First Kidney Failure, Then A $540,842 Bill For Dialysis

For months, Sovereign Valentine had been feeling progressively run-down. The 50-year-old personal trainer, who goes by “Sov,” tried changing his workout and diet to no avail.

Finally, one Sunday, he drove himself to the hospital in the small town of Plains, Mont., where his wife, Jessica, happened to be the physician on call. “I couldn’t stop throwing up. I was just toxic.”

It turned out he was in kidney failure and needed dialysis immediately.

“I was in shock, but I was so weak that I couldn’t even worry,” he said. “I just turned it over to God.”

He was admitted to a nearby hospital that was equipped to stabilize his condition and to get his first dialysis session. A social worker there arranged for him to follow up with outpatient dialysis, three times a week. She told them Sov had two options, both about 70 miles from his home. They chose a Fresenius Kidney Care clinic in Missoula.

A few days after the treatments began, an insurance case manager called the Valentines warning them that since Fresenius was out-of-network, they could be required to pay whatever the insurer didn’t cover. The manager added that there were no in-network dialysis clinics in Montana, according to Jessica’s handwritten notes from the conversation. (The insurance company disputes this, saying that its case manager told Jessica there were no in-network dialysis clinics in Missoula.)

Jessica repeatedly asked both the dialysis clinic staff and the insurer how much they could expect to be charged, but couldn’t get an answer.

Then the bills came.

Patient: Sovereign Valentine, 50, a personal trainer in Plains, Mont. He is insured by Allegiance, through his wife’s work as a doctor in a rural hospital.

Total Bill: $540,841.90 for 14 weeks of dialysis care at an out-of-network Fresenius clinic. Valentine’s insurer paid $16,241.73. The clinic billed Valentine for the unpaid balance of $524,600.17.

Service Provider: Fresenius Medical Care, one of two companies (along with rival DaVita) that control about 70% of the U.S. dialysis market.

Medical Treatment: Hemodialysis at an outpatient Fresenius clinic, three days a week for 14 weeks.

What Gives: As the dominant providers of dialysis care in the U.S., Fresenius and DaVita together form what health economists call a “duopoly.” They can demand extraordinary prices for the lifesaving treatment they dispense — especially when they are not in a patient’s network. A 1973 law allows all patients with end-stage renal disease like Sov to join Medicare, even if they’re younger than 65 — but only after a 90-day waiting period. During that time, patients are extremely vulnerable, medically and financially.

Fresenius billed the Valentines $524,600.17 — an amount that is more than the typical cost of a kidney transplant. It’s also nearly twice Jessica’s medical school debt. Fresenius charged the Valentines $13,867.74 per dialysis session, or about 59 times the $235 Medicare pays for a dialysis session.

When Jessica opened the first bill, she cried. “It was far worse than what I had imagined would be the worst-case scenario,” she said. (...)

Dialysis companies are quite profitable. Fresenius reported more than $2 billion in profits in 2018, with the vast majority of its revenue coming from North America. The discrepancy in payments between Medicare and commercial payers gives dialysis centers an incentive to treat as many privately insured patients as possible and to charge as much as they can before dialysis patients enroll in Medicare. It may also give dialysis centers an incentive to charge the few out-of-network patients they see outlandish prices.

“The dialysis companies may think they can get closer to what they want from the health plans by staying out-of-network and charging these prices that are totally untethered to their actual costs,” said Sabrina Corlette, a professor at Georgetown University’s Health Policy Institute. “They have the health plans over a barrel.”

by Jenny Gold, Kaiser Health News |  Read more:

Image: Tommy Martino for KHN
[ed. See also: Dialysis Industry Spends Big To Protect Profits and Taking Dialysis Providers to Task: Nowhere But In The USA (KHN)]

The Great Seattle Pot Heist

Regina Liszanckie was about to head to work when she got the text from the owners of the business next door to hers: The razor-wire-topped chain-link gate and front door to her building were swinging open, and a single jar of marijuana lay on the ground beside the gate. She had been robbed.

