The Cult of Selfishness Is Killing America

The right has made irresponsible behavior a key principle.

America’s response to the coronavirus has been a lose-lose proposition.

The Trump administration and governors like Florida’s Ron DeSantis insisted that there was no trade-off between economic growth and controlling the disease, and they were right — but not in the way they expected.

Premature reopening led to a surge in infections: Adjusted for population, Americans are currently dying from Covid-19 at around 15 times the rate in the European Union or Canada. Yet the “rocket ship” recovery Donald Trump promised has crashed and burned: Job growth appears to have stalled or reversed, especially in states that were most aggressive about lifting social distancing mandates, and early indications are that the U.S. economy is lagging behind the economies of major European nations.

So we’re failing dismally on both the epidemiological and the economic fronts. But why?

On the face of it, the answer is that Trump and allies were so eager to see big jobs numbers that they ignored both infection risks and the way a resurgent pandemic would undermine the economy. As I and others have said, they failed the marshmallow test, sacrificing the future because they weren’t willing to show a little patience.

And there’s surely a lot to that explanation. But it isn’t the whole story.

For one thing, people truly focused on restarting the economy should have been big supporters of measures to limit infections without hurting business — above all, getting Americans to wear face masks. Instead, Trump ridiculed those in masks as “politically correct,” while Republican governors not only refused to mandate mask-wearing, but they prevented mayors from imposing local mask rules.

Also, politicians eager to see the economy bounce back should have wanted to sustain consumer purchasing power until wages recovered. Instead, Senate Republicans ignored the looming July 31 expiration of special unemployment benefits, which means that tens of millions of workers are about to see a huge hit to their incomes, damaging the economy as a whole.

So what was going on? Were our leaders just stupid? Well, maybe. But there’s a deeper explanation of the profoundly self-destructive behavior of Trump and his allies: They were all members of America’s cult of selfishness.

You see, the modern U.S. right is committed to the proposition that greed is good, that we’re all better off when individuals engage in the untrammeled pursuit of self-interest. In their vision, unrestricted profit maximization by businesses and unregulated consumer choice is the recipe for a good society.

Support for this proposition is, if anything, more emotional than intellectual. I’ve long been struck by the intensity of right-wing anger against relatively trivial regulations, like bans on phosphates in detergent and efficiency standards for light bulbs. It’s the principle of the thing: Many on the right are enraged at any suggestion that their actions should take other people’s welfare into account.

This rage is sometimes portrayed as love of freedom. But people who insist on the right to pollute are notably unbothered by, say, federal agents tear-gassing peaceful protesters. What they call “freedom” is actually absence of responsibility.

Rational policy in a pandemic, however, is all about taking responsibility. The main reason you shouldn’t go to a bar and should wear a mask isn’t self-protection, although that’s part of it; the point is that congregating in noisy, crowded spaces or exhaling droplets into shared air puts others at risk. And that’s the kind of thing America’s right just hates, hates to hear.

Indeed, it sometimes seems as if right-wingers actually make a point of behaving irresponsibly. Remember how Senator Rand Paul, who was worried that he might have Covid-19 (he did), wandered around the Senate and even used the gym while waiting for his test results?

Anger at any suggestion of social responsibility also helps explain the looming fiscal catastrophe. It’s striking how emotional many Republicans get in their opposition to the temporary rise in unemployment benefits; for example, Senator Lindsey Graham declared that these benefits would be extended “over our dead bodies.” Why such hatred?

It’s not because the benefits are making workers unwilling to take jobs. There’s no evidence that this is happening — it’s just something Republicans want to believe. And in any case, economic arguments can’t explain the rage.

Again, it’s the principle. Aiding the unemployed, even if their joblessness isn’t their own fault, is a tacit admission that lucky Americans should help their less-fortunate fellow citizens. And that’s an admission the right doesn’t want to make.

Just to be clear, I’m not saying that Republicans are selfish. We’d be doing much better if that were all there were to it. The point, instead, is that they’ve sacralized selfishness, hurting their own political prospects by insisting on the right to act selfishly even when it hurts others.

