Friday, 30 September 2016 / TRUTH-OUT.ORG

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Speakout

Speakout is Truthout's treasure chest for bloggy, quirky, personally reflective, or especially activism-focused pieces. Speakout articles represent the perspectives of their authors, and not those of Truthout.

Cost effectiveness analysis (CEA), as applied to health care, attempts to estimate the value of expenditures on procedures or treatments that is returned to patients, such as longer life, better quality of life, or both. Given that the US has the most expensive health care in the world, with comparatively low value and outcomes compared to many other advanced countries, you would think that CEA would be a major part of health policy in this country. Sadly, the opposite is true, and it is notably absent from the way we do things.

In the final act of the Democratic presidential primary, it is easy to believe the US has gone through a battle unparalleled in modern history. A liberal outsider candidate, expected to remain in the margin of error at the outset of the race, has mounted a massively successful campaign against the overwhelming establishment choice. Bernie Sanders has regularly shattered ceilings imposed by media pundits and conventional wisdom, taking his populist message and urgent desire for change straight to the banks by running a remarkably powerful campaign against Hillary Clinton.

In Plato's Republic, Socrates criticizes the belief that we would prefer to act unjustly if we could do so without consequences, namely, without incurring punishment or damage to our reputation. In support of this position, Socrates' interlocutor recounts the story of Gyges, a shepherd from Lydia or what is now Western Turkey. Gyges, we are told, discovered a ring with the power of invisibility, allowing him to circumvent all external mechanisms of accountability for his actions. In short, this ring granted him impunity, leaving only his will to influence his choices.

In the name of "growth," forests are burning, oil is spilling, ice caps are melting, animals are dying and villages are disappearing. Unsustainable economic systems are being replicated in the developing world where labor is cheap so that more forests can burn, more oil can be spilled, more ice caps can melt, more animals can die and more villages can disappear. What is actually being sold to us under the auspices of "growth" and "development"? How does consumerism contribute to this? Why is this bad for us as persons? And what we can do to change for the better?

John Perkins used to work as a chief economist for a major international consulting firm, advising the World Bank, International Monetary Fund, the US Treasury Department and several Fortune 500 Corporations on how to exploitthe resources of developing countries for profit. He retrospectively dubbed his role an "economic hitman," a person who helps multinational corporations and wealthy governments prey on weaker nations, a form of neocolonialism. 

Along with VCNV companions, I'm part of a 150 mile walk from Chicago to Thomson, IL, a small town in Northwest IL where the US Bureau of Prisons is setting up an Administrative Maximum prison, also known as a Supermax. Prison laborers from US minimum security prisons now labor to turn what once was an Illinois state prison into a federal supermax detention facility with 1900 cells that will confine prisoners for 23 hours of every day.

The US deposed Muammar Gaddafi and Saddam Hussein, but now many Americans are choosing to back their own strongman. Donald Trump's bad boy image plays to an irrational immaturity in US voters and exposes a naïve trust in outlandish promises. "I could stand in the middle of 5th Avenue and shoot somebody and I wouldn't lose any voters." That braggadocios boast may not be true, but it does please his base. Donald Trump knows how to appeal to the United States' macho, romantic, gun-culture.

We have some long unanswered questions in US health care: Is health care in the public interest based on medical need, not ability to pay? Is it a commodity on an unfettered for-profit, largely investor-owned corporate marketplace? Is it different from other commodities? And who is the health care system for -- providers of services or patients? The questions have not received much public or policy debate over the last 50 years, but the answers have been solidly entrenched in the medical-industrial complex over that period.

In the past year, students in South Africa, the United States, the United Kingdom, Brazil and India have mobilized to challenge the status quo at their universities. An important strand of the student movements seeks to "decolonize" universities by contesting the symbols, systems and daily experiences of privilege, knowledge and knowledge production that were instituted, along with many universities, in the service of colonialism. One collection of movements, often labeled together as "RhodesMustFall," contests the legacy of Cecil John Rhodes, the whip of British imperial capitalism in southern Africa.

As I sat in the San Diego sunshine Sunday listening to Bernie Sanders outside of Qualcomm Stadium, I was struck by the stunning contrast between the senator and Donald Trump, particularly on the issue of race. Sanders emphasized racial justice, citing the courage of African Americans and their allies who fought against racism and bigotry during Jim Crow. He talked of the thousands of undocumented workers who are ruthlessly exploited, overworked and underpaid, vowing to end the current deportation policies.

