Assumed Conditions


In the practice of American and Canadian life insurance companies, asbestos workers are generally declined on account of the assumed health-injurious conditions of the industry. — Frederick L. Hoffman, chief actuary, Prudential Life Insurance Company, 1918

The fibrosis of this disease is irreversible and permanent so that eventually compensation will be paid to each of these men. But, as long as the man is not disabled it is felt that he should not be told of his condition so that he can live and work in peace and the company can benefit by his many years of experience. — Dr. Kenneth W. Smith, medical director, Johns-Manville Corporation, 1949

They told me that his death was due to industrially incurred disease from asbestos particles in the lungs, but my appeal for burial and medical expenses was turned down due to statutes of limitations. — from a letter by a Johns-Manville widow, published in Outrageous Misconduct by Paul Brodeur, 1985

In this week’s Sift:

  • The Next Time You’re in the Bookstore … look for Doubt Is Their Product by David Michaels. I used to think the tobacco companies were the exception. Now I understand that they’re the model.
  • Can Obama Compromise on Health Care? It sounds simple and obvious to go halfway, but the pieces of health-care reform don’t separate easily.
  • Dick Being Dick. The Cheney Family goes on another Torture Misinformation Tour. Why exactly are we listening to these people?
  • Short Notes. Robbing the low-wage workers. The sad state of economics. Long-running political soap operas. And homeless children in our schools.

The Next Time You’re In the Bookstore …

… look for Doubt Is Their Product: How Industry’s Assault on Science Threatens Your Health by David Michaels.

I found this to be a radicalizing book. Each chapter examines a separate example of an industry that knew it was probably killing either its workers or its customers, and how it maneuvered to be allowed to keep on killing them.

What becomes apparent is that this is standard procedure. Sure, nobody creates a product with the idea of killing workers or customers. But if a corporation finds out that either its product or its processes are deadly, there is now an entire industry of firms and consultants that help it “manage” the situation and keep the profits rolling as long as possible — maybe for decades.

The blueprint.The tobacco companies were the trail-blazers, and the path they trod is now well mapped and widely followed:

  1. Hide the data you’ve collected as long as possible. Claim that any internal reports you wrote would reveal your “trade secrets”.
  2. Discourage other people from collecting or publishing data. If you can intimidate or destroy the reputations of the researchers who try, so much the better.
  3. Argue that there is not enough data to justify regulating your product or the process by which you manufacture it.
  4. When independent studies are prove that your product kills people, hire your own scientists to obfuscate the issue. No matter how egregiously they have to abuse scientific method, you can publish their results in “scientific journals” set up by you and other like-minded corporations.
  5. Argue that there is no scientific consensus on the harmfulness of your product. Regulation should be delayed until “conclusive” research is done. Then fight the funding of that research, because there’s not enough evidence to justify an effort to gather evidence.
  6. When regulation becomes inevitable, argue that only the exposure levels that have been proven harmful should be banned. Below that, argue that there might be a “threshold effect”. In fact, no one has ever found a threshold for a carcinogen. If some level of exposure causes cancer in 1 out of every 10 people, a lower level might only cause cancer in 1 out of 100 or 1 out of 10,000. But it still kills people.
  7. Fight every attempt to tighten the initially weak standard you got into the first regulation. Lobby, bribe, threaten — do whatever you have to do to influence Congress and the regulating agency. At every proposed tightening of the standard, start a new round of obfuscation and claim that the science is unclear.
  8. Lobby to diminish or eliminate funding for the agency that enforces the regulations. Uninspected is almost as good as unregulated.
  9. When the jig is up, hide behind the government. You always complied with the regulations — or at least no one can prove you didn’t. And the FDA or EPA (or whoever) could have banned your product, but didn’t. So it’s their fault — you should be immune from liability. The Bush administration actually tried to make this federal policy, in a push known as preemption immunity.

