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Trump Launches One More Grift Before Inauguration

By dianeravitch
January 19, 2025 //
8

Trump has his eye on what matters most: making more money. MONEY! PROFIT! He can never get enough!

The New York Times reported on his latest money-making scheme:

President-elect Donald J. Trump and his family on Friday started selling a cryptocurrency token featuring an image of Mr. Trump drawn from the July assassination attempt, a potentially lucrative new business that ethics experts assailed as a blatant effort to cash in on the office he is about to occupy again.

Disclosed just days before his second inauguration, the venture is the latest in a series of moves by Mr. Trump that blur the line between his government role and the continued effort by his family to profit from his power and global fame. It is yet another sign that the Trump family will be much less hesitant in this second term to bend or breach traditional ethical boundaries.

Mr. Trump himself announced the launch of his new business on Friday night on his social media platform, in between announcements about filling key federal government posts. He is calling the token $Trump, selling it with the slogan, “Join the Trump Community. This is History in the Making!”

The venture was organized by CIC Digital LLC, an affiliate of the Trump Organization, which already has been selling an array of other kinds of merchandise like Trump-branded sneakers, fragrances and even digital trading cards.

But this newest venture brings Mr. Trump and his family directly into the world of selling cryptocurrency, which is regulated by the Securities and Exchange Commission. Mr. Trump recently disclosed he intended to name a cryptocurrency advocate as S.E.C. chairman.

A disclosure on the website selling the tokens says that CIC Digital and its affiliates own 80 percent of the supply of the new Trump tokens that will be released gradually over the coming three years and that they will be paid “trading revenue” as the tokens are sold.

The move by Mr. Trump and his family was immediately condemned by ethics lawyers who said they could not recall a more explicit profiteering effort by an incoming president.

“It is literally cashing in on the presidency — creating a financial instrument so people can transfer money to the president’s family in connection with his office” said Adav Noti, executive director of Campaign Legal Center, a nonprofit ethics group. “It is beyond unprecedented.”

Trump’s greed cannot be restrained. And there are no boundaries because the U.S. Supreme Court has already ruled that he has “absolute immunity” while he is president.

How low can he go? Just watch.

Categories Accountability, Character, Corruption, Ethics, For-Profit, Trump

Heather Cox Richardson: A New Era of Lies and Corruption Begins

By dianeravitch
January 19, 2025 //
3

Heather Cox Richardson is wise not to put titles on her posts. They combine several topics. But this day’s posting has a common thread: the next four years will see a changed focus: from the public interest to private greed. Please read it all!

She writes:

Shortly before midnight last night, the Federal Trade Commission (FTC) published its initial findings from a study it undertook last July when it asked eight large companies to turn over information about the data they collect about consumers, product sales, and how the surveillance the companies used affected consumer prices. The FTC focused on the middlemen hired by retailers. Those middlemen use algorithms to tweak and target prices to different markets.

The initial findings of the FTC using data from six of the eight companies show that those prices are not static. Middlemen can target prices to individuals using their location, browsing patterns, shopping history, and even the way they move a mouse over a webpage. They can also use that information to show higher-priced products first in web searches. The FTC found that the intermediaries—the middlemen—worked with at least 250 retailers.

“Initial staff findings show that retailers frequently use people’s personal information to set targeted, tailored prices for goods and services—from a person’s location and demographics, down to their mouse movements on a webpage,” said FTC chair Lina Khan. “The FTC should continue to investigate surveillance pricing practices because Americans deserve to know how their private data is being used to set the prices they pay and whether firms are charging different people different prices for the same good or service.”

The FTC has asked for public comment on consumers’ experience with surveillance pricing.

FTC commissioner Andrew N. Ferguson, whom Trump has tapped to chair the commission in his incoming administration, dissented from the report.

Matt Stoller of the nonprofit American Economic Liberties Project, which is working “to address today’s crisis of concentrated economic power,” wrote that “[t]he antitrust enforcers (Lina Khan et al) went full Tony Montana on big business this week before Trump people took over.”

Stoller made a list. The FTC sued John Deere “for generating $6 billion by prohibiting farmers from being able to repair their own equipment,” released a report showing that pharmacy benefit managers had “inflated prices for specialty pharmaceuticals by more than $7 billion,” “sued corporate landlord Greystar, which owns 800,000 apartments, for misleading renters on junk fees,” and “forced health care private equity powerhouse Welsh Carson to stop monopolization of the anesthesia market.”

It sued Pepsi for conspiring to give Walmart exclusive discounts that made prices higher at smaller stores, “​​[l]eft a roadmap for parties who are worried about consolidation in AI by big tech by revealing a host of interlinked relationships among Google, Amazon and Microsoft and Anthropic and OpenAI,” said gig workers can’t be sued for antitrust violations when they try to organize, and forced game developer Cognosphere to pay a $20 million fine for marketing loot boxes to teens under 16 that hid the real costs and misled the teens.

The Consumer Financial Protection Bureau “sued Capital One for cheating consumers out of $2 billion by misleading consumers over savings accounts,” Stoller continued. It “forced Cash App purveyor Block…to give $120 million in refunds for fostering fraud on its platform and then refusing to offer customer support to affected consumers,” “sued Experian for refusing to give consumers a way to correct errors in credit reports,” ordered Equifax to pay $15 million to a victims’ fund for “failing to properly investigate errors on credit reports,” and ordered “Honda Finance to pay $12.8 million for reporting inaccurate information that smeared the credit reports of Honda and Acura drivers.”

