How Much Police Corruption Would There Be Without a Drug War?

Speaking of dysfunctional culture is only stereotyping when it's applied to all members of the group and/or if the claim isn't grounded by evidence - which is why it's imperative to dig deeper into how a given dysfunctional culture got to be so dysfunctional. 

I am now firmly convinced that the core of the problem is the political economy of the trade in forbidden substances. The trade in forbidden substances provides a broad-based source of economic sustenance that no other criminal activity can match.

The trade in forbidden substances provides advantages - or at least the appearance of advantages - that grant it the power to present an alternative path to upward mobility.  The dope game provides instant economic gratification without the lengthy effort and remote reward process linked with academic achievement. The dope game eliminates the uncertainty around future employment in the  non-criminal economy.  Honestly, without our current zero-tolerance drug laws, outside the trade in forbidden substances,  how many career opportunities exist in crime?  

Doing what, as muggers, burglers, bank robbers, car thieves?

Political discussion of the drug war/drug prohibition focuses exclusively on the phenomenon of forbidden drug use rather than on the economic dynamics of markets for mind-altering substances.

Think about that for a minute. 

Political discussion of the drug war/drug prohibition focuses exclusively on the phenomenon of forbidden drug use rather than on the economic dynamics of markets for mind-altering substances.

But the cost and consequences to society are not so much rooted in the use of forbidden substances, as they are in the existence and proliferation of a complicated multi-generational criminal supply chain operated by career criminals servicing a lucrative , high-demand market. Those socially corrosive consequences are concentrated in impoverished communities, and they don't assume the same level of significance in economically stable or affluent ones.

The appearance, growth, and maintenance of illegal drug markets in the present day begins in the middle schools and high schools; across the board, rich or poor, it's been that way for around 40 years. But there are crucial differences, the main one being that in economically stable communities the teenagers dealing the drugs don't view it as a means of upward mobility, a career path, or a means of supplementing household income.  They don't have to. 

The more affluent the community, the more this tends to be the case. Because necessity doesn't play the same role that it does in a low-income or impoverished community, there's much less violence associated with the illegal drug trade. There are many fewer pretexts for feeling the need to engage in violence when there are no issues about customer payment, minimal threat of holdups, or home invasions by rivals. There's no need to form organized self-protection syndicates to contend with those sorts of problems.

Drug dealing money is side money, and middle-class or upper-class retail dealers are mostly in it for status and access to free supplies of product. Because problems of theft and violence so seldom arise, drug dealing in more affluent communities receives less notice from the police. And because drug dealing is nearly always viewed as a sideline, most middle class retail drug dealers give up the business at some point between their notice of admission to college and their graduation. There are problems, occasionally serious ones, but they mostly center on teenage drug use, not gun play in the streets associated with drug sales. The drug trade doesn't just take over, and run the neighborhoods.

Is this because middle-class drug dealers are inherently virtuous? Of course not. Is it a function of economic privilege? Almost entirely.

In a community in economic stagnation or decline, it's usually a much different story. Dealing illegal drugs presents itself as a multilevel marketing scheme that holds out the promise of a pathway to economic success. Like practically all multilevel marketing schemes, that promise is realized in only a handful of cases. But it still works more reliably than any legal multilevel scheme I can think of, especially in the short run. 

Age is no barrier to employment. In fact, in this dope game, minor status has distinct advantages. So it's easy for teenage kids to view illegal drug dealing as a career path. Except that it's a gravely serious business, with perils and implications that teenagers- particularly teenage males - have trouble appreciating. The risks are of an entirely different magnitude than they are in wealthier parts of town. 

By the time a teenage drug dealer turns 18 and becomes eligible for adult criminal penalties, it's often too late to get out of the business. Too many bridges have been burned to simply reset the counters to zero. At that point, jail and prison enter into the mix in a big way. And if you don't think there's any such thing as dysfunctional culture, consider the prevailing effects of jail and prison. The culture of confinement, violence, paranoia, mistrust, and anti-sociality tends to move out into the streets after a lot of people experience it firsthand. 

When these carcerally corrupted and now thoroughly dysfunctional people have children, the children assimilate that prison-culture dysfunction - just like children do everywhere else. That's a whole lot of multi-generational ugliness concentrated within a community. (and no Bee Dee, it's not the result of IQ-75 limitations)

Is this state of affairs racist? Yes. Because it didn't have to happen. 

Now that the rural white majority in this country are beginning to truly experience the same combined stresses from criminal syndicates, prison culture, street criminals, punitive policing, and the courts - as the law-abiding majority in low-income black majority neighborhoods have experienced over the last 40 years - there is a glimmer of hope that the drug prohibition may have to give.

Bottom line, however, this isn't a race-related problem. I'm not talking about a "Black thing" or a "Mexican thing." At least not since the bottom dropped out of a lot of majority-white regional economies in this country. Economically stressed white neighborhoods and rural small towns now deal with the same problems related to the political economy of the illegal drugs trade: 

• breakdown of social trust
• theft among neighbors
• violence
• family abuse
• high rates of incarceration
• loss of employment eligibility due to criminal convictions or addiction
• increasing rates of self-harming behavior

The problems of having a huge chunk of the local economy reliant on drug money- and, yes, the type of welfare that advantages non-working people at the expense of their employed neighbors- begin to merge with harder and harder drugs use over time, as those communities, schools, and families spiral into dysfunction and desperation.  White kids are now increasingly subject to the same impacts - all of which works to put them in the same deplorable corner - as long as they can see and think clearly enough to suss out the analogous experience across race lines.

Oops, I almost forgot about the police corruption problem.  Severe police corruption has existed as long as the Drug War/Drug Prohibition. Matter of fact, police corruption has been a rapidly growing and metastasizing aspect of the larger societal dysfunction, and it threatens to dismantle the social contract between authorities and the communities whom they were formerly sworn to protect and serve.

This is an 11-year weekly archive.

So far it's 67 very long pages, with new stories added every week. Coast to coast. City and country. Judges, DEA, FBI, city police chiefs, county sheriffs, entire "elite" drug squads, small-town police officers, forensics scientists, prison guards... this list of stories is far from complete, and, it doesn't take into account the corrupt law enforcement people who never got caught, or who haven't been caught yet.

Drug Prohibition/War is the Dry Rot Within the American Body Politic

The corruption, dishonesty, social and ethical cannibalism within the sphere of forbidden substance users and those who prey on forbidden substance users -  has done more than any other single factor to bring on the climate of political malaise in this country.  Its still largely third rail status as a subject for national political consideration is a crucial indication of its importance. If Prohibition/War isn't the most important factor, it's certainly the most important unmentioned factor in the increasing antipathy of Americans to both traditional political parties.

For most of my lifetime, it's been out of bounds to broach the notion of drug law reform in a large public forum.   That decades-long evasion of honest debate on the relevant issues has enabled the Drug War- with its combination of unchallenged rationale and array of actual consequences - to exert a profoundly destructive effect on both official and unofficial institutions of this society. We're dealing with a corrosive situation that's been allowed to grow and fester for at least 40 years. Not drug use - but the illegal drug markets and the consequences to society of those markets. The society nurtured by that underground economy, which advantages hardened criminals over those who aren't as willing and able to resort to deceit and violence, has routinely exported the psychotic and antisocial values from jails into our communities.

