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Anticapitalist Meetup: “Separate but Equal” Shuts Down Women’s Health Care by TPau

3:40 pm in Uncategorized by Anti-Capitalist Meetup

This week has a certain nostalgia for me. I am working the last four shifts in my home, Humboldt County. Nestled between pristine redwoods and dramatic cliffs overlooking the west coast of California, I want to stay here, but cannot. I am feeling the full force of the United States health care crisis. In the four years I have worked here eight of ten obstetricians in the southern half of the county have left, and now I find I am one of them.

Two obstetricians, far apart geographically and serving two different hospitals, are all that is left to serve an area once supporting 10 obstetricians. Both doctors are men over 60, who have a tough future ahead of them. Without outside help there is no way they can see all the patients that will need them. They have to remain within 30 minutes of the hospital and can be told to come to work any time of the day or night. They can never have a moment off, a full night’s sleep, a drink of alcohol to ring in the New Year. Watching a full length movie, or having a nice dinner with the spouse without interruption is a thing of the past. Neither of the remaining doctors can get sick or injured. This is really asking them to be super human and there is no cavalry on their horizon. In fact, if Catholic Health Systems is successful at closing one of the two hospitals, only one physician will remain.

As a young person, I wanted to take my medical skills to a disadvantaged third world nation. Looks like I got my wish—right here in the US. How did we get here?

Humboldt County illustrates many of the ills, both old and new, this broken system imposes on the citizens, and particularly the women, of the US. To really see the complexity, you have to look at all the levels putting pressure on this shattered system.

National:

If you were listening to American propaganda news casts last week, you heard the Affordable Health Care Act (ACA) or “Obamacare” shut down thousands of private health insurance plans and that President Obama lied when he made the campaign promise, “If you like your health care plan, you can keep it.”

The standard set by the ACA was so low any real health insurance plan could have stumbled over it dead drunk and in the dark. So why are some of the plans failing?

For decades, the health care system in America has been plagued with “Junk Insurance.” These are plans that call themselves insurance, but if someone on the plan actually got sick, the insurance would not cover anything. Companies get away with this, because all health insurance contracts read like real estate derivative scams; they are so complicated, no one can understand them. It is not legally fraud. The customer signs a contract that does actually say they won’t get coverage for their heart attack, stroke, appendicitis, car accident, etc. It says it in fine print, in ways no one is intended to decipher.

People enrolled in these plans pay monthly premiums that are slightly less than real insurance, believing they have a great deal. Sales people, who “explain” the plan to them, give them that impression. But should they actually become ill or have an accident, they quickly find their premiums were wasted. They have been duped into believing they actually bought something. The truth is, those people would have been better off uninsured than paying premiums for years for no real benefit.

Even if you had real insurance you are a victim of this sort of scam. As junk insurance became more profitable, legitimate insurance companies found they could cover fewer and fewer benefits for the same price. It has created a race to the benefit bottom.

So the Affordable Care Act got rid of all those types of insurance, right? Wrong. The ACA apparently was never meant to stop scam insurance. Those plans were still operating even before the President caved in to media pressure and allowed new fraudulent insurance plans to continue. You might even be enrolled in one right now. Turns out I am.

When my adult daughter, who is getting a graduate degree and still on my insurance, hedged at going to the doctor for a check up this year, I proudly told her that she need not worry. The Affordable Care Act guaranteed that as of August 1, she could go for her annual, get her birth control and her immunizations for free.

15 Covered Preventive Services for Adults
1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
2. Alcohol Misuse screening and counseling
3. Aspirin use for men and women of certain ages
4. Blood Pressure screening for all adults
5. Cholesterol screening for adults of certain ages or at higher risk
6. Colorectal Cancer screening for adults over 50
7. Depression screening for adults
8. Type 2 Diabetes screening for adults with high blood pressure
9. Diet counseling for adults at higher risk for chronic disease
10. HIV screening for all adults at higher risk
11. Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
Hepatitis A
Hepatitis B
Herpes Zoster
Human Papillomavirus
Influenza (Flu Shot)
Measles, Mumps, Rubella
Meningococcal
Pneumococcal
Tetanus, Diphtheria, Pertussis
Varicella
Learn more about immunizations and see the latest vaccine schedules.
12. Obesity screening and counseling for all adults
13. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
14. Tobacco Use screening for all adults and cessation interventions for tobacco users
15. Syphilis screening for all adults at higher risk

22 Covered Preventive Services for Women, Including Pregnant Women
The eight new prevention-related health services marked with an asterisk ( * ) must be covered with no cost-sharing in plan years starting on or after August 1, 2012.
1. Anemia screening on a routine basis for pregnant women
2. Bacteriuria urinary tract or other infection screening for pregnant women
3. BRCA counseling about genetic testing for women at higher risk
4. Breast Cancer Mammography screenings every 1 to 2 years for women over 40
5. Breast Cancer Chemoprevention counseling for women at higher risk
6. Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women*
7. Cervical Cancer screening for sexually active women
8. Chlamydia Infection screening for younger women and other women at higher risk
9. Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, not including abortifacient drugs*
10. Domestic and interpersonal violence screening and counseling for all women*
11. Folic Acid supplements for women who may become pregnant
12. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes*
13. Gonorrhea screening for all women at higher risk
14. Hepatitis B screening for pregnant women at their first prenatal visit
15. Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
16. Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older*
17. Osteoporosis screening for women over age 60 depending on risk factors
18. Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
19. Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
20. Sexually Transmitted Infections (STI) counseling for sexually active women*
21. Syphilis screening for all pregnant women or other women at increased risk
22. Well-woman visits to obtain recommended preventive services*
Learn more about Affordable Care Act Rules on Expanding Access to Preventive Services for Women.
(Effective August 1, 2012)

