This Week: Drugs, Crime, Medicare, Nixon


Back in the 1980s I used to have arguments about Ronald Reagan that had to do with trying to decide if his reactionary policies were motivated by indifference or ill-will (or, as a friend of mine would put it, “Is he evil?  Or crazy?”).  Now I know better, because I am more able to stay oriented to a “systems” approach to the world.  People who think systems are much less concerned with intentions than they are with outcomes.  So, whether it’s Reagan or Trump, I’m more interested in what will happen as a result of their actions than I am with what they think they are trying to do.  For one thing, how would we know, really, what they are trying to do?

This week’s essay about the Trump revival of the War on Drugs illustrates the point.  Whatever he—or his benighted Attorney General, who is leading the charge—think they are doing, the predictable outcome of their planned crackdown will fall most heavily on people of color.  And my point is that they should be held accountable for this outcome, regardless of whether or not they plan or desire such an outcome.

It’s much easier this way; no need to be a mind reader, after all.

The rest of this issue includes a thought on privatization, and a little story that I think illustrates how corporate power has come to supplant national power.  That is to say, how unaccountable private power often overwhelms democratic power.

I always love your feedback, so keep those cards and letters (or emails) coming!


“Quote” of the Week: “The Two Largest Drivers of the Nation’s Debt.”

The federal budget proposal released by the Trump administration on May 23rd received front-page coverage in the New York Times, and rightly so.  The Times highlighted the budget’s absurdly-high projections of economic growth for the coming decade, which “not only make deficit-increasing tax cuts appear more affordable than they actually are, but could also add to pressure for cuts in programs for low- and middle-income families if the promised growth fails to materialize,” as the Center for Budget and Policy Priorities put it.  But here’s the paragraph that earns the lofty distinction of Nygaard Notes “Quote” of the Week (it was paragraph #3):

“The wildly optimistic projections balance Mr. Trump’s budget, at least on paper, even though the proposal makes no changes to Social Security’s retirement program or Medicare, the two largest drivers of the nation’s debt.”


As I have said innumerable times, including in these pages, Social Security has NOTHING to do with the nation’s debt.  But don’t take my word for it, here’s the National Academy of Social Insurance, in a posting from last August called “Short Answers to Common Questions about Social Security”.  The question was: “Is Social Security contributing to the national debt?”  And the answer is:

“Social Security cannot contribute to the debt because by law it cannot borrow money. Since 1935 Social Security has collected $19 trillion and paid out $16 trillion, leaving a balance of $2.8 trillion in the trust funds at the end of 2015.”

Medicare Advantage: “The Average Person Is Probably Appalled by This”

Young people may not know that there is a “private option” for seniors to choose when they become old enough to qualify for Medicare.  If a senior does not want to participate in the traditional fee-for-service Medicare program, they can choose “Medicare Advantage.”  I’ll let the Center for Medicare Advocacy explain what we’re talking about: “Traditional Medicare is administered and run by the federal government. Traditional Medicare includes both Part A which covers hospital care and Part B which covers medical insurance. Part C is an alternative to traditional Medicare that allows private health insurance companies to provide Medicare benefits.  The private health plans are known as Medicare Advantage plans.”

The Medicare Advantage program—that is, the partial privatization of Medicare—was sold to the public with the traditional pitch that “increased competition” in the “marketplace” would result in better care for less money.  This doesn’t appear to be the case, and just this month reports are coming out that offer details about a fairly huge scam that’s been going on for a very long time.  In fact, the original complaint about the scam was filed in 2011, but the record was just unsealed in February of this year, and the details are now coming to light as the Justice Department has decided to sue UnitedHealth on the basis of the recently-revealed claims.

The New York Times reports in its May 16th edition that “now a whistle-blower, a former well-placed official at UnitedHealth Group, asserts that the big insurance companies have been systematically bilking Medicare Advantage for years, reaping billions of taxpayer dollars from the program by gaming the payment system.”

Adds the Times, “The amounts in question industrywide are mind-boggling: Some analysts estimate improper Medicare Advantage payments at $10 billion a year or more.”

“In the first interview since his allegations were made public, the whistle-blower, Benjamin Poehling of Bloomington, Minn. [just minutes from Nygaard Notes HQ!], described in detail how his company and others like it—in his view—gamed the system: Finance directors like him monitored projects that UnitedHealth had designed to make patients look sicker than they were, by scouring patients’ health records electronically and finding ways to goose the diagnosis codes.  The sicker the patient, the more UnitedHealth was paid by Medicare Advantage—and the bigger the bonuses people earned, including Mr. Poehling.”