The Antitrust Division of the Department of Justice sued “seven giant corporate landlords for rent-fixing, using the software and consulting firm RealPage,” Stoller went on. It “sued $600 billion private equity titan KKR for systemically misleading the government on more than a dozen acquisitions.”

“Honorary mention goes to [Secretary Pete Buttigieg] at the Department of Transportation for suing Southwest and fining Frontier for ‘chronically delayed flights,’” Stoller concluded. He added more results to the list in his newsletter BIG.

Meanwhile, last night, while the leaders in the cryptocurrency industry were at a ball in honor of President-elect Trump’s inauguration, Trump launched his own cryptocurrency. By morning he appeared to have made more than $25 billion, at least on paper. According to Eric Lipton at the New York Times, “ethics experts assailed [the business] as a blatant effort to cash in on the office he is about to occupy again.”

Adav Noti, executive director of the nonprofit Campaign Legal Center, told Lipton: “It is literally cashing in on the presidency—creating a financial instrument so people can transfer money to the president’s family in connection with his office. It is beyond unprecedented.” Cryptocurrency leaders worried that just as their industry seems on the verge of becoming mainstream, Trump’s obvious cashing-in would hurt its reputation. Venture capitalist Nick Tomaino posted: “Trump owning 80 percent and timing launch hours before inauguration is predatory and many will likely get hurt by it.”

Yesterday the European Commission, which is the executive arm of the European Union, asked X, the social media company owned by Trump-adjacent billionaire Elon Musk, to hand over internal documents about the company’s algorithms that give far-right posts and politicians more visibility than other political groups. The European Union has been investigating X since December 2023 out of concerns about how it deals with the spread of disinformation and illegal content. The European Union’s Digital Services Act regulates online platforms to prevent illegal and harmful activities, as well as the spread of disinformation.

Today in Washington, D.C., the National Mall was filled with thousands of people voicing their opposition to President-elect Trump and his policies. Online speculation has been rampant that Trump moved his inauguration indoors to avoid visual comparisons between today’s protesters and inaugural attendees. Brutally cold weather also descended on President Barack Obama’s 2009 inauguration, but a sea of attendees nonetheless filled the National Mall.

Trump has always understood the importance of visuals and has worked hard to project an image of an invincible leader. Moving the inauguration indoors takes away that image, though, and people who have spent thousands of dollars to travel to the capital to see his inauguration are now unhappy to discover they will be limited to watching his motorcade drive by them. On social media, one user posted: “MAGA doesn’t realize the symbolism of [Trump] moving the inauguration inside: The billionaires, millionaires and oligarchs will be at his side, while his loyal followers are left outside in the cold. Welcome to the next 4+ years.”

Trump is not as good at governing as he is at performance: his approach to crises is to blame Democrats for them. But he is about to take office with majorities in the House of Representatives and the Senate, putting responsibility for governance firmly into his hands.

Right off the bat, he has at least two major problems at hand.

Last night, Commissioner Tyler Harper of the Georgia Department of Agriculture suspended all “poultry exhibitions, shows, swaps, meets, and sales” until further notice after officials found Highly Pathogenic Avian Influenza, or bird flu, in a commercial flock. As birds die from the disease or are culled to prevent its spread, the cost of eggs is rising—just as Trump, who vowed to reduce grocery prices, takes office.

There have been 67 confirmed cases of the bird flu in the U.S. among humans who have caught the disease from birds. Most cases in humans are mild, but public health officials are watching the virus with concern because bird flu variants are unpredictable. On Friday, outgoing Health and Human Services secretary Xavier Becerra announced $590 million in funding to Moderna to help speed up production of a vaccine that covers the bird flu. Juliana Kim of NPR explained that this funding comes on top of $176 million that Health and Human Services awarded to Moderna last July.

The second major problem is financial. On Friday, Secretary of the Treasury Janet Yellen wrote to congressional leaders to warn them that the Treasury would hit the debt ceiling on January 21 and be forced to begin using extraordinary measures in order to pay outstanding obligations and prevent defaulting on the national debt. Those measures mean the Treasury will stop paying into certain federal retirement accounts as required by law, expecting to make up that difference later.

Yellen reminded congressional leaders: “The debt limit does not authorize new spending, but it creates a risk that the federal government might not be able to finance its existing legal obligations that Congresses and Presidents of both parties have made in the past.” She added, “I respectfully urge Congress to act promptly to protect the full faith and credit of the United States.”

Both the avian flu and the limits of the debt ceiling must be managed, and managed quickly, and solutions will require expertise and political skill.

Rather than offering their solutions to these problems, the Trump team leaked that it intended to begin mass deportations on Tuesday morning in Chicago, choosing that city because it has large numbers of immigrants and because Trump’s people have been fighting with Chicago mayor Brandon Johnson, a Democrat. Michelle Hackman, Joe Barrett, and Paul Kiernan of the Wall Street Journal, who broke the story, reported that Trump’s people had prepared to amplify their efforts with the help of right-wing media.

But once the news leaked of the plan and undermined the “shock and awe” the administration wanted, Trump’s “border czar” Tom Homan said the team was reconsidering it.

—

Categories Accountability, Billionaires, Corruption, Democracy, Disruption, Economy, Elections, Ethics, Evil, Extremism, For-Profit, Fraud, Funding, Hypocrisy, Injustice, Lies, Republicans, Trump

Sherrilyn Ifill: The Truth

By dianeravitch
January 17, 2025 //
8

Sherrilyn Ifill is a law professor who holds an endowed chair at Howard University. She is a former president and director-counsel of the NAACP Legal Defense Fund.

