Month: February 2018

Meet The New Boss, Same As The Old Boss

Posted on February 1, 2018

The announcement by the CEO’s from JP Morgan Chase, Amazon and Berkshire-Hathaway that they are forming a new healthcare company signals the symbolic end of the ACA-reform era. They recognize the inefficiencies and profiteering of the private insurance companies, who add no value to businesses dealing with healthcare. And should there be any doubt that the end of the ACA is nigh, there’s this from Trump: “We repealed the core of disastrous Obamacare. The individual mandate is now gone.”

Given the record of the CEO-in-chief who now occupies the White House, it’s doubtful we can expect improved healthcare, or lower costs, under his leadership, which should give us pause before putting CEOs in charge of our health.

If the ACA had fulfilled its promises, a new company by these CEOs would not be needed. The ACA sought to lower costs by forcing consumers to put more “skin in the game,” in Obama’s Budget Director Peter Orzag’s infamous phrase. Yes, patients are spending more, and in 2017 insurance premiums went up over 25% in many areas, deductibles have continued to climb to an average of $1440 for employees in large groups, and drug prices have skyrocketed for long-standing medications like Insulin and newer specialty drugs like Harvoni for Hepatitis C. High-deductible plans and a steady shift so workers pay more for insurance (on average 30% of premiums that are $18,000/year) has not lowered overall costs. Even worse, patients who have paid high premiums are not able to get care because they cannot afford the out-of-pockets costs their expensive insurance does not cover.

Into the breach come the heroic CEOs Bezos, Dimond and Buffett (BDB*). What do they offer? A company that can control costs. How will they do it? With technology, of course. Apparently we have come full circle: since the government regulatory program couldn’t enact effective cost control and utilize technology to save money, let’s have a corporation do so. But it is precisely the industry model that has created our dysfunctional, “money is the metric” approach to health. In the present healthcare industry, the war for revenue between insurers, drug companies, and hospital corporations, along with medical equipment manufacturers and other suppliers, has raised prices and created immense profits. Electronic Medical Records, and other technological innovations are supposed to anchor the new healthcare system. They are expensive, in fact more expensive than any savings they generate. The result of the ACA push to pay for “performance” has been to punish clinicians and hospitals with high-needs patients, no lowering of costs, and increased denials of care since there is an incentive to avoid rather than treat patients who will lower your “performance” score.

Somebody or some entity is going to make the decisions regarding the healthcare we get. Do we really believe CEO’s rather than clinicians should make those decisions? If the decisions are based on corporate bottom lines we can expect continued cost shifts to workers, deployment of labor-displacing technologies with unproven impacts on patient care quality, and fragmentation as each corporate castle fortifies its strategic market position: Aetna-CVS will go toe-toe-toe with BDB* as the Ascension hospital corporation (nation’s largest) pushes back, for example. Since less care equals greater profits, and more covered lives means greater revenue, we can see that money will likely remain the metric.

Those who control capital, like the richest guy in the world, investment banks and investors, favor capital-intensive approaches to social problems. Technology fits that bill. Yet, technology only serves the purposes for which it is designed: it is neither socially neutral nor a panacea. Nurses know, however, that human health cannot be reduced to an algorithm, subject as it is to the particularities of an individual’s family history, environment and most fundamentally, socio-economic status. Let’s hope the technologists and CEOs quickly learn from direct care RNs. Standardization of treatments whether through algorithms, protocols, or budget-mandates do not match the needs of individual patients.

Alternatively, the US could expand and improve the current program that puts clinicians in charge, is popular, and works at controlling costs: Medicare. With administrative costs as low as 5–6% compared to the 13% or higher for private insurance, Medicare is more efficient. The growth in Medicare spending, around 2.4% annually, is much less than growth in overall healthcare spending and far less than recent premium increases. Under Improved Medicare for All, benefits would be expanded to include those that ACA, Medicaid and CHIP provide, and Medicare will negotiate prescription drug prices. The biggest shortfalls in Medicare, the escalating privatization pushed by the insurance-financed politicians that have resulted in higher out of pocket costs for seniors, over payments to the private Medicare Advantage plans and the “donut hole” in the private the prescription drug benefit, would be eliminated through a robust Medicare for all plan, such as proposed nationally in Sen. Bernie Sanders S 1804 bill or the California single payer bill SB 562.

Moreover, traditional Medicare enables physicians to deliver the care their patients need without onerous “gate-keeping,” prior authorizations or narrow networks that insurers use to restrict access, limit choice of providers and undermine the clinical judgment of doctors and nurses. In fact, since older Americans tend to be the most intensive users of health services, expanding the pool by including everybody especially low-needs patients will make the program more sustainable.