We don't give nearly enough consideration to the negative consequences engendered by mass incarceration and what that has brought back to our communities from the bedlam(s) of the prison industrial complex. It is the criminal marketplace rather than the effect of forbidden substances which has acquired a hegemonic influence over our communities and popular culture. Who among us is factoring in the current state of most of our jails and prisons and what these contagiously export into our communities?  Who is factoring in the personal and public health problems and socially corrosive mentalities bubbling up out of prisons - which factors are incontestably worse than the worst impacts even of forbidden substance addiction, per se.

Race obsessives think that the main problem in America is drawn along racial lines. I disagree. The big problem in America is the long-term result of nearly a half-century of a profoundly and deceptively metastasizing Drug War. This dry rot has spread throughout our society corrupting banks, schools, police, courts, jails, politicians, professions, rents, housing, social welfare programs, the public health system, big pharma. 

The problems of forbidden substance misuse and abuse are dwarfed by the problems of Greed, Punitive Morality, Stigmatization, and Deception on both sides of the crooked line irrationally drawn by the forbidden substance criminal statutes.  The country would see a noticeable improvement within two years of effective drug law reform that worked to minimize the economic demand in the criminal marketplace: cannabis legalization, opioid addiction maintenance, a liberalized prescription and/or registry regime for some of the other substances, all while retaining laws against illegal sales operations.

In less than ten years, we might even get many of our worst schools and neighborhoods back on the path to recovery from that long-standing condition of beleaguered competition with the burdens imposed by the illicit economy.

Addicts Pawns in a Sprawling National Network of Insurance and Treatment Fraud

BostonGlobe  |  Drug users, desperate to break addictions to heroin or pain pills, are pawns in a sprawling national network of insurance fraud, an investigation by The Boston Globe and STAT has found.

They are being sent to treatment centers hundreds of miles from home for expensive, but often shoddy, care that is paid for by premium health insurance benefits procured with fake addresses.

Patient brokers are paid a fee to place insured people in treatment centers, which pocket thousands of dollars in claims for each patient. They often target certain Blue Cross Blue Shield plans, because of their generous benefits and few restrictions on seeking care from out-of-network treatment programs.

The fraud is now so commonplace that brokers use a simple play on words to describe how it works: “Do you want to Blue Cross the country?”

Prohibition Has Been An Epic Policy Failure

Illicit drug markets were flourishing in white communities in the 1970s, and they continue to flourish in white communities to this very day. The crucial difference between affluent white drug markets and gritty black urban drug markets is the drive-through customer service provided to strangers in mostly black ghetto neighborhoods. 

White neighborhoods feature a drug market staffed by affluent teenagers doing it as a sideline for free drug supplies, social-peer status, and disposable income with a customer base of similarly well-heeled schoolmates and friends. Black and brown ghettos feature a market run in deadly earnest by poor and marginalized people viewing it more like a career choice- as their best chance at earning good money, fast money, and possibly even a boost to long-term upward mobility.

Open-air street markets are riskier all around, and much more criminogenic. But that's principally a function of the illegal marketplace, not the underlying commodity "drugs" being bought and sold. Prohibition has been an epic policy failure. Instead of success in curbing the use of officially forbidden drugs, 50 years of get-tough criminalization, zero tolerance, and mandatory minimums have resulted in;

1. a state of perpetual civil conflict
2. an unregulated supply of a wider array of harder and harder drugs
3. diverse harder drug abuse by younger and younger people
4. broad-based antagonism against police and government
5. unparalleled levels of police corruption

Unfortunately, the respectable negroes of impoverished black ghettos made the same mistake as the morally upright but deeply hypocritical WW2 generation of adults in more affluent white communities.  Faced with an unfamiliar phenomenon (the newfound popularity of some legally prohibited drugs among the youth), they imagined that a law enforcement crackdown would solve the problem and reset their status quo back to more familiar conditions, back before the kids were smoking pot and experimenting with drugs. 

Let's be clear- the initial 1960s-era domestic "illegal drug problem" related almost entirely to marijuana; the heroin market was confined to "bad neighborhoods" in a handful of large cities, and it took years for the cocaine market to develop a significant consumer base anywhere in the country.

Instead, the resulting Drug War only made matters worse, across the board. Including problems of police brutality and the impression that a coercive regime was being imposed upon urban black neighborhoods by outsiders. Which is, yes, what the citizens originally asked for. But the source of the folly was the naive idea that "drugs" were the primary source of the breakdown of civic order, rather than the illicit markets empowered by a simplistic prohibition regime that was- and still is- rationally indefensible.

Even the most responsible black American parents of teenagers are in much the same position as practically every other ethnic population- there's only so much they can do to counteract negative peer group influence on their adolescent children, given the circumstances of the modern world. And the stance that "studying is a white thing" would have a lot less social currency in the absence of the attractions of economic success provided by opportunities in the retail illicit drugs trade. "Studying is a white thing" is part of a narrative of fake resistance promulgated by criminals and delinquents. It's an excuse proffered by nihilistic elements of the black lumpenproletariat - pornographically promoted by Madison Avenue - not by "black culture".

The source of the problem- the basis for the appeal of the story that tells boys to kick school to the curb and go for fast money and instant gratification- isn't the inherent criminality of "black culture", or black people. It isn't ethnically based. It's mostly about Pinocchio Pleasure Island. The real-life Pleasure Island of the drug dealing game. In the absence of a lucrative underground market in prohibited drugs, criminality is a pretty pathetic career path.  In the presence of that avenue of opportunity, it's a glamor profession. Or at least it contains enough glamorous aspects to make it a very attractive occupation, especially for teenage males at the outset. Remember what eventually happens to the boys on Pleasure Island.

The useless not-see narrative blames the dysfunctions of poor black communities on a lack of moral character - a deficiency purportedly inherent to lower racial IQ or some allegedly monolithic "black culture." The useless BLM narrative blames the problems in impoverished black ghettos on some all-pervading, amorphous, undifferentiated, supposedly rampant white racism, i.e., an inherent moral deficiency of monolithic "white culture." 

Neither of those stories address the actual source of the problem.

A Turnkey Operation For A Totalitarian Society

The Federal government put policies in place that practically mandated a criminal monopoly over the trade in a wide array of illegal substances, while criminalizing the entire population with which users/dealers were most closely identified.  Leaving aside marijuana for a moment, and fast forwarding to the crack cocaine epidemic - while cocaine/crack can still be found as a street drug in this country; it's just that not as many people want it. They've seen how it can derail someone's life. Although both the supply and the numbers of cocaine users remain many times what they were 45-50 years ago. 

The criminalization and stigmatization of prohibited drugs users works to pre-emptively wall them off from most avenues of participation in legitimate society.  Their permanent stigmatization in the mainstream economy, effectively encourages them to confine their energies to participating in the criminal economy.  As for trends in urban violence, they're probably destined to cycle through for some time.

45 years of Drug War has made gangsterism dynastic. Furthermore, it has entrenched it through the prison systems. Alcohol prohibition only lasted 13 years and firmly established organized crime for two or three generations thereafter. What would the mafias have become if the "noble experiment" of alcohol prohibition hadn't been put to an end after only 13 years?  Along with Mass Incarceration, this is a crucial difference between the current Drug War and the Prohibition Era.

