After 27 pandemic months of economic strains, emptied sidewalks and palpable decay, San Francisco’s Market Street will be in the spotlight Monday for a strikingly different reason: a celebratory parade.
But as city officials and local business groups spent a hectic weekend preparing for the masses arriving to cheer the Golden State Warriors’ NBA championship triumph over the Boston Celtics, they also kept their fingers crossed that the moment would boost the long struggling boulevard in a bigger way.
“Market Street since the pandemic has felt empty, sort of a ghost town,” said Marisa Rodriguez, executive director of the Union Square Alliance, which is funded by property owners to provide maintenance and services to a 20-block district including three blocks of Market Street. “A parade like this is a way to remind our Bay Area residents that the heart of our city is beating strong, and it still offers people something different than what they can get at home.”
That positive reminder will be in contrast to negative messages like the proliferation of “for lease” signs on storefronts in the mile-long stretch of Market between Main and Eighth streets where the Warriors parade will march. Or the blocks on either side of United Nations Plaza, where conditions related to drug dealing and large numbers of unhoused people prompted Mayor London Breed to declare a state of emergency last winter.
Discussions about a possible parade began as soon as the Warriors battled their way to the NBA finals, said Beth Rubenstein, a spokesperson for San Francisco Public Works. They kicked into high gear as the Warriors clinched the championship on Thursday evening. On Friday afternoon, the city organized a call with several dozen officials and neighborhood leaders.
By Sunday afternoon, clusters of metal barricades along the Mid-Market corridor were in bunches waiting to be deployed to block off the parade route. Two representatives of the nonprofit street assistance group Urban Alchemy were at the ready, but not in any rush to get the street completely cleaned.
“If we clean it now, what will be left for the morning crew to do?” said one.
At the Proper, a boutique hotel with 60 rooms on six floors, all of the rooms facing the Market Street parade route were reserved, said Ana Kutle, director of rooms.
“We’ve had a lot of last-minute bookings and those people have been asking for them,” she said. “They’ve also been asking if the rooftop bar will be open during the parade, which it won’t. But the restaurant patio, with tables on Market Street, will.”
All other retailers on the strip planned to be open, though Bait, a streetwear store between Seventh and Eighth, might not open until after the parade passes.
“We don’t want any snatch and runs,” said Angel Santos, a store associate. They also don’t want any damage to the 10-foot statue of Stephen Curry that stands inside the door. But they are considering moving it outside so Steph can greet Steph when the Warriors leader rolls by in his parade car.
Oxford Street, a souvenir clothing store on the same block, was sold out of everything with Curry on it by Sunday, and everything with a championship logo on it. “Sweatshirts, championship T-shirts, shoes. Everything is gone, gone, gone,” said Ty, a sales associate. “I didn’t even get anything myself, and I work here.”
Generic Warriors hats and T-shirts with a “Dynasty” motif were all that was left, and those will be prominently displayed during the parade. “We’ve got to get rid of those ‘Dynasty’ shirts,” Ty said.Warriors’ Championship Parade
Out front, Bay Wheels was moving its fleet of for-hire bicycles from the Ferry Building down to Mid-Market, where they will be available for rental during the parade.
“They always get damaged,” said Kuanisha Mayers, who was riding the bikes down a ramp from the truck and to the sidewalk stall. “I just hope people mind their liquor and be safe.”
The logistical details for the parade are similar to other large civic events, Rubenstein said. This includes the San Francisco Pride Parade, which will take place Sunday and promises to be at least as large.
“We already have a template for something like this,” Rubenstein said. “Our city does a lot of celebrations at this scale. Not one a month, but five or six each year.”
This won’t be the first time that sports fans from the across the region flock to Market Street for a feel-good event, of course; enormous joyous parades for the Giants after the baseball team won the World Series in 2010, 2012 and 2014 came and went without reversing the fortunes of San Francisco’s best-known boulevard.
Even so, an event of this nature coming after years of bad news can’t help but raise the hopes of people invested in downtown’s future.
“It’s like medicine. People have been struggling — something like this is a blessing,” said Kelly Powers, director of the Hotel Council of San Francisco. “The parade will be shown all over the world, and all the scenic beauty shots, and that’s good marketing for the city.”
Sam Whiting has been a staff writer at The San Francisco Chronicle since 1988. He started as a feature writer in the People section, which was anchored by Herb Caen’s column, and has written about people ever since. He is a general assignment reporter with a focus on writing feature-length obituaries. He lives in San Francisco and walks three miles a day on the steep city streets.Written ByJohn KingReach John on
John King is The San Francisco Chronicle’s urban design critic, taking stock of everything from Salesforce Tower to sea level rise and how the pandemic is redefining public space. A two-time Pulitzer Prize finalist and author of two books on San Francisco architecture, King joined The Chronicle in 1992 and covered City Hall before creating his current post. He is an honorary member of the American Society of Landscape Architects.VIEW COMMENTSTop of the News
Left-wing MP Jean-Luc Mélenchon, leader of the New Ecological and Social People’s Union, delivers a speech in Paris on June 19, 2022 after initial results came in during the second round of France’s parliamentary elections. (Photo: Bertrand Guay/AFP via Getty Images)
The president of far-right National Rally, meanwhile, celebrated a “historic breakthrough” as Le Pen’s xenophobic party won a record 89 seats.
France’s new left-wing coalition picked up enough votes during Sunday’s legislative elections to help deny President Emmanuel Macron the absolute majority he needed to ram through his unpopular austerity agenda.
Macron’s neoliberal alliance Ensemble won the most seats in the National Assembly with 245 but fell well short of the 289 needed to control parliament.
Meanwhile, the New Ecological and Social People’s Union (NUPES)—the recently formed coalition led by leftist MP Jean-Luc Mélenchon—won 131 seats, more than doubling the combined number of representatives that its four parties had in 2017.
NUPES, which brings together Mélenchon’s France Unbowed, the center-left Socialist Party, French Communist Party, and Greens, campaigned on lowering the retirement age from 62 to 60, hiking the minimum wage, and freezing prices on essential products—in sharp contrast to Macron’s alliance, which is trying to raise the retirement age to 65 and has reduced the corporate tax rate, exacerbating economic inequality and insecurity.
“The rout of the presidential party is complete and no clear majority is in sight,” Mélenchon told a cheering crowd of supporters in Paris on Sunday night. “It is the failure of Macronism and the moral failure of those who lecture us.”
Clémentine Autain, one of Mélenchon’s top allies, said that the election results vindicate the left’s strategy and reflect “a gathering of the forces for a social and ecological transformation on the basis of a profound change of society.”
Although the strong showing by NUPES has made it the largest opposition force in parliament, a distinction that enables it to chair the assembly’s key finance committee, the far-right National Rally picked up 89 seats and has also claimed a right to the position as the largest single opposition party.
National Rally’s record showing, which its president Jordan Bardella called “a historic breakthrough,” represents an eleven-fold increase in representation for the xenophobic party of presidential runner-up Marine Le Pen.
In addition to pushing a pro-corporate agenda, Macron’s pursuit of anti-immigrant and anti-Muslim policies has legitimized Le Pen’s reactionary ideas, progressive critics say.
Some of Macron’s allies portrayed National Rally and NUPES as equally extremist. Mélenchon, by contrast, instructed his supporters to “not give a single vote” to the far-right after he finished just behind Le Pen in the first round of April’s presidential race, thereby helping Macron win the runoff.
The conservative Les Républicains, which picked up 61 seats, are “likely to become kingmakers,” Reutersreported, as Macron’s center-right majority seeks out potential allies to overcome France’s first hung parliament since 1988.
If Macron is unable to form a stable alliance with Les Républicains, which has a platform “more compatible with Ensemble than other parties” and could give the president an outright majority, he will be forced to “run a minority government that will have to negotiate bills with other parties on a case-by-case basis,” Reuters noted.
Les Républicains leader Christian Jacob said his party “will remain in the opposition but be ‘constructive,’ suggesting case-by-case deals rather than a coalition pact,” the news outlet added.
Macron’s government is not confining its search for possible legislative friends to the right.
According toAgence France Presse, “Senior Macron officials were on Sunday already trying to drive a wedge through the different factions of the NUPES alliance,” accusing France Unbowed of being too rigidly radical and adversarial in a bid to peel off more moderate Socialists and Greens.
“There are moderates on the benches, on the right, on the left,” said government spokesperson Olivia Gregoire. “There are moderate Socialists and there are people on the right who, perhaps, on legislation, will be on our side.”
If legislative gridlock persists, Macron could eventually call a snap election.
“The word for sin and debt is the same in all language.”–Dr. Michael Hudson
On December 8th, 2016, the Kairos Center hosted “The Land Belongs to God: The Bible’s Commandment Against Wealth and Poverty” at Union Theological Seminary. Our featured speaker was Dr. Michael Hudson, an economist who has studied the history of debt — as well as its consequences and the struggles that have been fought around it — in societies from ancient Babylonia up through today. Dr. Hudson’s recent book, J is for Junk Economics, was released in February, 2017, and his work on the history of debt in the Near East will be published by The Institute for the Study of Long-Term Economic Trends (ISLET) in early 2018.
