Will Medical Trade Be Included in the EU Trade Deal and the TPP? If Not, Why Not?
CEPR | August 4, 2013
The NYT has an article today on the enormous savings available to people who had major surgeries performed in Europe rather than the United States. The piece reports that the cost of hip replacement or knee replacement surgery in the United States are more than five times higher than they are in comparable quality facilities in Europe. (The gap would be even larger with facilities in Thailand and India.)
This shows the enormous potential gains from increased medical trade. In effect, our hospitals, doctors, and medical equipment makers benefit from tariffs on the order of 500 percent or more. If the Obama administration really is interesting in promoting growth through trade it would be difficult to imagine a sector with larger potential gains than trade in medical care. The agreements would focus on setting clear liability rules, accreditation systems, and removing obstacles for insurers and government programs that prevent them taking advantage of lower cost medical services in other countries.
If the trade deals do not include major openings on medical trade then it would be a clear example of why these deals are in fact about selective protectionism rather than free trade. Past trade deals have been quite explicitly focused on putting U.S. manufacturing workers in direct competition with the low paid manufacturing workers in developing countries.
Anyone who believes in free trade would want U.S. doctors and other professionals subjected to the same sort of competition. Otherwise, they really only want to use trade to lower the wages of less educated workers to benefit the the wealthy. (Low wages means cheap help.) It is dishonest to call that policy “free trade.”
Obama’s Plan for Economic Immiseration
By ROB URIE | July 26, 2013
President Barack Obama spoke at length on the economy on Wednesday in the first of what is reported to be a series of speeches he will give around the country to push his economic ‘agenda.’ A question for his supporters is why Mr. Obama is now purporting to promote the interests of the middle class and working poor when he has remained silent for the last five years during the worst economic downturn since the Great Depression? If he cared one whit about these people the time to promote economic policies to help them was five years ago. And conversely, the economic policies he has pursued have decimated the very people he now claims to want to help.
Mr. Obama’s analysis of economic travails—globalization and its effects on an under-educated workforce, are the same neo-liberal pabulum the ‘Washington consensus’ has been serving up since Jimmy Carter was in office. And his economic prescriptions—public-private ‘partnerships’ to boost investment in technology, bringing corporate executives in to assess what is wrong with the educational system, building out lower cost ‘online’ education and community colleges to ‘boost American competitiveness,’ increased infrastructure spending and the creation of tax advantaged savings accounts for middle class families, are straight from the neo-liberal playbook as well. To ask the obvious question: if neo-liberal policies worked, why then the laundry list of economic travails?
Taking the speech at face value, the contention market forces (‘globalization’) are the central cause of the decades old downward mobility of the ‘American workforce’ leaves out the specific role Mr. Obama has played in pushing the monopoly capitalist coup forward with the Trans-Pacific Partnership agreement (TPP), the role he personally has played in reviving the Wall Street banks responsible for the ‘financialization’ of the economy, the bi-partisan effort by official Washington to diminish the lot of organized labor and the ‘privatization’ schemes he continues to push to hand the public economy over to corporate interests. Government policies in the service of capital are no more ‘market’ forces than the much derided ‘central planning’ is.
A recent paper by the International Labour Organization (ILO) presents a broad and reasonably nuanced effort that concludes financialization, and not ‘technology,’ is the central explanation for the increased, and still increasing, share of income going to corporations and away from labor. By changing the corporate motive from continuing economic production to ‘financialized’ production—the creation of corporate architecture designed for maximum extraction of previously existing value, the ‘balance of power’ between labor and capital was shifted to capital by its corporate agents (executives). A prime example can be found in Wall Street itself—individual firms willing to sink the entire financial system for short term trading gains. Additionally, through the permeation of debt-based leverage, rentier income is now drawn from every section of the economy.
Mr. Obama’s unconditional bailout of Wall Street, with upwards of $25 trillion of public funds made available to ‘save’ the banks, is the single greatest gift from working people to the forces of their own demise in world history. The ILO paper articulates the role of Wall Street in the immiseration of the West’s toiling classes– not only was the transfer of public resources to ‘private’ banks in the bailouts taken from the working class, the financial economy Mr. Obama ‘saved’ is the absolute enemy of working people. Wall Street provided the tactic of immiseration of the working poor and middle class through financialization of economic production and it facilitated the process through financialization of the broader economy. In fact, Mr. Obama’s economic agenda can be read as the explicit continuation of this process.
