California’s Hepatitis A Outbreak Is the Future Poking Us in the Face

It wasn’t just that people were getting sick—it was who. And how many.

Hepatitis A is a viral disease that primarily attacks the liver, and if it gets serious—as it can in the elderly and immune-compromised people—it can be fatal. But the graph of cases in the US over time looks like the second, fun half of a roller coaster ride. In the early 1970s, nearly 10,000 people a year got it. By the mid-1980s, the number was half that. (Wheee!) In 1996, the Centers for Disease Control and Prevention started recommending vaccination, and from there it was a fast, bracing plunge to just tens of cases a year.

Then, this past summer, people started getting sick in San Diego. Just a handful at first, among those most at risk. Like HIV, hep A gets transmitted through sex and sharing needles. You can also get it through fecal-oral contact—as can happen when people don’t have access to bathrooms. In San Diego, the infected were primarily homeless, illicit drug users, and men who have sex with men. The initial handful became two handfuls, and then the curve headed upward. Now, a few months later, the toll stands at 546 cases and 20 deaths, with a confirmed spread of another several dozen in Los Angeles and Santa Cruz.

Homeless people present a particular challenge for health—but for reasons as much political as medical. When the urban infrastructure shows signs of weakness, as it has with these hep A outbreaks, it’s not just a medical tragedy. It’s a signal of a failure yet to come. If social policy doesn’t deal with America’s ongoing social and political homelessness crisis, it’s going to be an even worse public health problem later—for everyone.

San Diego and Michigan are the biggest person-to-person outbreaks of hep A since the late 1990s, when San Diego regularly saw 400 to 600 cases every year—most of them children, many without symptoms. Today’s epidemiology is vastly different. “We have had only one pediatric case, somebody who had not gotten an immunization. All of our other cases are over 25 years old, and the average age is 44,” says Eric McDonald, the medical director for San Diego County Public Health Services’ epidemiology program. The reason: San Diego has more homeless people now, McDonald says.

That made the outbreak harder to fight. In San Diego, teams of public health workers went into the field, trying to convince people to get vaccinated—it’s a two-shot series, so it requires multiple visits. They installed hand-wash stations near homeless encampments, distributed portapotties, and washed streets with bleach solution. “It’s a crisis within a crisis,” says Wilma Wooten, director of public health services for San Diego County. “The homeless situation is a crisis in San Diego, and thrown on top of that is a hepatitis A outbreak.”

It spread—to Santa Cruz, first, and then LA. First to people who’d been in one of the earlier cities, and then to people who had contact with them. And then, in LA, hep A showed up in two more homeless people who had no contacts that traced anywhere else. “And we thought, ‘Uh oh, now there’s local transmission,’” says Jeffrey Gunzenhauser, interim health officer for the Los Angeles County Department of Public Health. It was enough to declare an outbreak.

As in San Diego, LA public health teams spread out to vaccinate as many people as they could. It wasn’t easy. “Here in LA county, with 58,000 homeless and tens of thousands of others using illicit drugs, we were like, whoa, how many of them would we have to vaccinate?” Gunzenhauser says. “When we approach a homeless encampment, for every one of the individuals willing to vaccinate, two or three others are turning it down.”

The LA public health teams learned two lessons. First, homeless people are much more mobile than they knew. And second, 58,000 people without basic services is a catastrophe-in-waiting. Homeless people often have untreated medical problems, but this is a new scale. “We’ve certainly been very interested in housing as a single important determinant of health in Los Angeles county,” Gunzenhauser says, “but we haven’t thought about homelessness in terms of the threat of communicable diseases.”

Another way to think about public health solutions for the homeless in America—550,000 people on a given night, says one estimate, with another 1.5 million in shelters or other assisted housing—is as similar to the very poorest in cities around the world, living in what sociologists and urban planners call “informal settlements.” (I’m eliding the rural homeless here, which isn’t totally fair. Stick with me for a bit.)

Around the world, a billion people—much of the urban population—live in these informal settlements—the term of art used to be “slums.” Pollution, disease, and violence are all risks. When large populations of refugees arrive in a city, they often settle in peri-urban areas without services. Most of these people don’t have access to clean water, garbage collection, or a good sewer system. Very bad, right?

In the United States, those services are municipal. Cities provide them—but almost exclusively to places of residence. Water and toilets are literally behind a paywall. City planners today often think about public health in terms of greenspace and tree cover, bike paths and other alternatives to automobiles, reducing industrial pollution. All of that's great, and necessary. Yet basic infrastructure doesn’t seem like a public health measure—until it fails, in places like Flint’s water supply. But denial of service to an entire population is also a kind of failure.

It wasn’t always so. The cities of ancient Rome had public baths, toilets, and potable water. The cholera outbreak in London in 1854 that led the physician John Snow to literally create epidemiology, mapping the homes of affected people to find the source, traced back to a public well. Famously, the city removed the pump’s handle, cutting off access to the water and helping end the outbreak.

I don’t mean to get all paternal here. City people with money have always equated poverty with disease, and conflated the fear of the latter with prejudice against the former. The genius of Haussmann’s widescreen remodeling of Paris was that his sewers lowered the likelihood of disease while razing neighborhoods with narrow, winding streets lowered the likelihood of revolution. Nineteenth-century French colonial cities separated the colonizers from the colonized with a de-urbanized zone they called a cordon sanitaire because it was nominally there to prevent the spread of malaria.

Even the first zoning regulations in the United States had a (nominal, again) health rationale, stepping back the ever-higher skyscrapers of Manhattan to let light and air into the concretizing canyons. The strain of American Progressivism that comes from the noblesse oblige of the rich has to do with altruism, sure, but also a fear of contagion, as Spiro Kostoff writes in his book The City Assembled. Fear of disease, fear of revolution, fear of the poor—all these things are intertwined.

But if fear of disease serves as a spur to end homelessness, let’s go for it. Because housing and other policies seem to be pushing more and more people to the fringes, and those populations are going to be more and more vulnerable to health issues. This is happening everywhere on Earth. “It’s an increasing polarization between the two halves of society,” says Harris Ali, an environmental sociologist at York University.

It isn’t just that people are getting sick. It’s who, and how many. When people lose access to the last century’s worth of improvements to services and health care, they’re more likely to get sick. And the next outbreak might not be something people can vaccinate against.

Read more: https://www.wired.com/story/californias-hepatitis-a-outbreak-is-the-future-poking-us-in-the-face/

Poland Risks Being the EUs Rogue State

Behind the noise of Brexit negotiations, the talk in the European Union this year has been that there’s potentially a bigger problem in the east. And the prospect of another rupture looks to be increasing.

Poland’s de facto leader, Jaroslaw Kaczynski, hand-picked his second prime minister in two years, opting last week for western-educated Finance Minister Mateusz Morawiecki as he seeks to boost the economy after revamping the judicial system. He is another Kaczynski acolyte who has backed the increasingly authoritarian Law & Justice party’s push to seize more control of the courts, a plan condemned by the European Parliament and European Commission.

The mood in Brussels is that EU institutions can no longer stand by and watch a country that’s the biggest net recipient of European aid thumb its nose without paying some sort of price. Few people are discussing Poland following Britain out of the bloc, but a protracted conflict is getting more likely.

Mateusz Morawiecki
Photographer: Piotr Malecki/Bloomberg

Concerns about the shift in Poland triggered calls to limit access to EU funds for countries disrespecting the democratic rule of law. At a ministerial meeting on Nov. 15 in Brussels, the issue was raised during a discussion about the 2021-2028 budget by countries including Germany, France and the Nordic states, according to two EU officials with knowledge of the matter.

Poland’s refusal to take in mainly Muslim refugees was referred last week to the European Court of Justice along with Hungary and the Czech Republic.

“There is a growing feeling in Brussels that solidarity cannot be a one-way street, and that it becomes difficult to justify the 10 billion-euro per year net transfers for a country that is increasingly at odds with the bloc’s values,” said Bruno Dethomas, a senior policy adviser at GPLUS consultancy in Brussels and a former EU ambassador to Poland. “It is high time the EU reacted, or it risks losing its soul.”

‘Sick Europe’

Poles are accustomed to their government stirring up nationalist fervor with blistering attacks on the EU while welcoming the policies of U.S. President Donald Trump. It’s railed against taking in Muslim refugees, claimed the country has been enslaved and snapped at criticism of its power grab this year.

But even by Kaczynski’s standards, his speech on Nov. 10 to mark Independence Day pulled no punches. It’s up to Poles to show “the sick Europe of today the path back to health, to fundamental values, to true freedom and to the strengthening of our civilization based on Christianity,” he said.

Jaroslaw Kaczynski, the man who pulls the strings in Poland.
Photographer: John Guillemin

The risk for the EU is that a country that was so key to its post-Cold War political and economic integration shifts closer to becoming a rogue member under Kaczynski, 68, a critic of Poland’s deal to enter the bloc in 2004. A breakdown would undermine the European project in arguably a more symbolic way than traditionally lukewarm Britain’s pending departure.

The cost of Kaczynski’s stance has — so far — largely been counted in lost influence within the 28-nation bloc, which lacks the unanimity needed to up the ante and strip the Polish government of its voting rights at EU summits. 

There’s been no hit to the 229 billion euros ($270 billion) in aid granted to Poland through 2022 and used for everything from new airports to sewage pipes.

The narrative has changed, though. French President Emmanuel Macron said last month that Poland could pay a price if it continues to defy the EU on justice. The Dutch coalition government agreement, signed in October, specifies “subsidies should be reduced for member states that do not fulfill their obligations.”

Nationalist Forces

The Polish Parliament, meanwhile, is finalizing legislation to revamp the Supreme Court and Judicial Council, a powerful body that chooses which judges get promoted. Passage of the bills constitutes the removal of the “last fuses” on Poland’s democracy, according to Adam Bodnar, the country’s commissioner for human rights.

Even some Law & Justice lawmakers have questioned the legality of the court changes. “I will vote in line with my party,” Krystyna Pawlowicz told a parliamentary committee. “But this measure is a glaring contradiction to the constitution.”