26 Covered Preventive Services for Children
1. Alcohol and Drug Use assessments for adolescents
2. Autism screening for children at 18 and 24 months
3. Behavioral assessments for children of all ages
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
4. Blood Pressure screening for children
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
5. Cervical Dysplasia screening for sexually active females
6. Congenital Hypothyroidism screening for newborns
7. Depression screening for adolescents
8. Developmental screening for children under age 3, and surveillance throughout childhood
9. Dyslipidemia screening for children at higher risk of lipid disorders
Ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
10. Fluoride Chemoprevention supplements for children without fluoride in their water source
11. Gonorrhea preventive medication for the eyes of all newborns
12. Hearing screening for all newborns
13. Height, Weight and Body Mass Index measurements for children
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
14. Hematocrit or Hemoglobin screening for children
15. Hemoglobinopathies or sickle cell screening for newborns
16. HIV screening for adolescents at higher risk
17. Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
Diphtheria, Tetanus, Pertussis
Haemophilus influenzae type b
Hepatitis A
Hepatitis B
Human Papillomavirus
Inactivated Poliovirus
Influenza (Flu Shot)
Measles, Mumps, Rubella
Meningococcal
Pneumococcal
Rotavirus
Varicella
Learn more about immunizations and see the latest vaccine schedules.
18. Iron supplements for children ages 6 to 12 months at risk for anemia
19. Lead screening for children at risk of exposure
20. Medical History for all children throughout development
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
21. Obesity screening and counseling
22. Oral Health risk assessment for young children
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
23. Phenylketonuria (PKU) screening for this genetic disorder in newborns
24. Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
25. Tuberculin testing for children at higher risk of tuberculosis
Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
26. Vision screening for all children

Health and Human Service

I was flabbergasted when she was actually charged for all those things in October of this year—long before the media ganged up on the President. I called Aetna, my insurance carrier, sure there had been some error. I was told it was no error, and if I had questions, I should contact the state. Since my employer is in South Carolina, I had to contact the insurance board for that state. Here is my conversation with the board:

Rosa Rivers
Senior Insurance Regulatory Analyst
Consumer Service Division

You requested clarification on the ACA law in regards to contraceptive and immunizations. A grandfathered health plan isn’t required to comply with some of the consumer protections of the Affordable Care Act that apply to other health plans that are not grandfathered.  If you have health coverage from a plan that existed on March 23, 2010 — and that has covered at least one person continuously from that day forward — your plan may be considered a “grandfathered” plan.

If your plan is a grandfathered plan it is not required to provide certain recommended preventive services at no additional charge to you.  This would include charges for contraceptives.  This would be the only reason the company is not paying for contraceptives.

The above also applies, but also the ACA requires coverage on vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) prior to September 2009 with no co-payments or other cost-sharing requirements when those services are delivered by an in-network provider.  The immunization vaccine you listed in your email is not on the recommended list. [Note from author: This is an inaccurate statement. HPV vaccine is covered. See the lists above.]

Sincerely
Rosa Rivers

TP: When can I expect the health care plan to cover contraception if it is “grandfathered?”

Rosa: There is no specific end date for grandfathered status.   When a company significantly alters its a health plan it can cause the plan to lose its grandfathered status.  Companies must send out notices advising if the plan is grandfathered or has lose its grandfathered status.

In other words, insurance that didn’t really insure anything, could seek “grandfather status” and completely ignore the ACA rules, as long as the insurance was created before the ACA went into effect August 1, the policy didn’t change too much after that, and they had at least 1 person enrolled.

So Obama went to extremes to honor his promise that you could keep your insurance, even to the point of giving insurers a way to keep junk insurance going indefinitely. Due to the grandfather clause, the ACA didn’t really guarantee Americans they would actually get anything out of their insurance. But, it did demand that its citizens enroll in something calling itself “health insurance” by the end of the year, delivering thousands of paying customers to the insurance companies and guaranteeing tax subsidies to these companies.

Even these concessions were not enough. People on these plans do eventually become ill, and realize they have been duped and drop the insurance. Or they complain to their employer that the insurance is worthless. So these plans must periodically shut down, change their names and enroll (fool) a new crop of customers. They needed to create “new” junk insurance plans every year. What the insurance companies are complaining about is that junk insurance plans created after August 1, or who did not go through the grandfathering process, will not be allowed to continue after January 1.

The real lie here is being perpetrated by Aetna, Blue Cross and Goldman Sachs (yep, they are in this too) and a host of other insurers who lead people to believe their premiums are going to cover a future health care crisis, which they will clearly never do. In fact, they are the ones who have been lying about their products for decades.
 
What these companies are peddling does not deserve to be called “health insurance” at all. They are the ones that should be held to account here, not the President. These plans don’t deserve to be “grandfathered,” rescued by the President or Congress, or supported by the Clintons. These plans deserve to die.

So what does this mean to the people of Humboldt county and thousands of other rural communities across the U.S? ACA will still support under insurance and high deductible insurance. That means people are sicker when they finally seek help, and they are still at risk for medical bankruptcy. In bankruptcy, or just nonpayment, it is the hospitals, labs and health care providers who foot the bill because they have already provided the service and won’t get paid.

Woman’s health care is hit the hardest by this betrayal. Supposedly, one of the hard won benefits of the ACA was the end of “separate but equal” health care for women. Women and men get charged the same or women get charged more for their health care, but cannot find health care that supports contraception and obstetric services. The grandfather clause, Obama’ s cave in to religious groups on birth control and abortion, and now his reversal on scam insurance means women will still face a barrage of insurance that does not cover their medical needs. Women will have to come out of pocket for these needs. That means more nonpayment for these services for doctors and hospitals and more pressure to decrease these services.

Finally, there is Medicare. Medicare reimburses gynecologic procedures at a rate of about 1/3 what is paid for similar skill level and time as other services, reinforcing the “separate but equal” health care system for women in this country. Those inequities fly below the radar and no one is even offering to fix that.

State:

Medicaid (state insurance for the poor) pays doctors very poorly in general. In California, it reimburses Gynecology less than it costs to provide the care. It pays a barely adequate amount for Obstetrics. Most obstetric patients have Medicaid because they are young and have not had time to establish themselves financially. Commercial insurance, conversely, pays well for gynecology and poorly or not at all for obstetrics.

