Because my Uncle Tony’s business partner was Jewish & my cousin Ron’s best friend is Jewish my childhood experience with Jews was unusual in Chester County.

Also lots of students in Coatesville schools worked at Chertok’s store, including my brother in law. 

Betsy’s first job was at a Jewish owned woman’s clothing store, The Colony Shop.  I can’t think of his name but that store owner Jerry Daghir, vocal music Scott High School, & Ray Pellegrino my barber & family friend were friends.  I think a lot of Chester & Lancaster county residents first experience with Jewish people might have been in the City of Coatesville. 

‘“When Kate Nolt moved from Baltimore to the Chester County suburbs more than a decade ago with her boyfriend, it turned out to be a dramatic change.

"I had culture shock, coming from Baltimore, with 100,000 Jews on every corner, to Chester County, where I could go into a grocery store and barely even find Chanukah candles," said Nolt.

"I would oftentimes go to look for traditional-type items and would really have to go from store to store to find them. Or they were scarce, and the stores would only order a handful, and if I was too late, I was out of luck."

The area, as she put it bluntly, was"devoid of Jews."

That's hardly the case today.”

“According to Susannah Brody, the author of the recently published Remembering Chester County: Stories From Valley Forge to Coatesville, Jews came to Chester County in the early 20th century for the same reasons they went anywhere — seeking opportunity. Many, she said, were merchants, vendors or itinerant peddlers, who often gathered in individual homes for Shabbat or High Holiday services.

The area's first synagogues sprung up. Kesher Israel Congregation in West Chester was established in 1914, while Beth Israel Congregation of Chester County in Eagle was incorporated two years later at its initial home in Coatesville.

Families that kept kosher in the early days — and even in the middle — of the 20th century had to drive to West Philadelphia for kosher meat and other Jewish delicacies, though after World War II, some kosher butchers began delivering to the Chester County area. Prior to that, a shochet, a kosher ritual slaughterer, would come to various homes and slaughter chickens and other fowl, according to residents of the area at the time.

Back then, it seemed that "each of the communities kept to themselves" because they were so geographically separated, according to Bill Chertok, an 81-year-old native of the region who ran a furniture business in Coatesville.

This is understandable, since then as now, Chester County is spread out over 760 square miles, which range from the far western Main Line down to the Delaware state line. Jewish residents tend to be sprinkled from the King of Prussia/ Valley Forge area to the west along the Route 202 business corridor, with pockets in Wayne, Berwyn, Malvern, Phoenixville and West Chester¬

These days, Brody and her husband live in an "Over 55" community in Coatesville, where there are only about 15 Jewish families out of 300, she said, but she noted that she's seen growth in the area, as young families relocate for good schools and more affordable housing, sometimes even followed by their parents…

State Sen. Andrew Dinniman (D-District 19) and his wife Margo first moved to the county in 1972 so he could take a faculty position at West Chester University.

The two-term senator was first elected to public office in 1975, when he joined the Downingtown Area School Board, and has served in various positions since before being elected to the Senate in 2006.

Dinniman, who grew up in New Haven, Conn., said that when he first arrived, the Jewish community was concentrated in only a few locales, like West Chester, Downingtown and Coatesville, but that today, Jewish families and individuals are now spread through the county. That's made the community less insular, even as the diffusion has made cohesion more challenging.

In Chester, he said, an area is Jewish if three out of 40 families belong to the tribe. Long involved with Jewish communal life — he currently serves on the board of the Chester Kehillah — Dinniman observed that, if anything, he thinks the population study undercounted the number of Jews, as well as the number of intermarried families, in the county.

"We are the youngest Jewish community, perhaps between Washington and New York, and perhaps the largest in terms interfaith marriage, and there is more need to come up with innovative approaches," he said. "The paradox is: How do you maintain a Jewish presence in a large area where there is no concentration — no specific concentration of Jewish people?”

