The coming crisis in American primary healthcare

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Over the past several years, there has been a growing shortage of physicians in this country, especially in primary care. A new report by the Association of American Medical Colleges suggests that the shortage will only worsen in the coming years, in large part because of physician burnout.

A stronger claim could be made that just the opposite would happen.

“The system is grinding us,” said one of the doctors interviewed for the Kaiser Health News article. “It’s grinding good docs and providers out of existence.”

The article noted that burnout is increasingly identified as a major problem facing medicine. Four in 10 physicians report feelings of burnout, according to a 2019 Medscape report. And the physician suicide rate is more than double that of the general population.

In most cases, those barriers were erected by private insurance companies. Among them are the ever-increasing requirement that doctors must get “prior authorization” from insurers before treating their patients, trouble making patient referrals and “endless clicking on electronic medical records.”

Researchers studying physician burnout recently began to apply that term to health care. They concluded that moral injury was an appropriate term to describe the root cause of physicians’ anguish: Physicians know how best to care for their patients but are blocked from doing so by systemic barriers related to the business side of health care.

Physician burnout has reached such proportions among American doctors that researchers are now using a term that comes from war: “moral injury.” As Kaiser Health News reported in February, moral injury was first used to explain why military veterans were not responding to standard treatment for post-traumatic stress disorder. Moral injury, as defined by researchers from veterans hospitals, refers to the emotional, physical and spiritual harm that people feel after “perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.”

As the supply of doctors continues to shrink we can only expect we will fall even further behind other developed countries in both doctors per 1,000 population and the number of physician visits per year in the future.

Not only that, but Canadians visit their doctors an average of 6.8 times a year, compared to four times a year in the United States. Germans go to the doctor more than twice as often as we do–9.9 times a year on average.

We even perform worse than Canada, a country that reform opponents often cite as a place where doctors are so unhappy they are packing up and moving to the U.S. The truth is that Canada, with 2.7 doctors per 1,000 residents, actually has slightly more doctors available to treat patients than we do. And in Norway, another country with a single-payer system, there are 4.8 doctors per 1,000 people.

According to a recent analysis by the Commonwealth Fund, which monitors the performance of health care systems around the world, there are 2.6 physicians per 1,000 people in the United States–way below the 3.5 per 1,000 average of the 37 countries that comprise the Organization for Economic Cooperation and Development.

The U.S. has already fallen far behind other rich countries when it comes in the number of physicians per 1,000 residents. While the expected shortfall can be explained in part because of changing demographics, the report says a big problem is the fact that more and more physicians are retiring early–a trend that likely will accelerate–because of burnout.

By 2033, the report found, the shortage of physicians is expected to range from 54,100 to 139,000 with the shortage being most pronounced among primary care doctors.  (Tarbell 7/1/2020).

 

Oxford is tying itself in knots over racism

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Oxford University apparently has plans for “trauma dispensation” and the “decolonisation of science degrees”. ( Excuse  me!  What on earth is trauma dispensation and when was science “ colonized”?  Ed.)

”Stepford students! Snowflakes! Students are mocked but in the wake of Black Lives Matter protests, it is vice-chancellors who spot trauma everywhere and want to turn universities into one big safe space.

“The vice-chancellor of Oxford University, Louise Richardson, has announced that students traumatised by the video of George Floyd’s death at the hands of a police officer can ask for special dispensation if they feel they were unable to perform at their best in final exams or assessments. She has urged her colleagues to “reach out to any black students who may be experiencing difficulty at this time”.

“No one who watched Floyd plead for his life was left unmoved. But grades for trauma takes us down a slippery slope. Exactly how many additional marks is a traumatic experience worth? How do students go about proving their distress? The call to “reach out” to black students suggests skin colour will be evidence of suffering.

“Richardson’s announcement means black students at Oxford may have their exams graded more leniently than their white peers. This is a giant leap backwards for racial equality. At first glance, Richardson’s proposal might seem unfair to white students who will struggle to prove they have been traumatised. But it is black students who should be furious.