Earlier in the day, the Kairos Center had a lunch conversation with Dr. Hudson on debt, politics, the Bible, and other issues. Below is an edited and condensed transcript of that discussion.
Kairos Center: Where did your interest in politics come from? Dr. Michael Hudson: My father was a labor leader. He was sent to jail 75 years ago under the Smith Act for advocating the overthrow of the government through force and violence. The Attorney General later wrote it was the only thing he was ashamed of doing. When he got out of jail, we moved to Chicago. I grew up in Hyde Park, went to the Lab School. It was a very formative experience. My closest friend in high school was Gavin MacFadyen — he was the head of the Center for Investigative Journalism and we spent a lot of time together. I grew up knowing most of the labor leaders and socialists in Chicago and elsewhere. People would come to the house – people who worked with Rosa Luxembourg, Karl Liebknecht – and they taught me the stories to remember when they all died. KC: What inspired you to study economics? MH: I came to New York and was encouraged by various people in my life that if I wanted to learn about economics I should go work on Wall Street. My degree in Chicago was in Germanic philology not economics. I never went near the economics department. So I went to work first for the Central Bank, then moved to Chase Manhattan. And while I was there I met an executive from the National Catholic Welfare Conference who I spoke to about population growth and Malthus, and I wrote him a letter saying that if you were not going to cut the population down to the food supply then you had to increase the food supply to feed the population. He sent this around to most of the bishops and I began working with Monsignor Knot at Pittsburgh who later became Cardinal Knot and the foreign secretary of the Vatican. The Vatican then sent me around the country giving speeches on economics. I also worked with various Protestant groups who were attracted to my ideas. The plan was for Pope John Paul I to start an academy for Geo-economics to talk about land reform and debt that was to be centered in Tulane. But then he died and the two other popes who came in were not interested. KC: How did you go from modern economics to the study of debt in the Bible and the ancient world? MH: I worked in London with Peter Challen for the Christian campaign for monetary justice. He introduced me to Archbishop Welby, focusing on debt, but they were not able to get the Church as a whole to focus on debt. As it happened I worked for the UN pointing out that third world debt could not possibly be paid and had to be forgiven. After a riot at a meeting in Mexico, I decided to write a whole history of debt cancellations. It took me about a year to get back to Greece and Rome and the biblical world. But I found a mass of material that had been ignored in the books on Mesopotamia, Sumer and Babylonia. So in 1984 I joined the Peabody Museum, Harvard’s anthropology department in Babylonian archaeology. We found that the word that was used in Babylonian for debt cancellation, andurarum, was the cognate to the Hebrew word, duror, which was used for the Jubilee year. And it turned out that the biblical scholarship taking place and just gaining momentum in the 1980s showed that the Bible was really written upon the return of the Jews from Exile. The archaeology picture is very different from what you read in the Bible. There are no records at all about who got what land, no records at all about the Jubilee year after the return from exile, because they didn’t use clay. The most recent research in the last few years has shown that only some of the Jews came back to Israel, that there were many Jewish families that remained in Babylonia. They were thoroughly assimilated, part of the local culture. So it was a particular group of Jews that came back. What we’ve also found is the Qumran scrolls. The scrolls were in Midrash, that is a collection of all of the biblical commentary on debt cancellation and everywhere that it occurred, Psalms, Isaiah. The whole Bible was rewritten from the point of view of redistributing the land and canceling the debts. The laws were a literal translation of the royal Babylonian proclamations of the time. What we found out was a parallel line of biblical studies. You can imagine that when the Qumran scrolls were found the Christian churches all said this isn’t Christianity and they claimed that they must have been a sect. It turns out that these were the basic library of the temple in Jerusalem that was moved for safekeeping and they weren’t a sect, this was the official background. KC: How does all this relate to Jesus and the New Testament period? MH: This throws new light on what the fight over Jesus was. During his time a waiver was proposed whereby people would sign away their rights under the Jubilee year. The pretense in modern biblical scholarship is that the Jubilee could never have really occurred, because if it really happened, people wouldn’t lend money. Who would lend money if the debts were going to be cancelled? The fallacy here is that people didn’t owe debts for borrowing money. They owed debts for not paying their bills. They ran up debts cause they couldn’t pay their taxes and owed money to the tax collectors who said, “You pay this or we’re going to throw you in jail.” And the whole economy worked very much on credit, not on cash. This is what the debts were owed for. And these are the debts that Jesus said should be cancelled. He gave his very first sermon when he opened up the book of Isaiah and read about canceling the debts and Jesus said that’s why he’s here. You do not hear this often in the churches, but this is in the Bible. KC: What, then, do you say to those who say that the Bible isn’t about economics? MH: The Bible is all about economics. Take, for example, the translation of the Lord’s Prayer, and compare it to the scroll 11Q Melchizedok which is the Midrash of all debt cancellation. It’s very clear debt cancellation is what’s meant. The word for sin and debt is the same in all language, and it goes back to the ancient concept in Europe called wergild. If you injure somebody, either he gets to kill you or you get to pay him and the payment which was called the Schuld, or the obligation, was the word injury with a saying. So a Schuld, debt and injury are the same everywhere. KC: Has any of this work been popularized outside of the Academy to those who need to hear it? MH: Most of my work on antiquity has been in scholarly publications, not popular lecturing. I didn’t think anybody was going to be interested in the near Eastern background until they were interested in today’s debt problems. But David Graeber wrote Debt following this theory and it took off. There was a time when the whole ancient world was in a debt crisis going into a dark age. There is a dispute around this term, “the dark age.” We’ve had economists who’ve studied the GDP back then and they’ve found that the GDP and output were going up, because they’ve found expensive pottery and artwork in the houses of the very rich. Well imagine how Andy Warhol’s paintings are part of the GDP and it’s all going up and if you look at how rich the rich were getting, the economy was actually expanding, despite the fact that the 99% were falling into serfdom. I think we’re in a similar situation right now. Since 2008, we’ve been hearing that the economy has been getting better and better. It turns out that all of the growth in national income and GDP since 2008 has been absorbed by the upper 5%. For the 95% it’s been going down. My most recent book, J is for Junk Economics, basically claims that what people call economic growth is actually the FIRE sector. It’s Goldman-Sachs, it’s Chase Manhattan, it’s Donald Trump and the landlords. None of its adds anything to output at all, adds any goods and services, it’s because the rich are the whole GDP and the rest of the population are simply left at the bottom. KC: How, if at all, have the churches responded to your research? MH: I think it would be appropriate to have an encyclical on debt and property. But the spirit of our times is exactly the opposite: you’re having the pressure under the Democrats and Republicans to cut taxes on the rich, especially to cut taxes on real estate, and that’s where all of the money is. This absence of a public option in real estate is forcing all of the rents up, which is why so many people are homeless, because housing should basically be a public right, just as healthcare and other things. All of this used to be done. And it was done for very practical reasons in Sumer and Babylonia. If the rulers wouldn’t cancel the debts, people would just run away and go somewhere else. By the 14th century BC the situation was so bad that they were all defecting and would make armed bands called the hapiru. And there’s a general belief that the hapiru were the original Hebrews. They were people fleeing from debt peonage in their own country. I think we’re having a similar economic dynamic today. I’ve spent quite a bit of time in Greece and you can see the problems the Greeks are having, being reduced to debt peonage. Europe is basically shrinking. It’s turning into a dead zone and yet the labor parties, the parties that call themselves socialists, are now on the far right of the spectrum. There has to be a whole realignment. Now the question is how do you do this? Thirty years ago, there was hope. Then you had almost all the religions swing around to the right. Obviously it’s going to be a fight. KC:How could we do more to popularize what you’re doing? Because I think most people don’t know this history at all. Both the connection with the biblical material and the way that you are seeing what’s happening right now. They seem to be inextricably connected, those two things. MH: My archaeology and biblical work has only been discussed academically. There’s been almost no connection at all made between my current economic work and political work. Liz Theoharis: I have a couple of questions. Most of my academic work is informed by the anti-poverty organizing I’ve been doing for a long time, but is rooted in a reinterpretation of Matthew 26, where Jesus says, “The poor will be with you always, but you will not always have me.” And in part it’s a quotation of Deuteronomy 15. When I was doing some of this work, even the very progressive biblical scholars were skeptical of the conservatism of Deuteronomy. And so they argue that radical social movements are what produce some of the debt cancellation but then what’s reified in Deuteronomy are the more social democratic responses to more radical action. I would love to hear some of your thoughts on that. Maybe to do with Deuteronomy, maybe to do with other historical parallels that one could apply methodologically to Deuteronomy, because to me they said that to discredit the radicalism, how revolutionary these economic practices really were. And how they actually happened. So that much of the work of reclaiming Deuteronomy is saying these practices really happened and these are written down because people were trying to do away with practices that were happening. The other question or point is that I think much of the reason that we have been trying to look at the Bible in its social and economic context is that it has something to say about