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US Imposed Syria Sanctions Hit Children’s Cancer Treatment at Damascus Children’s Hospital

Six years of conflict have brought the Syrian health service, once one of the best in the Middle East, close to collapse
syrian children cancer

Damascus: In the cancer ward at Damascus Children’s Hospital, doctors are struggling with a critical shortage of specialist drugs to treat their young patients — and it’s not just due to the general chaos of the Syrian civil war.

Local and World Health Organisation (WHO) officials also blame Western sanctions for severely restricting pharmaceutical imports, even though medical supplies are largely exempt from measures imposed by the United States and European Union.

Six years of conflict have brought the Syrian health service, once one of the best in the Middle East, close to collapse. Fewer than half of the country’s hospitals are fully functioning and numbers of doctors have dived.

The result is tumbling life expectancy — even after accounting for the hundreds of thousands directly killed in the fighting — and soaring deaths in pregnancy and childbirth.

On top of this, cuts in health spending by the government that is fighting a hugely expensive war, a drastic fall in the Syrian currency and indirect effects of the sanctions are all deepening the misery of patients who need foreign-made drugs.

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Children suffering from cancer at Damascus Children’s Hospital. Image credit: Reuters

For families with sick children, the situation is dire.

At the children’s hospital in government-held Damascus, the waiting room outside the cancer ward was crowded with relatives, many of whom had brought clothes, mattresses and blankets in case they had to spend long periods far from their homes outside the city.

One of them was Naim Der Moussa, 55, who has been living in Damascus for a year to secure regular treatment for his 10-year-old daughter Wa’ad. They left his wife and six other children behind in the eastern city of Deir Al Zor, where government forces are besieged by Daesh.

“My daughter was first diagnosed with kidney cancer and treated,” he said. “Now cancer has been found also in her lungs.”

Before the conflict, Syria produced 90 per cent of the medicines it needed but anti-cancer drugs were among those where it traditionally relied on imports.

Elizabeth Hoff, the WHO representative in Syria, said medicine imports have been hit by significant cuts in the government’s health budget since the war began in 2011 plus a 90 per cent drop in the value of the Syrian pound, which has made some pharmaceuticals prohibitively expensive.

However, a lack of cash is not the only reason why supplies of cancer drugs are falling far short of increasing demand.

“The impact of economic sanctions imposed on Syria heavily affected the procurement of some specific medicine including anti-cancer medicines,” said Hoff. The sanctions were preventing many international pharmaceutical companies from dealing with the Syrian authorities as well as hindering foreign banks in handling payments for imported drugs, she added.

The United States and EU have imposed a range of measures targeted both at the government and some of the many armed groups operating in the country.

Washington has banned the export or sale of goods and services to Syria from the United States or by US citizens.

The EU has imposed travel bans, asset freezes and an arms embargo, with sanctions also targeting financial ties with Syrian institutions, buying oil and gas from the country or investing in its energy industry.

President Bashar Al Assad has partly blamed the sanctions for turning many Syrians into refugees, often heading to Europe.

Both the US and EU regimes include exemptions for medicines and other humanitarian supplies. However, by clamping down on financial transactions and barring much business with the Syrian government, the sanctions are indirectly affecting trade in pharmaceuticals.

Many drugs companies have erred on the side of caution, avoiding any business with Syria for fear of inadvertently falling foul of the sanctions.

The US State Department said the Treasury had authorised services in support of humanitarian activities in Syria, adding that there were legal ways to bring medicine into the country.

The EU also rejected criticism of its sanctions.

“Such measures are not aimed at the civilian population,” an EU spokeswoman said. “EU sanctions do not apply to key sectors of the Syrian economy such as food and medicine.”

She acknowledged firms had increasingly pulled out of business with Syria but said this was also due to other reasons, including “security, reputation, commercial motivation, anti-money laundering measures” and the presence of militant groups.

The WHO brings essential medicines and medical supplies into Syria, procuring generic drugs from approved sources in Europe, North Africa and Asia. Branded US products cannot be imported due to the sanctions situation, Hoff said.

With funds from Kuwait, the WHO has delivered life-saving medicine to more than 16,000 cancer patients, of whom thousands are children with leukaemia.


Syrian girl Rahma sits on a bed as she receives treatment for cancer at Damascus Children’s Hospital. Image Credit:Reuters

But this does not meet demand. Besides cancer medication, there are critical shortages of insulin, anaesthetics, specific antibiotics needed for intensive care, serums, intravenous fluids and other blood products and vaccines, Hoff said.

The overall collapse in Syrian health care has contributed to a drop in life expectancy to 60 years for men and 70 for women in 2014, from 72 and 75 respectively in 2009. Only 44 per cent of hospitals are now fully functioning and more than a quarter aren’t working at all, the WHO said.

By 2014, the number of doctors in Syria had dropped to 1.3 per 1,000 people, less than half the level in neighbouring Jordan and Lebanon.

Against this deterioration, Damascus Children’s Hospital has also come under increasing pressure. Cancer units in the provincial cities of Aleppo and Latakia were both put out of service in fighting earlier in the war.

Now about 200 children visit the Damascus hospital every week, with more than 70 per cent from outside the capital, according to its head, Maher Haddad.

The weight of demand has delayed treatment for dozens of sick children by 15-20 days, affecting their prospects, overall health and response to medication, he added.

Haddad also singled out the sanctions. Pharmex, the state-owned company that buys drugs for government-funded hospitals across Syria, was able to provide only 5-10 per cent of the cancer medication that is required, he told Reuters.

“Most of the cancer medicines are imported. Pharmex used to import the stock of medicines that public hospitals need. But it has not been able to do so largely because of the economic sanctions, I believe,” he said.

His hospital has only 36 free beds, with 17 of those allocated to children with cancer.

In the waiting room, a woman who identified herself only by her first name Nawal, said she travels from the Qalamoun area north of Damascus every fortnight with her 14-year-old daughter who requires chemotherapy treatment for leukaemia.

“We don’t have hospitals or charities in Qalamoun. Free treatment is offered only at the Children’s Hospital in Damascus,” Nawal said.

One private charity, Basma, is trying to help out by funding cancer drugs for poor families. The proportion of patients who need assistance has risen from about 30 per cent to nearly 80 per cent since the war began, executive manager Rima Salem said.

Salem finds the delays in treatment worrying.

“A child with cancer might die waiting for his turn to get treatment,” she said.

Posted in USA, Health, Syria0 Comments

Trump’s Pay or Die Healthcare Plan

Donald Trump

Proposed Trumpcare is a boon to America’s privileged and sickness industry, a bane for most others – leaving millions more uninsured than under Obamacare.

The plan released Monday will likely be revised before Congress votes on it later this year. If enacted, change will come next year and in 2020.

Trump’s promise of improved healthcare for everyone at less cost than Obamacare was baloney. The final bill when voted on will be worse – how much depends on what revisions are made.

Things don’t look promising. Most people will pay more for less or settle for inadequate coverage, leaving them mostly on their own in case of serious health issues.

Under his American Health Care Act (AHCA – Trumpcare), most taxes on industry will be eliminated. Medicaid will be starved by less funding to states, perhaps en route to eliminating it altogether – replaced by who knows what or nothing, leaving America’s poor dependent on charity.

Medicaid expansion will survive in limited form, enrollment frozen in 2020 – after which states will receive federal block grants based on population size, effectively cutting a vitally needed program for millions of America’s poor.

The nation’s most vulnerable and elderly will pay more in premiums and out-of-pocket costs. Young, healthy and wealthy Americans will benefit.

An estimated $600 billion in tax revenue over the next decade is eliminated, adding to annual deficits and national debt if not compensated for by other means, according to the Committee for a Responsible Federal Budget (CRFB).

Estimates don’t include “the cost of repealing the individual and employer mandates or the cost of the replacement tax credits in the House legislation – though they do include the cost of the legislation’s proposed Health Savings Account (HSA) expansions. These estimates are only for the individual tax measures repealed by the House bill,” CRFB said.

The legislation “will worsen the financial state of the Medicare Hospital Insurance trust fund” – perhaps intended as part of a plan to eventually eliminate the program vital to millions of seniors and others eligible.

Proposed tax credits based on age, not income, will replace Obamacare subsidies, phased out by 2020. They’ll range from $2,000 for individuals under 30 to $4,000 for aged 60 or older people.

Individuals with annual incomes over $75,000 and couples earning more than $150,000 will gradually lose these credits, America’s poor and middle-income households hard-pressed to pay for increasing healthcare costs.

Insurers will be allowed to charge seniors five times more than younger people, compared to three-fold under Obamacare.

Millions unable to afford adequate coverage will be forced to be underinsured or settle for eroding Medicaid.

Many Obamacare provisions remain, including letting adults under age 26 stay on their parents’ plan, and preventing insurers from discriminating against individuals with pre-existing conditions. It bars them from imposing annual and lifetime limits on coverage.

Instead of the individual mandate, taxing people without coverage, insurers may impose a one-year 30% premium surcharge on anyone letting it lapse.

The plan doesn’t account for cost differentials in different parts of the country, penalizing many Americans for living in the wrong places.

Proposed health savings accounts (HSAs) are a tax shelter for the rich, most Americans unable to benefit from them.

Obamacare is a healthcare rationing scheme, benefitting insurers, drug companies and large hospital chains. Trumpcare makes a bad system worse.

Americans pay double or more for healthcare than consumers in other developed countries. Government-guaranteed universal, single-payer coverage alone works equitably for everyone.

Posted in USA, Health0 Comments

Big Pharma Quietly Enlists Leading Professors to Justify $1,000-Per-Day Drugs

To persuade payers and the public, the pharmaceutical industry has deployed a potent new ally.

To persuade payers and the public, the pharmaceutical industry has deployed a potent new ally. (Photo: Pixabay)

This story was co-published with Consumer Reports.

Over the last three years, pharmaceutical companies have mounted a public relations blitz to tout new cures for the hepatitis C virus and persuade insurers, including government programs such as Medicare and Medicaid, to cover the costs. That isn’t an easy sell, because the price of the treatments ranges from $40,000 to $94,000 — or, because the treatments take three months, as much as $1,000 per day.

To persuade payers and the public, the industry has deployed a potent new ally, a company whose marquee figures are leading economists and health care experts at the nation’s top universities. The company, Precision Health Economics, consults for three leading makers of new hepatitis C treatments: Gilead, Bristol-Myers Squibb, and AbbVie. When AbbVie funded a special issue of the American Journal of Managed Care on hepatitis C research, current or former associates of Precision Health Economics wrote half of the issue. A Stanford professor who had previously consulted for the firm served as guest editor-in-chief.

At a congressional briefing last May on hepatitis C, three of the four panelists were current or former Precision Health Economics consultants. One was the firm’s co-founder, Darius Lakdawalla, a University of Southern California professor.

“The returns to society actually exist even at the high prices,” Lakdawalla assured the audience of congressional staffers and health policymakers. “Some people who are just looking at the problem as a pure cost-effectiveness problem said some of these prices in some ways are too low.”

Even as drug prices have come under fierce attack by everyone from consumer advocates to President Donald Trump, insurers and public health programs have kept right on shelling out billions for the new hepatitis C treatments, just as Precision Health Economics’ experts have urged them. With a battle looming between the industry and Trump, who has accused manufacturers of “getting away with murder” and vowed to “bring down” prices, the prestige and credibility of the distinguished academics who moonlight for Precision Health Economics could play a crucial role in the industry’s multipronged push to sway public and congressional opinion.

While collaboration between higher education and industry is hardly unusual, the professors at Precision Health Economics have taken it to the next level, sharpening the conflicts between their scholarly and commercial roles, which they don’t always disclose. Their activities illustrate the growing influence of academics-for-hire in shaping the national debate on issues from climate change to antitrust policy, which ultimately affect the quality of life and the household budgets of ordinary Americans — including what they pay for critical medications.

The pharmaceutical industry is digging in, with one of its trade groups raising an additional $100 million for its “war chest.” For years, it has spent millions of dollars lobbying politicians, hoping to enlist their support on a wide range of legislation. It has similarly wooed doctors, seeking to influence what they research, teach and prescribe. Now, it’s courting health economists.

“This is just an extension of the way that the drug industry has been involved in every phase of medical education and medical research,” said Harvard Medical School professor Eric G. Campbell, who studies medical conflicts of interest. “They are using this group of economists it appears to provide data in high-profile journals to have a positive impact on policy.”

The firm participates in many aspects of a drug’s launch, both advising on “pricing strategies” and then demonstrating the value of a drug once it comes on the market, according to its brochure. “Led by professors at elite research universities,” the group boasts of a range of valuable services it has delivered to clients, including generating “academic publications in the world’s leading research journals” and helping to lead “formal public debates in prestigious, closely watched forums.”

Precision Health Economics may be well-positioned to influence the Trump administration. Tomas Philipson, an economist at the University of Chicago and the third co-founder of Precision Health Economics, reportedly served briefly as a senior health care adviser for the Trump transition team. He did not respond to requests for comment. Dr. Scott Gottlieb, reported to be a candidate for commissioner of the Food and Drug Administration, is a clinical assistant professor at New York University School of Medicine and a former “academic affiliate” of Precision Health Economics, according to its website.

Although it’s hard to gauge the firm’s precise impact, associates of Precision Health Economics have often waded into the political fray. Last fall, big pharma spent more than $100 million successfully defeating a California referendum that would have controlled the prices of both generic and name-brand drugs. Testifying in September at a state Senate hearing on a generic drug, co-founder Goldman steered the discussion to name-brand drugs, such as the hepatitis C treatments, arguing that their prices should not be regulated.

“We have to ensure access to future innovation, and that’s going to require some recognition that if someone develops an innovative drug, they’re going to charge a lot for it,” Goldman said.

Prescription drugs on average cost more than twice as much in the US as in other developed nations. That’s mostly due to name-brand drugs. They represent 10 percent of all prescriptions but account for almost three-quarters of the total amount spent on drugs in the US Their prices have doubled in the past five years.

The US grants drugmakers several years of market exclusivity for their products and remains one of the only industrialized countries that allows them to set their own prices. These protections have allowed the pharmaceutical industry to become one of the economy’s most profitable sectors, with margins double those of the auto and petroleum industries.

To justify the value of expensive drugs, the professors affiliated with Precision Health Economics rely on complicated economic models that purport to quantify the net social benefits that the drugs will create.

For one industry-funded hepatitis C study, Lakdawalla and nine co-authors, including three pharmaceutical company researchers, subtracted the costs of the treatment from the estimated dollar value of testing all patients and saving all livers and lives. By testing and treating all patients now, they concluded, society would gain $824 billion over 20 years.

