Tuesday, March 18, 2008

Nygaard Notes #402

Nygaard Notes
Independent Periodic News and Analysis
Number 402, March 11, 2008

On the Web at http://www.nygaardnotes.org/


This Week: Taxes, Health, and Victory Laps


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1. “Quote” of the Week
2. The Story Here: High Taxes? Or Equality?
3. “Stripping Poor Nations of Their Skilled Health Workers”
4. “Private Insurers Would Offer Policies to Everyone Else”
5. “A Victory Lap For Bush” in Africa?

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Greetings,

As promised a couple of weeks ago, this issue is a sort-of backlog of the strange and important things that have passed before our eyes over the past couple of months while I was occupied with Venezuela and the federal budget and so forth. I still have a big stack of clippings that could use some attention, so look for more bite-sized tidbits in the next couple of issues before I update the ongoing secret air wars in Iraq and Afghanistan and other as-yet unknown issues.

Nygaard

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1.
“Quote” of the Week

March 19 is a day that will live in infamy, as it is the day, in 2003, that the U.S. decided to invade and occupy Iraq. You can find out about protest rallies and actions near you by checking these websites:
http://answer.pephost.org/
OR
http://events.unitedforpeace.org/5yearstoomany/calendars/show

This week’s “Quote” of the Week is an announcement of a rally in opposition for those in the Twin Cities of Minneapolis and St. Paul, which is after all the World Headquarters of Nygaard Notes:

“Saturday, March 15, 1:00 p.m. Gather at Hennepin and Lagoon Avenues (Uptown), Minneapolis. March begins at 1:30 p.m. There will be a closing rally near Loring Park in downtown Minneapolis. Join a mass antiwar demonstration to mark the 5th anniversary of the war with a call of: "Not One More Death! Not One More Dollar! Not One More Day! U.S. Out of Iraq Now! End the War and Occupation! No War on Iran! Fund education, housing, health care and other human needs! Bring the troops home now!" Initiated by: the Year 5 Committee to End the War. Interested in being a peace marshal?: Call Marie Braun, 612-522-1861. FFI: Call 612-522-1861 or 612-827-5364.”

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2.
The Story Here: High Taxes? Or Equality?

Two articles that appeared in the New York Times recently give a hint of the values and priorities that shape coverage in that paper and, due to its power and influence, that shape coverage around the nation.

The first one appeared in the Business Section on December 26th when the Times assigned a reporter named Carter Dougherty to cover a problem with taxes in Denmark. The lengthy article was headlined “Denmark Feels the Pinch as Young Workers Flee to Lands of Lower Taxes.” The subject was the problem of skilled Danish workers who have been “Born and trained at Denmark's expense, but [are] working—and paying lower taxes—elsewhere in Europe.”

The article focused on “a self-employed software engineer, Thomas Sorensen,” who lives and works in Germany because of the high taxes in Denmark. Mr. Sorensen is held up as an example of “Young Danes, often educated abroad and inevitably fluent in English, [who] are primed to quit Denmark for greener pastures. One reason is the income tax rate, which can reach 63 percent.” (That percent, by the way, is the “marginal” tax rate, meaning that this percentage is applied only on the part of one’s income that is above a certain level. No one, that is, pays 63 percent of their income in taxes, as that last comment seems to imply.)

The article points out that the tax rate is one reason for “such effective income redistribution that Denmark is the most nearly equal society in the world, in that wealth is more evenly spread than anywhere else.” Also, the Danish “economy barreled ahead in 2006 by 3.5 percent, one of the best performances in Western Europe. The country is effectively at full employment.” Still, the Times worries, some projections (they cite only one) say that there will be problems in the future, “reflecting a dwindling supply of a vital input for any economy: labor.”

There are those who may think that it would be interesting and useful for the Times to run an article explaining the meaning of having “the most nearly equal society in the world.” But, apparently, the Times considers the problem of high taxes more newsworthy than the largely-successful banishment of inequality. Contrast this coverage with the following...