Should patients, workers and employers be on the hook for the excessive compensation and enormous profits of the health insurance industry? In California between 2011–16, insurers made $27 billion in profits/net income. Why should we subsidize the failed business model of health insurers? (Employers get $342 billion each year in tax subsidies to lessen the cost to them of private health insurance.)

On this BDB is right—health insurance companies add no value, and the profits in healthcare are obscene. That recognition matters and can point the way toward real reform. The solution is not more of the same. We must contain prices in order to control costs. An industry approach cannot do that and also place patient care at the center of a reformed system.

Remarks At The Ethics In Action Conference

Posted on February 1, 2018

My remarks will focus on the ethical challenges of one particular aspect of the financial system: the investment management industry. Given the increasing size and importance of this industry globally, I believe that it is of utmost importance that we develop an ethical framework for its functioning.

In my remarks today, I would like to argue that there is a quiet, large scale “illicit financial flow” happening under our noses – and that is from everyday savers and pensioners to the employees of the financial sector and the shareholders of these companies. I believe that this “illicit financial flow” is deeply problematic for the end investor, who is trying to save for retirement or important expenses in their lives, and for our broader economic and planetary system, which does not have the appropriate stewards in the financial sector. I believe that without a transformation in how our collective savings are managed, we will not be able to achieve the broader goals of sustainable development.

My comments will focus on three particular aspects of the investment management industry that constitute the key pillars of the ethical challenges of the industry: 1) costs and fees, 2) time horizon mismatch the investment management industry versus the beneficiaries, and 3) lack of active stewardship of investments. I will end with a few comments on innovations in the industry that are trying to tackle some of the challenges I have outlined and will close with some reflections on whether they are moving in the right direction.

Before I begin, let me give you a sense of the size of the global investment management industry:

When I speak about the “investment management industry,” I am referring to the thousands of companies involved in the management of our savings in our pension funds, insurance accounts, additional savings we may have accrued.
The total size of the asset owner community – pension funds, SWFs, Endowments and Foundations, Mutual Funds, and Insurance Funds – is approximately $131 trillion. This number has been growing at between 5 and 7% per annum for the past 10 years.
The total size of all professionally managed, third-party investments has reached $79.2 trillion at the end of 2017. Roughly half of these assets – $37 trillion – are in the United States, $22 trillion in Europe, and $13 trillion in Asia excluding Japan.
The total direct revenues associated with the management of professional assets have reached approximately $200-$250 billion a year and is growing as global wealth increases.

The first major ethical challenge of the investment management industry is the extraordinary level of fees that are charged by the various intermediaries involved in the management of money. A recent study by Professor Andrew Clare of the Cass Business School has found that in between you as an end investor placing your money within a pension fund or into an investment account, and that money earning a return in a publicly listed security, there are over 100 fees placed on you by various intermediaries in the financial industry. A recent study by Grant Thornton, a global accounting and audit firm, has found that someone who entrusts a GBP 100,000 with a financial advisor in the UK will end up paying 2.56% annually in the various fees that are levied, which would mean that after ten years, 40% of your return would be eaten up by fees along the way. Given the fact that over 90% of actively managed equity portfolios underperform their low cost benchmark over a ten year period, this is quite troubling. And despite the growth of automation, robo financial advice, the number of financial advisors to manage assets of all kinds is increasing significantly, not decreasing. I could go on and on about the fee structure of the investment management industry, but I will spare you all for the time being.

The second major ethical challenge of the investment management industry is the mismatch of time horizons between financial market participants and the beneficiaries for whom they are managing money. The average, asset-weighted portfolio turn over rate for US mutual funds from 1984-2017 is 57%, which means that the average US mutual fund turns over their entire portfolio less than every two years. What is the benefit of such turnover? It is certainly not for the end investors, who pay a significant cost to the traders, accountants, book keepers, stock exchanges and more for their investors to churn portfolios. In addition, if the average professional investors has less than a 2 year time horizon for holding a stock, do we really think that they will be thinking about long-term, systemic risks in the global economy and financial system – things like climate change, inequality, corruption and so on?

This brings me to the third and final ethical challenge of the investment management industry, which is that of stewardship. Owning a stock of a company, or owning the bond of a company or country, gives you a right to future earnings of these entities, but it also gives you a responsibility as a small owner of the security. It gives you a vote in the election of the company’s board members, it gives you the right to issue resolutions for the company’s board to consider reform their practices on certain issues ranging from environmental impact to pay gaps to gender diversity on corporate boards and more. Over the past forty years, what has happened is that stock ownership has moved from individuals, who in the early 1980s owned 80% of the stock market directly, to institutional investors and asset managers, who now own a large majority of publicly listed companies on behalf of individuals. Although this may have created some efficiencies, it has also delegated an important set of decisions to intermediaries such as pension funds and asset management firms, who I believe, are not putting sufficient resources in being representative stewards of capital on behalf of their beneficiares. To give you one important anecdote, in 2017, there were 63 climate change related resolutions for publicly listed corporations, a small number to begin with compared to the multiple thousands of publicly listed companies. The average vote outcome was only 33% in favor, and only 3 positive outcomes. Do we really think that asset managers and institutional investors are voting in line with the best, long term interests of their clients and customers with a voting record like this? I think not.

