[ed. Guitar lesson here.]
Wednesday, November 23, 2022
The Pentagon Fails Its Fifth Audit in a Row
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Last week, the Department of Defense revealed that it had failed its fifth consecutive audit. “I would not say that we flunked,” said DoD Comptroller Mike McCord, although his office did note that the Pentagon only managed to account for 39 percent of its $3.5 trillion in assets. “The process is important for us to do, and it is making us get better. It is not making us get better as fast as we want.”
The news came as no surprise to Pentagon watchers. After all, the U.S. military has the distinction of being the only U.S. government agency to have never passed a comprehensive audit. (...)
The Pentagon’s most famous recent boondoggle is the F-35 program, which has gone over its original budget by $165 billion to date. But examples of overruns abound: As Sens. Jim Inhofe (R-Okla.) and Jack Reed (D-RI) wrote in 2020, the lead vessel for every one of the Navy’s last eight combatant ships came in at least 10 percent over budget, leading to more than $8 billion in additional costs. (...)
Despite the long odds, a bipartisan group of lawmakers led by Sen. Bernie Sanders (I-Vt.) proposed a bill last year that could help make that happen. The legislation would cut one percent off the top of the budget of any part of the Pentagon that fails an audit. That means that, if the proposal had already passed, 20 of the agency’s 27 auditing units would face a budget cut this year.
Unfortunately, momentum around that bill appears to have fizzled out, leaving the Pentagon’s accountants as the last line of defense. (...) That may coincide with another historical moment, according to Andrew Lautz of the National Taxpayers Union.
“[W]e could reach a $1 trillion defense budget five years sooner [than the CBO estimates], in 2027,” Lautz wrote.
by Connor Echols, Responsible Statecraft | Read more:
Image: gualtiero boffi/shutterstock[ed. One percent. Ouch! That's gonna hurt. Whenever someone starts complaining about tax and spend blah, blah, blah for unnecessary things like healthcare, social programs, infrastructure, or anything else that "we can't afford", this is what comes to mind.]
World Cup 2022: Capitalism Can’t Kill Football — Try As It Might
A week or so before the kickoff of the 2022 World Cup in Qatar, I was walking in the coastal city of Zihuatanejo in Mexico’s southern Guerrero state when I passed a group of children playing football with a plastic Coca-Cola bottle. They were as gleefully animated as any group of children playing football anywhere, while the Coke bottle was, I thought, regrettably appropriate in a world governed by corporate toxicity.
It was particularly appropriate, perhaps, given that Coca-Cola and football go way back. The company, which has been an official World Cup sponsor since 1978, entered into a formal association with FIFA in 1974 – although its logo has saturated World Cup events since 1950. The partnership was initially ostensibly meant to promote youth development programmes, since there is clearly nothing better for youth development than ingesting sticky brown liquid that is bad for human health.
Of course, that alliance is just the tip of the iceberg in terms of global capitalism’s efforts to suck the soul out of football and eradicate any remnants of primordial joy by monetising and commodifying everything on and off the field. Given the deluge of corporate propaganda that we call “sponsorship”, the uninitiated football spectator would be forgiven for thinking Adidas was a football team – or that matches are waged between Emirates and Etihad airlines.
[ed. Seen a NASCAR/Formula 1 race recently? See also: The eerily quiet $200 billion World Cup stadiums marooned in the Qatar desert (Daily Mail).]
It was particularly appropriate, perhaps, given that Coca-Cola and football go way back. The company, which has been an official World Cup sponsor since 1978, entered into a formal association with FIFA in 1974 – although its logo has saturated World Cup events since 1950. The partnership was initially ostensibly meant to promote youth development programmes, since there is clearly nothing better for youth development than ingesting sticky brown liquid that is bad for human health.
And there’s nothing like sponsoring football’s biggest competition to improve one’s international branding. Chinese firms have also caught on – they’re leading in spending for the Qatar World Cup.
In his book, El Fútbol a sol y sombra (Football in sun and shadow), first published in 1995, the renowned Uruguayan writer and die-hard football fan Eduardo Galeano remarked how every footballer had become an “advertisement in motion”- though not everyone was happy with that arrangement. In the mid-1950s, he recalled, when the prominent Montevideo club Peñarol had endeavoured to impose company advertising on its shirts, 10 members of the team had obediently taken to the field with the updated jerseys while Black player Obdulio Varela had declined: “They used to drag us Blacks around with rings in our noses. Those days are gone.”
To be sure, it’s never just fun and games when obscene quantities of money are involved. Take the case of Horst Dassler – the son of Adidas founder Adi Dassler, himself charmingly a former member of the Nazi Party – who in 1982 started a company called International Sports and Leisure, which promptly acquired exclusive marketing and TV rights to FIFA operations, including the World Cup. This was done by paying bribes to then-FIFA President João Havelange – the same Havelange who had graciously appeared alongside Argentine dictator Jorge Videla during the 1978 World Cup in Buenos Aires. (...)
But as the US well knows, corrupt self-enrichment and corporate impunity are business as usual in capitalism – which has also produced a “gentrification” of the sport itself, as researchers have shown. A study published by the Royal Society in December 2021 found that the “excessive monetisation of football” had led to increasing inequality between teams in major European leagues and a growing predictability of match outcomes. Even as those responsible for the sport’s governance claim to be globalising football, in reality, the process replicates the inequality endemic to corporate globalisation.
In his book, El Fútbol a sol y sombra (Football in sun and shadow), first published in 1995, the renowned Uruguayan writer and die-hard football fan Eduardo Galeano remarked how every footballer had become an “advertisement in motion”- though not everyone was happy with that arrangement. In the mid-1950s, he recalled, when the prominent Montevideo club Peñarol had endeavoured to impose company advertising on its shirts, 10 members of the team had obediently taken to the field with the updated jerseys while Black player Obdulio Varela had declined: “They used to drag us Blacks around with rings in our noses. Those days are gone.”
To be sure, it’s never just fun and games when obscene quantities of money are involved. Take the case of Horst Dassler – the son of Adidas founder Adi Dassler, himself charmingly a former member of the Nazi Party – who in 1982 started a company called International Sports and Leisure, which promptly acquired exclusive marketing and TV rights to FIFA operations, including the World Cup. This was done by paying bribes to then-FIFA President João Havelange – the same Havelange who had graciously appeared alongside Argentine dictator Jorge Videla during the 1978 World Cup in Buenos Aires. (...)
But as the US well knows, corrupt self-enrichment and corporate impunity are business as usual in capitalism – which has also produced a “gentrification” of the sport itself, as researchers have shown. A study published by the Royal Society in December 2021 found that the “excessive monetisation of football” had led to increasing inequality between teams in major European leagues and a growing predictability of match outcomes. Even as those responsible for the sport’s governance claim to be globalising football, in reality, the process replicates the inequality endemic to corporate globalisation.
