When Medical Debt Collectors Decide Who Gets Arrested

Lizzie Presser

Propublica.org
Originally posted 16 Oct 19

Here is an excerpt:

Across the country, thousands of people are jailed each year for failing to appear in court for unpaid bills, in arrangements set up much like this one. The practice spread in the wake of the recession as collectors found judges willing to use their broad powers of contempt to wield the threat of arrest. Judges have issued warrants for people who owe money to landlords and payday lenders, who never paid off furniture, or day care fees, or federal student loans. Some debtors who have been arrested owed as little as $28.

More than half of the debt in collections stems from medical care, which, unlike most other debt, is often taken on without a choice or an understanding of the costs. Since the Affordable Care Act of 2010, prices for medical services have ballooned; insurers have nearly tripled deductibles — the amount a person pays before their coverage kicks in — and raised premiums and copays, as well. As a result, tens of millions of people without adequate coverage are expected to pay larger portions of their rising bills.

The sickest patients are often the most indebted, and they’re not exempt from arrest. In Indiana, a cancer patient was hauled away from home in her pajamas in front of her three children; too weak to climb the stairs to the women’s area of the jail, she spent the night in a men’s mental health unit where an inmate smeared feces on the wall. In Utah, a man who had ignored orders to appear over an unpaid ambulance bill told friends he would rather die than go to jail; the day he was arrested, he snuck poison into the cell and ended his life.

The info is here.

Billions spent rebuilding Notre Dame shows lack of morality among wealthy

Gillian Fulford
Indiana Daily News Column
Originally posted April 23, 2019

Here is an excerpt:

Estimates to end world hunger are between $7 and $265 billion a year, and surely with 2,208 billionaires in the world, a few hundred could spare some cash to help ensure people aren’t starving to death. There aren’t billionaires in the news rushing to give money toward food aid, but even the richest man in Europe donated to repair the church.

Repairing churches is not a life and death matter. Churches, while culturally and religiously significant, are not necessary for life in the way that nutritious food is. Being an absurdly wealthy person who only donates money for things you find aesthetically pleasing is morally bankrupt in a world where money could literally fund the end of world hunger.

This isn’t to say that rebuilding the Notre Dame is bad — preserving culturally significant places is important. But the Roman Catholic Church is the richest religious organization in the world — it can probably manage repairing a church without the help of wealthy donors.

At a time when there are heated protests in the streets of France over taxes that unfairly effect the poor, pledging money toward buildings seems fraught. Spending billions on unnecessary buildings is a slap in the face to French people fighting for equitable wealth and tax distribution.

The info is here.

A Pedophile Doctor Drew Suspicions for 21 Years. No One Stopped Him.

Christopher Weaver, Dan Frosch and Gabe Johnson
The Wall Street Journal
Originally posted February 8, 2019

Here is an excerpt:

An investigation by The Wall Street Journal and the PBS series Frontline found the IHS repeatedly missed or ignored warning signs, tried to silence whistleblowers and allowed Mr. Weber to continue treating children despite the suspicions of colleagues up and down the chain of command.

The investigation also found that the agency tolerated a number of problem doctors because it was desperate for medical staff, and that managers there believed they might face retaliation if they followed up on suspicions of abuse. The federal agency has long been criticized for providing inadequate care to Native Americans.

After a tribal prosecutor outside of the IHS finally investigated his crimes, Mr. Weber was indicted in 2017 and 2018 for sexually assaulting six patients in Montana and South Dakota. Court documents and interviews with former patients show that Mr. Weber plied teen boys with money, alcohol and sometimes opioids, and coerced them into oral and anal sex with him in hospital exam rooms and at his government housing unit.

“IHS, the local here, they want to just forget it happened,” said Pauletta Red Willow, a social-services worker on the Pine Ridge reservation. “You can’t ever forget how someone did our children wrong and affected us for generations to come.”

The info is here.

Just deserts

A Conversation Between Dan Dennett and Gregg Caruso
aeon.co
Originally published October 4, 2018

Here is an excerpt:

There are additional concerns as well. As I argue in my Public Health and Safety (2017), the social determinants of criminal behaviour are broadly similar to the social determinants of health. In that work, and elsewhere, I advocate adopting a broad public-health approach for identifying and taking action on these shared social determinants. I focus on how social inequities and systemic injustices affect health outcomes and criminal behaviour, how poverty affects brain development, how offenders often have pre-existing medical conditions (especially mental-health issues), how homelessness and education affects health and safety outcomes, how environmental health is important to both public health and safety, how involvement in the criminal justice system itself can lead to or worsen health and cognitive problems, and how a public-health approach can be successfully applied within the criminal justice system. I argue that, just as it is important to identify and take action on the social determinants of health if we want to improve health outcomes, it is equally important to identify and address the social determinants of criminal behaviour. My fear is that the system of desert you want to preserve leads us to myopically focus on individual responsibility and ultimately prevents us from addressing the systemic causes of criminal behaviour.