Over the past few years, there has been a significant amount of hope that “institutional investors” and “private sector financial institutions” would be leading actors for sustainable development. Every UN and World Bank meeting related sustainable development financing since 2014 has had a significant discussion on “how to get the investment management industry through institutional and retail investors” to contribute to the SDGs? The intuition may be right, given the size and influence of this industry, but the reality is a lot more challenging than what most people expect.

The good news is that innovation is under way to tackle some of the challenges that I have outlined. Low cost index investing has the potential of bringing down the costs of investment management by 1, if not 2, orders of magnitude. Behavioral finance insights are being used to decrease the churn of portfolios. New platforms are being built to give retail investors a mechanism to express their voting preferences to their fund managers so that they vote according to their beneficiaries interests on Environmental and Social issues. But all of this is still at the margin, and a lot more work is needed.

Thank you.

Why We Need Rise-Up Economics, Not Trickle Down

Posted on February 27, 2018

How to build the economy? Not through trickle-down economics. Tax cuts to the rich and big corporations don’t lead to more investment and jobs.

The only real way to build the economy is through “rise-up” economics: Investments in our people – their education and skills, their health, and the roads and bridges and public transportation that connects them.

Trickle-down doesn’t work because money is global. Corporations and the rich whose taxes are cut invest the extra money wherever around the world they can get the highest return.

Rise-up economics works because American workers are the only resources uniquely American. Their productivity is the key to our future standard of living. And that productivity depends on their education, health, and infrastructure.
Just look at the evidence.

Research shows that public investments grow the economy.

A recent study by the Washington Center for Equitable Growth found, for example, that every dollar invested in universal pre-kindergarten delivers $8.90 in benefits to society in the form of more productive adults.

Similarly, healthier children become more productive adults. Children who became eligible for Medicaid due to expansions in the 1980s and 1990s were more likely to attend college than similar children who did not become eligible.

Investments in infrastructure – highways, bridges, and public transportation – also grow the economy. It’s been estimated that every $1 invested in infrastructure generates at least $1.60 in benefits to society. Some research puts the return much higher.

In the three decades following World War II, we made huge investments in education, health, and infrastructure. The result was rising median incomes.

Since then, public investments have lagged, and median incomes have stagnated.

Meanwhile, Ronald Reagan and George W. Bush’s tax cuts on the top didn’t raise incomes, and neither will Donald Trump’s.

Trickle-down economics is a hoax. But it’s a convenient hoax designed to enrich the moneyed interests. Rise-up economics is the real deal. But we must fight for it.

Have We Lost the Common Good?

Posted on February 22, 2018

In 1963 over 70 percent of Americans trusted government to do the right thing all or most of the time; nowadays only 16 percent do.

There has been a similar decline in trust for corporations. In the late 1970s, 32 percent trusted big business, by 2016, only 18 percent did.

Trust in banks has dropped from 60 percent to 27 percent. Trust in newspapers, from 51 percent to 20 percent. Public trust has also plummeted for nonprofits, universities, charities, and religious institutions.

Why this distrust? As economic inequality has widened, the moneyed interests have spent more and more of their ever-expanding wealth to alter the rules of the game to their own advantage.

Too many leaders in business and politics have been willing to do anything to make more money or to gain more power – regardless of the consequences for our society.

We see this everywhere – in the new tax giveaway to big corporations, in gun manufacturer’s use of the NRA to block gun controls, in the Koch Brother’s push to roll back environmental regulations, in Donald Trump’s profiting off his presidency.

No wonder much of the public no longer believes that America’s major institutions are working for the many. Increasingly, they have become vessels for the few.

The question is whether we can restore the common good. Can the system be made to work for the good of all?

Some of you may feel such a quest to be hopeless. The era we are living in offers too many illustrations of greed, narcissism, and hatefulness. But I don’t believe it hopeless.

Almost every day I witness or hear of the compassion of ordinary Americans – like the thousands who helped people displaced by the wildfires in California and floods in Louisiana; like the two men in Seattle who gave their lives trying to protect a young Muslim woman from a hate-filled assault; like the coach who lost his life in Parkland, Florida, trying to shield students from a gunman; like the teenagers who are demanding that Florida legislators take action on guns.

The challenge is to turn all this into a new public spiritedness extending to the highest reaches in the land – a public morality that strengthens our democracy, makes our economy work for everyone, and revives trust in the major institutions of America.