In this post, she offers sage advice about how to recharge your batteries and re-engage in the struggle for a better society. She wrote this piece soon after the 2024 election. It’s good advice.

….But ours is a subtle strength
Potent with centuries of yearning,

Of being kegged and shut away
In dark forgotten places.
We shall endure
To steal your senses
In that lonely twilight
Of your winter’s grief.


-Pauli Murray, To the Oppressors (1939)            

The truth is that things are going to get very bad. America has gone over the cliff’s edge. How hard we land in the ravine below remains to be seen. But we are one week in, and things are already quite dire. Trump’s first round of cabinet nominees, and his insistence that his picks be installed without a vote of Congress is a defining moment. It demonstrates that there will be no bottom with this Administration.

Donald Trump and his coterie of supporters are firmly in control of the most powerful and wealthy country in the world. And because they are in charge of this country – which perhaps undeservedly,  has stood as an example throughout much of the world as a symbol of freedom, equality, ethics, the rule of law and democracy – other countries will fall in our wake.

I am saying this now because I have always tried to be honest in my writings and analysis about this country. I say all of this because I have been able over the years to encourage my clients, my colleagues, my staff, my family and community to believe that we can fight and win. I have infected other people with my unshakeable optimism about what we can accomplish to transform this country.

I am going to keep fighting. It’s what I do. But I do not want to lead you astray. Because I do think that many of us – especially those of us in communities likely to be targeted by this Administration – need to see this moment as one in which we are focused on surviving this difficult time. I have faced the fact that we will not be able to move much forward in the next few years. In fact, I expect things to become so dire over the next two years, that we will scarcely recognize the country we live in. I expect that fear and cruelty will become part of our daily diet. We will hear the frightening sound of silence, as those who speak out most boldly against the excesses of the incoming administration, against its policies, against Musk and against Russia, find themselves at cross-purposes with a vindictive and cruel administration with almost unimaginable power to control communications, law, and the sense of reality itself.

Perhaps it won’t be that bad. But we are here in some measure, because far too many failed to imagine that the worst could happen. I have written already about “the nadir,” and I believe we must face it.

And so, our goal now must be first and foremost to survive this dark period with as much of our values, dignity, integrity, work, financial stability and physical and mental health intact as possible. We must also work to protect our families and communities, and to hold in place our most trusted and needed institutions, a modicum of the rule of law, our constitutional commitment to equality and to free expression.
As I have said in earlier pieces, this is “planting time.” Planting is work. That work must be aimed at building ideas, theories, paradigms, institutions, skills, practices, and alliances that we can seed now for a future harvest – a fulsome and lush democracy that will reflect the very best of us.

We are not “watching the Trump show” this time. We’ve seen it already. We can dip in every now and then, but we must not become paralyzed watching the train wreck. We will, of course, push back against injustice, and defend our rights and citizenship when necessary in the courts. We will demand that congressional representatives, our Governors and our Mayors, act to protect our democratic rights. Even when we know they will not stand up for what is right, we must not be silent. We must not make it easy for them to be cowards or to take our rights. We must still call, write and email our representatives and show up at town halls and meetings. Remember that those who have fought for us over these past years are tired too. Let them see us in these spaces and hear from us.

But our primary work must be first and foremost to work in our communities – both physical and ideological. To build them up and to share time and ideas with those committed to democracy and justice. We each need a curriculum of local service.

We also need a personal curriculum that will allow us to contribute to the building of the future we dream of for ourselves and our families. That means that our core work must be to commit during this time to do less watching, and more learning and more growing. We need to become better citizens for the democracy we want. That means we must dedicate time to expanding our thinking and our knowledge, and to building up our democratic imagination. That means our work is to imagine, to ally, to experiment, restore, befriend, study, read, write, serve, and create. Every one of us. Even as chaos swirls around us.

I encourage you to show your children and grandchildren real things – nature, animals, how things are built, how to cook from scratch. Teach them cursive writing, so that they have a signature all their own. Take them to live concerts and theater. Go on field trips. Infuse their lives with memories of things that are true and concrete.

If you teach, use primary documents in your teaching, take your students to historic sites, listen to audio of oral arguments and speeches so that they will feel confident in their understanding of history, and know that history was made by human beings not machines.

If you litigate, do it with the expectation that you will win. And act like it. Show out. Be excellent and remain confident. Those who can still feel shame – whether those at your opponents table or those on the bench – will feel it when you hold the standard high. And your clients will never forget it.

If you organize, never stop. Plant those seeds deep in our communities.

If you hold office. Hold it. Do not give up your power. Use your voice. Master every rule. Make a record. I repeat. Make a record–so that the truth might be known.