Tuesday, November 22, 2022
Chance of Showers
[ed. 31 degees and snowing. Looks like golf season's over for this year. Here's my friend Matt negotiating a few water hazards this summer.]
Image: markk
Sick Profit
Investigating Private Equity’s Stealthy Takeover of Health Care Across Cities and Specialties
Two-year-old Zion Gastelum died just days after dentists performed root canals and put crowns on six baby teeth at a clinic affiliated with a private equity firm.
His parents sued the Kool Smiles dental clinic in Yuma, Arizona, and its private equity investor, FFL Partners. They argued the procedures were done needlessly, in keeping with a corporate strategy to maximize profits by overtreating kids from lower-income families enrolled in Medicaid. Zion died after being diagnosed with “brain damage caused by a lack of oxygen,” according to the lawsuit. (...)
Private equity is rapidly moving to reshape health care in America, coming off a banner year in 2021, when the deep-pocketed firms plowed $206 billion into more than 1,400 health care acquisitions, according to industry tracker PitchBook.
Seeking quick returns, these investors are buying into eye care clinics, dental management chains, physician practices, hospices, pet care providers, and thousands of other companies that render medical care nearly from cradle to grave. Private equity-backed groups have even set up special “obstetric emergency departments” at some hospitals, which can charge expectant mothers hundreds of dollars extra for routine perinatal care.
As private equity extends its reach into health care, evidence is mounting that the penetration has led to higher prices and diminished quality of care, a KHN investigation has found. KHN found that companies owned or managed by private equity firms have agreed to pay fines of more than $500 million since 2014 to settle at least 34 lawsuits filed under the False Claims Act, a federal law that punishes false billing submissions to the federal government with fines. Most of the time, the private equity owners have avoided liability.
New research by the University of California-Berkeley has identified “hot spots” where private equity firms have quietly moved from having a small foothold to controlling more than two-thirds of the market for physician services such as anesthesiology and gastroenterology in 2021. And KHN found that in San Antonio, more than two dozen gastroenterology offices are controlled by a private equity-backed group that billed a patient $1,100 for her share of a colonoscopy charge — about three times what she paid in another state.
It’s not just prices that are drawing scrutiny.
Whistleblowers and injured patients are turning to the courts to press allegations of misconduct or other improper business dealings. The lawsuits allege that some private equity firms, or companies they invested in, have boosted the bottom line by violating federal false claims and anti-kickback laws or through other profit-boosting strategies that could harm patients.
“Their model is to deliver short-term financial goals and in order to do that you have to cut corners,” said Mary Inman, an attorney who represents whistleblowers.
Federal regulators, meanwhile, are almost blind to the incursion, since private equity typically acquires practices and hospitals below the regulatory radar. KHN found that more than 90% of private equity takeovers or investments fall below the $101 million threshold that triggers an antitrust review by the Federal Trade Commission and the U.S. Justice Department.
Spurring Growth
Private equity firms pool money from investors, ranging from wealthy people to college endowments and pension funds. They use that money to buy into businesses they hope to flip at a sizable profit, usually within three to seven years, by making them more efficient and lucrative.
Private equity has poured nearly $1 trillion into nearly 8,000 health care transactions during the past decade, according to PitchBook.
by Fred Schulte, Kaiser Health News | Read more:
Image: ABC Arizona Broadcast
His parents sued the Kool Smiles dental clinic in Yuma, Arizona, and its private equity investor, FFL Partners. They argued the procedures were done needlessly, in keeping with a corporate strategy to maximize profits by overtreating kids from lower-income families enrolled in Medicaid. Zion died after being diagnosed with “brain damage caused by a lack of oxygen,” according to the lawsuit. (...)
Private equity is rapidly moving to reshape health care in America, coming off a banner year in 2021, when the deep-pocketed firms plowed $206 billion into more than 1,400 health care acquisitions, according to industry tracker PitchBook.
As private equity extends its reach into health care, evidence is mounting that the penetration has led to higher prices and diminished quality of care, a KHN investigation has found. KHN found that companies owned or managed by private equity firms have agreed to pay fines of more than $500 million since 2014 to settle at least 34 lawsuits filed under the False Claims Act, a federal law that punishes false billing submissions to the federal government with fines. Most of the time, the private equity owners have avoided liability.
New research by the University of California-Berkeley has identified “hot spots” where private equity firms have quietly moved from having a small foothold to controlling more than two-thirds of the market for physician services such as anesthesiology and gastroenterology in 2021. And KHN found that in San Antonio, more than two dozen gastroenterology offices are controlled by a private equity-backed group that billed a patient $1,100 for her share of a colonoscopy charge — about three times what she paid in another state.
It’s not just prices that are drawing scrutiny.
Whistleblowers and injured patients are turning to the courts to press allegations of misconduct or other improper business dealings. The lawsuits allege that some private equity firms, or companies they invested in, have boosted the bottom line by violating federal false claims and anti-kickback laws or through other profit-boosting strategies that could harm patients.
“Their model is to deliver short-term financial goals and in order to do that you have to cut corners,” said Mary Inman, an attorney who represents whistleblowers.
Federal regulators, meanwhile, are almost blind to the incursion, since private equity typically acquires practices and hospitals below the regulatory radar. KHN found that more than 90% of private equity takeovers or investments fall below the $101 million threshold that triggers an antitrust review by the Federal Trade Commission and the U.S. Justice Department.
Spurring Growth
Private equity firms pool money from investors, ranging from wealthy people to college endowments and pension funds. They use that money to buy into businesses they hope to flip at a sizable profit, usually within three to seven years, by making them more efficient and lucrative.
Private equity has poured nearly $1 trillion into nearly 8,000 health care transactions during the past decade, according to PitchBook.
by Fred Schulte, Kaiser Health News | Read more:
Image: ABC Arizona Broadcast
[ed. It's not just healthcare, it's everything. Distressed businesses, real estate, news media, and on and on and on. A capitalistic virus. See also: What Private Equity Firms Are and How They Operate (ProPublica)]
The 20-Year Boondoggle
These days, the mess at the Department of Homeland Security is one of the only things that all of Washington can agree on. Disliked by both Democrats and Republicans, DHS has metastasized into the worst version of what we imagine when we think of bureaucracy: rigid, ineffective, wasteful, chaotic, cruel. Since its inception, DHS has been on the Government Accountability Office’s “High Risk List,” which highlights programs vulnerable to “fraud, abuse, and mismanagement.” It consistently has the lowest morale of any federal agency with more than a thousand employees, according to the Federal Employee Viewpoint Survey.
“It’s like an agency no one wanted and everyone is stuck with,” said Juliette Kayyem, assistant secretary for intergovernmental affairs at DHS from 2009–2010.
