Samuelson on Health

Some adult talk about solving the heath care standoff from the Sunday, April 30th, Washington Post OpEd pages, by economic guru Robert J. Samuelson:

There’s a genuine solution to our health-care problem

                                                         Columnist April 29

No doubt about it: Health care is a vexing political problem.

There’s a contradiction at the core of our thinking. We want the best care when we or our loved ones get sick. It’s a moral issue. There should be no limits on treatment. But the resulting uncontrolled health spending harms the country. It undermines other priorities — higher wages (more labor income gets channeled into health-insurance premiums) and competent government (defense and other programs may be underfunded).

By and large, Americans ignore the contradiction. Presidents and Congresses have wrestled with it for decades without subduing it. The stakes are huge. Collectively, major federal health programs now constitute the budget’s largest spending item, more than $1 trillion in 2017, or 26 percent of outlays. In 1990, the comparable figures were $137 billion and 11 percent of outlays. Meanwhile, insurance premiums — often paid by employers — have jumped, as have deductibles.

What can be done?

Based on experience, it’s tempting to say “not much.” This may ultimately be the case. But a growing number of studies suggest some cause for optimism; health costs can be contained.

The relevant studies compare Medicare reimbursement rates with private insurance payments for the same medical conditions. The finding: Medicare pays less — much less. A 2017 Congressional Budget Office study found that Medicare’s average payment for a standardized hospital admission was $11,354 — 47 percent lower than insurers’ $21,433.

This research has two interpretations. One is that Medicare rates have been cut to artificially low levels. To replace lost revenue, doctors and hospitals must raise their charges on privately insured patients. The increases are passed along in higher premiums. There’s massive cross-subsidization of Medicare recipients by the working-age population.

Not surprisingly, the rival explanation denies Medicare’s role in boosting premiums. Instead, providers — mainly doctors and hospitals — get the blame. Their market power has increased. Hospitals have merged. Doctors’ group practices have grown larger or been sold to hospitals. Providers and insurance companies typically renegotiate premiums once a year. The fewer providers there are, the harder it is for insurance companies to dictate terms to the survivors.

Probably both theories contain some truth. But scholarly opinion seems to favor the market-power explanation. Significantly, the congressionally created Medicare Payment Advisory Commission has endorsed that view.

Many health-care experts believe that high prices — hospital and doctors’ charges — as opposed to more utilization of medical services are the main reason that U.S. health spending outstrips costs in other advanced societies, says Miriam J. Laugesen of Columbia University’s School of Public Health and author of “Fixing Medical Prices: How Physicians Are Paid.”

You can see where this is going. If higher American health spending reflects the growing market power of providers, then why not curb that power with some form of price controls? This is what most affluent societies do, notes Laugesen.

Writing in the liberal Washington Monthly magazine, Paul Hewitt and Phillip Longman recommend just that. Under their proposal, Congress would adopt the Medicare fee and reimbursement system for the entire country. If this were done, employer-paid premiums would drop sharply, and some savings — maybe all — would be passed along to workers. (Hewitt and Longman call their proposal the “single-price system,” as opposed to the “single-payer system,” which is universal coverage.)

We ought to be grappling with these issues. We aren’t, for understandable if not commendable reasons. The relentless controversy over the Affordable Care Act (“Obamacare”) reminds us how incendiary health-care debates become, raising — as they do — issues of life and death.

There’s also the reality that the self-interest of medical providers is mixed inexorably with their professional opinions. If price controls were proposed, doctors might well lose. They would surely raise legitimate questions about quality of care. Controls would also be denounced as inflexible and un-American, despite the fact that Medicare already has controls: the roughly 750 Diagnosis-Related Groups through which payments are made for various ailments and injuries.

There are few genuine solutions to our health-care problems — only changes that are less bad than the alternatives. We need to slow medical spending and relax the pressures on wages and other government programs. The recognition of the huge gap between Medicare and private reimbursement rates creates the opportunity to do that. We should take it.

Read more from Robert Samuelson’s archive.

Posted in Fun, Governance, Health, politics

Ronan Farrow, Pulitzer Laureate

[I first saw Ronan Farrow when he was a noontime CNN News host (or whatever those talking faces are called) two or three years ago. At the time I thought he was a smarmy pretty-boy airhead. Apparently I was wrong, or maybe it’s just “smarmy pretty-boy airhead prodigy.” Joking aside, he’s a voice worth following. Below is the text preface to the recorded The New Yorker interview by David Remnick, editor.]

On April 16th, the Pulitzer Prize committee awarded the gold medal for public service to The New Yorker and the New York Times, for contributing to “a worldwide reckoning about sexual abuse of women” through their work investigating allegations of assault and harassment against the powerful Hollywood producer Harvey Weinstein. The stories on Weinstein that appeared in The New Yorker—which detailed not only the abuse but also the system of suppression and intimidation used to cover it up—were penned by Ronan Farrow. The day after the Pulitzer announcement, Farrow sat down with The New Yorker’s editor, David Remnick, to talk about the path that brought him to investigative journalism and about how his reporting connects with his lifelong interest in public service.

Farrow grew up with a number of adopted siblings, who came from “every corner of the Earth,” and he would travel with his mother, the movie star Mia Farrow, on humanitarian trips to refugee camps abroad. Such experiences caused him to develop an early interest in international advocacy. He remembers thinking, “I want to do something useful.”

Farrow had what he calls “a Doogie Howser thing”: he started college at the age of eleven, and was admitted to law school at fifteen, but he deferred admission for a few more years, while working at the U.N. By the time he was twenty, Farrow was working closely with Richard Holbrooke, a giant of American diplomacy, in Afghanistan.