our social and economic context today. What I am finding is that people, regular people, are just really hungry for understanding that context and for learning about any moment in the public sphere when those kinds of histories took place. For instance around the Da Vinci Code, the reason it was so popular was because people know there’s a different story that’s never told to them, even in some of its inaccuracies, and they’re drawn to it. And I see something similar with the kind of economic practices and particularly debt cancellation practices. I see people really hungry for this and yet there is a real inadequacy of resources to make that translation and to make that transition. Most of the books and articles I read doesn’t make those connections. But your work makes these connections. MH: After the return from exile, that’s when the Bible was put together and Jewish history rewritten as if the whole Bible from the very founding of Israel, of David and Solomon, as if it were all a class war. And the real class war was debtors against creditors. The pyramids were not built by slaves, neither Jewish nor anyone else. They were built by very skilled labor that was well fed and had a lot of beer. We have the records for all of this. So we know what they were paid. This is all published in Labor in the Near East. We know what was happening in Israel was just what was happening in Rome. You had Zedekiah going to war with the Assyrians and he promised everyone he was going to cancel the debts if they came and joined the army. Then they joined the army, they fought, and then he didn’t cancel the debts. So he was a bad king. As a matter of fact, if you look at the Bible, all the kings are pretty bad. They realized that all throughout the ancient world in the first millennium, the kings either were overthrown or they became just the heads of the aristocracy. So what Leviticus did was take debt cancellation out of the hands of kings. Throughout the near east when a king would take the throne, the first thing he would do would be to cancel everybody’s debts, redistribute the land, free the bondholders, and the slaves would be returned to their original owners. They didn’t free the slaves in this, they were returned to the owners. They did this because they had the idea that every reign should begin in economic balance. It should begin in order. We have the economic models they used, the mathematical models that were used in 1,800 BC. These mathematical models are superior to any model that’s taught today in the University of Chicago or elsewhere, because they’re very simple. The first thing, they understood compound interest and how principles double every five years. And any rate of interest is a doubling time. They also understood the S-curve, that growth tapers off. Well, every economy works in an S-curve. Basically if you look at a business cycle it’s a series of S-curves tapering off. As a natural tendency of any economy, if you know simple mathematics, you know that debt succeeds the means to pay. They all knew that — in Sumer, in Babylonia –and the job of the ruler was to free the debt bondsmen. Because if you let the debtors be enslaved to the creditors, then who is going to train the army? Any country that didn’t do that was going to be conquered by other people. We have Greek military manuals from, I think, the 3rd century by Tacticus saying, “People, if you want to conquer a city say you’re going to cancel debts; they’ll come over to your side. And if you want to defend a city, you promise to cancel their debts.” While Zedekiah was going back on his word in Judea, you had Coriolanus in Rome doing the same thing. Rome went to war, he promised to cancel the people’s debts — this is what Shakespeare’s play was all about — and then he didn’t do it. You had the same thing everywhere. They all promised the population one thing and then they slammed down and double-crossed their backers. It’s what kings did then and it’s what’s happening today. KC: Any final thoughts about what this history means for us today? MH: I think in popularizing this history, the fact is you can’t depend on rulers. You cannot put your faith in princes to do things. It can only be the people that will actually do something. That has to be the message. Now, people say that the rulers never canceled debts. But we now translated all of the legal records. We have the lawsuits: “Do I really have to cancel this debt?” “No you don’t or yes you do have to cancel them.” They went to court. We have every debt cancellation of every member of Hammurabi’s dynasty and his great-great-grandson Ammi-Saduqa. You can see the rulers are trying to close all of the loopholes that the creditors keep trying to develop. You can show that this was done for 2,000 years. For example, just about everybody’s heard of the Rosetta Stone. What they don’t know is that it’s about debt cancellation. They had a young ruler and said, “Do what the pharaohs of the past did, cancel the debts.” It’s all written right there. There’s a reason everybody knows about the Rosetta Stone and yet nobody knows what’s in it. I think that’s what you have to say: what the churches tell you is Christianity is not Christianity. Jesus is not going to make you rich. Jesus is not going to give you a bigger car if you help us build a cathedral. And you have to say that the Bible is all about economics. This is the real Bible, this is the real history.
Common chemicals sprayed on many crops each year are cloaked in bureaucratic uncertainties
By Meg Wilcox on June 15, 2022 (scientificamerican.com)
Scientists have been raising growing concerns for decades over the use of toxic “forever chemicals,” so called because their strong molecular bonds can take hundreds of years to completely break down in the environment. Widely used in consumer products such as cookware and clothing, these substances are turning up everywhere from drinking water to our bloodstream. And now researchers are warning of yet another—and so far underrecognized—source of these troubling toxins: common pesticides. Nearly 70 percent of all pesticides introduced into the global market from 2015 to 2020 contained these chemicals or related compounds, according to a review paper recently published in Environmental Pollution. And the surge in their use has come without a full understanding of their potential impact on the environment and human health.
Forever chemicals—scientifically known as perfluoroalkyl and polyfluoroalkyl substances, or PFASs—are a subset of so-called fluorinated chemicals, which possess strong carbon-fluorine bonds. That means such chemicals are both highly stable and useful in products designed to repel grease and water. But it also means they do not readily biodegrade. Though governments have been working to limit the use of PFASs, those efforts are complicated by differing technical definitions of which fluorinated chemicals are technically PFASs—and as such pose a risk to people and the environment. Many chemicals considered PFASs in much of the rest of the world are not classified this way in the U.S. This situation could leave communities exposed to harmful chemicals, including pesticides that contain fluorinated compounds and are sprayed on many different crops around the world every year.
Pesticides made from fluorinated chemicals, commonly referred to as fluorinated pesticides, “can be incredible molecules that meet a lot of the challenges that exist in agriculture,” says study co-author Diogo Alexandrino, a researcher at the University of Porto in Portugal and a co-author of the Environmental Pollution paper. “But they should be properly vetted, and we should be aware that they can have a very huge impact on the environment, on biodiversity and eventually on our own health.”
Stability or Persistence?
Fluorinated chemicals, including PFASs, have been widely used in consumer products since the 1940s. But in the following decades scientists began realizing that these chemicals persisted in drinking water and human bodies, and in the 1990s the Environmental Protection Agency began investigating PFASs. Nearly every U.S. resident now carries low levels of PFASs in their blood. These chemicals have been linked to testicular and kidney cancers, reproductive disorders, thyroid disease, high cholesterol levels, reduced immune response and even increased susceptibility to COVID-19. Based on these concerns, the U.S. Congress is weighing several bipartisan bills to restrict their use in food containers and cookware and to require the EPA to take comprehensive action to prevent PFAS pollution—including setting national limits on levels in drinking water. Under the Biden administration, the EPA has published a PFAS Strategic Roadmap for addressing the crisis. Eight states have already adopted laws to ban PFASs in certain products, especially food packaging—but not in pesticides.
Fluorinated pesticides first appeared on the market in the 1930s, but it is only in the past decade that this use has expanded so dramatically. This rise is linked to improvements in manufacturing processes and the expiration of patents that have allowed for wider competition, Alexandrino says.
Fluorinated pesticides bring “efficacy and stability” to pest management, says Karen Reardon, spokesperson for the pesticide industry group Responsible Industry for a Sound Environment (RISE). That stability makes pesticides remain effective longer, she says—so crops can be sprayed less often than would be needed with a nonfluorinated alternative.
But what Reardon calls stability, others call persistence. Data compiled by Alexandrino and his team show half-lives (the amounts of time it takes chemicals to dissipate by half in the environment) ranging from a few days to 2.5 years for top-selling fluorinated pesticides. That is less than the half-lives of some older pesticides such as DDT, but at the upper end of the scale, it is still a relatively long time: the EPA defines a “persistent” pollutant as having a half-life of 60 days or more. As Kyla Bennett, science director of the nonprofit environmental advocacy organization Public Employees for Environmental Responsibility (PEER), bluntly puts it, “Why on earth would you allow PFAS to be put in something that’s sprayed on millions and millions of acres every single year? It’s called a forever chemical for a reason.”
What Is—and Isn’t—a PFAS?
One of the most widely used fluorinated pesticides is bifenthrin. It targets insects’ nervous system and is the prime ingredient in more than 600 pesticide formulations used on corn, soy, vegetables, berries and orchard crops. It is also used to treat seeds and to control ants, termites and other pests in urban settings. Its potential effects on human health are not well known, though there is some evidence that chronic exposure is linked to neurotoxicity, and the EPA has classified it as a possible human carcinogen. Ultimately, the EPA concluded in a 2020 human health risk assessment that “dietary exposure and risk estimates are not of concern for the existing uses of bifenthrin”—at least when levels designated as safe for human consumption are not exceeded. But amounts found in recent years on collard greens, eggplants, spinach, cherry tomatoes, sweet potatoes and peaches have exceeded those EPA safety levels. Removing such residues from produce requires extra scrubbing because bifenthrin is an oily substance.