MORE AT:

Chester County: Forgotten Frontier?

February 11, 2013

It never occurred to me that the people who painted swastikas in Elkins Park could have been Ukrainian immigrants. The Azov Regiment in Ukraine and United States.

 For a few decades I worked in Elkins Park, PA. 

When Russia was part of the Soviet Union my dentist was deeply involved with bringing  Jews to the United States, many of them were Ukrainian and settled in the Elkins Park area. I worked in dental laboratories in Elkins Park. As a result I knew several people from Ukraine. None of them appeared to be  interested in politics. 

In about 1976 I worked with Valeri a man who came over from Ukraine. In Russia he was a dental technician making crown and bridge work. He had a clandestine business making crown and bridge work for wealthy people in Russia and Ukraine. This was illegal and if the KGB found him he could be put in a Russian Gulag. 

To more than survive in the Soviet Union you needed to be an extraordinary person. Valeri was on the 4th floor of a terraced restaurant. He punched a guy and then realized the guy was KGB. Val jumped from the 4 story terrace to the shrubs below. 

He said in Ukraine I was a millionaire. But the KGB was on to him and he had to come to United States to keep out of prison. His wife was Jewish and that was his ticket to the United States.

He told me the Soviet union would break up. He said the communists are all old men.

I had a habit of eating lunch in local parks that began when I ate lunch in Independence Park in Philly accompanied by rats and pigeons and lunch at Washington Square accompanied by squirrels and pigeons. The squirrels could be aggressive biting my shoes to get a piece of my lunch but the pigeons and rats waited for crumbs. 

Anyway when I ate lunch in the park in Elkins Park there were places you could see the undersides of bridges. There were always swastikas on the undersides of the bridges in this traditionally Jewish area. 

At the time I was beginning to track skinheads & KKK in the Schwenksville area. They had cross lighting ceremonies along the Perkiomen Creek. I helped a woman who was terrified for her children because of skinheads living next door. I spoke to the mayor of Schwenksville and they were gone a few days later. 

It never occurred to me that the people who painted swastikas in Elkins Park could have been Ukrainian immigrants.

***

I learned that the French Connection heroin circulating in Chester County in 1976 came here via CIA transport. I’ve come to believe that the CIA is a quasi governmental military for profit organization that works in its own interests of the moment without consideration of long term effects, such as training Nazi Azov Militia who can end up in the United States.  

***

“A number of prominent individuals among far-right extremist groups in the United States and Europe have actively sought out relationships with representatives of the far-right in Ukraine, specifically the National Corps and its associated militia, the Azov Regiment,” states a 2020 report from the West Point US Military Academy’s Combating Terrorism Center. “US-based individuals have spoken or written about how the training available in Ukraine might assist them and others in their paramilitary-style activities at home.’

A 2018 FBI affidavit asserted that Azov “is believed to have participated in training and radicalizing United States–based white supremacy organizations,” including members of the white supremacist Rise Above Movement, prosecuted for planned assaults on counterprotesters at far-right events, including the Charlottesville “Unite the Right” rally that Joe Biden later co-opted as a rationale for his presidential campaign. While it seems the perpetrator of the Christchurch mosque massacre didn’t travel to Ukraine as he claimed, he clearly took inspiration from the far-right movement there, and wore a symbol used by Azov members while carrying out the attack”

MORE AT:

Jacobin

The CIA May Be Breeding Nazi Terror in Ukraine

BY

BRANKO MARCETIC

The CIA has been secretly training anti-Russian groups in Ukraine since 2015. Everything we know points to the likelihood that includes neo-Nazis inspiring far-right terrorists across the world.

01.15.2022

***

"The snow had just melted on the streets of Kyiv when Shawn Fuller, a U.S. Navy veteran, arrived in the early spring of 2018, his roller suitcase clattering over the pavestones of the Ukrainian capital. On the western edge of town, he found the address that his recruiter had sent him via Facebook, a flophouse with about two dozen beds, each reserved for a foreign fighter.