Farrow has recently published his first book, “War on Peace,” about the state of U.S. foreign relations, which he sees as entering a particularly troubled moment. “We have been chipping away at diplomacy,” Farrow says, “and, when we do this, it is a disaster.” Under the Trump Administration, the diplomatic apparatus that allows the U.S. to communicate with its allies and its enemies alike has been taking “a nosedive.” In his conversation with David Remnick, which you can watch [at the link] above, Farrow details his journey into the world of international relations, his candid interview with Rex Tillerson, and his prescription for salvaging the diplomatic profession.

Posted in Governance, Media, politics

ISLANDS ADRIFT – Post Irma/Maria State-of-Preparedness of the Eastern Caribbean Islands

This report by BVI Beacon Editor Freeman Rogers and a team of reporters from the Center for Investigative Journalism (CPI) in Puerto Rico. Check the article at the link above for some excellent photography not shown in this text copy (Captions marked [Caption]below.)

This story is part of the ISLANDS ADRIFT series, resulting from the work of a
dozen Caribbean journalists (including Freeman Rogers of the BVI Beacon) led by the Center for Investigative Journalism (CPI) in Puerto Rico. The investigations were possible in part with the support of the Ford Foundation, Para la Naturaleza, Miranda Foundation, Angel Ramos Foundation,and Open Society Foundations.

To continue and extend this important work, make a contribution to the Centro de Periodismo Investigativo at <http://periodismoinvestigativo.com>. Your donation will be processed through the reputable “Network for Good” non-profit, which I have been using for support of several groups or projects since 2007. On the Network for Good site, you can designate if you want your funds to support a specific project or program. I suggest you cite ISLANDS ADRIFT.

Climate Change Series > Islands Adrift: As climate warms, Caribbean ill-prepared

by Freeman Rogers, Omaya Sosa Pascual and Emmanuel Estrada López
April 20, 2018

PUERTO RICO CENTER FOR INVESTIGATIVE JOURNALISM —
[Caption] Dinelle Henley fears for her native Cane Garden Bay, one of the most iconic and pristine beaches of the Caribbean. Like much of the Virgin Islands, the village was devastated by winds, waves and flooding when the centre of Hurricane Irma passed directly over the territory on Sept. 6, 2017.]

Eighty nautical miles to the west, Alexis Correa feels the same way. Although
they do not know each other, they speak different languages and their
governments are unrelated, he has also seen firsthand what the fury of a
Category Four hurricane is capable of doing to a small, vulnerable island. When
Hurricane Maria devastated Puerto Rico with its 155-mile-per-hour winds on
Sept. 20 it swept away roofs, structures, bridges and roads all over the island.

But Mr. Correa has been watching a prelude to this destruction in his community
for more than a decade. The ocean first claimed the social and cultural centre of
his Parcelas SuaÅLrez neighborhood in the municipality of Loiza. Then Hurricane
Maria swept away the basketball court and the park. The places were an integral
part of this community, one stricken by poverty, criminality, discrimination and
limited social mobility, and its destruction has left residents with practically no
options.

“Here the community board and residents used to meet, but we also used to
celebrate weddings and quinceaneros,” Mr. Correa said as he looked at the ruins
of the building, which also served as a childcare center before it was closed in
2002 because of the damage caused by erosion. “We moved to the court and
the park, but Maria destroyed them. Now we donʼt have a place to meet.”

In St. Croix, organic farmer Luca Gasperi is similarly distraught, but not
surprised: He believes the back-to-back September storms that hit his native
United States VI were consistent with other weather patterns that he had been
noticing for years.

“Everything is more intense,” he said as his wife Christina sold produce on a
Saturday afternoon at the 40-acre farm they operate on his parentsʼ land.
Then he ticked off a list of evidence: A lengthy drought struck in 2015,
rainstorms have been heavier, and for the first time in more than a decade of
farming he suddenly is unable to grow broccoli. Another hurricane, he added,
could be the last straw.

“For us, if it happens again…,” he said, his voice trailing off. “Thatʼs the thing:
The way these storms this year got so strong so quick — thatʼs nerve-racking.”
Ms. Henley, Mr. Correa and Mr. Gasperi blame rapid climate change due to
global warming and government inaction for greatly exacerbating their islandsʼ
losses, and they worry that the ocean and extreme weather events like Irma and
Maria will continue to expose the fragility of their islandsʼ infrastructure and
flawed construction practices.

[Caption]A solar farm near Charlotte Amalie, St. Thomas was largely destroyed by the September storms. (Photo: FREEMAN ROGERS)

Destruction in plain sight

Their stories are a snapshot of how climate change is not only eroding the
coasts of these territories and other Caribbean islands, but actively destroying
community life and economic activity in plain sight with little to no governmental
action to protect citizens, according to a regional investigation by the Puerto
Rico Center for Investigative Journalism (known as CPI for its Spanish initials)
and half a dozen Caribbean media outlets.

Experts agree. Ramon Bueno, coauthor of one of the few existing studies on
climate change in the Caribbean, said the scientific community agrees that the
hotter air in the atmosphere caused by global warming carries more humidity
that elevates the sea level and provokes stronger storms, with more rain and
higher surges. These were among the conclusions of the most recent report
from the United Nationsʼ Intergovernmental Panel on Climate Change (IPCC), its
Fifth Assessment Report (AR5), published in November 2014. The IPCC, where
more than 2,000 scientists from 195 member countries collaborate, is the
worldʼs primary source of scientific information on climate change and its
effects.

“While the number of hurricanes may not change much, or may even decrease
somewhat, what is most probable with global warming is that we will see a
greater amount of high category hurricanes,” Mr. Bueno said. The scientist
worked at Tufts University Global Development and Environmental Institute
(GDEI) and was a staff scientist at the Stockholm Environmental Institute, and
since 2013 he has been an independent consultant specialising in climate
change.