“You worked hard to win a place at a top university — 18.3 per cent of Oxford students are British BAME, compared with the Russell Group average of 21.6 per cent. Once there, you spent long hours in the lab or the library, before frantic weeks cramming for finals. Exam results are announced and — fantastic news! — your efforts paid off. But rather than celebrating you are left with nagging doubts. Did you score highly because your lecturers felt sorry for you? Will your degree classification be forever shrouded in doubt?  (Joanna Williams, The Times, June 18 2020).

My comment:  I don’t always find myself in agreement with The Times (London), but  I do think Ms. Joanna Williams is right – all this is patronising.  If I were black I would resent being talked down to in this manner.  It will take less than a year before the word goes round that a degree earned by a colored student isn’t worth as much as the same degree earned by a white one, and all the best intentions will be for naught.  If you are accepted by Oxford, you are resilient enough to do the work involved (a huge load) and take the exams on the same basis as everyone else.

I had the experience of a final exam paper on European History which my tutor subsequently told me was the most difficult he had seen for many years.  Like everyone else I messed it up, and as a result, the Final grading for me and everyone else involved was affected negatively.  Did we go crying “unfair” to the authorities?  No, by that time we were adults, I suppose. A non-coddled generation.

Annexation of the occupied West Bank

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(This post is a bit longer than usual, but the injustice is so troublesome that I wanted to reproduce it;  one won’t find it easily in the American media):

Medical Aid for Palestinians (MAP) decries the Israeli government’s intended annexation of significant parts of the occupied West Bank (to start this coming Wednesday), for the intensified widespread and severe violations of Palestinians’ right to health and well-being that it will cause.

Annexation constitutes a flagrant violation of international law and of the post-World War Two international order, which prohibits absolutely the acquisition of territory by force. As stated in a robust rebuke on 16 June of the Israeli government’s plan, by a group of UN experts: “The international community has prohibited annexation precisely because it incites wars, economic devastation, political instability, systematic human rights abuses and widespread human suffering.”

The UN experts said that the 53-year-old Israeli occupation has already been “the source of profound human rights violations against the Palestinian people” and outlined a number of them:

“These violations include land confiscation, settler violence, discriminatory planning laws, the confiscation of natural resources, home demolitions, forcible population transfer, excessive use of force and torture, labour exploitation, extensive infringements of privacy rights, restrictions on the media and freedom of expression, the targeting of women activists and journalists, the detention of children, poisoning by exposure to toxic wastes, forced evictions and displacement, economic deprivation and extreme poverty, arbitrary detention, lack of freedom of movement, food insecurity, discriminatory law enforcement and the imposition of a two-tier system of disparate political, legal, social, cultural and economic rights based on ethnicity and nationality…These human rights violations would only intensify after annexation.”

All of these violations, stemming directly and indirectly from the occupation, impact Palestinians’ health and well-being. The experts’ statement was led by Michael Lynk, Special Rapporteur on Human Rights in the occupied Palestinian territory, who previously documented that Israel is in “profound breach” of its responsibilities with regards Palestinians’ right to health across the territory.

Medical Aid to Palestinians publicizes the health, development challenges and structural impediments to health for Palestinians arising out of decades of displacement and occupation, There are documented barriers to accessing healthcare and impunity for repeated attacks on what Palestinian healthcare there is available.  This is without a mental health crisis and a feeling of constant humiliation.

The consolidation and expansion of settlements, all illegal under international law, is envisaged through annexation. Settlements fuel widespread violations of Palestinians’ right to health and well-being and consequently annexation will exacerbate the damage and suffering they cause. The building and development of settlements can only occur through the confiscation of Palestinian land and resources, to the detriment of the Palestinian economy, environment, livelihoods and well-being.  Their development goes hand-in-hand with restrictions imposed by the occupying power on the development of Palestinian infrastructure, including medical centres. No permanent clinic or hospital is permitted anywhere in Area C of the West Bank.