Then, when that situation eventually gets out of hand, the government steps in with well-funded militarization of the police, paramilitary tactics, and mass incarceration policies. It's a turnkey operation for a totalitarian society, and the justification for it appears entirely rational as long as the population thinks of it solely in terms of fear reactions and their relief, and never questions the flaws in the original premise that led to the breakdown of civic order in the first place. (Nixon's declaration of war on the left and on blacks for opposition to the Vietnam War)

Black Rifles Matter in Berkeley

SFBayview |  In 2015, Berkeley City Councilor Max Anderson voiced this eloquent opposition to militarization of the police during the annual Bay Area Urban Shield war games and weapons expo:

“The culture that’s cultivated by the type of training that you receive becomes the way you conduct yourselves …

“When I was in the Marines in the early ‘60s, all our pop-up targets that we practiced on were Asians. You know now they’re Middle Easterners, so it kinda shifts, and so the rationale and the justification for targeting people on these bases shifts along with it.

“And when military weapons follow military thinking into our police ranks, you know we have a problem. You know it’s a problem of association because when you’re in a combat situation, you’re thinking about survival, and you’re thinking about enemies and friendlies. And when you inculcate that into our environment here, and we start thinking about the citizenry as either being friendly or enemies, and react accordingly based on what designation we lay on people, then we’re sliding down that track.”

What could better describe the prevailing mindset of U.S. police? And we all know who’s on the enemies list that they feel compelled to kill to survive: Black and Brown people, Muslims and poor people.

Philando Castile, a Black citizen of Minnesota, calmly and respectfully told Police Officer Jeronimo Yanez, “Sir, I have to tell you I do have a firearm on me,” without pulling it out. Officer Yanez responded by firing the seven bullets that killed Castile as he sat in a car, then started screaming, sobbing and wailing, “I thought I was gonna die!”

What could better describe the prevailing mindset of U.S. police? And we all know who’s on the enemies list that they feel compelled to kill to survive: Black and Brown people, Muslims and poor people.

SFBayview |   Some 400 people packed a special city council meeting here on June 20 to demand that the city end its “shameful collaboration” with federal police and spy agencies. But the council, while widely hailed as “progressive,” ignored the near-unanimous popular opinion and voted to renew three controversial police programs:

1. City participation in a Regional Intelligence Fusion Center and its “suspicious activities” domestic spying operation, coordinated nationally by the FBI and used locally to spy on Black Lives Matter demonstrations.
2. City participation in the Urban Areas Security Initiative – and its annual $5 million Urban Shield weapons and SWAT team training expo – aimed at militarizing and increasing federal control over local police forces under Homeland Security. UASI promotes the model of the “warrior cop.”
3. The city’s acquisition of a $205,000 bulletproof armored personnel carrier, partly funded by DHS (presumably anticipating some future wave of “civil unrest” in this small city)

Former mayor Gus Newport scolded the city council for going along with the various schemes for further empowering the police. “I cut my teeth in the civil rights movement by getting brutalized by police at the age of 11,” he said. “I would hope that you all have the principles, the heart and the concern for the people of Berkeley to make sure these (police programs) do not go any further.”

Many spoke of the racist impacts of these federal police programs. Sharif Zakout, with the Arab Resource & Organizing Center, said: “I want to be absolutely clear that Urban Shield was developed in response to 9/11 and the Patriot Act and is an Islamophobic and racist program.” AROC is part of a broad Stop Urban Shield Coalition, whose mobilization succeeded in driving the racist program out of Oakland in 2015. That was the year when “Black Rifles Matter” was the most popular t-shirt sold at the Urban Shield police expo.

Berkeley resident James McFadden said the Intelligence Fusion Center and UASI “are part of a continuous effort to consolidate federal control over local police … that escalated after 9/11 with the passage of the Patriot Act and creation of Homeland Security.” He said Berkeley, for example, should not be collecting data that can help ICE round up immigrants for deportation. “We don’t need a militarized surveillance state, or if unrest grows, a police occupation force as we saw in Ferguson, Missouri,” he added.

The Militarization of America’s Local Police Proceeds Unabated

nationalinterest |  A recent incident in Hutto, Texas, a sleepy, outlying suburb of Austin, illustrates just how dangerously promiscuous the utilization of SWAT teams has become. On June 26, local police conducted a raid to implement a search warrant on a house in a low-crime, middle-class neighborhood. The alleged crime? Police suspected that some residents of the target house were involved in gambling. Investigators were backed up by a SWAT unit with nearly a dozen officers in full combat regalia pouring out of an armored vehicle.

Needless to say, the neighbors were both stunned and alarmed to see such an operation take place in their quiet community. One mother stated: “I went to my daughter’s room and looked outside their window to see if I could get a better view of what was going on, and there was a man in fatigues with a sniper rifle laying in my neighbor’s driveway.”

What was even more striking is that the police spokesman admitted to a reporter that the authorities “had no reason to believe” that the residence undergoing the search was involved in any violent activity. In other words, police were using paramilitary tactics and forces to execute a search warrant involving a nonviolent (indeed, victimless, crime) in a low-crime neighborhood. Such arrogant bullying should alarm anyone who cherishes domestic civil liberties.

Unfortunately, such incidents have become all-too-common as local authorities seek new missions to justify the existence of SWAT teams and to keep the personnel alert and well trained. The expansion of SWAT units and missions is closely correlated to the existence of federal programs making surplus military hardware available at little or no cost to local police forces.

Such deadly toys have become a prime justification for law enforcement budget increases and the receipt of federal grants in communities around the country.

Black Law and Order

theatlantic |  If a conservative is a liberal who has been mugged, you might expect black folks, who are disproportionately victims of crime, to support the politics of law and order. And they frequently have done just that, according to Forman, a former public defender in Washington, D.C.; a co-founder of a D.C. charter school for at-risk youth; and now a professor at Yale Law School. Using the District of Columbia (a k a “Chocolate City”) as his laboratory, Forman documents how, as crime rose from the late 1960s to the ’90s, the city’s African American residents responded by supporting an array of tough-on-crime measures. A 1975 measure decriminalizing marijuana died in the majority-black city council, which went on to implement one of the nation’s most stringent gun-control laws. Black residents endorsed a ballot initiative that called for imposing harsh sentences on drug dealers and violent offenders. Replicated on a national level over the same period, these policies led to mass incarceration and aggressive policing strategies like stop-and-frisk, developments that are now looked upon as affronts to racial justice.

Much of what Forman reports would not surprise anyone who has spent time at a black church or a black barbershop—or in the company of my mother. In the ’60s, she marched with Malcolm X, and during the ’80s, after the public school where she taught was vandalized, she said, “Those niggers should be put under the jail.” My mom’s ideas about criminal-justice policy are informed by getting held up at gunpoint in front of our house on Chicago’s South Side, seeing family members suffer from addiction, and watching the cops treat my stepfather like a criminal after he got into a fender bender with a white man.