“The problem is that, as 2017 made quite clear, only a few Category Four
or Five hurricanes represent a very high threat to the sustainability of
communities in the islands of the Caribbean. It is worse when a same place is hit
by more that one [hurricane]. After Maria, even a mere tropical storm or
Category One hurricane would be devastating,” he added.

Dr. Kerry Emanuel, professor of atmospheric science at Massachusetts Institute
of Technology, who is currently working on two studies about the impact of
hurricanes in the Caribbean, said that there is consensus on two issues about
the effects of climate change: The sea-level is rising and the amount of rainfall
is increasing. And both are set to cause serious hurricane flood damage in the
Caribbean.

In the coastal town of Rincon, in the north of Puerto Rico, Julian Rodriguez knew
that in ten years many things could happen, but he didnʼt see that the two family
beach apartments — an investment of over $400,000 — could be destroyed
overnight. During Hurricane Maria the sea undermined the foundations of
Rincon Ocean Club II, a three-story condominium next to the beach, and his
dream became salt and water, literally.

“If I am honest, I imagined that this would happen. I had seen that this had
happened three times already, with tropical storms that passed through the
south of Puerto Rico — even if they did not hit the island. And even if Rincon
didnʼt get a drop of rain, the waves came and the fence of the condominium was
washed to sea. When they told me that a Category Four hurricane was coming, I
knew that was it. The shock of seeing it is different. But I knew it was coming,”
he recalled.

When his family bought the two apartments, Julian remembers seeing — and
playing on — a sandy beach of about 30 feet wide. It never occurred to him that
the ocean would end up swallowing the building, which is just under 15 years
old.

“And many of those who have, or had, an apartment here, they still owe a
mortgage. You buy this thinking that 30 or 40 years from now you will still have
it,” he said.

Ten years ago Ramon Bueno and his colleagues at Tufts GDEI — Cornelia
Herzfeld, Elizabeth A. Stanton and Frank Ackerman — saw this coming. In their
2008 study The Caribbean and Climate Change: The Costs of Inaction, they
warned that the two dozen island nations and territories of the Caribbean with
their 40 million inhabitants were especially vulnerable to the effects of global
warming though they have contributed little to the release of the greenhouse
gases that drive the phenomenon.

The researchers looked at optimistic and pessimistic scenarios based on a
study developed by IPCC, analysing average hurricane damages, tourism losses
and infrastructure damages due to sea-level rises from hurricanes, and
projected $22 billion in losses to the Caribbeanʼs economy by year 2050 — or
10 percent of the regionʼs gross domestic product. Nonetheless, individual
projections of losses vary much from island to island, with some in the range of
40 percent and Haiti at the top with 61 percent.

“As ocean levels rise, the smallest, low-lying islands may disappear under the
waves. As temperatures rise and storms become more severe, tourism — the
life-blood of many Caribbean economies — will shrink and with it both private
incomes and the public tax revenues that support education, social services and
infrastructure,” the scientists said.

Now, concrete impact of rising sea levels and temperatures and extreme
weather events is not a future projection, but a tough reality. In places like
Puerto Rico, the VI, the USVI, Dominica, Panama, Dominican Republic and Haiti,
CPIʼs regional investigation documented ongoing floods, population
displacement, significant loss of the shoreline, and impacts on tourism
businesses that are already happening.

Palominito island, a popular tourism destination for boaters off the eastern coast
of Puerto Rico, has almost disappeared.

Recent hurricanes have dramatically exacerbated coastal erosion and exposed
the fragility of infrastructure and the potentially deadly impact on populations of
the worst hit islands: Puerto Rico, the VI, the USVI, Dominica, Barbuda and St.
Martin.

“We as a region now have to look particularly at the events of last year and the
projections of the future that this is the new reality for the Caribbean, and we
have to protect ourselves,” said Dr. Ulric Trotz, the deputy director and science
advisor for the Caribbean Community Climate Change Centre in Belize.

[Caption]A salt pond breached the beach at Cane Garden Bay, pictured above in December, which is steadily rebuilding but still has a long way to go. (Photo: CHRISTINA KISSOON)

VI flooding

Amid the catastrophic devastation that Irma wrought in the VI, it is easy to
forget that another natural disaster struck the territory about three weeks
earlier.
As residents prepared for the annual August Emancipation Festival parade, the
sky darkened and rain began to fall. Soon the parade was called off, although a
handful of troupes performed anyway, dancing through Road Town as thunder
crashed and water poured down in sheets.

Over the next 24 hours, some 16 inches fell in parts of the territory, and the
capital city and other areas flooded to a level that was unprecedented in recent
memory.

Leaders have since dubbed the disaster a “100-year flood,” but Department of
Disaster Management Director Sharleen Dabreo pointed out that catastrophic
floods have struck the territory on a seven-year cycle since 2003.

“Itʼs not just Irma and Maria: Itʼs that you have these flooding events triggered
by these [weather] troughs, which is something that you didnʼt have in the
past,” Ms. DaBreo said, adding, “There needs to be a better relationship
between the scientific community and the development planning elements of
government.”

University of Puerto Rico geology professor and geographer Dr. Maritza Barreto
Orta, who has conducted numerous studies on beach erosion in Puerto Rico
and the Dominican Republic, agrees. In Puerto Rico, she found that between
1970 and 2010 the most severely eroded point had a net loss of 70 metres of
shoreline, in the municipality of LoiÅLza. Since 2011 the average annual loss rate of
two metres has gone up to more than four metres in some areas.