“Even for someone who is kind of cynical, it was shocking,” said John Roth, the DHS inspector general from 2014–2017. “You do a little scratching, and there was just rot underneath.”
We see the downstream effects of the Kafkaesque ineptitude at DHS every day, even if we don’t recognize the connection between headlines about alleged sexual abuse at migrant detention centers, billions of dollars disappearing into fraudulent disaster aid, and the erasure of text messages likely detailing an attempted coup. DHS functions as a loose confederation of subagencies, meaning that the absurdity of security procedures at airports is attributed to the Transportation Security Administration, not to DHS, and the anemic response to Hurricane Katrina was blamed on the Federal Emergency Management Agency, not its parent organization. Yet the tensions between these satellite operations and the cabinet secretary’s headquarters in Washington, DC, are crucial to understanding DHS.
“I would call it unwieldy,” said Kevin McAleenan, who served as acting secretary of homeland security in 2019 after working at the department since it was founded. McAleenan recalled moments when he saw people at headquarters “trying to direct activities they didn’t understand very well and mission sets they weren’t familiar with and legal frameworks they hadn’t studied, and I thought, ‘This isn’t going to work. We’re not going to overcome the problem of expertise or, in this case, the lack of expertise.’”
Some consider the Department of Homeland Security successful because there has not been another major terrorist attack in the United States since 9/11. And it’s true that only about a hundred people have died on US soil from Islamic terrorism in the past two decades. But domestic terrorism and mass shootings are on the rise, with Americans now justifiably afraid of malls, parades, supermarkets, churches, and elementary schools. Militias plot against democracy. A deadly virus has killed over a million Americans. Foreign governments infiltrate social media and snatch our data. Storms and wildfires grow bigger and more frequent every year. Tens of thousands of migrants linger in refugee camps at the southern border. Those that make it across face what one high-level whistleblower called “a system that involves widespread abuse of human beings.”
All of this is under the purview of DHS.
The Department of Homeland Security was supposed to protect Americans from earthquakes, nukes, pandemics, assassins, smugglers, hackers, and hijackers. These are the folks in charge of securing critical infrastructure, meaning everything from voting machines to sports stadiums to the water supply. DHS checks for explosives at airports and border crossings; manages the immigration process and migrant detention centers; helps rebuild after natural disasters; and coordinates intelligence and threat response with the CIA and FBI, as well as state and local law enforcement.
It’s a truly bonkers amount of responsibility, fueled by $80–$150 billion a year in taxpayer money and encompassing an alphabet soup of around two dozen entities, including FEMA, the TSA, Customs and Border Protection (CBP), Secret Service (USSS), Citizenship and Immigration Services (USCIS), Coast Guard (USCG), Cybersecurity and Infrastructure Security Agency (CISA), and Immigration and Customs Enforcement (ICE). In a nationally televised address announcing his intention to form the department, Bush said DHS would “unite essential agencies that must work more closely together” and increase “focus and effectiveness.” But the 2002 bill creating the Department of Homeland Security may as well have been called Murphy’s law.
“It was a walking nightmare from the very beginning,” said John Magaw, the founding administrator of the TSA and a former director of the US Secret Service. “It just was not gonna work.”
(A spokesperson for DHS was given ample time to comment on this story but missed multiple deadlines to do so.)
How did the Department of Homeland Security become such a disaster? In recent months, I’ve spoken to a few dozen insiders and watchdogs across every era of DHS, reviewed thousands of pages of documents, and read up on the history and political science behind what makes government agencies effective. An investigation like this one might normally hope to answer the question: Whose fault is this? Who can we point to and fire or malign? But what I’ve found is that those lines of inquiry are irrelevant. This is a boondoggle spanning four presidencies, 11 Congresses, seven secretaries, and seven acting secretaries in a department with very high turnover that oversees 212,000 employees and hundreds of thousands of private contractors at any given moment. It’s not just one person’s fault or a handful of bad apples.
There will always be corrupt officials, lazy civil servants, sociopathic politicians, pedophile teachers, and sadistic prison guards. As James Madison wrote in 1788, “If men were angels, no government would be necessary.” The Constitution’s framers were trying to build a system that would keep the worst human tendencies in check. Evil is banal, yes, but our tendency to blame individuals for bad behavior can distract from the institution incentivizing that bad behavior.
So what is it about this institution in particular that allows wrongdoing to flourish? Why does the Department of Homeland Security suck so much?
by Amanda Chicago Lewis, The Verge | Read more:
“It’s like an agency no one wanted and everyone is stuck with,” said Juliette Kayyem, assistant secretary for intergovernmental affairs at DHS from 2009–2010.
“Even for someone who is kind of cynical, it was shocking,” said John Roth, the DHS inspector general from 2014–2017. “You do a little scratching, and there was just rot underneath.”
“I would call it unwieldy,” said Kevin McAleenan, who served as acting secretary of homeland security in 2019 after working at the department since it was founded. McAleenan recalled moments when he saw people at headquarters “trying to direct activities they didn’t understand very well and mission sets they weren’t familiar with and legal frameworks they hadn’t studied, and I thought, ‘This isn’t going to work. We’re not going to overcome the problem of expertise or, in this case, the lack of expertise.’”
Some consider the Department of Homeland Security successful because there has not been another major terrorist attack in the United States since 9/11. And it’s true that only about a hundred people have died on US soil from Islamic terrorism in the past two decades. But domestic terrorism and mass shootings are on the rise, with Americans now justifiably afraid of malls, parades, supermarkets, churches, and elementary schools. Militias plot against democracy. A deadly virus has killed over a million Americans. Foreign governments infiltrate social media and snatch our data. Storms and wildfires grow bigger and more frequent every year. Tens of thousands of migrants linger in refugee camps at the southern border. Those that make it across face what one high-level whistleblower called “a system that involves widespread abuse of human beings.”
All of this is under the purview of DHS.
The Department of Homeland Security was supposed to protect Americans from earthquakes, nukes, pandemics, assassins, smugglers, hackers, and hijackers. These are the folks in charge of securing critical infrastructure, meaning everything from voting machines to sports stadiums to the water supply. DHS checks for explosives at airports and border crossings; manages the immigration process and migrant detention centers; helps rebuild after natural disasters; and coordinates intelligence and threat response with the CIA and FBI, as well as state and local law enforcement.
It’s a truly bonkers amount of responsibility, fueled by $80–$150 billion a year in taxpayer money and encompassing an alphabet soup of around two dozen entities, including FEMA, the TSA, Customs and Border Protection (CBP), Secret Service (USSS), Citizenship and Immigration Services (USCIS), Coast Guard (USCG), Cybersecurity and Infrastructure Security Agency (CISA), and Immigration and Customs Enforcement (ICE). In a nationally televised address announcing his intention to form the department, Bush said DHS would “unite essential agencies that must work more closely together” and increase “focus and effectiveness.” But the 2002 bill creating the Department of Homeland Security may as well have been called Murphy’s law.