Law & Justice has built on its popularity since winning an unprecedented parliamentary majority two years ago with promises of standing up for ordinary Poles. An ongoing EU investigation into the government’s behavior has played into the party’s them-against-us rhetoric.

Some Polish politicians have been privately telling their EU partners that if bashing the Law & Justice government doesn’t stop, Poles will turn against the EU and nationalist forces will be emboldened, according to three people with knowledge of the discussions.

Kaczynski’s DNA

On Independence Day after Kaczynski spoke the day before, the traditional march in Warsaw became a demonstration for far-right groups claiming that “Europe will be white.” The government condemned the racists, though also blamed the media of focusing on some “fringe incidents.”

A couple hold flares as as thousands gather for the nationalist march of Poland´s Independency Day.
Photographer: SOPA Images/LightRocket

Historically, Kaczynski has been cool toward the EU. He backed accession in the run-up to a referendum in 2003, when 78 percent of Poles supported membership. He warned at the time entry on the conditions that Poland had negotiated was a “threat to fundamental values including independence and democracy.”

A reduction in funds that Poland receives from the EU would help shift public opinion against the bloc, said Marcin Matczak, a law professor at Warsaw University.

“Hostility towards the EU is part of Law & Justice’s DNA, and if it was up to the party, Poland would leave the bloc,” said Matczak. “But Kaczynski knows he can’t do that because Poles are benefiting from EU membership. Hence, the party slowly builds a negative attitude towards EU — while declaring that Poland has no intention of leaving.”

    Read more: http://www.bloomberg.com/news/articles/2017-12-10/forget-brexit-poland-risks-being-the-eu-s-real-rogue-state

    Tony Blair confirms he is working to reverse Brexit

    Former PM argues claims made by leave campaign now clearly untrue and so British voters deserve second referendum

    Tony Blair has confirmed that he is trying to reverse Brexit, arguing that voters deserve a second referendum because the 350m per week for the NHS promise has now been exposed as untrue.

    In an interview with the BBC Radio 4s The World This Weekend on Sunday, the former prime minister said that what was happening to the crumbling NHS was a national tragedy and that it was now very clear that the Vote Leave promise about Brexit leading to higher NHS spending would not be honoured.

    When the facts change, I think people are entitled to change their mind, said Blair, who has always been a strong opponent of Brexit but who has rarely been so explicit about being on a personal mission to stop it happening.

    Asked if his purpose in relation to Brexit was to reverse it, Blair replied: Yes, exactly so.

    He added: My belief is that, in the end, when the country sees the choice of this new relationship, it will realise that its either going to be something that does profound damage to the country, or alternatively, having left the European Union, left the single market, we will try and by some means recreate the benefit of that in some new relationship, in which case I think many people will think, Whats the point?

    Blair rejected the argument that he was defying the will of the people. The will of the people is not something immutable. People can change their mind if the circumstances change, he said.

    Read more: https://www.theguardian.com/politics/2017/dec/03/tony-blair-confirms-he-is-working-to-reverse-brexit

    The moral and intellectual bankruptcy of the Republican Party | Dana Nuccitelli

    Dana Nuccitelli: The GOP strategy on taxes and climate: reject evidence and expert opinion, lie, and wage culture wars

    The parallels between the Republican Party positions on taxes and climate change are striking. Both are morally appalling and reject the available evidence and expert opinion.

    The Initiative on Global Markets panel of economic experts was recently asked about the Republican tax plan. Among the experts who took a position either way, there was a 96% consensus that the plan would not substantially grow the economy more than the status quo, and a 100% consensus that it would substantially increase the national debt.

    Paul Krugman (@paulkrugman)

    Economists aren’t exactly big fans of current GOP tax plans https://t.co/B0jodtnv2v pic.twitter.com/4qqqzwsePd

    November 21, 2017

    Those numbers are quite similar to the 97% consensus among climate scientists that humans are driving global warming and the 95% consensus among economists that the US should cut its carbon pollution.

    The House and Senate Republicans have passed similar versions of their tax bill, and neither chamber is allowing any climate policy to move forward.

    So whats making Republican Party leaders reject the expert consensus on these incredibly important issues?

    Unwavering faith in the face of contradictory facts

    Sometimes tax cuts make sense; for example, when trying to stimulate a depressed economy, or when operating with a budget surplus. Neither is currently the case. This message from the president:

    Donald J. Trump (@realDonaldTrump)

    Unemployment is down to 4.1%, lowest in 17 years. 1.5 million new jobs created since I took office. Highest stock Market ever, up $5.4 trill

    November 4, 2017

    Is incompatible with Senator Lindsey Graham saying the economy needs a tax cut. The tax cut plan, which by design will increase the US national debt by $1.5tn, is also incompatible with Republican opposition to increased deficits. Just last year the Republican National Committee was warning of an unsustainable path toward crippling debt.

    Economists also agree that we should be paying down the debt when the economy is going strong. When the next recession inevitably strikes, governments need monetary flexibility to respond. Thats when it makes sense to run a deficit (for example, see the 2009 stimulus package, which helped pull the US out of the Great Recession and cost less than the Republican tax plan).

    These Republican economic contradictions make no sense, but theyre familiar to those of us who follow climate change news. The only consistency in climate denial is in its contradictions deniers claim global warming isnt happening, but its a natural ocean cycle, and caused by the sun, and galactic cosmic rays, and Jupiters orbital cycles, and its really just a Chinese hoax, and in any case its not bad.

    On taxes, the Republican argument is cuts pay for themselves by stimulating economic growth and creating jobs.

    Seung Min Kim (@seungminkim)

    This is not going to be a deficit-producing effort, McConnell says, believing economic growth will pay for bill.

    November 30, 2017

    But the economic literature is far from clear about whether tax cuts necessarily spur economic growth at all, let alone enough to pay for themselves. Moreover, corporate CEOs have repeatedly said that the Republican tax plan wont spur investment or job creation instead theyll mostly pass the gains to their wealthy shareholders. There was an embarrassing video clip when Trump economic adviser Gary Cohn was confronted with this inconvenient truth:

    Natalie Andrews (@nataliewsj)

    VIDEO: CEOs asked if they plan to increase their company’s capital investments if the GOP’s tax bill passes.
    A few hands go up.
    “Why aren’t the other hands up?” Gary Cohn asks.#WSJCEOCouncil pic.twitter.com/TD2oAlN27S

    November 14, 2017

    When presented with the nonpartisan congressional Joint Committee on Taxation analysis concluding the bill would increase the national debt by over $1tn even when accounting for associated economic growth, Republicans immediately rejected the results.

    Steve Inskeep (@NPRinskeep)

    In NPR interview, Paul Ryan said he thinks the tax cuts will pay for themselves despite analysis to the contrary. Im telling you thats what I believe will happen. Im not going to tell you Im sure. https://t.co/CdXtuJmf0P

    December 1, 2017

    As Nobel-winning economist Joseph Stiglitz said, Either its a religious belief, a belief where no amount of evidence would change that, or they are using the argument cynically and they just want more money for themselves. He was talking about trickle-down economics, but just as easily could have been describing climate denial.

    A growing disdain for nerds

    Im old enough to remember when the GOP considered itself the party of intellectuals, back in the days when Republicans invented the concept of pollution cap and trade systems, for example. It wasnt long ago that party leaders like Newt Gingrich and 2008 GOP presidential candidate John McCain were calling for the party to support climate policies.

    Starting with the brief rise of the Tea Party in 2010, that all changed, and the intellectual rot of the GOP has accelerated under President Trump. In a July 2017 Pew poll, just 36% of Republicans said colleges and universities have a positive impact on America, and a stunning 58% said they have a negative effect.

    Republicans
    Republicans view of the impact of colleges and universities.

    Similarly, in an August 2017 Gallup poll, just 33% of Republicans expressed confidence in higher education. Worst of all, the Republican tax bill even penalizes American graduate students.

    Eating away at the GOP intellectual core: Fox News

    A 2012 survey found that Americans who only watch Fox News are less informed than Americans who watch no news at all. At the time, 55% of Americans including 75% of Republicans reported watching Fox News. The network is powerful a recent study found that Fox News might have enough influence to tip American elections and on the whole it prioritizes ideological messaging over factual accuracy.

    Trumps attacks on the so-called fake news media have further eroded Republicans trust of news sources that lack a conservative bias. As David Roberts wrote for Vox:

    The US is experiencing a deep epistemic breach, a split not just in what we value or want, but in who we trust, how we come to know things, and what we believe we know what we believe exists, is true, has happened and is happening the right has created its own parallel set of institutions, most notably its own media ecosystem conservative media is more partisan and more insular than the left.

    Truth papered over by lies

    Because so many conservatives rely on right-wing media sources for their news, its easy to misinform them through a constant stream of lies.

    For example, Trumps Treasury Secretary Steve Mnuchin promised that his department would produce an analysis showing that the tax cuts will pay for themselves. One economist in the department leaked to the New York Times that such an analysis doesnt exist and Treasury staffers werent even asked to study the issue. It was a lie. Mnuchin also claimed the plan would only raise taxes on Americans who earn more than $1 million a year the exact opposite of reality and another blatant lie. In fact, the entire Republican case for their tax plan was based on lies.

    Similarly, climate denial is based on endless myths and misinformation Skeptical Science has catalogued and debunked about 200 of them. And recent research showed that these myths are quite effective at misinforming their audience.

    Republicans including Trump cited a list of 137 economists supporting tax reform, but further investigation showed the list is full of ghosts, office assistants, Koch employees, and many others who failed to mention theyre retired. The climate change equivalent is the Oregon Petition, whose signatories included Spice Girls and fictional characters among its fake experts.

    Money and power the root of all evil

    The Republican tax plan and the partys obstruction of climate policies are nevertheless both unpopular positions. Just 25% of Americans support the tax plan, though that includes 60% of Republican voters.