Five negative trends can be anticipated with regards to the worsening impact of ongoing occupation and annexation on the health of Palestinians:

1.  Restriction of freedom of movement

While movement is promoted for settlers through preferential road and supporting infrastructure, it is obstructed for Palestinians, including for ambulances, mobile clinics, patients and health-workers. Journeys to homes, schools, workplaces and relatives are lengthened and prevented, affecting health, education, livelihoods and family life.

2.  Loss of property, land and other resources

Further extensive loss of privately-owned Palestinian land and natural resources to undermine Palestine’s agricultural, small industry, extractive and other commercial sectors. Less food to be produced, incomes to continue to fall, aid dependency to increase. Access to water, already controlled by Israel, to worsen for Palestinian communities.

3.  Settler attacks, detention of children and demolitions

Already perpetrating a surge of attacks with impunity, settlers will be emboldened to carry out yet more. The attacks cause loss of life, injuries, damage to crops, orchards, homes and vehicles, with self-evident impact on health and well-being. Abusive and illegal arrests and detentions of Palestinian children already occur primarily adjacent to settlements, causing harm to mental health, schooling and family income. Demolitions of Palestinian homes and structures to increase, fuelling an even more hostile environment and probable expulsion of Palestinians from their homes and lands.

4.  Exacerbated risks to vulnerable groups

Worsening socio-economic circumstances to hit disadvantaged groups hardest. Bedouin communities and others in Area C, people with disabilities (through access to education, employment, essential services etc), breastfeeding mothers and young children to suffer worsening rates of malnutrition. Mental health to deteriorate, risking higher rates of attempted and successful suicides, and more domestic abuse.  MAP and its partners will continue to work alongside these made-vulnerable Palestinian communities and groups, striving to alleviate the worsening impacts of occupation and annexation, while also calling for the political drivers of such suffering to be condemned and addressed.

5, Threats to dignity

Systematic inequality and loss of dignity alongside chronic impunity for historical and ongoing injustices to be ever more tangible, causing daily and accumulative indignity for Palestinians.  As stated by the UN experts above:

“The morning after annexation would be the crystallisation of an already unjust reality: two peoples living in the same space, ruled by the same state, but with profoundly unequal rights. This is a vision of a 21st century apartheid.”

MAP is deeply concerned by the scale of the potential further harm to Palestinians’ health and well-being, which relentless occupation and annexation will cause. The UK government and the entire international community must be resolute in opposing the annexation agenda of the Israeli government and in supporting Palestinians’ right to health and well-being, as well as to the most basic principles of international law.   (A statement from Medical Aid for Palestinians 6/27/2020, slightly edited for length).

My comment: This action by the Israel government goes against everything that Epicurus stood for.

 

Basics of Epicureanism

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From time to time I post a brief description of Epicureanism, not for the benefit of the cognoscenti, but for new readers for whom Epicurus is just the name of a philosopher:

Epicureanism is a system of philosophy based on the teachings of Epicurus, founded around 307 B.C. It teaches that the greatest good is to seek modest pleasures in order to attain a state of tranquillity, freedom from fear (“ataraxia”) and absence from bodily pain (“aponia”). This combination of states is held to constitute happiness in its highest form, and so Epicureanism can be considered a form of hedonism, although it differs in its conception of happiness as the absence of pain, and in its advocacy of a simple life.

Epicurus directed that this state of tranquillity could be obtained through knowledge of the workings of the world and the limiting of desires. Thus, pleasure was to be obtained by knowledge, friendship and living a virtuous and temperate life. He lauded the enjoyment of “simple pleasures”, by which he meant abstaining from bodily desires, such as sex and appetites, verging on asceticism. He counselled that “a cheerful poverty is an honourable state”.

He argued for moderation in all things, so that when eating, for example, one should not eat too richly, for it could lead to dissatisfaction later, such as indigestion or the grim realization that one could not afford such delicacies in the future. Likewise, sex could lead to increased lust and dissatisfaction with the sexual partner, and Epicurus himself remained celibate. Even learning, culture and civilization were discouraged, as they could result in disturbing one’s peace of mind, except insofar as knowledge could help rid oneself of religious fears and superstitions, such as the fear of the gods and of death.

