com/archive/175502/

5)      http://armscontrolcenter.org/policy/securityspending/articles/fy09_dod_request_global/

6)      http://www.gutenberg.org/files/14328/14328-h/14328-h.htm

7)      http://www.kff.org/healthreform/upload/7871.pdf

8)      http://www.fair.org/index.php?page=3633

9)      http://www.nytimes.com/2009/06/21/health/policy/21poll.html

10)   http://www.pnhp.org/publications/nejmadmin.pdf

11)   http://www.commonwealthfund.org/Publications/Issue-Briefs/2011/Jul/US-Health-System-in-Perspective.aspx

12)   http://www.nejm.org/doi/full/10.1056/NEJMp0910064

13)   http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

14)   http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2008.157685

15)   http://www.ncbi.nlm.nih.gov/pubmed/8336376

16)   http://aspe.hhs.gov/health/reports/2011/CPSHealthIns2011/ib.shtml

17)   http://www.guardian.co.uk/commentisfree/cifamerica/2011/may/31/healthcare-pharmaceuticals-industry

18)   http://www.heritage.org/research/reports/2006/04/the-significance-of-massachusetts-health-reform

19)   http://www.heritage.org/research/reports/2006/07/the-massachusetts-health-plan-lessons-for-the-states

20)   http://pnhp.org/news/2010/march/pro-single-payer-doctors-health-bill-leaves-23-million-uninsured

21)   http://www.usnews.com/education/blogs/student-loan-ranger/2011/09/28/college-tuition-growth-rate-is-biggest-bubble-of-them-all

Healthcare failure: the occupied Palestinian territories

This article originally appeared in CounterPunch on 3/15/2012.

Healthcare is a unique issue in international politics and discussions of modern civilization.  As an institutional entity, it has both a substantial and direct implication regarding the very existence of human populations.  That’s in contrast to markers such as employment, GDP, or literacy that have effects that are slightly harder to trace out.  Indeed, the authors 2010 World Health Report recognized that “promoting and protecting health is essential to human welfare and sustained economic and social development” and that people “rate health one of their highest priorities” (1).  As a majorly accepted sentiment, it becomes morally difficult to justify institutional healthcare inequalities if we choose to believe in principles of democracy and Rawlsian equality of opportunity.

If, as a nation, we impose economic sanctions on another country as a method of foreign policy, it’s okay for that nation’s economy to suffer because it puts pressure on the government and state leaders to capitulate.  What you’re not allowed to talk about are the direct outcomes on the population because the point is to get the boogey man—Saddam or Osama—but not to cause a humanitarian crisis characterized by the starvation of children in, say, Afghanistan (2).  Unfortunately, severe economic decline and mass suffering are inexorably linked as is clearly demonstrated by the Palestinian condition.

Starting in 2009, one of the world’s leading medical journals, The Lancet, began publishing a series of studies and commentaries concerned with the socioeconomic condition in the occupied territories.  The chief editor of the journal, Richard Horton, recognized that “since 2000, the occupied Palestinian territory has experienced increased human insecurity, with the erosion and reversal of many health gains made in earlier years” and that “these setbacks, together with the latest Israeli air and ground attacks on Gaza, have plunged the region into a humanitarian crisis” (3).  Indeed, a February 2012 poll by the Palestinian Center for Public Opinion reported that 54.7% of Palestinians are concerned about their subsistence of themselves and their family.  Furthermore, when asked about their main present concern, 39.6% said it was employment and 22.4% said it was security (4).

The reason for their bleak outlook is pretty straightforward, let’s just look at the facts.  The aftermath of the Second Intifada and the blockade of the Gaza Strip left the population of 1.7 million in a devastated state.  In 2008, 37% of the active workforce in Gaza was unemployed and 74% of the population lived below the poverty line of $3.15 per person per day.  Unemployment in the West Bank was 19% and 40% lived under the poverty line.  Though physical, institutional, and trade restrictions imposed on the Occupied Territories since the Oslo accords had been deteriorating the internal Palestinian economy, foreign aid allowed for continued development (32% of GDP according to the World Bank) (5).  However, the situation collapsed upon the popular election of Hamas: “Diplomatic ties and international donor funding were cut, and Israel withheld Palestinian tax revenues, which together form about 75% of the budget of the Palestinian National Authority.”  (6).