Mr. Obama’s plan to ‘work with’ private technology companies to provide every college student in America with high speed internet service has particular irony as apparently the main capability to be boosted is the NSA’s ability to spy on students, long known to be periodically politically active, all the more quickly. As there was no mention of this ‘enhanced’ service being free—Mr. Obama is providing students the ‘right’ to buy products from private companies who then sell the information they gather from their ‘customers’ to the highest bidder while inventing ever more intrusive and corporate-totalitarian methods of controlling them. It is agreed that in theory high speed Internet service has value. That Mr. Obama’s actual corporate-state policies have made it a tool of totalitarian control shines a light on his true constituency. Conversely, it illustrates the destruction of actual economic value (high speed internet service) through strategies of domination by the same capitalists claiming they create economic value.
Asking business leaders to opine on the system of public education is more cynical still given Mr. Obama’s appointment of long-term public school privatizer Arne Duncan as Education Secretary. Business leaders’ interest is to shift the cost of training ‘their’ workforces onto the public dime. Even granting the dubious proposition education is to benefit capitalist enterprise, truly educating ‘the workforce’ provides for a broad set of potentially socially beneficial applications whereas training teaches skills that benefit certain employers. Given the history of American corporations trying to limit the mobility of workers, such as pensions with long vesting periods, providing specific training in lieu of broad education serves corporate interests against those of labor. And ‘education’ only creates ‘American’ jobs to the extent Federal government policies put certain classes of labor into faux ‘competition’ with more effectively exploited workers overseas. ‘Education,’ as Mr. Obama presents it, is a phony solution to an engineered problem.
Even in the dim corporate-state worldview of Mr. Obama’s patrons there must be interest in education outside rote training and inculcating maximum consumption—otherwise, who will create? Additionally, the basic arithmetic of privatized education is revenue – costs = profits. If profits are zero, as is the case with public education, then expenditures equal revenues. Why extracting profits–increasing public expenditures that go to capitalists rather than to education, adds value to education when it so clearly detracts is a mystery Mr. Obama should explain. And paradoxically, his ‘private’ model for education finds precedence in his health care ‘reform’ plan, the ACA, with the central difference being that Mr. Obama’s explanation for retaining a private healthcare system is that it is already ‘private’ whereas the educational system Mr. Obama now wants to privatize is largely public. And there is no grimmer view of human existence than corporations training human ‘consumption units’ in the empty ideology of capitalist consumption.
Mr. Obama’s ‘tax advantaged’ savings accounts for middle class families are a particularly cynical ploy. Middle class wages were stagnant for thirty years before declining in the economic calamity associated with the financial ‘crisis’ of 2008. What middle class (and poor) families need is income, not accounts to put income they don’t have into. With more details allegedly forthcoming, the initial read is through his ‘private accounts’ Mr. Obama hopes to effectuate George W. Bush’s plan for his own ‘private accounts’ as a step toward privatizing Social Security. And in his Wednesday speech Mr. Obama made coded comments about cutting Social Security that tie directly to his Hamilton Project (Robert Rubin) speech nearly a decade earlier. To be clear, the working poor would be hurt most were Mr. Obama to push ‘private’ savings accounts only the rich can afford while cutting the Social Security the working poor most depend on.
The infrastructure spending Mr. Obama advocates may or may not be a good idea depending on how it is financed. In the U.S., given its geography and geopolitics, infrastructure has unambiguously provided an economic benefit in the post-WWII period. But corporations formerly paid a substantial proportion of the costs of building infrastructure through taxes. Over the last fifty years taxes on corporations and the wealthy have been massively cut leaving the middle class to pay an increased share of public expenditures. And a significant proportion of this burden, in the form of municipal debt, is coming due.
The struggle currently underway in ‘bankrupt’ Detroit between ‘bondholders’ and pensioners has the Democratic Party of the last forty years supporting the immiseration of pensioners to pay financial speculators for financing infrastructure spending. To be clear, public (and private) pensions are deferred income negotiated in lieu of current income. Democrat Robert Rubin, with whose acolytes Mr. Obama has continued to fill his Cabinet, is an insistent advocate of Detroit’s bondholders being fully paid. And the only way to do so is to take the money, earned income that was deferred, from pensioners. Mr. Obama’s threat to appoint arch Rubinite Larry Summers—the man who bears significant responsibility for deregulating Wall Street and for the ensuing economic calamity, to Chair the Federal Reserve is a clear signal increased infrastructure spending is intended to transfer even more public wealth to ‘private’ hands.