    Washington Post (@washingtonpost)

    Analysis: Deeply unpopular Congress aims to pass deeply unpopular bill for deeply unpopular president to sign https://t.co/3Bkhw6Pn5A

    November 29, 2017

    Similarly, 80% of Americans – including 62% of Trump voters – agree that the US should regulate and/or tax carbon pollution. But public support often doesnt translate into policy, and Republican policymakers have been surprisingly honest and forthright about why they support the tax plan despite opposition by a majority of voters and economic experts:

    Cristina Marcos (@cimarcos)

    .@RepChrisCollins (R-NY) on tax reform: “My donors are basically saying, ‘Get it done or dont ever call me again.'”

    November 7, 2017

    Alan Rappeport (@arappeport)

    Lindsey Graham says the financial contributions will stop if tax reform fails.

    November 9, 2017

    The plan also raises taxes soonest and most on poorer Americans, slashes their health care coverage, and Republicans are already planning to pay for the plan by cutting social programs that low-income Americans rely on. While massive income inequality is one of the biggest problems in America, squashing the American dream, Republicans voted to make the problem much worse. Similarly, poorer countries are the most vulnerable to the consequences of climate change. The Republican Party motto may as well be benefits for the rich at the expense of the poor.

    Quite simply, Republican politicians need campaign donations from oil companies and other big corporations to win elections. To maintain their power they must keep the cash flowing. That means keeping rich donors happy by cutting corporate taxes and obstructing climate policies. To achieve that, Republican politicians reject scientific evidence and expert opinion, lie to their voters, and rely on right-wing media echo chamber propaganda and tribalism to keep their supporters voting against their own best interests.

    Its all morally reprehensible, and so far, its working. At this point, the only way to fix the problem is to defeat the Republicans who have rotted their party to its core and are now spreading that rot throughout America and the rest of the world.

    Read more: https://www.theguardian.com/environment/climate-consensus-97-per-cent/2017/dec/04/the-moral-and-intellectual-bankruptcy-of-the-republican-party

    Senate Suspends Bill Votes to Friday Morning: Tax Debate Update

    The Senate tax bill is headed for a marathon debate this week after Republican leaders brought the measure to the floor Wednesday with the goal of holding a final vote by the end of the week. Here are the latest developments, updated throughout the day:

    Senate Republicans Scramble to Salvage Bill (8:51 p.m.)

    Senate Majority Leader Mitch McConnell said votes on the tax bill will resume at 11 a.m. on Friday as the collapse of a key compromise to win a majority for a Senate tax overhaul left Republicans scrambling to salvage the legislation.

    Debate over the bill may continue into the evening, McConnell said. It’s unclear when the unlimited amendment vote series known as “vote-a-rama” would begin.

    After seeming to gain momentum during the day, the GOP’s tax cut plan smacked into a decision from the Senate’s rule-making office that said a so-called trigger proposed by GOP holdouts didn’t pass procedural muster. At least three Republicans — Bob Corker of Tennessee, Jeff Flake of Arizona and James Lankford of Oklahoma — had tied their votes to the mechanism, which would have increased taxes if revenue targets weren’t met. The trio is now demanding that leaders agree to other changes in the bill to avoid a huge deficit increase.

    Republicans have a slim majority in the Senate and can only afford to lose two members if they want to pass the tax bill without Democratic support.

    Adding to the difficulty was a ruling by a key fiscal referee that the tax plan would blow a $1 trillion hole in the nation’s debt — even after accounting for economic growth.

    The day’s events left GOP leaders contemplating a variety of potentially unpalatable measures — including making some tax cuts on the individual and corporate side end within six or seven years. The current version of the Senate bill would sunset individual breaks in 2026.

    It’s a potential nightmare scenario for Republicans, who have been counting on a tax overhaul to be their first major legislative accomplishment of the year. The party is under enormous pressure to complete the tax measure with less than a year to go before the mid-term elections and with wealthy donors and large corporations demanding tax rate cuts.

    Senator Ted Cruz of Texas “absolutely” will fight Corker’s effort to add taxes back to the Senate’s tax bill, he said in a brief interview late Thursday as he left the Senate following a lengthy conversation with Corker on the Senate floor.

    "Fifty-one senators want to cut taxes," Cruz said. "One is trying to raise taxes. That’s not right."

    A subdued Corker said minutes earlier the bill is "still changing."

    “I’m trying to do the best I can to make it a better bill,” Corker said.

    No. 2 Senate Republican John Cornyn said his preference would be not to add additional taxes, "but what I want most is 50 votes," he said.

    Cornyn said Senator Pat Toomey is working with Corker to reach an agreement.

    Senator Ron Johnson of Wisconsin also held out during an hourlong standoff on the Senate floor over a procedural vote that would have sent the measure back to the Senate Finance Committee. Johnson said he wants to ensure he can offer amendments, including one to raise the pass-through deduction to about 25 percent, paid for by eliminating the corporate deduction for state and local taxes.

    Another GOP senator whose support is in question, Susan Collins of Maine, is pushing to preserve the deduction for individual property taxes up to $10,000. That issue could be headed for a resolution. The Senate will ultimately adopt the House Republican proposal allowing the property tax break, according to Senator Mike Rounds of South Dakota, who’s close to Republican leaders.

    Republican Senator Lindsey Graham added: “I think you’re going to see a lot of these scrums, and here’s the way they’ll end: We’ll pass the bill sometime tomorrow.” — Laura Litvan, Erik Wasson, Steven T. Dennis and Sahil Kapur

    Senate Bill Seen Losing $1 Trillion After Growth (5:09 p.m.)

    A new analysis released Thursday by the Joint Committee on Taxation found that the Senate tax bill would generate enough economic growth to lower its $1.4 trillion revenue cost by only about $458 billion over a decade.

    After accounting for interest rates, the growth figure would fall to $407 billion, said the JCT, Congress’s official scorekeeper on tax legislation. That would leave a 10-year revenue loss of roughly $1 trillion.

    The bill’s backers have argued the tax plan would pay for itself through robust economic growth resulting from the cuts — but the new analysis is the latest among several to counter that argument. JCT estimated that the bill would boost gross domestic product by about 0.8 percent on average over the next 10 years.

    Growth estimates are especially important for a trio of senators — Bob Corker of Tennessee, James Lankford of Oklahoma and Jeff Flake of Arizona, who have voiced concerns about tax cuts adding to the deficit. The three support adding a revenue trigger to the bill that would provide for an automatic tax increase if revenue targets weren’t met, and Senate Republicans are wrangling over the issue.

    Discussions have centered around a $350 billion tax-increase trigger, far short of the $1 trillion revenue loss the JCT projects.

    A conservative-leaning policy center, the Washington-based Tax Foundation, released a statement saying JCT’s findings were “likely underestimating the economic growth spurred by this tax bill.”

    “The range of estimates from JCT includes several important assumptions that limit its growth results, particularly, assumptions regarding the Federal Reserve’s response to potential inflation and the United States being a closed economy,” the policy group said in a statement. The group is working on its own score for the latest version of the Senate bill.

    The Senate bill includes a provision that repeals all the individual tax cuts by 2026, which would tend to crimp economic growth. Senate tax writers included the expirations to make the bill comply with Senate rules against budget legislation increasing long-term deficits.

    The new estimate “ends the fantasy about magical growth and claims that tax cuts pay for themselves,” said Senator Ron Wyden, the top Democrat on the tax-writing Senate Finance Committee, who called the finding the “total opposite” of what Republicans have said.

    “It’s hard to see how they’re going to fix this with some kind of trigger,” Wyden said.

    A spokeswoman for the Senate Finance Committee said official findings that the Senate tax bill would reduce federal revenue by about $1 trillion over 10 years — even after accounting for economic growth — “are curious and deserve further scrutiny.”

    It’s unclear when that scrutiny might take place. Senate Republicans have already voted to begin debate on the tax bill, leaving little time for the sort of public consideration that typically takes place in committee hearings.

    Nonetheless, Senate Finance spokeswoman Julia Lawless called the JCT analysis “incomplete” because the Senate bill is “evolving.”

    Senators have so far written more than 70 potential amendments to the provision — though it’s unclear how many of them might be considered. Senate Majority Leader Mitch McConnell has not announced any new timetable for a vote on the actual bill, though he and others have set a goal of passing it by the end of this week. — Sahil Kapur, Erik Wasson and Laura Litvan

    John McCain Says He Will Support Senate Bill (2:03 p.m.)

    Republican John McCain of Arizona said in a statement Thursday that he’s decided to support the Senate tax bill — helping GOP leaders get one step closer to passing their overhaul.

    McCain hadn’t taken an official position on the tax plan until now — and no one was taking his vote for granted after he shocked the political world by voting against a rushed attempt to demolish the Affordable Care Act this summer.

    “I believe this legislation, though far from perfect, would enhance American competitiveness, boost the economy, and provide long overdue tax relief for middle class families,” McCain said in the statement.

    The Arizona lawmaker joins Lisa Murkowski of Alaska — another GOP senator whose support had been in question — in publicly endorsing the Senate tax bill in recent days. The GOP has a slim majority in the Senate, and can only afford to lose two of its 52 members to pass a bill without Democratic support. Republican senators that could still prove difficult votes include Susan Collins of Maine, Bob Corker of Tennessee, Jeff Flake of Arizona, James Lankford of Oklahoma and Ron Johnson of Wisconsin.

    Negotiations were ongoing Thursday to address some of the senators’ concerns, including over a trigger provision that would automatically increase taxes if economic growth doesn’t meet revenue targets.

    It’s unclear how long the 20 hours of tax debate currently ongoing will stretch. It could continue into the wee hours of Friday morning before kicking off the unlimited amendment vote series known as “vote-a-rama” overnight. Republican leaders said Thursday morning they hadn’t yet decided whether to just resume the process Friday morning, since an all nighter for some members would be hard, according to Collins. McCain is 81 and battling brain cancer.

    McCain has pushed for the Senate to return to regular order — hearings, markups, bipartisan input and amendments — for passing major bills, including tax legislation. He had signaled support for the Senate Finance Committee’s process after it approved a tax proposal earlier this month.

    McCain has had a mixed record on tax cuts, voting against measures in 2001 and 2003, citing deficit concerns.

    “I take seriously the concerns some of my Senate colleagues have raised about the impact of this bill on the deficit,” McCain said. “However, it’s clear this bill’s net effect on our economy would be positive.”