Critics have at times questioned the assumptions underlying the consultants’ economic models, such as the choice of patient populations, and suggested that some of their findings tilt toward their industry clients. For example, some have tried and failed to reproduce their results justifying the value of cancer treatments.

Precision Health Economics allows drugmakers to review articles by its academics prior to publication in academic journals, said a former business development manager of the consulting group. Such prior review is controversial in higher education because it can be seen as impinging on academic freedom.

“Like other standard consulting projects, you can’t publish unless you get permission from the company,” the former employee said. Carolyn Harley, senior vice president and general manager of the firm, said that pre-publication review was not company policy, but “in some cases, client contracts provide them the opportunity for review and comment before submission.”

“I have never published anything that I am not comfortable with or prepared to defend, nor have I ever been asked to,” said Lakdawalla about his firm’s research.

Goldman says the firm’s research is independent, and its clients don’t influence its findings. “From my perspective it’s very clear: I say things that piss off my sponsors, I say things that piss off the detractors,” he told ProPublica. “People are coming to us because they have an interest in sponsoring the research that’s generated. These are our ideas. This is how you get your ideas recognized.”

He said his consulting work does not involve setting prices of specific drugs, and his academic research focuses only on categories of drugs, rather than on particular brands.

The professors’ disclosure of their ties to the firm and to the pharmaceutical industry in scholarly articles is inconsistent: sometimes extensive, sometimes scanty. Members of Precision Health tend to reveal less about their paid work in blogs, public forums like conferences, and legislative testimony. At the Capitol Hill briefing last May on hepatitis C drugs, Lakdawalla didn’t mention his affiliation with Precision Health Economics, though it was listed in the journal issue, which was provided to attendees.

“Conflicts are always a concern, which is why it is important to be transparent about study methods — that way they can be scrutinized and debated in the academic literature,” said Lakdawalla, adding that he has disclosed his ties to the firm in at least 33 publications over the past three years.

Goldman said he and other academics at Precision Health Economics disclose their ties whenever appropriate, but typically journal editors and conference sponsors decide how to make that information available. “I wear two hats,” Goldman said in an interview. “And I try to reveal what that might mean in terms of perceived conflict of interest.”

The issues at stake aren’t just academic. Goldman says that pharmaceutical companies need to reap financial rewards from the enormous time and expense they invest in developing better medical treatments. Yet the high prices of some drugs have left government health programs strapped, or forced them to limit coverage. For example, one promising hepatitis C treatment is so expensive that some state Medicaid programs have chosen to cover its cost for only the sickest patients.

“Triage, triage, triage,” said Emily Scott, a Tennessee factory worker with hepatitis C who was denied coverage for the new treatment. “They set their price so high that we poor folks can’t afford it.”

Despite such cases, four researchers from Precision Health Economics warned in an article last month that any government controls on drug prices could actually shorten the average American’s life by two years by discouraging development of new drugs.

“As the pace of innovation slows, future generations of older Americans will have lower life expectancy relative to the status quo,” they wrote. The article, funded by the pharmaceutical trade group PhRMA, was published in Forum for Health Economics & Policy, of which Goldman is the editor-in-chief and co-founder. More than half of the editors listed on its masthead are current or former consultants at the firm.

Just after Precision Health Economics co-founder Dana Goldman completed his Ph.D. in economics at Stanford, in 1994, he was diagnosed with type 1 diabetes. He was 29 years old. With a pump he wears every day, he takes insulin to treat the disease.

“I would pay hundreds of thousands of dollars if I could take one pill that would make me better,” Goldman said.

His desire for a cure led to a new scholarly interest: the economics of medical innovation. Because there were few government funders for research in the field, he turned to industry. In 2005, Goldman established the firm with Lakdawalla and Philipson.

The headquarters of Precision Health Economics sits in a West Los Angeles office building flanked by palm trees, about 10 miles from Goldman’s academic center at USC. Goldman’s assistant at USC is also an executive assistant at the consulting firm. Daniel Shapiro, director of research compliance at USC, said that both Goldman and Lakdawalla were in compliance with the university’s standards on consulting.

Precision Health Economics has counted at least 25 pharmaceutical and biotech companies and trade groups as clients. The roster includes Abbott Nutrition, AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Celgene, Gilead, Intuitive Surgical, Janssen, Merck, the National Pharmaceutical Council, Novartis, Otsuka, Pfizer, PhRMA, rEVO Biologics, Shire and Takeda. The firm has 85 staff members in nine locations.

Over the years, the founders recruited an impressive cadre of high-profile academics to consult for these clients. Early in 2016, the firm boasted more than two dozen academic advisers and consultants from top universities on its website. (The site later stopped identifying professors by their university affiliations.) The list of associates has also included some policy heavyweights who recently left the government, including a top official from the Congressional Budget Office, a senior economist from the White House’s Council of Economic Advisors, and an FDA commissioner. About 75 percent of publications by the firm’s employees in the past three years have either been funded by the pharmaceutical industry or have been done in collaboration with drug companies, a ProPublica review found.

Some academics worry that a tight relationship with industry might suggest bias. “I personally find, when your enterprise relies so substantially on a particular source of funds, you will tend to favor that source,” said Princeton economist Uwe Reinhardt.

Goldman says his industry connection has helped him ask better questions.

“The right way to do these things is not to push away the private sector, but to engage them,” he told ProPublica. “If we end up with a world where everyone who has a voice in a debate must be free of perceived bias, we lose the importance of the diversity of ideas.” In a later interview, he added, “You have to separate the appearance of the bias with actual bias.”

These ideas were recently echoed in an op-ed that he wrote with Lakdawalla in the online publication The Conversation.

“To be sure, collaboration with industry supplements our income through consulting fees. But no matter who funds our research — foundations, government, or companies — we apply the same template to our work,” wrote Goldman and Lakdawalla. “The ivory tower is not always the best place to understand the social benefits of treatments, the incentives for medical innovation, and how aligning prices with value can aid consumers.”

Engaging the private sector has indeed boosted Goldman’s income. According to federal conflict of interest forms filed last year, when he served on an advisory panel to the Congressional Budget Office, Goldman earned consulting income from the firm in the range of $25,000 to $200,000, on top of his income as a USC professor. He also has more than $500,000 in equity in the firm. Precision’s Harley says Goldman and Lakdawalla each have equity stakes of less than 1 percent, indicating that the firm is worth at least $50 million. Lakdawalla and Philipson have not publicly disclosed their consulting incomes.

In April 2015, Precision Health Economics was acquired by a privately held biotech company, Precision for Value. Terms weren’t disclosed.

Precision Health Economics raised its profile in 2013 when the president’s annual economic report cited a cancer study by several of the firm’s principals and consultants. To some critics, though, the study showed how industry funding can taint academic research.

Originally published in Health Affairs, where Goldman also serves on the editorial board, the study found that Americans paid more for cancer care than Europeans but had better survival gains.

As the study acknowledged, it was funded by Bristol-Myers Squibb, a company that at the time was developing a much-anticipated cancer treatment. It was priced at more than $150,000 per year when it eventually came on the market. All three founders of Precision Health Economics were listed as authors of the Health Affairs article, alongside one of their employees, yet none of the founders disclosed their ties to their consulting firm in the published study. In an interview, Goldman said this might have been an “oversight.”

Goldman later emailed ProPublica to clarify that the journal was aware that the study was a Precision Health Economics publication and that Goldman and his co-founders were affiliated with the firm. Goldman has published more than 25 articles and letters to the editor in Health Affairs since co-founding Precision Health Economics, and only five have listed the connection.

“This affiliation is clearly not a secret and I include it where relevant,” Goldman wrote in the email. “The bottom line is that disclosure policies vary across journals, journal editors, and over time. Definitions of what is ‘relevant’ are also subject to their own judgments.”

Donald Metz, executive editor of Health Affairs, said the journal followed its policy of leaving disclosure to the “authors’ discretion.” Its editorial staff did not exclude any information on conflicts or affiliations that the authors provided alongside their draft, he said.

As the cancer study gained national recognition, its methodology and findings came under fire. Researchers from Dartmouth College tried and failed to reproduce the results. Cancer care in the US, their research found, may actually provide less value than cancer care in Europe, considering cost.

“We know that [the US health care system] is more disorganized and disorganization is more expensive, so it’s surprising to believe that the US would perform better in a cost-effectiveness sense,” said Samir Soneji, one of the authors of the counter-study and an assistant professor of health policy at Dartmouth. The science in the original study, Soneji says, was “questionable.”

Soneji was not alone in his criticism. Aaron Carroll, a pediatrics professor at the Indiana University School of Medicine, reviewed the methodology and concluded that the Precision Health Economics researchers had used a measure that can frequently be misinterpreted. Instead of relying on mortality rates, which factor in a patient’s age of death, the study employed survival rates, looking at how long people live after diagnosis. Cancer screening, which can increase survival rates, is more frequent for some cancers in the US than in other countries, Carroll says.

“When they wrote that paper using survival rates, they were clearly cherry picking,” Carroll told ProPublica. “If the arguments are flawed and people keep using them, I would be concerned that they have some other motive.”

The founders of Precision Health Economics defended their use of survival rates in a published response to the Dartmouth study, writing that they “welcome robust scientific debate that moves forward our understanding of the world” but that the research by their critics had “moved the debate backward.”

Precision Health Economics has become a prominent booster of a new way of setting drug prices — based on their overall value to society. Value is determined by comparing the drugs’ cost with their effectiveness in saving lives and preventing future health expenses.

Pharmaceutical companies have traditionally justified their prices by citing the cost of research and development, but recent research on drug pricing has challenged this argument. Many of the largest drug companies spend more on sales and marketing than on developing their drugs. And notably, one researcher has found that about 75 percent of new molecular entities, which are considered the most innovative drugs, trace their initial research funding back to the government.

“There is substantial evidence that the sources of transformative drug innovation arise from publicly funded research in government and academic labs,” said Dr. Aaron Kesselheim, an associate professor at Harvard Medical School whose research looks at the cost of pharmaceuticals. Pharmaceutical pricing, he says, is primarily based on what the market can bear.

Many early proponents of value pricing, including American health insurers, saw it as a way to rein in drug prices. Some nations, particularly those with national health systems, like the UK, rely on official cost-effectiveness analyses to decide which drugs to pay for. Overpriced drugs are sometimes denied coverage. This powerful negotiating tool has helped keep drug prices down abroad.

Efforts to establish similar practices in the US, however, have been stymied by lobbying from patient groups, many of them funded by the pharmaceutical industry, contending that value pricing could lead to rationing of health care. More recently, though, the industry has used academic consultants to help it redefine the concept of “value” to justify its pricing.

At the congressional briefing on the new hepatitis C drugs, Harvard Medical School associate professor Anupam Jena, a Precision Health Economics consultant, suggested that part of a drug’s value is earning enough profit that pharmaceutical companies are enticed to develop treatments for other diseases. Otherwise, Jena said, “you don’t incentivize innovations that actually deliver value, and so the next cure … may not be developed.”

Princeton’s Reinhardt said pricing drugs based on this notion of value could give the industry carte blanche to charge whatever it wants. “If you did value pricing and say it’s OK for the drug companies to charge up to what the patient values his or her life to be, you are basically saying that the pharmaceutical companies can take your savings,” he said. “American society will not stand for that.”

Not long after the controversy over its cancer research, Precision Health Economics became embroiled in another academic spat related to a client’s product. This time, it was over a breakthrough treatment that, injected one to two times per month, could help millions of Americans with high cholesterol. At the $14,000-per-year price set by one of its makers, Amgen, the PCSK9 inhibitor could also hike the nation’s annual prescription drug costs by an unprecedented $125 billion, or 38 percent. Its price in the US is twice as much as in the UK.

The US price of the drug has come under vigorous attack from the nonprofit Institute for Clinical and Economic Review. ICER, which began as a small research project at Harvard Medical School, studies the cost-effectiveness of drugs, balancing their value to patients against the impact of their cost on society. The Centers for Medicare and Medicaid Services proposed a new rule in March 2016 that includes the use of value-based pricing studies, specifically citing the work of ICER.

The industry has attacked many of the institute’s studies, particularly those that find a treatment is overpriced. Some patient groups have contended that ICER emphasizes cost savings because it receives funding from health insurers. However, foundations are ICER’s biggest source of funding, and it is also supported by the pharmaceutical industry and government grants. The pharmaceutical lobby has similarly attacked the Drug Effectiveness Review Project, a coalition of state Medicaid agencies and other payers, accusing it of using its studies to justify “rationing.”

ICER concluded in 2015 that the new cholesterol treatment, the PCSK9 inhibitor, should cost about one-fifth what Amgen is charging. A few months later, Philipson, the Precision Health Economics co-founder, and Jena wrote an op-ed in Forbes, citing the institute’s research and deriding its approach to value pricing as “pseudo-science and voodoo economics.” Only Philipson disclosed his ties to Precision Health Economics, and neither academic disclosed that Amgen was a client of the firm.

After being asked by ProPublica about the lack of transparency, Forbes added a disclosure statement to the op-ed. “Manufacturers of PCSK-9 inhibitors and novel treatments for hepatitis C, such as Amgen, Gilead, and Abbvie, are clients of Mr. Philipson’s consulting firm, Precision Health Economics, for which Dr. Jena also works,” the publication noted. “In general, the pharmaceutical and biotechnology companies which retain Precision Health Economics benefit from higher drug prices.”

Goldman, along with Precision Health Economics employees and two Harvard professors, including Jena, published their own study on the cholesterol drug in the American Journal of Managed Care, where Goldman serves on the editorial board. They found that the new cholesterol drugs were indeed cost-effective at the listed prices. The article disclosed the authors’ ties to Precision Health Economics and the source of funding: Amgen.

The drug is “not cheap, but it’s a good deal” for patients who need it, Goldman said, after his team’s economic models calculated its net value between $3.4 trillion and $5.1 trillion over 20 years.

ICER’s finding that the PCSK9 inhibitor was overpriced was later affirmed in a related study published in the peer-reviewed Journal of the American Medical Association, or JAMA. Associates of Precision Health Economics again rushed to Amgen’s defense. Philipson and an Amgen executive wrote a letter to the editor of JAMA to dispute the study’s conclusion that the price should be about $4,500 per month, less than a third of the drug’s average price.

The two studies made different assumptions that shaped their conclusions. Dr. Dhruv Kazi, one of the authors of the JAMA study and an associate professor at the University of California San Francisco, said that the Precision Health Economics study assumed that there were fewer eligible patients who would take the drug, lowering the cost to society. It also posited that they had a higher risk of cardiac events, like heart attacks, boosting the drug’s value as measured in lives saved.