In short, as long as the government can’t assemble (over your constant roadblocks) 100%-conclusive proof that you’re killing people, you shouldn’t be regulated. And as long as no one can prove that you didn’t follow all regulations applicable at the time, you shouldn’t be liable. And if you have trouble carrying out this plan, there are public relations firms that will guide you through it, and other firms that specialize in providing the obfuscating scientific reports you’ll need.

Why they get away with it. The striking thing about this pattern is that the individual steps sound reasonable. And that’s always how you hear them. When some corporate flack on TV claims that his company is being regulated or sued based on flimsy evidence, no one points out that his corporation caused that lack of evidence and has manipulated it to its own advantage.

But when you see the pattern laid out end-to-end, it’s just premeditated murder. Go back and re-read this week’s opening quotes and consider whether Johns-Manville murdered its asbestos workers. They did. Now look at the speech then-Majority Leader Senator Bill Frist gave describing Johns-Manville as a “reputable company” that had been driven into bankruptcy by litigation. (Damn those asbestos-injury lawyers and what President Bush called their “junk lawsuits“.)

Corporations get away with this because the public has been primed to hear their arguments. A very effective propaganda campaign tells us every day that industry is burdened by unreasonable regulations and lawsuits run wild. The discussion you hear in the mainstream media takes for granted that regulation is a drag on our economy.

In fact the opposite is true: American industry is vastly under-regulated, and regulating it effectively would be a huge boon to our economy. Good regulation saves money, because it’s much more cost-effective to stop a Love Canal before it happens than to deal with its effects later.

And what do you think the long-term economic effects of this will be: American children born in the 1990s have higher IQs than children born in the 1970s. Why? Unleaded gasoline. Today’s young people are smarter because they breathed in much less lead while growing up. So if you look into the eyes of your kid or grandkid and see something sparkly looking back, thank government regulation.

Buttered popcorn. For me, the example that brings it all home is in Chapter 10. Most of us know that in the Bad Old Days industries did irresponsible things with heavy metals like lead or mercury or chromium, or with chemicals like dioxin or PCBs. But did you know that until just a couple years ago workers were dying to put the artificial butter flavor into microwave popcorn?

It’s true. The flavoring chemical was diacetyl, and while the FDA had approved it for eating, no one had ever tested what happens when people inhale it. Turns out they get the disease now known as popcorn lung. It was discovered, as most of these things are, by what Michaels calls “the body-in-the-morgue method”: Workers at a popcorn plant in Missouri started getting the same previously rare lung disease. At least one frequent popcorn-eater got it.

The government’s National Institute for Occupational Safety and Health recommended setting exposure standards for diacetyl in 2003, but (due either to step-8 underfunding or Bush-administration foot-dragging) OSHA couldn’t get around to it. By 2007 Rep. Lynn Woolsey introduced a bill to force OSHA’s hand. So naturally, the Bush administration and Republicans in Congress rose to protest this bill, using the step-5 “inconclusive research” dodge. During Congressional debate, Rep. Buck McKeon said:

More research currently is underway to determine a connection between diacetyl and this respiratory condition, and I fully support that research moving forward. Until the agency draws any conclusions, however, it is an open question as to whether diacetyl alone is to blame or whether the chemical, in combination with other agents, places workers at risk. … In short, without proper scientific research into this question, I do not see how we can effectively legislate on it.

You see, butter-flavored microwave popcorn is so essential to the American way of life that workers should continue dying until we’re absolutely sure what’s killing them. (The workers would have been much better off if terrorists had been poisoning them rather than their employers. Then the one-percent doctrine would have come into play, and even a small likelihood would have demanded a drastic response.)

Eventually, the popcorn lung story got enough exposure that the major microwave popcorn companies stopped using diacetyl. The impact on the economy seems to have been minimal. (And of course we know the new flavoring is perfectly safe.) But it’s still not illegal, and if you get an obscure popcorn brand, diacetyl might still be in there. Don’t inhale the steam when you open the bag.