Needing the criminal-justice system to help keep you safe, to be fair in its investigations, and to be merciful with people who’ve run afoul of the law—this urgent, unwieldy agenda explains much of African American politics, from the anti-lynching campaigns of the early 20th century to the Black Lives Matter movement today. As Forman reminds his readers, black people have long been vigilant, often to no avail, about two kinds of equality enshrined in our nation’s ideals: equal protection of the law, and equal justice under the law.

The absence of equal protection has been, historically, the most vexing problem in the lives of African Americans. The NAACP was founded in 1909 partly in response to the federal and state governments’ turning a blind eye to white violence against blacks. More than half a century later, as open-air drug markets flourished in inner-city neighborhoods, black activists perceived a related form of racist neglect by the state. The police, they believed, would have shut down those markets had they existed in white communities. In fact, as Forman notes, many activists thought that those in power actually condoned the availability of drugs in the hood, as a means to keep the black man down. (In those days, it was black men—rather than all black people—who were seen as principally injured by racism, a fallacy that made its way into government policy under the guise of the controversial Moynihan Report in 1965.) The black radical Stokely Carmichael, speaking at a historically black college in 1970, said, “Fighting against drugs is revolutionary because drugs are a trick of the oppressor.”

Back then, many white progressives were pro-pot, and disinclined to see drug prohibition as part of a revolutionary utopia. African American suspicion of white liberals is a theme throughout Locking Up Our Own. One reason the 1975 effort to decriminalize marijuana in Washington, D.C., failed is that the bill’s two primary supporters were white men. Forman quotes the spoken-word artist Gil Scott-Heron’s portrayal of a typical white member of Students for a Democratic Society: “He is fighting for legalized smoke … / All I want is a good home and a wife and children / And some food to feed them every night.”

Scott-Heron’s very traditional wish list reveals another important explanation for black support of law and order. Not for the first time, many middle-class African Americans subscribed to the “politics of respectability”: The race advances, the view goes, when black people demonstrate that they are capable of living up to white standards of morality and conduct. Among the black elite, advocacy for lenient criminal-justice policies was deemed an admission that black interests were allied with the interests of criminals. That sort of solidarity would hardly help the cause. For many bougie African Americans—certainly those in cities like Washington and Atlanta, where light-skinned blacks dominated the middle class—colorism was also at work: The fact that their dark-skinned hoodlum cousins were getting locked up was not a problem. Indeed, one of the primary arguments for allowing African Americans to join Atlanta’s police department in the 1930s and ’40s was that they would be better able than white officers to distinguish between elite blacks and the riffraff.

Pill City

vice |  When the Baltimore riots erupted in April 2015 after Freddie Gray's death in police custody, James "Brick" Feeney and Willie "Wax" Harris*, two tech-savvy teenagers with ties to Maryland's Black Guerrilla Family (BGF), saw opportunity. Using the chaos as cover, they managed to steal at least a million doses of prescription drugs and heroin from city pharmacies and rival dealers. But even if their caper was essentially an old-school, smash-and-grab-style theft, the teens had plans to sell the drugs in a more sophisticated manner: via the Dark Web, where pills went for upward of $100 each.

Leaning on location-based technology and encrypted messaging software, Brick envisioned their operation as an "Uber of drug dealing."

As the looted drugs were shipped up and down the East Coast, a spike in opiate overdoses in African American communities raised eyebrows, and the DEA and FBI eventually took notice. In his forthcoming book Pill City: How Two Honor Roll Students Foiled the Feds and Built a Drug Empire, veteran crime reporter Kevin Deutsch profiles the the teens' massively profitable scheme, which he contends had (distant) ties to El Chapo's Sinaloa cartel. 

Deutsch enjoyed incredible access to the two teens and some 300 other dealers, addicts, gang bangers, police, and drug-treatment specialists for the book. A reporter who prefers to work with his "feet on the ground," Deutsch saw the vicious effects of America's opioid epidemic in an urban setting. VICE talked to the journalist about how he wrapped his head around the technology in play, how opiates were never just a middle-class white problem, and where Brick and Wax are at now.

Hunger Games Society in Baltimore

stockboardasset |  In the 1990s it was COPS. Now it’s Worldstar Hiphop, Facebook Live, and Liveleak broadcasting a constant stream of no-budget sadism-as-entertainment to satiate the curious and the bloodthirsty in real time, direct from the deepest corners of the most depraved, impoverished districts. And while we, the spectators, marvel in awe and disgust at the fights and robberies and suicides and murders that we watch live onscreen, we forget that we, too, are denizens of a similarly curated and managed ghetto environment: the digital one.

Whereas the actual, physical ghettos are the product of 1960s utopian ideas about government spending being the answer to social ills gone awry, the digital ghettos are also an inverted utopia, albeit one crafted by the rogue programmers of the 1970s and 1980s. These programmers imagined a world where personal computers and the emerging internet would literally connect the world; where ideology would wither away as the postmodern World Wide Web would force all of us to confront a myriad of foreign ideas and foreign people, all from the comfort of your home office.

These technologies have not connected us, or at least not in the ways that these computing pioneers imagined. We, too, have been hyperfragmented and atomized into our own digital ideological echo chambers. The 21st century collapse of the nuclear family that we discussed earlier was perhaps intended to redefine one’s sense of self in relation to society as a whole rather than in relation to one’s immediate or extended family (you know, the whole “It takes a village” nonsense that people liked to talk about a couple of decades ago). But what we’re seeing now is a sort of fragmentation of the self, facilitated by these digital technologies, where there is a disconnect between one’s online self and one’s physical self-a sort of “social schizophrenia” that threatens to destroy the very societies that these technologies were supposed to solidify.

Now back to the districts: what the Capitol fears most is an uprising of the district that bleeds into the Capitol. We call this The Fourth Turning: S​ummer of Rage and the Tot​al Eclipse of the Deep St​ate. Provincial wars are fine, as long as they are kept far away from the ruling elite. Periodically, though, rival factions governing the Capitol enlist mercenaries from the districts to cause trouble at the doorstep. We see this regularly with the astroturf Black Lives Matter, Occupy Wall Street, and other seemingly ‘grassroots’ franchise protest movements erupt in American cities every few years-these dispossessed citizens of the district, unemployed or underemployed with little to no job prospects, saddled with debt, and very little to lose or gain are shipped around from city to city, given some protest signs, and proceed to yell, fight, burn buildings, and disrupt traffic.

A genuine uprising would be terrifying to the ruling elite, because it would be a refusal to participate at all in a society that exploits you solely by your participation in it. Non-participation is much quieter than the manufactured type, and doesn’t lend itself as well to dramatic photo ops. It’s impact, however, would be much more significant.

Jay-Z's No Prophet, Just Old, and No, No Respect...,

theguardian |  After a consortium led by Jay-Z bought Tidal (previously known as WiMP) in January 2015, it had a star-studded launch where many of the biggest pop acts on the planet pledged to give it exclusive material first. That amounted, initially, to a Madonna video that soon appeared on YouTube. After that came Rihanna’s Anti, in January 2016, which ended up being released early by mistake, then 1m copies were given away to appease fans while Tidal blamed Universal Music Group for the error. UMG countered by saying it was actually Tidal’s fault. The album eventually ended up on other streaming services. 