Health outcomes also deteriorated sharply as a result of economic penalties and restrictions.  Electricity and cooking gas to Gaza was heavily diminished which subsequently “disrupted the operation of water and sewage pumps throughout the Gaza Strip.”  In addition to continual shortages of medicines and medical supplies, a WHO report found that “medical devices are often broken, missing spare parts, or out of date” (7).  Amnesty International’s 2011 Report revealed that the infant mortality rate in the occupied territories is 23/18 (m/f) per 1000 in contrast to 6/5 in Israel.  Furthermore the life expectancy in the territories is 72.9 years as opposed to 80.3 years in Israel (8).  Proper access to healthcare has also been severely impaired by the stringent restriction on travel outside of the occupied territories.  Reports by Physicians for Human Rights revealed an increase in the medical referrals outside of Gaza coupled with a decreased in travel permissions allowed for these cases by Israeli officials (9).  The population inexorably suffers.

The fundamental barrier Palestinians face in attaining healthcare is ubiquitous: inability to afford high costs.  There is no realistic way of implementing a system of pooled risk to decrease up-front costs and the distribution of healthcare resources (including personnel) among the sick is extremely inefficient.  Because of the stipulations of the Israeli occupation, the “Palestinian National Authority is expected to perform as the government of a state while lacking control over its borders, basic resources, and many of the social determinants of health” and “vague institutional arrangements have hindered the establishment of a proper governance system” (10).

Modern medicine is built upon basic principles of inter- and intra- state trade.  This is in sharp contrast to an advanced profession such as law where an expertly trained professional can provide legal counsel just about anywhere and to anyone.  In addition to the physician’s knowledgebase and skill set, he/she requires material goods and resources such as medicines and biomedical equipment.  The internal economy of Palestine is deeply impoverished and exchange with external parties is severely hindered by check points, roadblocks, and blockades.  There are no economic and logistical frameworks to get patients what they need.

The bottom line is that the population suffers due to external forces beyond their control (and desire as revealed by the polls).  A crippled economy left the people without jobs or an infrastructure for societal development: they’re stuck.  In the ghetto that is Gaza Strip: “social solidarity and resilience have nurtured the Palestinian health response to occupation.”  However, in light of continued political and economic degeneration, “the social fabric of Palestinian society is eroding (11).”  Ordinary Palestinians are completely disenfranchised.  Even if they were to engage in popular demonstration which has been used globally to achieve egalitarian health objectives (12), the Palestinian Authority does not have the capacity to react significantly in any way.  If the only parties that enter the discourse are Fatah, Hamas, Israel, and the United States, then health outcomes will decline.  Poor healthcare has become an effective means of nonviolently undermining a population.  Sadly enough, the same strategy was employed in Apartheid South Africa.

(1)    http://www.who.int/whr/2010/en/index.html

(2)    http://www.pbs.org/frontlineworld/stories/iraq/sanctions.html

(3)    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60100-8/fulltext

(4)    http://www.pcpo.ps/polls.htm

(5)    http://siteresources.worldbank.org/INTWESTBANKGAZA/Resources/AHLCReportSept.08final.pdf

(6)    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60107-0/abstract

(7)    http://apps.who.int/medicinedocs/en/m/abstract/Js16445e/

(8)    http://www.amnesty.org/en/region/israel-occupied-palestinian-territories/report-2011

(9)    http://www.phr.org.il/default.asp?PageID=111&ItemID=558

(10)http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60111-2/abstract

(11)http://www.thelancet.com/series/health-in-the-occupied-palestinian-territory

(12)http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02817.x/abstract