Bifenthrin is also a persistent pollutant with a half-life of 97 to 345 days in soil, depending on soil type. A 2016 U.S. Geological Survey study found that it binds to sediments contained in stormwater and can persist in surface waters, where it harms beneficial insects that provide food for fish, birds and wildlife. Its particular configuration of carbon and fluorine is “really stable and will be really persistent in the environment,” says University of Porto researcher Maria de Fátima Carvalho, a co-author of the new paper.
Although bifenthrin is one of more than 200 active pesticide ingredients that would be recognized as a PFAS by the latest Organization for Economic Co-operation and Development (OECD) definition and is banned for most agricultural uses in the European Union, the EPA has a narrower definition of a PFAS. Differing definitions complicate efforts to understand and regulate such chemicals’ use. The EPA definition only includes compounds with relatively longer carbon-fluorine molecule chains because it says those are generally less likely to accumulate in the food chain and are potentially less toxic—though not all experts agree on this. “It is incorrect to argue that everything is safe until you have two, three or four [carbon-fluorine] bonds,” says Rolf Halden, director of the Biodesign Center for Environmental Health Engineering at Arizona State University. “We’ve created a chemistry with no known biodegradation mechanism. You’re signing up for a lifetime of exposure around the world and for millennia.”
In an e-mail to Scientific American, EPA spokesperson Robert Daguillard wrote that the agency’s PFAS definition, first developed in 2006, was intended to “identify the PFAS most likely to present risk to human health and the environment.” The definition has since been adjusted, Daguillard added, and “we are currently looking at the differences between the OECD and [EPA] definitions to determine whether the [EPA] definition should be modified to capture additional substances.”
At least three active pesticide ingredients currently allowed by the EPA—broflanilide, pyrifluquinazon and noviflumuron—meet its definition for a PFAS. Four others that the EPA qualifies as a PFAS have been banned in the U.S. but are still used in Japan, China and some countries in Latin America. New pesticide ingredients that the EPA would classify as PFASs continue to come on the market in China. While the three allowed in the U.S. have half-lives of a few months at the most, that measure does not tell the whole story, says Nathan Donley, environmental health science director at the Center for Biological Diversity, a nonprofit conservation group. “On paper, they look like they break down within a reasonable time period”—but the by-products of that breakdown also need to be considered, Donley says. “You’ve got the parent pesticide molecule that can break down into something that’s … still a complex molecule, fairly fluorinated,” he adds. “And what those degradation products are doing in the environment is really not followed up with at all.” Wendy Heiger-Bernays, a clinical professor of environmental health at the Boston University School of Public Health, says the breakdown products of fluorinated pesticides may interact with other environmental PFAS pollution in unknown ways.
EPA spokesperson Cathy Milbourn says the agency “has a robust process for identifying and assessing the environmental risks of pesticide degradation products or metabolites.” But Donley argues that while the EPA looks at initial breakdown products, it does not follow the pesticide degradation process to its completion—which he says can take decades or centuries and can produce dozens of different molecules along the way. Moreover, what happens in the environment does not always track what happens in the laboratory. “I don’t necessarily expect the EPA to do all the study necessary to get definitive answers for all of these things, but they need to account for this uncertainty somehow,” Donley says. “The benefit of the doubt should be given to people and the environment, not to the pesticide companies.”
When Scientific American asked what actions the EPA may take to restrict pesticides that do meet its definition of a PFAS, Milbourn responded in an e-mail that “regardless of the evolving definition of PFAS, pesticides undergo a rigorous scientific assessment process prior to registration” and that “fluorinated pesticides in commerce have met appropriate risk-based standards for registration.”
But PEER’s Bennett, who previously worked at the EPA’s New England regional office for more than a decade, is among many who point out that the data the agency use to evaluate pesticide safety are almost entirely provided by manufacturers—which Bennet says leaves regulators open to “incredible industry capture” and “political pressure” to get pesticides on the market. She claims that EPA staff evaluating pesticide risks do not have access to enough information to do their job correctly. Recent reporting by the Intercept and Investigate Midwest has also brought these issues to light. Responding to Bennett’s points, RISE’s Reardon says that the “EPA’s pesticide determinations are made solely by the agency as it fulfills its remit under the Federal Insecticide, Fungicide and Rodenticide Act.” The EPA declined to comment when asked about Bennett’s claims.
“The EPA and everyone is telling us these [fluorinated pesticides] are so much better than the older [nonfluorinated] ones. And in some regards, that might be true,” Donley says. “But it’s really worrisome to me that even though these don’t technically meet the EPA definition of PFAS, they meet the PFAS definition of much of the rest of the world.”
Others, however, prefer to focus on the pesticides that the EPA has already labeled as PFASs. “We’ve seen fluoro groups in insecticides, but I would not call those PFAS,” says Graham Peaslee, a professor of physics at the University of Notre Dame. Heiger-Bernays also says she is “less concerned” about the potential for human harm from some pesticides such as bifenthrin. Emphasizing that she is not a “pesticide advocate,” she says there can be legitimate uses for these chemicals: “There are,” Heiger-Bernays notes, “times when we would like our houses not to be consumed by termites.” The issue, she says, is to figure out what those limited, legitimate uses are—and then curtail everything else.
Whether the EPA’s PFAS Strategic Roadmap will lead to action on fluorinated pesticides—particularly those that meet its PFAS definition—remains to be seen. In an e-mail to Scientific American, Milbourn wrote that “as EPA continues to refine the testing process, as regulatory work matures, and as the Agency learns more from its partnerships across the country, the Agency will adjust the definition of PFAS to reflect the information gathered through this process. As the agency determines the scope of this issue, it will continue to use all available regulatory and non-regulatory tools to address PFAS.”
For some, those words are not reassuring. “I think a lot of us are holding our breath. We really don’t know a lot right now,” Donley says. “I’m hoping for the best, but I think it’ll take a few years, or even a few decades, to really grasp what is going to happen with all these new fluorinated pesticides.”
ABOUT THE AUTHOR(S)
Meg Wilcox is a Boston-based environmental journalist.
THE LATEST FORAY into Democratic Party primaries by the American Israel Public Affairs Committee, or AIPAC, is targeting former Maryland Rep. Donna Edwards: a progressive who is running to represent Maryland’s 4th Congressional District, a seat she held from 2008 to 2017.
The contest between Edwards and corporate attorney Glenn Ivey had been relatively quiet. This week, the race was upended when United Democracy Project, an AIPAC-aligned super PAC that has spent millions to thwart the campaigns of progressive women of color, put big money behind an ad accusing Edwards of poor constituent services during her previous tenure in Congress.
On Friday, Edwards’s campaign held a press conference outside the headquarters of the Amalgamated Transit Union Local 689 — one of several local labor unions that have endorsed her bid — where Edwards blasted Ivey for accepting hundreds of thousands of dollars in outside spending from “corporate interests that are fueled by AIPAC.” After Edwards condemned AIPAC and its allies’ intervention, a number of her supporters — including elected officials, labor leaders, and constituents — also rebuked the ad’s content. One critic, in particular, stood out: House Speaker Nancy Pelosi, D-Calif.
In a video recorded this week in response to AIPAC’s attacks, Pelosi dismissed the new ad’s claims against Edwards. “She was one of the most effective members in Congress,” Pelosi says in the video. “Donna fought hard for Prince George’s County — for jobs and investments in her community, to help constituents in need and to deliver results.”
Former Rep. Donna Edwards hugs constituent Joyce Moyer Williams, who says Edwards saved her home from foreclosure during the Great Recession in Forestville, Md., on June 17, 2022.
Photo: Austin Ahlman
Pelosi, a Maryland native who endorsed Edwards in May, is a long-standing ally of AIPAC and aligned pro-Israel forces. She attends the group’s yearly conferences and rarely departs from its hawkish pro-occupation stances.
In a spate of competitive Democratic primaries between progressives and moderates this election cycle, AIPAC has reliably weighed in on the side of the moderate — including those with spotty records on abortion and gun rights. Pelosi had declined to weigh in on some of the races and, in others, supported the AIPAC-backed moderates.
Liberal pro-Israel group J Street, which has supported Edwards in past elections, identified at least $1.5 million in upcoming ad spending over the next week — nearly $200,000 a day. They expect that number to increase dramatically in the run-up to the July 19 primary. If that happens, Edwards may face more outside spending from pro-Israel groups than any other candidate this cycle.RelatedJewish Progressives Sound the Alarm as Pro-Israel Groups Target Marginalized Candidates
AIPAC and its allies Democratic Majority for Israel and Mainstream Democrats PAC previously spent millions against the campaigns of Summer Lee in Pennsylvania, who prevailed anyway, and Jessica Cisneros in Texas, whose race to unseat Rep. Henry Cuellar remains too close to call. Democratic Majority for Israel is already running ads supporting Ivey, but the full extent of their spending remains unclear until updated Federal Election Commission reports are filed.