Mr. Obama refers to the student debt ‘crisis’ as if he had no role in it. In fact, about half of the total student loan debt outstanding was accumulated while Mr. Obama has been President. Mr. Obama ‘removed the banks’ from making student loans in 2009 as part of his effort to shift bad bank debts and economic risk from the banks onto the public balance sheet, not in an effort to help middle class students as he now asserts. Under Mr. Obama student loan debt fraudulently incurred through bogus ‘for-profit’ colleges and trade schools has exploded with fully one-third of indebted students failing to receive degrees. With full knowledge that student loan debt is nearly impossible to discharge, Mr. Obama encouraged students to take loans as part of his education ‘initiative’ creating a new generation of debt slaves to a particularly pernicious type of debt.
The ‘middle class’ jobs Mr. Obama now claims to have created through the automaker bailouts is a particularly offensive sleight of hand. Before the bailouts a proposal had been floated to create a ‘tiered’ wage system where new autoworkers would earn approximately one-half what existing workers made. As a condition of the automaker bailouts Mr. Obama forced the issue by putting tiered wages in place while no restrictions were put on executive compensation. In large measure the same executives who had sunk the auto industry were left in their jobs at full pay and were left free to continue relocating autoworker jobs to low wage countries. And in fact, the bailouts Mr. Obama now claims were his were largely engineered by the George W. Bush administration before it left office. As with Mr. Obama’s healthcare plan, right-wing Republicans conceived the automaker bailouts.
On a positive note, it was refreshing to hear Mr. Obama correctly characterize his healthcare ‘reform’ plan, the Affordable Care Act (ACA), as a plan to provide health insurance, rather than health care, to those lacking it. The Democrat partisans who tried to draw such a stark line between Mr. Obama’s policies and the likely policies of his Republican rival in the last election, Mitt Romney, largely avoided the fact that Mr. Obama’s health care ‘reform’ was the same plan Republican Mitt Romney had implemented as Governor of Massachusetts. The right-wing Heritage Foundation originally conceived the plan as the radical right’s ‘solution’ to the ‘threat’ of national health care. Under the guise of political feasibility Mr. Obama has pushed through the major policies of the radical corporate-right with his long-suffering constituents believing they got a good deal.
The genesis of the ACA as a corporate-right ‘solution’ to a public health crisis is what it is, but this alone doesn’t doom it to failure. What it leaves is a system that provides about two-thirds of the benefits of a functioning health care system at twice the cost. While implementation of the plan in Massachusetts initially reduced the number of medical bankruptcies —families that were bankrupted by medical costs, the number quickly recovered. The basic flaws of the existing healthcare system remain—monopoly power in pricing medical services and medical provision, a disjoint and ring-fenced system designed to maximize profits rather than to provide healthcare, and hugely asymmetrical political-economic power between insurance companies, medical providers and the ‘insured’. The ACA’s liberal supporters believe against all history that private insurers will willingly provide the health care they are contractually obligated to provide when they only have when forced to in the past. The question then, with the unconditional bank bailouts as guide, is who is going to force them?
Again, the received wisdom amongst the self-described ‘liberal’ economists supporting the ACA is that it is all that was politically feasible. In fact, with poll results showing 75% of the American people initially supporting a national (single payer) health care system, Mr. Obama could have taken his case to the people. Alternatively, Mr. Obama could have represented popular disillusion as a potential threat to the extractive, dysfunctional private health care providers and won concessions. Instead, he had a health insurance lobbyist write the ACA and proceeded to pass the Republican plan conceived by the right-wing Heritage Foundation off as his signature achievement.