A week after Maria, Dr. Barreto and her team visited 75 percent of Puerto Ricoʼs
1,225 beaches and visually documented significant erosion and flattening. The
most striking case found was in La Boca sector in the municipality of
Barceloneta, where the beach was reduced from its 60 metres to only four. She
is currently looking for state and federal funding to update the full study.

“I feel there is a lack of trust towards academia, and that is a serious problem
because the government has to trust the data experts and scientists generate,”
she said. “At the same time, academia should go to public hearings and make
itself heard, because the knowledge we generate is important to public policy.”

The political and colonial dilemma

According to Dr. Trotz, Mr. Bueno, Dr. Barreto and other scientists, the recent
weather events clearly illustrate the effects of global warming in the region,
which is highly dependent on tourism and suffers from a low level of agricultural
activity and food sustainability.

Nonetheless, many of the countries and territories in the Caribbean are being
overlooked by their governments and international organisations. CPIʼs
investigation found that only three – the VI, Cuba and Mexico — out of 13
countries and territories surveyed have climate change legislation in place and
even in these places, building codes, environmental rules, and other regulations
often are not followed.

It also found that there is not even reliable, standardised and up-to-date data on
what is happening in about a dozen islands in the region in the databases of
international organisations dedicated to studying climate change impact, such
as the IPCC and the University of Notre Dameʼs Global Adaptation Initiative,
among others.

These islands — some of the most vulnerable in the world — have a crucial
thing in common: They are so-called territories or colonies in the 21st century.
They have no individual participation in the IPCC and other international
organisations devoted to monitoring the impact of climate change around the
world and proposing solutions.

They are forgotten islands like about a dozen more in the Caribbean, and many
of them belong to but are not part of the US, England, Holland and France.
There is little to no information about their indicators in IPCC, UN and ND-Gain
Index databases. In some cases there is not even a slot with their names. That is
the case with the ND-Gain Index, which uses UN data and shows US information

in the case of Puerto Rico — misleadingly portraying that the island is doing
great — and no information at all in the case of VI, the USVI and the rest of the
Caribbean territories.

Currently 86 experts from 39 countries are working on IPCCʼs next world
climate change assessment report (AR6), which will be published in September
2018. Only two of these experts are from the Caribbean, both from Cuba.
“Itʼs just terrible. The neglect of that whole part of the world is shocking,” Dr.
Emanuel from MIT said.

Dangerous consequences

Puerto Rico, the USVI and the BVI all offer striking examples of the problems
associated with climate change and the dangerous consequences for their
people and their economies. The islandsʼ policymakers, legislators and
governors, and their imperial owners, have known for decades about the
vulnerability of their infrastructure and the increased dangers that climate
change pose to these islands and populations. And for decades they have
debated, legislated and talked about it. But words have not translated into
action.

For instance, the Puerto Rican Legislature has seen more than 45 measures
between 2005 and 2018 directed at putting into place mitigation and adaptation
measures and dealing with the urgency of coastal erosion. Only one has passed:
Climate Change Law 246, which was signed by Governor AniÅLbal Acevedo VilaÅL in
2008. It did not last eight months. It was officially repealed less than two years
later by his opposing party successor Luis Fortuno Burset, and its provisions
were never enacted before that.

In 2007 the Puerto Rico House of Representatives discussed PC 3414, the first
bill related to climate change that was presented in that body. It was not
approved in the Special Commission on Global Warming and Security, but just
the possibility of the proposal being considered at a legislative level was enough
for gasoline distributors in Puerto Rico — the Gasoline Retailers Association
(ADG), Peerless Oil & Chemicals and Caribbean Petroleum Refining — to
oppose the government preparation of a Plan for the Reduction of Gas
Emissions and Control of Global Warming and to question Puerto Ricoʼs
adherence to the Kyoto Agreement of 1997.

In the USVI, similar stalled measures include a climate change strategy that was
required by a 2015 executive order but never materialised.

The VI, on the other hand, now appears on paper to be a poster child for
preparedness, thanks mostly to steps taken in the past decade. In 2012, the
territoryʼs Cabinet adopted a Climate Change Adaptation Policy, setting dozens
of specific deadlines for mitigation measures that in many cases had been
promised for decades. Then in 2015, the BVI became the first in the region to
adopt a legal framework for a trust fund designed to raise money to prepare for
global warming.

However, at least two thirds of the deadlines listed in the 2012 policy have
already been missed, and the trust fund is not yet operational, the CPI found.
And although VI leaders say that the promised reforms are in the works,
scientists and policymakers who recall the repeated failure of such efforts over
the past quarter century worry that the territoryʼs elected officials — who are
responsible for passing laws and managing the territoryʼs internal affairs — will
be unable to muster the political will to see them through.

Such concerns are echoed throughout the region, even though experts say that
comprehensive measures are essential for protecting islands from climate
change and for helping them access badly needed international funding.

“We only start to talk about resilience when we have a big event,” Dr. Trotz said.
“Post-disaster, thereʼs a lot of rhetoric, a lot of activity and whatnot, and then it
fades. So thereʼs a big challenge: We canʼt move ahead significantly without the
political direction, without the political will.”

[Caption]Even as a team worked to repair the extensive hurricane damage at Quitoʼs Gazebo in Cane Garden Bay, Tortola, the business was pounded by a heavy swell in early March. (Photo: FREEMAN ROGERS)

The experience of the VI, the USVI and Puerto Rico shows why failure to take
decisive action could be catastrophic. Policymakers and scientists say that the
2017 hurricanes and other recent weather events have exposed decades-old
shortcomings in the territoriesʼ development frameworks, building rules,
environmental laws, energy practices and other areas that have left them
increasingly vulnerable to global warming.