Four months earlier, in September 2017, Liszanckie’s business, Plantworks, had joined the thousand-plus other “producer-processors” licensed to supply Washington’s burgeoning trade in recreational marijuana. She and her partner set out to grow high-end “craft” weed in 2,500 square feet of an anonymous industrial strip in Seattle’s North End. On the night of the break-in in January 2018, Plantworks had a full crop—26 pounds of high-quality dried, cured flower, worth about $52,000—ready to deliver to local cannabis shops.

The thieves, recounts Liszanckie, bypassed the live plants and headed straight for the ready-to-sell stock, cleaning it out. It was devastating.

Liszanckie asked around and discovered she was just one in a rash of growers in and around Seattle who’ve suffered similar break-ins, six of whom consented to be interviewed for this article. Their accounts followed a pattern: The burglars came in the wee hours and speedily cut the electricity to the security cameras and alarms. Sometimes they smashed through walls to get in, avoiding the alarms on the doors. Because even the legal grow operations tend to be unsigned and inconspicuously located in small warehouses and industrial strips, the noise went unnoticed. And the burglars chose their targets well: Bypassing large grow operations with highly secure, purpose-built facilities, they hit smaller, more vulnerable growers producing high-end, easy-to-move weed.

The robbers also showed an uncanny sense of timing, striking just as the growers had amassed inventories of cut, cured, ready-to-sell product worth thousands, even tens and hundreds of thousands of dollars.

The growers began posting news of the heists on Instagram, swapping conjectures as to how the burglars knew where and when to strike. Two hypotheses emerged. The first: that an employee at a retail pot shop was either involved in the break-ins or telling the burglars whom to hit.

But as the burglaries continued, the growers came to suspect that the criminals had found another way of getting the information they needed to target vulnerable businesses offering big payoffs: The government was giving it to them.

After Washington’s residents became the first in the nation (together with Colorado’s) to vote to legalize recreational marijuana sales and possession in 2012, the state liquor board, newly renamed the Washington Liquor and Cannabis Board (WLCB) adopted exhaustive rules and regulations to govern the new trade. These require that cannabis producers and processors provide much more detailed information about their activities to the state each month than other businesses are obliged to provide—things like exactly how many plants they grow and harvest by batch and strain, how much inventory they hold and how much they sell, when, to whom, for how much. Whenever they transport product, they must file cargo manifests with detailed vehicle information. “We plant a seed, we report it,” Liszanckie says. “You take a cutting, you report it. How long you dry. What the final weight was. How soon did it go out door? What did you sell, who did you sell it to, for how much? What did they mark it up to? Easily 25 percent of our time is given over to tracking.”

The state and state-licensed data firms then post much of this information online, where it is available to the public.

In other words, Liszanckie and other growers fear that this system, put in place to ensure transparency and accountability in the newly legalized industry, may also leave a data trail that leads thieves straight to their doors, right when the pickings are fattest.

“If you are a crook, it’s a veritable laundry list of targets,” says Andrew Marris, a partner in the Seattle cannabis grower Fire Bros., which lost what it says was $200,000 worth of weed to burglars last summer.

by Eric Scigliano, Politico | Read more:
Image: Owen Freeman

Do Women’s Clothes Seem Weird Lately? Because I’m Into It

The consensus among my friends, as well as a lot of the women I follow on the internet, is that clothes suck lately. This summer, if you were to pop into any of the fast fashion outlets where trends both live and die, you’d find a strange mix of styles, indeed: ’90s-era crop tops and babydoll dresses, wacky prints, poofy sleeves, ruching and draping, and big, boxy shapes that don’t appear to align with the build of any actual human body. One could sum up fashion right now as “sexy baby” or “cursed prairie” or, as my friend and editor Rachel put it, a bizarre blend of both “modest and horny.”

I hear everybody’s qualms about this moment in style — and I respect them! — but I have to go against the grain here and speak my truth: I am loving it.

I’ve been a fan of fashion’s weird journey for years now. I love a good sack dress, even though I am one of the millions of people who hover somewhere between straight and plus sizes and they are not technically “flattering” on my body type. If I were to follow fashion magazine convention, I should always wear something that draws attention to my waist, where I'm smallest, and draws attention away from where I’m biggest: ass, hips, thighs. I shouldn’t wear horizontal stripes or, really, any sort of loud pattern at all but, rather, dark, neutral tones for their slimming effects. Anything architectural, bulky, or frilled is certainly a no-no — those additions will just make me take up more space, not less.