In California, the playing field for doctors is uneven. The more established doctors in town are getting three times as much for every Medicaid patient, due to previous programs the state offered to rural doctors that new doctors cannot enter. When I came to Humboldt, I had to compete with these more established practices while getting lower rates for everything I did with Medicaid patients (about half of my practice). I did this by joining a large group. But when all the other doctors in the group moved or retired, I found myself having to pay all the overhead on my own. One of the ways I survived was to stop seeing obstetrics and Medicaid patients. This shifted my patients to gynecology with commercial insurance—the highest reimbursement profile. It allowed me to continue practicing for six months and gave my staff time to find work elsewhere. But it also decreased the physicians seeing obstetrics in town by one.

Multiple times the state has voted to open Medicaid to all the state citizens. This may have leveled the playing field and increased the reimbursement to doctors and hospitals because Medicaid would have had more funding. Right now, Medicaid in most states covers more than most insurance and could be provided to a state’s citizens for less than commercial insurance. Unfortunately, the law the people voted for was vetoed by the Governor each time.

County:

Santa Rosa, Ukiah, and Crescent City, cities in other counties surrounding Humboldt, are also recruiting for obstetrics for similar reasons. At least in our area, the crisis is wide spread. Santa Rosa can afford to pay more and clearly offers bigger practices and more city. It is likely to divert candidates from the smaller hospitals.

Humboldt and the surrounding counties are finding it very difficult to recruit, because reimbursement is so poor. With 50% Medicaid, a new physician may not be able to meet overhead demands. They could make more on Medicaid if they joined an existing practice with their special reimbursement rates, but the two surviving practices in Humboldt both have issues. Catholic Health Systems is considering closing the obstetrics ward in the southern half of the county, where one of the practices is based. The other practice is headed by a person who has a history of multiple partnership rifts. Catholic Health Systems could recruit into their own clinics, which also have a higher reimbursement, but this would mean the new doctor could not prescribe ANY birth control, further limiting birth control availability within the county. They have already interviewed a candidate for a position in that clinic.

Catholic Health Systems made a bid for Crescent City hospital. Crescent City is suffering its own lack of obstetric services. If the Catholics did buy Crescent City’s hospital, that would stop sterilizations in all hospitals along the Northern Coast of California except for the one small hospital in the north end of Humboldt that remains secular. Doctors from other cities along the coast would have to leave their practice area to do sterilizations on their patients in Northern Humboldt. Something they cannot do without partners to cover their practices in their absence.

Then there is a question about what the Catholics would do with Crescent City’s labor and delivery unit. Would it close that obstetric unit as it threatens to do with the labor and delivery unit at the southern end of Humboldt County? How far is too far to drive in labor?

This situation could be helped by a county-run health system. After all, the Health Department is county run. It’s not such a stretch to expand the Health Department’s responsibilities to meet the health needs of all the inhabitants of a county if they can not be met by commercial and private industry. I tried to set up a county run health care system in Arizona eight years ago and then network the various counties to provide care throughout the state. This is how universal health care in Europe first got started in the early 1900’s. Unfortunately, I discovered there is a federal law preventing counties from doing just that, because it would compete with commercial insurance. The federal law has never been tested and in the age of ACA, might be outdated. I would love to see a movement to organize single payer health care, county by county, in this country and right now, that might be the best solution.

Hospital:

As I mentioned earlier, Medicaid is the biggest payer of obstetric services in the rural sector. Although it pays physicians adequately for obstetric care, it pays hospitals poorly. Hospitals can only break even on obstetrics if they do very large volume or are in an affluent area where Medicaid is not such an issue. All the rural hospitals I have served lose money on obstetrics and that makes it the lowest service on the totem pole. Obstetrics is the last to get new equipment, always runs lean on staffing and is the last for recruitment. Right now, the staffing in Humboldt’s obstetrics wards is so sparse, the nurses are calling around to beg other nurses to come in and work, every time I am on call. The last time I was on the ward, a nurse actually broke into tears on the phone to one of her colleagues begging her to come in and help.

If this was any other type of business, the solution would be to close the department that wasn’t making any money and consolidate the work into another department. And Catholic Health Systems is considering doing just that. They are trying to close the obstetrics ward in the southern half of the county and force women to drive the extra 20 miles to the middle of the county. Unlike other nations, there are no rules or laws to prevent Catholic Health System from closing a ward and limiting access.

In fact, because our health care is own by private for profit interests, closing obstetrics at BOTH hospitals and letting obstetrics patients find their own solution outside of the hospital system is not out of the question. Only strong public objection and the communities withdraw of charitable contributions has stopped Catholic Health Systems from closing the southern obstetrics ward so far.

Health Care Provider:

My case illustrates the difficulties of making a living at this profession. I am not the first doctor to be driven out by financial difficulties. It is also not the first time for me to leave an area due to the financial collapse of a group. This is a recurring story in all of rural America for Obstetricians. My troubles started back in Arizona when my group adopted Electronic Med Records (EMR).

One of the first elements of the ACA to go into effect was the requirement for doctors and hospitals to use EMR. Technology that is marketed naturally, has to be convenient and useful so people will buy it. If the government forces you to buy something, there is no pressure on the manufacturer to make it work for the user whether it is a computer program or a health insurance plan.

The ACA asked doctors to invest in technology that was unproven, expensive, and takes about 2 to 5 times as long per patient as pen and paper. It is the poster child for inappropriate technology. Additionally, it is prone to errors and has a terrible safety profile. Orders are incorrect more often than pen and paper, they end up on the wrong patients, and labs get missed due to the difficult to read screens.

My former group in Arizona went under due to EMR and the expense and slow down in seeing patients that came from the conversion. The company that sold the program to us went out of business and so we invested in a $250,000 program that became junk after the company folded, taking our patient records with it into oblivion. It was a disaster we never quite recovered from and eventually I took the new job in Humboldt, only to find the older physicians in the practice unwilling to commit finances to EMR. One by one they retired, rather than invest in the available systems, or take the decrease in compensation Medicare and Medicaid threatened if we did not convert, leaving me without partners to share costs.

If EMR does not make health care cheaper or more safe, one might wonder why the government was so hot to trot to convert all the US to these untried software programs. One of the main requirements of the EMR programs is that they are able to provide the government with statistical information. That, in and of itself, is not concerning and might actually be useful to track types of care that decreases disease over large populations. But remember, this is a government that colluded with corporations to collect huge volumes of information on everyday people illegally. And then lied to Congress about it. A few months ago, I became much more concerned about the data collection EMR is performing.