“It was a walking nightmare from the very beginning,” said John Magaw, the founding administrator of the TSA and a former director of the US Secret Service. “It just was not gonna work.”
(A spokesperson for DHS was given ample time to comment on this story but missed multiple deadlines to do so.)
How did the Department of Homeland Security become such a disaster? In recent months, I’ve spoken to a few dozen insiders and watchdogs across every era of DHS, reviewed thousands of pages of documents, and read up on the history and political science behind what makes government agencies effective. An investigation like this one might normally hope to answer the question: Whose fault is this? Who can we point to and fire or malign? But what I’ve found is that those lines of inquiry are irrelevant. This is a boondoggle spanning four presidencies, 11 Congresses, seven secretaries, and seven acting secretaries in a department with very high turnover that oversees 212,000 employees and hundreds of thousands of private contractors at any given moment. It’s not just one person’s fault or a handful of bad apples.
There will always be corrupt officials, lazy civil servants, sociopathic politicians, pedophile teachers, and sadistic prison guards. As James Madison wrote in 1788, “If men were angels, no government would be necessary.” The Constitution’s framers were trying to build a system that would keep the worst human tendencies in check. Evil is banal, yes, but our tendency to blame individuals for bad behavior can distract from the institution incentivizing that bad behavior.
So what is it about this institution in particular that allows wrongdoing to flourish? Why does the Department of Homeland Security suck so much?
by Amanda Chicago Lewis, The Verge | Read more:
Image: Ryan Peltier
Monday, November 21, 2022
COP Out
'Cooperate or Perish' (CNET)
Image: The Egyptian Pyramids were illuminated to mark the start of COP27 (COP27)
[ed. So depressing. This is No. 27, so that alone tells you everything you need to know. Even slick branding.]
"Despite having no agreement for a stronger commitment to the 1.5 C goal set in the 2015 Paris Agreement, "we went with what the agreement was here because we want to stand with the most vulnerable," Germany's climate secretary Jennifer Morgan, visibly shaken, told Reuters."
When asked by Reuters whether the goal of stronger climate-fighting ambition had been compromised for the deal, Mexico's chief climate negotiator Camila Zepeda summed up the mood among exhausted negotiators.
"Probably. You take a win when you can." (Reuters 11/20/2022)
A Velocity of Being
by Maria Popova, Brain Pickings | Read more:
Image: Art by the Brothers Hilts for a letter by David Delgado
Nit-Twits
“Um, Twitter’s sick. My best friend’s sister’s boyfriend’s brother’s girlfriend heard from this guy who knows this kid who’s going with the girl who saw Twitter pass out at 31 Flavors last night. I guess it’s pretty serious.” That’s basically where we are with the coverage. Meanwhile: “‘Twitter Is Dead,’ 300 Million People Post On Twitter.”
I like to think of myself as technically literate, moreso back in the day than I am now. Thanks to my Web 1.0 heritage, I can set up and run a website, including the backend. However, the systems that Twitter engineers are (or were) maintaining at scale are unimaginably complex to me. These systems — their design and implementation, who runs them, what they deliver to users — are at the heart of the Twitter story. Unfortunately, the first two aspects of Twitter are opaque just now, so finding out what’s really going on is very difficult (and on this story, Twitter the platform isn’t helping very much). So what’s really going on?
The Only Crypto Story You Need?
"Conversely, I didn’t sit down and write 40,000 words to tell you that crypto is dumb and worthless and will now vanish without a trace. That would be an odd use of time. My goal here is not to convince you that crypto is building the future and that if you don’t get on board you’ll stay poor. My goal is to convince you that crypto is interesting, that it has found some new things to say about some old problems, and that even when those things are wrong, they’re wrong in illuminating ways."
[ed. Two issues burning up the internet this week. A lot of people must have lost a lot of money, or something. Lots of links in each.]
All My Exes Live In Pixels
Tyler calls the folder on his laptop that contains nudes of his exes “Rogaine.” He changed it from “cocaine” after too many people asked him what he was keeping in there. Anwar called his “random stuff,” but he kept the nudes nested in the fourth of four untitled folders. That was before he deleted the folder sometime last year, when he got paranoid about potential hacking. Ryan’s old nudes are scattered throughout his email — you can find them by typing “.jpg” into the search bar — but he rarely looks at them, except when he’s newly single. Bill says he doesn’t know where his are, probably on camera memory cards and old hard drives. But now that I mention it, he’s gonna gather them into a single place.
Nudes from my exes are collected in a folder called “just drunk enough to send this.” I made it when I was studying abroad at a South African university with slow internet and a long-distance girlfriend. One day, she sent a video with the subject head “just drunk enough to send this.” I took my laptop to the library immediately and made small talk with a fellow American while the progress bar slowly filled up. The video featured my girlfriend wearing a tank top and camouflage booty shorts. “True Affection” by The Blow played in the background. The first line of that song is “I was out of your league,” which she almost definitely was. (I’ve only heard that song once in the years since she sent me the video. I would describe my reaction to it as Pavlovian.) (...)
And, though the specific practice is a modern phenomenon, we would be lying to ourselves if we said it wasn’t deeply rooted in history. Photographers like Albert Arthur Allen were producing boudoir photography as early as the 1920s, but nudes must have predated that. After all, the Tourist Multiple and the Simplex were consumer-focused cameras that debuted in 1913 and 1914, respectively. Another thing that debuted around that time was World War I. If you think that British, French and German women were sending their soldier husbands off to war empty-handed, then I have some beachfront property in Arizona to sell you.
Nudes from my exes are collected in a folder called “just drunk enough to send this.” I made it when I was studying abroad at a South African university with slow internet and a long-distance girlfriend. One day, she sent a video with the subject head “just drunk enough to send this.” I took my laptop to the library immediately and made small talk with a fellow American while the progress bar slowly filled up. The video featured my girlfriend wearing a tank top and camouflage booty shorts. “True Affection” by The Blow played in the background. The first line of that song is “I was out of your league,” which she almost definitely was. (I’ve only heard that song once in the years since she sent me the video. I would describe my reaction to it as Pavlovian.) (...)