The AIPAC ad’s attacks on Edwards’s constituent services echoed accusations that arose during her run for U.S. Senate against fellow Maryland Democrat Chris Van Hollen in 2016. In that race, Edwards was accused of not being a reliable supporter of Israel for eschewing many AIPAC-backed efforts on the Hill, including resolutions and letters in support of AIPAC’s agenda and sanctions against Iran being pushed by the group. Edwards was also criticized for joining nearly 60 other Democrats — including then-Vice President Joe Biden — in a boycott of a 2015 Capitol Hill speech by then-Israeli Prime Minister Benjamin Netanyahu where the right-wing politician asked Congress to reject the Iran nuclear deal that President Barack Obama had just struck.
The contest between Edwards and Van Hollen, who both represented Maryland in the House at the time, was in many ways a preview of Israel debates roiling the Democratic Party’s nominating contests this cycle. In the 2016 race, AIPAC endorsed and supported Van Hollen, who ultimately won the Senate seat. J Street, which supported Edwards during her original Congressional run, backed her initially — but after Edwards faced scrutiny over her foreign policy views, the group moved to support both candidates at once. Now the two groups appear more firmly opposed.
In an interview with The Intercept Friday, Edwards highlighted AIPAC’s support for Republicans who voted against certifying Joe Biden’s election victory, and she criticized Ivey for accepting the outside spending from the group. She called on Ivey, a former state’s attorney for Prince George’s County, to disavow the new ads.
In an email to The Intercept, a representative for the Ivey campaign defended the contents of UDP’s ad. “The facts are clear cut and well-documented,” the statement said. “Ms. Edwards has publicly acknowledged on multiple occasions her poor constituent services.” Ivey’s campaign did not respond to questions about AIPAC’s support for election deniers or their repeated targeting of marginalized candidates.
Patrick Dorton, a spokesperson for UDP, defended his group’s entrance into the race in a statement provided to The Intercept: “Donna Edwards has a lengthy track record of hostility to the U.S.-Israel relationship, and on top of that was one of the worst members of Congress in terms of constituent service. We are looking at races where there is a clear contrast between a pro-Israel candidate and a detractor of Israel, and there is no doubt that Donna Edwards would undermine the U.S-Israel relationship at every turn should she get the opportunity.” AIPAC did not respond to a request for comment.
In a statement from J Street, spokesperson Kevin Rachlin condemned AIPAC’s latest ad blitz and lauded Pelosi for pushing back. “It’s great to see Speaker Pelosi standing with Donna Edwards to fight back against disingenuous smears funded by a right-wing group.” he said. “AIPAC has been attacking Democrats who stand for human rights and the rule of law on the one hand, while endorsing insurrectionist Republicans on the other. They shouldn’t be in the business of telling Democrats who to vote for, and Glenn Ivey should be disavowing these misleading ads.”
Correction: June 19, 2022 This story has been updated to mention J Street’s 2016 endorsement of Chris Van Hollen, who the group supported in addition to Donna Edwards.
The fragmented and inefficient healthcare system in the United States leads to many preventable deaths and unnecessary costs every year. Universal healthcare could have alleviated the mortality caused by a confluence of negative COVID-related factors. Incorporating the demography of the uninsured with age-specific COVID-19 and nonpandemic mortality, we estimated that a single-payer universal healthcare system would have saved 212,000 lives in 2020 alone. We also calculated that US$105.6 billion of medical expenses associated with COVID-19 hospitalization could have been averted by a Medicare for All system.
The fragmented and inefficient healthcare system in the United States leads to many preventable deaths and unnecessary costs every year. During a pandemic, the lives saved and economic benefits of a single-payer universal healthcare system relative to the status quo would be even greater. For Americans who are uninsured and underinsured, financial barriers to COVID-19 care delayed diagnosis and exacerbated transmission. Concurrently, deaths beyond COVID-19 accrued from the background rate of uninsurance. Universal healthcare would alleviate the mortality caused by the confluence of these factors. To evaluate the repercussions of incomplete insurance coverage in 2020, we calculated the elevated mortality attributable to the loss of employer-sponsored insurance and to background rates of uninsurance, summing with the increased COVID-19 mortality due to low insurance coverage. Incorporating the demography of the uninsured with age-specific COVID-19 and nonpandemic mortality, we estimated that a single-payer universal healthcare system would have saved about 212,000 lives in 2020 alone. We also calculated that US$105.6 billion of medical expenses associated with COVID-19 hospitalization could have been averted by a single-payer universal healthcare system over the course of the pandemic. These economic benefits are in addition to US$438 billion expected to be saved by single-payer universal healthcare during a nonpandemic year.
Despite spending more on healthcare than any other country, both overall (1) and on a per capita basis (2), the United States does not provide universal healthcare, resulting in preventable deaths and excessive costs (3). In 2019, prior to the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), over 28 million adults were uninsured, an increase of 2.2 million from 2016 (4). Since 2020, the COVID-19 pandemic has underscored the public health, economic, and moral repercussions of widespread dependence on employer-sponsored insurance, the most common source of coverage for working-age Americans. Business closures and restrictions led to unemployment for more than 9 million individuals following the emergence of COVID-19 (5, 6). Consequently, many Americans lost their healthcare precisely at a time when COVID-19 sharply heightened the need for medical services.With over 973,000 reported deaths attributed to COVID-19 as of 14 March 2022, the United States represents 16% of the documented worldwide mortality burden of the virus (7), while only composing 4% of the global population (8). Inadequate health insurance coverage has exacerbated the COVID-19 pandemic on both individual and population levels. At the individual level, concerns over medical expenses delay diagnosis and treatment (9), elevating case fatality rates (10). At the population level, postponement of diagnosis, and thus of case isolation, fuels transmission. In addition, fear of losing employer-sponsored health insurance during a pandemic may make it untenable for people to miss work even when they feel unwell. We quantify the financial benefits and lives saved if the United States had provided universal healthcare coverage to all individuals during the COVID-19 pandemic. As proposed by the Medicare for All Acts of 2019 (11) and 2021 (12), a major feature of such reform would be elimination of the high deductibles and copays that currently make medical services unaffordable even among many who are nominally insured (13).
Ramifications of Pandemic-Driven Unemployment for Health Insurance Coverage.
While stay-at-home orders and temporary closures of nonessential businesses curbed the immediate spread of COVID-19 and prevented catastrophic demands on hospital capacity (14), the measures also led to spikes in unemployment. For employees, a layoff often results in insurance loss or the need to switch to a different type. To determine the changes in coverage by insurance type over the course of 2020, we combined data on monthly Medicaid/Children’s Health Insurance Program (CHIP) enrollment (15), monthly employment (16, 17), and employer-sponsored health insurance plan participation rates (18), as well as insurance exchange enrollment during both the standard (19) and special enrollment periods (20). We calculated the difference in insurance enrollments for each month of 2020 compared to December 2019, the final month prior to pandemic disruptions. In March 2020, employment dipped slightly, followed by a steep drop in April, precipitating a loss of 14.5 million employer-sponsored insurance enrollments compared to December 2019 (Fig. 1A). Employment gradually rebounded but remained below its December 2019 level throughout 2020.Fig. 1.
Concurrent with reductions in employer-sponsored insurance over the course of 2020, Medicaid/CHIP enrollments rose steadily from 71.6 million in March 2020 to 80.2 million in December 2020. There were fewer total insurance enrollments from March through September 2020 compared to December 2019, but increasing Medicaid/CHIP enrollment boosted total insurance enrollment to 3.5 million above that baseline by December 2020 (Fig. 1B). Increased Medicaid enrollments in 2020 may be a response to unemployment, the result of ongoing Medicaid expansion efforts (21), or due to individual perception of elevated risk during the pandemic. Another driver may be the disaggregation of family members previously covered together under an employer-sponsored family plan. On average, each employer-sponsored enrollment covers more than one individual. Some individuals may be eligible for employer-sponsored coverage through their spouse or may opt to purchase insurance, such that unemployment does not necessarily lead to becoming uninsured. Conversely, job loss may be associated with the loss of insurance for an entire family, potentially resulting in separate enrollments into Medicaid or CHIP for each family member. Such events might appear from the federal data as an increase in enrollments, when in reality the same number of individuals have coverage prior and subsequent to the job loss. Due to this disaggregation, the apparent rise in Medicaid/CHIP enrollments may not have translated to higher overall coverage, and the pandemic-driven insurance gap may have persisted longer than indicated by the raw data. Despite these sources of uncertainty, US Census Bureau data indicate that more Americans were uninsured at some point in 2020 compared to 2018 (22). Consistent with our evaluation, April was the most common month for insurance loss in 2020, contrasting with nonpandemic years (22, 23).
Insurance Gap Prior to the COVID-19 Pandemic.
The pandemic-driven changes occurred against a backdrop of preexisting incomplete insurance coverage. To evaluate coverage when SARS-CoV-2 emerged, we calculated the age-specific number of uninsured individuals in 2019 by applying the change in overall reported coverage between 2018 and 2019 (24) to the 2018 coverage in each age cohort (25). We estimated that 40,963,120 Americans were uninsured in 2019 (SI Appendix, Table S1).
Life-Saving Potential of Universal Healthcare.
Quantifying lives that could be saved by universal healthcare in nonpandemic conditions.
