Tapped: The Prospect Group Blog

SCOTUS Abortion Ruling Benefits Women of Color, Low-Income Women

The Supreme Court’s 5-3 ruling on Monday to throw out restrictive Texas abortion laws in the landmark case known as Whole Woman’s Health v. Hellerstedt is a major victory for reproductive rights advocates, who have been fighting a wave of what they call “clinic shutdown” laws nationwide.

First enacted in 2013, the Texas laws rejected by the Court Monday had imposed numerous medical requirements on abortion providers, and had the effect of reducing the number of abortion clinics in the state from 40 to approximately 19. The law had required that doctors have admitting privileges at local hospitals, and that clinics meet hospital-like standards. Referred to as Targeted Regulations Against Providers (TRAP) laws, such restrictions have been proliferating in states around the country.

The resulting drop in abortion clinics has had “a disproportionate effect on women of color, young women, and rural women,” said Nancy Northrup, president of the Center for Reproductive Rights, during a press call earlier this month. Northrup’s group represented the Texas women’s clinic Whole Woman’s Health in its Supreme Court challenge.

“There have been higher costs to women who seek the care,” Northup said on the call. “They have to take multiple days off work, travel up to in some cases 200-300 miles to get to a clinic, obtain child care, experience a delay up to 20 days just to get an appointment.”

The ruling has far-reaching implications for other states that have enacted TRAP regulations. According to the Guttmacher Institute, about 24 states have laws or policies that regulate abortion providers and go beyond what is necessary to ensure patients’ safety; all apply to clinics that perform surgical abortion.

Proponents of the Texas law had argued that it was enacted for the protection, health, and safety of women and their families. Not so, argued reproductive rights and justice advocates before the Court, who cited a tremendous economic and emotional strain on women of limited means seeking reproductive health care in Texas. The state’s clinic mandates had been compounded by such additional abortion restrictions as mandatory waiting periods and mandated ultrasounds.

“There was a woman who drove her RV, camped in parking lot of the Austin clinic with her husband and two children to accommodate the mandatory waiting period in order to have the abortion procedure,” recounted Northrup in this month’s conference call. “And it was the only way they could afford lodging and transportation to get the procedure done.

It was stories like this that motivated Whole Woman’s Health staff members to fight the Texas law all the way to the the Supreme Court.

“It has been a long and arduous journey for Texans,” Andrea Ferrigno, the clinic’s corporate vice president, told the Prospect. “We embarked on this journey because we wanted to protect their rights and provide services in their communities.”

Nevertheless, having closed half its clinics and laid off half its staff, Ferringo acknowledged, Whole Woman’s Health will need some time to reach capacity again.  “It’s not a simple process to re-open clinics,” Ferringo says. Nevertheless, she adds, the ruling means that “clinics that are open will remain open.

American Intelligence Agencies Lag Behind in Diversity

For decades, intelligence agencies like the CIA and NSA that have been tarred with accusations of sexism and racial profiling have worked hard to clean up their images and present a friendlier, more inclusive face to the world. Unfortunately, despite these efforts, similar scandals continue to hound the intelligence community, from the CIA’s hand in helping the NYPD monitor “ancestries of interest” to a culture within the NSA that condones violations of women’s privacy.

A recently released report by the Office of the Director of National Intelligence may help to explain why: American intelligence agencies remain disproportionately white and male.

This the first time that a National Intelligence diversity report been declassified and publicly released since the department began producing the reviews in 2005. The report, which covers the period between October 2014 and September 2015, shows that while the numbers of minorities working in the intelligence community has increased in the past five years, minority groups are still underrepresented.

Minorities make up just under one quarter of the intelligence workforce, despite making up nearly 40 percent of the U.S. population, according to the report. Diversity is much higher in other sectors: Minorities comprise about 30 percent of the civilian labor force and roughly 35 percent of all federal employees. Promotions and honorary awards also tend to go to whites in higher numbers.   