Generally speaking, Epicureans shunned politics as having no part in the quest for ataraxia and aponia, and likewise a potential source of unsatisfiable desires and frustration, which was to be avoided.

Like Democritus and Leucippus before him, Epicurus was an Atomist, believing that all matter, souls and gods are all comprised of atoms, and even thoughts are merely atoms swerving randomly.

Epicurus was one of the first to develop a notion of justice as a kind of social contract, an agreement “neither to harm nor be harmed”. He argued that laws and punishments in society are important so that individuals can be free to pursue happiness, and a just law is one that contributes to promoting human happiness. In some respects, this was an early contribution to the much later development of Liberalism and of Utilitarianism.

Abortion No. 2

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Yesterday I wrote about Tennessee and the attempt to use the corona virus crisis to shut down  abortion services.

Tennessee is not the only state determined to end abortion. Other states are using the ruse of declaring abortions “elective”, rather than medical, emergencies.  Texas, Ohio, Iowa, Oklahoma, Alaska and Alabama have issued bans on abortion procedures and threatened legal repercussions for physicians who continue to perform them.  These bans have brought forth a flurry of law-suits by pro-choice advocates, and various federal courts have issued temporary restraining orders, which have been reversed, or have proceeded to appeal.  Other states involved in this issue are Kentucky, Louisiana and Mississippi.   (The Humanist May/June 2020).

My comment: There is no end to the cruelty and vindictiveness of some self-described “christians”, (not all, I hasten to add!)

I have never been involved, peripherally or otherwise, in an abortion.  However, I claim an imagination, and can well imagine the feelings of a young, poor, woman, possibly raped or at least forced to have sex unwillingly, now deeply regretting what happened, barely able to feed and clothe herself, desperate to keep a job but unable to see how she can achieve that and bring up a child successfully.

But it is the baby I feel the most sorry for.  If the “conservatives” (conserving…what exactly?)  have their way there will be even more unloved, poorly cared for, uneducated and resentful young people around, feeling unwanted.  We have more than enough of these people, whose first thought is to buy a gun and mow down the people they blame for their plight. I have no idea how many unwanted human beings there are in the US, but everyone should have a good start in life, surrounded by love.  Now that is conservative!  It is also Christian.  It is despicable to treat women and children like these self-described christians treat their fellow human beings.

Abortion

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At around 12.30 p.m on Juneteenth, with the doors of the legislature locked to the public, Tennessee passed one of the country’s most restrictive abortion bans, one that would prohibit abortion before many patients even know they are pregnant. It includes medically unnecessary, anti-science restrictions, including some rooted in racism and misogyny. If Tennessee Governor Bill Lee signs the bill into law, it will take effect immediately. An emergency lawsuit asks the court to block it.

This law will disproportionately impact Black Tennesseans.   It is a disgrace that in the face of a true public health crisis, Tennessee politicians wasted their time with this last-minute move to attack abortion access before closing up shop this session. We know that the goal of the politicians behind this bill is simple: a total ban on safe, legal abortion, just as the Supreme Court is poised to severely erode Roe v. Wade in a decision due any day.

Tennessee has earned the dubious distinction of being the first state to pass legislation banning abortion since several state governors, including Governor Lee, attempted to use executive orders barring nonessential medical procedures in the wake of COVID-19 to ban abortion. Planned Parenthood and their partners went to court to stop those egregious attempts to exploit a pandemic to block abortion access.  Thanks to a  collective effort access to abortion care has largely been protected.

Now, amidst protests against police violence and the ongoing COVID-19 crisis, politicians are doubling down, pushing racist stereotypes and ignoring public health,  to ban abortion. But we won’t let them. We’re going to do everything in our power to fight back and stand up for reproductive freedom.   (Alexis McGill Johnson, Acting President and CEO, Planned Parenthood Federation of America).