In Puerto Rico, Maria put at risk the lives of the territoryʼs 3.5 million citizens,
caused a death toll than could exceed 1,000 deaths, caused the displacement of
183,000 citizens who left the island, and directly impacted the tourism industry,
one of the governmentʼs few bets to relaunch the badly damaged economy. The
whole electrical grid of the island collapsed, more than 472,000 houses were
severely damaged, and more than 90,000 families were left without a roof. Most
of the population was left in the dark and without communications for four
months and was exposed to serious health hazards like contaminated water and
deficient hospital services. More than six months after the storm there are still
50,000 households and businesses without electricity, and power outages and
water problems are common all over the island.

The USVI got a one-two punch. Irma devastated much of St. Thomas and St.
John, and about two weeks later Maria pounded the southernmost island of St.
Croix. Both of the territoryʼs main hospitals were mostly destroyed, and more
than 400 patients were evacuated to the mainland US. Thirteen schools were
closed, more than 100,000 of the territoryʼs 103,000 residents lost power, and
most major resorts were severely damaged.

Irma wrought similar havoc in the VI, where about 22 percent of the 28,000
population was displaced and an estimated 70 percent of buildings suffered
damage, with many of those — including some that housed government offices
— totally destroyed.

Since the storm, no major resort has fully reopened — a serious blow in a
territory where tourism generates more than 30 percent of the gross domestic
product and directly employs one in three people. As of March 1, the total
number of hotel rooms available in BVI was 336, compared to 2,700 before Irma.
The yacht charter industry was hit hard too: Available berths at sea as of March
1 were 1,584, compared to 3,800 before the storm.

Other islands in the stormsʼ path suffered similar losses, including Dominica, St.
Martin and Barbuda, which was hit so hard that all of its approximately 1,800
residents evacuated.

All these islands are far from recovering from Irma and Maria, and the new
hurricane season is than two months away.

“Our natural resource infrastructure — things like mangroves, wetlands, ghuts;
the key things that are really there to help storm protection, flooding — weʼve
basically destroyed it all before this happened,” said Dr. Shannon Gore, a VI
biologist who serves on the board of the territoryʼs recently appointed Climate
Change Trust Fund. “And this basically exposed the fact that we shouldnʼt have
done that. And if this isnʼt a wakeup call, nothing else is really.”

Cane Garden Bay, for instance, still appeared pristine before the storm, but for
decades it had faced mounting pressures that werenʼt obvious to the tens of
thousands of tourists who annually flocked to its sandy, palm-tree-lined shore.
Mangroves and other wetlands around the village have been damaged or
destroyed by patchwork development, exacerbating flooding and runoff from
poorly protected road and construction sites, Dr. Gore explained. That runoff, in
turn, has damaged reefs that might have better protected the shoreline from the
waves during Irma.

In the same way, iconic beach bars — many of which were built in contravention
of a planning guideline that prohibits construction within 50 feet of the high
water mark — have contributed to erosion, and the villageʼs sewage system has
been overworked and under-functioning for years.

Irma served as a stark reminder of the dangerous exposure exacerbated by
such issues. All the beach bars there were severely damaged — if not totally
obliterated — and the government had to temporarily ban swimming because of
high levels of bacteria in the water caused in part by the faulty sewage system.

Although some bars have since reopened and others are rebuilding, the
shoreline often remains empty and tourists are typically taken instead to an
undeveloped beach that is not lined with damaged buildings and other debris.
Puerto Rico faced a similar situation. Many beaches were closed because of the
high levels of bacteria, and cement structures on the shoreline crumbled in
some areas.

Thereʼs a lesson to be learned from Cane Garden Bayʼs plight, according to VI
ecologist Clive Petrovic.

“If people want to protect what they build there now, then clean the water so
that the corals can grow and rebuild the coral reef outside,” Mr. Petrovic said,
adding that coral is a primary source for the sand on many VI beaches. “You
look at nature and you look at how does nature solve a problem. And the way
nature protects shorelines is with reefs.”

[Caption]This church near Charlotte Amalie, St. Thomas, still stands open to the elements. (Photo: FREEMAN ROGERS)

Promising reform

In spite of its challenges, the VI has recently committed to comprehensive
reform in the midst of a much broader global push.

In 2009, the worldʼs richest nations met in Copenhagen, Denmark, and pledged
to provide $100 billion in funding annually to help developing countries prepare
for global warming by 2020. That commitment was reaffirmed under the Paris
Agreement in 2015.

But donor countries want to ensure that those funds are well spent.

“The donors are really looking for the countries to get their house in order,” said
George de Berdt Romilly, a Canada-based environmental lawyer who has
consulted extensively on climate change initiatives throughout the Caribbean
and South Pacific. “This is not a blank cheque: They want to see … national
strategies and policies approved at a very high level which really articulate the
vision or the roadmap for going forward.”

The BVI has stayed ahead of the curve. A 2010 green paper was followed in 2011
by a tourism impact assessment. And in 2012, the territoryʼs Cabinet adopted a
comprehensive Climate Change Adaptation Policy, which included deadlines in
four years for about 140 goals ranging from environmental legislation to
development guidelines to energy policy to agricultural and fishing reforms.
But by 2018, no more than a third of the goals has been met, found the CPI.
Leaders argue that such measures take time and point to a variety of resilience
projects being implemented by the government and other stakeholders,
including a recent shoreline revetment in Cane Garden Bay, efforts to make
schools and health facilities more eco-friendly and resilient, and flood mapping
studies. But conservationists and technocrats say that history shows a tendency
for VI legislators to brush aside the difficult comprehensive reforms that are
necessary to fundamentally change the way the territory does business on a
day-to-day level.