What Mr. Obama apparently hopes to accomplish in the remainder of his term, as evidenced by his economic ‘agenda,’ is the conversion of every remaining socially beneficial public institution into private enterprises designed to provide the highest profits for connected capitalists while converting their (public institutions’) ‘products’ into tools for the domination and control of the populace. Postmodernist insights notwithstanding, there is a difference between education and capitalist-corporatist propaganda. There is a difference between education and technical training in the service of industry. Savings accounts for people who have no income to save are a hoax. Infrastructure designed to extract ongoing fees for private interests at public expense is a cynical ploy. And as ACA supporters will soon be learning in excruciating detail, there is a difference between health insurance and health care. Finally, privatization isn’t efficient rationalization of public institutions; it is the replacement of the public interest with private interests. Lest the result remain unclear, replacement means elimination of the public interest.
Rob Urie is an artist and political economist in New York. His book, Zen Economics, will be published by CP/AK Press in 2014.
Detroit: The Bell Tolls for All of Us
A Black Agenda Radio commentary by Glen Ford | July 23, 2013
In Detroit, even the thin gruel of democracy that America advertises to the world, has ceased to exist. Not one of its 700,000 residents retains the political rights of citizens, those rights having been usurped by the agents of Wall Street: Governor Rick Snyder and bankruptcy lawyer Kevyn Orr, the Lone Ranger and Tonto who were the sole authorities empowered to file bankruptcy for the city. Their mission is to render the judgment of capital that Detroit is too poor, in its present demographic composition, for participation in the democratic order, and must be forcibly reconstituted, beginning with a divvying up of its assets. At the end of this process, a “new” Detroit is supposed to emerge, which will have divested itself of enough Black and poor people to allow the reinstatement of some form of electoral franchise.
Or, maybe not. Direct rule by Wall Street, which is the real meaning of the Emergency Financial Manager regime, is not some idea especially concocted for Detroit. It is the political and economic superstructure that the plutocracy envisions for the whole country – for the entire planet, if they can get away with it. Due to the particular racial history of the United States, where Black citizenship rights have always been deemed illegitimate, those who would strip away democratic freedoms and privatize the public sphere have always found it easier to mount their offensives against heavily Black regions and sectors of society. White people with identical interests in democracy and fairness in schools, public services and in the workplace root for the plutocrats when Blacks are under attack, never imagining that the same weapons will soon be turned on them.
Thus, Detroit’s dissolution is perceived as a Black problem – more politely referred to by its euphemism: an “urban” crisis.
However, Wall Street and its mercenary law firms, like Kevyn Orr’s godfathers at Jones Day, are not motivated by petty racial prejudice; they are simply skilled at taking advantage of it, always aiming their daggers at the soft spots in democracy, where Black people live. With Detroit and the other largely Black cities of Michigan, where half of the state’s African American population has been disenfranchised, Wall Street is creating new law and new models for the total subjugation of American society to the Lords of Capital.
Primary elections are scheduled for Detroit, in August. Mayor Dave Bing, who swung wide the gates to the city for the conquistadors, won’t be running for reelection. City council president and former mayor Ken Cockrel Jr. says he doesn’t see any point in running. But, they are irrelevant. The Detroit model for imposing direct rule of the rich can only be challenged by a mass movement of the hundreds of thousands who remain in the city – either by choice, or by no-choice – and by the millions elsewhere in the country who are next on the corporate juggernaut’s quickening agenda. The resistance must choose its tactics from a menu of “By any means necessary,” make the enemy understand the meaning of “No Justice, No Peace,” and show him that we are deadly serious when we say, “We shall not be moved.”
BAR executive editor Glen Ford can be contacted at Glen.Ford@BlackAgendaReport.com.
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Detroit Bankruptcy Takes Aim at Pensions
By Jane Slaughter | Labor Notes | July 19, 2013
Detroit hit the Trifecta last week—the third in a series of body blows that politicians have landed on the city’s working people.
The Michigan legislature passed “right-to-work” in December and gave the governor the right to impose “emergency managers” on cities two days later. When Detroit’s emergency manager Kevyn Orr announced Chapter 9 bankruptcy Thursday, he was following a predicted trajectory that will lead to further impoverishment and privatization.
The bankruptcy will enable an appointed judge to impose further cuts to city expenses and to void union contracts. A prime target for cost-cutting is the pensions owed to 21,000 city retirees and 9,000 active workers. The city estimates its pensions are underfunded by $3.5 billion, and wants to reduce payments to both workers and the bondholders who have lent the city money over the years: equality of sacrifice.