My comment:  I don’t think Epicurus ever specifically addressed abortion, but were he alive today I think he would take the position that abortion is the business of the mother alone, and that bringing into this world unhappy and unwanted children is both a sin and a blight on society.  The last thing we need is more unhappy, angry and violent young people taking it out on society with gunfire and death.  If you cannot love and cherish a child do not have one!  And certainly do not have one as a result of rape.

US voting data being traded on the dark web

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Data on millions of US voters is being illegally traded on the dark web as the US is gearing up for the 2020 presidential election. The data could be used to attempt to influence voters.

The dark web is a part of the internet not searchable using normal means. It is encrypted and visible only through specialist web browsers that anonymise data transfers, and it is a thriving marketplace for illicit material.

Cybersecurity firm Trend Micro has analysed 600 dark web forums dealing in underground trading. The firm found that databases of US voter information, containing names, addresses and political affiliations, could be bought for $9.99 or less – a fraction of the going rate on the dark web of $26 for 1000 fake YouTube likes, which some people buy to boost their popularity on the video site.

Voter information is cheaper because clicking YouTube’s “like” button requires a human or a bot, which costs money,  and voter databases age and depreciate in value.

Information from other nations can cost more – the highest price Trend Micro saw was $400 for a Turkish voter database. That is because, unlike the US, most countries don’t publicly publish information about their voters.

In the US, some of this information is available for free at a state-wide level.  If it’s harder to obtain the information, they’re going to charge more.

Access to US voter registration lists varies by state.  Generally, political parties can view redacted versions of the lists for free, but other organisations or individuals must pay a fee or visit a local government office in person. That can make buying an electronic version on the dark web attractive.

There have been a number of high-profile hacks of voter data. In 2017, more than a terabyte of voter data, covering 62 per cent of the US population, was taken from an unsecured server operated by a firm called Deep Root Analytics. Rosario Fuentes says this data is being sold on the dark web. Deep Root Analytics declined to comment for this article.

The Philippines’s election commission and the Turkish government both had voter data breaches of around 50 million individuals each in 2016, and this data is also being traded, according to Trend Micro. The Philippines’s election commission and Turkey’s justice department didn’t respond to requests for comment.

“Citizens are worried that their country’s election can be interfered with,” says Rosario Fuentes. Recent votes, including the 2016 US presidential election and the UK Brexit referendum, have seen accusations of interference through the use of bots and other social media exploits.

The data being traded on the dark web could be used for this purpose. “If you have a database where you can in some way infer the ideology of someone, carrying out a disinformation campaign would be easier,” says Yevgeniy Golovchenko at the University of Copenhagen in Denmark.  (Chris Stokel-Walker, New Scientist, 20 June 2020)

My comment:  I have no doubt that the November election is going to be chaotic, to say the least, and I think we should fear for the future of the Constitution, which has served us well until now.  As a citizen one  shouldn’t have to worry about politics and the Constitution., but it’s hard not to be concerned.  This is not good for Epicurean peace of mind.

Defund the Pentagon!

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“In 1997, the Department of Defense set up the 1033 program as part of the National Defense Authorization Act to provide thousands of domestic police forces with “surplus” equipment of almost every imaginable militarized kind.

“Since then, thanks to your tax dollars, it has given away $7.4 billion  worth of such equipment, some of it directly off the battlefields of this country’s forlorn “forever wars.”  For items like grenade launchers, mine-resistant armored vehicles, military rifles, bayonets, body armor, night-vision goggles, and helicopters, all that police departments have to fork over is the price of delivery. The Pentagon has, in fact, been so eager to become the Macy’s of militarized hardware that, in 2017, it was even willing to “give $1.2 million worth of rifles, pipe bombs, and night vision goggles to a fake police department,” no questions asked. That “department” proved to be part of a sting operation run  by the Government Accountability Office (GAO). “It was like getting stuff off eBay,” a GAO official said, “only, of course, for free”.