African Americans make up 12 percent of the intelligence community workforce. Hispanics comprise 6.6 of all intelligence community employees. Asians, Native Hawaiians, and Pacific Islanders are 4.4 percent of the workforce; multiracial people, 1.8 percent; and American Indians/Native Alaskans, 0.6 percent.

It’s a similar, though better, story when it comes to women in the intelligence community. Women make up a little less than half of the population, and about 46 percent of the civilian labor force. They comprise 40 percent of all intelligence employees, but sometimes outdo men when it comes to promotions and honorary awards.

Minorities and women are also underrepresented as managers. Less than 25 percent of managers are minorities; 34 percent are women. Intelligence community hiring has shown some progress. Minority hiring increased from almost 21 percent in 2011 to nearly 25 percent in 2015. During that same period, the minority share of the workforce increased from about 23 percent to roughly 25 percent.

National Intelligence agencies have attempted to increase female and minority representation by launching a number of initiatives, such as the Intelligence Community Centers of Academic Excellence program, which provides grants to select higher education institutions to fund programs and courses that are designed to ultimately attract more diverse groups of potential employees.

Past scandals illustrate how the intelligence community’s lack of diversity has affected its surveillance activities. Historically, intelligence agencies have targeted minority groups. In the 1960s and 1970s, the CIA and the National Security Agency spied on civil rights organizations, Puerto Rican independence groups, black radicals, and others, all of which they viewed as threats to domestic security.

Documents obtained through a FOIA request by The Intercept last year revealed that the Department of Homeland Security and the FBI have monitored Black Lives Matter protesters around the country. Meanwhile, during the Bush years, the NSA spied on a number of prominent Muslim American leaders, while the CIA sent one of its officers to work with the NYPD in setting up its “Demographics Unit,” which spied on “ethnic communities,” often Muslim, in order to root out terrorist threats.

In recent years, the NSA has also been in hot water after reports surfaced of employees eavesdropping on overseas military personnel having intimate conversations with their wives and girlfriends back home. Employees also spied on women they were involved with or romantically interested in. According to whistleblower Edward Snowden, NSA employees also regularly passed around nude photographs of women that they happened to come across while gathering other data.  

National Intelligence Director James Clapper said he hoped that the report would persuade future intelligence leaders to work to increase diversity in the intelligence community. Earlier this month, Clapper ordered intelligence agencies to produce plans for increasing diversity within 90 days.

Farewell to ‘Darling Corey’ Lewandowski

AP Photo/Gerald Herbert, File

Donald Trump speaks to supporters in Palm Beach, Florida, as campaign manager Corey Lewandowski listens at left. 

 

Donald Trump just said, “you're fired” to his campaign manager, Corey Lewandowski.

This was predictable. In fact, it was predicted years ago in a traditional bluegrass folk song called “Darling Corey.”

The Corey in the song is a woman, but otherwise it fits the tragedy of Corey Lewandowski to a tee. Her fate was sealed when she got involved with what the song describes as a “gamblin' man,” clearly a reference to Trump's casino empire. The song is also prescient about Trump's tax problems (“the revenue officers are coming”). Corey's partner was a con man engaged in selling moonshine liquor made in a local “still house.” Is this not an obvious reference to Trump's effort to enter the booze business through Trump Vodka, which the Donald marketed under the slogan “Success Distilled,” but which quickly failed?

The “meadow” and the “graveyard” in the song no doubt refer to Trump's burial site. Some folks recently erected a tombstone to the presumptive GOP presidential candidate in the Sheep's Meadow section of Central Park. Since Trump just killed Lewandowski's job, perhaps he'll be generous enough to bequeath his “lonesome graveyard ground” to his former campaign manager.

Questions about the size of Trump's wealth are clearly anticipated in the first verse, which is found in the earliest published version of the song, “The Gambling Man,” collected from oral tradition by folklorist Cecil Sharp, as sung by Mrs. Clercy Deeton, at Mine Fork, Burnsville, North Carolina, on September 19, 1918. Versions of “Darling Corey” were recorded by The Weavers, Buell Kazee, Doc Watson, the Monroe Brothers, Flatt and Scruggs, Jean Ritchie, the Kingston Trio, and Pete Seeger, among others.