Now, in some ways the popcorn workers were lucky. Because the disease that threatened them was so rare and showed up so quickly, not that many of them had to die before people started catching on. But chemicals that just increase the rates of more common diseases are much harder to recognize as dangerous. Probably there are factories whose long-term workers suffer an uncommon number of heart attacks or prostate cancers, and nobody notices.

Or maybe just the company notices.

Can Obama Compromise on Health Care?

On Wednesday, President Obama will give a nationally televised address to Congress about health-care reform. He’s expected to lay out what he wants, and to make a case for it to the nation. Everyone is trying to guess to what extent he’ll accept half a loaf, and if so, where he’ll compromise.

Words like compromise and bipartisan sound good, and suggest that if we only do half the job, it should only cost half as much. But the problem with designing half-way measures is that a lot of health-care reform ideas interlock. So if you just pick a few of them, it’s possible to make things worse, or to create a system that will be so unpopular that the public will never support finishing the job. Let’s go through the major reform ideas and see how they depend on each other.

The main idea.Sick people should get care, and paying for it shouldn’t drive them bankrupt. I wish every Democrat who spoke in public about health-care reform started with that statement. It frames health care in terms of people, and makes it a moral issue.

No pre-existing conditions.If you’re insured for everything but the illness you actually have, you’re not insured. No-pre-existing-conditions is the most popular reform idea. Even Republicans say they’re for it. So if you don’t get this, you don’t have reform at all.

No caps. Another very popular idea, for good reasons. If your insurance policy has a lifetime or annual cap, you’re covered unless you really get sick — then you’re not covered. That’s not insurance.

Mandates. Mandates say that people have to be insured, or somebody — either an employer or the individual — pays a penalty. Nobody likes being told what to do, so this is one of the least popular reforms. But it’s linked to no-pre-existing-conditions like this: If you’re healthy and the law says insurance companies can’t turn you down for being sick, the clever thing to do is to stay uninsured until you get sick. You get most of the benefits of insurance without paying the premiums. If a lot of people do that, then everybody else has to pay whopping premiums to make up for them.

Insurance companies love mandates. (What business wouldn’t love to have the government force people to buy its product?) Hospitals also love mandates, because their administrative costs go down if they can assume that everybody who comes in the door is covered.

Minimum coverage standards.If the law is going to mandate coverage, then it has to define what coverage means. Otherwise bogus insurance companies will sell worthless policies to individuals and employers who are just trying to avoid the mandate penalty. But defining coverage raises a bunch of hot-button issues like abortion.

Cost.Lowering coverage standards is one way to limit costs. A policy can be a lot cheaper if it has a high deductible, high co-pays, and covers broken legs and heart attacks but not mental health or plastic surgery.

Low cost is particularly important if you have a mandate, because you don’t want to force people to buy something they can’t afford. But there’s a trade-off, because a policy with a $2,000 deductible is useless if you don’t have $2,000. If you can’t go to the doctor because the co-pays and deductibles would bankrupt you, you’re not really insured.

Subsidies.No matter how far you lower the cost of coverage, there will be people who can’t pay it. So the government will have to pick up the full cost of insuring the poor, with a sliding subsidy that pays at least part of the cost of insurance for the working class. Otherwise a mandate is too onerous and the program will be wildly unpopular. Or, without a mandate, people will spend their premium-money on something else and gamble that they can stay healthy for the next few months.

Public option.
In many parts of the country, health insurance companies are like Coke and Pepsi: There only a handful of them, and they compete on advertising rather than on anything that matters, like price or quality. Now imagine that people are forced to buy their product and government money flows in to pay for it. What a gold mine! They can continue to raise premiums 10-15% a year without improving anything. So costs get out of hand unless there’s real competition, not Coke/Pepsi competition.

Democrats want competition to come from a government-run public option. I never (OK, rarely) hear anybody make this analogy, but the logic is similar to FDR starting the TVA and the rural electric co-ops: Non-profit power companies provided a point of comparison that kept the profit-making power companies honest.