“The militarization (or, thought of another way, the commercialization) of the police has grown apace these last 23 years, while the Pentagon’s ever-soaring budgets for its ever-sinking wars could be thought of as the great American commercial success story of this century. With more and more taxpayer dollars in its wallet, it’s been on a remarkable looting spree. Ask yourself: has there been a weapons system it couldn’t have, a military base it couldn’t establish, a war expense Congress wouldn’t fund even while cutting back on crucial aspects of the domestic budget like infrastructure programs or disease prevention programs?    No wonder the Pentagon could supply all those police departments with a cornucopia of goods with which to turn themselves into over-armed occupying forces in this country.

“It’s never thought of that way, but the Pentagon and the police have essentially been looting the coffers of the American taxpayer for a long time now and, in the Trump era, the process has only intensified.  Nonetheless, even with protests over racism filling the streets of America, protests over defunding the Pentagon have yet to surface in any significant way. Perhaps it’s finally time. (Tom Dispatch 6/23/2020)”   *

My question:  were you aware of the above, dear reader?  I certainly was not.  In another country this would be called gross maladministration and misappropriation, if not corruption.

And what has this to do with Epicurus?  Why, peace of mind, trust in both government and police, the unfairness of taxing the populace then arming a police force not entirely devoted to the welfare of all the people.  If you know any history (doesn’t generally get you a job, so maybe you are not conversant with it?) you will spot a country in sharp decline.  This is a painful and worrying conclusion I hate to arrive at.

* Tom Dispatch is a daily blog that concentrates on the military and the endless wars it fights.

Are they born so uncaring and greedy? An un-Epicurean story

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In 2019, Samuel Hazen, CEO of HCA Healthcare in Nashville, was paid  $26.8 million in compensation ( don’t you just love the word “ compensation”? ).  Until the pandemic hit things looked even better.  Then HCA promptly cut the salaries of 11,000 corporate staff, and even Hazen “sacrificed,” donating $237,000 of his salary — less than 1 percent of his total pay — to a worker relief fund.

HCA nurses and other frontline workers, meanwhile, sacrificed a whole lot more. Two two lost their lives amid widespread staff complaints about a lack of adequate protective gear. Hazen’s HCA responded by denying any gear problems and threatening unionized nurses with layoffs if they didn’t give up scheduled pay increases and accept benefit cuts. The nurses didn’t cave. They demonstrated instead outside 15 HCA hospitals. Hazen’s reaction? HCA has started a new line of business – recruiting scab “replacement workers” to fill in should HCA nurses choose to strike.

It is stories like this that give American healthcare such a dreadful reputation.  Meanwhile, there are thousands of decent doctors and nurses who went into the business to help the sick and the poor.
Thank you, guys!

Making the legal profession great again

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$1699.00

The top rate attorneys at Weil, Gotshal and Manges are charging to handle the bankruptcy of retailer J. Crew (American Lawyer, 22 May 2020)

A year ago J. Crew had 14,500 employees, 10,000 of them part-time.  {Inequality.org)

Meanwhile, America, known worldwide for being the go-to country for lawyers who want to make fortunes, is in the middle of a zillion legal cases. The President starts one every thirty-five minutes, and someone counter-sues every forty.  The law must be the most ( if not the only) thriving industry in the United States.

At one time I thought I would like to be a lawyer, but when I caught myself yawning at the thought I dropped the idea.

 

Light relief

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A 75-year-old man who took up ballet four years ago in memory of his late wife has passed his grade one exam. Bernard Bibby, who was married to Celia for 55 years, said dancing had brought them together because he was “the only boy at the youth club who could jive”.

Following her death in 2015, he decided to sell his TV to force himself to go out and find new ways to entertain himself. After trying ballroom and Latin dancing, as well as tap, he settled on ballet. He took his exam in November at the Bridge Academy of Performing Arts in Rochester, and received the (successful) result two weeks ago.