The men Fuller met inside were mostly from Europe, as was his recruiter, a chain-smoking Norwegian named Joachim Furholm, who had been convicted of bank robbery in Norway in 2010. The two of them had met over Facebook and gotten to know each other well, gaming out their plans to get military training and combat experience from one of Ukraine’s militia groups.

When they finally rendezvoused, Fuller noticed the swastika tattoo on the middle finger of Furholm’s left hand. It didn’t surprise him; the recruiter had made no secret of his neo-Nazi politics. Within the global network of far-right extremists, he served as a point of contact to the Azov movement, the Ukrainian militant group that has trained and inspired white supremacists from around the world, and which Fuller had come to join.

Its fighters resemble the other para-military units—and there are dozens of them—that have helped defend Ukraine against the Russian military over the past six years. But Azov is much more than a militia. It has its own political party; two publishing houses; summer camps for children; and a vigilante force known as the National Militia, which patrols the streets of Ukrainian cities alongside the police. Unlike its ideological peers in the U.S. and Europe, it also has a military wing with at least two training bases and a vast arsenal of weapons, from drones and armored vehicles to artillery pieces.

Outside Ukraine, Azov occupies a central role in a network of extremist groups stretching from California across Europe to New Zealand, according to law enforcement officials on three continents. And it acts as a magnet for young men eager for combat experience. Ali Soufan, a security consultant and former FBI agent who has studied Azov, estimates that more than 17,000 foreign fighters have come to Ukraine over the past six years from 50 countries.

The vast majority have no apparent links to far-right ideology. But as Soufan looked into the recruitment methods of Ukraine’s more radical militias, he found an alarming pattern. It reminded him of Afghanistan in the 1990s, after Soviet forces withdrew and the U.S. failed to fill the security vacuum. “Pretty soon the extremists took over. The Taliban was in charge. And we did not wake up until 9/11,” Soufan tells TIME. “This is the parallel now with Ukraine.”

At a hearing of the House Committee on Homeland Security in September 2019, Soufan urged lawmakers to take the threat more seriously. The following month, 40 members of Congress signed a letter calling—unsuccessfully—for the U.S. State Department to designate Azov a foreign terrorist organization. “Azov has been recruiting, radicalizing, and training American citizens for years,” the letter said. Christopher Wray, the director of the FBI, later confirmed in testimony to the U.S. Senate that American white supremacists are “actually traveling overseas to train.”

MORE AT:

TIME

Like, Share, Recruit: How a White-Supremacist Militia Uses Facebook to Radicalize and Train New Members

BY SIMON SHUSTER/KYIV, UKRAINE AND BILLY PERRIGO/LONDON

JANUARY 7, 2021 6:20 PM EST

***

***

I knew a man who was forced into the Hitler Youth. He wore the scars of SS lashings on his back the rest of his life. 

As I watched the video below it occurred to me that the trainers at the Azov Youth Camps were using stress position torture methods as punishment for the boys. When they return to their parents no welts or bruises will be visible. 

”In Vietnam the United States was ứa Ngô Đình Diệm’s “most important ally” until he was assassinated by the CIA. President Zelensky doesn’t want Ukraine to be Vietnam II as a means to sell U.S. weapons.

This is upside down. Ukraine borders Russia. Russia considers Ukraine part of a protective ring of countries dividing Russia from Western Europe. A nuclear armed NATO Ukraine is a direct military threat to Russia:

 “Zelensky’s Ukraine finds itself in the crosshairs of Moscow’s attempts to reassert its influence in what it considers its sphere of influence and prevent the North Atlantic Treaty Organization from moving into the states that once constituted the Soviet Union.” 

***

“We’re his most important ally and he’s poking us in the eye and creating daylight between Washington and Kyiv,” said the U.S. official. “It’s self-sabotage more than anything else.”