But where’s the fun in that?

I appreciate the value of simple, timeless clothing and can understand that if you’re a less risk-taking dresser, shopping must be pretty stressful these days. Maybe I’m just a hopeless trend monster, but I don’t know, man — I’m having the time of my life. I love these loud patterns! I love the bold color, the fascinating shapes, the funky additions to an otherwise unremarkable top or skirt that give it some flair. I love that fashion right now isn’t about what’s technically the most “flattering,” because those rules are designed with the thinnest, whitest, and most conventionally beautiful among us in mind.

The game is already rigged; even if we follow every rule, we still can’t really win. So why not just go wild and lean into the wackiness of it all? If I’m never actually going to attain the unattainable ideal of the sexy-but-not-too-sexy woman, then I might as well have a good time when I’m getting dressed in the morning.

by Shannon Keating, BuzzFeed |  Read more:

Image: Abbey Lossing for BuzzFeed News

The Shadow World
via:

 

[ed. The local grocery store was packed today with young people, all stocking up for a 4-day EDM festival at The Gorge. I told the checkout guy something like that would probably kill me... 4 days. Of EDM.]

The Big Splat

When the Earth Had Two Moons (Nautilus)
Image: M. Jutzi (U. Bern), E. Asphaug (ASU, UCSC)

It’s Official: Parts of California Are Too Wildfire-Prone to Insure

California is facing yet another real estate-related crisis, but we’re not talking about its sky-high home prices. According to newly released data, it’s simply become too risky to insure houses in big swaths of the wildfire-prone state.

Last winter when we wrote about home insurance rates possibly going up in the wake of California’s massive, deadly fires, the insurance industry representatives we interviewed were skeptical. They noted that the stories circulating in the media about people in forested areas losing their homeowners’ insurance was based on anecdotes, not data. But now, the data is in and it’s really happening: Insurance companies aren’t renewing policies areas climate scientists say are likely to burn in giant wildfires in coming years.

Insurance companies dropped more than 340,000 homeowners from wildfire areas in just four years. Between 2015 and 2018, the 10 California counties with the most homes in flammable forests saw a 177 percent increase in homeowners turning to an expensive state-backed insurance program because they could not find private insurance.

In some ways, this news is not surprising. According to a recent survey of insurance actuaries (the people who calculate insurance risks and premiums based on available data), the industry ranked climate change as the top risk for 2019, beating out concerns over cyber damages, financial instability, and terrorism. While having insurance companies on board with climate science is a good thing for, say, requiring cities to invest in more sustainable infrastructure, it’s bad news for homeowners who can’t simply pick up their lodgings and move elsewhere.

“We are seeing an increasing trend across California where people at risk of wildfires are being non-renewed by their insurer,” said California Insurance Commissioner Ricardo Lara in a statement. “This data should be a wake-up call for state and local policymakers that without action to reduce the risk from extreme wildfires and preserve the insurance market we could see communities unraveling.”

A similar dynamic is likely unfolding across many other Western states, according to reporting from the New York Times.

by Nathanael Johnson, Grist | Read more:
Image: AP/Marcio Jose Sanchez
[ed. Might want to re-think buying that coastal or riverfront property, too.]

St. Vincent

St. Vincent (Annie Clark)
via: here and here (from the ifuckinglovestvincent Tumblr blog).
[ed. Talent to burn. See also: Los Ageless. St. Vincent's Life in 6+ Riffs, and Being a Guitar God (YouTube)]

Real Estate for Dummies

The aborted Greenland purchase, however, was not necessarily the response many geopolitical strategists had in mind and comes at a time when Mr. Trump has seemed particularly erratic. In recent days, he proudly quoted a radio host declaring that Israeli Jews love him as if he were the “King of Israel” and “the second coming of God,” while Mr. Trump himself accused Jews who vote for Democrats of “great disloyalty.”

Speaking with reporters on the South Lawn on Wednesday, he suggested that God had tapped him to lead a trade war with China. “I am the chosen one,” he said, glancing heavenward. In the Oval Office on Tuesday, he exhibited his universal suspicion. “In my world, in this world, I think nobody can be trusted,” he said.