    McCain’s statement added to an already buoyant tone in the U.S. stock market. The Dow Jones Industrial Average extended its climb past 24,000 while the S&P 500 was set for its longest monthly winning streak since 2007, rising more than 1 percent. The dollar erased earlier losses, gaining as much as 0.6 percent against the yen as Treasuries declined, sending 10-year yields above 2.4 percent, to their highest level so far this month. — Alexis Leondis and Chris Nagi

    Collins Says ‘Not Committed’ on Bill Yet (9:33 a.m.)

    Republican Senator Susan Collins of Maine said it “would be very difficult” to support the Senate tax bill unless Congress agrees to preserve an individual deduction for state and local property taxes and passes separate legislation to support the individual health care market.

    “I am not committed to voting for this bill,” she said during a breakfast session organized by the Christian Science Monitor. She has said that Senate Majority Leader Mitch McConnell has committed to making health care legislation a priority.

    Collins also said she’ll pursue an amendment to enhance the child tax credit — and pay for the revenue cost by ending the “carried interest” tax break that favors investment managers. Carried interest is the portion of an investment fund’s profit — usually 20 percent — that’s paid to investment managers. Currently, it’s taxed as capital gains, meaning it qualifies for a tax rate as low as 23.8 percent. The top individual tax rate is currently 39.6 percent.

    The Senate bill would address carried interest by requiring that only gains on assets held more than three years — up from one year — would qualify for the break. Collins called that provision “modest.”

    Collins’s health-care concerns center on the Senate bill’s provision to repeal the Obamacare law’s individual mandate, which requires individuals to buy health insurance. Repealing the provision is estimated to save the federal government more than $300 billion over 10 years and result in roughly 13 million fewer insured people.

    On the property-tax deduction, Collins said she’s seeking a provision that would mirror the House bill approved earlier this month: retaining the break for property taxes, but capping it at $10,000. Currently, the Senate bill proposes to abolish deductions for all state and local taxes. — Erik Wasson

    Corker Says Trigger Deal Still Facing ‘Difficulties’ (4:00 a.m.)

    Senate Republicans are looking to approve their tax-overhaul legislation as soon as Thursday night — but wrangling continues over whether to include a trigger for tax increases if economic growth doesn’t meet revenue targets.

    “They’re having a few difficulties but hopefully in the morning they’ll have something,” Senator Bob Corker of Tennessee, who’s pushing for the trigger mechanism, said Wednesday evening. “There’s nothing to show right now.”

    Corker and Republican Senator Pat Toomey of Pennsylvania are negotiating over the trigger concept, according to Senate Majority Whip John Cornyn of Texas. Corker and Toomey, both members of the Budget Committee, reached an agreement in September that allowed a budget that would add to the deficit.

    Toomey said a deal would be announced Thursday, but declined to provide details.

    Corker, along with Arizona Senator Jeff Flake and Oklahoma Senator James Lankford, have said their votes are contingent on the tax trigger. Others, like Senator Thom Tillis of North Carolina have said they are wary of the effect on the economy of tax increases during a recession.

    While Senate Finance Chairman Orrin Hatch said he thought it was likely a trigger would be included, Senator David Perdue of Georgia countered that saying: “There is no foregone conclusion that we will have a trigger. Because there is a debate going on about that.”

    “We’re not going to do anything to jeopardize this bill,” Perdue said.

    In addition to deciding whether or how to include a future tax increase if revenue targets aren’t met, Republicans may have to tweak or add other provisions during the next 24 hours or so to secure the votes they need. Another change in the works would deepen the tax cut for pass-through businesses such as partnerships and limited liability companies.

    All 52 Senate Republicans united to vote to open debate on the $1.4 trillion tax-cut measure Wednesday in the latest sign that the bill has the momentum it needs to pass. Republicans must have 50 of their 52 members vote “aye” in order to send the bill to a planned House-Senate conference, the next step in GOP efforts to get tax legislation to President Donald Trump by the end of 2017.

    The Senate is now spending 20 hours of limited debate time on the tax bill. During that period, Democrats may try to strip out parts of the bill by raising objections to them based on Senate rules. Republican staff members have been working to tweak tax and oil-drilling provisions in the bill to comply with rules meant to exclude provisions that aren’t primarily fiscal in nature.

    The formal debate time is set to expire close to midnight on Thursday, after which an unlimited amendment vote series known as “vote-a-rama” would ensue. Senators could agree to speed up the debate and start the amendment votes sooner.

    During vote-a-rama, Democrats are likely to offer numerous amendments meant to highlight any flaws they believe the bill contains. Democrats say the bill gives most tax benefits to the wealthy while raising taxes on many in the middle and working class, in addition to increasing budget deficits.

    “What’s on offer is a plan to force working people and middle-class families to pay for handouts to corporations and tax cheats," said Democratic Senator Ron Wyden as debate kicked off Wednesday evening.

    Republican Senator Mike Enzi, chairman of the Budget Committee, disputed that characterization. “We need tax reform that will make our system simpler and fairer and allow people to keep more of what they earn,” he said. “This bill before us would do that.”

    Some Republicans are expected to offer amendments that would be paid for by setting the corporate rate higher than the 20 percent proposed in the Senate tax bill. The current corporate rate is 35 percent.

    Moderate GOP Senator Susan Collins filed an amendment that would retain the individual deduction for state and local property taxes and cap it at $10,000 for individuals — mirroring the House tax bill. She said she would pay for the change with a 21 percent corporate rate and by keeping the individual top rate at 39.6 percent.

    “I think it’s significant that many members believe that we don’t need to go all the way to 20 percent in order to spur investment and job creation,” Collins said.

    Republican senators Mike Lee and Marco Rubio also plan to make the bill’s child tax credit refundable up to 15.3 percent of earnings, paid for with a 22 percent corporate rate.

    Behind the scenes, Republicans will be crafting a final substitute amendment containing any changes they’ll need to get the required 50 votes.

    Wavering senators Steve Daines of Montana and Ron Johnson of Wisconsin appear to be on track to support the bill after securing a 20 percent deduction for pass-throughs, an increase from the 17.4 percent in the draft bill. Johnson said Wednesday he expects to see the larger deduction included in the final version of the Senate legislation. He added he would support an amendment calling for the elimination of state and local tax deductions for corporations. — Erik Wasson, Kaustuv Basu, Allyson Versprille and Laura Davison

    What to Watch on Thursday:

    • Senate Republicans approved the “motion to proceed,” 52-48, on party lines. After up to 20 hours of debate, the chamber will begin considering a series of amendments proposed by senators in what’s known as a “vote-a-rama” marathon that’s likely to end with an amendment by Republican leaders incorporating all the changes.
    • Tax writers may release details of the trigger concept. GOP senators have discussed a provision that would allow for as much as $350 billion in automatic tax increases starting in 2022. Republican Senator Ted Cruz of Texas has said he’s working on a trigger provision that would apply two ways and bring additional cuts if there’s robust growth.
    • The nonpartisan Joint Committee on Taxation may release a “dynamic scoring” analysis of the bill’s effect on the deficit.

    Here’s What Happened on Wednesday:

    • President Donald Trump said the tax overhaul would hurt him financially, disputing findings from the non-partisan Congressional Research Service and other analysts saying top earners would benefit more than the middle class.
    • Senate Republicans agreed to raise a proposed deduction for pass-through businesses, such as partnerships and limited liability companies, to 20 percent from 17.4 percent, according to Republican Senator Steve Daines of Montana.
    • Republicans Senators Marco Rubio and Mike Lee said they plan to introduce an amendment that would enhance the child tax credit — and offset the cost by setting the corporate rate at 22 percent, higher than the 20 percent rate President Donald Trump favors. The White House said the president doesn’t support the amendment.
    • Republican Senator Susan Collins of Maine said she would vote to begin debate after she got a commitment from Republican leaders to put legislation aimed at stabilizing Obamacare’s insurance exchanges on a must-pass bill next month.
    • The bill got an important commitment as GOP Senator Lisa Murkowski of Alaska said she would vote for it.

      Read more: http://www.bloomberg.com/news/articles/2017-11-30/republicans-grapple-over-trigger-provision-tax-debate-update

      Portugals radical drugs policy is working. Why hasnt the world copied it?

      The long read: Since it decriminalised all drugs in 2001, Portugal has seen dramatic drops in overdoses, HIV infection and drug-related crime

      When the drugs came, they hit all at once. It was the 80s, and by the time one in 10 people had slipped into the depths of heroin use bankers, university students, carpenters, socialites, miners Portugal was in a state of panic.

      lvaro Pereira was working as a family doctor in Olho in southern Portugal. People were injecting themselves in the street, in public squares, in gardens, he told me. At that time, not a day passed when there wasnt a robbery at a local business, or a mugging.

      The crisis began in the south. The 80s were a prosperous time in Olho, a fishing town 31 miles west of the Spanish border. Coastal waters filled fishermens nets from the Gulf of Cdiz to Morocco, tourism was growing, and currency flowed throughout the southern Algarve region. But by the end of the decade, heroin began washing up on Olhos shores. Overnight, Pereiras beloved slice of the Algarve coast became one of the drug capitals of Europe: one in every 100 Portuguese was battling a problematic heroin addiction at that time, but the number was even higher in the south. Headlines in the local press raised the alarm about overdose deaths and rising crime. The rate of HIV infection in Portugal became the highest in the European Union. Pereira recalled desperate patients and families beating a path to his door, terrified, bewildered, begging for help. I got involved, he said, only because I was ignorant.

      In truth, there was a lot of ignorance back then. Forty years of authoritarian rule under the regime established by Antnio Salazar in 1933 had suppressed education, weakened institutions and lowered the school-leaving age, in a strategy intended to keep the population docile. The country was closed to the outside world; people missed out on the experimentation and mind-expanding culture of the 1960s. When the regime ended abruptly in a military coup in 1974, Portugal was suddenly opened to new markets and influences. Under the old regime, Coca-Cola was banned and owning a cigarette lighter required a licence. When marijuana and then heroin began flooding in, the country was utterly unprepared.