“There were bonuses when Mr. Poehling and his team hit their revenue targets, Mr. Poehling said, but no bonuses for better health outcomes or for more accurate patients’ charts.  ‘You or I or the average person is probably appalled by this,’ Mr. Poehling said.  ‘But the scheme here was not about delivering better care to members—the thing you would expect from a health care company. It was about increasing the bottom line.’”

I have no doubt that “the average person” believes that the primary concern of a private health care company is to provide better care.  That’s the basis upon which Medicare Advantage—in fact, the entire private health care sector in the United States—is sold to the public.  The sales pitch goes like this: “Public” programs are rife with waste, fraud, and abuse, while “private” corporations that follow the laws of the market are run like well-oiled machines.

That second part is correct: There is a well-oiled machine at work.  The Times quotes Poehling as saying “They’ve set up a perfect scheme here.  It was rigged so there was no way they could lose.” But UnitedHealth, and the others, are profit-generating machines, not health-generating machines.  And, well-oiled though they are, whistle-blowers like Benjamin Poehling are throwing sand into the gears.

Buried deep in the article, the Times succinctly sums it up the meaning of all of this: “Mr. Poehling’s allegations, if true, could help explain why insurers are staying in the Medicare Advantage program even as they pull out of the Affordable Care Act exchanges in some states: Medicare Advantage offers a way to get extra money from the federal government.”

Almost all of the reporting about Medicare—about health care policy in general—appears in the Business pages.  That’s a powerful message in itself (telling us as it does that health care is a “business”), but it also means that most citizens remain ignorant about these developments, as most people do not regularly read the business press.  Despite the long-standing advice from Nygaard Notes to do so.

Who knows where the President stands on the issue, but privatizing Medicare is certainly a high priority for House Speaker Paul Ryan and also for Tom Price, the new head of the Department of Health and Human Services.  And the sales pitch, as always, will be the promise that a privatized system will deliver better health care for less money.  The Benjamin Poehling whistle-blower suit tells a different story, and it’s up to us to talk about this story and to help make the real goal of privatization—increased profits for Wall Street, not better health care—clear for all to see.

“Vulnerable Voices” at Climate Change Talks

In the last Nygaard Notes I quoted political scientist Sean Starrs, who noted that, even if American wealth “relative to the world is in decline, this does not necessarily imply that American corporations are in decline.”  And—wouldn’t you know it?!—right after I published that comment, the New York Times had a story on its front page that illustrates the point so well that I just have to revisit the subject this week.

The story was headlined “‘Vulnerable Voices’ Lash Out as Companies Sway Climate Talks.”  The “vulnerable voices” are the voices of the people of the world’s poorest countries, and where those voices are trying to be heard is at the United Nations Framework Convention on Climate Change, or UNFCCC, which is the parent of the Paris Climate Change Agreement.  Poorer, developing countries have charged that their voices in the UNFCCC are being drowned out by big-money corporate voices.  As the Times puts it, “The dispute opens an additional battle in the struggle over how to fashion a global response to climate change, one that corporate interests appear to be winning, for now.”

The Times explains that, “Though companies are not permitted to participate directly in the climate talks, representatives from almost 300 industry groups are free to roam the negotiations in Bonn, Germany, as ‘stakeholders,’ and to lobby negotiators on behalf of corporations that may seek to slow action” on climate change.

According to, “In climate negotiations, countries usually do not act alone – they act in blocs.”  And one of these blocs is the Like Minded Group of Developing Countries, or LMDC.  The LMDC issued a statement this month warning about the “undue influence” of the corporate “stakeholders” that are allowed to roam around the UNFCCC making their presence felt.
Indeed, the Times quotes Chebet Maikut, the delegate from Uganda, saying that “These corporations are so powerful,” in support of which the Times notes that “Uganda’s economy is less than a tenth of the market capitalization of the fossil fuel giant Exxon Mobil, for example.”

The Times article seemed to be stimulated by a meeting held on May 16th, at which “delegates from the United States, Russia and Australia made a last-minute defense of the corporate presence,” the details of which we do not know, as the meeting “was abruptly closed to outside observers.”  (Closed by whom?  For what reason?  The Times doesn’t say, and Nygaard Notes hasn’t been able to find out.)

The LMDC statement had to do with “risks” to the successful implementation of the 2015 Paris Agreement on climate change in light of the “enhanced participation of the rich and powerful.” Their statement called for “specific measures” to “avoid and manage” such risks.

[Warning: Dense bureaucratic language ahead!]

What “risks” are they talking about?  The Statement explains: “The risks included [among other things], clear references to several forms of conflict of interest, a possible whitewashing of a non-State actor’s image through an engagement with [the World Health Organization], or a competitive advantage for a non-State actor.”  (When they say “non-State actors,” they are referring largely to the “almost 300 industry groups” mentioned above, whose interests are discussed in the next paragraph.)