The release of Kanye West’s The Life Of Pablo did no better. Despite West’s assurances that it would never be on Apple, a matter of a few weeks after its Tidal debut it was available on … Apple. And Spotify. And everywhere else. To paraphrase Oscar Wilde, to lose one exclusive may be regarded as a misfortune; to lose two or more looks like carelessness. 

That said, Beyoncé’s Lemonade remains a streaming exclusive on Tidal over a year after its release. But the knock-on effect was to send fans to pirate sites as well as CD retailers and iTunes to spend their money there rather than taking the carrot and joining Tidal. The fact that Lemonade, according to IFPI numbers, sold 2.5m copies globally last year to become the biggest album in the world would suggest that it was downloads and CDs that accounted for the bulk of that. The “album equivalent streams” of Lemonade on Tidal will have barely touched the sides here. 

Universal, smarting from the Frank Ocean debacle last August – in which Apple Music got an exclusive for the contract-fulfilling album Endless and then, the next day, Ocean put out Blonde himself – reportedly imposed an embargo on exclusives. Warner Music Group and most indie labels were always against them. That leaves Sony, which has hinted exclusives will be considered on a case-by-case basis, the unspoken subtext being they have fallen in line with all the other labels. 

There will be the occasional outlier, such as the totally autonomous Chance the Rapper’s two-week exclusive with Apple Music for his album Coloring Book in May 2016, for which he claims he was paid $500,000; but everyone else is increasingly of the belief that exclusives dangerously impede the reach of an album and, as such, only annoy fans at a time where loyalty can no longer be presumed and has to be earned again with every new release.

Jay-Z has an allegiance to his own service and one of its biggest investors, hence this Tidal–Sprint deal; but it feels like a message beamed in from a different place and a different time. In an age of digital ubiquity, exclusives are an anachronistic bet on a roulette wheel where the only pockets are marked as either “invisibility” or “irrelevance”.

The Real Cause of the Opioid Epidemic

charleshughsmith |  We also know that the proximate cause of this epidemic is Big Pharma, which promised non-addictive painkillers that lasted for 12 hours but delivered addictive painkillers that did not last 12 hours.

The unsavory truth was reported by the Los Angeles Times last May (2016) in a scathing investigative series: 'You Want a Description of Hell?' Oxycontin's 12-hour problem.

There are plenty of other participants who share responsibility for the public health and law-enforcement disaster: physicians who all too readily passed out prescriptions for powerful synthetic opioids like aspirin; the government agencies that approved the synthetic heroin as "safe" (heh) and paid for their distribution via Medicaid, the Veterans Administration, etc., and the patients who all too willingly accepted the false promises of synthetic opioids.

But what's missing from the public conversation is the underlying cause of the epidemic: a structural scarcity of paid work and positive social roles for vast swaths of America's workforce.

We all know what paid work means: jobs. Positive social roles include jobs--supporting oneself and one's family provides purpose, meaning, identity and a source of pride, all atrributes of positive social roles--but the concept extends beyond work to any role in which the participant feels needed and that offers dignity: this includes volunteer, guardian, mentor, coach, etc., many of which are unpaid.

A significant essay in the March/April issue of Foreign Affairs describes The Dignity Deficit: Reclaiming Americans' Sense of Purpose (subscription or registration required)

At its core, to be treated with dignity means being considered worthy of respect. Certain situations bring out a clear, conscious sense of our own dignity: when we receive praise or promotions at work, when we see our children succeed, when we see a volunteer effort pay off and change our neighborhood for the better. We feel a sense of dignity when our own lives produce value for ourselves and others. Put simply, to feel dignified, one must be needed by others.

Giving people welfare, cheap prescriptions for opioids and Universal Basic Income (UBI) does not make them feel needed--it makes them feel superfluous and worthless.

Addiction An Irresistable Business Opportunity - Same As It Ever Was....,

CounterPunch |  In Ohio a heroin (and other opioids) epidemic, and attendant overdoses, has stretched the city budget because Paramedics respond and administer Narcan (Naxalone) to revive the patient. And Narcan is expensive. City Councilman Dan Pickard offered the solution of cutting off paramedic responses after two visits. In other words, let the OD victim die. Besides Pickard’s fundamental stupidity, the glaring question that goes unasked is why has the price of Naxalone tripled in the last year? Well, because there is a heroin epidemic, and an Oxycontin epidemic. That is capitalism.

One of the by products of the spike in Narcan usage (its even sold over the counter in some cities, without prescription) is a kind of Overdose-porn; cell phone videos of addicts passing out and in respiratory arrest being given Narcan and having those symptoms reversed. I see a reality TV show in the future. Of course Narcan also triggers severe withdrawl symptoms in anyone with an opioid addiction. I remember friends being given Narcan and immediately running out to find some junk to stop the pain. There is such an obvious disregard for addicts in this society that it almost feels pointless to repeat the same statistics yet again. The War on Drugs is much like The War on Terror. It is a business opportunity for western Capital.

Interestingly, 76% of Americans think addicts should be a medical problem and not a criminal one. However, compassion is NOT a business opportunity, ergo compassion is not part of the lexicon of the ruling class.

Cops Weaponizing Narcan to Torture and Stigmatize Addicts

dailybeast |  M______ Charles M_____ turned 26 in jail on March 2, a week after his arrest for misdemeanor heroin possession. But his entire life may as well boil down to an inglorious 30 seconds of tightly edited video, played on local news channels, that shows him nearly dying.

On Feb. 18 a closed-circuit surveillance camera captured him shooting heroin, then falling out of his seat on a crowded city bus in Philly suburb, Upper Darby. The video cuts to a police officer hovering over the unconscious man and applying a dose of the powerful overdose antidote naloxone.

Naloxone (sold under the brand name Narcan) has been the subject of increasing media attention since the Food and Drug Administration approved a nasal spray version of the drug in last November to reverse the effects of opioid overdose, namely severe respiratory depression that can be fatal if left untreated. Narcan works by reversing those symptoms. A number of police departments now outfit their officers with it, and changes to state laws have made the drug legal for sale over the counter in some pharmacies. In 2014, Pennsylvania passed a law that made naloxone available through a standing prescription to laypeople, including drug addicts themselves and their families.

The video footage of M_____’s overdose concludes with him back on his feet and being escorted off the bus by police paramedics—a seemingly happy ending to a nearly fatal tragedy.

But M_____’s story is anything but happy. And it’s far from over.

After saving his life, the police arrested him for the tiny amount of heroin (four baggies) they found on him. While M_____ suffered the first pangs of opioid withdrawal in a jail cell (imagine severe flu combined with anxiety and depression) the police humiliated him by tweeting a link to the video provided by the transit authority.

It went viral.

Baltimore Having to Ration Opioid Overdose Remedy

washingtontimes |  Citing the deadly opioid crisis, Baltimore officials made it easier on Thursday to acquire an overdose-reversing drug over the counter, saying the antidote should be as prevalent as possible to prevent more deaths.

City Health Commissioner Leana Wen waived training requirements for acquiring and using naloxone, a fast-acting medication that’s become a vital and ubiquitous tool in fighting the nation’s heroin and prescription painkiller crisis.