      Pereira tackled the growing wave of addiction the only way he knew how: one patient at a time. A student in her 20s who still lived with her parents might have her family involved in her recovery; a middle-aged man, estranged from his wife and living on the street, faced different risks and needed a different kind of support. Pereira improvised, calling on institutions and individuals in the community to lend a hand.

      In 2001, nearly two decades into Pereiras accidental specialisation in addiction, Portugal became the first country to decriminalise the possession and consumption of all illicit substances. Rather than being arrested, those caught with a personal supply might be given a warning, a small fine, or told to appear before a local commission a doctor, a lawyer and a social worker about treatment, harm reduction, and the support services that were available to them.

      The opioid crisis soon stabilised, and the ensuing years saw dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates. HIV infection plummeted from an all-time high in 2000 of 104.2 new cases per million to 4.2 cases per million in 2015. The data behind these changes has been studied and cited as evidence by harm-reduction movements around the globe. Its misleading, however, to credit these positive results entirely to a change in law.

      Portugals remarkable recovery, and the fact that it has held steady through several changes in government including conservative leaders who would have preferred to return to the US-style war on drugs could not have happened without an enormous cultural shift, and a change in how the country viewed drugs, addiction and itself. In many ways, the law was merely a reflection of transformations that were already happening in clinics, in pharmacies and around kitchen tables across the country. The official policy of decriminalisation made it far easier for a broad range of services (health, psychiatry, employment, housing etc) that had been struggling to pool their resources and expertise, to work together more effectively to serve their communities.

      The language began to shift, too. Those who had been referred to sneeringly as drogados (junkies) became known more broadly, more sympathetically, and more accurately, as people who use drugs or people with addiction disorders. This, too, was crucial.

      It is important to note that Portugal stabilised its opioid crisis, but it didnt make it disappear. While drug-related death, incarceration and infection rates plummeted, the country still had to deal with the health complications of long-term problematic drug use. Diseases including hepatitis C, cirrhosis and liver cancer are a burden on a health system that is still struggling to recover from recession and cutbacks. In this way, Portugals story serves as a warning of challenges yet to come.

      Despite enthusiastic international reactions to Portugals success, local harm-reduction advocates have been frustrated by what they see as stagnation and inaction since decriminalisation came into effect. They criticise the state for dragging its feet on establishing supervised injection sites and drug consumption facilities; for failing to make the anti-overdose medication naloxone more readily available; for not implementing needle-exchange programmes in prisons. Where, they ask, is the courageous spirit and bold leadership that pushed the country to decriminalise drugs in the first place?


      In the early days of Portugals panic, when Pereiras beloved Olho began falling apart in front of him, the states first instinct was to attack. Drugs were denounced as evil, drug users were demonised, and proximity to either was criminally and spiritually punishable. The Portuguese government launched a series of national anti-drug campaigns that were less Just Say No and more Drugs Are Satan.

      Informal treatment approaches and experiments were rushed into use throughout the country, as doctors, psychiatrists, and pharmacists worked independently to deal with the flood of drug-dependency disorders at their doors, sometimes risking ostracism or arrest to do what they believed was best for their patients.

      In 1977, in the north of the country, psychiatrist Eduno Lopes pioneered a methadone programme at the Centro da Boavista in Porto. Lopes was the first doctor in continental Europe to experiment with substitution therapy, flying in methadone powder from Boston, under the auspices of the Ministry of Justice, rather than the Ministry of Health. His efforts met with a vicious public backlash and the disapproval of his peers, who considered methadone therapy nothing more than state-sponsored drug addiction.

      In Lisbon, Odette Ferreira, an experienced pharmacist and pioneering HIV researcher, started an unofficial needle-exchange programme to address the growing Aids crisis. She received death threats from drug dealers, and legal threats from politicians. Ferreira who is now in her 90s, and still has enough swagger to carry off long fake eyelashes and red leather at a midday meeting started giving away clean syringes in the middle of Europes biggest open-air drug market, in the Casal Ventoso neighbourhood of Lisbon. She collected donations of clothing, soap, razors, condoms, fruit and sandwiches, and distributed them to users. When dealers reacted with hostility, she snapped back: Dont mess with me. You do your job, and Ill do mine. She then bullied the Portuguese Association of Pharmacies into running the countrys and indeed the worlds first national needle-exchange programme.

      A flurry of expensive private clinics and free, faith-based facilities emerged, promising detoxes and miracle cures, but the first public drug-treatment centre run by the Ministry of Health the Centro das Taipas in Lisbon did not begin operating until 1987. Strapped for resources in Olho, Pereira sent a few patients for treatment, although he did not agree with the abstinence-based approach used at Taipas. First you take away the drug, and then, with psychotherapy, you plug up the crack, said Pereira. There was no scientific evidence to show that this would work and it didnt.

      He also sent patients to Lopess methadone programme in Porto, and found that some responded well. But Porto was at the other end of the country. He wanted to try methadone for his patients, but the Ministry of Health hadnt yet approved it for use. To get around that, Pereira sometimes asked a nurse to sneak methadone to him in the boot of his car.

      Pereiras work treating patients for addiction eventually caught the attention of the Ministry of Health. They heard there was a crazy man in the Algarve who was working on his own, he said, with a slow smile. Now 68, he is sprightly and charming, with an athletic build, thick and wavy white hair that bounces when he walks, a gravelly drawl and a bottomless reserve of warmth. They came down to find me at the clinic and proposed that I open a treatment centre, he said. He invited a colleague from at a family practice in the next town over to join him a young local doctor named Joo Goulo.

      Goulo was a 20-year-old medical student when he was offered his first hit of heroin. He declined because he didnt know what it was. By the time he finished school, got his licence and began practising medicine at a health centre in the southern city of Faro, it was everywhere. Like Pereira, he accidentally ended up specialising in treating drug addiction.

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      A nurse hands out methadone to addicts in Lisbon. Photograph: Horacio Villalobos/Corbis via Getty Images

      The two young colleagues joined forces to open southern Portugals first CAT in 1988. (These kinds of centres have used different names and acronyms over the years, but are still commonly referred to as Centros de Atendimento a Toxicodependentes, or CATs.) Local residents were vehemently opposed, and the doctors were improvising treatments as they went along. The following month, Pereira and Goulo opened a second CAT in Olho, and other family doctors opened more in the north and central regions, forming a loose network. It had become clear to a growing number of practitioners that the most effective response to addiction had to be personal, and rooted in communities. Treatment was still small-scale, local and largely ad hoc.

      The first official call to change Portugals drug laws came from Rui Pereira, a former constitutional court judge who undertook an overhaul of the penal code in 1996. He found the practice of jailing people for taking drugs to be counterproductive and unethical. My thought right off the bat was that it wasnt legitimate for the state to punish users, he told me in his office at the University of Lisbons school of law. At that time, about half of the people in prison were there for drug-related reasons, and the epidemic, he said, was thought to be an irresolvable problem. He recommended that drug use be discouraged without imposing penalties, or further alienating users. His proposals werent immediately adopted, but they did not go unnoticed.

      In 1997, after 10 years of running the CAT in Faro, Goulo was invited to help design and lead a national drug strategy. He assembled a team of experts to study potential solutions to Portugals drug problem. The resulting recommendations, including the full decriminalisation of drug use, were presented in 1999, approved by the council of ministers in 2000, and a new national plan of action came into effect in 2001.

      Today, Goulo is Portugals drug czar. He has been the lodestar throughout eight alternating conservative and progressive administrations; through heated standoffs with lawmakers and lobbyists; through shifts in scientific understanding of addiction and in cultural tolerance for drug use; through austerity cuts, and through a global policy climate that only very recently became slightly less hostile. Goulo is also decriminalisations busiest global ambassador. He travels almost non-stop, invited again and again to present the successes of Portugals harm-reduction experiment to authorities around the world, from Norway to Brazil, which are dealing with desperate situations in their own countries.

      These social movements take time, Goulo told me. The fact that this happened across the board in a conservative society such as ours had some impact. If the heroin epidemic had affected only Portugals lower classes or racialised minorities, and not the middle or upper classes, he doubts the conversation around drugs, addiction and harm reduction would have taken shape in the same way. There was a point whenyou could not find a single Portuguese family that wasnt affected. Every family had their addict, or addicts. This was universal in a way that the society felt: We have to do something.

      Portugals policy rests on three pillars: one, that theres no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs; two, that an individuals unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them, and with themselves; and three, that the eradication of all drugs is an impossible goal.

      The national policy is to treat each individual differently, Goulo told me. The secret is for us to be present.


      A drop-in centre called IN-Mouraria sits unobtrusively in a lively, rapidly gentrifying neighbourhood of Lisbon, a longtime enclave of marginalised communities. From 2pm to 4pm, the centre provides services to undocumented migrants and refugees; from 5pm to 8pm, they open their doors to drug users. A staff of psychologists, doctors and peer support workers (themselves former drug users) offer clean needles, pre-cut squares of foil, crack kits, sandwiches, coffee, clean clothing, toiletries, rapid HIV testing, and consultations all free and anonymous.

      On the day I visited, young people stood around waiting for HIV test results while others played cards, complained about police harassment, tried on outfits, traded advice on living situations, watched movies and gave pep talks to one another. They varied in age, religion, ethnicity and gender identity, and came from all over the country and all over the world. When a slender, older man emerged from the bathroom, unrecognisable after having shaved his beard off, an energetic young man who had been flipping through magazines threw up his arms and cheered. He then turned to a quiet man sitting on my other side, his beard lush and dark hair curling from under his cap, and said: What about you? Why dont you go shave off that beard? You cant give up on yourself, man. Thats when its all over. The bearded man cracked a smile.

      During my visits over the course of a month, I got to know some of the peer support workers, including Joo, a compact man with blue eyes who was rigorous in going over the details and nuances of what I was learning. Joo wanted to be sure I understood their role at the drop-in centre was not to force anyone to stop using, but to help minimise the risks users were exposed to.