“This is an example where you would end up assuming that the population is at higher risk than is true for the real world population and that would make your drug look better,” Kazi said. “It’s not a wild idea to think that a cost-effectiveness study funded by industry would look more favorable” to the industry’s viewpoint, he said. “If that weren’t the case, they wouldn’t fund it.”

Jena said the patient population for the Precision Health Economics study more accurately reflected the real world. One should not automatically assert that a study is “invalid or flawed” because of industry funding, he added.

The JAMA study “over-exaggerated the cost” of the drug and “unnecessarily rang ‘alarm bells,'” said Amgen spokeswoman Kristen Neese.

Amgen has ties to all three founders of Precision Health Economics. Working for other firms, Philipson has twice testified as an expert witness for Amgen, defending the company’s rights to drug patents, according to his curriculum vitae. The other two founders, Goldman and Lakdawalla, are principals at the Leonard D. Schaeffer Center for Health Policy and Economics at USC, which received $500,000 in late 2016 from Amgen for an “innovation initiative,” according to public disclosures. Goldman said the funds were unrestricted and could be used at the center’s discretion. Robert Bradway, the CEO and chair of Amgen, is on the advisory board of the university center, and Leonard Schaeffer, a professor at USC and the namesake of the center, sat on Amgen’s board of directors for nearly a decade.

With funding from Amgen, the Schaeffer Center hosted a forum in Washington, D.C., in October 2015 on the affordability of specialty drugs. Before a panel focused on the new cholesterol treatment, Goldman cautioned against lowering drug prices.

“We know that the pricing of these treatments is often controversial,” he told the crowd of policymakers, which included Sen. Bill Cassidy, R-La., a physician who sits on the Health, Education, Labor and Pensions Committee. “If we dropped all the prices today, in the long run, we wouldn’t have any innovation.”

The PCSK9 inhibitor’s price inhibits access for some patients who need it. Scott Annese, a 50-year-old computer technician from South Daytona, Florida, has diabetes and a total blood cholesterol level topping 260. After he suffered a heart attack and had two stents inserted in his left coronary artery, his doctor prescribed a statin, a low-cost drug to lower cholesterol. However, the statin combined with his diabetes to cause painful side effects, including muscle aches, cramping, and soreness in his legs that incapacitated him, he said. Amgen’s drug, his doctor told him, was the only other option.

But Annese, who makes $13.50 an hour, couldn’t afford the new drug. He doesn’t have health coverage through his job and says Obamacare, especially with its rising premiums, is too expensive for him. He tried to get insurance through Medicaid, but he earns too much to qualify. His last option, he said, is Amgen’s patient assistance program, which he has applied for. His application is pending.

“If you’re in the industry to help people, you’re not helping them if you raise the drugs to the point that they can’t afford it,” said Annese. “The drug companies are hurting the people who need it most.”

Gilead Sciences’ $84,000 list price for its highly effective treatment for the hepatitis C virus prompted dozens of state Medicaid programs and prison systems to restrict treatment to only the sickest patients. A congressional investigation in 2015 found that Gilead, which purchased the drug from a smaller pharmaceutical company, had set the price of the treatment at the peak it thought the market could bear, more than double what the drug’s original developers had suggested.

“Gilead pursued a calculated scheme for pricing and marketing its hepatitis C drug based on one primary goal, maximizing revenue, regardless of the human consequences,” said Sen. Ron Wyden, D-Ore., when he presented the findings of the congressional investigation.

While Precision Health Economics often portrays itself as an advocate for wider access to vital medications such as the hepatitis C drugs, the high price of those drugs forces some payers, such as the Medicaid programs, to ration them. As a result, the professors may influence who ultimately gets the drug and who doesn’t. The impact is reverberating in the rugged hills of eastern Tennessee, where hepatitis C is spreading due to the opioid epidemic. Because the virus can be asymptomatic for years, only a fraction of those infected know they are carriers, leading many to spread the potentially fatal liver disease unknowingly, mostly by sharing needles.

Over the past seven years, the number of acute cases of hepatitis C in Tennessee has tripled. The state has estimated that more than 100,000 residents are likely to have a chronic version of the disease without realizing it. Just last year, the state issued a public-health advisory addressing the crisis, but the rates of infection continue to rise.

It took years for Emily Scott, the factory worker from the Cumberland Gap region of eastern Tennessee, to find out she had the virus. After donating blood in January 2016, she received a certified letter from the blood bank informing her that her blood could not be accepted because it had tested positive for hepatitis C.

She didn’t believe the letter at first, hoping they had mistaken her blood with that of another donor. After all, she had never experienced any symptoms. But a local doctor reran her blood work and her diagnosis was confirmed.

Like many in her community, Scott had battled an addiction to drugs, mostly painkillers, and she had used syringes in the past for her highs. She’d been clean for the past four years but believes that she contracted the disease through her drug use.

“I made some mistakes,” said the 26-year-old Scott. “But I didn’t ask to be sick.”

Shortly after her diagnosis, Scott learned from a television advertisement that the new drugs had a cure rate of 90 percent. But getting the treatments would prove elusive.

Raising her two sons on her own, Scott barely supports the family with her weekly income of about $350 from sewing shirts at an apparel factory. She is one of more than 11,000 Tennesseans on Medicaid who have been diagnosed with hepatitis C, according to the most recent state data. If all of them received the new medication, the state estimated that it would cost over $1.6 billion, more than double what Tennessee’s Medicaid program spends on drugs in a year.

“There isn’t an endless bank account,” said Darin Gordon, Tennessee’s former Medicaid director, who was in charge when the hepatitis C cure was launched. “States have to balance budgets, and this came in and hijacked our budget.”

Tennessee quickly limited the treatments to the sickest patients. After reviewing the scientific literature, Gordon’s medical team determined that it was only medically necessary to treat patients whose livers had begun to show scarring, a sign that the disease had progressed beyond the initial latent stage. Even if patients’ conditions stabilize while they await the treatment, they are still contagious. Once the treatment is finished, they no longer can spread the virus.

Under this policy, less than 10 percent of diagnosed Medicaid patients have been treated, still costing the program more than $100 million in the past two years. Patients like Scott, whose liver has no significant scarring, were forced to wait for the disease to progress before being prescribed any of the new drugs.

The state denied Scott’s request for the cure in March 2016. But she wouldn’t let that stop her. She appealed and was granted a hearing in Knoxville, which she had to attend by phone because it was two and a half hours’ drive from her home. She explained to the judge that she was a single mother of two young boys and could not risk her health declining. A few days later, she received a court order in the mail, denying her access to the treatment.

By forcing Tennessee Medicaid and other public payers to delay coverage, the high price of the hepatitis C drugs incurs a social cost. While waiting to become sick enough for treatment, patients may transmit the disease. Some, including Scott, begin to feel symptoms like fatigue and muscle pains, which may hinder their ability to work.

“The drug companies do not have people’s interest in mind, they have money in mind,” Scott said. “It’s not fair that they are playing with people’s lives.”

Since the firm’s sale in 2015, Precision Health Economics’ three founders have taken roles in its parent company. Goldman is an executive economist at Precision for Value and chairs an advisory board focused on “value and evidence.” Lakdawalla is the chief scientific officer, and Philipson is listed as chief economist and the chair of the strategy and innovation board.

On its website, Precision for Value lays out how it can help biotech companies with “preliminary pricing, access, and evidence strategy” and “launch price strategy.” The company says that it can “pressure test” a company’s proposed messaging strategy on value with key stakeholders and determine how willing the market might be to pay future drug prices.

Under its new ownership, Precision Health Economics recently launched a group focused explicitly on assessing the value of innovative drugs. The firm’s three founders are involved with this Innovation and Value Initiative, which bills itself as an “unparalleled convergence of academic leaders and scientific experts.” Lakdawalla serves as executive director of the initiative. On the initiative’s health advisory panel, which is supposed to steer the research agenda, Goldman and Philipson sit alongside mostly executives from pharmaceutical companies and trade groups.

The initiative also has a scientific advisory group for internal peer review. All of its members are current or former Precision Health Economics consultants or staffers. Lakdawalla said in an email that all of its projects “either undergo academic peer review at a journal, or include an external peer reviewer outside [the firm].”

To promote the new initiative, Precision Health Economics has launched an extensive advertising campaign, sponsoring content in Health Affairs, writing op-eds in The Washington Post and Forbes, and even buying ads on Google.

In a phone conversation, Goldman was asked whether the stratospheric drug prices bolstered by the professors at Precision Health Economics deprive low-income patients, like Emily Scott, of vital treatments. He responded that it’s important to take a longer-term view.

Posted in USA, Health0 Comments

Global Environmental Pollutants: Is Anthropogenic Activity Despoiling the Planet?

Or is it Mainly the Anti-Human Activity of Multinational Corporations?

Definition of Anthropogenic: “an adjective used to describe the environmental pollution and pollutants that originate from human or corporate activity.”

Conscientious whistleblowers in the honor-the-earth, protect-the-water and assorted other environmental movements regularly point out the glaring reality that it is actually the amoral, conscienceless multinational corporations that are the main cause of local, regional and planetary environmental pollution.

But if an investigative journalist accidentally allows those assertions to be published or voiced, the media’s propaganda machine predictably goes into defensive mode or attack mode, first casting doubt on the whistle-blower’s assertions or else it issues an ad hominem attack upon the whistle-blower.

The corporation’s stable of lawyers and public relations department  – with the assistance of assorted media mouthpieces – start mis-directing the public’s perceptions by repeatedly using the “time-honored” phrase of human activity or “man-made activity” for causing the problem (even though all the credible truly scientific evidence implicates corporate activity” for the damage).

Thereafter, especially if the media outlet depends on advertising revenue from the corporate polluter, the whistle-blower will likely be black-balled from further interviews.

Every polluting, fossil fuel-burning multinational corporation could be indicted in any unbiased court of law for crimes against humanity and for crimes against the planet – if any courageous lawyer could be found to prosecute the case. Plenty of solid scientific data exists to convict polluting corporations for their crimes against the planet – if a fair-minded judge could be found that is not beholden to corporate interests.

And any legislative body containing a majority of honorable politicians (that have not taken corporate campaign bribes) would easily pass legislation protecting the planet rather than listening for even another minute to the corrupted “pseudoscience” that is spouted so regularly by the highly-paid mercenary lobbyists that do the bidding their industry paymasters.

It is the rare corporation that does not pollute the earth in the process of mining the earth’s natural resources and in the manufacturing of their products. And then the end-products invariably cause serious pollution in many ways, including the act of disposing of the often toxic used-up product.

Pentagon SuperFund Sites, the Worst of the Worst

The Pentagon and its military-industrial complex of weapons suppliers are acknowledged to be the worst and most plentiful polluters on the face of the earth, with hundreds of military bases and weapons production sites that qualify for the designation of SuperFund sites. Those sites contain the most toxic by-products of war-making and the environmental pollution is so bad that the government and the taxpayers are on the hook for doing the impossible clean-up!

The same can be said of the mining industry, so that when a mine shuts down, the metallic ore plays out or the mining company goes belly-up, the government and the taxpayers are on the hook to do the clean-up. (The so-called clean-up is particularly difficult in the deadly residue and toxic tailing ponds at the sites of sulfide (sulfuric acid-producing)  mines where gold, silver, copper and zinc had been mined.

(For much more information about sulfide mining, see my column on the Butte, Montana SuperFund open pit copper mine that is located just outside of the dying community of Butte, Montana. The Butte mine clearly illustrates the long-term pollution that just one abandoned copper mine invariably causes as it gradually fills up with heavy metals that are dissolved in  sulfuric acid that has a  highly acidic pH of 2.5 [approximating stomach acid].) The Butte SuperFund site is just one of 16 Montana SuperFund sites that the has been assigned to remediate.

Here is the link:

Minnesota’s 25 EPA SuperFund Sites

Incidentally, Minnesota at one time had over 40 SuperFund sites, with 25 remaining on the EPA’s list, including Duluth’s St. Louis River site at the old US Steel Plant, where there are carcinogenic PAHs (Polycyclic aromatic hydrocarbons), carcinogenic VOCs [volatile organic chemicals) , cyanide, naphthalene, and heavy metals – including mercury – in the sludge at the bottom of the river, where US Steel dumped its chemical and metallic refuse. Most of the Minnesota sites are either corporate refuse site, municipal landfill sites or weapons manufacturing sites. All have serious heavy metal and/or carcinogenic contaminants that are poisoning the ground water, soil and even the air.

The recently discussed irremediable pollution in the slip near Duluth’s Canal Park, where the decommissioned ore boat, the William A. Irvin, is moored, is not large enough to warrant SuperFund status, nor has the upstream St. Louis River Cloquet Paper Mill operation, which, for many decades, discharged toxic paper-processing by-products (especially carcinogenic chlorinated hydrocarbons from the bleaching process) directly into the St. Louis River before it was forced to change its manufacturing operations.

Corporate Disinformation Tactics

When confronted by damaging information about their corporate processes, one of the early disinformation tactics that CEOs order is to have their public relations propagandists play the “doubt card”, which tries to deflect blame for the malfeasance on some other entity, often by producing some pseudoscientific research that the industry concocted in secrecy.

Wealthy corporations have the monetary resources to use that tactic for decades if necessary, thus delaying real remedies while the profits keep rolling in. The “doubt card” tactic is currently being used by climate change deniers, especially the accused, amoral corporations in the Big Tobacco, Big Oil, Big Coal, gas, energy, pipeline, mining, pharmaceutical and weapons industries, despite the evidence for global warming that is everywhere that an unbiased, well-informed person might look.

Big Tobacco particularly has become infamous for casting doubt on whether or not cigarette smoking was a public health problem. Big Tobacco’s executives have even expressed pride in inventing that tactic, stating that doubt was their greatest weapon in delaying government interference in their obscenely profitable industry. Casting doubt delayed the public’s perception that cigarettes were carcinogenic or could cause respiratory illnesses, and thus they got away with murder for decades longer than they should have.

Science-minded physicians like US Surgeon General C. Everett Koop, who served under Ronald Reagan (who was Big Pharma’s, Big Food’s, Big Agribusiness’s and the nuclear weapons industry’s hero), knew the facts about tobacco’s lethality. But Koop and many other unbiased scientists were essentially accused of being conspiracy theorists when they tried to warn the public about the tobacco industry’s dangerous products. Selling highly addictive but highly lucrative products creates life-long customers and patients who will pay almost anything to get their next caffeine, nicotine, opioid or prescription drug fix in order to avoid the painful symptoms of withdrawal.