Trump’s Interest in Buying Greenland Seemed Like a Joke. Then It Got Ugly (NY Times).

[ed. No worries! I hear Britain will be coming on the market soon. See also: Trump Goes Godly (NY Times). Maybe this post should be titled 'Dementia for Dummies - How to Recognize It, What to do About It'.]  

What Does It Even Mean to be a Tech Company in 2019?

The coworking company WeWork’s newly unveiled public filings raise a question: What does it even mean to be a tech company these days?

WeWork, which leases office space to people and businesses, is valued at a whopping $47 billion — more than 10 times its bigger rival IWG, which is considered a real estate company but does the same thing. A “tech company” like WeWork, the rationale goes, is more valuable because it is bigger, faster, stronger, and will bring in more future profits for shareholders.

“If you’re going to raise capital, it’s an easier way to get your foot in the door by saying you’re some new kind of disruptive tech company,” Paul Condra, lead emerging technology analyst at research firm PitchBook, told Recode.

That’s why WeWork went to great lengths in its filings to point out all the things that make it a tech company and, by extension, validate its price tag. It has purchased lots of other tech companies and brings that technology to bear on its regular operations by “scanning technologies and software to automate the design and construction layout of any given space,” applying “data science to compare new buildings with similar proven locations,” and using machine learning to “forecast demand for each building to set the opening day price and optimize on a real-time basis.”

It also boasts 1,000 tech employees out of 12,500 total employees.

But does that make it a tech company?

Ultimately, WeWork’s main business involves leasing buildings on a long-term basis, remodeling and styling them so they feel like trendy places to be, and then subleasing space in those buildings to people and companies on a short-term basis. It looks a lot like a real estate company.

But it’s certainly not alone in having tech aspirations. Startups of every stripe are touting their tech bona fides.

Are direct-to-consumer brands like Glossier (makeup) and Away (luggage), where you purchase goods online but otherwise don’t interact with technology, tech companies? Amazon and Etsy, which primarily function as online marketplaces — are they tech? What is it that makes Tesla a tech company but not General Motors? GM uses plenty of technology and is even making competing, autonomous electric cars.

Airbnb? DoorDash? Blue Apron? Uber? Lyft? Sweetgreen? The list goes on, as does the justification. As many have noted before me, every company is a tech company — or at least thinks it is. Katrina Lake, the CEO of clothing recommendation company StitchFix told Recode’s Kara Swisher, “if you want to be relevant 10 years from now, every company is going to be a tech company.”

“The first question is, ‘Does the company sell tech?’ That’s easy. If yes, that’s a tech company,” Condra said. “If they don’t, then you have to ask yourself, ‘Is there some kind of modern technology core to its customer acquisition or customer retention?’”

But as technology becomes increasingly central to companies’ businesses, that line becomes harder to draw.

“Twenty years ago, if the internet was an important part of a business — I’d say, ‘yes, that’s a tech company,’” Jay Ritter, a finance professor at the University of Florida who tracks IPOs, told Recode. “But today, what company has a business where the internet isn’t an important part of it?”

He added, referring to other IPO researchers he’s talked with over the years, “We all agree that companies like WeWork or Etsy, whether you classify them as a technology company or not is definitely a judgment issue.”

For plucky entrepreneurs aspiring to found tech companies, that leaves many ways in. You don’t necessarily need to sell or develop technology as your main line of business. Simply using technology does the trick, and the more buzzwords you can fit in a pitch deck — AI, machine learning, data mining, blockchain — the better. Hiring engineers and software developers helps, too.

Or perhaps being a tech company is more of a mindset: We are new and we use the internet, therefore we are tech. It’s certainly a branding tool. But the distinction can feel mind-numbing.

In 2011, prominent tech venture capitalist Marc Andreessen penned a widely read Wall Street Journal article, “Software Is Eating the World” that made the prescient point that software companies would take over a large portion of the economy. These days, it feels like it’s eating our brains.

by Rani Molla, Recode | Read more:
Image: Jonathan Brady/PA Images via Getty Images
[ed. See also: WeWork: Is There Any There There? (NY Times)]

Molly Tuttle

[ed. Not just three chords and a cloud of dust.]