Women of Humboldt County:

This all filters down to women in Humboldt and the rest of rural America. Routine care is likely to be delivered by a less specialized provider—Midwives and Family Medicine physicians. The remaining obstetricians in Humboldt have both hired multiple midwives to assist them. This is probably alright, as these providers are qualified to give routine care and they do spend more time with patients. Patients requiring a more specialized level of care are going to have little or no choice about who provides the care and their visit will be crammed into a schedule that is already too full.

Birth control remains an issue. The only place offering sterilization is one small hospital in the north end of the county. Even though some of the doctors have privileges to do sterilizations in the north, the doctors who are left might not have coverage for their practice in order to get away and do their sterilizations in the North.

It also puts into question quality issues. Recently, lactation (breast feeding) counseling and home health visits for new mothers have been cut and I think other very good programs will also be cut soon. The nurses and physicians who are left are not enough. They are being run ragged. Patients who need a critical level of care will soon face a doctor and a nurse who are much more stressed and less supported than previously.

Patients in the South end of the county could be facing the closure of their obstetrics ward and a longer drive in labor, or in an emergency, putting them at increased risk. I think it is a matter of time until disaster happens.

And for all that chaos, I would stay if I could. I like it here. I like the people and the family of bears that live in my neighborhood. I love the calm of the redwoods and the moodiness of the ocean. But, financially, I’m beaten. I have been working 2-3 jobs to recover. Next year, I am moving to Washington State, and starting over . . . again.

One Economy under God by T’Pau

4:20 pm in Uncategorized by Anti-Capitalist Meetup

Has it occurred to you how strange it is that your job can slip across international boundaries, but you are prohibited from crossing the same border to follow that job? It should.

Multinational Corporations have been busy for the last twenty years creating a new type of serf. In feudal Europe and Asia, serfs were tied to the land by a master, called the lord, and obligated to work for him. Now, the 1% are creating serfs out of whole nations of people. Sure, those lands are huge—nations—but they are still boundaries that bind you, and prevent you for selling your work freely, while multinational corporations are borderless entities.

Seeking to continue the tail spin to the bottom of wages, big business has been busy writing international treaties, allowing jobs to shift to ever lower paying environments with the least protections for workers. Australia, Brunei, Chile, Malaysia, New Zealand, Peru, Singapore, United States, and Vietnam are already involved in the latest negotiations, the Trans-Pacific Partnership. If signed the treaty will be a “docking agreement” open to any country to sign later. Canada and Mexico are expected to join this month. Japan and China are being courted to join. It is the largest trade agreement the world has ever seen.

The treaty creates an über-government superseding and overriding existing law in sovereign nations–seeking to stamp out democracy. In old feudalism, it was the Catholic church that held dominion over the nations of man. Now “the market” has taken the place of God. Profits are all that matters. Anything the market endorses is right because the market is infallible, unchallengeable. Keep democracy out of it.

The powerful and wealthy have finally found a way to regain the power they once held in feudal times. They have done it in ways intentionally hidden from the majority. Most of us don’t even realize we are in a battle for the type of global governance we will have in the future. For the last 50 years corporate leadership have simply bought our democracies and media outlets, making it easy for corporations to gain the upper hand, and convince voters to support governance that is secretive and totalitarian, without letting voters know they are doing so. Now the 1% want to solidify that power into an actual international treaty. They are seeking one economy under the rule of American corporations. They are, in fact, seeking world dominion.

The Cost of NAFTA

In 1993, the North American Free Trade Agreement (NAFTA) was sold to the American public with grand promises. NAFTA would create tens of
thousands of good jobs here. U.S. farmers would export their way to
wealth. NAFTA would bring Mexico’s standard of living up, providing
new economic opportunities there that would reduce immigration to the
U.S.–Public Citizen

NAFTA was the opening salvo for the economy of outsourcing. Instead of focusing on reducing tariffs and trade quotas, NAFTA was a new breed of trade agreements. It protected the rights of foreign investors—even over the rights of the people in democratic countries.

Now, 19 years after NAFTA, most of us can clearly see the benefits touted to the
American worker never materialized. Instead of creating jobs, free trade agreements slashed wages and jobs on both sides of national borders. Investors used NAFTA’s new protections to move US operations to Mexico, where wages were lower and regulations lax. This skyrocketed the US trade deficit and unemployment. Since NAFTA, one in four manufacturing jobs in the US has eroded away, more than a million jobs lost.

Even for the jobs left in the US, the race to the bottom was on. The workers, who still had jobs, felt pressure from the growing number of jobless to accept poorer benefits and, finally, lower wages. NAFTA gutted worker unions, leaving workers without protections from downward pressure on their wages. Decreased income, means decreased tax base, and decreased ability to pay mortgage payments, adding fuel to the housing crisis. This deprived state funded social services, like schools and road repair, eroding local safety nets just when people needed them most.At the same time NAFTA allowed companies to off shored their production, it also allowed those same companies to bring goods and services back into the US duty (tariff) free–thus the “free” in free trade. The end result was increased worker productivity that was rewarded with lower wages, no safety net, and a smaller share of the wealth of the nation, resulting in the redistribution of wealth to the upper 1%. The pro-NAFTA Peterson Institute for International Economics estimated that 39% of the wage inequity that developed during this time was due to trends in international trade. Even with the cheaper goods on Walmart shelves, US workers are worse off with the wage decreases they have suffered.

Bad for American workers, the agreement was a disaster for Latin Americans. NAFTA duped Mexico, the same way Walmart duped the rest of America. It promised more jobs to Latin American countries if they would give foreign investors a tax break. Local businesses were put at an economic disadvantage by this unequal taxation. Instead of bringing new jobs, foreign corporations merely shifted jobs from local companies to foreign companies. This lead to a large share of profits going off shore, destabilizing Latin American economies. Additionally, NAFTA was used to extract $325 million from member countries in tribunals that overturned already frail environmental laws and labor protections.