      Our objective is not to steer people to treatment they have to want it, he told me. But even when they do want to stop using, he continued, having support workers accompany them to appointments and treatment facilities can feel like a burden on the user and if the treatment doesnt go well, there is the risk that that person will feel too ashamed to return to the drop-in centre. Then we lose them, and thats not what we want to do, Joo said. I want them to come back when they relapse. Failure was part of the treatment process, he told me. And he would know.

      Joo is a marijuana-legalisation activist, open about being HIV-positive, and after being absent for part of his sons youth, he is delighting in his new role as a grandfather. He had stopped doing speedballs (mixtures of cocaine and opiates) after several painful, failed treatment attempts, each more destructive than the last. He long used cannabis as a form of therapy methadone did not work for him, nor did any of the inpatient treatment programmes he tried but the cruel hypocrisy of decriminalisation meant that although smoking weed was not a criminal offence, purchasing it was. His last and worst relapse came when he went to buy marijuana from his usual dealer and was told: I dont have that right now, but I do have some good cocaine. Joo said no thanks and drove away, but soon found himself heading to a cash machine, and then back to the dealer. After this relapse, he embarked on a new relationship, and started his own business. At one point he had more than 30 employees. Then the financial crisis hit. Clients werent paying, and creditors started knocking on my door, he told me. Within six months I had burned through everything I had built up over four or five years.

      Addicts
      Addicts waiting for methadone at a drug treatment project in Lisbon. Photograph: Horacio Villalobos/Corbis via Getty Images

      In the mornings, I followed the centres street teams out to the fringes of Lisbon. I met Raquel and Sareia their slim forms swimming in the large hi-vis vests they wear on their shifts who worked with Crescer na Maior, a harm-reduction NGO. Six times a week, they loaded up a large white van with drinking water, wet wipes, gloves, boxes of tinfoil and piles of state-issued drug kits: green plastic pouches with single-use servings of filtered water, citric acid, a small metal tray for cooking, gauze, filter and a clean syringe. Portugal does not yet have any supervised injection sites (although there is legislation to allow them, several attempts to open one have come to nothing), so, Raquel and Sareia told me, they go out to the open-air sites where they know people go to buy and use. Both are trained psychologists, but out in the streets they are known simply as the needle girls.

      Good afternoon! Raquel called out cheerily, as we walked across a seemingly abandoned lot in an area called Cruz Vermelha. Street team! People materialised from their hiding places like some strange version of whack-a-mole, poking their heads out from the holes in the wall where they had gone to smoke or shoot up. My needle girls, one woman cooed to them tenderly. How are you, my loves? Most made polite conversation, updating the workers on their health struggles, love lives, immigration woes or housing needs. One woman told them she would be going back to Angola to deal with her mothers estate, that she was looking forward to the change of scenery. Another man told them he had managed to get his online girlfriends visa approved for a visit. Does she know youre still using? Sareia asked. The man looked sheepish.

      I start methadone tomorrow, another man said proudly. He was accompanied by his beaming girlfriend, and waved a warm goodbye to the girls as they handed him a square of foil.

      In the foggy northern city of Porto, peer support workers from Caso an association run by and for drug users and former users, the only one of its kind in Portugal meet every week at a noisy cafe. They come here every Tuesday morning to down espressos, fresh pastries and toasted sandwiches, and to talk out the challenges, debate drug policy (which, a decade and a half after the law came into effect, was still confusing for many) and argue, with the warm rowdiness that is characteristic of people in the northern region. When I asked them what they thought of Portugals move to treat drug users as sick people in need of help, rather than as criminals, they scoffed. Sick? We dont say sick up here. Were not sick.

      I was told this again and again in the north: thinking of drug addiction simply in terms of health and disease was too reductive. Some people are able to use drugs for years without any major disruption to their personal or professional relationships. It only became a problem, they told me, when it became a problem.

      Caso was supported by Apdes, a development NGO with a focus on harm reduction and empowerment, including programmes geared toward recreational users. Their award-winning Check!n project has for years set up shop at festivals, bars and parties to test substances for dangers. I was told more than once that if drugs were legalised, not just decriminalised, then these substances would be held to the same rigorous quality and safety standards as food, drink and medication.


      In spite of Portugals tangible results, other countries have been reluctant to follow. The Portuguese began seriously considering decriminalisation in 1998, immediately following the first UN General Assembly Special Session on the Global Drug Problem (UNgass). High-level UNgass meetings are convened every 10 years to set drug policy for all member states, addressing trends in addiction, infection, money laundering, trafficking and cartel violence. At the first session for which the slogan was A drug-free world: we can do it Latin American member states pressed for a radical rethinking of the war on drugs, but every effort to examine alternative models (such as decriminalisation) was blocked. By the time of the next session, in 2008, worldwide drug use and violence related to the drug trade had vastly increased. An extraordinary session was held last year, but it was largely a disappointment the outcome document didnt mention harm reduction once.

      Despite that letdown, 2016 produced a number of promising other developments: Chile and Australia opened their first medical cannabis clubs; following the lead of several others, four more US states introduced medical cannabis, and four more legalised recreational cannabis; Denmark opened the worlds largest drug consumption facility, and France opened its first; South Africa proposed legalising medical cannabis; Canada outlined a plan to legalise recreational cannabis nationally and to open more supervised injection sites; and Ghana announced it would decriminalise all personal drug use.

      The biggest change in global attitudes and policy has been the momentum behind cannabis legalisation. Local activists have pressed Goulo to take a stance on regulating cannabis and legalising its sale in Portugal; for years, he has responded that the time wasnt right. Legalising a single substance would call into question the foundation of Portugals drug and harm-reduction philosophy. If the drugs arent the problem, if the problem is the relationship with drugs, if theres no such thing as a hard or a soft drug, and if all illicit substances are to be treated equally, he argued, then shouldnt all drugs be legalised and regulated?

      Massive international cultural shifts in thinking about drugs and addiction are needed to make way for decriminalisation and legalisation globally. In the US, the White House has remained reluctant to address what drug policy reform advocates have termed an addiction to punishment. But if conservative, isolationist, Catholic Portugal could transform into a country where same-sex marriage and abortion are legal, and where drug use is decriminalised, a broader shift in attitudes seems possible elsewhere. But, as the harm-reduction adage goes: one has to want the change in order to make it.


      When Pereira first opened the CAT in Olho, he faced vociferous opposition from residents; they worried that with more drogados would come more crime. But the opposite happened. Months later, one neighbour came to ask Pereiras forgiveness. She hadnt realised it at the time, but there had been three drug dealers on her street; when their local clientele stopped buying, they packed up and left.

      The CAT building itself is a drab, brown two-storey block, with offices upstairs and an open waiting area, bathrooms, storage and clinics down below. The doors open at 8.30am, seven days a week, 365 days a year. Patients wander in throughout the day for appointments, to chat, to kill time, to wash, or to pick up their weekly supply of methadone doses. They tried to close the CAT for Christmas Day one year, but patients asked that it stay open. For some, estranged from loved ones and adrift from any version of home, this is the closest thing theyve got to community and normality.

      Its not just about administering methadone, Pereira told me. You have to maintain a relationship.

      In a back room, rows of little canisters with banana-flavoured methadone doses were lined up, each labelled with a patients name and information. The Olho CAT regularly services about 400 people, but that number can double during the summer months, when seasonal workers and tourists come to town. Anyone receiving treatment elsewhere in the country, or even outside Portugal, can have their prescription sent over to the CAT, making the Algarve an ideal harm-reduction holiday destination.

      After lunch at a restaurant owned by a former CAT employee, the doctor took me to visit another of his projects a particular favourite. His decades of working with addiction disorders had taught him some lessons, and he poured his accumulated knowledge into designing a special treatment facility on the outskirts of Olho: the Unidade de Desabituao, or Dishabituation Centre. Several such UDs, as they are known, have opened in other regions of the country, but this centre was developed to cater to the particular circumstances and needs of the south.

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      A man receives clean syringes after being given methadone at a clinic in Lisbon. Photograph: Horacio Villalobos/Corbis via Getty Images

      Pereira stepped down as director some years ago, but his replacement asked him to stay on to help with day-to-day operations. Pereira should be retired by now indeed, he tried to but Portugal is suffering from an overall shortage of health professionals in the public system, and not enough young doctors are stepping into this specialisation. As his colleagues elsewhere in the country grow closer to their own retirements, theres a growing sense of dread that there is no one to replace them.

      Those of us from the Algarve always had a bit of a different attitude from our colleagues up north, Pereira told me. I dont treat patients. They treat themselves. My function is to help them to make the changes they need to make.

      And thank goodness there is only one change to make, he deadpanned as we pulled into the centres parking lot: You need to change almost everything. He cackled at his own joke and stepped out of his car.

      The glass doors at the entrance slid open to a facility that was bright and clean without feeling overwhelmingly institutional. Doctors and administrators offices were up a sweeping staircase ahead. Women at the front desk nodded their hellos, and Pereira greeted them warmly: Good afternoon, my darlings.

      The Olho centre was built for just under 3m (2.6m), publicly funded, and opened to its first patients nine years ago. This facility, like the others, is connected to a web of health and social rehabilitation services. It can house up to 14 people at once: treatments are free, available on referral from a doctor or therapist, and normally last between eight and 14 days. When people first arrive, they put all of their personal belongings photos, mobile phones, everything into storage, retrievable on departure.

      We believe in the old maxim: No news is good news, explained Pereira. We dont do this to punish them but to protect them. Memories can be triggering, and sometimes families, friends and toxic relationships can be enabling.

      To the left there were intake rooms and a padded isolation room, with clunky security cameras propped up in every corner. Patients each had their own suites simple, comfortable and private. To the right, there was a colour room, with a pottery wheel, recycled plastic bottles, paints, egg cartons, glitter and other craft supplies. In another room, coloured pencils and easels for drawing. A kiln, and next to it a collection of excellent handmade ashtrays. Many patients remained heavy smokers.

      Patients were always occupied, always using their hands or their bodies or their senses, doing exercise or making art, always filling their time with something. Wed often hear our patients use the expression me and my body, Pereira said. As though there was a dissociation between the me and my flesh.