 

My pocketbook full of money,
My friends are all standing around.
My pocketbook are empty
And I ain't got a friend to be found

 

Wake up wake up darling Corey
What makes you sleep so sound?
The revenue officers are coming
They're gonna tear your still house down

 

Dig a hole dig a hole in the meadow
Dig a hole in the cold cold ground
Dig a hole dig a hole in the meadow
Gonna lay darling Corey down

 

Can't you hear those bluebirds a singing
Don't you hear that mournful sound
They're preaching darling Corey's funeral
In some lonesome graveyard ground

 

Oh yes, oh yes, my darlin'
I'll do the best I can
But I'll never take my pleasure
With another gamblin' man

 

Throughout its many versions, the basic theme of the song has remained the same: Don't mess around with people involved in shady and illegal activities.

American Dream Fading Fast, Study Finds

When the American economy crashed in 2008, economists took care to use the term “Great Recession” to distinguish the severity of the first major downturn of the 21st century from the 1929 stock market crash that ended up in the history books as the Great Depression. But there’s one byproduct of the recession that has Depression-era overtones: income inequality.

Today income inequality is pervasive. Since 2009, income gains have accrued almost exclusively to the country’s highest income earners, according to a new study by the Washington-based Economic Policy Institute. In 2013, the top 1 percent of American families acquired 25 times as much income as those in the bottom 99 percent. The average income for the top 1 percent was $1.2 million, while the average income of the bottom 99 percent was $45,567. 

“These trends in income concentration can’t go on,” says Mark Price, labor economist for the Keystone Research Center based in Harrisburg, Pennsylvania, who is a co-author of the report. “We’re on this conveyor belt that is spinning off greater and greater amounts of income to a tiny group of people,” he says. “It threatens to undermine the engine of our economic growth, which is our people.”

The researchers examined the period from 1917 to 2013, using Internal Revenue Service data for states, counties, and metropolitan areas.

They found that in 15 states all income growth went to the top 1 percent in the four years leading up to 2013. 

Florida, which has fifth greatest rate of income inequality, claimed four of the top seven most unequal metropolitan areas in the country—Naples-Immokalee-Marco Island, Sebastian-Vero Beach, Miami-Fort Lauderdale-West Palm Beach, and Key West. Franklin County, located on the coast of the Florida panhandle, is the most unequal county in the state. The county’s top 1 percent of income-earners averaged $1.8 million in income; the average income for the remaining 99 percent a little is more than $25,000.

Income inequality became a hot topic when the Occupy Wall Street movement hit the streets in 2011, but these unnerving developments have been building since 1979. In 1978, income inequality reached a nadir between the Great Depression and the Great Recession, with the top 1 percent earning 9 percent of all the country’s income. 

Income inequality had peaked in 1928 when 24 percent of income in the country went to the top 1 percent. In 2012, that figure had reached 23 percent. It dipped a few points in 2013 (only because of savvy tax planning by the wealthiest Americans, who shifted income from 2013 to 2012 to avoid a higher tax rate in the later year.) But according to a 2015 update of a 2003 study conducted by Thomas Piketty and Emmanuel Saez, which uses the same methodology, income inequality rose again in 2014.

“We haven’t quite passed that previous peak [of 1928], says Price, but that’s where we’re headed.”

For Price, the most frightening aspect of this increase in inequality is the reversal of an ideal that is ingrained in the American identity—upward mobility. “Because ability is distributed randomly rather than according to the income of your parents, the great danger is that the next brain surgeon or inventor of apps for things that will fundamentally improve human health and capacity might be born to poor parents and not get the education they need to realize their full potential,” Price says. “That doesn’t just hurt them, it hurts us all.”

A 2008 Pew Charitable Trust report came to a similar conclusion. “Americans are more optimistic than others about their chances of getting ahead,” the report’s authors noted. But “the earnings of American men are more closely tied to the earnings of their fathers than are those of men in other countries.”