In Vietnam the United States was ứa Ngô Đình Diệm’s “most important ally” until he was assassinated by the CIA. Zelensky doesn’t want Ukraine to be Vietnam II.

***

Nevertheless, Zelensky’s message has found an audience among some U.S. officials, who emphasize that it’s the Ukrainian leader and his citizens who should have the last word.

“I have listened closely to what President Zelensky has said and he reminds us time and again that there could be a way out of this short of military action,” Sen. Richard J. Durbin (D-Ill.) said Sunday on “Meet the Press.”

“I hope there is,” he added. “But it’s his decision to make.”

MORE AT:

The Washington Post

Ukraine’s Zelensky’s message is don’t panic. That’s making the West antsy.

***

The United States vs Iraq War is over. 

The United States vs Afghanistan War is over. 

Defense contractors need a new war to sell weapons. 

“If it sounds like Hayes is using mounting tensions as an advertising opportunity for his company, this may not be far fetched. On a January 25 earnings call (which was noted on Twitter by Nick Cleveland-Stout of the Quincy Institute), Hayes included “tensions in Eastern Europe” among the factors that Raytheon stands to benefit from. He said: “We just have to look to last week where we saw the drone attack in the UAE, which have attacked some of their other facilities. And of course, the tensions in Eastern Europe, the tensions in the South China Sea, all of those things are putting pressure on some of the defense spending over there. So I fully expect we’re going to see some benefit from it.” 

Raytheon isn’t alone in its projections. Among those noting the likely boost to profits is Jim Taiclet, the chairman, president and CEO of Lockheed Martin. In a January 25 earnings call, he told investors, “If you look at the evolving threat level and the approach that some countries are taking, including North Korea, Iran and through some of its proxies in Yemen and elsewhere, and especially Russia today, these days, and China, there’s renewed great power competition that does include national defense and threats to it.”

This “great power competition,” he suggested to investors, bodes more business for the company. Taiclet says, “And the history of the United States is when those environments evolve, that we do not sit by and just watch it happen. So I can’t talk to a number, but I do think, and I’m concerned personally that the threat is advancing, and we need to be able to meet it.”

The statements come from leaders of an industry that exerts tremendous influence in Washington, employing an average of 700 lobbyists per year over the past five years, or more than one lobbyist per member of Congress, according to Brown University’s Costs of War project. 

Raytheon, Lockheed Martin and General Dynamics are also funders of the influential think tank, Center for Strategic and International Studies, which has been encouraging the United States to take immediate action, including militarily, in the event of a Russian invasion.

“Everyone in D.C. knows that weapons manufacturers are helping skew U.S. policy towards militarism, but they usually try to be less obvious,” Erik Sperling, executive director of Just Foreign Policy, an anti-war organization, told In These Times. “They are cashing in on tensions over Ukraine as the U.S. pours weapons into the region.”

General Dynamics, meanwhile, has noted that past tensions have increased demand for the company’s products. On a January 26 earnings call, the company was asked, “The Ukraine and everything going on with Russia has been in the headlines. What does that mean for your international Land Systems business, particularly in Eastern Europe?” 

CEO Phebe Novakovic replied, “Well, for some time now, the Eastern European demand for combat vehicles has been at elevated level.”

MORE AT:

Top Weapons Companies Boast Ukraine-Russia Tensions Are a Boon for Business

In calls with investors, Raytheon and Lockheed Martin boasted that the worsening conflict is helping profits.

January 27, 2022

Like 1967 when we lived at 22nd & Green & Philly PD ran drugs. "I’m a Broad Street runner, so I know that Temple Hospital is mile marker 2 and City Hall is mile marker 6, and within four short miles all of this violence is going on. Where was that outrage?

 When we lived on Green Street. Our friend Dr. Lena Stella lived downstairs. She worked weekends at Misericordia Hospital. Weekends of near fatal knife wounds & near fatal gunshot wounds. 