To protect ourselves and our loved ones, there are also pragmatic things we must do. I’ve thought of a few:

  • Save some cash. And keep enough in the house for gas and food for a week.
  • Let yourself imagine what you would do if you lost your job in terms of finding new employment, paying rent/mortgage for several months, and start building what you need to be able to meet that moment if it comes.
  • Get needed vaccinations in case new HHS policies result in changes or delays in their development or availability. Stock up on COVID tests, and get the most recent COVID booster. Purchase Plan B if it’s available in your area.
  • Think about tightening security on your electronic devices. Be more thoughtful about social media, and even return to making phone calls and writing letters in some instances. I know it’s old school, but actually memorize the phone numbers of at least two loved ones.
  • Gird yourself spiritually, through your faith or other meditative practices, as we are all likely to hear or confront many disturbing and ugly interactions. Experience art, go on walks, dance, play Spades, Dominoes, Scrabble. We need resilience.
  • Walk away when you need to walk away. Challenge when you need to. Try to always have back up.
  • Take the bystander training offered by groups https://righttobe.org/ so that when you see outrages committed against members of your community or against strangers, you will have practice in how you might intervene or respond.
  • Get an online subscription to a news service from another country so that you have a reliable sense of what’s going on in the world, and how this country is being perceived.  
  • Are your taxes paid, or more importantly, filed?
  • Is your passport up-to-date?
  • If you have money to give – then give to your local library, the food pantry, homelessness services. But also give to cultural institutions. Get a library card and a membership to a museum. Give to organizations working to hold back the worst that this administration may dish out – the NAACP Legal Defense Fund, the ACLU, the National Women’s Law Center, and so many others.
  • I am going to write more in this space. I hope you’ll subscribe and even pay a nominal fee to sustain the writing. I’m right here, going through this with all of you. And for me there is beauty in our shared walk. Let’s do this together.

Categories Bigotry, Billionaires, Budget Cuts, Censorship, Civil Rights, Courage, Creativity, Democracy, Elections, Equity, Ethics, Evil, Extremism, Fascism, For-Profit, Freedom of Speech, Freedom of the Press, Freedom to Read, Trump

Just Published: My Review of the Trump Education Agenda

By dianeravitch
January 11, 2025 //
5

This article just appeared on the website of The New York Review of Books.

https://www.nybooks.com/online/2025/01/11/their-kind-of-indoctrination/

It is my review of Trump’s plans for K-12 education.

NYRB is the most distinguished literary-political journal in the nation. It has a huge readership. It reaches a different audience than education journals.

If you subscribe to NYRB, you can open it in full. If you don’t, it costs $10 for 10 issues. Or, if you wait, I will post it in full in a few weeks.

Categories Accountability, Arizona, Budget Cuts, Censorship, Charter Schools, Civil Rights, Cruelty, Curriculum, Democracy, Deregulation, Disruption, Education Industry, Elections, Ethics, Extremism, For-Profit, Freedom to Read, Funding, Gender, History, Ignorance, Inequality, Lies, Privatization, Racism, Religion, Segregation, Separation of church and state, Trump, U.S. Department of Education

Don’t Be Tricked into Giving Up Your Medicare!

By dianeravitch
January 11, 2025 //
23

For-profit healthcare companies, many of which are owned by private equity, are aggressively expanding their efforts to trick seniors into abandoning their enrollment in traditional Medicare and joining for-profit Medicare Advantage plans.

About half of all seniors are now enrolled in Medicare Advantage. The pitch for MA plans is seductive. They offer bells and whistles that are not part of Medicare. If you enroll in a MA plan, you will get free gym membership, prescription drug coverage, dental coverage, and a variety of other attractive benefits.

What’s wrong with MA? It’s great when you are not sick. It’s very bad when you have a serious illness.

When you have surgery or other serious illness, Medicare and your secondary pays almost all of your medical costs. MA may or may not. MA has panels to decide whether to pay your bills. You may be denied and stuck with huge bills.

Privatization produces worse service because the corporation must turn a profit. Make no mistake: MA is privatization.

How does MA make a profit? By denying the claims of patients.

I had open heart surgery in 2021. I was hospitalized for a month. I spent a week in the ICU (intensive care unit). When the total hospital bill arrived many weeks later, I almost had a stroke: it was over $839,000! After Medicare negotiated with the hospital, the actual cost to me was $300. That’s a miracle. Why give up that kind of coverage?

The Lever reports that the federal government has been complicit in tricking people to abandon Medicare and switch to Medicare Advantage.

It begins:

A new Medicare privatization scheme developed under President Donald Trump and now being expanded under President Joe Biden is forcing hundreds of thousands of seniors onto new private Medicare plans without their consent.

The development represents a troubling new dimension in the fight by corporate interests to privatize Medicare, the federal health insurance program for people 65 or older. Medicare Advantage, which allows for-profit health insurers to offer privatized benefits through Medicare, already results in unexpected costs for routine procedures and wrongful denials of care. Private plans have cost Medicare an astonishing $143 billion since 2008, and are now drivingsome health insurers’ record profits.

The new Direct Contracting Entity (DCE) program similarly adds a private-sector third party between patients and Medicare services. Medicare allows these intermediary companies to offer unique benefits, like gym membership coverage. But as for-profit operations ranging fromprivate insurers to publicly traded companies to private equity firms, these intermediaries are incentivized to limit the care that patients receive, especially when they are very sick.

While Medicare Advantage patients choose to sign up for private insurance plans, patients are being enrolled in these DCE health care plans without their informed consent. As Rep. Pramila Jayapal (D-Wash.) noted in a January op-ed, “Seniors in traditional Medicare may be ‘auto-aligned’ to a DCE if any primary care physician they’ve visited in the past two years is affiliated with that DCE. That means Medicare automatically searches two years of seniors’ claims history without their full consent to find any visits with a participating DCE provider as the basis for enrollment.”

Open the link and continue reading.

Don’t be fooled.