The Economic Policy Institute study offered a number of recommendations to stem rising inequality, including encouraging greater unionization, which is currently at a historic low particularly in the private sector, raising the minimum wage, and addressing the problems created by a business culture that condones top corporate executives earning salaries that vastly outpace the ones earned by their employees.

Democrats Ramp Up Calls for Garland Confirmation Hearing

Senators Charles Schumer and Sheldon Whitehouse took to the steps of the Supreme Court Wednesday to demand that the Senate give Merrick Garland, President Obama’s Supreme Court nominee, a fair confirmation hearing. League of Conservation Voters (LCV) activists joined them, carrying boxes containing petitions with more than 200,000 signatures gathered nationwide calling on Republican senators to act.

“For nearly four months, Senate Republicans have sat on their hands and refused to do their jobs,” said Schumer, a New York Democrat. “Environmental cases are now winding their way through the courts, and they’re going to determine how clean our air and water are. … So it’s imperative … that we get a decent Supreme Court.”

In March, Obama nominated Garland, the chief judge of the D.C. Circuit Court of Appeals, to fill the vacancy left by Justice Antonin Scalia’s death in February. Garland’s strong reputation among conservatives as well as liberals seemed to suggest a quick confirmation. Yet even before Garland was tapped, Senate Majority Leader Mitch McConnell announced that the GOP-controlled Senate would refuse to confirm any replacement nominated by Obama.

Senate Republican leaders have honored that pledge. In an early morning meeting Wednesday, key staffers in the office of Senator Chuck Grassley, chair of the Senate Judiciary Committee, told LCV organizers that under no circumstances would Garland get a hearing. “We asked, what if there were different nominees, if he withdrew, if they added someone else, and basically what circumstances would have to happen?” Seth Stein, LCVs’ national press secretary, told The American Prospect. “It was a very strong ‘It’s not going to happen.’”

It has been 84 days since Obama tapped Garland, the longest a Supreme Court nominee has waited for a Senate hearing in U.S. history (the previous record was 83 days). “They’re playing partisan politics at its very worst and have really sunk to a new low with this unprecedented and extreme obstruction,” said Tiernen Sittenfeld, LCV’s senior vice president.

For environmental advocates, the stakes could not be higher. In February, three days before Scalia’s death, the high court blocked the Clean Power Plan, Obama’s signature climate change initiative. The unprecedented stay order, which halts the plan’s implementation while a GOP-led lawsuit works its way through the courts, seemed to confirm fears that the high court would soon kill the measure. Although Scalia’s death made such a ruling less likely, the stay order still puts the plan’s future in uncertain territory.

Senator Whitehouse, a Rhode Island Democrat, also pointed to the high court’s attack on campaign-finance rules, which has given certain industries, like the oil and coal sectors, a blank check to influence policymaking in Washington. “This should not be complicated,” Whitehouse said. “Protect Citizens United with a vacancy and use Citizens United to buy a polluter-funded Congress, and protect the fossil fuel industry from any progress on climate change.” Not surprisingly, McConnell has long been one of the top recipients of oil and coal money in Congress.

“Our Republican colleagues have a choice to make,” Schumer added. “They can continue to keep the seat vacant so Donald Trump can fill it. Or they can do their jobs and give Judge Garland a hearing and a vote.”

Poverty, Not Gentrification, Is the Biggest Barrier to Affordable Housing

When the mainstream media cover housing affordability issues, journalists often hone in on gentrification. Young, mostly white, college educated people are moving into urban cities, they say, followed by yoga studios, coffee shops, and luxury apartments. This influx of affluent individuals allegedly fuels the displacement of the poor.

These narratives may be popular, but research studies have shown that gentrification is rare and, in some cases, beneficial. The biggest housing problems facing America’s low-income residents have little to do with wealthier people moving in and everything to do with low-income residents falling even further behind.

Last month, a new Pew Charitable Trusts report found that just 15 of Philadelphia’s 372 residential census tracts gentrified between 2000 and 2014. Neighborhoods that experienced gentrification had at least a 10 percent increase in the median income during this period, according to the study. All but one of these gentrifying tracts are located in or adjacent to downtown Philadelphia. Pew also found that over 160 Philadelphia neighborhoods saw a significant decline in the median income during this same period.