The same two officers would park car 914 at the 22nd. St end of Green St. They walked down Green St. putting tickets on all the vehicles that would be illegally parked on Tuesdays and Thursdays street cleaning days. 

Our landlord refused to pay $100 per year to the Phillly PD superintendent & also the Philly plumbing inspector, Fire inspector & electric inspector. Running out to move the car to the other side of the street was a small price to pay to live in an apartment that was always up to code. 

Corruption was endemic in Philly government. The drug business brought high profits into political corruption. Political corruption in Philadelphia was laid on a foundation of drug money. 

“Since 1993, Amy Goldberg has been a trauma surgeon at Temple University Hospital, which has the distinction of treating more gunshot patients than any other hospital in the state. Last year, there were 747, up from 576 the year before.

Goldberg, a native of Broomall who went to the University of Pennsylvania and Icahn School of Medicine at Mount Sinai, says she’s treated thousands here, in rare cases those who have been shot on more than one occasion. And though Goldberg and Scott Charles, Temple’s trauma outreach manager, over the last 15 years have started programs to advocate for and assist victims, educate schoolchildren about gun violence, and train community members on how to provide first aid to gunshot victims, they have watched as the city’s gun violence has escalated again this past year.

In the early hours of New Year’s Day, after two were killed and 12 injured in three separate shootings — one of them near Temple’s campus — Goldberg tweeted: “Last night was an abomination in our city. Our community is dying. Where is the outrage ... from everyone?”

MORE AT:

The Philadelphia Inquirer 

‘Where is the outrage ... from everyone?’ The story behind this Temple trauma surgeon’s tweet.

We sat down with Amy Goldberg to talk about that tweet, her work as both a surgeon and more recently the interim dean of Temple’s medical school and what she would like to see from Philadelphians.

Susan Snyder

Published Jan 21, 2022

READ:

Police, Politics, Corruption: The Mixture Dangerous to Freedom and Justice Hardcover – May 15, 2000

by Colonel Frank McKetta (Author)

The best answer Republicans have to COVID is Justice Alito’s “magic wand.” If the Democrats have a political strategy for 2022 going forward it appears to be, we tried to stop Republicans from killing themselves, the Supreme Court stopped us.

Justice Alito and the magic wand COVID cure:

“Suppose that this protection were provided not by the administration of a vaccine but by waving a wand over employees when they arrive at work and suppose that wand also had the capability of taking away this protection when the employee leaves work. Would OSCA have the authority to tell employees you must have this wand over you when you arrive but you can’t taken off when you leave?” 

"The Supreme Court on Thursday stopped the Biden administration’s vaccination-or-testing requirement for the nation’s largest employers, a dramatic blow to the federal government’s most far-reaching initiative to combat the coronavirus and boost the country’s lagging vaccination rate.

But the court allowed a different and smaller policy to go forward, requiring vaccinations for most health-care workers at the facilities that receive Medicaid and Medicare funds."

MORE AT:

Supreme Court blocks Biden’s workplace vaccine rules, allows requirement for health-care workers

Robert Barnes  7:23 p.m. EST January 13, 2022

“Vaccine Police” Christopher Ray “traveling the country with guns, flame thrower & fake badge” threatening to execute pharmacists & Democratic Governors is “not about violence.”

 “I will do it [the citizen arrests] lawfully, and the sheriffs will be with me,” he added."  

THESE SHERIFFS?

Friday, October 14, 2016

Are Chester County Sheriff’s coming to the polls locked & loaded?