Mexican markets were flooded with US taxpayer subsidized corn and wheat products. The subsidized products were priced below what it costs to actually grow these commodities due to the US tax money given to industrial producers of wheat and corn. The price paid for a bushel of corn to a small Mexican farmer, campesino, fell by 50%. Yet the price of tortillas actually increased 279%, leading to food riots in Mexico. The real value of Mexican minimum wage fell by 20%, and the number of families in need of food assistance increased by 50%. Yet, every attempt the Mexican government made to preserve jobs was met with judicial challenges by corporations whose investors are “wronged” by such favoritism of the government. Mexico is now on the verge of becoming a failed state. Migration to the north, due to this social collapse, increased 60% in the years after NAFTA. The massive influx of Latin American workers into the US (undocumented workers up 185%) cycled around to put further downward pressure on US worker wages.

Public Citizen: NAFTA’s Broken Promises

Obama and Free Trade

Leaked drafts of the agreement “sent shock waves through Congress because it showed that U.S. negotiators had totally abandoned Obama’s campaign pledges to replace the old NAFTA trade model and in fact were doubling down and expanding the very Bush-style deal that Obama campaigned against in 2008 to win key swing states.” –Lori Wallach, Public Citizen Global Trade Watch

Obama campaigned against NAFTA and used his stance on NAFTA in his bid for the presidency in 2008, saying it was time to rewrite our trade agreements to something that would create jobs. After his election, he dusted off the free trade deals, Bush could not get through Congress, and became their champion.

Obama also called for congressional passage of three controversial free trade pacts, stating “It’s time to clear the way for a series of trade agreements that would make it easier for American companies to sell their products in Panama, Colombia and South Korea.” –Between the Lines

All these deals made it past the Republican dominated Congress. Obama even touted this as a success in the recent debates. Despite his assertion that the deals bolstered US exports, the governments own figures show a widening of the trade deficit by 29% over 2011 levels, dragging down jobs with it. Estimates are that 50,000 jobs were lost in the first few
months of the trade deals. The promised controls over laws in South America have not materialized either—Panama is still a tax haven and Columbia is still the most dangerous place in the world to be a labor leader.

AFL-CIO President, Richard Trumka, has warned that a free trade agreement with South Korea will cost U.S. workers 159,000 jobs, while a deal with Colombia will cost 54,000 jobs. — Between the Lines

After the election, Obama called for a stop to Trans-Pacific Partnership (TPP) negotiations for a “period of reflection.” That reflection never came. The negotiations continued, and Obama’s stance shifted, possibly due to worsening recession—with the thought that the trade agreement would increase jobs. This is nonsense, of course, but many of his advisers supported NAFTA in the Clinton era.

CWA Chief of Staff Ron Collins said, “The TPP is shaping up to become one of the biggest and most destructive trade agreements because it could lead to even more offshoring of our manufacturing and service sector jobs, downward pressure on wages and benefits, and the subversion of our labor rights and environmental protections. But the public is unaware that the TPP even exists because negotiators are keeping their proposals hidden. Americans deserve the right to know what’s being proposed in our names.” –Communications Workers of America


At the time that NAFTA was being negotiated, the full text of the agreement was available on line. This led to a firestorm of controversy—not that the demonstrations against NAFTA had any effect. The agreement was still passed by the Clinton administration.

With NAFTA, jobs went to lower paid Mexico. Other free trade agreements saw jobs flee from Mexico to China. Now, big business feels Chinese workers are being paid too much and have too many protections! They want to move jobs to Vietnam and Malaysia. Labor unions and opposition political parities are illegal in Vietnam
making it the new bottom for low paid, exploited workers.

ACLU has called TPP one of the biggest threats to free speech that nobody knows about. Almost every environmental group and most worker unions have come out against the agreement. Even the Tea Pary is largely against both NAFTA and TPP. Unfortunately, Tea Party candidates usually vote for free trade once in
Congress.

Globalization leaders apparently learned a lesson from their ordeal with NAFTA. While Obama’s trade negotiator, Ron Kirk, called the TPP negotiations “the most engaged and transparent process [possible].”–Public Citizen the truth is self evident. TPP is being negotiated behind closed doors since 2008. (That’s right in the middle of the financial crisis that NAFTA helped to create, the Bush administration opened up another chapter of globalization in secret. Color me surprised.)

None of the text of this agreement is available for the press, Congress, or the peoples of the world who will labor under the treaty. When Sen Ron Wyden, on both the Budget and Finance Committees, requested to read the agreement, he was told
it would not be available in the Congressional reading room, where secret
documents are kept, but he would have to go to the negotiations without staff, paper or pen, in order to read the text.

The secrecy surrounding the negotiations is breathtaking. In July, 134 members of the House of Representatives sent a letter to U.S. Trade Representative Ron Kirk requesting that the appropriate congressional committees be consulted and that a draft of the text be released. The members reminded Kirk that draft texts were circulated and congressional committees consulted throughout the NAFTA negotiations in the early 1990s. Their letter received no response. A month later, House members petitioned Kirk to allow a congressional delegation to observe the negotiations—as in the Uruguay Round of the General Agreement on Tariffs and Trade, the launch of the Doha Round of the World Trade Organization, and numerous NAFTA rounds. Despite its persistence, Congress has not been granted any significant oversight or insight regarding the
negotiations.–Foreign Policy in Focus

A quarter million signatures on petitions were turned in to the US trade representative asking for the text to be released. The only response from the negotiators was to accelerate the timetable for the process so the deal can be signed before public outcry can be obtained.

The schedule for negotiation has recently accelerated in order to bring the agreement to a close. The process has become more and more closed—stakeholder forums, which were more common toward the beginning of the process, have now been replaced with “stakeholder tables” – a table staffed by interested stakeholders to which negotiators may or may not go. The negotiators are also holding off-the-record “intersessional” meetings between official sessions. Public Knowledge

Currently the text is not to be release to Congress or the public until the negotiations are complete. Congress will be asked to ratify it after a brief time for the public to comment on the deal. Of course, the public will need to comment on it after a near complete media blackout. Proposals that lead up to the final agreement would not be available until four years after it is signed.