In the Pew report, Beth McConnell, policy director of the Philadelphia Association of Community Development Corporations noted, “This gentrification stuff is happening in very few places, affecting a small number of people.” She added, “We have many more poor neighborhoods where there is no change.”

Researchers have found that even in New York, where high housing prices have crept into once less desirable neighborhoods, gentrification does not fully explain why affordable housing is so scarce. The Community Service Society of New York, an anti-poverty research and advocacy organization, recently released a report that found rents increased well above the rate of inflation even in some of the city’s poorest neighborhoods.

One reason for this development is that landlords have been using loopholes in housing regulations to increase their rents, a problem that tenant advocates are fighting to fix. But crucially, the report states that poorer New Yorkers with stagnant incomes and inadequate safety nets have seen declines in their living standards “whether they live in gentrifying neighborhoods or not.”

Tom Waters, one of the report’s co-authors, tells The American Prospect that although gentrification is not the only housing problem facing New York, it has been “very productive from a tenant advocacy point of view” because it has helped the public understand that lower Manhattan is not the only area that needs rent regulation.

These gentrification discussions have sparked broader conversations about housing affordability. When Waters first began working on housing issues, New York landlords told state and local legislators that rent regulations only benefited high-income white people living on the Upper East Side. According to Waters, now people understand that rent regulations are important tools for diverse groups of New Yorkers.

For low-income families, the housing issues associated with concentrated poverty and economic segregation are far more pressing than those associated with gentrification. City Observatory, an urban policy think tank, found that between 1970 and 2010, high-poverty communities that didn’t gentrify fell even further into poverty, and lost, on average, 40 percent of their population.

Daniel Kay Hertz, City Observatory senior fellow, has noted, “If our concern is displacement, then that number ought to be a major concern. It represents the movement of countless households away from their homes, not because of rising rents but because high-poverty neighborhoods don’t provide the residents with enough of the necessities of a good life: strong schools, safe streets, access to jobs, and so on.”

Last year, journalist John Buntin suggested that one reason we see so many myths about gentrification in the news media may be because much of the gentrification that does exist has occurred in New York and Washington D.C., the two major East Coast hubs for journalists. Another reason may be that gentrification is a proxy for middle-class concerns about steadily rising housing prices, according to Buntin.

Nevertheless, housing affordability problems and solutions vary from region to region, and they cannot be properly addressed by blaming poverty on gentrification. In his book Evicted: Poverty and Profit in the American City, sociologist Matthew Desmond argues that weak housing regulations are not merely a function of poverty, they actually create it. Many Americans care about growing income inequality and want to figure out ways to reduce the gaps between the haves and have-nots. If we are serious about changing these dynamics, then a more nuanced focus on housing simply has to be on the agenda. 

McCain Pulls a Bait-and-Switch on Vets

Almost as soon as Senator John McCain had finished working with Senator Bernie Sanders to craft the veterans’ health-care bill now known as the Choice Act in 2014, the Arizona Republican set out to renege on his promise that Choice would be temporary, and began floating plans to make it permanent. 

Part of the Choice Act was the establishment of the Commission on Care, whose deliberations the Prospect has covered extensively. This week that Commission is meeting to hammer out its final report, which will include recommendations about what the VHA should look like in 20 years. Instead of waiting to see what the Commission mandated by his own bill recommends, McCain has once again jumped the gun. He is lobbying hard for a bill that would not only make the Choice program permanent, but would eliminate any restrictions on veterans’ access to private-sector health care.

McCain’s gift to veterans is a bill misleadingly labeled The Care They Deserve Act. The subject of hearings on Capitol Hill the week of June 23, the bill would make the Choice Act—a three-year experiment enacted following revelations of delays in care at VHA facilities in Phoenix and elsewhere—permanent. Choice allows veterans to seek care from private-sector health-care providers if they face more than a 30-day wait for an appointment, or trips of 40 miles or more to the nearest VHA facility.