"In a series of Telegram messages posted over the past week, Key has visited countless state offices and harassed officials over vaccines, masks, and mandates. In a phone conversation with The Daily Beast this past week, Key stated that he has been traveling the country “serving” people with packets of information he believes supports his conspiracy theory that COVID-19 vaccines are “bioweapons.” But it’s not only firearms Key has shown off, he also appears to have access to a flamethrower. “All those bioweapons that we have, that are not vaccines, they all need to be lined up, and they need to be exterminated,” Key said in a video posted in mid-December while brandishing a flamethrower. On Saturday night, when asked about the guns and if he intends to bring them along when conducting the planned arrests, Key told The Daily Beast he is “never about violence.” “I will do it [the citizen arrests] lawfully, and the sheriffs will be with me,” he added."

MORE AT:

Anti-Vax Leader Traveling Country With Guns, Flamethrower, and Fake Badge in Quest to Arrest Dem Governors

OUT OF CONTROL

Zachary Petrizzo

Media Reporter

Updated Jan. 01, 2022 9:06PM ET / 

***

"Livestreaming on Facebook, a man known online as the "vaccine police" harassed pharmacists at a Walmart in Springfield — saying the workers would be "executed" for administering the COVID-19 vaccine.

Invited from Alabama to last week's Mercy hospital rally, Christopher Key is an entrepreneur who came to prominence after convincing Ravens linebacker Ray Lewis to use his "deer antler spray" to treat his injury.

In recent months, Key has been speaking out against the COVID-19 vaccine. And since the Saturday rally, he has been in Springfield.

Monday evening, Key and his "Missouri crew" entered the Walmart Supercenter west of Springfield on Sunshine Street. Making a beeline to their pharmacy, Key yelled that he was putting the store's workers "on notice."

By the time Key and his group of about a half dozen reached the pharmacy, staff had locked the door, closed the window, and were hiding in the room.

"You are being put on notice!" he shouted outside the door. "And if they give one more vaccine, as of this day after being put on notice, then they can be hung up. And they can be executed."

Over the course of almost 30 minutes, Key and his "Missouri crew" taunted and jeered at the pharmacists through the door window — all captured through Key's Facebook livestream.

"What they're doing here is they're violating the Nuremberg Code, and if you allow one more shot to go into one more person's body, you yourself can be executed," he told the pharmacists as well as other Walmart workers present. "It's a violation of the Nuremberg Code. I do this out of love, I'm not trying to give you any fear and intimidation — I'm just letting you guys know that if you continue to do this, that you guys will be held accountable."

Throughout the tirade, Key claimed that a "sworn affidavit" proved 45,000 people had died within three days of being vaccinated against COVID-19 — a claim he also made two days prior at the Mercy Hospital anti-vaccine rally.

That belief is based on a lawsuit filed by a group called “America’s Frontline Doctors,” which has spread other discredited claims about COVID-19. Their lawsuit is on behalf of an unnamed “computer programmer.”

MORE AT:

Andrew Sullender Springfield News - Leader 

Published 5;30 a.m. CT

August 18, 2021 

Updated 8;26 a.m. CT Aug. 18, 2021

Man threatens Springfield Walmart workers, tells them they will be executed for administering vaccines

It’s not Biden, Trump, the GOP, QAnon or Fox News. United States is number one in COVID deaths because for profit capitalist medical care is a gargantuan failure. In 2024 Trump & the GOP could blame Biden for that failure.

"In early September, amid the delta variant surge, Biden reiterated the promise that “every American, no matter their income, can access free and convenient tests.”

Now, nearly a full year into Biden’s term, as the virus has mutated its way through the Greek alphabet to the omicron variant, testing is in short supply in many places, leaving frustrated Americans waiting in long lines for tests — if they can get them at all.

That is feeding into a wave of concern, despondency and in some places near-frenzy at the likely approach of yet another spike in a pandemic the country has battled for nearly two years. This late-December disarray — crowded testing sites, empty drugstore shelves — is raising fresh questions about how Biden and his team have executed on his pledge to defeat the pandemic.