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3.
“Stripping Poor Nations of Their Skilled Health Workers”

If, indeed, the out-migration of skilled workers is an problem worth considering in Denmark, that is not the only place in the world where the issue rears its head. Two months after the Times ran its lamentation of high Danish taxes, they ran another story on another aspect of the same problem. This article (on February 22nd) had to do with doctors being lured out of Africa to work in the wealthier nations. While the article on the Danish software engineer who didn’t like his tax rate was deemed worthy of a 1,000-word article, the African public-health crisis reported two months later ran a mere 136 words and appeared in the “World Briefing” section as a Reuters wire story.

The brief article referred to a piece published in the February 23rd issue of the respected British medical journal The Lancet. The Lancet story considered it a problem that wealthy countries have far more doctors to serve their populations than do poor countries. Even more of a problem is that this is not an accident. As their summary tells us, “High-income countries, such as Australia, Canada, Saudi Arabia, the USA, the United Arab Emirates, and the UK. have sustained their relatively high physician-to-population ratio by recruiting medical graduates from developing regions, including countries in sub-Saharan Africa.”

The practice is called “poaching,” and it is not a new phenomenon. In fact, England banned the “active recruitment”of medical staff from Third World countries in 1999 “in response to criticism that Britain was stripping poor nations of their skilled health workers,” reports the London Independent.

The situation has progressed to the point where “over half of the countries in sub-Saharan Africa do not meet the minimum acceptable physician to population ratio... Nurses, pharmacists, and other health workers are systematically recruited from a region struggling with the greatest burden of infectious and chronic illness, and the specific challenge of HIV/AIDS.”

The Lancet article concludes by saying that “Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm: the practice should, therefore, be viewed as an international crime.” Add the authors, “Although the active recruitment of health workers from developing countries may lack the heinous intent of other crimes covered under international law, the resulting dilapidation of health infrastructure contributes to a measurable and foreseeable public-health crisis.”

The Lancet calls for action to avert this crisis by “countries that then accept these placements, such as Australia, Canada, Saudi Arabia, the UK, the United Arab Emirates, and the USA.”

Consider the last story about Denmark, and pair it with this story, also from the nation’s Newspaper of Record.

One is the story of an impending public-health crisis in numerous countries around the world, caused in part by unethical behavior by companies and inaction by governments in numerous wealthy countries, including the U.S. The other story is about some upper-income Danes who don’t like to pay taxes and are migrating out of their country.

If I ran the New York Times, I would consider one of these stories to be front-page worthy (Hint: Not the second one.) The people who actually do run things see it differently.

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4.
“Private Insurers Would Offer Policies to Everyone Else”

The private health insurance industry, like most industries, has its own trade association that lobbies and otherwise advocates for the interests of its members. On December 19th the health insurance industry’s association AHIP (America’s Health Insurance Plans) released “a proposal to guarantee access to health care coverage in the individual market.” The proposal was dutifully covered by the New York Times, under the headline “Insurers Seek Bigger Reach in Coverage.” The article appeared in the Business Section, where much important health care news seems to appear.

The article led off by saying “Acknowledging that too many people simply cannot obtain health insurance on their own, the insurance industry plans ... to propose a series of steps the companies say would let more individuals, even those who have health problems, obtain coverage.”

The Times quoted Karen Ignagni, the chief executive of AHIP, the trade group, America's Health Insurance Plans, who said “We are taking responsibility for ensuring that no one falls through the cracks.”

The reason her words are so sadly ridiculous was revealed in the very next sentence, which read, “While the [insurance industry] group is proposing that the states cover the most costly individuals, private insurers would offer policies to everyone else.”

Now, that’s the kind of proposal that any insurance company should love! Private plans collect premiums from the healthiest people, and the costs of caring for the sickest, and most expensive, people are borne by the taxpayers. The phrase that some use for this is “privatized profits, socialized costs,” and it’s a capitalist’s dream. I’m sure AHIP appreciates the New York Times reporting this absurdity without ridiculing it.

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5.
“A Victory Lap For Bush” in Africa?

Mr. George W. Bush made a trip to Africa last month that was widely reported as a big success, largely due to the AIDS program that he initiated in 2003. Typical headlines were “In Global Battle On AIDS, Bush Creates Legacy” (NY Times), “A Victory Lap for Bush” (Durham, NC Herald-Sun), and “In Africa, Bush Touts Aid Efforts, Basks in Popularity” (Christian Science Monitor). What they are talking about is something called the “President's Emergency Plan for AIDS Relief,” or PEPFAR.