We have never been a perfect union; our finest moments have been when we sought to become more perfect than we had been. We can help restore the common good by striving for it and showing others it’s worth the effort.

I started my career a half-century ago in the Senate office of Robert F. Kennedy, when the common good was well understood, and I’ve watched it unravel over the last half-century.

Resurrecting it may take another half century, or more. But as the theologian Reinhold Niebuhr once said, “Nothing that is worth doing can be achieved in our lifetime; therefore we must be saved by hope.”

Roma And African Americans Share A Common Struggle

Posted on February 20, 2018

On 20 February, we mark the abolition of Roma slavery on the territories of today’s Romania. Much has changed across continents but the enslavement of people in both Romania and the US has converted into new forms of exploitation and control.

The impetus to kill and chain Roma and African American bodies remains one of the appalling facets of how the criminalization and demonization of these peoples have historically translated into action. For example, in Romania, Levente, a 21-year-old Roma man, was recently shot dead by a police officer in front of two Romakids, aged 10 and 14.

According to Marian Mandache, the executive director of the Roma rights group Romani CRISS, the young man was unarmed. In the US, police killings of black Americans are common too, with Amadou Diallo to Manuel Loggins Jr, Ronald Madison, Kendra James, Sean Bell, Eric Garner, Michael Brown, and Alton Sterling just a handful of the victims.

From early on in their histories, Roma and African Americans have crossed similar paths, as white policymakers continued to employ similar tactics to maintain white normativity, social power, and privilege.

Since 1853, Mihail Kog?lniceanu, one of the most progressive Romanian intellectuals of all time, has pointed out the comparable struggles of African Americans in bondage and enslaved Roma people.

His preface about Roma slavery and the translation of Uncle Tom’s Cabin – the first American novel to be published in Romanian – increased a consciousness of shame about the brutality of slavery across a few strands of Romanian society. Kog?lniceanu was one white intellectual among many in both Europe and the Americas who, along with fellow abolitionists, denounced slavery and advocated for its eradication.

But the moral responsibility and paideia of some intellectuals did not concur with the decisions and actions of governing institutions. Along with a litany of unfulfilled promises – for example the 40 acres and a mule promised in the US by former masters – the losses of African Americans and Roma people have not been restored.

If in the US there is some level of acceptance of this atrocious legacy, Romania still lacks acknowledgement and a break with its own past, starting with public apologies from state institutions and the Orthodox Church, both of which enslaved Roma.

The widening adoption of international human rights instruments over the past 70 years might suggest that the end of humanity’s dark heritage of state-sponsored atrocity was in sight, and that a consciousness of shame, discomfort, or even compassion would prompt immediate and effective condemnation. Yet many atrocities continue unnoticed, and most of those who stand up for the minority, the poor, and the weak are still perceived as radicals.

Whiteness, gadjo-ness, or the supremacy of the dominant still resides at the heart of the world’s dogmas and practices, without being challenged much. New policies, laws, and discourses in place do not seek to dismantle the system that discriminates and devalues the descendants of enslaved people but rather conserve in many a belief in their own inferiority.

Essentially, whiteness and gadjo-ness, are still perceived by many African Americans and Roma people as a naturally superior state of being. More broadly, those that do not belong to the dominant group, be they Roma, African Americans, Dalits, migrants and many others, are still more valuable to the supremacist when they fail.

Overt structural discrimination is as harsh a reality for many minority and marginalized groups across the world. Paradoxically, most seem intrinsically equipped with the hope that they will find the humanity in the very societies that have dehumanized and traumatized them for centuries. In resistance, they have found within themselves the grace to embrace the oppressor with forgiveness, and in fear, to respond with obedience and compliance to white normativity. Yet, global solidarity among the oppressed fails to materialize.

One would also expect that in times of global communication and social media, social movements and social justice intellectuals across continents would be better able to harness their collective resources in the face of similar structures of domination and subordination.

Even among those who actively fight injustice, many fail to speak up when it does not affect their own group. They even fail, for instance, to claim reparations for the comparable histories of enslaved people, as social movements in the US, Romania, or the Caribbean islands remain divided by identity-defined silos.

And yet, the issue of global solidarity must find the momentum and build on it to work toward a unified movement against injustice across historical and geographical spheres.

The Meaning Of America

Posted on February 17, 2018

When Trump and his followers refer to “America,” what do they mean?

Some see a country of white English-speaking Christians.

Others want a land inhabited by self-seeking individuals free to accumulate as much money and power as possible, who pay taxes only to protect their assets from criminals and foreign aggressors.

Others think mainly about flags, national anthems, pledges of allegiance, military parades, and secure borders.

Trump encourages a combination of all three – tribalism, libertarianism, and loyalty.

But the core of our national identity has not been any of this. It has been found in the ideals we share – political equality, equal opportunity, freedom of speech and of the press, a dedication to open inquiry and truth, and to democracy and the rule of law.