Yet, 600 corporate “advisers” from companies like Wal-Mart, Cargill, Halliburton, Dow Chemical, and led by General Electric, the US corporation that prides itself in pioneering outsourcing, have direct access to the US trade negotiator. It is actually US law that the US trade rep consult with corporate leaders before, during, and after the writing of a trade agreement. The corporate leadership gets to red line any part of this agreement before Congress and the rest of us get a chance to even see it.

Springing a Leak

All the concerns about NAFTA and jobs and trade deficits are amplified in the TPP. Asia, unlike South America, is a hub of technology. Green jobs and high tech
jobs promised in the presidential campaign will go overseas to Asia under this
agreement.

Luckily, the secrecy has been rather leaky. Three sections of the draft have been leaked to the public so far. What has emerged is NAFTA on steroids, with even more
draconian provisions by corporations to overturn democracy and national sovereignty. Only 3 of the 26 chapters of the agreement deal with trade. The other 23 chapters are a dream sheet of corporate hegemony.

1. A Gift for Big Pharma:

The agreement increases the number of years a pharmaceutical company has a monopoly over a drug, beyond the twenty years that already applies in the US. It would broaden the scope of patents, making even minor variations of an old medication patentable, while making it harder to challenge a patent. Finally, it would demand that patents be allowed on plants, animals and surgical procedures.

Developing nations would be prevented from using generics before drug monopolies ended. TPP would negatively impact the number of patients getting compassionate AIDS, Tuberculosis, and Malaria therapy. The first round of generic treatments for patients with HIV in poor nations brought the price per patient from $10,000 to $120.

Just because Britain was such a smarty-pants about your public health care system at the Olympics, the US trade negotiator is pushing several clauses to prevent governments from using formularies to reduce prices for medications, considered a form of price fixing here in the Pharma-friendly US. Of course, most other countries use formularies to keep prices low. TPP would force countries to have a judicial appeal system for pharmaceuticals to make sure governments “appropriately recognize the value” of various drugs. In Australia, where such a system has been implemented, the result was predictably higher drug costs.
Public Citizen, Citizen Trade

“The leaked text confirms the worst fears of health officials.
The Obama White House is walking back the core concessions on patent
extensions, patent linkage and test data protection that were
negotiated with the Bush White House in May 2007. Obama is now
objectively much worse than Bush on these issues. It may help
the White House raise campaign money from big drug companies, or help
USTR officials find their next high paying job working as lobbyists
for the drug companies. It is a huge disappointment for us.
The texts cover complex issues, and it is hard to summarize all that
is important. Even as regards to the reference to the WTO Doha
Agreement, the White House tries to sneak in text that makes it
appear as though it is limited to only some diseases or emergencies.
Collectively, the provisions are designed to strengthen IPR
monopolies on drugs, and make it harder to regulate prices. The
consequences of stronger monopolies and higher prices are less access
to medicine.”— James Love, Knowledge Ecology International

Don’t be fooled here. Obama is touting increased access. “Increasing access” means new drugs get to market faster and drug companies have access to more markets. What we need is not access to medications, but affordable medications.

“The leaked draft intellectual property proposals by the United States for the Trans-Pacific Free Trade Agreement have confirmed our fears that the Obama administration is walking away from previous efforts to ensure that developing countries can access affordable medicines, setting a dangerous new standard that will likely be replicated in future trade agreements with developing nations. The administration is touting a so-called ‘access window’ as a mechanism to boost access to medicines. In fact, the administration is confusing access with affordability. The ‘access window’ is all about getting brand-name drugs to market faster, and giving their producers longer monopoly rights that prevent price-lowering competition and keeping medicines out of the hands of the millions of people who need them. Our doctors who work across the developing world rely on affordable generic medicines to trade patients. For example, competition among generic manufacturers is what brought down drug prices for HIV/AIDS by 99 percent, from US$10,000 per person per year to roughly $100 today. Trade agreements of the type being pushed this week in Peru threaten these types of crucial gains in access to life-saving medicines.”— Judit Rius Sanjuan, Medecins Sans Frontieres/Doctors Without Borders

2. Gutting Worker and Environmental Protections at the Global Level:

. . . negotiations thus far have given corporations the right to avoid government review when acquiring land, natural resources, or factories. They have also banned corporate performance requirements, guaranteed compensation
for the loss of “‘expected future profits’ from health, labor, [or] environmental” regulations, and included stunning provisions concerning the right to “move capital without limits.” If these are indeed terms of the TPP, then the agreement would make it nearly impossible for countries to hold corporations accountable for their conduct—and would in fact hold governments liable for any “damage” incurred by corporations due to the institution of regulations.–Foreign Policy in Focus


TPP has a rewrite of NAFTA’s “Investor State Section.” Corporations can sue governments directly for violations of their investor’s rights and for projected loss of profits due to democratically passed laws. They do this, not in an impartial international court, but in a tribunal set up with corporate interests in mind, called an “investor-state dispute settlement mechanism.” If the democratic laws of a nation are found to be in conflict with the trade agreement, the trade agreement wins. Corporations can demand taxpayer money to replace predicted future profits not realized due to a nation’s laws. Multinationals already did this in Guatamla Peru, El Salvador, Ecuador and the US. In the US portions of the Clean Air Act, Endangered Species Act and the Marine Mammals Protection Act have all been rolled back under similar agreements. That is why you don’t see dolphin free tuna any more. In fact over $325 million have been extracted already just from countries involved in NAFTA via such a tribunal.–Counterpoint, Public Citizen, Citizen Trade

So far, Australia stands alone in resisting this part of the TPP agreement. Kudos to
the Kiwis.