Consider, for example, the crazed reaction to [the then US president Barack] Obama’s claim that, ‘if you’ve got a [successful] business, you didn’t build that’ alone. The Republicans were so incensed by this claim that they dedicated the second day of the 2012 Republican National Convention to the theme ‘We Built it!’ Obama’s point, though, was simple, innocuous, and factually correct. To quote him directly: ‘If you’ve been successful, you didn’t get there on your own.’ So, what’s so threatening about this? The answer, I believe, lies in the notion of just deserts. The system of desert keeps alive the belief that if you end up in poverty or prison, this is ‘just’ because you deserve it. Likewise, if you end up succeeding in life, you and you alone are responsible for that success. This way of thinking keeps us locked in the system of blame and shame, and prevents us from addressing the systemic causes of poverty, wealth-inequality, racism, sexism, educational inequity and the like. My suggestion is that we move beyond this, and acknowledge that the lottery of life is not always fair, that luck does not average out in the long run, and that who we are and what we do is ultimately the result of factors beyond our control.

The info is here.

I clipped out the more social-psychological aspect of the conversation.  There is a much broader, philosophical component regarding free will earlier in the conversation.

Want to live longer? Consider the ethics

John K. Davis
TheConversation.com
Originally published

Here is an excerpt:

Many people, such as philosopher John Harris and those in the Pew Center survey, worry that life extension would be available only to the rich and make existing inequalities even worse.

Indeed, it is unjust when some people live longer than the poor because they have better health care. It would be far more unjust if the rich could live several decades or centuries longer than anyone else and gain more time to consolidate their advantages.

Some philosophers suggest that society should prevent inequality by banning life extension. This is equality by denial – if not everyone can get it, then no one gets it.

However, as philosopher Richard J. Arneson notes, “leveling-down” – achieving equality by making some people worse off without making anyone better off – is unjust.

Indeed, as I argue in my recent book on life extension ethics, most of us reject leveling-down in other situations. For example, there are not enough human organs for transplant, but no one thinks the answer is to ban organ transplants.

Moreover, banning or slowing down the development of life extension may simply delay a time when the technology gets cheap enough for everyone to have it. TV sets were once a toy for the wealthy; now even poor families have them. In time, this could happen with life extension.

The info is here.

Why Rich Kids Are So Good at the Marshmallow Test

Jessica McCrory Calarco
The Atlantic
Originally published June 1, 2018

Here is an excerpt:

This new paper found that among kids whose mothers had a college degree, those who waited for a second marshmallow did no better in the long run—in terms of standardized test scores and mothers’ reports of their children’s behavior—than those who dug right in. Similarly, among kids whose mothers did not have college degrees, those who waited did no better than those who gave in to temptation, once other factors like household income and the child’s home environment at age 3 (evaluated according to a standard research measure that notes, for instance, the number of books that researchers observed in the home and how responsive mothers were to their children in the researchers’ presence) were taken into account. For those kids, self-control alone couldn’t overcome economic and social disadvantages.

The failed replication of the marshmallow test does more than just debunk the earlier notion; it suggests other possible explanations for why poorer kids would be less motivated to wait for that second marshmallow. For them, daily life holds fewer guarantees: There might be food in the pantry today, but there might not be tomorrow, so there is a risk that comes with waiting. And even if their parents promise to buy more of a certain food, sometimes that promise gets broken out of financial necessity.

The information is here.

Biased Algorithms Are Everywhere, and No One Seems to Care

Will Knight
MIT News
Originally published July 12, 2017

Here is an excerpt:

Algorithmic bias is shaping up to be a major societal issue at a critical moment in the evolution of machine learning and AI. If the bias lurking inside the algorithms that make ever-more-important decisions goes unrecognized and unchecked, it could have serious negative consequences, especially for poorer communities and minorities. The eventual outcry might also stymie the progress of an incredibly useful technology (see “Inspecting Algorithms for Bias”).