And, though the specific practice is a modern phenomenon, we would be lying to ourselves if we said it wasn’t deeply rooted in history. Photographers like Albert Arthur Allen were producing boudoir photography as early as the 1920s, but nudes must have predated that. After all, the Tourist Multiple and the Simplex were consumer-focused cameras that debuted in 1913 and 1914, respectively. Another thing that debuted around that time was World War I. If you think that British, French and German women were sending their soldier husbands off to war empty-handed, then I have some beachfront property in Arizona to sell you.
by Michael Hafford, MEL | Read more:
Image: uncredited
Sunday, November 20, 2022
Chaka Khan & Rufus
"Tell Me Something Good" is a song by Rufus and Chaka Khan, written by Stevie Wonder and released in 1974. The single was a hit in the United States, peaking at number three on the Billboard Hot 100 and spent one week at number one on the Cash Box Top 100. It was among the earliest hits to use the guitar talk box, by Tony Maiden. (Wikipedia)
[ed. See also: Ain't Nobody.]
[ed. Reminds me of a short-lived poppy explosion along the Glenn Highway outside of Anchorage, in Alaska. A DOT road engineer/employee died and specified in his will that his remaining estate be used to plant poppy seeds along the entire central median stretching from Anchorage to Eklutna (over 30 miles). It was one of the most awesome things I've ever seen. Certainly more intense than what's pictured here. Sadly, I can't seem to find any Google history of who that person was or when it happened (two or three decades ago anyway). Whoever it was, thank you for the wonderful experience!]
This Week, Billionaires Made a Strong Case for Abolishing Themselves
In recent years, a swelling chorus of Americans has grown critical of the nation’s bajillionaires. But in the extraordinary week gone by, that chorus was drowned out by a far louder and more urgent case against them. It was made by the bajillionaires themselves.
One after another, four of our best-known billionaires laid waste to the image of benevolent saviors carefully cultivated by their class.
It is a commendable sacrifice on their part, because billionaires, remember, exist at our collective pleasure. If enough of us decided to, we could enact labor, tax, antitrust and regulatory policies to make it hard for anyone to amass that much wealth while so many beg for scraps. It is not only the vast political power of billionaires that keeps us keeping them around, it’s also the popular embrace of certain myths — about the generosity, the genius, the renegade spirit, the above-it-ness of billionaires, to name a few.
As of this writing, Elon Musk is running Twitter into the ground, with much of the company’s staff fired or quitting, outages spiking and everyone on my timeline hurrying to tell the app the things they have been meaning to say before it departs for app heaven (or hell?).
In tweeting through one of the most extraordinary corporate meltdowns in history, Mr. Musk has been performing a vital public service: shredding the myth of the billionaire genius.
His particular pretension of benevolence is that his uncontainable genius can solve any challenge. Now he is lavishing his mind and time on electronic money, now on colonizing Mars, now on electric cars and solar panels, now on saving Thai soccer players trapped in a cave, now on liberating speech from its liberal oppressors.
Mr. Musk’s genius pose has long been undermined by his actual record, which is defined by claiming credit for what others have built and is shot through with complaints of discrimination, mismanagement and fraud.
But it wasn’t until Mr. Musk took over Twitter that his claim of infinitely transferable genius truly fell apart. That what Mr. Musk has called the global town square can be eviscerated in a time period somewhere between a Scaramucci and a Truss makes one wonder if we should be more skeptical of all the other billionaire geniuses with ideas for our schools, public health systems and politics.
For example, Jeff Bezos, the founder of Amazon, who this week was doing his part to undermine another pretension of billionaire benevolence: the generosity pose.
On Monday, he made a big splash when CNN released an interview in which he announced that he was giving the great bulk of his more than $120 billion fortune away, with a focus on fighting climate change and promoting unity.
That sure sounds impressive, but his gesture wasn’t about generosity any more than Herschel Walker’s Senate candidacy in Georgia is for the children. After all, the money Mr. Bezos is now so magnanimously distributing was made through his dehumanizing labor practices, his tax avoidance, his influence peddling, his monopolistic power and other tactics that make him a cause of the problems of modern American life rather than a swashbuckling solution.
It’s too soon to tell if Mr. Bezos’s philanthropy will help others, but what’s certain is that it will help Mr. Bezos a lot. Mega-philanthropists of his ilk tend to give through foundations, which they establish in ways that save them an immense amount in taxes, sometimes merely by moving the money from one of their own accounts to another. Giving will also burnish Mr. Bezos’s reputation, in that way preserving and protecting his opportunity to earn yet more money — and to do more social damage.
And it will increase his already gigantic power over public life. For plutocrats like Mr. Bezos, that may be the biggest payoff of all. Their wealth is so vast that by distributing even a small fraction of it, they skew the public agenda toward the kind of social change they can stomach — the kind that doesn’t threaten them or their class. Shortly before his big announcement, Mr. Bezos gave Dolly Parton a $100 million “Courage and Civility Award” to spend on her chosen causes. Ms. Parton is indeed courageous and civil, but so are the workers fighting to unionize Amazon facilities, and I don’t see anyone offering them nine-digit thank-you bonuses.
But once again, instead of the usual critics having to make this case, this week Mr. Bezos took the wheel. Just minutes after his philanthropy announcement on CNN, news broke that Amazon would be laying off thousands of workers, reminding everyone of what was really going on.
At first glance, the two stories might seem like matter and antimatter, or at least two opposite realities. But they are the same story: The system that treats human beings as disposable commodities upholds and reproduces itself by sprinkling some fairy dust and hoping that we will forget the injustice that paid for it.
by Anand Giridharadas, NY Times | Read more:
Image:Tom Brenner for The New York Times
One after another, four of our best-known billionaires laid waste to the image of benevolent saviors carefully cultivated by their class.
It is a commendable sacrifice on their part, because billionaires, remember, exist at our collective pleasure. If enough of us decided to, we could enact labor, tax, antitrust and regulatory policies to make it hard for anyone to amass that much wealth while so many beg for scraps. It is not only the vast political power of billionaires that keeps us keeping them around, it’s also the popular embrace of certain myths — about the generosity, the genius, the renegade spirit, the above-it-ness of billionaires, to name a few.
As of this writing, Elon Musk is running Twitter into the ground, with much of the company’s staff fired or quitting, outages spiking and everyone on my timeline hurrying to tell the app the things they have been meaning to say before it departs for app heaven (or hell?).
In tweeting through one of the most extraordinary corporate meltdowns in history, Mr. Musk has been performing a vital public service: shredding the myth of the billionaire genius.
Mr. Musk’s genius pose has long been undermined by his actual record, which is defined by claiming credit for what others have built and is shot through with complaints of discrimination, mismanagement and fraud.
But it wasn’t until Mr. Musk took over Twitter that his claim of infinitely transferable genius truly fell apart. That what Mr. Musk has called the global town square can be eviscerated in a time period somewhere between a Scaramucci and a Truss makes one wonder if we should be more skeptical of all the other billionaire geniuses with ideas for our schools, public health systems and politics.
For example, Jeff Bezos, the founder of Amazon, who this week was doing his part to undermine another pretension of billionaire benevolence: the generosity pose.
On Monday, he made a big splash when CNN released an interview in which he announced that he was giving the great bulk of his more than $120 billion fortune away, with a focus on fighting climate change and promoting unity.