Categories Ethics, For-Profit, Health

Carol Burris: The End Goal of “School Choice” Is the Death of Public Schools

By dianeravitch
January 6, 2025 //
9

Carol Burris, executive director of the Network for Public Education, writes in The Progressive about the hidden purpose of “school choice.” It’s not to educate children better; it’s not to save money. It’s to destroy your child’s right to a free public education.

She begins:

In 2017, PBS released School Inc., a rightwing billionaire-funded documentary created by the late Andrew Coulson, a conservative author and former director of the libertarian Cato Institute’s Center for Educational Freedom. School Inc. showcased Coulson’s theory that for-profit schooling, funded by parents without government involvement, is the best delivery model for education. In a review for the long-running Answer Sheet blog in The Washington Post, the education historian Diane Ravitch and I criticized Coulson’s romanticization of the era of American schooling before public education, during which children were homeschooled, church-schooled, or taught by private tutors—except for the poor, who, if they were lucky, were trained in charity schools.  

The “school choice movement,” which Coulson’s documentary promoted, has always been a classic bait-and-switch swindle: Charter schools were the bait for vouchers, and vouchers the lure for public acceptance of market-based schooling. While narrow debates about accountability, taxpayer costs, and the public funding of religious schools raise important concerns, the gravest threat posed by the school choice movement is its ultimate objective: putting an end to public responsibility for education. 

This goal is not a secret. The libertarian right has openly dreamed of ending public education for the past seventy years—the economist Milton Friedman advocated for school choice as early as 1955, and his acolytes have continued to do so ever since.

 And they have made extraordinary progress. During the past few years, the traditional voucher model championed by the right has morphed into the Education Savings Account (ESA). In exchange for promising not to enroll their child in public schools, parents receive funds to “shop” for services, including private school tuition, tutoring, and luxury purchases, including trips to Disney World, televisions, and waterskiing lessons. Nearly all recent state ESA programs have either no or high-income caps, and few have sensible protections. 

The libertarian right embraces this flagrant waste because it helps them achieve their ultimate objective of shifting all of the responsibility and costs to families. By approving universal ESA programs, they are creating a vested interest among middle and upper-income families in pay-as-you-go education. Frivolous spending is tolerated because it aligns with Friedman and Coulson’s objective of putting parents in charge of education without government responsibility or concern. 

The America First Policy Institute, where Trump’s Secretary of Education nominee Linda McMahonserves as board chair, states in its recent policy agenda that “the authority for educating children rests with parents.” As public responsibility for schooling shifts to parents, educational subsidies will be gradually reduced until Friedman and Coulson’s dream of a fully for-profit marketplace that competes for students is achieved.

Please open the link to finish reading this important article.

Categories Accountability, Charter Schools, Democracy, Education Industry, Extremism, For-Profit, Fraud, Hoax, Vouchers

When Private Equity Takes Over Healthcare, Costs Rise, Quality Declines

By dianeravitch
January 4, 2025 //
22

In a recent issue of The New Yorker, physician Dhruv Khullar writes about what happened to the practice of medicine when private equity began buying up hospitals and group practices. The result of privatization of healthcare was not surprising: the desire for profit became more important that the drive to improve patients’ health. Private equity was very successful in squeezing handsome profits out of community hospitals, but all too often those hospitals went bankrupt, leaving the communities without a hospital. Dr. Khullar says we are now in “the Gilded Age” of medicine, where wealth and corporate power are in charge.

Dr. Khullar is a physician and associate professor of health policy and economics at Weill Cornell Medical College.

Dr. Khullar wrote:

In 2010, a private-equity firm called Cerberus Capital Management, which is named for the three-headed dog that is said to guard the underworld, bought six Catholic hospitals in Massachusetts and christened the chain Steward Health Care. The state’s attorney general blessed the deal on multiple conditions, including that, during a five-year review period, the hospitals stayed open and their workers stayed employed. A few months after the period ended, however, Steward started selling the land on which the hospitals stood. A $1.25-billion-dollar deal, in 2016, helped to finance more acquisitions. Many facilities, asked to pay rent on land they’d previously owned, struggled.

According to a recent report published by Massachusetts Senator Ed Markey’s office, which covers the period between 2017 and 2024, some Steward facilities had to forgo key investments in staffing, surgical equipment, elevator repairs, and even clean linens. Patients increasingly languished in emergency rooms; many left without receiving care; and mortality rates for common conditions climbed sharply. (Steward has argued that its death rates were better than expected, given the underlying health status of the patients it cared for.) A hospital in Florida developed a bat infestation, and another, in Texas, was cited for placing potentially suicidal patients in rooms with materials with which they could hang themselves. Employees at Steward’s Carney Hospital, in Massachusetts, began calling their workplace “Carnage” hospital. (Cerberus’s ownership ended in 2020, and the firm claims that the quality issues at Steward are “overwhelmingly related to the post-Cerberus ownership period.”)

In May, Steward filed for bankruptcy. It has closed two hospitals and plans to sell thirty-one others. Steward’s C.E.O., Ralph de la Torre, who in 2011 purchased a forty-million-dollar superyacht, was subpoenaed by a Senate committee but failed to show up; he was held in contempt of Congress and resigned from his position. (De la Torre, in turn, sued the committee for violating his right against self-incrimination.) Nonetheless, Cerberus realized a profit of seven hundred and ninety million dollars from its investment in Steward. Meanwhile, in some places in the U.S., private-equity firms now own more than half of all medical practices within certain specialties. “We are being picked clean by private equity,” a New Jersey-based radiologist said at a recent meeting of the American Medical Association. “There are people who don’t know where their next paycheck is even going to come from because their groups have been flipped so often.”