Clare E. Rojas, Untitled, 2018
via:

Maybe Your Zoloft Stopped Working Because a Liver Fluke Tried to Turn Your Nth-Great-Grandmother Into a Zombie

Or at least this is the theory proposed in Brain Evolution Through The Lens Of Parasite Manipulation by Marco del Giudice.

The paper starts with an overview of parasite manipulation of host behavior. These are the stories you hear about toxoplasma-infected rats seeking out cats instead of running away from them, or zombie ants climbing stalks of grass so predators will eat them. The parasite secretes chemicals that alter host neurochemistry in ways that make the host get eaten, helping the parasite transfer itself to a new organism.

Along with rats and ants, there is a dizzying variety of other parasite manipulation cases. They include parasitic wasps who hack spiders into forming protective webs for their pupae, parasitic flies that cause bees to journey far from their hive in order to spread fly larva more widely, and parasitic microorganisms that cause mosquitoes to draw less blood from each victim (since that forces the mosquitoes to feed on more victims, and so spread the parasite more widely). Parasitic nematodes make their ant hosts turn red, which causes (extremely stupid?) birds to mistake them for fruit and eat them. Parasitic worms make crickets seek water; as the cricket drowns, the worms escape into the pond and begin the next stage of their life cycle. Even mere viruses can alter behavior; the most famous example is rabies, which hacks dogs, bats, and other mammals into hyperaggressive moods that usually result in them biting someone and transmitting the rabies virus.

Even our friendly gut microbes might be manipulating us. People talk a lot about the “gut-brain axis” and the effect of gut microbes on behavior, as if this is some sort of beautiful symbiotic circle-of-life style thing. But scientists have found that gut microbes trying to colonize fruit flies will hack the flies’ food preferences to get a leg up – for example, a carb-metabolizing microbe will secrete hormones that make the fly want to eat more carbs than fat in order to outcompete its fat-metabolizing rivals for gut real estate; there are already papers speculating that the same processes might affect humans. Read Alcock 2014 and you will never look at food cravings the same way again.

But del Giudice thinks this is just the tip of the iceberg. Throughout evolutionary history, parasites have been trying to manipulate host behavior and hosts have been trying to avoid manipulation, resulting in an eons-long arms race. The equilibrium is what we see today: parasite manipulation is common in insects, rare in higher animals, and overall of limited importance. But in arms race dynamics, the current size of the problem tells you nothing about the amount of resources invested in preventing the problem. There is zero problem with war between Iran and Saudi Arabia right now, but both sides have invested billions of dollars in military supplies to keep their opponent from getting a leg up. In the same way, just because mammals usually avoid parasite behavior manipulation nowdoesn’t mean they aren’t on a constant evolutionary war footing.

So if you’re an animal at constant risk of having your behavior hijacked by parasites, what do you do?

First, you make your biological signaling cascades more complicated. You have multiple redundant systems controlling every part of behavior, and have them interact in ways too complicated for any attacker to figure out. You have them sometimes do the opposite of what it looks like they should do, just to keep enemies on their toes. This situation should sound very familiar to anyone who’s ever studied biology.

Del Giudice compares the neurosignaling of the shrimp-like gammarids (small, simple, frequently hijacked by parasites) to rats (large, complex, hard to hijack). Gammarids have very simple signaling: high serotonin means “slow down”, low serotonin means “speed up”. The helminths that parasitize gammarids secrete serotonin, and the gammarids slow down and get eaten, transferring the parasite to a new host. Biologists can replicate this process; if they inject serotonin into a gammarid, the gammarid will slow down in the same way.

Toxoplasma hijacks rats and makes them fearless enough to approach cats. Dopamine seems to be involved somehow. But researchers injecting dopamine into rats don’t get the same result; in fact, this seems to make rats avoid cats more. Maybe toxoplasma started by increasing dopamine, rats evolved a more complicated signaling code, and toxoplasma cracked the code and now increases dopamine plus other things we don’t understand yet.

Aside from the brain, the immune system is the most important target to secure, so this theory should predict that immune signaling will also be unusually inscrutable. Again, this situation should sound very familiar to anyone who’s ever studied biology.