That sure sounds impressive, but his gesture wasn’t about generosity any more than Herschel Walker’s Senate candidacy in Georgia is for the children. After all, the money Mr. Bezos is now so magnanimously distributing was made through his dehumanizing labor practices, his tax avoidance, his influence peddling, his monopolistic power and other tactics that make him a cause of the problems of modern American life rather than a swashbuckling solution.
It’s too soon to tell if Mr. Bezos’s philanthropy will help others, but what’s certain is that it will help Mr. Bezos a lot. Mega-philanthropists of his ilk tend to give through foundations, which they establish in ways that save them an immense amount in taxes, sometimes merely by moving the money from one of their own accounts to another. Giving will also burnish Mr. Bezos’s reputation, in that way preserving and protecting his opportunity to earn yet more money — and to do more social damage.
And it will increase his already gigantic power over public life. For plutocrats like Mr. Bezos, that may be the biggest payoff of all. Their wealth is so vast that by distributing even a small fraction of it, they skew the public agenda toward the kind of social change they can stomach — the kind that doesn’t threaten them or their class. Shortly before his big announcement, Mr. Bezos gave Dolly Parton a $100 million “Courage and Civility Award” to spend on her chosen causes. Ms. Parton is indeed courageous and civil, but so are the workers fighting to unionize Amazon facilities, and I don’t see anyone offering them nine-digit thank-you bonuses.
But once again, instead of the usual critics having to make this case, this week Mr. Bezos took the wheel. Just minutes after his philanthropy announcement on CNN, news broke that Amazon would be laying off thousands of workers, reminding everyone of what was really going on.
At first glance, the two stories might seem like matter and antimatter, or at least two opposite realities. But they are the same story: The system that treats human beings as disposable commodities upholds and reproduces itself by sprinkling some fairy dust and hoping that we will forget the injustice that paid for it.
by Anand Giridharadas, NY Times | Read more:
Image:Tom Brenner for The New York Times
The FTX Saga - Simplified
A bank, in simple terms, is an entity where a customer can deposit their money (and get paid interest), or can borrow money (and pay interest to the bank). The way a bank makes money is that it charges more interest to the borrower than what it pays to the depositor. A bank is allowed to lend your money out without your explicit permission. Because of this, governments heavily regulate banks. They are limited as to who they can lend to and how much. They are audited frequently and have robust external oversight.
A brokerage, in simple terms, is an entity where a customer can deposit their money and buy investment assets, in hopes to grow their money over time. Typically, a customer can open two types of accounts in a brokerage:
FTX was a crypto exchange and brokerage, with a slick trading platform. FTX’s founder and CEO was Sam Bankman-Fried (SBF). What separated FTX from the rest of the firms that offered similar services was how fast and efficient their platform was, how liquid their market making business was (This means, in simple terms, that FTX was one of the best places to buy and sell cryptocurrencies. It was fast and the prices they offered where some of the best), and their margin lending business. At FTX, you were allowed to deposit cash or cryptocurrencies, then borrow against them. Their systems were so advanced when it came to risk management that the sale of collateral when margin was breached was automatic, no need to call the customer asking for cash to cover.
Enter Alameda Research
Alameda was an investment firm founded by SBF prior to his founding of FTX. Alameda invested in cryptocurrencies and its strategies were considered wildly successful in the crypto space. As a fund it only managed investments of its employees and a few early backers. SBF was the CEO of Alameda before becoming the CEO of FTX. Alameda was a major client of FTX.
Enter FTT Token
FTT is a cryptocurrency created by FTX as a rewards system for its customers. You were rewarded FTT tokens for trading in FTX (Although you could also just buy the tokens in the open market). Having FTT in your FTX account allowed you to have discounts on trading fees, and FTX allowed you to borrow up to 95% of the value of your FTT tokens in your account. How did the FTT token maintain its value? FTX would use some of its trading profits to buy back FTT in the open market and destroy the tokens. This would theoretically mean that FTT would increase in value the more trading profits FTX generated. FTT token holders theoretically had a partial claim to the future profits of FTX, similar to a stock.
So, how does this all lead to the implosion of FTX?
It is assumed that, like many other crypto investment and trading firms, Alameda Research incurred significant losses in their portfolio during the crypto downturn of this year. Alameda traded and invested using loans, and at one point their losses became so big that their lenders asked for their money back, which Alameda did not have. For reasons still unknown to the crypto space, SBF made a decision to bail out Alameda. Now allegedly the hole was so big that SBF’s own money or even FTX’s own capital was not enough to cover these losses (It is assumed that the losses at Alameda could have been over $10 billion USD), so SBF decided to use FTX’s customer funds to bail out Alameda.
Now, how can SBF do this without raising any flags? Transferring billions of dollars in assets from FTX to Alameda would have raised all of the red flags, and it would have leaked to the crypto market fairly quickly. SBF knew that he had to keep this hidden from the majority of the FTX organization.
by Jorge I Velez, Learning Decision Theory and its Applications (Substack) | Read more:
If you want to read a poorly researched fluff piece about Sam Bankman-Fried, feel free to go to the New York Times (PDF). If you want to understand what happened at Alameda Research and how Sam Bankman-Fried (SBF), Sam Trabucco, and Caroline Ellison incinerated over $20 billion dollars of fund profits and FTX user deposits, read this article. (...)
To be clear, we still don’t have a perfect understanding of what exactly happened at Alameda Research and FTX. However, at this point, I feel that we have enough information to get a grasp on the broad strokes. Through a combination of Twitter users’ investigations, forum anecdotes, and official news releases, the history of these two intertwined companies becomes progressively less hazy, slowly coalescing into something resembling a consistent narrative.
Of course, without witness testimonies and a full financial investigation, our claims only remain tentative at best. Any given piece of information may be flawed or even fabricated. However, if they are assembled together and put in context, they together lend credence to the following timeline:
A brokerage, in simple terms, is an entity where a customer can deposit their money and buy investment assets, in hopes to grow their money over time. Typically, a customer can open two types of accounts in a brokerage:
- Cash account: This account can exclusively buy and sell assets
- Margin account: This account can not only buy and sell assets, it can borrow against those assets. For example, you can deposit $10,000 USD and buy Apple stock. You can then use that Apple stock as collateral and borrow against it. Typically you could borrow up to a certain amount. For a stock like Apple, you could borrow up to 70% of the value of the stock, so in our example, you could borrow up to $7,000 USD, which you could use to buy whatever you want. However, there is a caveat: if Apple stock falls 50%, you would be faced with a margin call: Your account balance is $5,000 USD in Apple stock, but you borrowed $7,000. When this happens the brokerage will call you and ask you to deposit $5,000 USD in collateral so your account is covered. If you don’t have the money, the brokerage has the right to sell your remaining Apple stock to cover your bad debt. However in our example, there is a shortfall of $2,000 USD ($5,000 from the sale of Apple stock - $7,000 loan you took). In that case the brokerage will try to get that $2,000 from you through legal means, but that would cost money and time and they might not be able to recover it. What would happen is that the brokerage would then realize a loss of $2,000 against their capital.