Comment:  Everyone needs a non- work related hobby or pastime.  To sit all the time in front of a TV is not a good idea ( and, in America, repetitive and not good for stress).  I do drawing and watercolors, very absorbing and relaxing.  And you don’t have to be good at it because it is just for you.

The iniquities of the drug industry

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If ever we find a Covid-19 vaccine, it won’t just be the academics and pharmaceutical giants leading the search we have to thank.  It will also be down to all the funding provided by governments and global charities. Public-private organisations such as Gavi (the global vaccine alliance, supported by the WHO and the Gates Foundation) and Cepi (the Coalition for Epidemic Preparedness Innovations) have given drug companies over $4.4bn to help them beat Covid-19. Yet despite these huge subsidies, drug firms still charge what they want for the final product.

In 2009, a pneumonia vaccine created with the aid of $1.5bn in Gavi funding was so expensive that low-income countries couldn’t pay for it. And AstraZeneca has received £84m in government funds to help develop a Covid-19 vaccine,  yet still owns the intellectual property rights, can dictate the price, and won’t share research data with a WHO initiative to pool Covid-19 knowledge. The drugs market is a market crying out for more state control. “Medicines are a human necessity, not a profit-making machine.”  (Kenan Malik, The Observer, also carried in The Week, 13 June 2020)

My comment:  Healthcare is a human right, not a type of grocery.  Yes, developing an anti-covid vaccine is a risky and expensive business, and a disaster if you get it wrong and kill people.  But if taxpayer money goes into development there is absolutely no case for the developer to capture all the profits and remain unaccountable.

I used to be a product manager for a major pharmaceutical company.  Among my products was the Ventolin inhaler.  The cost of production was about ten percent of the average selling price.  That was 50 years ago.  Presumably the product stopped being a monopoly item years ago. But the Ventolin inhaler is still being used on a daily basis, especially at this time of year.  I have no idea of the current cost structure of the product, but can make an intelligent guess. (Ventolin was not developed using public money, as far as I know).   My point is that this particular product has been a honeypot for decades.  If you are going to benefit in this way and if the development costs are paid for by the taxpayer ( as the covid research and development is being paid for by the taxpayer), then the government should have the monopoly rights to it while the monopoly is extant.  The system is stacked in favor of the companies, not the public or the patients. This is not right.

 

 

Greed.Inc

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David Solomon, the CEO of Goldman Sachs, is having trouble getting out from under the shadow of his predecessor, Lloyd Blankfein. Goldman’s profits have dropped to a four-year low, and the bank had to set aside an extra $1.1 billion for legal fees involved in a Malaysian corruption scandal.

But Solomon is pressing ahead amid pandemic economic shock, as if his two-year reign as CEO has been an unqualified success. His first controversial move: buying two ultra-luxury private jets to shuttle Goldman execs to and fro. His second: engineering himself a 20 percent pay hike.

At the bank’s annual meeting last week, conducted online, critics pressed for a shareholder advisory “no” vote on Solomon’s $24.7-million pay, calling his deal out of line at a time of mass unemployment. Countered a Solomon friendly board member: “We believe David’s compensation is aligned with his peers and his predecessor.” In other words, if some CEOs get paid more than they deserve, all should. The “no” vote failed.   (Inequality.org, April 2020)

My comment: Which example in history can we consult to get a clue about what the future holds in store, in view of this fine example of the “Wisdom of Solomon”?   My favorite would be the the overthrow of the Tsar and the greedy, effete system he presided over.  Unless we see the (unlikely) reform of the American economic system and the advent of a modern Roosevelt to moderate the extremes of wealth and poverty,  Mr. Solomon, and people like him, will come to a sticky end, like the Tsarist regime, and the extremes of wealth will be moderated by force.

Oh, yes!  It can happen here, of course.  And it is really stupid to encourage these self-involved, unempathetic, greedy people.   And don’t give me the “That’s the American way”. trope. America used to be better than this.

Epicurus believed in moderation. I doubt whether many of these finance people can even spell moderation.