The Bush administration likes to say that PEPFAR is “the largest commitment ever by any nation for an international health initiative dedicated to a single disease,” and that “The United States now leads the world in its level of support for the fight against HIV/AIDS.” These things are true, in a technical sense, but there’s more to the story. I devoted an entire issue to this subject back in 2004 (Nygaard Notes #265), but now that the “President” has just concluded his “victory lap,” it seems like a good time to summarize some of the details of the Bush “legacy” in the realm of AIDS and public health.

Ideology and Profits

The gist of the matter is summed up by the U.S.-based Center for Health and Gender Equity, in their 2004 report “Debunking the Myths in the U.S. Global AIDS Strategy: An Evidence-Based Analysis.” They said, “Our review of the U.S. [PEPFAR] Strategy arrives at two conclusions. One is that the prevention strategy is crafted more to cater to the ideological agenda of the Administration’s ‘base’—the far political and evangelical right—than it is to meet the urgent prevention needs of the millions of people now at risk of infection throughout the world. The second is that the treatment agenda is based far more on the interests of pharmaceutical companies than on the urgent needs for access to [life-saving drugs] of the millions already suffering from AIDS.”

What they mean by “ideological agenda” is that the U.S. pushes what they call the “ABC” approach to AIDS, which is “Abstinence, Being faithful and Condoms” (in that order). This ideology dictates that 33% of U.S.-provided prevention funds are directed towards giving abstinence-only prevention messages in the recipient countries. This emphasis is widely criticized by activists around the world, who mostly support the “CNN” approach, which stands for “Condoms, Needles, and Negotiating Skills.”

This ideological focus is partly why, of the $15 billion in AIDS funding for which the “President” likes to take credit, only $1 billion goes to the “Global Fund to Fight AIDS, Tuberculosis and Malaria.” The Global Fund is organized by the UN and operates in 128 countries. PEPFAR, in contrast, arbitrarily names 15 countries as eligible for assistance, excluding scores of equally-needy nations. Activists point out that this is bound to drain support from the UN’s Global Fund, which was established a year before PEPFAR.

As for the Bush bias toward the “interests of pharmaceutical companies,” a hint of the Bush priorities appeared when Mr. Bush appointed as his first Global AIDS Coordinator one Randall L. Tobias, whose previous job had been as Chairman, President and CEO of Eli Lilly and Company, one of the largest pharmaceutical companies in the world.

Going beyond that hint, here’s what the World Health Organization reported in 2006 on the subject: “Several newer AIDS drugs and formulations of existing drugs are urgently needed in developing countries but are not available because pharmaceutical companies are choosing not to sell them, and no generic versions of these are available.” They’re not available due to the monopolies on these life-saving drugs—that is, patents—that are maintained under the rules of world trade so vigorously defended by U.S. politicians, both Republican and Democrat.

Despite his constant talk of “free trade,” the agreements supported by Mr. Bush and the big pharmaceutical companies actually seek to strengthen patent protections—known generally as “intellectual property protection”—to maintain the profits from the sale of AIDS, and other, drugs. This is the opposite of “free.” The AIDS activist group Health GAP says “a great danger” is presented “by so-called free trade agreements where the United States attempts to impose ... intellectual property protections that hamper countries ability to ensure access to medicines for all.”

In summary, then, the Bush AIDS initiative in Africa substitutes ideology for effective public health strategies, places corporate profits above access to life-saving drugs, and detracts from existing global efforts at prevention and treatment. Despite all that, it is no doubt true that the spending of billions of dollars by the U.S. on AIDS in Africa over the past five years has helped many people, which is no doubt why there were celebrations in some places upon Mr. Bush’s arrival. But I don’t think it will really be time for a “victory lap” until the U.S. decides to let go of its moralizing and corporate-friendly policies and commit to full support of the existing and effective multinational anti-AIDS efforts already underway.

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--
Jeff Nygaard
National Writers Union
Twin Cities Local #13 UAW
Nygaard Notes
http://www.nygaardnotes.org

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