Indeed, the unfulfilled goals listed in the climate change policy include dozens of
measures that have been promised for more than a decade, such as a national
development plan that has been in the works since the 1990s; environmental
legislation and planning regulations that politicians have pledged to pass nearly
every year since the mid 2000s; and long overdue updates to the 18-year-old
building ordinance, among others.

Premier Dr. Orlando Smith and Deputy Premier Dr. Kedrick Pickering, who is the
minister of natural resources and labor, did not respond to interview requests,
but Governor Gus Jaspert said that he and the UK are pushing for the elected
leaders of the territory to act quickly.

“It needs to be the government here making those changes,” Mr. Jaspert said.

“To be honest, I find it disappointing that a territory that is so naturally blessed
in terms of its environment doesnʼt have much in the way of alternative energy;
… doesnʼt have good recycling or energy efficiency, so I 100-percent support
the governmentʼs drive to do more on that.”

But Mr. Romilly said that the UK isnʼt necessarily putting its money where its
mouth is.

“When they introduced this announcement that the international community is
going to finance climate change programming with this $100 billion
commitment, the British government put in place a carbon levy on airline travel,”
he said, adding that half of that tax initially was promised for destination
countries, including ones in the Caribbean. “The money has been collected for
some years, but [the British government] have not made good on that
commitment to make the 50 percent available directly to the countries where
the travellers are going.”

But even when international funding is available, he added, donor countries and
other contributors also want in place a mechanism to effectively administer it,
such as the BVIʼs trust fund, which is to be operated by an independent board.
Thanks in large part to a regional push by the Caribbean Community Climate
Change Centre, 10 of 15 of Caricomʼs full members — and the five British
overseas territories that are associate members — have drafted a climate
change policy or strategy, according to the CCCCC. But they have seen varying
levels of success officially adopting them at the Cabinet level of government,
and so far only the BVI and Antigua and Barbuda have passed legislation to
establish the sort of independent fund that many donors want, Mr. Romilly said.
When there has been progress, it often has been patchy. Dominica, for instance,
first adopted a climate change adaptation strategy in 2002, but many of its
goals werenʼt met, according to Mr. Romilly.

“The government had very limited resources, so where there was action it was
because there was funding provided, … but there was slippage where funding
could not be mobilised,” he said.

And although the countryʼs government adopted a Low-Carbon Climate-
Resilient Development Strategy in 2012, he said, it still hasnʼt passed a bill
drafted in 2014 that would establish a trust fund — in spite of Dominica Prime
Minister Roosevelt Skerritʼs repeated promises to take decisive action after
Hurricane Maria devastated the country.

“Even though the prime minister has committed himself to being the first
climate resilient country in the region, and it has been made clear to the
government of Dominica that they need to have this legislation passed to do
this, they have not got round to passing this legislation,” said Mr. Romilly, who
helped draft the strategies and the bill.

He added that governments often donʼt pass such measures until they are
required to do so in order to obtain international funding.

“Unless thereʼs funding thereʼs invariably very little action,” he said, adding that
Dominica likely will pass the bill soon in order to access funding for a resilience
project that is in the works.

In spite of such hitches, however, the Caricom member countries in general are
ahead of many of their neighbours, thanks in part to their collaborative efforts,
Mr. Romilly said.

“The rest of the region is really trying to play catch-up, and of course that was
fairly successful [on US territories] under the Obama administration because
there was a recognition of climate change as an issue,” he said. “However, in the
current administration thereʼs been obviously a complete turnaround on that
one.”

In the case of Puerto Rico, there is not even a climate change plan in place and
Governor Ricardo Rossello appears completely aloof. He did not accept multiple
requests for interview for this story and since Hurricane Mariaʼs devastation he
has devoted only two public sentences to the issue, during his yearly State of
the Commonwealth Address to Puerto Ricoʼs Legislature March 5.

“The time has come to work on a holistic vision of the environment and the
impact climate change has in Puerto Rico. I will support the measures you
produce in this body to address this problem,” he said.

At the same time, he promoted new housing construction through economic
incentives in an island that is bedridden by debt, abandoned properties and
migration.

Posted in Disaster Management, Futures, Governance, Information, Media, Resource Management, Small Island, Tourism

Sarah Kliff, VoxCare: Workers Who Work Would Lose Coverage

CHART OF THE WEEK
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CBPP
I’m still not over this finding. To me, it just seems hard to justify Medicaid work requirements when they can lead to people losing their health insurance when they are, by any reasonable definition, working. As I wrote about this new CBPP study earlier in the week:
By CBPP’s estimate, one in four people who worked enough hours over the course of a year to meet Kentucky’s work requirement are still estimated to have at least one month where they fall below the state’s 80-hour monthly requirement, and could, therefore, be at risk of losing coverage.

In other words: A Medicaid work requirement could force working people to lose their health insurance because it isn’t structured to reflect the realities of what work looks like for people with lower incomes.

Posted in Fun

From our sister blog — WMWWGr8T

via The “EPA Medallion” — Who Knew?

But for those of us of a certain age, let’s go back to 1970, in this note from the nostalgia site Weird Universe (sort of a joke):

January 1970: The White House guard (secret service uniformed division) publicly revealed their new uniforms which featured a white, double-breasted tunic with gold shoulder trim and a stiff shako hat with peaked front. They replaced the black uniforms the guards had previously worn on ceremonial occasions.

President Nixon had ordered that a new uniform be designed after he had seen what palace guards wore in other countries and had decided that the White House needed something as fancy.


However, almost no one liked the new uniforms. People made comments such as:

  •  they look like extras from a Lithuanian movie”
  • “Late Weimar Republic”
  • “Nazi uniforms”
  • “like a palace guard of toy soldiers”
  • “will they be goose-stepping, or what?”
  • “falls somewhere between early high school band and late palace guard.”
  • “They look like old-time movie ushers.”
  • Chicago Tribune columnist Walter Trohan complained they were a “frank borrowing from decadent European monarchies, which is abhorrent to this country’s democratic tradition.”