The nations that are officially a part of  the climate agreement are called “parties” or “Party
Stakeholders.”  And so the Statement continues, explaining that “several of the non-Party Stakeholders which participation are invited to be enhanced in the context of the UNFCCC, are directly or indirectly related to transnational corporations that have business, commercial or financial interests that may be in contradiction of the Convention and the Paris Agreement.”

The risk of serious conflicts of interest, says the Statement, “is even more concerning in the context of the lack of sufficient funding for the budget of the UNFCCC and for climate finance in general, [especially] when we take into account that the revenues of some of those transnational corporations dwarf the gross domestic products (GDPs) of many countries, making it even more difficult to avoid or manage a conflict of interest or any other risks associated to their undue influence.”

So, here we have an example of exactly what I was talking about in the last Nygaard Notes, where huge corporations use their muscle to overpower smaller nation-states.  Actually, not necessarily smaller—the LMDC includes not just Uganda-sized nations, but also China and India, thus representing about one-half of the world’s population—but certainly the LMDC membership includes most of the world’s poor.  According to the U.S. representative, however, these poor folks don’t know what they’re talking about.  Here’s how the Times tells it:

“Trigg Talley, the United States deputy special envoy for climate change and the senior American negotiator in Bonn, called the proponents of the effort to rein in corporate influence ‘well intentioned but deeply misguided.  It’s not a good path to go down.’” Spoken like a true colonialist!  In case you think this is very Trumpian-sounding, be aware that Mr. Talley was appointed to his post by Barack Obama.

By the way, what unifies the Like Minded Group of Developing Countries—that is, what makes them “Like Minded”—is two things, which they neatly summarized in a 2013 statement to the Conference.  First of all, they note that, as poor countries, “our populations and economies are … among those that are particularly vulnerable to the adverse effects of climate change.”  And the second thing that they agree on is that “the largest share of historical global emissions of greenhouse gases originated in developed countries and that, owing to this historical responsibility, developed country Parties must take the lead in combating climate change and the adverse effects thereof.”

Whatever YOUR agenda is for the UNFCCC talks, there are some “non-state actors” with an agenda like yours who have observer status there.  I say that some have an agenda like yours not because I know your agenda, but because there are so many to choose from that SOME of them must be agreeable to you!  And your support may help them counter the pro-business voices that are threatening to drown out the “vulnerable voices” that I’ve been trying to amplify here.  Check out the (long!) list of non-governmental organizations that are lobbying the UNFCCC.

Drugs and Crime.  Nixon and Trump.

The May 15th New York Times ran a story about an initiative by U.S. Attorney General Jeff Sessions and a speech he made on May 12th speech when, as the Times puts it, “he ordered federal prosecutors to make sure they threw the book at criminal defendants and pursued the toughest penalties possible.”  Just to be clear, what Sessions is mainly talking about is drug crime.  As Michael Collins, deputy director at the Drug Policy Alliance, told National Public Radio, “This is a disastrous move that will increase the prison population, exacerbate racial disparities in the criminal justice system, and do nothing to reduce drug use or increase public safety.”  As a headline put it, “Jeff Sessions Is Bringing Back the Drug War—and Making it Worse.”

The Times was surprised by Sessions’ announcement because “it ran so contrary to the growing bipartisan consensus coursing through Washington and many state capitals in recent years—a  view that America was guilty of excessive incarceration and that large prison populations were too costly in tax dollars and the toll on families and communities.”

The Times found this story important because it reveals another instance of disagreement among the ruling classes.  But in fact a grassroots movement to combat the insanity of the War on Drugs has been in existence since Nixon declared the modern-day War on Drugs in 1971.

Speaking of Nixon, there’s much talk these days about Watergate, and how the current Trump Travails echo that unbelievable period in history.  I’m old enough to remember Watergate, which was all about an attempted burglary of the offices of the Democratic National Committee (at the Watergate complex) and the subsequent cover-up by the President and his cronies.  I couldn’t help thinking, at the time, that Nixon was guilty of far worse offenses than the Watergate break-in.  The “secret” bombing of Cambodia in 1969-70 leaps to mind, which not only caused unknown numbers of deaths (500,000 is a good guess), but was likely responsible for the rise of Pol Pot.  Just google “bombing of Cambodia crime” for details.

Another parallel with the Nixon years and the Trump years (maybe “months,” we’ll see) is the cynical embrace of what is commonly called the War on Drugs.  The original War on Drugs was declared by Richard Nixon in June of 1971, and some people back then actually thought that the Nixon White House was concerned about the human suffering caused by drug abuse and addiction.  If you’re among them, then the following excerpt from a 23-year-old interview is for you.