Is there a more devious way for an entity to make money than to sell customers a highly addictive product that also sickens and even kills its customers, while simultaneously lying about the addictive quality and lethality of its products?

Illicit vs. Legal Addictive Drugs

Welcome to the world of sociopathic Big Businesses that profit by pushing illicit – but highly addictive – street drugs like heroin, methamphetamine, cocaine and speed, each of which are intended to get customers addicted, thus becoming regular customers.

And welcome to the world of sociopathic Big Pharma industries that maximize profits by marketing legal – and oftentimes highly addictive – psychopharmaceutical prescription drugs such as “anti-depressants”, tranquilizers, opioids, the so-called ADHD drugs, the various anorexic/weight loss drugs and psycho-stimulating drugs like Ritalin, Strattera, Wellbutrin, Effexor and Provigil. Any adverse effects from these prescription drugs are iatrogenic.

Big Pharma and Iatrogenocide

Big Pharma’s psychotropic drug marketing programs are virtually indistinguishable from Big Tobacco’s. Until they were caught in the lie, both industries (falsely) asserted that their products were safe, effective and not addictive, and to this day, they both continue to co-opt their partners in deception (the tobacco sellers and the prescribing physicians, allied health professionals, psych drug salespersons and pharmacists) by convincing those groups to continue prescribing or dispensing these dangerous synthetic chemicals long enough to make their clients physiologically dependent.

And then, when the patient who has been taking brain-altering substances long enough and then realizes that he might be addicted, or feels sick or out of control and then  to get off the drug, he is at high risk of developing withdrawal symptoms (that are usually totally different from the symptoms that caused him to start the drug in the first place).

When withdrawal from addictive drugs occurs, the prescribing physician often erroneously makes a knee-jerk diagnosis that the patient’s initial “mental illness” is “relapsing”. And then, because of the unfounded assertion that the withdrawal syndrome is just the old disorder coming back, the patient is often told that he will have to take a cocktail of drugs for the rest of his life.

Of course the longer a potentially addictive brain-altering drug is taken, the more likely it will be that the patient will have difficulty overcoming the brain’s dependence on the substance, and it doesn’t matter whether the drug was legal or illicit. There is also a great likelihood of long-term brain damage as these drugs accumulate with each dose and therefore can continue their neurotoxic adverse effects.

Whether using Big Tobacco’s or Big Pharma’s addictive products, smokers and drugged-up patients are likely to become lifelong consumers of the products and will be helping both industries keep the drug prices high, the next quarter’s financial report positive and the corporation’s stock price up; all of which keeps the gravy train going strong for the CEOs who regularly take home tens of millions of dollars annually.

Immediately below is one formula for the successful marketing of prescription psychotropic drugs. These principles are just a variation of how people get hooked on nicotine, heroin and other assorted street drugs.

1) Brain-wash prospective targets so they will want to try the potentially addictive drug;

2) Convince the target to demand a prescription from their physician;

3) Cheer-lead the patient to tolerate the inevitable adverse effects so that the patient will continue taking the drug until they are hooked;

4) Get the patient to take the drug even though it can be obscenely expensive;

5) Be ready for the patient to fail at trying to stop taking the drug;

6) Recommend additional drugs to cover-up the drug’s adverse effects (rather than quitting the drug altogether);

7) Encourage the patient to increase the dose of the addictive drug when he gets drug-withdrawal symptoms or even encourage the patient to take additional drugs to cover-up the symptoms (rather than taking the time to help the patient get off the drug completely).

Industries that sell addictive entertainment (such as videogames, online gambling and pornography), alcohol, caffeine, nicotine, sports, etc) are examples of addictive products that are regarded as good investments for the investor class, no matter what are the consequences for the patient.

Those examples of corporate amorality, malfeasance and greed could be called crimes against humanity and crimes against the planet. And just below is another crime against Mother Earth that has been essentially ignored by the national media. Pretending that the disastrous algae blooms in the Great Lakes aren’t there is irresponsible behavior whether corporations or individual humans are to blame. And to acknowledge the disaster might lead to criminal prosecution.  Of course, if the root causes of the algae blooms are identified, the next step is to identify the guilty entities (usually corporations) that should be legally responsible for the clean-up.

Toxic Algae Blooms in Herbicide and Pesticide-poisoned Lake Erie

The environmental catastrophe that has been well-documented in a multitude of satellite photographs (see one of them below) has been slowly killing off Lake Erie, the 11th largest “fresh” water lake in the world. The pro-corporate, anti-regulatory, neoliberal and neoconservative entities (from all political persuasions except for Greens and Social Democrats) from the rust-belt states of Michigan and Ohio have been negligent in their duty to ensure the sustainability of the environment. But all those politicians took large campaign contributions – and then acquiesced to pressure – from regional and multinational corporations to do what was best for the polluting industries and not for the environment. The corporations most responsible were the ALEC-associated Big Agribusiness, Big Chemistry, Big Mining, Big Energy, Big Food and Wall Street industries in whose interest it has always been to see abolished the common-sense efforts of the Department of Natural Resources and the Environmental Protection Agency for the regulation of toxic pollutants. Immediately below are named some of the corporate pollutants.

1) Pesticides and insecticides used in corporate agribusiness,

2) Phosphorus- and nitrogen-containing nutrients in corporate agribusiness-promoted fertilizer and phosphate detergents (PO4),

3) Corporate sewage treatment plants,

4) Corporate garbage-burning facilities,

5) Corporate mining waste runoffs,

6) Corporate pharmaceuticals that are excreted by humans and livestock animals,

7) Organochlorine toxins (often carcinogenic, from upstream corporate paper mills, chlorinated drinking water, etc),

8) Fluoridated drinking water,

9) Corporate farm animal manure (virtually always contaminated with antibiotics),

10) PCBs and mercury from coal-fired corporate electric power plants,

11) Other synthetic, non-organic, toxic food waste and water in aquifers, lakes, rivers and streams (even water that is intended for drinking!), and

12) Global climate change because of the fossil fuel industry’s refusal to change to sustainable energy sources.

The following satellite image is of a massive toxic algae bloom from the summer of 2015, which was the worst bloom in years. The summer of 2016 was expected to be worse than 2015. The photo shows Michigan’s Lake St. Clair and the western part of Lake Erie, Both fresh water lakes received enormous amounts of Agribusiness-facilitated, fertilizer-laden, herbicide-laden, pesticide-laden, highly polluted water from streams and rivers that drain the area’s chemically-treated, corporate-managed farm land. Normal lakes should be uniformly blue with zero green color! The green, of course, represents the algal bloom.

These algae are often toxic. They are able to thrive partly because of the warming water (more proof of global climate change), but the bloom is made much worse because of the combination of high nitrogen and phosphorus nutrient load from farm fertilizer and livestock manure and because algae are resistant to the above list of cellular toxins that kill off algae’s competitors, such as fish and other aquatic life.

Highly toxic herbicides and insecticides are commonly found in the watersheds leading into Lake St Clair and Lake Erie. The poisons that are secreted by the algae can be lethal to fish and animals, including humans, given a large enough exposure. Some of the toxic chemical herbicides and pesticides listed below are commonly sprayed on farm fields of large American corporate farming operations, thanks to Big Agribusinesses like Monsanto. They include:

1) Metolachlor, atrazine, deethylatrazine, cyanazine, simazine and Round-up are among the most frequently detected herbicides.

2) Diazinon, chlorpyrifos, and carbaryl were among the most frequently detected insecticides.

Algae are simple plant species that do not thrive in unpolluted cold water. Under certain conditions, the overgrowth of some algae species can produce deadly toxins that can kill or sicken fish, shellfish, mammals, birds and humans, and, of course, will make the water smelly and undrinkable.

When masses of algae die and decompose and de-oxygenate the water, massive fish die-offs – if there are any fish left – will occur.

Non-human corporations are the major culprits, not individual human persons. Corporations are not persons, no matter what the Supreme Court said in 2010, but they should be held responsible.

In a strict law and order society like Donald Trump claimed his presidency was all about, such crimes against humanity and the earth should be punished with the death penalty.

I say take the culprits to court and lock ‘em up before they kill again.

Posted in Health0 Comments

New Vaccines Still Cause Autism and the U.S. Government Knows It


Today in the US and a growing number of other countries, the official policy is that any scientific study, regardless of its methodology, quality, author credentials, and peer-reviewed process is summarily dismissed as incomplete, irrelevant or unsupported if it finds a connection between any vaccine or combination of vaccines and autism spectrum disorder. Even when the CDC’s own immunologist, Dr. William Thompson, whistle-blows and provides thousands of pages of scientific data and research proving a vaccine-autism connection, the matter is rapidly shoved under the table.

In the case of Dr. Thompson’s release of confidential documents to a Congressional subcommittee, the CDC intentionally concealed their evidence that African American boys under 36 months had a higher risk of autism after receiving the MMR vaccine.  The documents also proved the CDC has know for a long time that neurological tics, indicating brain disturbances, were associated with thimerosal-containing vaccines, such as the influenza vaccine.

We have also known for over fifteen years, thanks to a Freedom of Information Act filing, that CDC officials, vaccine scientists on the CDC’s vaccine advisory panel, the WHO and private pharmaceutical executives met secretly for two days at the Simpsonwood retreat center near Atlanta to deliberate on the Verstraeten research’s findings proving thimerosal’s role in the rise of autism. The meeting was held for the specific purpose to find ways to prevent the findings from reaching the public, and spin and manipulate the data to disprove a vaccine-autism connection.

More recently a private medical consultant, Barry Rumack MD, was hired by the FDA to review that status of mercury levels in children with an emphasis on childhood vaccines. According to his findings, “at no point from birth to 16-18 months of age that infants were mercury levels below the EPA guidelines for allowable mercury exposure…. In fact, according to the models, blood and body burden levels of mercury peaked at six months of age at a shocking high level of 120 ng/L. To put this in perspective, the CDC classifies mercury poisoning as blood levels of mercury greater than 10 ng/L.”  Dr. Rumack notes that the FDA chose to hide this finding from the public and higher health officials.[1]

Another damning case of government-industry knowledge about a vaccine-autism connection is a leaked December 16, 2011 document from GlaxoSmithKline, one of the world’s largest vaccine manufacturers. The text admits the corporation has been aware of the autistic risks associated with its Infanrix vaccine, which combines diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated polio and haemophilus influenza viruses. The report details adverse effects associated with autism, including encephalitis, developmental delays, altered states of consciousness, speech delays and other adverse reactions.[2]

While these events might be considered criminal activities that directly threaten public health, they have had little effect on changing national policy over vaccine safety. Rather, the official denial of any possible association between vaccines and autism has hardened into an absolute dogma. And to date, there is not a single gold standard publication to refute with certainty a vaccine-autism connection.

Unfortunately, the American media has accepted the federal denial as absolute too. Never do we hear the media questioning the veracity and scientific legitimacy of the official doctrine. In fact, the media goes even further, embracing the principles of fake news, to attack scientists, physicians and parents who provide evidence to the contrary. Therefore, what follows is for readers’ discretion to review and reflect upon the proof being presented to show an unequivocal relationship between vaccination and autistic disorders.

Unlike the US, the UK and Australia, the majority of the governmental health ministries in the modern industrialized world do not take an official national stance on the vaccine-autism controversy and other serious vaccine-related injuries. Only nineteen countries, including the US, have no-fault policies to the pharmaceutical industry for vaccine injury compensation programs. This is partially due to the American and British health agencies being heavily compromised by private vaccine business interests. The revolving doors and conflict of interests between these federal agencies and the pharmaceutical industry have been well documented.

In the US, the CDC’s vaccine advisory community are in the deep pockets of pharmaceutical firms. This is not the case for most nations where independent and scientific integrity in ruling compensation for vaccine adverse events remain the norm. In 2014, French authorities ruled there was a direct relationship between the Hepatitis B vaccine and a sudden rise in multiple sclerosis.[3] In 2012, after a long investigative trial, an Italian court ruled that the MMR vaccine caused brain injury leading to autism in the case of Valentino Bocca.[4]

This ruling was intentionally blacked out by the American media. The Japanese government halted the MMR in 1993 due to rising autism rates.

To date, the US vaccine injury compensation court has paid out approximately $3.1 billion to families of vaccine-victimized children. The actual number of awarded cases nevertheless is very small compared to the large number of claims filed and subsequently denied. Among these are cases related to autism, such as Hannah Poling, Bailey Banks, Ryan Mojabi, Emily Moller, and several others. Many more compensations have been awarded to cases of vaccine-induced encephalitis or brain inflammation, a common event associated with regressive autism. Therefore, within the legal record, contrary to the adamant denials of the CDC and pro-vaxxers such as Paul Offit, vaccines can cause autism.

Thimerosal, the ethylmercury preservative commonly found in vaccines, is perhaps the ingredient with the longest history of controversy. The pharmaceutical company Eli Lily tested thimerosal back in 1930, giving it a clean record of safety even though its own trials had shown it caused serious neurological damage and even death in both animals and humans.  During that decade, a competitor vaccine maker, Pittman-Moore, had also conducted toxicological studies with dogs and concluded the preservative was “unsatisfactory as a serum intended for use on dogs.”

During the Second World War, vaccines with thimerosal were required to be labeled as “poison,” and later in 1972, Eli Lily itself discovered that thimerosal in doses a hundred times weaker than in a typical vaccine at that time, was “toxic to tissue cells.”  Nevertheless, the drug maker continued to promote the illusion that thimerosal was safe and highly suitable as a vaccine preservative.  Government health officials and vaccine manufacturers to this day have known of the long history of research confirming thimerosal as a toxic poison unsuitable for human delivery. A former leading vaccine developer for Merck had once warned his firm of the dangers of administering mercury-laced vaccines to newborns and infants and declared that the industry knows very well there are “nontoxic alternatives” that were equally effective and could be used to replace thimerosal.

The scientific literature relied upon to discredit thimerosal risks contain serious flaws in trial design and the quality of science. When the father of the modern pro-vaccine ideology, Dr. Paul Offit, goes on the attack to condemn anyone who would suggest a thimerosal-autism association, it is difficult for a rational, objective person to take him seriously. None of the most commonly cited twenty-plus primary flagship studies referenced to discredit thimerosal risks is a biological study.  Instead each is either an ecologic or cohort report.