Under McCain’s new plan, the nine million veterans eligible for VHA care would be free to use any private health-care facility or provider, for any form of service, with the federal government paying the tab—no questions asked. McCain has gathered seven other Republican sponsors for his bill, all of them pushing the new conservative narrative that the VHA is broken beyond repair. This, of course, ignores reports by a Choice Act-mandated Independent Assessment of the VHA, which documents that its veteran/patients actually receive better care, at lower cost, than millions of Americans who rely on private sector health care.  

What’s wrong with The Care They Deserve Act? Just about everything, which is why many veterans service organizations like the Disabled American Veterans (DAV) and Vietnam Veterans of America oppose the plan, and why the VHA’s own undersecretary for health, David Shulkin, has proposed a more sensible alternative. 

Economists advising the Commission on Care estimate that McCain-style privatization could triple the cost of veterans’ care to almost  $450 billion a year—money that would not be well spent. The VHA’s clinicians and other staff specialize in the complex health problems related to military service, and deal with patients who are older, sicker, and poorer, with more mental health problems that those cared for in the private sector. The average elderly patient in the private sector shows up presenting between three to five physical problems. The “co-morbidities” of a Vietnam vet, for example, can number from nine to 12. That’s why VHA primary care providers spend at least 30 minutes with their patients per visit, compared to the ten or 15 minutes allotted to patients in the private sector. Will private sector providers want to take the time to care for aging, sometimes homeless, often mentally ill, veterans? Even if they do, will they be able to detect the difference between ordinary type 2 and Agent Orange-related diabetes, or be equipped to parse the myriad symptoms of PTSD?

McCain’s bill promises veterans a choice between VHA and private sector care. In reality, it would ultimately erode choice by weakening the VHA option, putting the entire veterans’ health system at risk. The VHA’s current budget is determined by how many veterans use the system and for what services. If far more eligible veterans start using private sector health care, there will be less funding available for VHA services that are unavailable elsewhere, and for maintaining the agency’s highly specialized research and clinical expertise in military-related health problems. As funding for costly private sector care eats up more of the VHA’s annual budget, there will be hospital and clinic closings, along with VHA staff layoffs. To reduce expenditures on veteran health care, Congress may also be tempted to make eligibility for veterans’ health-care benefits even more restrictive than it is today.

If Congress wants to improve the VHA, it should embrace the reform proposals of Shulkin and those Commission on Care members who want to allow veterans access to private sector providers in networks coordinated by the VHA. With luck, this recommendation will appear in the Commission’s June report. Strengthening the VHA, and giving veterans the choice to see outside providers if necessary, would really give veterans the care they deserve.

Is Donald Trump a Bald Bald-Faced Liar?

Elizabeth Frantz/Concord Monitor via AP

 

It is well established that Donald Trump is a liar. Many journalists have documented his consistent disregard for the truth. For example, the highly regarded Politifact points out that 76 percent of Trump's statements are “mostly false,” “false,” or “pants-on-fire” outrageous lies.

But Politifact didn't bother to investigate Trump's comments about one of his most interesting characteristics—his hair. Last year, Today's Emily Sher compiled Trump's statements about this important topic, including this explanation, which Trump tweeted in April of 2013: “As everybody knows, but the haters and losers refuse to acknowledge, I do not wear a ‘wig.’ My hair may not be perfect, but it's mine.”

Last August, at a campaign rally in Mobile, Alabama, Trump said: "If it rains, I'll take off my hat, and I'll prove once and for all that it's mine."

The color, cut, and combing of Trump's hair beg the question: Is the GOP's nominee-in-waiting also lying when he claims that his hair is his own?

In other words, we know that Trump is a bald faced liar. We just don't know for sure if he's a bald bald-faced liar.

This has been the subject of much journalistic investigation and speculation.

In “An Illustrated History of Donald Trump’s Hair,” Vanity Fair offered photos of the evolution of Trump's hairstyle over many years, but came to no conclusion about whether the mop on top was actually his.