      To help bring the body back, there was a small gym, exercise classes, physiotherapy and a jacuzzi. And after so much destructive behaviour messing up their bodies, their relationships, their lives and communities learning that they could create good and beautiful things was sometimes transformational.

      You know those lines on a running track? Pereira asked me. He believed that everyone however imperfect was capable of finding their own way, given the right support. Our love is like those lines.

      He was firm, he said, but never punished or judged his patients for their relapses or failures. Patients were free to leave at any time, and they were welcome to return if they needed, even if it was more than a dozen times.

      He offered no magic wand or one-size-fits-all solution, just this daily search for balance: getting up, having breakfast, making art, taking meds, doing exercise, going to work, going to school, going into the world, going forward. Being alive, he said to me more than once, can be very complicated.

      My darling, he told me, its like I always say: I may be a doctor, but nobodys perfect.

      A longer version of this piece appears on thecommononline.org. Research and travel for this piece were made possible by the Matthew Power Literary Reporting Award

      Follow the Long Read on Twitter at @gdnlongread, or sign up to the long read weekly email here.

      Read more: https://www.theguardian.com/news/2017/dec/05/portugals-radical-drugs-policy-is-working-why-hasnt-the-world-copied-it

      Should the Upper Middle Class Take the Biggest Tax Hit?

      Humans learn the concept of fairness at a very young age. After all, it doesn’t take long for a child to start whining about a sibling who gets an extra serving of ice cream. As the Republican-controlled Congress tries to push through tax reform this year, one group of Americans may similarly question why it’s coming up a scoop short.

      The upper middle class gets relatively few benefits and a disproportionate number of tax hikes under the $1.4-trillion Tax Cuts and Jobs Act approved by the U.S. House of Representatives last week. Families earning between $150,000 and $308,000—the 80th to 95th percentile—would still get a tax cut on average. But by 2027, more than a third of those affluent Americans can expect a tax increase, according to the Tax Policy Center.

      If the House bill becomes law, overall benefits for the upper middle class will start out small, and later vanish almost entirely.

      Is this fair? Some argue it’s only right for the upper middle class to carry a heavier burden. This is because the top fifth of the U.S. by income has done pretty well over the past three decades while the wages and wealth of typical workers have stagnated. People in the 81st to 99th percentiles by income have boosted their inflation-adjusted pre-tax cash flow by 65 percent between 1979 and 2013, according to the Congressional Budget Office. That’s more than twice as much as the income rise seen by the middle 60 percent. (The top 1 percent, meanwhile, saw their income rise by 186 percent over the same period, but that’s another story.)

      “Many upper-middle-class families will tell you they do not feel wealthy,” said Brian Riedl, a senior fellow at the Manhattan Institute, a right-leaning think tank. “Their standard of living [is] closer to the middle class than to the top 1 percent.” The income numbers don’t tell the whole story, he explained. The upper middle class is weighed down by high costs: Affluent workers live in expensive areas, pay a lot for real estate and daycare, and are taxed far more than Americans further down the ladder.

      Richard Reeves, a senior fellow at the left-leaning Brookings Institution, isn’t buying that argument. He’s the author of “Dream Hoarders: How the American Upper Middle Class Is Leaving Everyone Else in the Dust, Why That Is a Problem, and What to Do About It.”

      “There’s a culture of entitlement at the top of U.S. society,” Reeves said. While others focus on rising wealth of the top 1 percent, Reeves argues that the gap is widening between the top 20 percent and everyone else. The upper middle class is guilty of “hoarding” its privileges, using its power to skew the job market, educational institutions, real estate markets, and tax policy for its own benefit, he contends.

      “The American upper middle class know how to take care of themselves,” Reeves said during a presentation at the City University of New York last week. “They know how to organize. They’re numerous enough to be a serious voting bloc, and they run everything.”

      So by his measure, the tax legislation’s disproportionate hit to the upper middle class is indeed fair.

      A family earning $240,000 a year is bringing in four times the U.S. median household income of $59,000, according to the U.S. Census Bureau. All that money, along with the upper middle class’s political power, buys some huge advantages, Reeves said. For example, affluent parents compete for access to the best schools, bidding up home values in the best school districts. Then, they use zoning rules to prevent new construction, keep property values high, and prevent lower-income Americans from moving in. In the process, children of this demographic end up at the most prestigious universities, nab the best internships and jobs, and ultimately join their parents at the top of U.S. society. 

      The very existence of the House tax bill rebuts Reeves’s argument that the upper middle class is in a position to manipulate Washington. (The Senate is considering its own tax legislation, which differs from the House bill in several ways.) Compared with middle class Americans, the upper middle class is less likely to see marginal tax rates fall under the House legislation. The bill also limits or scraps entirely some of the group’s favorite tax breaks, especially deductions for state-and-local taxes, and medical expenses, and tax breaks for education.

      If you’re part of the upper middle class and concede you should be paying more, don’t count on wealthier groups making the same sacrifice—at least under the House bill. 

      While a repeal of the alternative-minimum tax helps some people with incomes below $300,000, it’s more likely to benefit those on the higher wealth rungs. The very rich, including President Donald Trump, who has been pressing for a legislative victory before the end of his first year in office, would benefit from a repeal of the estate tax, lower corporate tax rates and a lower “pass-through” rate on business income. The House bill explicitly tries to limit the pass-through benefit for doctors, lawyers, accountants, and other high-earning professionals—traditional denizens of the upper middle class. 

      This all may seem terribly unfair to members of the upper middle class, but there are some provisions they can take solace in. The bill leaves untouched some sweet tax breaks that predominately benefit people with lower six-figure salaries, such as 529 college savings plans and 401(k)s and other retirement perks. The CBO calculates that two-thirds of the government’s costs for retirement tax breaks go to the top 20 percent.

      But beyond these few exceptions, much of the upper middle class will still take it on the chin.

      And maybe they should. Higher taxes on the upper middle class make sense to some liberal tax experts—but only if the proceeds are used the right way, they said, for things like better health care, more affordable college, and rebuilding infrastructure. Under the House bill, though, any new tax revenue is used to offset tax cuts—much of which will benefit the super wealthy and corporations, especially over time.

      “There would be a lot of people in the country who would be willing to chip in for those goals,” said Carl Davis, research director of the left-leaning Institute on Taxation and Economic Policy. In the House plan, however, the upper middle class is “going to pay more for a bill that’s going to grow the national debt, and provide the lion’s share of the benefits to corporations and their shareholders.”

      Riedl, who has advised Republican candidates, argues the upper middle class should get a more generous tax cut under GOP tax reform. “It’s hard to argue the upper middle class is not currently paying its fair share,” he said. Reeves said the U.S. should ultimately tax the upper middle class more—but “the top 5 percent more still.”

      Looking at Republican tax plans, Reeves said, “it’s like they only read half my book.”

        Read more: http://www.bloomberg.com/news/articles/2017-11-20/should-the-upper-middle-class-take-the-biggest-tax-hit

        Senate Passes Tax-Cut Bill in Milestone Move Toward Overhaul

        Senate Republicans narrowly approved the most sweeping rewrite of the U.S. tax code in three decades, slashing the corporate tax rate and providing temporary tax-rate cuts for most Americans.

        The 51-49 vote — achieved just before 2 a.m. Saturday in Washington and only after closed-door deal-making with dissident senators — brings the GOP close to delivering a much-needed policy win for their party and President Donald Trump. 

        After the vote, Trump said on Twitter that he looks forward to signing a final bill before Christmas. Vice President Mike Pence tweeted that a pre-Christmas tax cut would be a “Middle-Class Miracle!”

        Before it goes to Trump, lawmakers will have to resolve differences between the Senate bill and one the House passed last month, a process that could begin Monday. Although both versions share common top-line elements, negotiations on individual provisions inserted to win votes, particularly in the Senate, may be protracted and difficult. The final product will end up being a central issue in the 2018 elections that will determine control of Congress.

        “We’re going to take this message to the American people a year from now,” Senate Majority Leader Mitch McConnell said after the vote.

        Speaking in New York on Saturday, Trump also predicted the tax package would be a winner for Republicans in the 2018 midterm elections. “We got no Democrat help and I think that’s going to hurt them in the election,” Trump said at a fundraising event.

        Read about the sticking points between Senate, House bills.

        Both the House and Senate measures would cut the corporate tax rate to 20 percent from 35 percent — though the Senate version would set that lower rate in 2019, a year later than the House bill would. Also, the Senate bill, unlike the House version, would provide only temporary tax relief to individuals, ending tax cuts for them in 2026. Both bills are expected to add more than $1.4 trillion to the federal deficit over 10 years, before accounting for any economic growth.

        Senator Bob Corker of Tennessee, who had cited concerns over the bill’s effects on federal deficits, was the only Republican dissenter. McConnell rejected revenue scores that suggested the bill’s tax cuts would add to the deficit. He predicted it would be a “revenue producer” by stimulating economic growth. Congress’s official tax scorekeeper this week said otherwise.

        The House and Senate bills also align on the contentious issue of individual deductions for state and local taxes: They’d eliminate all but a deduction for property taxes, which would be capped at $10,000.

        Mortgage Interest

        But they differ on the home mortgage-interest deduction; the House bill would restrict that break to loans of $500,000 or less with regard to new purchases of homes. The Senate legislation would leave the current $1 million cap in place.

        They also differ — narrowly — on the tax rates they’d apply to multinational companies’ accumulated offshore earnings. The House bill would tax those profits at 14 percent for earnings held as cash and 7 percent for less-liquid assets. The revised Senate bill contains a lengthy section that has no direct mention of the rates, but a person familiar with the Senate plan said they’d be 14.5 percent for cash and 7.5 percent for less-liquid assets.

        Senate Republican leaders muscled the sweeping legislation through the chamber less than two weeks after releasing the bill draft. Many GOP lawmakers, including Corker and Lindsey Graham of South Carolina, have expressed concerns that the party has little to show so far before next year’s congressional elections, after the collapse of an Obamacare repeal earlier this year and no action on issues ranging from immigration to infrastructure.

        ‘Working Families’

        Trump expressed gratitude to McConnell and Finance Committee Chairman Orrin Hatch for steering the measure through the Senate.