The guards themselves complained that they felt too theatrical and that the hats were uncomfortable. So within a month the hats had disappeared. The white jackets lasted longer, but eventually they too were mothballed.

Alton Evening Telegraph – Jan 30, 1970

However, the uniforms weren’t thrown out. They sat in storage for a decade, and in 1980 they were sold to the Meriden-Cleghorn High School Marching Band in Iowa.

 

 

Posted in Fun

The Psychological Toll of Anti-Immigration Rhetoric and Policy

from the extraordinary magazine, Undark <https://undark.org/2018/04/05/immigration-daca-trump-border/>

CROSS SECTIONS / News & Features

Exploring the Psychological Toll of Anti-Immigration Rhetoric and Policy

A study of psychological distress among U.S. Latino parents is one of the first to look at the mental impacts of new immigration policies.

04.05.2018/ BY Robin Lloyd

On Wednesday, President Trump officially ordered the National Guard to assist patrol agents at the U.S./Mexico border. The action followed his calls earlier this week for stronger border-control laws, and an Easter Sunday tweet opposing Obama-era policies that have allowed certain illegal immigrants who were brought to the U.S. as children to attend college and become permanent residents. Last November, Trump said he would phase that program out entirely.

President Trump has made no secret of his intentions to crack down on illegal immigration. But the psychological toll of his rhetoric reaches beyond those who are in the U.S. illegally, a new study suggests.

Visual: Michael Vadon/Flickr/CC

Such actions no doubt weigh heavily on the minds of immigrants who are in the U.S. illegally, but a new study of psychological distress suggests that the anti-immigrant rhetoric of the Trump era takes a toll on U.S. Latino parents regardless of their legal residency. Overall, the study’s results, which were derived from a survey conducted last November of 213 U.S. Latino adults in a mid-Atlantic suburb who have at least one adolescent child, might not bode well for the nation’s future workforce and leadership.

About two-thirds of the parents surveyed were in the U.S. legally. The majority of the sample arrived in the U.S. from El Salvador, Guatemala and Honduras. Beyond discussions about whether to renew or roll back well-known policies like Deferred Action for Childhood Arrivals (DACA), immigration and policy changes during 2017 included plans to end Temporary Protected Status (TPS) for immigrants from some countries, and expanded deportation enforcement for more long-term residents without criminal records.

Depending upon their standing as U.S. citizens, or residents with permanent, TPS or undocumented status, between 14 percent and 18 percent of the parents surveyed reported that they had been frequently stopped, questioned or harassed by immigration authorities in the past three months, says public health researcher Kathleen M. Roche of George Washington University, who led the study. The results were published March 2 in the Journal of Adolescent Health.

Parents who reported this difficult experience have eight times the odds of scoring high on a test for anxiety, depression and other symptoms of psychological distress compared with parents who said they were stopped, questioned or harassed less frequently or not at all during the period, the researchers found.

Other experiences or responses linked to immigration policy changes that increased the odds of a parent’s high distress score by as much or even more included reporting that one’s child had been negatively affected by immigration actions, worries about their child finishing school, and having spoken to a child about changing their behavior such as where they spent time after school.

Posted in Fun

Lest We Forget — Secret use of census info helped send Japanese Americans to internment camps in WWI I

I thought you might like this story from The Washington Post.

Secret use of census info helped send Japanese Americans to internment camps in WWII
The abuse of data from the 1940 census has fueled fears about a citizenship question on the 2020 census form.

https://www.washingtonpost.com/news/retropolis/wp/2018/04/03/secret-use-of-census-info-helped-send-japanese-americans-to-internment-camps-in-wwii/

Retropolis

Secret use of census info helped send Japanese Americans to internment camps in WWII

By Lori Aratani

April 6 at 3:59 PM ET

Children at the Manzanar internment camp in California in 1943; photo taken by photographer Toyo Miyatake. (National Park Service/AP)

The Census Bureau plans to ask people if they are U.S. citizens in the 2020 count of the nation’s population, igniting fears that the information could be used to target those in the country illegally.

The decision has become a lightning rod for controversy. More than a dozen states and at least six cities have sued to block the Trump administration from adding the question to the 2020 Census, alleging that it would depress turnout in states with large populations of immigrants. The decennial survey is key to determining how federal funding is spent nationwide.

Census officials said the question is being reinstated for the first time since 1950 to help enforce the Voting Rights Act and that there are safeguards in place to prevent any abuse of the information. It is illegal to release information that would identify individuals or families.

But that does not mean that census data has not been used to target specific populations in the past.

In fact, information from the 1940 Census was secretly used in one of the worst violations of constitutional rights in U.S. history: the internment of Japanese Americans during World War II.

In papers presented in 2000 and 2007, historian Margo J. Anderson of the University of Wisconsin at Milwaukee and statistician William Seltzer of Fordham University found evidence that census officials cooperated with the government, providing data to target Japanese Americans.

The 1943 film “Japanese Relocation” tried to justify the government’s decision to move people of Japanese ancestry from the West Coast to internment camps. (U.S. Office of War Information)

The Japanese American community had long suspected the Census Bureau of playing a role in the push to banish 120,000 Japanese Americans, mostly living on the West Coast, into nearly a dozen internment camps after the bombing of Pearl Harbor on Dec. 7, 1941, according to former commerce secretary Norman Mineta.

Mineta, who lived in San Jose, was 11 when he and his family were sent to live in an internment camp in Heart Mountain, Wyo.

For decades, though, census officials denied that they had played any role in providing information.