The provisions undo laws that force exports to be manufactured into some sort of
commodity, making “rip and ship” economies more likely. Current laws in developing nations prohibit raw materials, like logs, from leaving the country. They force exporters to make raw materials into a commodity, like boards, so they support local manufacturing economies. These laws would be undercut, allowing foreign corporations to come into a country, and take the raw materials for export at an inexpensive price, increasing mining or drilling in less developed nations by the cheapest way possible, without regard for the local people or the environmental destruction. The acquired raw materials are shipped to the Western world at a lower financial cost, but a much higher environmental and social cost. Citizen Trade

3. Capital Controls Overturned

After the banking crisis, some countries did re-regulate banks. Countries which instituted such capital controls could be taken to court by private corporations and could be held liable for damages. Limits on the size and scope of financial institutions (too big to fail laws) would be outlawed, reducing the regulation of hedge funds and insurance companies.–Foreign Policy in Focus, Public CitizenCitizen Trade

4. Public Safety Sacrificed

Countries would be forced to import food that does not meet their minimal safety requirements. The pact would mandate “scientifically justifiable” safety laws, which would undercut any “precautionary principle” for putting new pesticides and other chemicals into the environment. In other words, you would have to provethat a new or current chemical, food additive, genetically modified food caused cancer or some other harm before it could be restricted or removed from your countries shelves.

Additionally, US subsidized corn, soy, cotton, wheat and rice would be dumped on the poorer countries, driving out their family farms. This works to condense the owners of the global food supply into fewer and fewer hands. (Anyone read The Wind Up Girl?) –Public Citizen, CitizenTrade

5. Copyright Use

The draft strengthens copyright to the point of the ridiculous. “Fair use” laws that allow limited copies at libraries and for educational purposes (including the
block quotes commonly seen on blogs) could be abandoned.–Public Knowledge

6. Public Procurement Provisions:

The agreement provides companies greater access to government contracts. This would prevent local governments from favoring local businesses to keep taxpayer dollars in the local economy. It also prevents local governments from spending money preferentially on businesses that do not pollute their environment, advance social goals, or have good human rights records.–Citizen Trade

These represent roll backs of legislation won during the Bush era, making Obama actually worse than Bush on these issues. TPP is being called a trade agreement, but most of the agreement is granting business new privileges over nations and democracies. Collectively this agreement represents big businesses interest in domination of world governments and the end of democracy.

Citizen Trade
Citzens Trade Campaign
Transnational Capitalist Class (i.e. the 0.0001%)
Between the Lines Audio with Ben Beachy
Counterpoint audio with Arthur Stamoulis
Eyes on Trade
What Corporations are Seeking from the Deal
Sign the Petition to tell Obama you want to see the text of the agreement
Donate to reward offered by Wikileaks for leaks of the Agreements drafts

Let’s Talk ‘Decolonization’ by Unaspencer

3:00 pm in Uncategorized by Anti-Capitalist Meetup

I write today to, hopefully, start a dialogue and ongoing series about the concept of decolonization. I’m fairly new to the term. Some of the concepts have been in me for a while, but I did not have connection to a philosophy or political movement, much less a name. So, I’ll share my entry point and early thoughts about decolonization. I invite you to share yours.

When I left my house in Boston and headed to New York City to be present in Liberty Square last September, I was going as an “Occupier”, I suppose, since the action was called “Occupy Wall Street”. So many of us felt so strongly that the message about the deep layers of corruption in our economic and political systems resonated, that we didn’t even think about the word defining this burgeoning movement.

For me, the Occupy movement was connected to Arab Spring and the Encampanadas of Spain and even the Green movement in Iran. And Palestine.

Palestine. How could I even think for one moment that “occupying” was a good thing? Well, clearly, I didn’t think.

It didn’t take long, though, for some to realize that the corruption wasn’t just about banking and money in politics. The corruption goes to the core of the culture we’re living in. Some of the very tenets we base our value system on are unjust. Built right into what we believe is an acceptance of being the generators of pain and suffering for others. What we’re seeing in the blatant exploitation and inhumanity of the financial crimes is reflective of something in all of us: a predatory nature. A predatory nature that we socially codify through memes such as “possession is 9/10ths of the law” and “survival of the fittest” and “competitive edge” and “independence” and “free market”. That it is radical to suggest that a culture, which measures profit-making as the key indicator of it’s health, is based on something ugly, tells us that we have deeply rooted ways of being which foster the corrupt systems we live within.

I’ve had these thoughts for a long time. In my youth I was a very competitive athlete. I had a prosperous early career as a computer programmer in the 1980s. I have multi-faceted, ‘pedigreed’ American ancestry. A direct ancestor was celebrated for being the leader of the people who “forged the first great pathway west” through Kentucky and Tennessee. Family documents show them celebrating their colonizing efforts. (ironically, another branch of my family is quite likely related to Cherokee Chief Ross who led his people along the Trail of Tears.) In short, I was a yuppie, happily thriving in the world created by colonization.

I always had a bit of a “radical” edge, I suppose. Once, while I was at a business luncheon, in my fancy, $900, Donna Karn suit, a glass of champagne was sent to me with a note, “from one closet punk to another.” I looked around the room at all the other suits and knew who sent that drink. A moment of subversive solidarity. Still, I was pursuing “The American Dream” until I went to business school. There, when faced with the founding principles of capitalism, I wholly rejected them. Everything was cold and with zero concern for a just and sustainable existence for all people. War terminology applied to business practices. I could not adopt that. I had gone to school to “boost my resumé” and, presumably, my career. I ended up turning down offers to join venture capital firms. I would go on to run the first urban composting company in the United States, a very mission-oriented pursuit. Everything I have done since then has been mission-oriented.

Still, I didn’t have the words for how I perceived things. I no longer felt good about the concept of “competition”. Competitions have winners and losers. A society built on “competitive spirit” requires losers. Far more losers than winners. Only one person claims the title at the end of a tennis tournament. Everyone else is some varying degree of loser. It rankles me to no end that someone who is second best in the world at what they do is “suffering a disappointing loss” at The Olympics when they receive their silver medal. Moreover, I feel great pain about the history of our culture. It’s a living history. Here in the United States, we have committed and continue to commit genocide against The First Peoples. The early settlers came here for economic opportunity and they generated their successes by dragging millions from their homelands and enslaving them to get free labor and greater profits for themselves. Every single aspect of what this country is would not exist without slavery and genocide. Yet, we continue to call this “exceptional” and we continue to state that the lifestyle we have become accustomed to is a good and normal thing that we should continue to aspire to and convince, well force, everyone else in the world to aspire to.