Most of these studies have been independently reviewed and trashed for gross bias, serious design flaws and scientific negligence. The chief author of the ever-popular Danish thimerosal-autism survey is under criminal investigation for embezzling vast funds from the CDC to finance the study. A review of the Danish study’s collection methods reveals immediately it was a complete sham. Since these studies are only statistical analyses using a variety of massaged parameters to compare select populations or sub groups within a population, they are highly predisposed to intentional design defects and data manipulation in order to reach a desired result. For this reason ecologic and cohort studies are politically desirable within the vaccine industry and the CDC. Data can be massaged in numerous ways to reach a chosen conclusion.

However, in the real world of hard science, such observational, non-biological studies lack the methodological rigor to establish trustworthy scientific assumptions. In fact, the only conclusion we can draw from the arsenal of studies cited incessantly by the deniers of thimerosal’s neurotoxicty is that more comprehensive and rigorous research is demanded.

This is not to say that all ecologic and cohort studies are worthless. There are also many important cohort studies showing a vaccine-autism relationship. Some of these also suffer from poor design. Nevertheless, population studies are inconclusive and should never be used as substantial proof nor the final word to posit nor negate biomolecular activity and adverse effects of any toxic chemical or substance. Only double-blind, placebo controlled biologic research can determine a probable medical certainty.  In the case of thimerosal and other vaccine ingredients this requires accurate detection and measurement of toxic activity and its consequences at the cellular level. This is accomplished by observing neurotoxic effects in either of two methods. One is by in vivo studies, which observe the entire living organism. For example, in vivo studies conducted at the University of Pittsburgh report that when macaque monkey infants were injected with thimerosal-containing vaccines equivalent to a human infant’s vaccine schedule, they exhibited neurotoxic disorders characteristic of autism. For the first time, an animal model examined behavioral and neuromorpometric consequences of the CDC’s childhood vaccination schedule and primates mimicking autistic abnormalities.

The Pittsburgh studied was attacked viciously by the vaccination community. Consequently it never got past peer-review for publication in a leading medical journal. Every manner of attempt was made to discredit the findings by alleging flaws in the research. Yet, even if there are flaws in the study’s design or execution, a biologic trial should have alerted federal health authorities that further investigation and funding is essential to convincingly duplicate Pittsburgh’s results or negate them. Instead the study has been denied outright and no efforts have been by the CDC or through NIH grants to launch a more thorough biologic primate study to bring greater clarity to the vaccine-autism debate.

The second method is in vitro studies that investigate a substance’s toxicity to cells or tissue in an artificial environment, such as a cultured medium, which are factually known to be related to a serious health or neurological. One critically important in vitro study observed thimerosal’s direct association with the deterioration of mitochondria in human brain cells.

In a 2012 issue of the Journal of Toxicology, neuroscientists at the prestigious Methodist Hospital Medical Center in Houston published their investigation into thimerosal’s toxicological effects upon mitochondria in human astrocyte cells. Astrocytes are the most abundant cells found in the human brain and are critical for maintaining normal, healthy blood-brain barrier function.  The researchers observed that vaccine ethylmercury, which is more lipophilic (able to cross the blood-brain barrier) than methylmercury, is readily taken up by the astrocyte’s mitochondria, thereby disrupting the cell’s respiratory functions and eventually leading to cell death. The researchers observed that astrocytes, when exposed to thimerosal, exhibited extreme signs of oxidation and “highly damaged mitochondrial DNA.”[5] This study seems to provide biological evidence to support claims that thimerosal is very likely associated with some incidences of autism.

The influenza vaccine, which continues to use a high mercury level, and the MMR are the two most cited vaccines associated with autism. Yet studies point to other vaccines as well.  Doctors at Stony Brook University’s Medical Center determined that male infants vaccinated with the Hepatitis B vaccine prior to 1999 have a three-fold higher autism rather. The risk was greater among non-white boys. During the first four year period of the study—between 1997 and 2000—thimerosal was stilled used as a preservative in the Hepatitis vaccine.[6]

Although significant attention is being placed upon the presence of thimerosal in vaccines, most vaccines no longer contain the mercury preservative.  By 2001, except for the influenza vaccine, mercury has been either completely removed or present only in trace amounts for all other vaccines given to children under the age 6 months. One would therefore expect that autism rates would noticeably decrease; however, the opposite has been the case. Since 2001, autism continues to steadily rise annually.

The CDC argues that this proves thimerosal is not the culprit. It ignores a 2012 Australian study published in the journal Toxicological and Environmental Chemistry that there is a direct maternal transfer of ethylmercury from pregnant mothers to the embryo/fetus.[7] It remains American federal health policy for pregnant women to receive the flu shot that contains 25 mg of mercury.  But vaccinations’ association with neurodegenerative conditions was never solely about thimerosal. Another culpable ingredient now conventionally used in most childhood vaccinations, and also associated with adverse neurological effects is the adjuvant aluminum.  Since 2000, as thimerosal was being phased out, the aluminum adjuvant burden has increased.[8]

Similar to thimerosal, aluminum is a heavy metal that contributes to oxidative stress leading to neuroinflammation and microgliosis, an intense adverse reaction of the central nervous system microglia that leads to a pathogenic results characteristic in some ASD conditions.[9] The National Library of Medicine lists over 2,000 references about aluminum’s toxicity to human biochemistry.  Aluminum’s dangers, often found as alum or aluminum hydroxide in vaccines and food preparations, have been known since 1912, when the first director of the FDA, Dr. Harvey Wiley, later resigned in disgust over its commercial use in food canning; he was also among the first government officials to ever warn about tobacco’s cancer risks back in 1927.[10]

A common argument against vaccine opponents who blame aluminum for a variety of health conditions, including autism, is that the metal is the third most prevalent element found on earth.  What they fail to acknowledge is our gastric-intestinal system is rather impervious to aluminum absorption.  About 2% of orally consumed aluminum from the environment is actually absorbed and much of this is later expelled from the body by other means.  However, injectable and intravenous aluminum compounds directly entering the bloodstream are a completely different matter. And this is why the use of aluminum adjuvants in vaccines carries a high neurodegenerative and autism risk.  Aluminum neurotoxicity in preterm infants after intravenous feeding, which then contained alum, was observed back in 1997 and reported in the New England Journal of Medicine.[11] Thirty-nine percent of infants receiving aluminum-containing solutions developed learning problems upon entering schools compared to those receiving aluminum-free solutions.

Drs. Christopher Shaw and Lucjia Tomljenovic at the Neural Dynamics group at the University of British Columbia have conducted the most extensive research to date in order to determine the neurotoxicological effects of vaccine aluminum, and its correlation with the rise of autism spectrum disorders. There is already a strong correlation between children in countries with the highest autism rates and the amount of vaccine aluminum exposure. The maximum amount of aluminum permitted in a single vaccine dose is 850 mg. However the FDA established this measurement based upon the amount necessary to trigger the vaccine’s antigenicity rather than toxic concerns about safety. In an earlier study published in the journal of Neuromolecular Medicine, Dr. Shaw and his team demonstrated that the extreme toxicity of aluminum adjuvant contributed to motor neuron death associated with Gulf War illness.[12]

Another recent 2012 study carried out at MIT and published in the journal Entropy that requires serious further investigation is potentially a combination of aluminum adjuvant and acetaminophen, or tylenol, and the onset of autism. This was noted especially in children receiving the MMR and Hepatitis B vaccines. Both of these vaccines have high incidence of spiking high fevers following administration.  It is common practice for parents to administer children’s Tylenol to counter vaccine-induced fevers. Although this study was not biologic, rather a review and analysis of vaccine injury data from the CDC’s VAERS database. Remaining inconclusive, the study does identify raise an important observation that may explain why autism rates show no sign of decline.[13]

Some of the research to discover aluminum-adjuvanted vaccines toxic levels and their adverse effects have found the following:

  • Aluminum inflicts strong neurotoxicity on primary neurons.[14]
  • Aluminum-laced vaccines increase the aluminum levels in murine brain tissue leading to neurotoxicity.[15]
  • Aluminum hydroxide, the most common form of adjuvant used in vaccines deposits mostly in the kidney, liver and brain.[16]
  • Long term exposure to vaccine-derived aluminum hydroxide (which is today an ingredient in almost all vaccines) results in macrophagic myofastitis lesions.[17]

Vaccine opponents for a long time have focused upon non viral ingredients in vaccines. This has led to a sizeable faction within this community claiming to be pro-vaccine but demanding safer vaccines. According to this argument, simply removing the toxic ingredients such as thimerosal, aluminum, polysorbate 80, formaldehyde and others will make vaccination safe. However this denies other vaccine risks.  Significant contamination of vaccine formulas during the manufacturing process is one serious threat that the vaccine industry has no solution to prevent. Today, the fact that a vaccine is likely contaminated with foreign DNA and genetic fragments is a given.  The biomolecular and neuronal risks from genetic contamination remains a no-man’s land and federal officials have barely begun to tackle this problem.

In addition, since 2000, advancements in virology are now identifying serious risks to the viruses and viral components in the vaccines themselves. Other factors increasing vaccination risk include abnormal immunological reactions in response to vaccination.  In 2002, researchers at Utah State University conducted a serological study of elevated measles antibodies and myelin basic protein (MBP) autoantibodies from 125 autistic children and 92 children in a normal control group. MBP has been identified as playing a significant  role in the onset of autism. Ninety percent of the MMR antibody positive autistic children were also positive for MBP autoantibodies. The researchers concluded that “an inappropriate antibody response to MMR, specifically the measles component thereof, might be related to the pathogenesis of autism.[18] It is well known that in addition to metals such as mercury and aluminum, viral infections also cause oxidative stress that decreases methylation capacity common in autism.[19]

Although not an extended longitudinal study and with a limited number of participants, Dr. J Bradstreet el al detected genomic RNA from the vaccine’s measles virus in the cerebrospinal fluid of children with regressive autism or autistic encephalopathy (AE). In addition each child had concomitant gastrointestinal symptoms previously observed by Dr. Andrew Wakefield at the Royal Hospital London in the 1990s.[20]

According to the World Health Organization, the US ranks 39th in the overall health of its population. A large proportion of this ranking is contributed to the failing health American children, with autistic and neuro-developmental disorders soon reaching 1 in 50.

The public needs to demand a national debate between those who advocate for mandatory vaccination and those who challenge them. More than ever before it is imperative to have this dialogue as privately controlled interests infiltrate the halls of state legislators to lobby for state-wide mandates. It is highly predictable that autism rates will escalate as more vaccines come to market and states mandate the CDC’s vaccination schedule. The public needs to be educated about the science and ultimately decide for themselves. In a real democracy, an informed patient should have the freedom of choice in making his or her own health decisions. Today, there is no honest debate, no informed consent, no real science, no transparency of vaccine research, and no accurate statistics. Instead, we have federal health agencies, such as the CDC, on its own website, making false claims, advocating fake news. Finally, it is worse that the powers of federal and state governments are being used to mandate the enforcement of vaccination in a totalitarian manner upon its citizens. This is not democracy, this is medical tyranny.







[5] Sharpe MA, Livingston AD, Baskin DS. Thimerosal-derived ethylmercury is a mitochondrial toxin in human astrocytes: possible role of Fenton chemistry in the oxidation and breakage of mtDNA. Jounral of Toxicology vol. 2012, (2012)

[6] J Toxicol Environ Health A. 2010;73(24):1665-77. doi: 10.1080/15287394.2010.519317.

[7] Gallagher CM, Goodman MS. Hepatitis B vaccination of male neonates and autism diagnosis, NHIS 1997-2002.Toxicological and Environmental Chemistry. Volume 94, Issue 8, 2012

[8] Brown IA, Austin DW. Maternal transfer of mercury to the developing embryo/fetus: is there a safe level?

[9] Seneff S, Davidson RM, Liu JJ. Empirical Data Confirm Autism Symptoms Related to Aluminum and Acetaminophen Exposure. September 24, 2012


[11] Bishop NJ, Morley R, Day JP, Lucas A. Aluminum neurotoxicity in preterm infants receiving intravenous-feeding solutions. New England Journal Medicine. May 29, 1997 336(22):1557-61

[12] Shaw C. Aluminum adjuvant linked to gulf war illness induces motor neuron death in mice. Neuromolecular Medicine, 2007

[13] Seneff S, Davidson RM, Liu JJ. Empirical Data Confirm Autism Symptoms Related to Aluminum and Acetaminophen Exposure. September 24, 2012

[14] Kawahara M et al. Effects of aluminum on the neurotoxicity of primary cultured neurons and on the aggregation of betamyloid protein. Brain Res. Bull. 2001, 55, 211-217

[15] Redhead K et al. Aluminum adjuvanted vaccines transiently increase aluminum levels in murine brain tissue.Pharacol. Toxico. 1992, 70, 278-280

[16] Sahin G et al. Determination of aluminum levels in the kidney, liver and brain of mice treated with aluminum hydroxide.Biol. Trace. Elem Res. 1994. 1194 Apr-May;41 (1-2): 129-35

[17] Gherardi M et al. Macrophagaic myofastitis lesions assess long-term. Brain. 2001. Vol. 124, No. 9, 1821-1831

[18] Singh VK, Lin SX, Newell E, Nelson C. Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autrism. J. Biomed Science. 2002 Jul-Aug;9(4):359-64.[19]James J, Culter P, Melnyk S, Jernigan S, Janak L, Gaylor DW. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. Am J Clin Nutr December 2004 vol. 80 no. 6 1611-1617


Posted in USA, HealthComments Off on New Vaccines Still Cause Autism and the U.S. Government Knows It

Crimes against Humanity? Nazi regime Bans Delivery of Anaesthesia Gas to Gaza Hospitals


Nazi Jewish has banned anaesthetic gas from entering the Gaza Strip, the Palestinian Ministry of Health revealed yesterday.

This is the third time that the occupation has prevented Nitrous Oxide (nitrox) gas, which is used for patients during surgery, from entering the besieged enclave, the ministry’s spokesman, Ashraf Al-Qidra, said. The ban means a number of urgent medical procedures have now been halted, he explained.

There are currently 200 patients awaiting urgent medical treatment in Gaza’s hospitals, Al-Qidra said.

In addition, he said, there healthcare sector in Gaza needs more than 4,000 kilogrammes of Nitrous Oxide each year, noting that the Israeli occupation rations the entry of the gas.

He urged international organisations to put pressure on the Nazi Jewish occupation in order to resume the entry of the vital gas to allow surgical operations to continue.

Posted in Palestine Affairs, ZIO-NAZI, Gaza, Health, Human RightsComments Off on Crimes against Humanity? Nazi regime Bans Delivery of Anaesthesia Gas to Gaza Hospitals

Trump’s assault on human kindness, cooperation and the environment

Trump and envionmental degradation

By Graham Peebles

An undercurrent of fury is bubbling beneath the prevailing gloom that is the election of Donald Trump as president of the United States.