Algorithms that may conceal hidden biases are already routinely used to make vital financial and legal decisions. Proprietary algorithms are used to decide, for instance, who gets a job interview, who gets granted parole, and who gets a loan.

The founders of the new AI Now Initiative, Kate Crawford, a researcher at Microsoft, and Meredith Whittaker, a researcher at Google, say bias may exist in all sorts of services and products.

“It’s still early days for understanding algorithmic bias,” Crawford and Whittaker said in an e-mail. “Just this year we’ve seen more systems that have issues, and these are just the ones that have been investigated.”

Examples of algorithmic bias that have come to light lately, they say, include flawed and misrepresentative systems used to rank teachers, and gender-biased models for natural language processing.

The article is here.

Budgets are moral documents, and Trump’s is a moral failure

Dylan Matthews
vox.com
Originally published March 16, 2017

The budget is a moral document.

It’s not clear where that phrase originates, but it’s become a staple of fiscal policy debates in DC, and for very good reason. Budgets lay out how a fifth of the national economy is going to be allocated. They make trade-offs between cancer treatment and jet fighters, scientific research and tax cuts, national parks and border fences. These are all decisions with profound moral implications. Budgets, when implemented, can lift millions out of poverty, or consign millions more to it. They can provide universal health insurance or take coverage away from those who have it. They can fuel wars or support peacekeeping.

What President Donald Trump released on Thursday is not a full budget. It doesn’t touch on taxes, or on entitlement programs like Social Security, Medicare, Medicaid, or food stamps. It concerns itself exclusively with the third of the budget that’s allocated through the annual appropriations process.

But it’s a moral document nonetheless. And the moral consequences of its implementation would be profound, and negative. The fact that it will not be implemented in full — that Congress is almost certain not to go along with many of its recommendations — in no way detracts from what it tells us about the administration’s priorities, and its ethics.

Let’s start with poverty.

The article is here.

Will America Pass the Test of Morality in 2016?

By Marian Wright Edelman
The Milwaukee Courier
Originally posted January 9, 2016

Here is an excerpt:

We are better than this. Dietrich Bonhoeffer, the great German Protestant theologian who died opposing Hitler’s holocaust, believed the test of the morality of society is how it treats its children. We flunk Bonhoeffer’s test every hour and every day in America, as we let the violence of guns and the violence of poverty relentlessly sap countless child lives. A child or teenager is killed by a gun every three and a half hours, nearly 7 a day, 48 a week.

More than 15.5 million children are poor and children are the poorest age group in America – the world’s largest economy, and the younger the children are, the poorer they are. Children of color, already the majority of our youngest children, will be the majority of our children in 2020.

The article is here.

Reforming the minimum wage: Toward a psychological perspective

Laura Smith
American Psychologist, Vol 70(6), Sep 2015, 557-565.

Abstract

The field of psychology has periodically used its professional and scholarly platform to encourage national policy reform that promotes the public interest. In this article, the movement to raise the federal minimum wage is presented as an issue meriting attention from the psychological profession. Psychological support for minimum wage reform derives from health disparities research that supports the causal linkages between poverty and diminished physical and emotional well-being. Furthermore, psychological scholarship relevant to the social exclusion of low-income people not only suggests additional benefits of financially inclusive policymaking, it also indicates some of the attitudinal barriers that could potentially hinder it. Although the national living wage debate obviously extends beyond psychological parameters, psychologists are well-positioned to evaluate and contribute to it.

The entire article is here.

Getting mental health services can be hard, despite law requiring parity

By Lisa Gillespie
The Washington Post
Originally published January 5, 2015

Even though more Americans than before have access to health insurance because of the Affordable Care Act, getting mental health services can still be challenging.

A report released in November concludes that despite a 2008 mental health parity law, some state exchange health plans may have a way to go to even the playing field between mental and physical benefits. The report, released by the advocacy group Mental Health America, was paid for by Takeda Pharmaceuticals U.S.A. and Lundbeck U.S.A., a pharmaceutical company that specializes in neurology and psychiatric treatments.

The report listed the states with the lowest prevalence of mental illness and the highest rates of access to care as Massachusetts, Vermont, Maine, North Dakota and Delaware. Those with the highest prevalence of mental illness and most limited access are Arizona, Mississippi, Nevada, Washington and Louisiana.

The entire article is here.

Why haven't more states expanded Medicaid yet?

By California Healthline
www.philly.com
Originally posted June 26, 2014

Two years after Roberts issued the majority opinion upholding the Affordable Care Act, the decision to expand Medicaid is far from settled. Despite predictions that all states will eventually embrace Medicaid expansion, a significant number continue to hold out.