Demographic shifts and the expanding insurance gap combined to increase the annual lives that could have been saved by the provision of universal healthcare compared to our previous analysis (3), even in the absence of COVID-19. We previously calculated that enacting universal healthcare would have saved over 68,000 lives in 2017 (3). To update this analysis to the most recent nonpandemic year, we took into account the proportion of uninsured in each age class for 2019, the size of every age class, age-specific life expectancy, and the elevation in mortality associated with lacking insurance (26). Our calculations indicate that 76,064 lives would have been saved by universal healthcare among individuals of all ages in 2019 (SI Appendix). Incorporating the life expectancy of the lives that were lost, we further calculated that 2,094,548 y of life would have been saved by universal healthcare in 2019 (SI Appendix), an increase of 360,519 compared to our calculation for 2017 (3). The greater loss of lives is due both to a widened insurance gap and to a rise in the average age of an uninsured individual (SI Appendix, Table S1).We also evaluated the deaths and years of life lost that are attributable to uninsurance for 2020, based on demographic trends, for the counterfactual scenario where the COVID-19 pandemic did not occur (SI Appendix, Table S1). Using 2019 estimates for age-specific coverage and updating with 2020 population growth (27), we estimated that there were 77,675 excess deaths and 2,099,133 excess years of life lost in 2020 due to lack of insurance without including repercussions from the pandemic (which we calculate below in Quantifying lives that could have been saved by universal healthcare during the COVID-19 pandemic).In addition to those without insurance, another 45.3 million adults are underinsured (13), burdened by copays and deductibles that are not affordable relative to their salary. Underinsured Americans often forgo healthcare that they require, thereby increasing their risks of mortality (28, 29). Consequently, our estimates are conservative with regard to the life-saving benefits of comprehensive universal healthcare that eliminates all costs to the patient.
Quantifying lives that could have been saved by universal healthcare during the COVID-19 pandemic.
As well as demographic shifts since 2019, loss of employment and therefore insurance coverage during the COVID-19 pandemic further contributes to premature mortality. Using the same methods detailed in Quantifying lives that could be saved by universal healthcare in nonpandemic conditions for age-specific elevations in mortality among the uninsured, we estimated the mortality impact specifically among those who experienced pandemic-driven job loss. Given the high Medicare coverage among elderly, we applied the pandemic-driven enrollment changes only to those under 65 y of age. While coverage rose toward the end of 2020, these gains were insufficient to compensate for the extent of lower enrollment early in the pandemic. Incorporating both the widening and then contracting insurance gap, we estimated 2,784 lives lost over the course of the year. From the combination of pandemic-related and background uninsurance, we calculate 80,459 excess deaths and 2,214,033 y of life lost in 2020.We previously calculated that 26.4% of the lives that were reported to be lost due to COVID-19 would likely have been saved if there had been universal healthcare throughout the pandemic (30). In addition, it has been estimated that 24.1% of COVID-19 fatalities were not documented on death certificates (31). In 2020, 377,883 deaths from COVID-19 were recorded (32), implying 497,870 actual deaths, of which 131,438 could have been averted if the United States had universal healthcare. Therefore, the number of lives that could have been saved in 2020 by universal healthcare from both non-COVID conditions and COVID-19 would be 211,897.Across the entire time frame of the pandemic thus far, 973,459 COVID-19 deaths have been recorded in the United States (7), meaning that there were actually 1,282,555 deaths due to COVID in the United States. Therefore, 338,594 COVID deaths are attributable to incomplete insurance coverage in the United States.
Mechanisms by which Medicare for All would save lives and avert morbidity during a pandemic.
The observed relationship between healthcare coverage and COVID-19 mortality is attributable to multiple factors, as detailed below.
Improved access to primary care and reduction in comorbidities.
First, the prevalence of those underlying conditions which exacerbate COVID-19 severity would be reduced via equitable access to care. For example, uninsured adults are significantly more likely than insured adults to be unaware of their hypertension (33, 34), much less likely to be receiving treatment (35), and much less likely to have their hypertension under control (36). Hypertension specifically increases the risk of COVID-19 mortality by 188% (37). Additionally, uninsured women were found to have a higher prevalence of obesity (35), which is another risk factor for severe COVID-19. Diabetes has similarly been associated with significantly increased COVID-19 severity and mortality (38). Uninsured adults with diabetes were half as likely to be aware of their condition as their insured counterparts (39).
Early diagnosis and access to life-saving medical care.
Financial barriers reduce and delay care for COVID-19. Due to apprehension about their ability to pay, 14% of US adults reported that even if they experienced the two most common symptoms of COVID-19, fever and dry cough, they would still avoid seeking care (40). These financial concerns are justified as 18% of the US population had medical debt even prior to the COVID-19 pandemic, collectively totaling $140 billion (41). Medical debt ballooned further during the pandemic as the confluence of lost insurance and lost income makes it more challenging to pay medical bills (42, 43). Removing financial obstacles to care can accelerate diagnosis. More timely medical attention increases the probability of recovery from COVID-19 infection (10, 44). For example, treatment with monoclonal antibodies early during the infection reduced the risk of severe outcomes (hospitalization or death) by 85% (45). Reducing the time to diagnosis also ensures more prompt isolation, which in turn reduces transmission to others.The Coronavirus Aid, Relief, and Economic Security (CARES) Act subsidizes all testing and medical bills for the uninsured with COVID-19. However, hurdles still exist that may prevent individuals from seeking care. Since this program does not directly offer insurance to patients, uninsured individuals may be unaware that their COVID-19–related medical expenses can be reimbursed, which may prevent them from seeking treatment (46, 47). Furthermore, CARES Act provides financial assistance for only one disease. It is a possibility that people without insurance and seeking medical care for COVID-19 symptoms might be billed for a different diagnosis or other services associated with testing (48).Geographic inequities in healthcare access have exacerbated case fatality rates in the United States (49). Specific provisions in the Medicare for All 2021 bill to iteratively monitor and address geographic and racial inequity (12) would have particular importance during a pandemic. Rural hospitals are disproportionately reimbursed at the relatively low rates paid by Medicaid (50) and have heavy burdens of uncompensated care (51), which has challenged the survival of rural facilities (52). Although hospital fees nationwide would be reduced by Medicare for All, applying Medicare rates across the board would actually increase support to those rural hospitals which currently serve substantial populations of Medicaid and uninsured patients (53). Furthermore, clinical outcomes such as mortality have been elevated among rural communities during the COVID-19 pandemic (49). Rural hospitals were more prone to shortages of ventilators, personal protective equipment, ICU capacity, and healthcare workers (54). These factors would be rectified by investment to expand healthcare facilities and hospital capacity in rural areas (12).
Facilitation of COVID-19 preventative measures.
COVID-19 mortality rates have been higher and vaccination rates lower among Black and Hispanic individuals relative to White individuals (55, 56). A key driver of these disparities is inequitable access to primary care (57, 58). For example, recommendation of COVID-19 vaccination to patients by their trusted primary care providers is effective in overcoming vaccine hesitancy (59, 60). Consequently, it is unsurprising that individuals without access to a primary care provider have lower rates of vaccine uptake despite it being free to the public. Universal healthcare would ameliorate such inequities, particularly given the provisions for investment to address racial and other disparities.
Alleviating pressure on hospitals during a pandemic.
Beyond COVID-19 outcomes, high hospital caseloads impact non-COVID care and also lead to premature death from non-COVID causes during a pandemic. Removal of cost barriers and alleviation of comorbidities would have reduced not only the risk of COVID-19 death but also hospitalizations, with positive externalities specific to the pandemic context. Particularly during outbreak surges, high demand for COVID-19 hospital services often delayed procedures related to other health conditions. Reduced hospitalization rates facilitated by Medicare for All would have blunted these COVID-19 peaks and thereby freed capacity for non-COVID care.
Fully addressing health disparities requires a multifactorial strategy.
Not all disparities in COVID-19 mortality could have been alleviated by adoption of a single-payer universal healthcare system. Even in countries with single-payer healthcare systems, there can be a steep income gradient associated with COVID-19 outcomes (61). While single-payer healthcare is paramount to addressing health disparities in the United States, the challenge is multifactorial. Pervasive inequities regarding income, education, and housing impact nutrition, mental health, exposure to pollution, and feasibility of accessing healthcare services. Paid sick leave, nutrition programs and affordable housing are among initiatives that are necessary to alleviate disease burdens overall and mitigate systemic gaps in health.
Economic Savings That Could Have Been Realized by Single-Payer Universal Healthcare during the COVID-19 Pandemic.
We calculated the economic savings of a single-payer universal healthcare system in 2020, relative to status quo, by examining two sets of costs: medical costs unrelated to COVID-19 and those attributable to the treatment of COVID-19.
National healthcare costs unrelated to COVID-19.