In “The 100 Greatest Descriptions of Donald Trump’s Hair Ever Written,” The Washington Post's Monica Hess explored the many ways, over 30 years, that people have categorized and labeled Trump's hair (both color and style), but refused to resolve the question: real or fake?

Earlier this year, for an article headlined “Hairdressers Reveal the Secrets of Donald Trump's Hair,” The New York Post's Doree Lewak talked to Louis Licari, who colored the hair of Trump's first wife, Ivana, for 20 years. Licari told Lewak: “I think it's all his hair—through transplants,” adding, "I saw him several times in the office of Dr. Norman Orentreich in the early '80s,” referring to the specialist who, in 1952, performed the first-ever hair transplant.

In an extensive investigation for Gawker, “Is Donald Trump's Hair a $60,000 Weave?” Ashley Feinberg reached a bolder, as well as balder, conclusion: Trump probably wears a $60,000 hair weave.

In light of Trump's obvious insecurity about his masculinity, his vanity and his narcissism, it will hardly be surprising if an independent PAC tries to get under Trump's skin (and on top of his scalp) by running an ad showing The Donald without any hair, accompanied by the headline, BALD BALD FACED LIAR?”

Trump is likely to go ballistic.

History books might record the ensuing controversy as the Battle of the Mane.

CFPB Takes Aim at Payday Loan Debt Traps

For two decades, the payday loan industry has preyed on low-income workers by offering short-term loans with sky-high interest rates and fees. Now the five-year-old Consumer Financial Protection Bureau is taking the first major steps to curb the sector’s predatory practices.

Under the proposed regulations announced this week, payday lenders must ensure that a borrower can afford the loan and meet his or her major financial obligations and basic living expenses. The rules would also limit the number of times a lender may withdraw money from a borrower’s bank account without reauthorization after two unsuccessful attempts. The final rules are expected to take affect in late 2017.

Typically, a borrower goes to a payday lender company and writes the lender a check for a specific sum of money—on average, Americans write payday loan checks for $375. The borrower then receives cash. The lender cashes the check or, on the individual’s next payday, withdraws the funds from the borrower’s bank account.

Payday lenders do not require borrowers to offer proof of financial ability to repay a loan: To qualify, a borrower only needs to provide checking account details, valid identification, and pay stubs or other proof of employment. The proposed regulations would prohibit payday lenders from providing funds to borrowers who have not been prequalified for short-term high interest loans.

The payday loan industry rakes in $7 billion in fees annually. According to the CFPB, the median fee for every $100 borrowed is $15. Interest rates are astronomical, averaging about 300 percent or higher. Coupled with the repeated attempts to withdraw funds from the borrower’s account, which lenders are permitted to do once the repayment period begins, repaying the loan can quickly become unmanageable.  

“The most profitable borrowers are the ones who can’t repay the loan,” said Mike Calhoun, the president of the Center for Responsible Lending, a nonprofit organization that promotes fair financial practices, during a telephone news conference.

Most payday lenders set up shop in low-income communities and communities of color, areas that often lack access to mainstream banking institutions. “This vulnerability is what payday lenders are counting on,” said Lindsay Daniels, the director of National Council de La Raza’s Wealth Building Initiative.

The payday lending industry is pushing back against the consumer watchdog’s regulatory push, claiming that these businesses provide a vital service to people with scant financial resources. Critics of the industry counter that borrowers have other options. “Even a pawn shop is better than these payday loans,” said Hilary Shelton, the director of the NAACP’s Washington Bureau. “Some credit unions make short-term loans available that are not as nearly predatory or costly,” he added.

However, the proposed regulations are not a cure-all. Daniels says that the regulations don't go far enough to protect borrowers from practices like loan flipping, whereby lenders compel a borrower to renew a loan even though the individual has been unable to repay the original amount borrowed. “We are concerned that people will continue to experience problems because there are loopholes,” she said.

The Hidden Irony of GOP Outrage over the VA Secretary’s Disney Comparison

Poor VA Secretary Bob McDonald. Neither he nor the Veterans Health Administration he oversees can ever catch a break.