“We’re going from emergency to emergency. We need a strategic plan, and executing on the strategic plan and just making it happen,” said Ezekiel Emanuel, a physician and bioethicist at the University of Pennsylvania who was on Biden’s covid advisory team during the transition. “You need a general getting all this done…" 

"A larger question for many health experts is whether the White House will see this moment as a time to return to the idea of a “wartime footing” — given that the country is seeing about 9,000 covid deaths a week.

'One can make a strong argument that we are at war, but for the White House to recommit to a wartime position, that’s really hard to do,'Kocher said. 'It’s going to end in people saying, ‘Why didn’t you win the war the first time?’ It’s hard to go back. But biology is hard.”

FROM: 

The Washington Post

Inside the administration’s failure to avert a covid testing shortfall

By Annie Linskey

December 23, 2021

***

“I came up with a vaccine,” Trump boasted in an interview released Wednesday to right-wing media personality Candace Owens. Despite Owens’s disagreement, Trump insisted that “if you take the vaccine, you’re protected” and “people aren’t dying when they take the vaccine.”

Trump has also been publicly encouraging people to get booster shots. He’s practically sounded like Anthony S. Fauci.

“Retcon” is short for “retroactive continuity,” in which existing stories are retroactively rewritten to accord with a new and contradictory story someone wants to tell. In an early famous case, Arthur Conan Doyle killed off Sherlock Holmes, then after fans demanded more stories, decided that Holmes had only faked his death. Retcons are particularly common in soap operas (Last season was all a dream!) and comics (That other stuff happened in a parallel universe!)."

MORE AT:

The Washington Post

Opinion: How Republicans will retcon the past to try to reelect Trump

Paul Waldman

"Trump’s “Warp Speed” vaccine push is one of the most underrated achievements of his presidency, and it understandably galls Trump to be blamed for covid-19 deaths when, in fact, he could more justifiably be credited for saving millions of lives…

To his credit, Trump seems undeterred. He considers the vaccines his babies, he believes in their efficacy, and he wants more Americans to embrace them. As Biden pointed out, for once he and Trump are on the same page."

MORE AT:

The Washington Post

Opinion: Trump touts boosters. Biden credits Trump. Trump appreciates Biden. Oh my.

Gary Abernathy

***

"Biology is hard" on ordinary people when the health care they can get is managed not for their outcomes but for the profits of a health care system designed to benefit a few wealthy investors:

"Abstract

The current economic crisis in Europe has challenged the basis of the economic model that currently prevails in much of the industrialised world. It has revealed a system that is managed not for the benefit of the people but rather for the corporations and the small elite who lead them, and which is clearly unsustainable in its present form. Yet, there is a hidden consequence of this system: an unfolding crisis in health care, driven by the greed of corporations whose profit-seeking model is also failing. Proponents of commodifying healthcare simultaneously argue that the cost of providing care for ageing populations is unaffordable while working to create demand for their health care products among those who are essentially healthy. Will healthcare be the next profit-fuelled investor bubble? In this paper, we call on health professionals to heed the warnings from the economic crisis and, rather than stand by while a crisis unfolds, act now to redirect increasingly market-oriented health systems to serve the common good."

Conclusions

European citizens today are like those who looked around them in Eastern Europe in 1989 and realised that the systems they inhabited were being run not for them but for a small elite. These systems were becoming increasingly dysfunctional and were failing to deliver on what they had promised. They had to change and they did. Today, it is equally clear that our systems have to change, but so far they have not.

One of the first things that new public health trainees are taught is the importance of looking upstream, to the fundamental determinants of health. To make a difference to population health it is necessary to tackle the causes of the causes.³⁰ The policies of austerity being pursued in Europe today are already impacting adversely on health, with rising suicides and denial of necessary care.⁶ Yet, as is now increasingly clear, they are not even doing what they were designed to achieve in the economy, instead they are choking recovery. As this paper has shown, many of those who promoted the deregulation of financial markets are now turning to the social sector as the next big opportunity to turn a profit. Yet their actions will not help those who need care and will medicalise the problems, real and imagined, of those who do not need it. Inevitably, scarce resources that could be used to alleviate genuine suffering will be wasted."