Second, you have a bunch of feedback loops and flexibility ready to deploy at any kind of trouble. If something makes dopamine levels go up, you decrease the number of dopamine receptors, so that overall dopaminergic neurotransmission is the same as always. If something is making you calmer than normal, you have some other system ready to react by making you more anxious again.

Del Giudice makes the obvious connection to psychopharmacology. Many psychoactive drugs build tolerance quickly: for example, heroin addicts constantly need higher and higher doses to get their “hit”. Further, tolerance builds in a pattern weirdly similar to antibody response – it takes a while to build up a cocaine tolerance, and you lose it over time if you don’t use cocaine, but the body “remembers” the process and a single hit of cocaine years later is sufficient to bring you back up to the highest tolerance level you’ve ever had.

The standard explanation for tolerance is that it’s an attempt to maintain homeostasis against the sort of conditions that can cause natural variation in neurotransmitter levels. I never questioned this before. But why is the body prepared to suddenly have all its serotonin reuptake transporters inhibited? Is that something that frequently happens, out in nature? I guess maybe plant toxins could do that, but then how come the body is prepared to deal with this for months or years?

While not denying the value of these standard explanations, Del Giudice thinks defense against parasite behavior manipulation may also play a role. Remember, gammarids absolutely have parasites that try to increase their serotonin levels as a prelude to getting them killed. Is it that surprising that a lot of different animal lineages would develop a reaction of “If something other than normal cognition has started increasing your serotonin levels, it’s a trap and you need to get them back down again”? Does that explain why SSRIs don’t work for some people, or randomly stop working, or need frequent dose escalation?

by Scott Alexander, Slate Star Codex |  Read more:

Despite Devastating Crashes, Boeing Stocks Fly High

In a turbulent world, some things remain stable, even to an irrational degree. One example is the price of Boeing stock, which, at $329 a share as of midday August 16, has barely moved—down just 1.6 percent—from a year ago.

As all the world knows, in the intervening 12 months, two Boeing 737 Max jets have crashed, killing a total of 346 people. We also know that the crashes were entirely thanks to corporate management rushing through a Rube Goldberg adaptation of a half century-old design, suborning the FAA to approve untested and incompetently programmed software control features along with other irresponsible shortcuts (such as cutting the company’s own test pilots out of MAX development planning and avoiding mention of the new control features in the airline pilots’ manuals).

Nevertheless, neither the slaughter of passengers nor the subsequent deluge of shocking revelations have had any long-term impact on the stock price. There have indeed been short-term fluctuations in the interim, notably a sharp climb in the months following the first MAX disaster in Indonesia last October, when management’s disgraceful PR spin ascribing blame to incompetent foreign pilots achieved some traction in the press. (...)

Even so, Wall Street appears unworried. Analysts still rate the stock a “strong buy” by a wide margin, with a consensus estimate that it will climb some 90 points from its currently stable position in the high $320s over the next 12 months. The $2.3 billion Boeing spent buying its own stock in the first three months of this year no doubt encouraged such bullish sentiment, part of the $43 billion splurged on price-propping buybacks since 2013.

In addition, other powerful forces are hard at work to save the corporate behemoth from going into a terminal stall. Boeing, for example, is a component of the Dow Jones Industrial Average, the 30-stock index generally if misleadingly cited as a bellwether of the market as a whole, and even the entire U.S. economy. Because the Dow is weighted by price, an upward or downward move in Boeing has a significant effect on the index, which makes it a particular object of interest for the trading desks at major Wall Street players. Hence the stock is traded very actively in the “dark pools,” otherwise known as “alternative trading systems,” with opaque names such as JP Morgan’s JPMX, operated by the big banks and major institutions as unregulated stock exchanges, courtesy of a toothless SEC.

These are ideal instruments for manipulating the market, since they don’t have to show their bids and offers to the general market place as is required on regulated exchanges. As analogy, think of carpet dealers in a bazaar negotiating prices privately among themselves behind the backs of ordinary customers.