According to Anderson and Seltzer, the Federal Bureau of Investigation and military intelligence agencies began pushing in late 1939 to relax census confidentiality rules in the hope of accessing data on individuals. But the effort was opposed by Census Bureau Director William Lane Austin.

After the 1940 presidential election, however, Austin was forced to retire. He was replaced by J.C. Capt, who backed efforts to remove confidentiality provisions. Capt’s efforts helped clear the way for other agencies to access the information on Japanese Americans.

In 2000, Anderson and Seltzer found documents that showed officials with the Census Bureau had provided block-level information of where those of Japanese ancestry were living in California, Arizona, Wyoming, Colorado, Utah, Idaho and Arkansas.

The revelations prompted Kenneth Prewitt, then director of the U.S. Census Bureau, to issue a public apology. Prewitt wrote: “The historical record is clear that senior Census Bureau staff proactively cooperated with the internment, and that census tabulations were directly implicated in the denial of civil rights to citizens of the United States who happened also to be of Japanese ancestry.”

Japanese Americans gather coal left for them at the Heart Mountain internment camp in Wyoming during World War II. (Heart Mountain Wyoming Foundation Okumoto Collection)

Anderson and Seltzer, however, weren’t finished. They suspected that despite the bureau’s denials, it had also released “microdata” — information about individuals, including names and addresses.

In 2007, they found proof, uncovering documents that showed Census Bureau officials provided names and addresses of individuals of Japanese ancestry in Washington, D.C.

While the Census Bureau had no such record, the pair found the information in records kept by the chief clerk of the Commerce Department. Under the Second War Powers Act, which suspended the confidentiality protections for census data, the chief clerk had the authority to release census data to other agencies. That meant while the information released was not illegal, it was ethically questionable, the researchers said.

The August 4, 1943, request was made by Treasury Secretary Henry Morgenthau. He had asked for the names and addresses of all individuals of Japanese ancestry living in Washington. Morgenthau had requested the information to aid in a Secret Service investigation of threats made against President Franklin D. Roosevelt.

The request was triggered by an incident that had taken place 17 months earlier, when a Japanese American man traveling from Los Angeles to the Manzanar internment camp allegedly said that “we ought to have enough guts to kill Roosevelt.” The man was later committed to a mental hospital for schizophrenia.

In all, information about 79 people in Washington was released, the researchers found. The records did not indicate that personal information was released on Japanese Americans living in other parts of the United States.

The request was filled within seven days — remarkably quick for a government bureaucracy, researchers said at the time.

The few remaining structures of the Heart Mountain Japanese internment camp near Cody, Wyo. (Bill O’Leary/The Washington Post)

“It leads us to believe this was a well-established path,” Seltzer told Scientific American in 2007. Starting in March 1942, standard confidentiality protections were suspended under the Second War Powers Act. Confidentiality provisions tied to census data were reinstated in 1947.

In 1988, President Ronald Reagan signed legislation issuing a formal apology for the wartime internment of Japanese Americans. Former internees also received $20,000 in reparations for property seized during the roundups.

The mass incarceration of Japanese Americans, the majority of whom were American citizens, is now considered a stain on American history.

“The Census Bureau doesn’t like to talk about it,” said Prewitt, who served as Census Bureau director from 1998 to 2000. He recalled that when he spoke to a colleague about the issue, he received a terse “Well, it was legal” as a response.

“It was not illegal,” Prewitt added. “But it was certainly inappropriate. It was obvious that the Census Bureau facilitated the roundup.”

In response, a Census Bureau spokesman wrote via email that under the Second War Powers Act officials were “. . . legally required to assist in the war effort.”

“It is important to acknowledge these wartime disclosures, but it is equally important to recognize significant change in the law to protect census data, as well as the other data the Census Bureau collects,” he continued. “The Second War Powers Act was repealed after World War II, while further legal protections for personal data were added and strengthened through legislation passed in the 1950’s and the 1970’s.”

Norman Mineta in 1936. He and his family were interned for several years during World War II.
(Family photo)

Census Bureau officials maintain that there are protections in place to protect individuals who take part in the 2020 Census and emphasized that information cannot be shared with any other agencies, including Immigration and Customs Enforcement, the Federal Bureau of Investigation, the Central Intelligence Agency or any other government agency. A 1954 law prohibits Census employees from sharing information. Those who break the law can be fined up to $250,000 and could face five years in prison.

“Census responses are safe, secure and protected by federal law,” said a spokesman for the Census Bureau. “Answers can only be used to produce statistics. Individual records are not shared with anyone, including federal agencies and law enforcement entities.”

Even so, that is not enough assurance for some, who cite a series of statements made by the Trump administration.

“Just the nature of this administration makes people that much more wary about what they might be asking about,” said Mineta, the former commerce secretary. “I don’t think there’s much confidence in the ability of this administration to have any credibility in terms of protecting privacy issues. For them that’s just a fishing license. It’s ‘I’m the government, and I should be able to go anywhere.’ ”

Even lawful disclosures can raise alarms. The Census Bureau came under scrutiny in the years after the Sept. 11, 2001, attacks, when the bureau gave publicly available information to the Department of Homeland Security about neighborhoods that were home to large numbers of Arab Americans.

Asked whether there are enough safeguards in place to prevent disclosure of personal information from the 2020 Census, Prewitt said, “I have to be agnostic.”

Still, he said: “We do know the mood of Washington with respect to immigration. We have an administration that has said we simply have got to get rid of the people who do not belong here.”

Lori Aratani writes about transportation issues, including how people get around — or don’t. Her beat includes airlines and airports, as well as the agencies that oversee them.

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The Russian objective is to make the truth seem unknowable.

Posted in Fun