I could articulate my perceptions, but I didn’t have a name for it until I entered the world of Occupy and encountered an already existing movement called “Decolonize”. (Though I can’t attend often due to a scheduling conflict, I am eternally grateful for the Decolonize to Liberate working group at Occupy Boston.)

Decolonize. That word seems to scare people. Almost every time I utter it in front of people, there is someone who will ask, “do you expect everyone to leave here and go to Europe?”

The political act of decolonizing is not about rearranging where everyone lives. Even if you did that, people would still have a mindset, an ethical compass, which would lead to new colonizing and new systems of oppression. Decolonizing is about rearranging the way we think and how we treat each other. What does “justice for all” really mean? Have the vast majority of people living on this land experienced justice?

We know the answer to that question. Injustice has plagued this land. “Freeing” slaves whilst keeping the rewards of their labor was not justice. Giving native peoples barely survivable land land that you claim they have sovereignty over, which you do not honor, is not justice. Breaching every treaty we ever made with those same people is certainly not justice.

Those are obvious examples of injustices and we do hear lip service given, culturally, to these “historical” events. (We’re breaching treaties to this day and the 13th Amendment has an exemption to the banning of slavery, which we are taking full advantage of in our private prison system. So, this is not just history. It’s contemporary.) What we don’t discuss much or in a way which might actually lead to justice, is how the very tenets of “The American Way”, the very things we honor as almost sacred truths, generated and continue to generate these injustices. We’re like the child who says, “Sorry for leaving my trash on the floor, mom”, but doesn’t pick up the trash and continues to leave trash on the floor. It’s a superficial acknowledgement of wrongdoing without any righting of the situation or commitment to prevention of further harm.

With our very ways of being, we cause harm and promote injustice every day. We cheer on the “winning” little league team without a concern for what the message of “life has winners and losers” implants in our children. We buy cheap food without making sure no one was abused to get it to us. We wear clothing made in sweat shops. We let children “cry it out” and put them in “time out” to show them they will be ostracized when they don’t ‘behave’, where ‘behaving’ means adopting the feelings and perceptions of an authority figure. We hug our children when they “make us proud” or “look so cute” or entertain us. Every aspect of our beings is shaped through a system of reward and deprive. And we’re willing deprive people of food, shelter, clothing and healthcare if they haven’t ‘behaved’. We are willing, in other words, to kill them. We kill people all the time. Our president now has a “kill list”. I don’t believe for a moment that we’re killing people as revenge for those killed in 2001. We’re killing anyone who dares to threaten the public perception that we are exceptional and democratic and harbingers of peace. We have the most weapons and an exponentially larger army than anyone on the planet has ever had and we dare to claim we are bringing peace. We are exceptional, yes. Exceptional at cognitive disconnect and self-deception in the name of glorifying ourselves and getting what we want, regardless of who pays what price.

But, it’s also micro. When we’re in a meeting and someone expresses a feeling about something and the first response is a rebuttal, we’re participating in the devaluing of someone. We tell them “don’t feel that. Don’t see that.” We do it to each other all the time. We compete over feelings. We compete over ideas. We normalize the concept that he who speaks with the most force gets to be ‘right’ and everyone else is silenced or ostracized. We see no room for simultaneous co-existence of multiple ideas, emotions and peoples. It happens in the workplace, in political dialogue, in families and even in the most intimate of relations. From the most subtle of interactions to the most tense, its all about who is best at dominating. We give up our agency in micro-moments everyday and hand our power to those who are most comfortable dominating.

Domination is the name of the game. It’s our “Manifest Destiny“. Our nationalism and self-proclaimed exceptionalism and sense that it is all part of a divine plan within which we are the chosen people, are all part of that ‘destiny’ and the Doctrine of Discovery. Most of us have probably never used those words. It’s not something we discuss often. We don’t have to. It’s the inherent axiom we embody. And it’s the sine qua non. We can’t generate a truly just and sustainable world until we purge ourselves of it.

That purge is supremely challenging. We must find a way to question every thing we do, the way we are in every moment, every assumption we have about what is ‘natural’ and ‘right’ and ‘acceptable’. We must do this without so destroying our own dignity that we either can’t bear to live or can’t bear to look or need to attack the dignity of others in order to feel better. Of any revolutionary movement out there, the resistance to this will be the strongest because we are rising up against ourselves.

I would argue that we are not rising up against our true selves, though. We are rising up against the selves we have been molded to become. From the moment we were born we were trained and brainwashed and ‘normalized’. A particular lens was fused to our eyes through which we are forced to perceive the world. Underneath all that is an original self, who can still look at the world in our innately natural way if we can remove those lenses. There isn’t a nice laser-surgery process to remove them in a few moments with some anesthesia to ease the way. It’s going to be painful. Yet, it will be freeing. We will be freed of the burden of supporting, and being weighed down by, the systems of oppression we’re existing in. And the connections we make to each other will be far more rewarding and joyous, as they are free of the guilt of achieving those connections at the expense of others. It will be liberating because we will not be forced to eradicate our true selves in order to survive.

I am trying to decolonize myself, my own mind. By doing so, I am creating space for something else. Cooperation. Collective. Interdependence. Exquisite joy.

In that vein, here are some of the ways I have challenged myself:

1) be willing to be wrong in every moment.
2) don’t allow someone to convince me I am wrong. If I don’t feel it, don’t just ‘cave’.
2) offer any power I have to those who have less
3) be willing to be threatened and to risk safety for the sake of justice.
4) always speak my truth with compassion, even if it creates tension with those I care about.
5) be willing to be uncomfortable in ‘mainstream’ society; reject coersion
6) be willing to share any material gains I may have

The list will grow, but those are a starting point.

Have you ever considered decolonization? What does it bring up for you? How do you challenge yourself?

Some links for your reading pleasure:
United Nations Declaration on the rights of inDigenous PeoPles

What UNDRIP can mean for the future

Permanent Forum on Indigenous Issues: Statement on the Doctrine of Discovery

Colonization of the Mind: Normalize This!

Colonizing and Decolonizing Minds by Marcelo Dascal, Tel Aviv University