- Charging commissions on trading. You buy $10,000 worth of Apple stock? That trade costs you $10.
- Charging a fee on your account. You have $10,000 in your account. The brokerage charges an 1% annual fee for holding your assets, but your trades are free. So if your account balance stays at $10,000 for a year, you would pay $100 for having your assets in there.
- They charge for making a market in an asset. In simple terms, they sell the asset to you at a price slightly higher than the purchase price in the open market, or buy the asset from you at a lower price than the sale price in the open market. The best example of this model for making money are currency exchange houses.
- Lending. They will lend cash and other assets to margin accounts, and charge an interest fee to the customer that borrows. Like I explained in our Apple example above, this adds considerable risk to the business model, so brokerages that engage in margin lending must have robust risk management processes to ensure that there are no shortfalls in the customers accounts. No brokerage wants to be constantly calling their customers asking for more money. Furthermore, a brokerage must have capital on hand to be able to lend to their customers and to be able to absorb shortfalls. A Brokerage (in most countries) is not allowed to lend customer funds out, unlike a bank. It must hold all customer deposits 1:1. This means that if you deposited $10,000 USD, it must always hold that $10,000 USD. If you deposited 10 Bitcoin it must hold that 10 Bitcoin at all times.
FTX was a crypto exchange and brokerage, with a slick trading platform. FTX’s founder and CEO was Sam Bankman-Fried (SBF). What separated FTX from the rest of the firms that offered similar services was how fast and efficient their platform was, how liquid their market making business was (This means, in simple terms, that FTX was one of the best places to buy and sell cryptocurrencies. It was fast and the prices they offered where some of the best), and their margin lending business. At FTX, you were allowed to deposit cash or cryptocurrencies, then borrow against them. Their systems were so advanced when it came to risk management that the sale of collateral when margin was breached was automatic, no need to call the customer asking for cash to cover.
Enter Alameda Research
Alameda was an investment firm founded by SBF prior to his founding of FTX. Alameda invested in cryptocurrencies and its strategies were considered wildly successful in the crypto space. As a fund it only managed investments of its employees and a few early backers. SBF was the CEO of Alameda before becoming the CEO of FTX. Alameda was a major client of FTX.
Enter FTT Token
FTT is a cryptocurrency created by FTX as a rewards system for its customers. You were rewarded FTT tokens for trading in FTX (Although you could also just buy the tokens in the open market). Having FTT in your FTX account allowed you to have discounts on trading fees, and FTX allowed you to borrow up to 95% of the value of your FTT tokens in your account. How did the FTT token maintain its value? FTX would use some of its trading profits to buy back FTT in the open market and destroy the tokens. This would theoretically mean that FTT would increase in value the more trading profits FTX generated. FTT token holders theoretically had a partial claim to the future profits of FTX, similar to a stock.
So, how does this all lead to the implosion of FTX?
It is assumed that, like many other crypto investment and trading firms, Alameda Research incurred significant losses in their portfolio during the crypto downturn of this year. Alameda traded and invested using loans, and at one point their losses became so big that their lenders asked for their money back, which Alameda did not have. For reasons still unknown to the crypto space, SBF made a decision to bail out Alameda. Now allegedly the hole was so big that SBF’s own money or even FTX’s own capital was not enough to cover these losses (It is assumed that the losses at Alameda could have been over $10 billion USD), so SBF decided to use FTX’s customer funds to bail out Alameda.
Now, how can SBF do this without raising any flags? Transferring billions of dollars in assets from FTX to Alameda would have raised all of the red flags, and it would have leaked to the crypto market fairly quickly. SBF knew that he had to keep this hidden from the majority of the FTX organization.
by Jorge I Velez, Learning Decision Theory and its Applications (Substack) | Read more:
-----
See also: What happened at Alameda Research (Milky Eggs):If you want to read a poorly researched fluff piece about Sam Bankman-Fried, feel free to go to the New York Times (PDF). If you want to understand what happened at Alameda Research and how Sam Bankman-Fried (SBF), Sam Trabucco, and Caroline Ellison incinerated over $20 billion dollars of fund profits and FTX user deposits, read this article. (...)
To be clear, we still don’t have a perfect understanding of what exactly happened at Alameda Research and FTX. However, at this point, I feel that we have enough information to get a grasp on the broad strokes. Through a combination of Twitter users’ investigations, forum anecdotes, and official news releases, the history of these two intertwined companies becomes progressively less hazy, slowly coalescing into something resembling a consistent narrative.
Of course, without witness testimonies and a full financial investigation, our claims only remain tentative at best. Any given piece of information may be flawed or even fabricated. However, if they are assembled together and put in context, they together lend credence to the following timeline:
- SBF, Trabucco, and Caroline were (probably) initially well-intentioned but not especially competent at running a trading firm
- Alameda Research made large amounts of book profits via leveraged longs and illiquid equity deals in the 2020-2021 bull market
- Although Alameda was likely initially profitable as a market maker, their edge eventually degraded and their systems became unprofitable
- Despite success with some discretionary positions, on net, Alameda & FTX jointly continued to lose large amounts of money and liquid cash throughout 2021-2022 as a result of excessive discretionary spending, illiquid venture investments, uncompetitive market-making strategies, risky lending practices, lackluster internal accounting, and general deficiencies in overall organizational ability
- When loans were recalled in early 2022, an emergency decision was made to use FTX users’ deposits to repay creditors
- This repayment spurred on increasingly erratic behavior and unprofitable gambling, eventually resulting in total insolvency
Saturday, November 19, 2022
Don’t Let Adderall Scarcity Trigger a Repeat of the Opioid Epidemic
U.S. pharmacies are critically low on Adderall and its generic equivalents, leaving more than 26 million patients scrambling and competing for the pills since late summer. The scarcity is going to last for many more months because of supply chain problems as well as federal restrictions on manufacturers and imports.
If we don’t act fast, this shortage could trigger two major public health crises.
Many people who have been taking this amphetamine-based stimulant – whether prescribed for attention deficit or narcolepsy or used illicitly as a performance or party drug – will lose access. This carries serious physical and mental health risks.
Amphetamine withdrawal symptoms, including depression, are not easily addressed with other kinds of drugs. So as countless individuals are confronting having to rapidly taper or stop, we’re facing a real possibility of a public health disaster on a scale not seen since the prescription opioid crisis that began a decade ago.