2024 was arguably the year that the mortal dangers of corporate medicine finally became undeniable and inescapable. A study published in JAMA found that, after hospitals were acquired by private-equity firms, Medicare patients were more likely to suffer falls and contract bloodstream infections; another study found that if private equity acquired a nursing home its residents became eleven per cent more likely to die. Although private-equity firms often argue that they infuse hospitals with capital, a recent analysis found that hospital assets tend to decrease after acquisition. Yet P.E. now oversees nearly a third of staffing in U.S. emergency departments and owns more than four hundred and fifty hospitals. In some of them, patients were “forced to sleep in hallways, and doctors who spoke out were threatened with termination,” according to Jonathan Jones, a former president of the American Academy of Emergency Medicine.

Erin Fuse Brown, a professor at the Brown University School of Public Health, told me that private-equity firms have learned that they “don’t have to make things better or make them more efficient. You can just change one small thing and make a ton more money.” They are hardly the only corporations to learn this lesson. Increasingly, health insurers, private hospitals, and even nonprofits are behaving as though they aim first to extract revenue, and only second to care for people. Patients often are viewed less as humans in need of care than consumers who generate profit.

In 1873, Mark Twain co-wrote the novel “The Gilded Age: A Tale of Today,” which satirized an era that was marked by inequality, greed, and moral decay but was painted in a veneer of abundance and progress. Industrialists made fortunes in oil, steel, and shipping even as millions suffered poverty and exploitation. Today, health care is where the money is. New technologies and treatments sustain the impression that patients have never been healthier, but corporations and conglomerates wield immense power at the expense of the people they’re meant to serve. Welcome to the Gilded Age of medicine.

In recent years, health-care corporations have embraced an approach that can only be described as gamification. In the U.S., all seniors over sixty-five are entitled to health insurance through Medicare, and, for several decades, private companies have offered plans through programs such as Medicare Advantage. The government pays insurance companies a fixed sum based partly on how sick those patients are. The sicker the patients, the bigger the potential payments. But who’s to say, really, how sick a patient is? Let the games begin.

This year, the health-news site STAT revealed that UnitedHealth, the country’s largest private insurer, had set up dashboards for practices to compete on how many conditions they could diagnose in patients. Doctors who completed the most appointments with seniors in Medicare Advantage were eligible for ten-thousand-dollar bonuses, and patients were offered seventy-five-dollar gift cards for getting checkups at which their medical histories could be recorded. At the height of the covid-19 pandemic, an e-mail sent to one practice told clinicians that documenting chronic illnesses was the “#1 priority.”

Insurance companies have even started to scour medical records for possible diagnoses, and to send nurses to patients’ homes to perform “health-risk assessments.” These strategies rack up so many additional diagnoses that, in 2023 alone, the federal government made $7.5 billion in “overpayments” to insurers, according to the U.S. Office of the Inspector General. Insurers are “pouring tremendous resources into developing the capacity to code patients in a way that nets more money from Medicare,” Donald Berwick, a former head of the Center for Medicare & Medicaid Services, told me. “That’s taxpayer money being siphoned away from people who need it.”

Berwick said that his own physician’s practice had recently been acquired by UnitedHealth. One day, he asked his doctor, “Anything different now?”

“Two things,” the doctor replied. “I have to see more patients each day. And my patients have new diagnoses that I didn’t put there.” Many patients with atrial fibrillation, for example, were now coded as having another condition known as “hypercoagulable state”—which was technically accurate, but didn’t change patients’ care in any way. It did, however, generate higher payments from Medicare. Ask not what your insurer can do for you—ask how much revenue you can generate for your insurer.

The insurance companies in Medicare Advantage tend to argue that they’re simply recording diagnoses, not making them up; that they offer vision and dental benefits that traditional Medicare doesn’t offer; and that they rein in unnecessary care, such as by requiring prior authorization for certain tests and procedures. But according to the Medicare Payment Advisory Commission, a nonpartisan agency that counsels Congress, private Medicare Advantage plans will cost the federal government eighty billion dollars more per year than if those patients had been in the traditional Medicare program. “You might as well flush most of that eighty billion dollars down the toilet,” Berwick told me.

On December 4th, after I drafted this piece, Brian Thompson, the C.E.O. of UnitedHealthcare, was fatally shot in midtown Manhattan. In the days that followed, the public response was not just one of shock but also of frustration and even rage against the health-insurance industry. Someone posted in a subreddit for nurses, “Honestly, I’m not wishing anyone harm, but when you’ve spent so much time and made so much money by increasing the suffering of the humanity around you, it’s hard for me to summon empathy that you died.” The comedian Bill Burr compared C.E.O.s like Thompson to gangsters. “It’s a dirty game,” he said. “Health care—dirty game.” I was saddened by the callousness of these comments. Thompson had become a symbol of a broken system; people who devalued his life, it seemed to me, were engaging in a version of the dehumanizing behavior that they found objectionable within the health-care industry.

Please open the link to finish reading the article.

Categories Accountability, Cruelty, Disruption, For-Profit, Health

Michigan: What Are Charter Schools Trying to Hide?

By dianeravitch
January 3, 2025 //
5

This article was written by Dr. Cassandra Ulrich, who served as president of the Michigan State Board of Education, and now is a member of the board of the Network for Public Education.