In 1994 writer Dan Baum was writing a book about the politics of drug prohibition, in the process of which he interviewed one of Nixon’s closest aides, the late John Ehrlichman, who was the Assistant to the President for Domestic Affairs.  Baum published an article in the April 2016 issue of Harper’s Magazine (“Legalize it All: How To Win The War On Drugs”), in which he recalled that interview.  Here’s a part of what he recalled:

At the time [1994], I was writing a book about the politics of drug prohibition. I started to ask Ehrlichman a series of earnest, wonky questions that he impatiently waved away. ‘You want to know what this was really all about?’ he asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. ‘The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.’”

Now skip forward to May of 2017.  May 12th, to be exact, which is when the U.S. Attorney General Jeff Sessions basically declared that the War on Drugs—never really gone but somewhat de-emphasized in recent years—is about to be reborn, with all of its harsh sentences and criminalizing of various groups deemed undesirable, such as poor and dark-skinned people.

The official justification, as before, is “law and order.”  The Attorney General, in his announcement, uttered these words: “And we know that drugs and crime go hand in hand. They just do. The facts prove that so.”

As it turns out, the relationship between drugs and crime has been studied a lot, over decades.  And the research does show various associations between drugs and crime.  But, as a 2003 report from the National Criminal Justice Reference Service (NCJRS) puts it, in classic bureaucratic language, “Considerable complexities and nuances underlie these associations.”  In other words, it’s not that simple.

Quoting further from the NCJRS study—Research on Drugs-Crime Linkages: The Next Generation—we read: “Many different data sources establish a raw correlation between drug use and other criminal offenses. But correlation does not equal causation: In principle, drug use might cause (promote, encourage) crime; criminality might cause (promote, encourage) drug use; and/or both might be caused (promoted, encouraged) by some set of ‘third variables’—environmental, situational, dispositional, and/or biological.”

The Attorney General’s call to revive the War on Drugs is based on a familiar idea, which is that the prohibition of drugs will reduce crime.  But the opposite may be the case.  The study puts it this way: “drug prohibition cannot be only a response to drug-related crime, but it may also be a  causal antecedent to some drug-related crime.”  In other words, drug prohibition may actually increase crime.  To paraphrase an old saying: If drugs are outlawed, only outlaws will have drugs.

Later on in his May 12th speech, the Attorney General likely thought that he was explaining something when he said, “Drug trafficking is an inherently dangerous and violent business. If you want to collect a drug debt, you can’t file a lawsuit in court. You collect it with a barrel of a gun.”

Long before Mr.  Sessions uttered those words, the Drug Policy Alliance noted that “Drug enforcement officials often cite drug-related violence as a reason that drugs must be eliminated from our society, but it is actually the system of drug prohibition that causes much of the violence.”  Why? “Prohibition has driven the drug trade underground, where violence is inevitably seen as the only means for resolving disputes between competitors.”

Back to Nixon.  While the frank comments of John Ehrlichman reveal the racism at the core of the modern-day War on Drugs, the problem didn’t start in 1971.  Drug laws in the U.S. have always been used to target people of color.  The Drug Policy Alliance summarizes some of the history: “The first anti-opium laws in the 1870s were directed at Chinese immigrants. The first anti-cocaine laws in the early 1900s were directed at black men in the South. The first anti-marijuana laws, in the Midwest and the Southwest in the 1910s and 20s, were directed at Mexican migrants and Mexican Americans. Today, Latino and especially black communities are still subject to wildly disproportionate drug enforcement and sentencing practices.”

So, not only is the reinvigoration of the War on Drugs that we’re witnessing under Trump bound to fail on it’s stated goals—reductions in drug abuse and crime—but it is bound to “succeed” in the ways it has always succeeded: By providing blanket justification for the persecution of populations perceived to be a threat to a system built on racial exclusion and white privilege.

So, like Nixon, whatever crimes may or may not be uncovered by whatever commissions or prosecutors may end up investigating President Trump, the far greater crimes unleashed by his revival of the War on Drugs will likely go unpunished.

So, with that in mind, let me offer a few resources for readers who may wish to resist this particularly racist front in the Trump assault on human rights.  The following groups represent just a few of the grassroots efforts underway to undo some of the damage that has been, is being, and will be done in the misguided and criminal War on Drugs.

The Drug Policy Alliance has been around, in one form or another, for 30 years, and I’ve found their analysis and action agenda to be effective and important.

“Founded in 1986, The Sentencing Project works for a fair and effective U.S. criminal justice system by promoting reforms in sentencing policy, addressing unjust racial disparities and practices, and advocating for alternatives to incarceration.” That’s from their website, and I think they’re telling the truth.

The American Civil Liberties Union is doing great work to counter the Trump/Sessions drug agenda:

To put the whole thing in context, I highly recommend the book “The New Jim Crow: Mass Incarceration in the Age of Colorblindness,” by Michelle Alexander.