Instead of enduring withdrawal, other individuals cut off from Adderall are likely to turn to alternative stimulants like crystal meth, fueling a much broader crisis.
The early 2010s taught us that dependence and addiction don’t simply disappear when the pills do. At that time, catastrophic regulation failures contributed to widespread opioid dependence and addiction. The government response to the prescription opioid crisis focused on rapidly reducing supply: crackdowns on pill mills, tightened restrictions on prescribing and reformulation of products to make them harder to snort and inject. This approach backfired, pushing many users onto the illicit market.
As a chemical analog of prescription opioids, heroin was widely available and far cheaper than its pharmaceutical cousins. But its unpredictable quality and link with injection drug use made heroin a much more dangerous alternative; the recent rise in fentanyl contamination has further fueled the crisis. Overdose rates have continued to soar, spiking from 16,000 during the height of the prescription opioid crisis to more than 100,000 annually. The number of cases of blood-borne infections like HIV and hepatitis has spiked in tandem.
Today’s Adderall shortage is setting up a similar crisis. For those losing adequate access to prescription amphetamine, illicit alternatives – especially methamphetamine – are readily available. Just as with heroin, years of increasingly punitive policies, aggressive law enforcement, government fear-mongering and growing public panic failed to address the “meth problem.”(...)
Enter the Adderall shortage.
A massive influx of people forced to switch from a pharmaceutical amphetamine to street methamphetamine would be nothing short of a nightmare. But there is still time to prevent a stimulant remake of the tragic scenario we have seen play out with opioids.
The F.D.A. has powerful tools at its disposal to ease the Adderall shortage. This includes attracting and fast-tracking approval for international manufacturers and helping rapidly develop domestic production.
Maintaining a reliable, safe supply of amphetamine medications is crucial to avoid a major public health crisis. Bigger thinking is also vital to prevent other similar crises from occurring in the future.
The current Adderall shortage is a symptom of deep structural dysfunction in our institutions, policies and systems responsible for drugs. As with opioids, stewardship of prescription stimulants in American healthcare is poor, often vacillating between excess and deficit. We need far more nuanced, patient-centered approaches to medication access that are not bogged down in drug panics and concerns about law enforcement.
Meanwhile, our streets are flooded with illicitly manufactured alternatives of unpredictable content and dosage, despite cavalier investments in criminal justice efforts to stem their supply. Instead, cost-effective lasting solutions like housing, social services, and wrap-around supports are necessary to make our society healthier and safer.
Bold actions are urgently needed to prevent history from repeating itself.
by Leo Beletsky, LA Times | Read more:
If we don’t act fast, this shortage could trigger two major public health crises.
Many people who have been taking this amphetamine-based stimulant – whether prescribed for attention deficit or narcolepsy or used illicitly as a performance or party drug – will lose access. This carries serious physical and mental health risks.
Amphetamine withdrawal symptoms, including depression, are not easily addressed with other kinds of drugs. So as countless individuals are confronting having to rapidly taper or stop, we’re facing a real possibility of a public health disaster on a scale not seen since the prescription opioid crisis that began a decade ago.
The early 2010s taught us that dependence and addiction don’t simply disappear when the pills do. At that time, catastrophic regulation failures contributed to widespread opioid dependence and addiction. The government response to the prescription opioid crisis focused on rapidly reducing supply: crackdowns on pill mills, tightened restrictions on prescribing and reformulation of products to make them harder to snort and inject. This approach backfired, pushing many users onto the illicit market.
As a chemical analog of prescription opioids, heroin was widely available and far cheaper than its pharmaceutical cousins. But its unpredictable quality and link with injection drug use made heroin a much more dangerous alternative; the recent rise in fentanyl contamination has further fueled the crisis. Overdose rates have continued to soar, spiking from 16,000 during the height of the prescription opioid crisis to more than 100,000 annually. The number of cases of blood-borne infections like HIV and hepatitis has spiked in tandem.
Today’s Adderall shortage is setting up a similar crisis. For those losing adequate access to prescription amphetamine, illicit alternatives – especially methamphetamine – are readily available. Just as with heroin, years of increasingly punitive policies, aggressive law enforcement, government fear-mongering and growing public panic failed to address the “meth problem.”(...)
Enter the Adderall shortage.
A massive influx of people forced to switch from a pharmaceutical amphetamine to street methamphetamine would be nothing short of a nightmare. But there is still time to prevent a stimulant remake of the tragic scenario we have seen play out with opioids.
The F.D.A. has powerful tools at its disposal to ease the Adderall shortage. This includes attracting and fast-tracking approval for international manufacturers and helping rapidly develop domestic production.
Maintaining a reliable, safe supply of amphetamine medications is crucial to avoid a major public health crisis. Bigger thinking is also vital to prevent other similar crises from occurring in the future.
The current Adderall shortage is a symptom of deep structural dysfunction in our institutions, policies and systems responsible for drugs. As with opioids, stewardship of prescription stimulants in American healthcare is poor, often vacillating between excess and deficit. We need far more nuanced, patient-centered approaches to medication access that are not bogged down in drug panics and concerns about law enforcement.
Meanwhile, our streets are flooded with illicitly manufactured alternatives of unpredictable content and dosage, despite cavalier investments in criminal justice efforts to stem their supply. Instead, cost-effective lasting solutions like housing, social services, and wrap-around supports are necessary to make our society healthier and safer.
Bold actions are urgently needed to prevent history from repeating itself.
by Leo Beletsky, LA Times | Read more:
Image: JB Reed/Bloomberg via Getty Images
[ed. I don't know whether to laugh or cry. When Purdue Pharma's aggressive opioid marketing campaign eventually revealed abuses, everyone - government (Congress, CDC, FDA, DEA), doctors, hospitals, politicians, media, insurance companies - everyone, fell all over themselves to "get tough" on opioids. Supplies and prescriptions for pain medications were cut off almost immediately and long-term patients thrown under the bus. Guess what happened next? Widespread suffering, diverted drug seeking, increased and accelerating mortalities, spiking suicides, new drugs (fentanyl) filling the vacuum, and newly emboldened cartels making tons of money. Now Adderall is in short supply, but this time the affected population includes financiers, bankers, students, professors, billionaires, businessmen, media hacks, technology bros, Hollywood, and just about everyone else that needs a little bump to perform at an elevated level of performance. In other words, everybody. So I don't imagine this supply crisis will last long (or experience the same kind of pharmaceutical malpractice we've seen with opioids). See also: How L.A. Got Hooked on Adderall (LA Magazine); Amid the Adderall Shortage, People With A.D.H.D. Face Withdrawal and Despair (NY Times); also, Cat Marnell's memoir How to Murder Your Life.]
Friday, November 18, 2022
11 Years
Image: Ethan Pines/The Forbes Collection via
[ed. Sociopathology, meet accountability.]
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