We are not a race. We are not a creed. We are a conviction – that all people are created equal, that people should be judged by the content of their character rather than the color of their skin, and that government should be of the people, by the people, and for the people.

Political scientist Carl Friedrich, comparing Americans to Gallic people, noted that “to be an American is an ideal, while to be a Frenchman is a fact.”

That idealism led Lincoln to proclaim that America might yet be the “last best hope” for humankind. It prompted Emma Lazarus, some two decades later, to welcome to American the world’s “tired, your poor/ Your huddled masses yearning to breathe free.”

It inspired the poems of Walt Whitman and Langston Hughes, and the songs of Woody Guthrie. All turned their love for America into demands that we live up to our ideals. “This land is your land, this land is my land,” sang Guthrie. “Let America be America again,” pleaded Hughes: “The land that never has been yet – / And yet must be – the land where every man is free. / The land that’s mind – the poor man’s, Indian’s, Negro’s, ME –.”

That idealism sought to preserve and protect our democracy – not inundate it with big money, or allow one party or candidate to suppress votes from rivals, or permit a foreign power to intrude on our elections.

It spawned a patriotism that once required all of us take on a fair share of the burdens of keeping America going – paying taxes in full rather than seeking loopholes or squirreling money away in foreign tax shelters, serving in the armed forces or volunteering in our communities rather than relying on others to do the work.

These ideals compelled us to join together for the common good – not pander to bigotry or divisiveness, or fuel racist or religious or ethnic divisions.

The idea of a common good was once widely understood and accepted in America. After all, the U.S. Constitution was designed for “We the people” seeking to “promote the general welfare” – not for “me the narcissist seeking as much wealth and power as possible.”

Yet the common good seems to have disappeared. The phrase is rarely uttered today, not even by commencement speakers and politicians.

There’s growing evidence of its loss – in CEOs who gouge their customers and loot their corporations; Wall Street bankers who defraud their investors; athletes involved in doping scandals; doctors who do unnecessary procedures to collect fatter fees; and film producers and publicists who choose not to see that a powerful movie mogul they depend on is sexually harassing and abusing women.

We see its loss in politicians who take donations from wealthy donors and corporations and then enact laws their patrons want, or shutter the government when they don’t get the partisan results they seek.

And in a president of the United States who has repeatedly lied about important issues, refuses to put his financial holdings into a blind trust and personally profits from his office, and foments racial and ethnic conflict.

This unbridled selfishness, this contempt for the public, this win-at-any-cost mentality, is eroding America.

Without binding notions about right and wrong, only the most unscrupulous get ahead. When it’s all about winning, only the most unprincipled succeed. This is not a society. It’s not even a civilization, because there’s no civility at its core.

If we’re losing our national identity it’s not because we now come in more colors, practice more religions, and speak more languages than we once did.

It is because we are forgetting the real meaning of America – the ideals on which our nation was built. We are losing our sense of the common good.

Ending America’s Disastrous Role In Syria

Posted on February 16, 2018

America’s official narrative has sought to conceal the scale and calamitous consequences of US efforts to overthrow Syrian President Bashar al-Assad. That is understandable, because US efforts are in blatant violation of international law, which bars UN member states from supporting military action to overthrow other members’ governments.

Much of the carnage that has ravaged Syria during the past seven years is due to the actions of the United States and its allies in the Middle East. Now, faced with an alarming risk of a renewed escalation of fighting, it’s time for the United Nations Security Council to step in to end the bloodshed, based on a new framework agreed by the Council’s permanent members.

Here are the basics. In 2011, in the context of the Arab Spring, the US government, in conjunction with the governments of Saudi Arabia, Qatar, Turkey, and Israel, decided to bring down Syrian President Bashar al-Assad’s regime, even though overthrowing another country’s government amounts to a blatant violation of international law. We know that in 2012, if not earlier, President Barack Obama authorized the CIA to work with America’s allies in providing support to rebel forces composed of disaffected Syrians as well as non-Syrian fighters. US policymakers evidently expected Assad to fall quickly, as had occurred with the governments of Tunisia and Egypt in the early months of the Arab Spring.

The Assad regime is led by the minority Alawi Shia sect in a country where Alawites account for just 10% of the population, Sunni Muslims account for 75%, Christians make up 10%, and 5% are others, including Druze. The regional powers behind Assad’s regime include Iran and Russia, which has a naval base on Syria’s Mediterranean coastline.

Whereas America’s goal in seeking to topple Assad was mainly to undercut Iranian and Russian influence, Turkey’s motive was to expand its influence in former Ottoman lands and, more recently, to counter Kurdish ambitions for territorial autonomy, if not statehood, in Syria and Iraq. Saudi Arabia wanted to undermine Iran’s influence in Syria while expanding its own, while Israel, too, aimed to counter Iran, which threatens Israel through Hezbollah in Lebanon, Syria near the Golan Heights, and Hamas in Gaza. Qatar, meanwhile, wanted to bring a Sunni Islamist regime to power.