At last count, 26 states and the District of Columbia intend to expand Medicaid, while four are actively considering it and 20 have no plans to expand the program at this time.

The Medicaid expansion was considered the sleeper issue in the legal case against the ACA that ultimately made its way up to the Supreme Court. Stakeholders were closely watching issues like the constitutionality of the individual mandate, not thinking Medicaid would be significant. And yet, in a surprise decision, the Supreme Court effectively took the teeth out of one of the law's major efforts to expand health insurance, by making it illegal to penalize states for not participating in the Medicaid expansion.

The entire article is here.

A Lack of Material Resources Causes Harsher Moral Judgments

By Marko Pitesa and Stefan Thau
Psychological Science 
March 2014 vol. 25 no. 3 702-710

Abstract

In the research presented here, we tested the idea that a lack of material resources (e.g., low income) causes people to make harsher moral judgments because a lack of material resources is associated with a lower ability to cope with the effects of others’ harmful behavior. Consistent with this idea, results from a large cross-cultural survey (Study 1) showed that both a chronic (due to low income) and a situational (due to inflation) lack of material resources were associated with harsher moral judgments. The effect of inflation was stronger for low-income individuals, whom inflation renders relatively more vulnerable. In a follow-up experiment (Study 2), we manipulated whether participants perceived themselves as lacking material resources by employing different anchors on the scale they used to report their income. The manipulation led participants in the material-resources-lacking condition to make harsher judgments of harmful, but not of nonharmful, transgressions, and this effect was explained by a sense of vulnerability. Alternative explanations were excluded. These results demonstrate a functional and contextually situated nature of moral psychology.

The entire article is here.

Cambodian Activist’s Fall Exposes Broad Deception

By Thomas Fuller
The New York Times
Originally published June 14, 2014

The fall from grace of one of Cambodia’s most prominent social activists and the unraveling of her sad tale of being an orphan sold into sex slavery has highlighted what aid workers here say is widespread embellishment and in some cases outright deception in fund-raising, especially among the country’s orphanages.

Somaly Mam, who rose from rural poverty in Cambodia to become a jet-setting and glamorous symbol of the fight against the exploitation of women and children, stepped down last month from the United States-based charitable organization that carries her name after details of her widely publicized story were thrown into question.

The entire article is here.

Catholic nuns group 'stunned' by Vatican scolding for 'radical feminist' ideas

By Reuters
Originally published April 20, 2012

The Vatican

A prominent U.S. Catholic nuns group said it was "stunned" that the Vatican reprimanded it for spending too much time on poverty and social justice concerns and not enough on abortion and gay marriage.

In a stinging report on Wednesday, the Vatican said the Leadership Conference of Women Religious had been "silent on the right to life" and had failed to make the "Biblical view of family life and human sexuality" a central plank in its agenda. It accused the group of promoting "certain radical feminist themes incompatible with the Catholic faith."

It also reprimanded American nuns for expressing positions on political issues that differed, at times, from views held by American bishops. Public disagreement with the bishops -- "who are the church's authentic teachers of faith and morals" -- is unacceptable, the report said.

The entire story is here.

Greek woes drive up suicide rate to highest in Europe

By Helena Smith
The Guardian

Homeless man begs for money

The suicide rate in Greece has reached a pan-European record high, with experts attributing the rise to the country's economic crisis.

Painful austerity measures and a seemingly endless economic drama is exacting a deadly toll on the nation. Statistics released by the Greek ministry of health show a 40% rise in those taking their own lives between January and May this year compared to the same period in 2010.

Before the financial crisis first began to bite three years ago, Greece had the lowest suicide rate in Europe at 2.8 per 100,000 inhabitants. It now has almost double that number, the highest on the continent, despite the stigma in a nation where the Orthodox church refuses funeral rights for those who take their lives. Attempted suicides have also increased.

"It's never just one thing, but almost always debts, joblessness, the fear of being fired are cited when people phone in to say they are contemplating ending their lives," said Eleni Beikari, a psychiatrist at the non-governmental organisation, Klimaka, which runs a 24-hour suicide hotline.

Klimaka received around 10 calls a day before the crisis; it now gets more than 100 in any 24-hour period.

"Most come from women aged between 30 and 50 and men between 40 and 45 despairing over economic problems," said Beikari. "In my experience it's the men, suffering from hurt dignity and lost pride, who are most serious."

The entire story is here.