Per capita healthcare spending in the United States increased from US$10,682 in 2017 to $11,582 in 2019 (62). We previously calculated that a single-payer universal healthcare system would have saved $458 billion in 2017 (3). There are several factors driving these savings. Streamlined administration, negotiated pharmaceutical prices, and application of the Medicare fee schedule throughout the healthcare system are major reforms that would achieve substantial reductions in national medical costs (SI Appendix). Combined, the savings from these mechanisms more than compensate for the expanded utilization when coverage is extended to the entire population (SI Appendix).Taking into account shifts in demography, healthcare utilization, and coverage composition, we updated our previous analysis and found that single-payer universal healthcare would have saved $438 billion in 2019. A key factor driving the slight reduction in savings compared to 2017 is the increase in the number of Americans who are underinsured from 41 million (63) to 45 million (13). In our analysis, we take into account that these individuals would likely have expanded utilization once provided with full healthcare coverage (64). Given the small difference in savings between 2017 and 2019, we anticipate that 2020 savings would have been similar in the absence of the COVID-19 pandemic.
National healthcare costs related to COVID-19.
Hospitalization and healthcare fees attributable to cases of COVID-19 are much higher under the current system than would have been incurred under Medicare for All. In general, Medicare charges are 22% lower than those charged by private insurance for the same services (65). However, the discrepancy is even greater for COVID-19 in particular. Private insurers paid more than double the Medicare rate for a hospitalized COVID-19 case (66, 67).To calculate the national expense associated with COVID-19 hospitalizations, we used the estimated cost of COVID-19 hospitalization with or without a ventilator stratified by whether the patient was insured and, if so, their type of insurance (67). While the average Medicare and Medicaid costs for a COVID-19 hospitalization that requires mechanical ventilation were $57,822 and $47,396, respectively, the average charge to private insurance was $114,842. Charges for hospitalizations that did not require ventilation were lower but showed a similar pattern across insurance types (SI Appendix, Table S5). We combined the age distribution of 11,832,077 [95% uncertainty interval (UI): (10,586,595, 13,077,559)] estimated hospitalizations through 12 March 2022 (68, 69) (SI Appendix), age-specific insurance coverage by type, and age-specific probability of ventilation given hospitalization to estimate the proportion of hospitalizations in each age group that were reimbursed at each different cost level (SI Appendix, Table S5). Since ratification of the CARES Act, the Federal Government has been reimbursing hospitals for the care of uninsured COVID-19 patients at Medicare rates. Therefore, we applied Medicare rates for uninsured individuals who were hospitalized. We calculated that the expense of COVID-19 hospitalization has totaled $365.8 [95% UI: (327.3, 404.3)] billion, of which $141.2 [95% UI: (126.3, 156.1)] billion occurred in 2020. If the Medicare rate had been applied to all hospitalizations, $105.6 [95% UI: (94.5, 116.7)] billion would have been saved during the pandemic thus far and $39.4 [95% UI: (35.2, 43.5)] billion in 2020.Consolidating the expected general savings from a transition to Medicare for All with savings specific to COVID-19, single-payer universal healthcare could have cost $459 billion less in 2020 than our current system. These savings would alleviate the burden on employers and individuals to cover insurance premiums, copays, and deductibles. Since Medicare for All would achieve savings overall, the tax revenue needed to fund Medicare for All would be significantly lower than the healthcare premiums that are currently paid by employers and households.The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 provided a mechanism by which individuals who become unemployed may temporarily retain healthcare insurance for themselves and their families. However, the unemployed individuals must shoulder the entire premium payments, including the proportion that was previously paid by their former employer, which on average is $21,342 annually for family coverage (70). Due to a 2% COBRA administrative fee, the premiums paid by the unemployed worker are actually higher than that paid when they were employed. The American Rescue Plan of 2021 included subsidies to cover COBRA premiums for individuals who lost employment during the pandemic. While essential to relieve household financial strain due to prolonged reliance on COBRA, an estimated $57 billion in subsidies will ultimately flow to insurers (71). In 2020, many of these companies made multibillion-dollar second quarter profits, double the amount for the previous nonpandemic year (72). Under a universal single-payer system, the recently unemployed keep their coverage, and the taxpayer is not subsidizing these profits.COVID-19 can also have long-term health and economic consequences. Among survivors of COVID-19, there can be substantial and often long-term morbidity (73). The debilitating symptoms of long COVID can include pulmonary and cardiovascular disorders, mental health impairments, neurologic symptoms, and functional mobility impairments (73). The cost of treatment for these symptoms is substantial (74). Uninsured individuals, including many whose unemployment was precipitated by the pandemic, would have to bear the full cost of these treatments. Further, long COVID may affect the ability to work, potentially reducing income or leading to insurance loss (75). As with acute COVID, affordability may be a deterrent to seeking needed care for long COVID, particularly for low-income families (75). By curtailing the spread of COVID-19, Medicare for All would also have reduced the incidence of long COVID. Additionally, medical expenses associated with long COVID would be lower under a more efficient healthcare system and covered for the patient regardless of employment status.
Medicare for All as Pandemic Preparedness.
The COVID-19 outbreak has underscored the societal vulnerabilities that arise from the fragmented healthcare system in the United States. Universal healthcare coverage decoupled from employment and disconnected from profit motivations would have stood the country in better stead against a pandemic. Emergence of virulent pathogens is becoming more frequent, driven by climate change and other global forces (76). Universal single-payer healthcare is fundamental to pandemic preparedness. We determined that such a system could have saved 211,897 lives in 2020 alone. Strikingly, it would have done so at lower cost than the current healthcare system, saving the US $459 billion in 2020 at a time of economic tumult. To facilitate recovery from the ongoing crisis and bolster pandemic preparedness, as well as safeguard well-being and prosperity more broadly, now is the time to transition to a healthcare system that can better serve the American people.
“Before our white brothers came to civilize us we had no jails. Therefore we had no criminals. You can’t have criminals without a jail. We had no locks or keys, and so we had no thieves. If a man was so poor that he had no horse, tipi or blanket, someone gave him these things. We were to uncivilized to set much value on personal belongings. We wanted to have things only in order to give them away. We had no money, and therefore a man’s worth couldn’t be measured by it. We had no written law, no attorneys or politicians, therefore we couldn’t cheat. We really were in a bad way before the white men came, and I don’t know how we managed to get along without these basic things which, we are told, are absolutely necessary to make a civilized society.” ― John Lame Deer, Lame Deer, Seeker of Visions
At the Battle of the Little Bighorn, 146 years ago, my ancestors defeated the US army’s Seventh Cavalry led by George Armstrong Custer, who had previously massacred Cheyenne people.
This 25 June, on the anniversary, I will make a call to end genocide to protect diversity. I do not make this call lightly. Rather, I am speaking with a great sense of urgency from lived experience.
For the Cheyenne, the genocide started with what the US army wrongfully called “the Indian wars”, when it was nothing more than the slaughter of our people, buffalo and horses to exterminate our way of life. It is this very genocidal mindset which now produces the climate crisis, further genocides, even the threat of nuclear war.
I want to share with you the story of how my people and my family survived through generations – despite many attempts to exterminate us. The fact that we survived is a lesson in resilience, and I know that we also survived for a reason: to protect and share our teachings for a time such as this.
My late father Chief Phillip Whiteman Sr was a descendant of chiefs. We are peace chiefs – we never provoke war, our main role is to steward our people and way of life.
My father’s grandmother, Quill Dress Woman, was a little girl at the battlefield and witnessed Cheyenne matriarchs push sewing awls into Custer’s ears so that next lifetime he would listen. They did this because after the Washita massacre in 1868, where Custer had attacked a peaceful Cheyenne camp resulting in the killing of many women and children, our Cheyenne chiefs still made peace with him in a sacred pipe ceremony.
They told him to rub the remaining ashes into the ground, and warned him he would end up like the ashes if he ever double-crossed the Cheyenne. Custer did not believe us, but whatever the medicine men said after ceremonies always came true.
My family holds the songs for the sacred site by our home community, where we went into ceremony before the Battle of the Little Bighorn. Our relative Ma’ome (Ice) served as the sun dance instructor for Sitting Bull when it was revealed that we would persevere.
We still pray there on 25 June every year, when Cheyenne children run the 45 miles to the battlefield.
My great-grandfather Vehoc was a young man at the Battle of the Little Bighorn. Vehoc means spider, trickster – a way Cheyenne refer to white people. Christian missionaries translated this to Whiteman, since his father was a US soldier. This is where our English family name comes from, a painful reminder of the abuse Indigenous women continue to suffer, with so many missing and murdered.
This historic trauma taught me that either you hate yourself or you accept and love yourself.
Vehoc’s mother, Vonha, chose the latter path. She loved her son and raised him Cheyenne.
After she perished, persecuted in the sacred Black Hills, her sister took over as his mother, only to later be massacred by the US army at Wounded Knee in 1890. She still lies buried in the mass grave.
Vehoc carried deep scars from the Sand Creek massacre in 1864 when he was three years old. There the US army slaughtered many of our people at a peaceful Cheyenne and Arapaho camp, where white flags were flying. My maternal grandmother, Milky Way Road Woman, was a direct descendant of Chief White Antelope, who was castrated there. Scores of women and children were also mutilated.
After their defeat at Little Bighorn, the US army made exterminating us their number one priority.
Within two years of the battle, our ancestors were forced to Oklahoma from our homelands in the north, even though they had been promised to us under their own treaties.