Dr. Wen said the training only took a few minutes — naloxone can be administered as a nasal spray or injected into the muscle, like an EpiPen. But the associated paperwork was cumbersome, so she implemented a recent state law allowing her to scrap the training altogether.

“Any resident can go into any of our pharmacies in Baltimore City and immediately get the medication for saving someone’s life,” she said.

City residents on Medicaid can acquire two doses of naloxone for $1 — it’s free if they don’t have the money — while those on private insurance typically face co-pays of $10 to $40.

Baltimore estimates that 20,000 residents use heroin and thousands more abuse prescription opioids. There were 481 fatal overdoses in the city during the first nine months of 2016, according to preliminary data, and deaths related to fentanyl have risen twentyfold in recent years, the health department said.

Cost of Being Rescued From Opioid Overdose Tripled...,

scientificamerican |  First came Martin Shkreli, the brash young pharmaceutical entrepreneur who raised the price for an AIDS treatment by 5,000 percent. Then, Heather Bresch, the CEO of Mylan, who oversaw the price hike for its signature Epi-Pen to more than $600 for a twin-pack, though its active ingredient costs pennies by comparison.

Now a small Virginia company called Kaleo is joining their ranks. It makes an injector device that is suddenly in demand because of the nation’s epidemic use of opioids, a class of drugs that includes heavy painkillers and heroin.

Called Evzio, it is used to deliver naloxone, a life-saving antidote to overdoses of opioids. More than 33,000 people are believed to have died from such overdoses in 2015. And as demand for Kaleo’s product has grown, the privately held firm has raised its twin-pack price to $4,500, from $690 in 2014.

Founded by twin brothers Eric and Evan Edwards, 36, the company first sought to develop an Epi-Pen competitor, thanks to their own food allergies.

Now, they’ve taken that model and marketed it for a major public health crisis. It’s another auto-injector that delivers an inexpensive medicine.

One difference, though, is that Evzio talks users through the process as they inject naloxone. The company says the talking device is worth the price because it can guide anyone to jab an overdose victim correctly, leave the needle in for the right amount of time and potentially save his or her life.

According to Food and Drug Administration estimates, the Kaleo product, which won federal approval in 2014, accounted for nearly 20 percent of the naloxone dispensed through retail outlets between 2015 and 2016, and for nearly half of all naloxone products prescribed to patients between ages 40 and 64—the group that comprises the bulk of naloxone users.

Rule of Nothing

mishtalk  |  Total capitulation by Governor Bruce Rauner is in the works. The taxoholics wore him down.

In the emergency session, Rauner has agreed to hike the personal income tax rate to 4.95% from the current 3.75%. The corporate income tax rate will rise to 7% from the current 5.25% rate.

For what? Nothing. Reforms are nonexistent.

Another Deadline Come and Gone

Illinois failed to approve a budget today and thus heads into its third fiscal year without one.

A vote has been scheduled for Sunday.

I do not expect your opinion will matter, but in the slim chance I am wrong, Please Email Your Representative voicing displeasure of the tax hike.

The preceding link will find your rep based on your address.

Rule of Nothing

A zombified Rauer has capitulated in every way but the final signing.

Tax hikes have been agreed to with no reforms in return.

The Rule of Nothing is clearly in play.

Rule of Nothing
In any given political situation, the best outcome one can reasonably expect generally happens when politicians do nothing.
Implied corollary#1: When politicians attempt to fix any problem, they are highly likely to make matters worse.
Corollary #2: Politicians almost never do nothing. It’s why we have a messed up healthcare system, education system, public pension system, etc..

Illinois Self-Inflicted Junk Status

zerohedge |  S&P warned one month ago will likely result in a humiliating and unprecedented downgrade of the 5th most populous US state to junk status. 

Then came the begging. 

According to Bloomberg, on Friday Illinois House Speaker Michael Madigan, a Democrat who controls much of the legislative agenda, pleaded with rating companies to "temporarily withhold judgment” as lawmakers negotiate. “Much work remains to be done,” the Democrat said on the floor of the House Friday, before the chamber adjourned for the day. “We’ll get the job done.”

Meanwhile, the state remains without a spending plan, its tax receipts and outlays mostly on "autopilot", leaving it with a record $15 billion of unpaid bills as it spent over $6 billion more than it brought in over the past year, and with $800 million in interest on the unpaid bills alone. The impasse has devastated social-service providers, shuttering services for the homeless, disabled and poor. The lack of state aid has wrecked havoc on universities, putting their accreditation at risk.

However, in a "shocking" development, just hours remaining before the midnight deadline to pass the Illinois budget, and Illinois' imminent loss of its investment grade rating, federal judge Joan Lefkow in Chicago ordered Illinois to come up with hundreds of millions of dollars it owes in Medicaid payments that state officials say the government doesn’t have, the Chicago Tribune reported. 

Judge Lefkow ordered the state to make $586 million in monthly payments (from the current $160 million) as well as another $2 billion toward a $3 billion backlog of payments - a $167 million increase in monthly outlays - the state owes to managed care organizations that process payments to providers.

While it is no secret that as part of its collapse into the financial abyss, Illinois has accumulated $15 billion in unpaid bills, the state's Medicaid recipients had had enough, and went to court asking a judge to order the state to speed up its payments. On Friday, the court ruled in their favor. The problem, of course, is that Illinois can no more afford to pay the outstanding Medicaid bills, than it can to pay any of its $14,711,351,943.90 in overdue bills as of June 30.

The backlog of unpaid claims the state owes to managed-care companies directly, as well as to the doctors, hospitals, clinics and other organizations “is crippling these providers and thereby dramatically reducing the Medicaid recipients’ access to health care,” Lefkow said in her ruling 

* * *

Friday’s court ruling, which meant that the near-insolvent state must pay an additional $593 million per month, may have been the straw that finally broke the Illinois camel's back. 

“Friday’s ruling by the U.S. District Court takes the state’s finances from horrific to catastrophic,” Comptroller Susana Mendoza, a Democrat, said in an emailed statement after the ruling. 

As a result of the court decision, “payments to the state’s pension funds; state payroll including legislator pay; General State Aid to schools and payments to local governments -- in some combination -- will likely have to be cut.” 

First It Was An Opioid Epidemic, Now It's A Terrorist Attack

WaPo |  There is an ongoing terrorist attack happening in Ohio. It has nothing to do with the Islamic State or political anarchists. The weapons in this case come in the form of heroin and other opioids, and the terrorists are the pushers who spread the deadly poison.

From the Columbus Dispatch this spring: “At least 4,149 Ohioans died from unintentional drug overdoses in 2016, a 36 percent leap from just the previous year, when Ohio had by far the most overdose deaths in the nation. . . . Many coroners said that 2017’s overdose fatalities are outpacing 2016’s.”

Consider that number — 4,149 overdose deaths in Ohio in one year, more than the number who died on 9/11. 

The worst of the state’s opioid problems are here in southern Ohio. The Highland County coroner provided our newspaper, the Times-Gazette, with a recap of cases from 2016 showing at least 16 overdose deaths in this small rural county. He also pointed to 50 deaths during the year from other causes where drug use or a history of drug use were present.

Even non-fatal overdoses are taxing local resources. During the first three weeks of May, emergency responders answered calls to at least 18 overdoses around the county, almost three times as many as during the same period a year ago. The public information officer for the local fire and emergency medical services department called it “the new normal.”