Republicans want to increase competition by tearing down the barriers to interstate competition between private insurance companies. The Republican plan could work, but only under conditions they undoubtedly would not support. Their plan eliminates any protection you get from state regulators, so there would have to be federal regulation at least as strict as the strictest state. And without serious anti-trust enforcement, a merger binge would replace the current local insurance oligopolies with a national oligopoly. Competition, in other words, would be temporary.

Taxes and deficits. Now that the Democrats are in power, deficits matter again. People who didn’t blink at spending a trillion borrowed dollars to take over Iraq are horrified that caring for the sick might cost money. (It’s all in the New Testament you know: “Curse you to hell, for I was hungry and you didn’t feed me. I was naked and you didn’t clothe me. I was an oil-rich Middle Eastern country and you didn’t invade me.”)

Some moderate Democrats have pledged not to vote for a bill that increases the deficit. (Republicans aren’t going to vote for any bill, no matter what’s in it.) In the campaign, Obama talked about reversing the Bush tax cuts for people who make more than $250,000 a year, but any tax increases beyond that would be a huge loss of face for him.

So what can Obama give up to get more support? Not much that I can see. The danger, if you start compromising, is that you wind up forcing people to buy over-priced policies that don’t really cover them, the extra money flows to the insurance companies, and middle-class folks end up paying for it either in high premiums or increased taxes.

That’s not half a loaf, and it would be so unpopular that you’d never be able to go back and get the rest of the loaf. Obama would do better to push through a good bill on a one-vote margin, and trust the results to speak for themselves.

Let me hit the deficit point a little harder: About 3,000 people died in the 9-11 attacks, and that was a reason to spend literally trillions invading Afghanistan and Iraq, not to mention homeland security spending. No one asked how we would pay for it; it just had to be done.

Do you know how many American lives we could save if our death-from-treatable-conditions rate got down the level of France? More than 100,000 a year. That’s like preventing a 9-11 disaster every 11 days. What’s that worth to you?

Dick Being Dick

If a recent liberal administration had been as across-the-board disastrous as Bush-Cheney, I doubt we’d be hearing much from its leading players. But for some reason Dick Cheney can get on TV any time he wants to spout new lies and nonsense. And his daughter can too, which is even crazier.

The Cheney family’s latest grand tour concerned the classified memos Dick said would prove that torture worked. Redacted versions of the memos were released, and they did no such thing. So he altered his phrasing:

The documents released Monday, clearly demonstrate that the individuals subjected to Enhanced Interrogation Techniques provided the bulk of intelligence we gained about al Qaeda.

Ummm, yeah. But the documents pointedly don’t say — and you have to think they would if it were true — that enhanced interrogation got that information out of those individuals. Former FBI interrogator Ali Soufan says that it didn’t. He also brings up the piece of the puzzle everyone else leaves out: What intelligence did torture cost us?

It is surprising, as the eighth anniversary of 9/11 approaches, that none of Al Qaeda’s top leadership is in our custody. One damaging consequence of the harsh interrogation program was that the expert interrogators whose skills were deemed unnecessary to the new methods were forced out.

Defenders always say something like “they kept us safe” (except for that one time) to excuse all the other Bush-Cheney failures: not catching Bin Laden, not winning the wars they started, wrecking our economy, selling out our moral principles, etc. But President Clinton kept us just as safe, if not safer. Maybe Chelsea Clinton should be on all the Sunday talk shows to tell us how he did it.

Short Notes

Happy Labor Day. A new study surveyed thousands of low-wage workers our three biggest cities. They found that underpaid wages, late paychecks, unpaid overtime, and various other abuses were common. “We estimate that 1.1 million workers across the three cities are robbed of $56.4 million every week because of employment and labor law violations.”

Paul Krugman sums up the current state of economics.

Not even a Death Panel can pull the plug on bad political soap operas: Sarah Palin and Rod Blagojevich.

What are the public schools supposed to do with one million homeless pupils? “We see 8-year-olds telling Mom not to worry, don’t cry.”

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