More at the Journal of Public Health Research

The Crisis of Capitalism and the Marketisation of Health Care: the Implications for Public Health Professionals

2012 Dec 28; 1(3): 236–239. 

***

There's hope.

ALSO SEE:

"Introduced during the Trump administration, “direct contracting” is a Medicare payment model that allows private medical practices and insurance companies to arrange set payments from Medicare for the year, rather than bill the administration for services. But critics warn that the system, which has continued under the Biden administration, is being exploited by venture capitalists. Merrill Goozner is a reporter who has spent decades covering the slow-moving crisis of American health care, and he joins Ryan Grim to discuss the present and possible future of Medicare.

[Musical introduction.]

Ryan Grim: You may not have heard much about it, but in the Medicare system, there’s now something called direct contracting. It was started under Trump, and it has continued under Biden, and it allows private physician practices, hospitals, or insurance companies to contract directly with Medicare and get a set amount of money over the year. That contrasts with traditional Medicare, in which healthcare providers bill Medicare directly for services. 

The stated point of direct contracting is to experiment with new models that would save money and improve care, but its critics warn that it’s a runaway scam that is being exploited by venture capital and private equity firms, and that it’ll lead to worse care in the long run, based on private equity’s poor record of delivering care in other settings. 

The project in question was designed by Adam Boehler, who was previously a dorm mate of Jared Kushner’s, and also the founder of Landmark Health, a VC-backed healthcare company. He was brought in to run the Centers for Medicare and Medicaid Innovation (CMMI) under Trump, and as he was designing this new model, career staff became concerned about conflicts of interest. 

When a calender alert went out to staff in May 2019 reading “discussion with Landmark on the direct contracting model,” career staff were appalled. I obtained a group text in which they commiserated with one another and expressed their disgust over the corporate influence. This is a family podcast, so I’ll edit the messages, but a sampling: “This stuff is so effing gross,” wrote one. “Ugh. What the eff,” replied another. A third sent a link to the Office of the Inspector General, suggesting somebody report it.

These were not off-the-wall concerns. The Office of the General Counsel for the Health and Human Services Department warned, in comments on a draft of the proposal that I obtained, that it appeared as if the new project was being set up to benefit specific companies: “We are concerned based on the regular references to organizations like Chen Med, Oak Street Health, and Verily in the comments and otherwise, that this model has been designed with specific private sector entities in mind. If accurate, this could create ethics concerns, as the creation of this model would give those entities a leg up in the market.”

And the model has indeed been extremely attractive to VC- and private equity-backed firms. It’s now being overseen by Liz Fowler, who serves as director of CMMI. She was previously the top healthcare aide to Max Baucus during the Obamacare fight, and if you remember, Baucus was the chair of the Senate Finance Committee, which wrote the meat of the bill. CMMI itself came out of the Affordable Care Act. Previously, Fowler had worked in the insurance industry, and between her time with Baucus and now, she was an executive at Johnson and Johnson.

This week, I published a story about the roots of the direct contracting program. Not long afterward, Fowler appeared at a conference by video in Washington and responded to the story. She appeared to be reading from a prepared statement. 

Liz Fowler: I have [perceived or received] the concerns that have been raised, some legitimate and some overblown. But as a responsible steward of Medicare, we appreciate the input and we are continuously looking for improvement opportunities, including how the model can help achieve our goals for advancing health equity. So, I know that wasn’t part of the question, but since I had the opportunity and since this issue has been in the press, I wanted to take the chance to weigh in and give you my perspective. 

RG: Now, claiming that your for-profit model is actually in the business of generating equity — and they don’t mean equity as in the stock market — is a rather old corporate trick. But what makes this story so interesting is that the principle behind this new Medicare effort is actually quite a good one."

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Ryan Grim