This is all happening around little Hillsboro, a town often compared with television’s idyllic Mayberry. With the FBI reporting that most heroin enters the United States from Mexico, and local officials saying that it then makes its way here through metropolitan drug rings, it’s no wonder that few people in Hillsboro think President Trump’s border security plans are extreme.

Like other forms of terrorism, the opioid attack will have a generational impact, in this case in a foster-care crisis being left in its wake.

Drugs, Mental Illness, Terrorism...,

thenews |  Terrorism, drugs-for-arms and money laundering are intrinsically linked and pose a considerable threat to global peace and security. They destabilise the political and financial stability of many nation-states. They were accelerated in the wake of 9/11. Militants and extremists have a nexus with criminal networks involved in dealing drugs and arms.

Evidence available with intelligence agencies confirms that from Al-Qaeda to Daesh the real challenge involves the free flow of legal and illegal funds. Until today, the international community has failed to sever their financial lifeline.

It is an open secret how the drug trade in post-Taliban Afghanistan was institutionalised through the puppet regime in Kabul and the patronising attitude of war lords in many provinces of the country. Once opium started being processed at a mass scale into morphine and heroin in Afghanistan, it brought tonnes of money for commanders on the ground.

Since 2004, the controlled democracy in Afghanistan has been playing into the hands of more sophisticated narco-enriched commanders. It is no longer a secret that the Taliban – with whom the US and its allies have always been in negotiation since 2004 – knew how to buy or muscle a vote which would protect their opium interests in every election.

Even Afghanistan’s neighbours have been making profits from the windfall: criminal groups from Central Asia, says the UN, have made profits worth $15.2 billion from the trafficking of opiates in 2015. Tajikistan is, by far, the worst affected by the drug plague owing to a combination of history, poverty and geography.

In the late 1990s, the drug trade was believed to be a source of finance for the Islamic Movement of Uzbekistan (IMU) – a terrorist group which had bases in Afghanistan and Tajikistan. After the war in Afghanistan, the IMU lost most of its influence. But the drugs trade continued with organised criminals taking the place of political or religious activists. In a survey conducted by the Open Society Institute, eight out of 10 of those polled said – hardly surprisingly – that “the main reason to turn to drug trafficking was to make big money”.

Positive Long-Term Growth Outlook for the Opioids Market

medgadget |  Opioids are the most widely prescribed medications to treat moderate to severe chronic pain. These analgesics are used to manage pain in cancer patients and also to treat severe constant pain in patients suffering from terminal illnesses. These are generally administered via subcutaneous, oral and intramuscular routes; other routes of administration include nasal insufflations, patient controlled analgesia, transdermal and oral mucosa routes via lozenges. Opioids can be classified into three major classes namely, strong agonists (fentanyl, oxymorphone, and morphine), mild to moderate agonists (codeine and hydroxycodone), and opioids with mixed receptor reactions (buprenophrine and pentazocine). Although they form one of the most widely used analgesic classes, they cause certain adverse effects such as constipation, nausea, vomiting, sedation, respiratory depression and others. However, the major concern with this drug class is the high level of drug abuse observed worldwide, leading to illegal trade of these drugs worth hundreds of billions of dollars. According to a study published in the Journal of American Medical Association in April 2011, the rate of deaths occurring due to the overdose of prescription opioids has increased substantially in the last decade in the U.S. alone. This study also indicated that high doses of opioid drugs prescribed for pain management possessed increased risk of overdose mortality in the patients.

This report gives readers a comprehensive overview of the Opioids Market: http://www.transparencymarketresearch.com/opioids-market.html

The leading molecules in this segment that constituted about 65% of the total opioids market include OxyContin (oxycodone), Nucynta (tapentadol), Rybix and Ultram (tramadol), Exalgo (hydromorphone), Ultiva (remifentanil) and fentanyl.The remaining 35% market revenue was contributed by other generic opioids as well as combination formulations of NSAIDs with opioids.The actual market scenario for this drug class, however, could be different due to the strong product pipeline, with two major entries MoxDuo IR (morphine/oxycodone) and Remoxy (oxycodone) set to hit the market in 2016. The market entry of these two drugs is expected to boost growth of the overall opioids market during the forecast period. The number of patients suffering from chronic pain is on a constant rise globally. Thus, increasing incidence of chronic pain conditions will continue to encourage the use of pain management drugs, thereby driving the opioids market. Doctors usually prescribe medicines in the initial stages of pain, followed by other treatment options. Prescription drugs are easy to use and economical and are expected to support the growth of the opioids market globally.

America Cannot Solve Its Pain and Misery With Addictive Distortions

unz |  All over America, I’ve seen posters warning against drug addictions. In Cheyenne, it’s “METHAMPHETAMINE / Don’t live this tragic story.” A few blocks away, I stepped over used needles on the sidewalk. In Buffalo, it’s an image of a beer bottle and a pill bottle, with “HEROIN addiction starts here…” Appended to it was a homemade sign, “SHOOT YOUR LOCAL HEROIN DEALER.” Also in Buffalo, it’s a photo of a seemingly dead man on the floor, with “Learn how to recognize OPIOID OVERDOSE and SAVE A LIFE.” In Cleveland, it’s a tagged toe in a morgue, with “DEATH BY HEROIN OVERDOSE IN CUYAHOGA COUNTY HAS QUADRUPLED,” and this was in 2014, before the prevalence of fentanyl.

 

In 2016, Philly had 277 murders and 907 fatal drug overdoses. For 2017, murders are up 21% and drug deaths, 33%. What’s your town’s drug toll?

A 33-year-old friend admits to popping street-bought Xanax every now and then to help her sleep. I suspect she’s on various pills, if not heroin, for she’s always broke and borrowing money. She has a spotty memory, sporadic hygiene and pinpoint pupils.

At Friendly, I sat next to my buddy Jeff, who’s in his late 40’s and HIV positive. Each day, Jeff pops a dozen pills, including Klonopin, a benzodiazepine that can trigger paranoid or suicidal thoughts, as well as degrade your memory, judgment and coordination. Mixed with other substances, particularly alcohol, it can slow your breathing or even kill you. Jeff is always drinking.

“Jeff, man, you’re always so outgoing, so gregarious, I can’t imagine you having anxieties!”

“That’s because of the Klonopin, dude. Without it, I’d be a mess. Without it, I’d be up all night pissed off, you know, about some stupid argument I had 15 years ago, some fight with a hot dog vendor who gave me ketchup instead of mustard!”

“That’s serious.”

“Here’s what it looks like,” Jeff showed me some innocent white pills in a yellow bottle. “You want one?”

“No, thanks.”

Jeff took one out anyway and gave it to the bartender, 42-years-old Lisa. She stashed it away for later.

Fat Childless Singleton's Fake Virtue Signalling on Obamacare

fmshooter |  On Monday, Huffington Post author Kayla Chadwick posted an article titled “I Don’t Know How To Explain To You That You Should Care About Other People,” which was essentially an emotional plea without any constructive argument on why Americans should pay higher taxes as well as sign up for Obamacare:

If I have to pay a little more with each paycheck to ensure my fellow Americans can access health care? SIGN ME UP.