The tender regard being exhibited by big players on Wall Street is not, of course, solely for the sake of propping up the Dow. There is a lot of money directly at stake, not least in the 67 percent of the Boeing stock owned by just five giant funds, including Vanguard ($5.3 trillion in total assets) and Blackstone ($6.8 trillion). It’s a sign that Boeing must keep borrowing money to stay afloat. Fortunately, thanks to low interest rates and the river of cash generated by the Federal Reserve since 2008, supplies are ready to hand. Thus on July 31, for example, Boeing borrowed a total of $5.5 billion via notes of varying maturities and interest rates taken up by major banks, including JP Morgan, Morgan Stanley, Wells Fargo, and Goldman Sachs—and that was on top of $3.5 billion borrowed in late April.

Given that it may be quite a while before money starts to flow again from airlines shopping for 737s, there is undoubtedly a lot of Wall Street interest in the alternative source for emergency Boeing cash flow: a giant taxpayer bailout in the form of a Pentagon contract of suitable proportions. Fortunately, there is a vehicle for delivering the cash: the Ground Based Strategic Deterrent, the Minuteman-replacement ICBM authorized by President Obama as part of his $1 trillion nuclear modernization program. It carries a price tag, gratifying to investors, of up to $100 billion—a sum that will quite certainly be exceeded down the road.

by Andrew Cockburn, The American Conservative | Read more:
Image: pjs2005/creativecommons
[ed. Too big to fail.]

Robert Plant

[ed... "life is a big tambourine, the harder you hit it the better it seems".]

Doxology

It was a bit uncanny to read Nell Zink’s new novel, “Doxology,” in the wake of the suicide this month of David Berman, the beloved singer and songwriter best known for his work with Silver Jews, his indie-rock band.

A similar type of outside-the-box musician, named Joe Harris, dies too young (heroin) in “Doxology.” Berman and Harris are different in many ways. But they share a surreal sense of humor. Zink shows us Harris onstage at one point, “rocking out to his own conception of beauty, alone and weird.” Berman and Harris also share a restless sort of talent that can lead artists to become more influential dead than alive.

“Doxology” isn’t fundamentally a music novel. It has many other things on its mind, including a subversive history of American politics from Operation Desert Shield through the start of the Trump presidency, and it’s superb. In terms of its author’s ability to throw dart after dart after dart into the center of your media-warped mind and soul, it’s the novel of the summer and possibly the year. It’s a ragged chunk of ecstatic cerebral-satirical intellection. It’s bliss.

“Doxology” displays two generations of an American family. Pamela and Daniel are semi-clueless young people who move individually to New York City in the late 1980s. They might have dropped sideways, like bookmarks, out of a Jonathan Lethem novel. He is fleeing college life after graduation; she is just fleeing. They meet, marry, struggle financially and play in small anti-bands, sometimes with Harris before he becomes famous. Pamela’s musical motto is: “If you gotta suck, suck loud.”

They’re ’80s hipsters, in other words, a genus with which Zink is intimate. Here’s a sample of this writer’s sociological acumen — her ability, like Tom Wolfe by way of Lorrie Moore, to cram observation into a tight space:

“The ’80s hipster bore no resemblance to the bearded and effeminate cottage industrialist who came to prominence as the ‘hipster’ in the new century. He wasn’t a ’50s hipster either. He knew nothing of heroin or the willful appropriation of black culture,” she writes. “Having spent four years at the foot of the ivory tower, picking up crumbs of obsolete theory, he descended to face once again the world of open-wheel motor sports and Jell-O salads from whence he sprang.”

Zink adds, as a flourish: “An ’80s hipster couldn’t gentrify a neighborhood.” She writes: “His presence drove rents down.” Also: “The ’80s hipster could get served a beer in the Ozarks.”

If you care about this sort of thing, Zink writes about music as if she were a cluster of the best American rock critics (Ellen Willis, Ann Powers, Jessica Hopper and Amanda Petrusich, let’s say) crushed together under a single byline. This novel is replete with erudite signifiers that drop all over the place, like a toddler eating a pint of blueberries: Robert Christgau jokes, nods to the “Casio-core” sound, paeans to the righteous punk glory of Ian MacKaye of Minor Threat and Fugazi.

One band sounds “like lawn mowers ridden by nymphets playing banjos.” When Pamela plays guitar, “her fingers move like it’s freezing out and she lost her mittens.” (...)