The armed groups supported by the US and allies since 2011 were assembled under the banner of the Free Syrian Army. In fact, there was no single army, but rather competing armed groups with distinct backers, ideologies, and goals. The fighters ranged from dissident Syrians and autonomy-seeking Kurds to Sunni jihadists backed by Saudi Arabia and Qatar.

While vast resources were devoted to overthrowing Assad, the effort ultimately failed, but not before causing massive bloodshed and displacing millions of Syrians. Many fled to Europe, fomenting Europe’s refugee crisis and a surge in political support for Europe’s anti-immigrant extreme right.

There were four main reasons for the failure to overthrow Assad. First, Assad’s regime had backing among not only Alawites, but also Syrian Christians and other minorities who feared a repressive Sunni Islamist regime. Second, the US-led coalition was countered by Iran and Russia. Third, when a splinter group of jihadists split away to form the Islamic State (ISIS), the US diverted significant resources to defeating it, rather than to toppling Assad. Finally, the anti-Assad forces have been deeply and chronically divided; for example, Turkey is in open conflict with the Kurdish fighters backed by the US.

All of these reasons for failure remain valid today. The war is at a stalemate. Only the bloodshed continues.

America’s official narrative has sought to conceal the scale and calamitous consequences of US efforts – in defiance of international law and the UN Charter – to overthrow Assad. While the US vehemently complains about Russian and Iranian influence in Syria, America and its allies have repeatedly violated Syrian sovereignty. The US government mischaracterizes the war as a civil war among Syrians, rather than a proxy war involving the US, Israel, Russia, Saudi Arabia, Iran, and Qatar.

In July 2017, US President Donald Trump announced the end of CIA support for the Syrian rebels. In practice, though, US engagement continues, though now it is apparently aimed more at weakening Assad than overthrowing him. As part of America’s continued war-making, the Pentagon announced in December that US forces would remain indefinitely in Syria, ostensibly to support anti-Assad rebel forces in areas captured from ISIS, and of course without the assent of the Syrian government.

The war is in fact at risk of a new round of escalation. When Assad’s regime recently attacked anti-Assad rebels, the US coalition launched airstrikes that killed around 100 Syrian troops and an unknown number of Russian fighters. Following this show of force, US Secretary of Defense Jim Mattis disingenuously stated that, “Obviously, we are not getting engaged in the Syrian civil war.” In addition, Israel recently attacked Iranian positions in Syria.

The US and its allies should face reality and accept the persistence of Assad’s regime, despicable as it may be. The UN Security Council, backed by the US, Russia, and the other major powers, should step in with peacekeepers to restore Syrian sovereignty and urgent public services, while blocking attempts at vengeance by the Assad regime against former rebels or their civilian supporters.

Yes, the Assad regime would remain in power, and Iran and Russia would maintain their influence in Syria. But the US official delusion that America can call the shots in Syria by choosing who rules, and with which allies, would end. It’s long past time for a far more realistic approach, in which the Security Council pushes Saudi Arabia, Turkey, Iran, and Israel into a pragmatic peace that ends the bloodshed and allows the Syrian people to resume their lives and livelihoods.

You Must ‘Agitate!’ On Frederick Douglass’ 200th Birthday

Posted on February 14, 2018

A few weeks before his death, 77-year-old Frederick Douglass was asked what advice he would give to a young black American.

“Agitate! Agitate! Agitate!” was his reply.

This pioneer of civil rights lived long enough to die of a heart attack in his old age, a heroic feat in and of itself for a former slave. Douglass was born on Maryland’s Eastern Shore 200 years ago today, Feb. 14, and it is my belief that he went on to become the greatest Marylander to have ever lived. His accomplishments would stand out in any era, but when put in the context of Douglass’ having been a former slave, he was the epitome of what we call “black excellence” today.

Douglass was a banker, a lawyer, an abolitionist, an escaped slave, the most-photographed American of the 19th century, and a leader who would help hold America together as a civil war threatened to tear it apart.

He had the courage to stand up for women’s rights, Native American rights, and immigrant rights even as his own rights were still being denied.

When Douglass attended the Seneca Falls Convention in 1848, he was the only African American to do so. As collected members voiced opposition to female suffrage, he admonished them, saying: “In the denial of the right to participate in government, not merely the degradation of woman and the perpetuation of a great injustice happens, but the maiming and repudiation of one-half of the moral and intellectual power of the government of the world.”

He said he would find himself unable to accept the right to vote as a black man if women could not also claim that right, tying the struggle for his right to vote to that of female suffrage, a unifying vision of universal suffrage rather than one that pitted two marginalized groups against one another.