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Speakout

Speakout is Truthout's treasure chest for bloggy, quirky, personally reflective, or especially activism-focused pieces. Speakout articles represent the perspectives of their authors, and not those of Truthout.

Cost effectiveness analysis (CEA), as applied to health care, attempts to estimate the value of expenditures on procedures or treatments that is returned to patients, such as longer life, better quality of life, or both. Given that the US has the most expensive health care in the world, with comparatively low value and outcomes compared to many other advanced countries, you would think that CEA would be a major part of health policy in this country. Sadly, the opposite is true, and it is notably absent from the way we do things.

In the final act of the Democratic presidential primary, it is easy to believe the US has gone through a battle unparalleled in modern history. A liberal outsider candidate, expected to remain in the margin of error at the outset of the race, has mounted a massively successful campaign against the overwhelming establishment choice. Bernie Sanders has regularly shattered ceilings imposed by media pundits and conventional wisdom, taking his populist message and urgent desire for change straight to the banks by running a remarkably powerful campaign against Hillary Clinton.

In Plato's Republic, Socrates criticizes the belief that we would prefer to act unjustly if we could do so without consequences, namely, without incurring punishment or damage to our reputation. In support of this position, Socrates' interlocutor recounts the story of Gyges, a shepherd from Lydia or what is now Western Turkey. Gyges, we are told, discovered a ring with the power of invisibility, allowing him to circumvent all external mechanisms of accountability for his actions. In short, this ring granted him impunity, leaving only his will to influence his choices.

In the name of "growth," forests are burning, oil is spilling, ice caps are melting, animals are dying and villages are disappearing. Unsustainable economic systems are being replicated in the developing world where labor is cheap so that more forests can burn, more oil can be spilled, more ice caps can melt, more animals can die and more villages can disappear. What is actually being sold to us under the auspices of "growth" and "development"? How does consumerism contribute to this? Why is this bad for us as persons? And what we can do to change for the better?

John Perkins used to work as a chief economist for a major international consulting firm, advising the World Bank, International Monetary Fund, the US Treasury Department and several Fortune 500 Corporations on how to exploitthe resources of developing countries for profit. He retrospectively dubbed his role an "economic hitman," a person who helps multinational corporations and wealthy governments prey on weaker nations, a form of neocolonialism. 

Along with VCNV companions, I'm part of a 150 mile walk from Chicago to Thomson, IL, a small town in Northwest IL where the US Bureau of Prisons is setting up an Administrative Maximum prison, also known as a Supermax. Prison laborers from US minimum security prisons now labor to turn what once was an Illinois state prison into a federal supermax detention facility with 1900 cells that will confine prisoners for 23 hours of every day.

The US deposed Muammar Gaddafi and Saddam Hussein, but now many Americans are choosing to back their own strongman. Donald Trump's bad boy image plays to an irrational immaturity in US voters and exposes a naïve trust in outlandish promises. "I could stand in the middle of 5th Avenue and shoot somebody and I wouldn't lose any voters." That braggadocios boast may not be true, but it does please his base. Donald Trump knows how to appeal to the United States' macho, romantic, gun-culture.

We have some long unanswered questions in US health care: Is health care in the public interest based on medical need, not ability to pay? Is it a commodity on an unfettered for-profit, largely investor-owned corporate marketplace? Is it different from other commodities? And who is the health care system for -- providers of services or patients? The questions have not received much public or policy debate over the last 50 years, but the answers have been solidly entrenched in the medical-industrial complex over that period.

In the past year, students in South Africa, the United States, the United Kingdom, Brazil and India have mobilized to challenge the status quo at their universities. An important strand of the student movements seeks to "decolonize" universities by contesting the symbols, systems and daily experiences of privilege, knowledge and knowledge production that were instituted, along with many universities, in the service of colonialism. One collection of movements, often labeled together as "RhodesMustFall," contests the legacy of Cecil John Rhodes, the whip of British imperial capitalism in southern Africa.

As I sat in the San Diego sunshine Sunday listening to Bernie Sanders outside of Qualcomm Stadium, I was struck by the stunning contrast between the senator and Donald Trump, particularly on the issue of race. Sanders emphasized racial justice, citing the courage of African Americans and their allies who fought against racism and bigotry during Jim Crow. He talked of the thousands of undocumented workers who are ruthlessly exploited, overworked and underpaid, vowing to end the current deportation policies.