Dr. Casandra Ulbrich is a former Michigan State Board of Education president (2014 – 2023). She is a member of the Network for Public Education Board of Directors Ulbrich has spent most of her career in higher education administration, currently serving as the Vice Chancellor for Institutional Advancement at the University of Michigan-Dearborn. Ulbrich began her career as a press secretary to the former U.S. House Democratic Whip David Bonior, acting as the official spokesperson for the Congressman. She has been recognized as one of Michigan’s 40 under 40 by Crain’s Detroit Business.

At the end of the 2023-2024 session, the House and Senate of Michigan took up bills to increase charter school transparency in a state where 70% of the schools are run by for-profits. Ultimately, the bills did not pass, but the problems persist. Below is the testimony given by Dr. Casandra Ulbrich, the former President of the Michigan Board of Education.

As the former President of the State Board of Education, I would like to commend the State Senate for taking the issue of financial transparency seriously. The bills before you today level the playing field by requiring charter schools, education management companies, and authorizers to demonstrate that they are responsible stewards of public dollars, just as traditional public schools are currently required to do.

Financial transparency is an essential element of accountability for all publicly funded institutions and a necessary component for an engaged citizenry. Absent timely and accurate financial data in a manner that is easily accessible and understood by the public, citizens lack the resources necessary to make informed decisions. Missing or misleading financial information removes a citizen’s ability to adequately determine the value of their public investments. Similarly, a charter school board that is denied this information cannot fulfill its oversight duty and its commitment to the citizens it serves.

This is particularly true for the K-12 public schools that educate approximately 1.3 million students in the State of Michigan, nearly 10 percent of whom attend a charter school. In 2022 – that year will be relevant during my testimony – Michigan Charter schools received roughly $1.4 billion in taxpayer funding. How this money is spent is often hidden from taxpayer view behind a wall of secrecy. One reason is that Michigan law allows charter school boards to contract out all the school’s services to a for-profit education management company that also assumes control of the school’s budget. This arrangement is known as a ‘sweeps’ contract in the charter school sector. Its name comes from the fact that nearly all of the school’s public dollars – anywhere from 95 percent to 100 percent – is ‘swept’ into a charter management company. Once that happens, that money is no longer reportable to the taxpayers who funded those dollars.

While the schools themselves must adhere to Freedom of Information Act(FOIA) laws, private, for-profit management companies themselves are not subject to FOIA. Therefore, when a management company assumes the vast majority, if not all, of the school’s budget, how that money is spent is legally hidden from public view.

For years, the charter lobby has argued that charter schools adhere to all applicable transparency laws. In most cases, they are correct. But, those laws fall far short of allowing taxpayers adequate oversight over the schools for which they fund.

In 2022, the State Board of Education used the Freedom of Information Act to identify and disclose the similarities and differences in financial reporting between traditional and charter school districts.

We sent FOIA requests to all school districts, both traditional and charter, in five Michigan counties. Of those districts, 112 were traditional school districts, representing over 551,000 full-time equivalent (FTE) student counts, and 166 were charter school districts, representing nearly 80,000 FTE student counts. For the charter districts, 117 (71%) used for-profit management companies, 19% used non-profit management companies, and 11% were self-managed. Individual district student counts ranged from a low of 71 to a high of more than 55,000 FTEs.

On January 5, 2022, each district received a FOIA from me as the President of the SBE. A second letter was sent to those who did not respond, and in some cases, a third letter was also sent. The FOIA request included five items:

  • Contracts for rental or lease of facilities.
  • Contracts for food service management or vended meals.
  • Contracts with custodial service vendors.
  • Contracts with lawn and grounds service vendors.
  • Contracts with educational service providers or education management
    companies.

The results demonstrated what we had assumed all along.

Following the third letter, 100% of traditional school districts responded to the FOIA request, while only 93% of charter districts responded. Seven percent of charter school districts didn’t even bother to respond to three Freedom of Information Requests from the State Board of Education.

When it came to facility contracts, Charter school districts were more likelyto submit facility rental or lease contracts. Sixty-eight percent, or 105, of charter districts submitted these contracts. Many charter districts lease their buildings from entities related to the management companies overseeing the schools.

A management company that also subleases its own facilities to the schools they manage raises obvious questions about conflicts of interest. It also allows the management company/facility owner to set lease terms that may be excessive. The State Board of Education FOIA did not address the market rates of each lease, but other states have identified this as an issue. For example, in 2012, the New York State Comptroller issued a report detailing how a Brooklyn charter school managed by National Heritage Academies approved a lease from a “related business” at a rate nearly $800,000 above market value, or $3.96 million more over the term of the five-year lease. The report also indicated that NHA refused to divulge financial records supporting expenses that it charged to the charter school. A 2019 Ohio Auditor report found similar examples in that state.

Another issue is that many charter management contracts also include a provision that allows the management company to own all property in the school, even though that property was most likely funded by taxpayers.

Food Service, Custodial, and Lawn Contracts

Charter school districts, particularly those managed by for-profit companies, were far less likely to share food, custodial or lawn contracts. In fact, these charter districts indicated they were not responsible for these contracts. This reflects the fact that many charter districts engage in “sweeps contracts.” Therefore, a common response among for-profit managed companies was to deny the State Board’s FOIA request related to these three contracts. The FOIA coordinator responded, “Your request for information contained in bullets 2 through 4 is denied because the Academy does not (i) contract for food service management or vended meals, (ii) contract with custodial service vendors, or (iii) contract with lawn and grounds service vendors. Instead, the Academy contracts for the above services through a third-party management company by way of an educational management agreement and, thus, the Academy is not a party to the service contracts.” (S. Wilson, personal communication, January 14, 2022).