Trump’s presidency may prove to be the final straw in the decades-long assault on social and economic justice, cooperation and solidarity which began during the reign of Margaret Thatcher and Ronald Reagan.

It could usher in an unstoppable popular uprising that unites people in common cause against the abhorrent ideals that are causing despair and anger among millions worldwide, a global campaign based on, and calling for unity, tolerance, cooperation and social responsibility.

People power

Since the fall of the Berlin Wall in 1989 popular protests of unprecedented scale and scope have swept across the world. Countries in every region of the world have experienced demonstrations of one kind or another. Common themes connect these peaceful campaigns: social injustice, economic inequality, political bias and environmental concerns.

Huge protests have been directed not only at governments and their policies, but also at large corporations such as oil companies and arms manufacturers.

The guiding principles for peaceful popular protests were laid out in the non-violent approach championed by Mahatma Gandhi: civil disobedience, creative public protest and non-cooperation – not against people but against their actions; not against officials but against the system they administer.

The roots of non-cooperation lie in the yearning for justice and the desire to combat the hatred and bigotry of the likes of Trump. As the reactionary, materialistic forces of the world attempt to assert themselves with increasing fury, and the political left drowns in a state of vacillation and disarray, groups of people are uniting to challenge the ascendancy of nationalism, bigotry and isolation – divisive ideals embodied by Trump whose election has emboldened far right groups all over the world.

Reckless actions

Trump came to power on a wave of deep anger, a sense of betrayal and suffering born of poverty and exclusion. As the US journalist Chris Hedges says, Trump told the people what they wanted to hear but is now “ramping up neo-liberalism… it’s going to be a naked kleptocracy, which is not what people voted for”.

There was a naïve hope that the responsibility of office would silence much of Trump’s toxic campaign rhetoric, but after just over two weeks in the White House it is clear that he has every intention of honouring his poisonous campaign pledges.

Among the many Trump policies of concern, his vile immigration policies and his approach to all things environmental are particularly alarming. Through a raft of executive orders, which are intended for use in times of emergency, he has banned nationals from seven, mainly Muslim countries from entering the US, including refugees fleeing war-torn Syria. Not only is this measure appalling, and probably illegal under international law, but it is the kind of action that is likely to increase, not decrease, the risk of terrorist attacks in the US and elsewhere in the West.

Trump’s economic and energy plans, coupled with his ignorance of the facts concerning the environment, threaten to have a calamitous impact on climate change and the natural world more broadly. He has surrounded himself with “sceptics” and climate change deniers, threatened to withdraw from the Paris Agreement on Climate Change, and after four days as president took actions that will greatly increase greenhouse gases and therefore intensify climate change.

Trump resurrected the Keystone XL pipeline which, according to Friends of the Earth (FoE), could “devastate ecosystems, pollute water sources and jeopardize public health”. If completed, the pipeline will transport tar sands oil – one of the world’s dirtiest fuels – 2,000 miles from Alberta, Canada, to the Gulf Coast of Texas and into the US oil pipeline network. During the production of tar sands oil “levels of carbon dioxide emissions are three to four times higher than those of conventional oil”, FoE says.

The pipeline would carry 830,000 barrels of dirty tar sands oil into the US every day, resulting “in climate-damaging emissions equal to adding more than 5.6 million new cars to US roads”.

In addition to this atrocious, irresponsible decision, Trump also “expedited another pipeline in the Dakotas that had become a major flashpoint for Native Americans”, the New York Times reported, and signed a directive ordering an end to protracted environmental reviews. Objections to the Dakota Access Pipelines, which would carry “450,000 barrels of fracked oil per day from North Dakota to Illinois”, were outlines in a letter signed by 37 environmental groups (including Greenpeace and FoE), sent to Barack Obama, when he was president.

Despite these environmentally destructive actions, Trump recently told automobile company executives – without a hint of irony – “I am, to a large extent, an environmentalist, I believe in it.”

Inter-related environmental crises are the greatest threat to humanity, the planet and the sub-human kingdoms, and now 62 million Americans have elected a president who fails to recognise the risks. His triumph, together with the wider successes of the Republicans, place total control of the government – the Executive, Congress and the Supreme Court – in the hands of the Republican Party which, because of its stance on environmental issues, Noam Chomsky says, “has become the most dangerous organisation in world history”.

The responsibility is ours

The answers to the numerous inter-related issues facing humanity – many of which find fertile ground in the new US presidency – are not to be found in the ways of competition and the darkness of suspicion and separation, but lie in the fertile grounds of cooperation, sharing and unity.

Solutions are, and will increasingly come from, the people, not from the current crop of politicians who are inadequate to the task, lack the imagination needed, are ideologically blinded and habitually turn to the past to meet the challenges of the present, which inevitably exacerbate the problems.

Humanity is at a crossroads, with fundamental choices to make: the likes of Trump – and he is far from alone in his perverse views – embody one way, and the millions who have marched, petitioned, demonstrated and cried out represent another, more positive and humane path. They are the vast majority and express the aspirations of people around the world for a new, fairer, saner way of living: a world in which our lives cease to be determined by market forces and a derelict, unjust economic model.

If Trump and his acolytes are to be cast aside, as they must be, we must act. The protests against his policies must be maintained and expanded, the outrage felt by people throughout the world harnessed and an unstoppable momentum for real change built.

If our collective will is to live in a world at peace, in which sharing, tolerance and cooperation prevail, we must express these ideals in our own lives and relentlessly stand up to those who work in opposition to them.

The election of Trump as president – brought about in large measure by voters’ legitimate anger at the economic injustices millions of Americans have been subjected to – is a clarion call to action: coordinated, peaceful protest, creatively presented and consistently undertaken.

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The British Government Colludes with Monsanto. Crimes against Humanity and “Ecocide”

Should be Held Accountable in the International Criminal Court



“The British Government has colluded with Monsanto and should be held accountable in the International Criminal Court in The Hague for crimes against humanity and ecocide.” Dr Rosemary Mason.

The British public and the environment are being poisoned with a deadly cocktail of 320 pesticides. Moreover, Wales has become a storage dump for Monsanto’s most toxic chemicals. These are the messages conveyed by Dr Rosemary Mason in her recent open letter to Councillor Rob Stewart, the leader of Swansea City and County Council.

Dr Mason adds that Swansea has over the years been a testing ground for glyphosate with the outcome being a huge spike in illness and disease among the local population as well as ongoing environmental devastation. There has been a long-term reckless use of a glyphosate-based weedkiller in Swansea, regardless of EU recommendations.

Dr Henk Tennekes, an independent toxicologist from the Netherlands, and Dr Pierre Mineau, an expert on ecotoxicology from Canada, both prophesied environmental catastrophe from the self-regulated and unsustainable use of pesticides by the agrochemical industry.

In Tennekes’ book, ‘The Systemic Insecticides: a disaster in the making’, he showed that these chemicals act on the brains of insects (and humans). He showed that collapse of bee colonies, the loss of other invertebrates and bird declines in Europe are associated with chronic low levels of these chemicals. Dr Pierre Mineau wrote a Report for the American Bird Conservancy ‘Neonicotinoids and Birds’ in which he accused the US Environmental Protection Agency (EPA) of collusion with the agrochemical industry and negligence.

Mason has written to the relevant UK authorities about these issues and the situation in Wales, but the UK Environment Agency has refused to act.

Monsanto using Wales as a toxic dump

Monsanto established a factory in Newport in 1949, and Mason notes that the company paid a contractor to illegally dump chemical waste in Brofiscin Quarry, Grosfaen. These included polychlorinated biphenyls (PCBs), the defoliant Agent Orange and dioxins used in the Vietnam War. When PCBs were banned in the US, the UK government agreed to ramp up production in a Monsanto-owned factory in Wales in 1971. They were manufactured until 1977. Toxic dumps were established at seven quarries around Wales.

Brofiscin Quarry in Grosfaen, near Cardiff, is one of the most contaminated places in Britain. In 2003, the lining of the quarry burst and the orange contents drained into west Cardiff. According to engineering company WS Atkins, the site contains at least 67 toxic chemicals. The Environment Agency claimed: “they offered no identifiable harm or immediate danger to human health.”

Citing a study by WWF-UK in 2003, Mason shows that residues of PCBs and other organochlorines were found in 75 adipose tissue samples taken from human cadavers throughout 1990 and early 1991 from Welsh populations. The researchers found: “little changes in the concentrations of these compounds in the Welsh population over the last decade, despite reduction in their use that came into force in the 1970s.”

Mason states that children in Wales have low scores in the PISA tests, a measure of reading, maths and science ability in 15 year olds, and low educational achievement in primary schools.

She also notes that organophosphate pesticides have supposedly been banned but are now used on salmon lice in fish farms: from 2006-2016 the salmon produced by fish farms has increased by 35%, but the use of OPs increased by 932%.

Theresa May promoting the great agrochemicals-pharmaceuticals scam

Glyphosate contamination of food is associated with an epidemic of diseases: in 2012, the area treated by glyphosate in the UK was 1,750,000 ha and by 2014 it had increased to 2,250,000 ha. Glyphosate (captures) and washes out the following minerals: boron, calcium, cobalt, copper, iron, potassium, magnesium, manganese, nickel and zinc.

Hypercholesterolaemia caused by glyphosate is now treated by statins.

The enzyme aromatase is activated by glyphosate and atrazine. Aromatase inhibitors are used to treat breast cancer and prostate cancer.

Mason says that the UK prides itself in being ‘in the forefront of new technologies’ that its companies can sell privately to the rich or to other countries: many are drugs to treat the toxic effects of pesticides. These include treatment for infertility, gene therapy, new treatments for cancer, Alzheimer’s and diabetes and drugs to boost immunity.

Theresa May was very upbeat about Brexit: she said Britain had many things to sell to the world including chemicals, pharmaceuticals and medical expertise.

Cover-ups, deceptions and the dodging regulation  

The industry has worked overtime to cover-up its crimes, to try and discredit those who challenge its products and practices and to put a positive spin on what it does. Mason discusses the Seralini affair and how a massive PR campaign sprang into operation to try to discredit the study and pressurize the editor of the journal that published it to retract it. The UK-based Science Media Centre (SMC) was in the forefront of the attacks. The SMC defends and promotes GM technology and is 70% funded by corporations, including Monsanto and other big GMO developer firms.

The SMC’s director was subsequently reported as saying that she took pride in the fact that the SMC’s “emphatic thumbs down” on the study “had largely been acknowledged throughout UK newsrooms.” Bruce M. Chassy, professor emeritus of food science at the University of Illinois provided scathing quotes about the study.

Yes, that Bruse Chassey: the one later exposed as having received a grant from Monsanto of more than $57,000 in less than two years.

Mason says that in Wales there are cancer/disease hotspots in the surrounding villages where Roundup has been sprayed: for example, brain tumours (mostly glioblastomas), cancers of the breast, ovary, prostate, lung (more than half of which were in non-smokers), oesophagus, colon, pancreas, rectum, and kidney as well as non-Hodgkin lymphoma (NHL), uterine carcinoma, leiomyosarcoma of the uterus, multiple myeloma, Parkinson’s, multiple sclerosis, motor-neurone disease and Alzheimer’s/Dementia.  Many of the cancers are aggressive and unusual; they resemble the cancers that were seen in factory workers in the pesticides industry in the 1960s.

And yet a global biocide industry has emerged to advise on dodging regulations. It is controlled by the pesticides industry and is based in the UK making lots of money for Britain.

Mason cites the example of Exponent Inc., which describes itself as “a research and scientific consultant firm with clients from industry (including crop protection) and government.” Exponent was employed by Bayer to criticise EFSA’s work on neonicotinoids and bees in 2013. It also contributed to a review by a Dow employee that concluded that “exposure to specific pesticides during critical periods of brain development and neurobehavioral outcomes is not compelling.” This review was supported by the various UK government agencies.

Glyphosate and the destruction of biodiversity

In her letter, Mason describes how Japanese knotweed Reynoutrie japonica was introduced to Europe in the mid-16 Century. For 500 years, it caused no problems. Glyphosate was introduced in 1974 and by 1981 both plants were classified in the Wildlife and Countryside Act as invasive species. Mason argues that Swansea has been a test-bed for Roundup and is known as the Japanese knotweed capital of Europe because recurrent spraying makes the plants grow bigger and stronger. It grows in in old mine workings where the soil is loose. So, the people most affected by Roundup are the poor.

She then highlights that in the US the first confirmed glyphosate-resistant weed, rigid ryegrass, was reported in 1998 within two years of Roundup Ready crops being grown. Super-weeds in the US in GM cropping systems are now a massive problem. Between 1996 and 2011, as a result of GM technology, 22 glyphosate-resistant super-weeds had developed.

In 2016, Charles Benbrook said:

“Since 1974 in the U.S., over 1.6 billion kilograms of glyphosate active ingredient have been applied, or 19 % of estimated global use of glyphosate (8.6 billion kilograms). Globally, glyphosate use has risen almost 15-fold since so-called “Roundup Ready,” genetically engineered glyphosate-tolerant crops were introduced in 1996. Two-thirds of the total volume of glyphosate applied in the U.S. from 1974 to 2014 has been sprayed in just the last 10 years.”

The 2016 UK State of Nature Report highlights the devastating loss of biodiversity in the UK.

What we are seeing a war on any plant (or creature) that is not part of the moncultured (increasingly genetically engineered) system of agriculture favoured by the agrichemicals/agritech cartel.

What can be done?

At the end of her letter, Rosemary Mason states:

“The people of Wales are sick and NHS Wales is in crisis. Human health depends on biodiversity and Wales has an environmental catastrophe caused by pesticides.”

The UK government is engaged in criminality by colluding with agrochemicals manufacturers that are knowingly poisoning people and the environment in the name of profit and greed. As Mason points out, communities, countries, ecosystems and species have become disposable inconveniences.

Corporate totalitarian tries to hide beneath an increasingly fragile facade of democracy.

The agrochemicals industry lobbies hard to have its products put on the market and ensures that they remain there. It uses PR firms and front groups to discredit individuals and studies which show the massive health and environmental devastation caused and gets its co-opted figures to sit on bodies to guarantee policies favourable to its interest are put in place. Mason has documented all of this in her numerous fully-referenced documents and has identified and named the culprits.

We have enough information to know that agrochemicals are killing us and exactly who (corporations, public bodies and individuals) is culpable.

Readers can consult all of Mason’s fully-referenced documents here.