On May 23, a reporter questioned McDonald about the VHA’s tracking of patient appointment times around the country. McDonald’s predecessor was forced to quit over allegations of appointment delays and a cover-up at a Phoenix VHA hospital, and McDonald has often been on the defensive about the issue as the agency tries to hire the additional caregivers needed for the influx of Iraq and Afghanistan veterans.

In his response to the reporter, McDonald suggested that in the meantime, the VHA’s performance should be judged by a broader set of metrics. “What really counts is how does the veteran feel about their encounter with the VA?” McDonald said. “When you go to Disney, do they measure the number of hours you wait in line? What is important is your satisfaction with the experience.”

Unfortunately for the secretary, his invocation of the Magic Kingdom triggered a pack-journalism social-media response. The Koch-funded Concerned Veterans for America (CVA), a leading advocate of VHA privatization, immediately denounced McDonald on its website. According to CVA, McDonald showed disrespect for all VHA patients: “The sacrifice that accompanies earning that care is not the same as the sacrifice of taking a road trip to Florida,” the CVA declared. “Shame on Bob McDonald for trivializing veteran wait times this way.”  

American Legion National Commander Dale Barnett was similarly offended. House Speaker Paul Ryan called the remark “disgusting” and “beyond the pale,” a sentiment shared by House Veterans Affairs Committee Chair Jeff Miller, a frequent critic of McDonald and ally of CVA in seeking to dismantle and privatize the VHA. There was even talk of calling for McDonald’s resignation.

After two days of negative news coverage, McDonald, a veteran himself, issued a clarification and apology to any veteran who felt his comments trivialized the VHA’s “noble mission.”

But lost in the Republican baying for more blood was a great political irony: Throughout private-sector health care, Disney’s corporate model for gauging customer satisfaction is now widely used to determine patient satisfaction and to regulate the patient “experience.”

Quality patient care requires an application of skills, experience, and teamwork quite different from the prerequisites for good “customer service” in the hospitality or entertainment industries. Yet treating sick people as “customers” has become part of mainstream management thinking.

The Disneyfication trend took off ten years ago after consultant Fred Lee published the bestselling If Disney Ran Your Hospital: 9 1/2 Things You Would Do Differently. Patient surveys using methods and metrics from resort hotels and amusement parks are now the norm in U.S. health care. A hospital’s results on the Hospital Consumer Assessment of Healthcare Providers and Systems standardized survey even determine, in part, its reimbursement rate for federally subsidized patients.

Disneyfication has spawned a huge crowd of high-priced consultants, like Lee, or Quint Studer of the Studer Group, who teach hospitals how to improve their patient-qua-customer experience to score well on questionnaires. As Studer puts it in his HCAHPS Handbook, hospital administrators need to “manage the patient’s expectations” to succeed, by convincing patients they are receiving good personal care—even if the hospital has poor nurse-patient ratios or lousy patient safety records.

In some hospitals, nursing staff trained and managed under this model have been forced to use scripts when interacting with patients and families. They are coached to smile and repeat words and phrases (such as “excellent care”) that administrators want to see echoed in patient surveys.

Some hospitals now designate an employee to be “chief patient experience officer” (CXO), a position enjoying executive status. As CEO of the Cleveland Clinic, Delos “Toby” Cosgrove, now vice-chairman of the VA Commission on Care, has overseen annual patient-experience conferences for the past seven years. Despite having both a CXO and a patient experience office, the Cleveland Clinic has been investigated for patient-safety lapses that almost resulted in the hospital’s suspension from the Medicare program. Some suspect Cosgrove withdrew his name for consideration as VA secretary because confirmation hearings would have led to negative publicity for the clinic.

Inappropriately treating—and, in fact, trivializing—sick patients as customers is a central feature of health-care corporatization, and represents everything the VHA has never been and should not become. If it’s not good for veterans, it shouldn’t be good for any of us. But that would mean Republican critics would apply the same standard to the VHA as they do to private-sector health care. Dream on.

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