Michael Mulholland, vice president of the city’s largest AFSCME local, said city workers are “in a state of somewhere between perplexion and total anger. Everything they’ve been promised, both contractually and kind of a social contract, is being pulled out from under them. It’s morally indefensible.”
Mulholland retired in February, after 29 and a half years in the Water Department. “I could have worked someplace else and made more money,” he said, “but I was told if I worked here I’d have a steady job and in my old age not be in poverty.”
The bankruptcy of Detroit, which now has fewer than 700,000 residents, is the largest city bankruptcy in U.S. history.
Orr sprung the hurry-up filing yesterday because union pension fund attorneys were scheduled to be in court on Monday, arguing for an injunction against bankruptcy.
The state constitution appears to protect public employee pensions: “The accrued financial benefits of each pension plan and retirement system of the state and its political subdivisions shall be a contractual obligation thereof and shall not be diminished or impaired thereby.”
But proponents of making city workers bite the bullet note that bankruptcy judges have wide latitude to break contracts.
Tag-Teaming with the Governor and the Banks
Pundits said other states and cities would look to Detroit as a template for how to manage ailing city budgets. A recent law in Rhode Island specifies that in a city bankruptcy, bondholders must be paid first, before pensioners.
Asked if the Michigan legislature could pass a similar law, Mulholland laughed. “If they proposed a law that Detroiters should all be shot,” he said, “some of them would get up at midnight to sign that one.” Governor Rick Snyder has guided the process of putting Detroit through a “consent decree,” Orr’s rule, and now the bankruptcy.
The Republican-dominated legislature has long been hostile to majority-black Detroit. In November 2012, the state’s voters passed a referendum that threw out a previous “emergency manager” law, which had been used almost exclusively to take over majority-black cities and school districts. A few weeks later the legislature simply passed the law again.
Although the law requires negotiations with affected parties before a city files for bankruptcy, Mulholland, who was in the talks, said, “It wasn’t negotiations, it was PowerPoint presentations about how bad the situation is.
“Orr wouldn’t answer AFSCME’s requests for negotiations, so they went and taped a letter to the door of his office.”
As an AFSCME member who had reached the top of the pay scale, Mulholland’s pension is $1,600 a month before health care contributions are taken out. He said exactly how much Orr intends to take from retirees has always been left vague, though union leaders were told health care would be slashed.
Two years ago, he said, city officials encouraged workers to retire right away. Now active workers are told to “relax, we’re going after the retirees.”
Local 207 is planning a demonstration in downtown Detroit July 25.
Orr touts the bankruptcy as a way to improve city services—which often, in the world he comes from, is code for privatization. Water, garbage pickup, an island park called Belle Isle, and the Detroit Institute of the Arts have all been mentioned as potential salable items. “The only thing they’re going to ‘improve’ is somebody’s bottom line,” Mulholland predicted.
General Motors, which is headquartered downtown, said it wouldn’t be affected by the bankruptcy. Apparently, with Snyder—who ran on his record as a businessman—in charge, business is going to be just fine.
Evo Morales: No Need for US Embassy in Bolivia
Al-Manar | July 5, 2013
Bolivia’s president threatened Thursday to close the US embassy as leftist Latin American leaders joined him in blasting Europe and the United States after his plane was rerouted over suspicions US fugitive Edward Snowden was aboard.
President Evo Morales, who has accused Washington of pressuring European nations to deny him their airspace, warned he would “study, if necessary, closing the US embassy in Bolivia.”
“We don’t need a US embassy in Bolivia,” he said. “My hand would not shake to close the US embassy. We have dignity, sovereignty. Without the United States, we are better politically, democratically.”
Morales arrived home late Wednesday after a long layover in Vienna. He said his plane was forced to land there because it was barred from flying over four European nations over groundless rumours that Snowden was aboard, sparking outrage among Latin American leaders.
The Bolivian president’s air odyssey began hours after Morales declared in Moscow he would consider an asylum application from Snowden, who is holed up at a Moscow airport as he seeks to evade US espionage charges for revealing a vast Internet and telephone surveillance program.
In a show of support, the presidents of Venezuela, Argentina, Ecuador, Uruguay and Suriname met with Morales in the central Bolivian city of Cochabamba to discuss the incident. They demanded that the four European countries — Spain, France, Italy and Portugal — explain their actions and apologize, saying that the treatment of Morales was an insult to Latin America as a whole.