Douglass also spoke out against the Chinese Exclusion Act, which was the first law to explicitly prevent a specific ethnic group from immigrating to the United States.

In opposition Douglass said:

“Our geographical position, our relation to the outside world, our fundamental principles of government, world-embracing in their scope and character, our vast resources, requiring all manner of labor to develop them, and our already existing composite population, all conspire to one grand end, and that is, to make us the perfect national illustration of the unity and dignity of the human family that the world has ever seen.”

As we celebrate Douglass’ 200th birthday, his legacy endures in the faces of all those who continue to agitate, agitate, agitate in pursuit of a more just and fair America. Douglass’ influence was in the actions of lawyers who flocked to American airports to help immigrants caught in Donald Trump’s Muslim ban. We saw it in the marchers who descended upon Charlottesville , Va., to say no to the Ku Klux Klan, and in the voices of all those who participated in last year’s Women’s March to agitate against the election of a man who bragged about sexually assaulting women.

Throughout my career as a civil rights leader and community organizer, I’ve often thought of Douglass and tried to mirror his example. Essentially, at his core, Douglass was an organizer and a believer in building big broad coalitions for change. I was fortunate enough to be named Marylander of the Year in 2012, because as president and CEO of the NAACP, I helped lead a historic effort to abolish the death penalty, achieve marriage equality and pass the Maryland DREAM Act all in one year. When skeptics doubted if immigrants, LGBT and civil rights groups could all come together and advance at once, I thought of Douglass’ courage and worked to help fashion the type of coalition he described as “the perfect national illustration of the unity and dignity of the human family the world has ever seen.”

His refusal to see opportunity and justice as a zero-sum game gives us a road map for every struggle for equality since. When we act as if only one group has the ability to gain power or that the success of other oppressed groups comes at the price of another, we allow ourselves to be pitted against those who would ally with us to ensure justice for all.

This Valentine’s Day and in honor of his birthday, let’s remember Douglass’ advice to agitate in the face of injustice and his courage in saying we are stronger when we act as one.

Supporting Bill To Fund Veteran Treatment Courts In Hawaii And Nationwide

Posted on February 13, 2018

Rep. Tulsi Gabbard (HI-02), co-chair of the Congressional Post 9/11 Veterans Caucus, announced support today for bipartisan legislation to authorize federal funding for veteran treatment courts in Hawaii and across the United States.

The Veteran Treatment Court Coordination Act (H.R. 4345) would provide federal grants to state, local, and tribal governments to establish new veteran treatment courts and maintain current programs, like the Big Island Veterans Treatment Court. More than 15,000 veterans nationwide have received support through veteran treatment courts.

Congresswoman Tulsi Gabbard said: “In Hawaii and across the country, veteran treatment courts are helping veterans who are dealing with substance addiction and have committed nonviolent crimes get treatment and get their lives back on track. Through high-intensity supervision and a network of support that includes veteran-to-veteran mentorship, job and housing support, employment assistance, treatment and counseling, and more, veteran treatment courts are ensuring that they get the care and services needed to heal, and putting them on a path to success. I’ve met veterans in Hawai‘i who have graduated from this program, and who tearfully share how this program has literally saved their lives. This legislation is an example of some of the long overdue reforms needed in our criminal justice system, and honors our veterans and their sacrifice by providing them with the care and treatment they need.”

Background: The Veteran Treatment Court Coordination Act of 2017 establishes a program within the Department of Justice to provide grants, training, and technical assistance to help state, local, and tribal governments maintain existing veterans treatment courts. The bipartisan legislation also provides federal resources for the establishment of new treatment courts.

H.R. 4345, the Veteran Treatment Court Coordination Act of 2017 is endorsed by numerous servicemembers and veterans organizations including American Legion, AMVETS, Disabled American Veterans, National Military & Veterans Alliance, American Logistics Association, American Military Retirees Association, American Military Society, American and Navy Union of the USA, American Retiree Association, Association of the US Navy, Military Order of Foreign Wars Military Order of the Purple Heart, Military Order of World Wars, Tragedy Assistance Program for Survivors, The Flag, and General Officers Network, The Independence Fund, The Retired Enlisted Association, Society of Military Widows, Vietnam Veterans of America.

The World Bank Needs To Return To Its Mission

Posted on February 9, 2018

The World Bank declares that its mission is to end extreme poverty within a generation and to boost shared prosperity. These goals are universally agreed as part of the Sustainable Development Goals. But the World Bank lacks an SDG strategy, and now it is turning to Wall Street to please its political masters in Washington. The Bank’s president, Jim Yong Kim, should find a better way forward, and he can do so by revisiting one of his own great successes.