Post-sensitive is not a bad description of Zink’s Weltanschauung. Her women tend to be the sort of people for whom, as the old joke has it, there was no Santa at 6, no stork at 9 and no God at 12. (...)

Her previous novels include “The Wallcreeper,” “Mislaid” and “Nicotine,” and I’ve admired many aspects of each of them. “Doxology” puts her on a new level as a novelist, however. This book is more ambitious and expansive and sensitive than her earlier work. She lays her heart on the line in a way she hasn’t before.

by Dwight Garner, NY Times |  Read more:

Image: Sonny Figueroa

How Shareholder Democracy Failed the People

Democracy is a messy thing. Shareholder democracy may be even messier.

For nearly a half-century, corporate America has prioritized, almost maniacally, profits for its shareholders. That single-minded devotion overran nearly every other constituent, pushing aside the interests of customers, employees and communities.

That philosophy was rooted in an idea that has an air of nobility about it. Shareholder democracy was the name given to investors asserting themselves in corporate governance. The idea was that investors would wrest control of companies from entrenched managers, letting the actual owners set their corporate priorities. But what we really got was something else: an era of shareholder primacy.

That may have a chance — a chance — of changing now that 181 chief executives have lent their signatures to a new “Statement on the Purpose of a Corporation” that was published by the Business Roundtable on Monday. The statement from the leaders of companies including JPMorgan Chase, Apple, Amazon and Walmart affirms that the nation’s largest companies have a “fundamental commitment” to all their stakeholders: putting employees, suppliers and communities on a pedestal that once belonged only to shareholders.

The companies’ statement is a significant shift and a welcome one. For years, businesses have resisted calls — including from this column — to rethink their responsibility to society. In response, corporations typically dismissed hot-button topics like income inequality, climate change, gun violence and more as political issues unrelated to them.

Some will doubt the sincerity of these business leaders’ words, and it remains an open question whether their companies will be held accountable — and by whom. But what we may be at the start of is less a new era and more a return to the past.

For nearly 50 years — following the publication of a seminal academic treatise in 1932 called “The Modern Corporation and Private Property” by Adolf A. Berle Jr. and Gardiner C. Means — corporations, for the most part, were run for all stakeholders. It was a time defined by organized labor, corporate pension programs, gold-watch retirements and charitable gifts from companies that invested heavily in their communities and the kind of research that promised future growth.

It is a period often referred to — sometimes derisively — as “managerialism.”

But by the 1970s, managerialism became synonymous in investment circles with immovable executives who were running bloated businesses more for their own benefit than for their shareholders.

It also coincided with the ascent of Milton Friedman, the University of Chicago economist who preached a gospel of profits-as-purpose and mocked anyone who thought that businesses should do anything else.

“What does it mean to say that ‘business’ has responsibilities?” Mr. Friedman wrote in this newspaper in 1970. “Businessmen who talk this way are unwitting puppets of the intellectual forces that have been undermining the basis of a free society these past decades.”

That began the rise of shareholder democracy, an idea that the public and news media embraced. Shareholders and, in turn, a new class of investors known as corporate raiders convinced executives to slash any and all fat from their budgets or risk being taken over or voted out. Layoffs increased, research and development budgets were cut, and pension programs were traded for 401(k)s. There was a rush of mergers driven by “cost savings” that grabbed headlines while profits soared and dividends increased.

And here we are. Americans mistrust companies to such an extent that the very idea of capitalism is now being debated on the political stage. Populism has been embraced on both ends of the political spectrum, whether in the trade protectionism of President Trump or the social-net supremacy of Senator Bernie Sanders.

It is against that backdrop that the Business Roundtable released its statement on Monday. The group should be commended for coming around — and no one wants to criticize progress — but it is undeniably late.

Make no mistake, it wasn’t shareholder democracy that created this new enlightened moment. Public outrage pushed this forward. So did anger in Washington and regulatory scrutiny that is finally coming to bear.

Shareholders — with some exceptions — did not come around until they had no choice but to realize that these forces could have an impact on their investments.

by Andrew Ross Sorkin, NY Times | Read more:
Image: Rick T. Wilking/Getty Images

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