But if making sure your fellow citizens can afford to eat, get an education, and go to the doctor isn’t enough of a reason to fund those things, I have nothing left to say to you.

Well, since Chadwick has no problem telling Americans to pay more for their healthcare, she should have no problem signing up for an Obamacare plan herself.  It sure appears as if Chadwick is on an employer-sponsored health insurance plan, as I imagine she would be singing quite a different tune if she had to “pay her own way” (with or without subsidies) via the Obamacare exchange.

First, Chadwick can go to the Obamacare exchange to sign up, but of course, only if it is either A) the “open enrollment” period, or B) she incurs a “qualifying life event” that would make her eligible to purchase insurance.  If she’s merely switching carriers… no cigar, you have to wait till the open enrollment period!

Half of America's $3.5 Trillion Healthcare Spend Goes to 5% of Patients

theatlantic |  Last year, America’s total medical costs hit a new record of $3.4 trillion, according to the federal government. That’s about 18 percent of the country’s total GDP, meaning that one out of every six dollars we spent in 2016 went to health care. The national doctor bill dwarfs anything else we spend money on, including food, clothing, housing, or even our mighty military.

If that $3.4 trillion were spread equally throughout the population, the bill would come to some $10,350 for every man, woman and child in the country. But fortunately –for most of us, anyway—the cost of health care is not equally distributed. Rather, a small number of Americans run up most of the expense. The biggest medical costs are concentrated on a fairly small segment of the population—people with one or more chronic illnesses, plus victims of accidents or violent crime. The cost is so concentrated, in fact, that an estimated five percent of the population accounts for 50 percent of total medical costs.

For the purposes of this project, we’re calling these people The Platinum Patients—they’ve also been described as “super-utilizers” or “frequent fliers.”

This concentration of total cost on a small segment of the total population is reflected in another common aspect of medical spending: the concentration of treatment, and cost, in the end of a life span. For most people, the vast majority of all the health care they’ll ever get comes near the hour of death. Hundreds of billions of dollars each year are spent treating Americans who are in the last weeks, or days, of life.

The old Marx Brothers’ joke—“I wouldn’t dare go to the hospital—people die there all the time”—is essentially true. Many people die in the hospital—in many cases, just after they’ve incurred a hugely expensive round of surgery, treatment, and medication. About one-third of Americans undergo operations in the last month of life.

If these issues were subject to hard, cold economic theory, a health-care system would probably distribute spending differently. The large sums it costs to keep a sedated cancer patient with dementia alive in a hospital bed from age 94 to 95 could presumably be directed instead to provide, say, a kidney transplant for a 40-something victim of renal failure, or a young woman who is too depressed to care for her baby. That money could be used for pre-natal care for uninsured mothers, setting the stage for both mother and child to have a healthier and happier life. Or, those funds could be used to provide health insurance at reasonable cost to the 29 million Americans who have no health coverage today.

One famous, or perhaps notorious, advocate of limiting late-in-life medical spending is former Colorado Gov. Richard Lamm, who was given the nickname “Governor Gloom” in the 1980’s for his argument that the elderly have a “duty” to avoid costly care when the end is near. There’s only so much money available for medical care, Lamm noted, so it ought to be used in the most efficient way. In the face of bitter criticism, Lamm stuck to his guns. Just this spring he told the Denver Post: “When I look at the literature, and there are such things as $93,000 prostate operations at some stage of prostate cancer that might give two extra months of life, it is outrageous.”   

The problem with these straightforward economic calculations is that they involve real human beings who have friends and relatives. That 94-year-old cancer patient, after all, may have loving children or grandchildren at the bedside; hardly anybody is willing to let Grandpa die just to save money for the overall health-care system.

Let Addicts Die

WaPo  |  Under a plan by a city council member in Ohio, people who dial 911 seeking help for someone who's overdosing on opioids would start hearing something new from dispatchers: “No.”

In response to the opioid epidemic that swept the nation — including the small city of Middletown, population 50,000 — council member Dan Picard floated an idea that's been called more of “a cry of frustration” than a legitimate solution.

At a council meeting last week, Picard proposed a three-strikes-style policy for people who repeatedly overdose: Too many overdoses and authorities wouldn't send an ambulance to resuscitate them.

Picard told The Washington Post that he sympathizes with anyone who has lost someone to drug abuse, but said that responding to an ever-increasing number of overdose calls threatens to bleed his city dry.

“It’s not a proposal to solve the drug problem,” Picard said this week. “My proposal is in regard to the financial survivability of our city. If we’re spending $2 million this year and $4 million next year and $6 million after that, we’re in trouble. We’re going to have to start laying off. We're going to have to raise taxes.”

Why Beauty Matters

gurdjieff |  Because literature for Gurdjieff, as for the Sufis, is inextricable from philosophy, it is appropriate in considering Beelzebub’s Tales to address some fundamental philosophical questions, the answers to which help put Gurdjieff’s writings into perspective. Among the issues to be addressed, one of primary importance is to define what constitutes literature for Gurdjieff, or what, according to his aesthetics, distinguishes literature from non-literature; art from non-art. 

Unraveling this distinction involves comprehending some of Gurdjieff’s fundamental ideas about human beings and their place in the world. We have already proposed that Gurdjieff’s primary philosophical stance is that of Sufism, and his philosophy of art supports this contention.¹ At the core of his aesthetics is the position that no form of artistic expression possesses value in itself; no art is appreciable for its intrinsic value alone. Because of his premises concerning the meaning and purpose of human existence, all “art” for Gurdjieff, and consequently all literature as an art-form, must be functional or didactic. The value of an art work resides in its potentiality to transform or metamorphose the art appreciator. Insofar as a work of literature, a piece of music, a painting, or any other potential art form aids humans in the process of their spiritual evolution, that object or activity earns the designation “art” for Gurdjieff and possesses what he refers to as “soul.”

Gurdjieff’s use of terminology to espouse his aesthetics and other branches of his philosophy frequently involves his supplying old terms with new meanings. Consequently, we are forced when approaching his writings to temporarily abandon old associations of key words used in his discussions. Such is the case with the terms “soul,” “objective” and “subjective,” “conscious” and “unconscious.” “Subjective art,” for example, in Gurdjieff’s terminology, refers to most of what is commonly interpreted as art. Most twentieth-century art in its various forms, according to his standards, would fall into this category. But subjective art is not authentic art for him; it is the result of mechanical, unconscious human activity, and most of humanity is unconscious according to Gurdjieff. For the same reason, he refers to subjective art as “soulless” in that it results from little or no consciousness on the part of the would-be artist. In his introduction to Meetings with Remarkable Men, he asserts that contemporary civilization is unique in history in its massive production of soulless, pseudo art.

On the other hand, “objective art” is authentic art in that it results from deliberate, pre-meditated efforts on the part of a conscious artist. In the act of creation, the true artist avoids or eliminates any input which is subjective or arbitrary, and the impression of such art on those who experience it is always definite. To the degree that objective art is the result of consciousness, it inherently possesses “soul.” As one example of soulful art, Gurdjieff cites the paintings of Leonardo da Vinci; as another he refers to the Taj Mahal. Both constitute objective works of art.