Kim and I worked closely together from 2000 to 2005, to scale up the world’s response to the AIDS epidemic. Partners in Health, the NGO led by Kim and his colleague, Harvard University’s Paul Farmer, had used antiretroviral medicines (ARVs) to treat around 1,000 impoverished HIV-infected rural residents in Haiti, and had restored them to health and hope.

I pointed out to Kim and Farmer 18 years ago that their success in Haiti could be expanded to reach millions of people at low cost and with very high social benefits. I recommended a new multilateral funding mechanism, a global fund, to fight AIDS, and a new funding effort by the United States.

In early 2001, UN Secretary-General Kofi Annan launched the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and in 2003 US President George W. Bush launched the PEPFAR program. The World Health Organization, led by the Director-General Gro Harlem Brundtland, recruited Kim to lead the WHO’s scale-up effort. Kim did a fantastic job, and his efforts provided the groundwork for bringing ARVs to millions, saving lives, livelihoods, and families.

There are four lessons of that great success. First, the private sector was an important partner, by offering patent-protected drugs at production cost. Drug companies eschewed profits in the poorest countries out of decency and for the sake of their reputations. They recognized that patent rights, if exercised to excess, would be a death warrant for millions of poor people.

Second, the effort was supported by private philanthropy, led by Bill Gates, who inspired others to contribute as well. The Bill & Melinda Gates Foundation backed the new Global Fund, the WHO, and the Commission on Macroeconomics and Health, which I led for the WHO in 2000-2001 (and which successfully campaigned for increased donor funding to fight AIDS and other killer diseases).

Third, the funding to fight AIDS took the form of outright grants, not Wall Street loans. Fighting AIDS in poor countries was not viewed as a revenue-generating investment needing fancy financial engineering. It was regarded as a vital public good that required philanthropists and high-income countries to fund life-saving treatment for poor and dying people.

Fourth, trained public health specialists led the entire effort, with Kim and Farmer serving as models of professionalism and rectitude. The Global Fund does not stuff the pockets of corrupt ministers, or trade funding for oil concessions or arms deals. The Global Fund applies rigorous, technical standards of public health, and holds recipient countries accountable – including through transparency and co-financing requirements – for delivering services.

The World Bank needs to return to its mission. The SDGs call for, among other things, ending extreme poverty and hunger, instituting universal health coverage, and universal primary and upper secondary education by 2030. But, despite making only slow progress toward these goals, the Bank shows no alarm or strategy to help get the SDGs on track for 2030. On the contrary, rather than embrace the SDGs, the Bank is practically mute, and its officials have even been heard to mutter negatively about them in the corridors of power.

Perhaps US President Donald Trump doesn’t want to hear about his government’s responsibilities vis-à-vis the SDGs. But it is Kim’s job to remind him and the US Congress of those obligations – and that it was a Republican president, George W. Bush who creatively and successfully pursued the battle against AIDS.

Wall Street may help to structure the financing of large-scale renewable energy projects, public transport, highways, and other infrastructure that can pay its way with tolls and user fees. A World Bank-Wall Street partnership could help to ensure that such projects are environmentally sound and fair to the affected communities. That would be all for the good.

Yet such projects, designed for profit or at least direct cost recovery, are not even remotely sufficient to end extreme poverty. Poor countries need grants, not loans, for basic needs like health and education. Kim should draw on his experience as the global health champion who successfully battled against AIDS, rather than embracing an approach that would only bury poor countries in debt. We need the World Bank’s voice and strenuous efforts to mobilize grant financing for the SDGs.

Health care for the poor requires systematic training and deployment of community health workers, diagnostics, medicines, and information systems. Education for the poor requires trained teachers, safe and modern classrooms, and connectivity to other schools and to online curricula. These SDGs can be achieved, but only if there is a clear strategy, grant financing, and clear delivery mechanisms. The World Bank should develop the expertise to help donors and recipient governments make these programs work. Kim knows just how to do this, from his own experience.

Trump and other world leaders are personally accountable for the SDGs. They need to do vastly more. So, too, do the world’s super-rich, whose degree of wealth is historically unprecedented. The super-rich have received round after round of tax cuts and special tax breaks, easy credits from central banks, and exceptional gains from technologies that are boosting profits while lowering unskilled workers’ wages. Even with stock markets’ recent softness, the world’s 2000+ billionaires have around $10 trillion in wealth – enough to fund fully the incremental effort needed to end extreme poverty, if the governments also do their part.

When going to Wall Street, or Davos, or other centers of wealth, the World Bank should inspire the billionaires to put their surging wealth into personal philanthropy to support the SDGs. Bill Gates is doing this, with historic results, for public health. Which billionaires will champion the SDGs for education, renewable energy, fresh water and sanitation, and sustainable agriculture? With a clear SDG plan, the World Bank would find partners to help it fulfill its core, historic, and vital mission.