The regulatory system surrounding agrochemicals is not broken and in need of a bit of tinkering to put things right. From bought-and-paid-for science and public relations that masquerades as journalism to policy implementation and the lack of regulation, the argohemicals industry wallows in a highly profitable cesspool of corruption. Money wields power and political influence.

We must restore the link between farmer and consumer and challenge the corporate hijack of the food system. As a global movement, Nyeleni has a radical agenda that is committed to challenging some of the issues that fuel the problems we are facing, including:

“Imperialism, neo-liberalism, neo-colonialism and patriarchy, and all systems that impoverish life, resources and eco-systems, and the agents that promote the above such as international financial institutions, the World Trade Organisation, free trade agreements, transnational corporations, and governments that are antagonistic to their peoples.”

The Nyeleni Europe website contains some valuable information.

The agrochemicals industry continues to get away with crimes against humanity and the environment. Not everyone can grow their own or afford to eat healthily all the time and no one can escape the pollution and destruction of the environment and the impacts. The aim must be to educate, organise, agitate and inform the wider public who are gradually waking up to the reality of a corrupt food system.

“The model of production dominating European food systems is controlled by corporate interests and is based on concentrated power, monocultures, patenting seeds and livestock breeds, imposing pesticides and fertilisers…. it is a system perpetuated by ineffective regulation and unjust laws. Across Europe we are developing and supporting local food systems, swapping local seeds, realising peasants’ rights, building the fertility of our soils, and strengthening and increasing the resilience of local production and food webs. We need to strengthen local food cultures and public policies that support links between producers and consumers… .” Nyeleni Europe

Further reading:

Readers are urged to consult Roundup and birth defects-the public has been kept in the dark’ by Rosemary Mason (2017), a 44-page, fully-referenced document

Posted in Health, UKComments Off on The British Government Colludes with Monsanto. Crimes against Humanity and “Ecocide”

Capitalism Rations What We Most Need — Let’s Demand Medicare for All: A Conversation With Mariame Kaba


By Sarah Jaffe, Truthout

Mariame Kaba speaks at an event she organized calling for the closure of youth prisons as part of the Chicago Teachers' Union's #ShutDownCHI one-day strike in April 2016. (Photo: Courtesy of Love & Struggle Photos)

Mariame Kaba speaks at an event she organized calling for the closure of youth prisons as part of the Chicago Teachers’ Union’s #ShutDownCHI one-day strike in April 2016. (Photo: Courtesy of Love & Struggle Photos)

It can be easy to despair, to feel like trends toward inequality are impossible to stop, to give in to fear over increased racist, sexist and xenophobic violence. But around the country, people are doing the hard work of fighting back and coming together to plan for what comes next. In this ongoing “Interviews for Resistance” series, we introduce you to some of them. Today’s interview is the second in the series. Click here to read the debut interview.

In this next installment of the “Interviews for Resistance” series, we speak with Mariame Kaba, the founder and director of Project NIA, whose work over the last few years has focused around issues of criminalization.

Sarah Jaffe: The project that you have launched in the wake of Donald Trump’s election is around health care. Why are you focusing on this right now?

Mariame Kaba: I am organizing, along with other volunteers, a Medicare For All virtual day of action that is slated for Inauguration Day, January 20. I have been listening to a lot of the conversations that have been happening around the repeal of the Affordable Care Act (ACA) with a mix of dread and frustration. Dread, mainly because I get my health care through the exchange. So it is directly impacting me. And frustration, because I always thought that it was really important for the message to be not about just “Don’t repeal the ACA,” which is filled with a lot of problems and is based on a model, in my opinion, that is flawed to begin with, a market-based health care system. I wanted to insert in the conversation more loudly the idea that we need to be pushing for a Medicare For All system, a single-payer system that takes profit out of health and health care. That is the intervention that I am making in the moment as a way to give people a sense of what might be possible in terms of organizing along the horizon. That we might be able to draw people across difference to build something together around an issue that has such an impact and crosses so many different kinds of spaces and impacts so many different kinds of people all across the country.

Can you talk a little bit more about that?

First and foremost, on a fundamental level, if you don’t have your health, you don’t have your life. It is a life-and-death issue for many people. I have chronic illnesses. I absolutely depend on being able to have insurance in order to be able to access care. If I couldn’t have insurance, then it is very, very possible that I would end up dead much sooner than if I had it. That visceral kind of issue for people is really important.

The other thing is that it is an economic issue. If you cannot access proper health care, it impacts your ability to work, but also if you get sick, God forbid, you end up in a position where you might just be bankrupt in the end. It is also an economic issue because, in our country, the forces of capitalism rule supreme, and health care is basically a great way to talk to people about the forces of capitalism and capital and the way it rations things that we need, the way that it makes things incredibly expensive that should actually be cheap, the way that it alienates us from ourselves.

Everybody in this country wants to be able to access care. Health care should be a right. It is a human right. Even if the ACA wasn’t under attack, this is an issue that we should be raising. Also, strategically, if we fight along the lines of a single-payer system, Medicare For All, we are going to push the Democratic Party left, too, in the process. It really does need to be pushed left, for those people who want to continue to struggle within the arena of the electoral organizing. This is a great opportunity to rally a lot of people together to fight together to win.

Can you talk about how this could work as a state-by-state strategy?

Absolutely, and also a local strategy. We are going to have to figure out ways to create community-based free clinics, things that are going to be on the defend-and-protect side of this equation, while we are fighting on the expansion side. That is really important. That is where a lot of the most important organizing has already been taking place, and will continue to take place, on the state level. People in Washington State are pushing for a ballot initiative for single-payer. People have tried to do it in Vermont. People have tried to push a Colorado ballot initiative for single-payer, which lost huge. That gives us an opportunity to think about, “What was it in the messaging, what was it in the lack of political education, what was it in the organizing strategy that made people reject it in an 80/20 split?” Learning from those individual state ballot initiatives will help us to build a stronger set of campaigns in individual states around the country. I think that is a great opportunity for us, as the federal government space is going to be foreclosed to many different kinds of demands at the moment. We are going to have to be more strategic about how we operate at the local and state levels. That connects, eventually, to talking about the carceral state and prisons. Anti-prison organizing, as well, is mostly a state issue.

The Black Panthers created a free ambulance service in Winston-Salem, North Carolina — they connected the work of mutual aid around health care and the fight against criminalization.

I was listening to a talk that Dean Spade gave a couple of weeks back in New York. He was really emphasizing the importance of mutual aid and mutual support, something that I have always thought is critical and important in organizing work, but will be even more so as we move forward. I think we have an opportunity to be creative in ways that we haven’t actually explored in the past, because we rely so much on the same way of doing things over time, that sometimes we have gotten stuck in a rut. This is going to force us to be more creative than ever, to be in some ways hyper-local. Sometimes people see that as a negative. For me, it is not. This is a huge country. There are so many different kinds of communities and those communities have very specific needs. We have to be open to people innovating and trying to figure out how to best meet the needs of their individual communities. I think that we are in a moment where we have to unleash, as Jeff Chang says, mass creativity all over the place. This is going to be in all aspects of the work that we do, but especially, in our organizing. I think that we are in a moment where we can do a lot and we have a good foundation for the work that we need to do going forward.

Part of the wave that elected Donald Trump, to whatever extent it was a wave, involved this “Blue Lives Matter” framing and backlash from the police and their supporters. Talk about the way the Movement for Black Lives and against prisons and policing changes and the way it continues to be central to resisting Trump.

I jumped pretty quickly into doing Medicare For All and the day of action, so I haven’t thought as deeply about what the role of the Movement for Black Lives is now. I know that stoking fear around murder rising to exponential degrees was critical to the sales pitch that Trump was doing — his “I am going to be this law-and-order tough guy and protect you from these thugs” [message] was a huge part of the narrative that he was knitting together. That resonated for a lot of people.

This is going to be a gut check moment for a lot of people who call themselves anti-prison organizers and have been very focused on reforms and have fought, inexplicably, mainly at the federal level, when criminal punishment is really hugely a state and a county issue. It is a city and township and a municipality issue when you are talking about policing, but when you are talking about incarceration and detention and all of that, that is at the county and at the state level. We already are seeing this uneven set of decreases in numbers of people who are incarcerated across the country. In some states there have been precipitous drops of numbers of people and in other states, there have been increases. You are very much seeing a whole bunch of different kinds of things happening in different kinds of places.

I think this is a moment where people are going to be forced to actually do the work that needs to be done at our state and local levels in order for it to be successful. It is also really an important moment for reframing what the new narrative has become. A lot of the push has been on what we need to do to get what Marie Gottschalk calls the “non-non-nons” which are the nonserious, nonviolent, non-sex offenders. That has been the focus of who we need to decarcerate. The low-hanging fruit. The drug war unfair convictions. You had a joint and you ended up with a 20-year sentence. That is an exaggeration and that is not the norm at all, but the conversation that we have is that we really need to focus on making sure that we decarcerate nonviolent offenders and nonviolent offenses. I think we need to reframe that conversation. We are not going end mass incarceration that way. We have to address how people are being sentenced for violent crimes.

It feels counterintuitive to talk about the fact that in the Trump era, we are going to have to address the issue of violent crimes, but I always think one of the most important things you can do in any moment, particularly in moments where it appears that you don’t have that much leverage, is to actually do a lot of narrative building and to fight on the ground that you actually want to fight on, rather than be fighting on the ground that you think is most amenable to your audiences at various levels.

It seems like the questions around violence are going to be core to the next four years, whether we are talking about an increase in racist violence or questions of strategies for fighting back — the narratives that are going around about how you respond to racist violence, to hate attacks, and how to think about solutions that aren’t calling police.

The kind of liberal embrace of the concept of hate crimes — Kay Whitlock and others have been writing about [that] for a very long time. A lot of queer theorists have written about the fact that, in fact, we shouldn’t be trying to up-crime various kinds of behaviors and various kinds of harms. It actually gets turned back against the most marginalized when we use those kinds of frames. After all, what is a hate crime? What does that mean? You are trying to look at people’s motivation and then you are tacking on extra sentencing time? It just doesn’t make any sense. We really are going to have to figure out, even more now, ways to solve problems within our communities without relying on the state because it is the case that the police are unleashed on our communities, already. Can you imagine now with Jeff Sessions, for example, as the attorney general, who is at his hearing basically saying, “The cops have nothing to be reproached about? They are absolutely blameless. In fact, I don’t believe in consent decrees?” Even the minimal kinds of mechanisms and tools that the federal government has at its disposal to try in some way to intervene with rogue departments are gone.

If you thought before that the police were your friends, you are definitely not going to think that now, when they are going to basically be given carte blanche to act with impunity. We are just going to have to figure out “What are the community accountability models that we can build at the local level to solve our problems, to address harm, to figure out how we are going to be able to have better interactions with each other, have stronger relationships with each other?” We need that more than ever in this moment. I think everything, basically, is up for transformation. Everything is up for being reconsidered in this moment. That is both daunting, but also incredibly freeing in a way — people haven’t gotten to that point yet to see that aspect of it, but I hope we get there soon.

You are not in Chicago anymore, but you spent quite a long time in Chicago, which has an incredibly well-organized left, and has the distinct honor of being the one city where Donald Trump actually cancelled a rally because there were so many protestors. What can people in other cities learn from the way movements in Chicago have worked together?

I think there is something about Chicago being ground zero for neoliberal Democratic rule that has built up the muscles that people need, in that particular city, to resist. The mass closure of public schools helped to radicalize the teacher’s union in Chicago and created a different kind of social justice teacher’s union. The closure, in large part, of most of the public mental health clinics over just the last six to seven/eight years [provoked resistance too].

This is the timeframe within which this stuff is going on, accelerating. It is ground zero for re-thinking, and also then, fighting in a different way around the austerity agenda. You have people like the Grassroots Collaborative giving us the intellectual scaffolding of Chicago being broke on purpose. That there is money available. That the financial sector is actually benefitting disproportionately and grossly in a way that is actually seizing and taking resources away from various people.

It is the city of Jon Burge and torture, of real police torture. People have had to fight on the policing front for decades. So, when there are opportunities and windows and moments, people are already organized and poised to actually fly through the openings to be able to win some stuff around that. It is the place where Alinsky organizing was born, and so people have this experience of neighborhood-based, community-based organizing that is in the lifeblood of the city. It is the place where the Nation of Islam is centered and built, so the concept of self-determination and Black liberation of a certain type has its roots there. It is a city that was fighting around issues of Garveyism [which] has a big amount of its roots in the Chicago area and the Midwest. It is the soup of all of those things, that make it so the people who are there, who are veteran organizers always, in some ways, have been multi-issue people, have not just been in individual silos. The city is small enough — it isn’t New York-sized — that you get to know people in different ways. A lot of the anti-eviction organizing, the direct action around literally putting your body on the line, that has been going on for decades in Chicago. I think there are lots of reasons, but those are some.

To wrap up, obviously, racism was central to Donald Trump’s appeals and attacks. I would love to have you talk about what antiracist organizing looks like when you have this explicitly racist force that just won a big victory.

I am not interested in organizing with racists. I am not explicitly going out trying to do that. But, here is what I think is important, at least for me: this is a racist country. We are organizing with racists, so to speak. That is just part of the soup. That is the air that we breathe. What I think is important in this moment is that we find issues around which broad scopes of people could unite enough, strategically, to be able to win a few things that we want. That doesn’t mean that everybody has to work with everybody. It doesn’t mean that we have to have some false sense of unity.

I think that some of that organizing is going to be done by intermediaries. I am thinking, particularly, white people who left rural areas, now is a good time to go and find out who else is doing interesting organizing in your old town and connect with those people and see whether or not there are issues that folks in your particular place want to organize around and link up.

What we should be doing is operationalizing specific kinds of opportunities, campaigns, concrete things that we could do with other people. Again, make sure that there are intermediaries who can be dispatched to do work with the people they should do work with. I am not going to be organizing white working-class people. There is no reason for me to be the person who is organizing that particular group, but it would be good if other white working-class people would organize with each other and find a way to be able to connect more broadly.

We should be less concerned about these thinkpiece ideas of the generic white working class … the people who supported Trump are not overwhelmingly white working class, since most white working class people, most poor people of any race, don’t actually engage in elections. They don’t vote in big numbers in terms of percentage of their population. Everybody — including, frankly, other white people — is blaming the white working class, when in fact, it is middle-class and rich folks who went big for Trump. They are getting off scot free, while the scapegoats are being made of white working-class people. That is a problem in and of itself.

We have to shake things up and focus less on a lot of pontification, analysis, right now. Focus less on that and focus more on instrumental ways for us to act. Find ways to act and find ways to act with numbers and together. What actions can we take?