Upon suffering starvation and sickness as they witnessed the genocidal mindset being implemented, our chiefs took our peoples’ lives into their hands by leading them back north.
The US army hunted us like animals. Dull Knife’s followers were caught and imprisoned at Fort Robinson. On 9 January 1879, after days without food, water and heat, they broke out. Many were slaughtered right there and then.
The few who lived, later reunited with Little Wolf’s band, ancestors on my father’s side, who had made it home and secured the survival of the Cheyenne people in the north.
For the last 26 years, through our organization Yellowbird Lifeways, we have been organizing a run where Cheyenne children follow the footsteps of their ancestors, running 400 miles through four states in harsh winter conditions.
It is amazing to see them work together and find themselves as they overcome the conditioning of their lives on the reservation. Alcohol, drugs and suicide are merely symptoms of oppression. When they run, we remind them of their spirit, resilience and sacredness. We remind them of what we survived to maintain our Cheyenne lifeways.
Over the past year, many non-Indigenous people have been shocked to hear of the unmarked graves at Indian boarding and residential schools in the US and Canada. Not us.
This system forcefully removed Indigenous children from our families with the intent of exterminating our way of life, in violation of Article 2(e) of the Genocide Convention. That mandatory school system meets the definition of this most heinous of all crimes under international law.
No need to dig up the children’s remains, you just have to go to the cemeteries on our reservations and you will see all the buried potential. So many of our people die young from the ongoing effects of genocide.
My late mother, Florence, Appears in the Morning Woman, was very little when she was put through ceremony and given her name by her grandfather, a medicine man who was shot in the leg at the Battle of the Little Bighorn.
She used to say that our medicine and teachings are the reason she survived boarding school and torture at Indian hospitals. As a descendant of chiefs, she was initiated into the Elk Scraper warrior society, whose role is to protect our Cheyenne way of life, at age 12, becoming the last warrior woman among the Northern Cheyenne.
Despite the prohibition on practicing our ceremonies and on speaking our language at the schools, my parents and grandparents raised me in both, and I inherited and earned the responsibility to maintain our lifeways.
The fact that we have survived this genocidal onslaught with our language, ceremonies and teachings is nothing short of a miracle. We were not supposed to survive, still we did.
Have you ever asked why? We know. We survived because these teachings, passed on from generation to generation, connect us to the land and the universe. They are the best counter-remedy to the intergenerational effects of genocide.
One of my teachings is that the Creator shows her love for diversity in her creation. Without the understanding of diversity there is no unity, and without unity there is no oneness with Creator.
The Creator wants us to love each other; that is what the loving Creator is all about.
Looking at the wars, mass shootings and genocides happening around the world right now, and reading about what has been done to my people above, you might ask: how can people do this to each other?
The answer is simple: what we do to each other has already been done to us. European peoples were engaging in wars and suffering the effects of genocide long before they came here, and unfortunately it is still happening now. Today, humanity faces unprecedented extinctions due to what we have done to Mother Earth.
What you call natural disasters are Mother Earth’s way of healing herself.
If western thinking could have solved these life and diversity-threatening conflicts, it would have been done by now. In 1946, Albert Einstein made a call to “let the people know that a new type of thinking is essential if mankind is to survive and move to higher levels”. Cheyenne teachings elevate our thinking, whereas western genocidal and exploitative thinking has brought us all to the brink of extinction. I call it a mind virus: it is oppressive and does not value diversity.
We will never end war and genocide unless we change the mindset that created it. War cannot defeat war, only love can stop war.
My love and my forgiveness do not depend on you. I want toforgive you for what you have done to my people, the genocide and the eradication process. This might be our last chance to put an end to this genocidal and suicidal mindset.
I love you, and there is nothing you can do about it.
Chief Phillip is the co-founder of Yellowbird Lifeways, Nurturing the Breath of Life, an organization working to pass on Indigenous teachings to facilitate a shift in consciousness. Their community empowerment projects focus on food sovereignty and horse medicine
NBC News Jun 16, 2022 Luttig spoke of the “danger” that former President Donald Trump poses to American democracy during the Jan. 6 hearing. Luttig said Trump, his allies and supporters would attempt to overturn the election in 2024 if Trump did not win. » Subscribe to NBC News: http://nbcnews.to/SubscribeToNBC » Watch more NBC video: http://bit.ly/MoreNBCNews NBC News Digital is a collection of innovative and powerful news brands that deliver compelling, diverse and engaging news stories. NBC News Digital features NBCNews.com, MSNBC.com, TODAY.com, Nightly News, Meet the Press, Dateline, and the existing apps and digital extensions of these respective properties. We deliver the best in breaking news, live video coverage, original journalism and segments from your favorite NBC News Shows.
More than 330,000 people in the United States died during the pandemic because they were uninsured or underinsured. That grim statistic was reported this week by researchers at the Yale School of Public Health. In addition to that staggering, preventable death toll, in 2020 alone, our “fragmented and inefficient healthcare system,” cost the U.S. $459 billion more than if we had genuine, universal healthcare. The Yale team prescription to prepare for the next pandemic: Medicare for All.
“Our current healthcare system is dysfunctional. It is extraordinarily wasteful and expensive, and it is cruel,” Vermont Independent Senator Bernie Sanders said as he opened a Senate Budget Committee hearing on Medicare for All last month.
“The American people understand as I do, that healthcare is a human right and not a privilege, and that we must end the international embarrassment of our great country being the only major nation on earth that does not guarantee health care as a human right to all of its people,” Sanders continued. “Over 70 million Americans today are either uninsured or underinsured… there are millions of people in our country who would like to go to a doctor, who have to go to the doctor, but cannot afford to do so. This is unacceptable, this is un-American, and this cannot be allowed to happen in the wealthiest country on earth.”
Sanders has introduced S.4204, the Medicare for All Act of 2022, with fourteen Democratic Senators as co-sponsors. Similar legislation is also before the House of Representatives. Medicare for All would lower the eligibility age for the federal Medicare health insurance program from 65 to the time of birth.
Opponents of Medicare for All disparage it as “government-run” healthcare. This criticism is wrong. In the United Kingdom, for example, the NHS, the National Health Service, is government-run. The government owns all the hospitals and clinics, and the doctors, nurses and other staff are government employees. In the U.S., the Veterans Administration and the Indian Health Service are government-run, just like the NHS.
With Medicare for All, the government simply pays the bills as the “single payer,” saving enormous amounts of money by removing the health insurance corporations from the equation.
The hospitals, medical offices and laboratories all remain unchanged, primarily as private or non-profit institutions, exactly as they are today. This is how our current Medicare system works for those over 65 years old. Medicare for All wouldn’t change that; it merely expands the population covered to everyone.
Medicare for All would dismantle the bloated, private insurance bureaucracy, saving hundreds of billions of dollars annually. At the Budget hearing, Committee Chair Sanders summarized, “The six largest health insurance companies in America last year made over $60 billion in profit, led by United Health Group which made $24 billion in the midst of the pandemic in 2021. But it’s not just the profits of the insurance companies…The CEOs of 178 major healthcare companies collectively made $3.2 billion in total compensation in 2020, up 31% from 2019. According to Axios, in 2020, the CEO of Cigna, David Cordani, took home $79 million in compensation while people died.”
An analysis produced by the Political Economy Research Institute, PERI, at UMass Amherst, includes a “just transition” for the close to 900,000 people employed by the health insurance industry. Savings provided by a single-payer system could pay for a combination of early retirement and retraining, lessening the impact on those workers.
Single-payer, or Medicare for All, makes sense in normal times, but we are not in normal times. The global COVID-19 pandemic has ripped the scabs off of so many sectors of our society, exposing and exacerbating inequities and a lethal lack of preparation.
The Yale study puts real numbers to it, noting the disproportionate impact on poor and low-income communities and on people of color.
Universal healthcare would lead to a healthier population, more capable of withstanding the impacts of the next pandemic. Regular, preventive doctor visits, the comfort and security of knowing that a needed procedure or hospital visit won’t lead to bankruptcy or add to personal debt, all contribute to a broader resilience. Citing a Gallup poll, the Yale researchers write, “due to apprehension about their ability to pay, 14% of US adults reported that even if they experienced the two most common symptoms of COVID-19, fever and dry cough, they would still avoid seeking care.”
Another lesson of the pandemic is that when any of us is exposed, all of us are. Universal, effective and affordable healthcare makes us all stronger and safer. The simplest way to achieve that is Medicare for All.
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Fight Back Fridays: Friday, January 14, 5–6PM. Join us every Friday to demand that Senator Feinstein, other Democratic Senators, and President Biden do more to defend our democracy. We gather each week at 1 Post in SF (in front of Senator Feinstein’s office building, at one of the Montgomery Street BART... Continue reading →
Fight Back Fridays: Friday, January 14, 5–6PM. Join us every Friday to demand that Senator Feinstein, other Democratic Senators, and President Biden do more to defend our democracy. We gather each week at 1 Post in SF (in front of Senator Feinstein’s office building, at one of the Montgomery Street BART... Continue reading →