Financial Disclosures

One thing that became evident through the FOIA process was the vast differences in detailed financial disclosures. All districts, regardless of charter or traditional, are required by statute to submit annual comprehensive financial data (MCL 388.1618(5) and a financial audit report (MCL 388.1618(4). While the reports tend to be detailed for traditional school districts, this is not the case for charter districts. Most PSAs report most of their current operating expenditures as“purchased services” through their management company. The management companies, themselves, are not required to report detailed information. As a private vendor, there is no statutory requirement for management companies to submit financial reports to the state.

It’s important to note that, with limited exceptions, traditional school districts are not permitted by law to contract for instructional services. On the other hand, many charter school districts contract with a management company for all or most of these services. According to a state board of education resolution, in FY21, 90.4% of charter schools reported that more than 50% of the school’s current operating expenditures were spent on purchased services (totaling $1.3 billion in purchased services), resulting in those expenditures not being reported and audited with the same level of detail provided for expenditures of traditional school districts, and not subject to public disclosure under FOIA” (MI State Board of Education, 2022).

Financial Reporting

Michigan school districts provide financial information to the state via the Financial Information Database (FID). Data submitted to the FID includes financial reports, revenues, and expenditures. However, what is reported looks very different depending on the type of district and their management contracts, leading to greater disparity between traditional and charter school districts. Under current reporting requirements, the costs for services provided to charter districts under a management agreement are often aggregated under “purchased services” and therefore lack any detailed information.

As a result of this method of reporting, it is nearly impossible to make any kind of accurate comparisons of financial spending. And, since management companies are not subject to the same financial reporting and audit requirements as districts, taxpayers have no way of knowing if their investments are being spent appropriately or if those dollars are being spent in an illegal or
inappropriate manner. In my role on the State Board of Education, I have heard many anecdotal examples of this happening, but absent real transparency laws, there is no way of holding bad actors accountable for their actions. Not only is this inappropriate for a public entity, but it also serves as a stain on all charter schools, including those that are acting in good faith and are truly interested in
providing quality education for children.

The bills before you today alleviate many of the concerns that the State Board of Education has been raising over the last twenty years. Specifically, financial information will be available to the Boards that are charged with overseeing these schools, allowing them to do their jobs effectively. Financial
information will also be not only FOIA-able for the public but in many cases available on the school’s website. It will bring to light related party transactions and taxpayer overspending.

If we are truly interested in parents making choices for their children, they should have access to this information, as should taxpayers who are funding these schools.

For these reasons, the Charter School lobby should be the first in line tosupport these financial transparency laws that could demonstrate what they have been saying…that the vast majority of charter school operators are conducting themselves appropriately and to send a message to those who may not be.

Absent that, I would ask yourself, what do they have to hide?

Dr. Casandra Ulbrich is a former Michigan State Board of Education president (2014 – 2023). She is a member of the Network for Public Education Board of Directors Ulbrich has spent most of her career in higher education administration, currently serving as the Vice Chancellor for Institutional Advancement at the University of Michigan-Dearborn. Ulbrich began her career as a press secretary to the former U.S. House Democratic Whip David Bonior, acting as the official spokesperson for the Congressman. She has been recognized as one of Michigan’s 40 under 40 by Crain’s Detroit Business.

Categories Accountability, Charter Schools, Corruption, Education Industry, Ethics, For-Profit, Funding, Michigan

Parents Fight UnitedHealth to Protect Their Son’s Coverage

By dianeravitch
December 20, 2024 //
28

Chris McNaighton was an athlete in college and led an active life until tragedy struck: he was diagnosed with a painful, debilitating disease called ulcerative colitis. He was so disabled by its symptoms that he became housebound. After trying many treatments and doctors, he finally went to the Mayo Clinic, where a specialist prescribed a mix of drugs that were very expensive but saved his life.

Chris was covered by his parents’ insurance; they were both faculty members at Penn State. Chris enrolled at Penn State, so he was covered as a student as well.

UnitedHealth did not like paying the cost of Chris’s treatment. It was $2 million a year. It had Chris’s claims reviewed by doctors who denied them and said he could do with a lower dose, which would cost less. The doctor at Mayo responded that lower doses were ineffective.

Chris’s parents sued UnitedHealth.

Chris’s story was told by ProPublica.

It begins:

Christopher McNaughton suffered from a crippling case of ulcerative colitis — an ailment that caused him to develop severe arthritis, debilitating diarrhea, numbing fatigue and life-threatening blood clots. His medical bills were running nearly $2 million a year.

United had flagged McNaughton’s case as a “high dollar account,” and the company was reviewing whether it needed to keep paying for the expensive cocktail of drugs crafted by a Mayo Clinic specialist that had brought McNaughton’s disease under control after he’d been through years of misery.

Categories Accountability, Ethics, For-Profit, Health

UnitedHealth Cuts Coverage for Autistic Children

By dianeravitch
December 20, 2024 //
4

In the wake of the brutal murder of United Healthcare’s CEO, there has been an outpouring of stories about UnitedHealthcare’s strategy of denying claims to increase profits.

ProPublica wrote about a mother in Louisiana who counted on UHC to pay the cost of behavioral therapy for her autistic son. The therapy offered promise of helping him learn necessary skills. But UHC, which made $16 billion in profits last year, denied the claim.

Categories Ethics, For-Profit, Health
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