On that note, where can people find more information about your Medicare For All day of action, broader Medicare for All organizing, and other work that you are doing?

People can go to People can also go to our Facebook and Twitter pages to find out about the day of action. We will be keeping up that site and putting more information for where people can actually connect with state-based coalitions that are doing single-payer work. Healthcare-NOW is doing excellent rapid response and ongoing single-payer organizing. On this Sunday, Our First Stand, Bernie Sanders and some of the Democrats are encouraging people to have rallies around the country to tell the Republicans not to repeal ACA, not to cut Medicare, not to cut Medicaid. Those are all places where people can connect with that work. If people are interested in my work around criminalization, they can go to my blog,

Posted in USA, HealthComments Off on Capitalism Rations What We Most Need — Let’s Demand Medicare for All: A Conversation With Mariame Kaba

Chomsky: The US Health System Is an “International Scandal” — and ACA Repeal Will Make It Worse


By C.J. Polychroniou, Truthout | Interview

(Image: Lauren Walker / Truthout; Adapted: Thomasjphotos)

(Image: Lauren Walker / Truthout; Adapted: Thomasjphotos)

Changes are coming to America’s health care system. Not long from now, the Affordable Care Act could be history. President-elect Donald Trump wants to repeal so-called Obamacare, although he is now urging Republicans to repeal and replace it at the same time. But replace it with what?

The political culture of the most powerful nation in the world is such that it vehemently defends the right of people to buy guns but opposes the right to free and decent health care for all its citizens. In all likelihood, the Trump health care plan will be one based on “free market principles.” Under such a plan, as Noam Chomsky notes in the exclusive interview for Truthout that follows, poor people are likely to suffer most. In other words, the scandalous nature of the US health care system is bound to become even more scandalous in the Trump era. Welcome back to the future.

C.J. Polychroniou: Trump and the Republicans are bent on doing away with Obamacare. Doesn’t the 2010 Patient Protection and Affordable Care Act (ACA) represent an improvement over what existed before? And, what would the Republicans replace it with?

Noam Chomsky: I perhaps should say, to begin, that I have always felt a little uncomfortable about the term “Obamacare.” Did anyone call Medicare “Johnsoncare?” Maybe wrongly, but it has seemed to me to have a tinge of Republican-style vulgar disparagement, maybe even of racism. But put that aside…. Yes, the ACA is a definite improvement over what came before — which is not a great compliment. The US health care system has long been an international scandal, with about twice the per capita expenses of other wealthy (OECD) countries and relatively poor outcomes. The ACA did, however, bring improvements, including insurance for tens of millions of people who lacked it, banning of refusal of insurance for people with prior disabilities, and other gains — and also, it appears to have led to a reduction in the increase of health care costs, though that is hard to determine precisely.

The House of Representatives, dominated by Republicans (with a minority of voters), has voted over 50 times in the past six years to repeal or weaken Obamacare, but they have yet to come up with anything like a coherent alternative. That is not too surprising. Since Obama’s election, the Republicans have been pretty much the party of NO. Chances are that they will now adopt a cynical [Paul] Ryan-style evasion, repeal and delay, to pretend to be honoring their fervent pledges while avoiding at least for a time the consequences of a possible major collapse of the health system and ballooning costs. It’s far from certain. It’s conceivable that they might patch together some kind of plan, or that the ultra-right and quite passionate “Freedom Caucus” may insist on instant repeal without a plan, damn the consequence for the budget, or, of course, for people.

One part of the health system that is likely to suffer is Medicaid, probably through block grants to states, which gives the Republican-run states opportunities to gut it. Medicaid only helps poor people who “don’t matter” and don’t vote Republican anyway. So [according to Republican logic], why should the rich pay taxes to maintain it?

Article 25 of the UN Universal Declaration on Human Rights (UDHR) states that the right to health care is indeed a human right. Yet, it is estimated that close to 30 million Americans remain uninsured even with the ACA in place. What are some of the key cultural, economic and political factors that make the US an outlier in the provision of free health care?

First, it is important to remember that the US does not accept the Universal Declaration of Human Rights — though in fact the UDHR was largely the initiative of Eleanor Roosevelt, who chaired the commission that drafted its articles, with quite broad international participation.

The UDHR has three components, which are of equal status: civil-political, socioeconomic and cultural rights. The US formally accepts the first of the three, though it has often violated its provisions. The US pretty much disregards the third. And to the point here, the US has officially and strongly condemned the second component, socioeconomic rights, including Article 25.

Opposition to Article 25 was particularly vehement in the Reagan and Bush 1 years. Paula Dobriansky, deputy assistant secretary of state for human rights and humanitarian affairs in these administrations, dismissed the “myth” that “‘economic and social rights constitute human rights,” as the UDHR declares. She was following the lead of Reagan’s UN Ambassador Jeane Kirkpatrick, who ridiculed the myth as “little more than an empty vessel into which vague hopes and inchoate expectations can be poured.” Kirkpatrick thus joined Soviet Ambassador Andrei Vyshinsky, who agreed that it was a mere “collection of pious phrases.” The concepts of Article 25 are “preposterous” and even a “dangerous incitement,” according to Ambassador Morris Abram, the distinguished civil rights attorney who was US Representative to the UN Commission on Human Rights under Bush I, casting the sole veto of the UN Right to Development, which closely paraphrased Article 25 of the UDHR.The Bush 2 administration maintained the tradition by voting alone to reject a UN resolution on the right to food and the right to the highest attainable standard of physical and mental health (the resolution passed 52-1).

Rejection of Article 25, then, is a matter of principle. And also a matter of practice. In the OECD [Organization for Economic Cooperation and Development] ranking of social justice, the US is in 27th place out of 31, right above Greece, Chile, Mexico and Turkey. This is happening in the richest country in world history, with incomparable advantages. It was quite possibly already the richest region in the world in the 18th century.

In extenuation of the Reagan-Bush-Vyshinsky alliance on this matter, we should recognize that formal support for the UDHR is all too often divorced from practice.

US dismissal of the UDHR in principle and practice extends to other areas. Take labor rights. The US has failed to ratify the first principle of the International Labour Organization Convention, which endorses “Freedom of Association and Protection of the Right to Organise.” An editorial comment in the American Journal of International Law refers to this provision of the International Labour Organization Convention as “the untouchable treaty in American politics.” US rejection is guarded with such fervor, the report continues, that there has never even been any debate about the matter. The rejection of International Labour Organization Conventions contrasts dramatically with the fervor of Washington’s dedication to the highly protectionist elements of the misnamed “free trade agreements,” designed to guarantee monopoly pricing rights for corporations (“intellectual property rights”), on spurious grounds. In general, it would be more accurate to call these “investor rights agreements.”

Comparison of the attitude toward elementary rights of labor and extraordinary rights of private power tells us a good deal about the nature of American society.

Furthermore, US labor history is unusually violent. Hundreds of US workers were being killed by private and state security forces in strike actions, practices unknown in similar countries. In her history of American labor, Patricia Sexton — noting that there are no serious studies — reports an estimate of 700 strikers killed and thousands injured from 1877 to 1968, a figure which, she concludes, may “grossly understate the total casualties.” In comparison, one British striker was killed since 1911.

As struggles for freedom gained victories and violent means became less available, business turned to softer measures, such as the “scientific methods of strike breaking” that have become a leading industry. In much the same way, the overthrow of reformist governments by violence, once routine, has been displaced by “soft coups” such as the recent coup in Brazil, though the former options are still pursued when possible, as in Obama’s support for the Honduran military coup in 2009, in near isolation. Labor remains relatively weak in the US in comparison to similar societies. It is constantly battling even for survival as a significant organized force in the society, under particularly harsh attack since the Reagan years.

All of this is part of the background for the US departure in health care from the norm of the OECD, and even less privileged societies. But there are deeper reasons why the US is an “outlier” in health care and social justice generally. These trace back to unusual features of American history. Unlike other developed state capitalist industrial democracies, the political economy and social structure of the United States developed in a kind of tabula rasa. The expulsion or mass killing of Indigenous nations cleared the ground for the invading settlers, who had enormous resources and ample fertile lands at their disposal, and extraordinary security for reasons of geography and power. That led to the rise of a society of individual farmers, and also, thanks to slavery, substantial control of the product that fueled the industrial revolution: cotton, the foundation of manufacturing, banking, commerce, retail for both the US and Britain, and less directly, other European societies. Also relevant is the fact that the country has actually been at war for 500 years with little respite, a history that has created “the richest, most powerful¸ and ultimately most militarized nation in world history,” as scholar Walter Hixson has documented.

For similar reasons, American society lacked the traditional social stratification and autocratic political structure of Europe, and the various measures of social support that developed unevenly and erratically. There has been ample state intervention in the economy from the outset — dramatically in recent years — but without general support systems.

As a result, US society is, to an unusual extent, business-run, with a highly class-conscious business community dedicated to “the everlasting battle for the minds of men.” The business community is also set on containing or demolishing the “political power of the masses,” which it deems as a serious “hazard to industrialists” (to sample some of the rhetoric of the business press during the New Deal years, when the threat to the overwhelming dominance of business power seemed real).

Here is yet another anomaly about US health care: According to data by the Organization for Economic Cooperation and Development, the US spends far more on health care than most other advanced nations, yet Americans have poor health outcomes and are plagued by chronic illnesses at higher rates than the citizens of other advanced nations. Why is that?

US health care costs are estimated to be about twice the OECD average, with rather poor outcomes by comparative standards. Infant mortality, for example, is higher in the US than in Cuba, Greece and the EU generally, according to CIA figures.

As for reasons, we can return to the more general question of social justice comparisons, but there are special reasons in the health care domain. To an unusual extent, the US health care system is privatized and unregulated. Insurance companies are in the business of making money, not providing health care, and when they undertake the latter, it is likely not to be in the best interests of patients or to be efficient. Administrative costs are far greater in the private component of the health care system than in Medicare, which itself suffers by having to work through the private system.

Comparisons with other countries reveal much more bureaucracy and higher administrative costs in the US privatized system than elsewhere. One study of the US and Canada a decade ago, by medical researcher Steffie Woolhandler and associates, found enormous disparities, and concluded that “Reducing U.S. administrative costs to Canadian levels would save at least $209 billion annually, enough to fund universal coverage.” Another anomalous feature of the US system is the law banning the government from negotiating drug prices, which leads to highly inflated prices in the US as compared with other countries. That effect is magnified considerably by the extreme patent rights accorded to the pharmaceutical industry in “trade agreements,” enabling monopoly profits. In a profit-driven system, there are also incentives for expensive treatments rather than preventive care, as strikingly in Cuba, with remarkably efficient and effective health care.

Why aren’t Americans demanding — not simply expressing a preference for in survey polls — access to a universal health care system?

They are indeed expressing a preference, over a long period. Just to give one telling illustration, in the late Reagan years 70 percent of the adult population thought that health care should be a constitutional guarantee, and 40 percent thought it already was in the Constitution since it is such an obviously legitimate right. Poll results depend on wording and nuance, but they have quite consistently, over the years, shown strong and often large majority support for universal health care — often called “Canadian-style,” not because Canada necessarily has the best system, but because it is close by and observable. The early ACA proposals called for a “public option.” It was supported by almost two-thirds of the population, but was dropped without serious consideration, presumably as part of a compact with financial institutions. The legislative bar to government negotiation of drug prices was opposed by 85 percent, also disregarded — again, presumably, to prevent opposition by the pharmaceutical giants. The preference for universal health care is particularly remarkable in light of the fact that there is almost no support or advocacy in sources that reach the general public and virtually no discussion in the public domain.

The facts about public support for universal health care receive occasional comment, in an interesting way. When running for president in 2004, Democrat John Kerry, The New York Times reported, “took pains .. to say that his plan for expanding access to health insurance would not create a new government program,” because “there is so little political support for government intervention in the health care market in the United States.” At the same time, polls in The Wall Street Journal, Businessweek, The Washington Post and other media found overwhelming public support for government guarantees to everyone of “the best and most advanced health care that technology can supply.”

But that is only public support. The press reported correctly that there was little “political support” and that what the public wants is “politically impossible” — a polite way of saying that the financial and pharmaceutical industries will not tolerate it, and in American democracy, that’s what counts.

Returning to your question, it raises a crucial question about American democracy: why isn’t the population “demanding” what it strongly prefers? Why is it allowing concentrated private capital to undermine necessities of life in the interests of profit and power? The “demands” are hardly utopian. They are commonly satisfied elsewhere, even in sectors of the US system. Furthermore, the demands could readily be implemented even without significant legislative breakthroughs. For example, by steadily reducing the age for entry to Medicare.

The question directs our attention to a profound democratic deficit in an atomized society, lacking the kind of popular associations and organizations that enable the public to participate in a meaningful way in determining the course of political, social and economic affairs. These would crucially include a strong and participatory labor movement and actual political parties growing from public deliberation and participation instead of the elite-run candidate-producing groups that pass for political parties. What remains is a depoliticized society in which a majority of voters (barely half the population even in the super-hyped presidential elections, much less in others) are literally disenfranchised, in that their representatives disregard their preferences while effective decision-making lies largely in the hands of tiny concentrations of wealth and corporate power, as study after study reveals.

The prevailing situation reminds us of the words of America’s leading 20th-century social philosopher, John Dewey, much of whose work focused on democracy and its failures and promise. Dewey deplored the domination by “business for private profit through private control of banking, land, industry, reinforced by command of the press, press agents and other means of publicity and propaganda” and recognized that “Power today resides in control of the means of production, exchange, publicity, transportation and communication. Whoever owns them rules the life of the country,” even if democratic forms remain. Until those institutions are in the hands of the public, he continued, politics will remain “the shadow cast on society by big business.”

This was not a voice from the marginalized far left, but from the mainstream of liberal thought.

Turning finally to your question again, a rather general answer, which applies in its specific way to contemporary western democracies, was provided by David Hume over 250 years ago, in his classic study of the First Principles of Government. Hume found “nothing more surprising than to see the easiness with which the many are governed by the few; and to observe the implicit submission with which men resign their own sentiments and passions to those of their rulers. When we enquire by what means this wonder is brought about, we shall find, that as Force is always on the side of the governed, the governors have nothing to support them but opinion. `Tis therefore, on opinion only that government is founded; and this maxim extends to the most despotic and most military governments, as well as to the most free and most popular.”

Implicit submission is not imposed by laws of nature or political theory. It is a choice, at least in societies such as ours, which enjoys the legacy provided by the struggles of those who came before us. Here power is indeed “on the side of the governed,” if they organize and act to gain and exercise it. That holds for health care and for much else.


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