        “We are one step closer to delivering MASSIVE tax cuts for working families across America,” Trump wrote on Twitter.

        Republicans were able to bring the legislation to a vote using Senate rules that allowed them to approve it with a simple majority, therefore without any Democratic support. The GOP controls just 52 votes in the chamber, eight shy of what’s typically needed to move controversial measures that draw delaying tactics by opponents.

        Narrow Majority

        That narrow majority made it important for Senate leaders to try to hold every member’s vote; moderate Senator Susan Collins of Maine used that leverage to secure various concessions, including an agreement to enhance an individual deduction for large unreimbursed medical expenses through the end of next year. The House bill would eliminate that tax break.

        Democrats decried the bill’s deficit impact and complained they were shut out of the process to help draft the measure. They cited research showing that the legislation primarily benefits the nation’s highest earners and business owners, and will bleed federal revenues in a way that hurts domestic programs.

        “At a time of immense inequality, the Republican tax bill makes life easier on the well-off and eventually makes life more difficult on working Americans, exacerbating one of the most pressing problems we face as a nation — the yawning gap between the rich and everyone else,” said Minority Leader Chuck Schumer of New York during debate on the bill.

        ‘Back of a Napkin’

        Schumer noted that a set of last-minute revisions to the bill changed it in ways that had yet to be analyzed by the Joint Committee on Taxation, Congress’s official scorekeeper for the effects of tax legislation. “Is this really how Republicans are going to rewrite the tax code? Scrawled like something on the back of a napkin?”

        McConnell said the bill, the first text of which was introduced on Nov. 20, went “through the regular order.” He dismissed complaints like Schumer’s. “You complain about process when you’re losing,” McConnell said.

        Attention now shifts to a House-Senate conference committee — a specially appointed, temporary panel that will be charged with hashing out the differences in the bills and preparing a final version for both chambers to consider. Party leaders will select a small group of lawmakers, likely from the House and Senate tax-writing panels in each chamber, who would then be approved by each chamber.

        That work could start as early as Monday, with many high-stakes issues to be worked through. The deadline of Dec. 31 is an artificial one, though — aimed partly at securing a victory well in advance of the 2018 congressional elections. Republicans would have until the end of 2018 before they lose their ability to clear final passage in the Senate without a filibuster.

        Expensing Provision

        Both bills share some key central elements: They both almost double the standard deduction for individual taxpayers while eliminating personal exemptions. They both allow companies to fully and immediately deduct the cost of their spending on equipment for five years. But the Senate version would slowly step down the expensing provision after the five-year period — a feature that the House bill doesn’t provide for.

        Yet there are many differences — ranging from the taxation of business income to the amount set for the child tax credit — and Senate negotiators may have the upper hand during talks. That’s because the wafer-thin two-vote majority in the Senate will make it harder to usher a final bill back through that chamber.

        The House bill would consolidate the current seven individual tax brackets to four, leaving the top tax rate at 39.6 percent. The Senate bill would have seven brackets — with lower rates, and a top rate of 38.5 percent. Studies have shown that many of the tax bill’s benefits would go to the highest earners — and some middle-class taxpayers might actually pay more — a finding that could impact the House-Senate talks.

        The Senate bill includes a repeal of Obamacare’s mandate that most Americans have health insurance or pay a penalty. The House bill does not.

        Pass-Through Businesses

        Senators approved a 23 percent tax deduction — subject to certain limitations — on business income earned from partnerships, limited liabilities and other so-called pass-through businesses. The House version would create a 25 percent tax rate for such business income — with restrictions on which businesses could qualify. Small businesses would get extra relief under the House legislation as well.

        The House bill would also eliminate the estate tax, while the Senate version would limit the tax to fewer multimillion-dollar estates, but leave it in place. And after 2025, the limits would lift.

        Under current law, the estate tax applies a 40 percent levy to estates worth more than $5.49 million for individuals and $10.98 million for married couples. The Senate bill would temporarily double the exemption thresholds. The House bill would double the exemption thresholds, and then repeal the tax entirely in 2025.

          Read more: http://www.bloomberg.com/news/articles/2017-12-02/senate-passes-tax-cut-bill-in-milestone-move-toward-overhaul

          Senators share photos of GOP tax bill pages, and they’re pretty illegible

          Senate Majority Leader Mitch McConnell walks to his office in the Capitol as he awaits the vote on his party's tax plan.
          Image: alex wong/Getty Images

          We’ve all been there. You have your assignment printed and ready to go, but are frantically scribbling down last minute additions in the desperate hope that you’ll get a passing grade.

          This was OK in high school English class, but what about in the U.S. Senate? 

          After several failed attempts to repeal and replace Obamacare, Senate Republicans are really doing everything they can get a legislative win once and for all with their tax plan—including making hasty and nearly illegible handwritten notes and straight up crossed out sections of the bill. 

          Their Democratic counterparts have been sharing photos of the absurdity, and they’re not too happy about it. 

          Sen. Jon Tester of Montana posted an angry video calling out his Republican counterparts and their scribbled legislative notes on Twitter. He said he had received his copy of the bill 25 minutes earlier, just a few hours before the Senate vote. 

          Just an hour before she had to report to the Senate floor for a vote, Sen. Elizabeth Warren also posted a video of her trying to read the messy bill. She couldn’t. 

          If passed by the Senate and the House and signed into law, the tax plan would make a massive cut to the corporate tax rate, give several tax cuts and benefits to the wealthiest Americans, and get rid of the individual health insurance mandate, among many, many other things. 

          With so many changes to the way our tax system works on the line, representatives should at least be able to know what decisions they’re making on behalf of their constituents, because, you know … democracy.

          Read more: http://mashable.com/2017/12/01/senators-gop-tax-plan/

          We should all be working a four-day week. Heres why | Owen Jones

          Ending life-sapping excessive hours was a pioneering demand for the labour movement. For the sake of our health and the economy we need to revisit it

          Imagine there was a single policy that would slash unemployment and underemployment, tackle health conditions ranging from mental distress to high blood pressure, increase productivity, help the environment, improve family lives, encourage men to do more household tasks, and make people happier. It sounds fantastical, but it exists, and its overdue: the introductionof a four-day week.

          The liberation of workers from excessive work was one of the pioneering demands of the labour movement. From the ashes of the civil war, American trade unionism rallied behind an eight-hour day, a movement which ran with express speed from the Atlantic to the Pacific, from New England to California, as Karl Marx put it. In 1890 hundreds of thousands thronged into Hyde Park in a historic protest for the same demand. It is a cause that urgently needs reclaiming.

          Many Britons work too much. Its notjust the 37.5 hours a week clocked up on average by full-time workers; itsthe unpaid overtime too. According to the TUC, workers put in 2.1bn unpaid hours last year thats an astonishing 33.6bn of free labour.

          That overwork causes significant damage. Last year, 12.5m work days were lost because of work-related stress, depression or anxiety. The biggest single cause by a long way in some 44% of cases was workload. Stress can heighten the risk of all manner of health problems, from high blood pressure to strokes. Research even suggests that working long hours increases the risk of excessive drinking. And then theres the economic cost: over 5bn a year, according to the Health and Safety Executive. Nowonder the public health expert John Ashton is among those suggesting a four-day week could improve the nations health.

          So the renewed call for a four-day week from Autonomy Institute is very welcome. We want to shift peoples perspectives, to better work and less work, says the thinktanks Will Stronge. Indeed, a deeply unhealthy distribution of work scars our society. While some are working too much, with damaging consequences for their health and family lives, there are 3.3 million or so underemployed workers who want more hours. A four-day week would force a redistribution of these hours, to the benefit of everyone. This will be even more important if automation in sectors such as manufacturing, administration and retail creates more poorly paid work and more underemployment.

          A four-day working week could alsohelp tackle climate change: as the New Economics Foundation thinktank notes, countries with shorter working weeks are more likely to have a smaller carbon footprint. This is no economy-wrecking suggestion either. German and Dutch employees work less than we do but their economies are stronger than ours. It could boost productivity: the evidence suggests if you work fewerhours, you are more productive, hour for hour and less stress means less time off work. Indeed, a recent experiment with a six-hour working dayat a Swedish nursing home produced promising results: higher productivity and fewer sick days. If those productivity gains are passed on to staff, working fewer hours doesntnecessarily entail a pay cut.

          Then theres the argument for gender equality. Despite the strides made by the womens movement, women still do 60% more unpaid household work on average than men. An extra day off workis not going to inevitably lead to men pulling their weight more at home. But, as Autonomy suggests, a four-day week could be unveiled as part of a driveto promote equal relationships between men and women. A national campaign could encourage men to use their new free time to equally balance household labour, which remains defined by sexist attitudes.

          It is heartening to see the resurrectionof one of the great early causes of the labour movement. Germanys biggest union, IG Metall, is calling for a 28-hour week for shift workers and those with caring responsibilities.

          That said, on its own the demand is not enough. Now that socialism is re-emerging as a political force that can no longer be ignored or ridiculed, the struggle for more time for leisure, family and relaxation should be linked to broader fights. Increased public ownership of the economy should be structured to create more worker self-management and control. If technology means a further reduction in secure work, a universal basic income a basic stipend paid to all citizens as a right may become ever more salient.

          Sure, work can be a fulfilling activity for some. It strikes me, though, that few would disagree with the notion that we should spend more time with our families, watching our children grow, exercising, reading books, or just relaxing. So much of our lives is surrendered to subordinating ourselves to the needs and whims of others, turning human beings into cash cows rather than independent, well-roundedindividuals.

          Our social model means economic growth all too often involves concentrating wealth produced by the many into the bank accounts of the few, without improving the lives of the majority. Growth should deliver not justshared prosperity and improved public services but a better balance between work, family and leisure.

          Labour politicians now position themselves as the harbingers of a new society, not mere tinkerers with the existing order. That must surely mean building a new economy that lightens the freedom-sapping burden of work. Labour may win the opportunity to build a socialist Britain. If it does, it must be ambitious enough to liberate citizens from the excesses of work.

          Read more: https://www.theguardian.com/commentisfree/2017/nov/16/working-four-day-week-hours-labour