What the coronavirus has revealed is the power of America’s cult of selfishness. And this cult is killing us.

What Wall Street Doesn’t Want You to Know About Hospital Emergency Rooms

Yves here. We’ve written regularly on Eileen Appelbaum and Rosemary Batt’s important investigations into how private equity has taken over more and more of hospital staffing, including of emergency rooms. This in turn has allowed them to override patient efforts to have only in-network doctors assigned to their case, as well as to engage in other practices that greatly inflate patient charges (so-called surprise billing).

The legal fig leaf that allows private equity firms like Blackstone and KKR to play doctor is that their deals are structured so that  MD or group of MDs is the nominal owner of the specialty practice, even though the business is stripped of its assets and the operating contracts are widely believed to strip them of any say. The now-notorious incident of Blackstone’s TeamHealth firing whistleblower Dr. Ming Lin confirms who is really in charge.

By Eileen Appelbaum, the Co-Director of the Center for Economic and Policy Research and visiting professor, School of Management, University of Leicester, UK and Rosemary Batt, the Alice Hanson Cook Professor of Women and Work, Cornell University ILR School. Produced by Economy for All, a project of the Independent Media Institute

Doctor Ming Lin is the first emergency room doctor to be fired for going public with his concerns about poor hospital emergency room safety practices and shortages of medical supplies and protective gear for health workers. He won’t be the last.

Like many hospitals in the US, PeaceHealth St. Joseph Medical Center in Bellingham Washington, where Ming Lin worked for the past 17 years as an emergency room doctor, has outsourced the management and staffing of its emergency rooms. So, Lin works on-site at the hospital’s emergency room, but he is employed by a physician staffing firm that runs the emergency room. These staffing firms are often behind the surprise medical bills for emergency room services that patients receive after their insurance company has paid the hospital and doctors, but not the excessive out-of-network charges billed by these outside staffing firms.

About a third of hospital emergency rooms are staffed by doctors on the payrolls of two physician staffing companies—TeamHealth and Envision Health—owned by Wall Street investment firms. Envision Healthcare employs 69,000 healthcare workers nationwide while TeamHealth employs 20,000. Private equity firm Blackstone Group owns TeamHealth, Kravis Kohlberg Roberts (KKR) owns Envision.

Care of the sick is not the mission of these companies; their mission is to make outsized profits for the private equity firms and its investors. Overcharging patients and insurance companies for providing urgent and desperately needed emergency medical care is bad enough. But it is unconscionable to muzzle doctors who speak out to advocate for the health of their patients and co-workers during the global pandemic that is rapidly spreading across the US.

Yet, that is what Blackstone-owned TeamHealth just did. Why would an experienced emergency room doctor be fired in the middle of a pandemic? One clue may be that Blackstone’s CEO, Stephen A. Schwarzman, is part of President Trump’s inner circle. He may not want to risk that relationship by allowing TeamHealth’s doctors to inform the public about Washington’s mishandling of the allocation of supplies and protective gear. The President might conclude that TeamHealth doctors didn’t appreciate him enough, and where would that leave Schwartzman?

PeaceHealth St. Joseph Medical Center may have the distinction of being the first hospital to have a doctor outsourced from a physician staffing firm unceremoniously fired for telling the public the truth. But it won’t be the last. Hospitals are now telling doctors treating coronavirus patients they will be fired if they speak to the press.

The American Academy of Emergency Medicine protested Dr. Lin’s ouster and questioned how TeamHealth is allowed to provide hospital services when the law requires that physician practices must be owned by a licensed medical practitioner. TeamHealth skirts the law by owning all the assets of the physician practices it acquires—the real estate, offices, equipment, supplies, inventory, and even accounts receivable.

On paper, the physician practices are owned by a doctor-led organization that TeamHealth has set up to comply with the law. But what does it mean to own a physician practice if the practice has no assets and no possibility to exist on its own?

The furor over patients hit by surprise medical bills revealed that TeamHealth controls the billing for the doctors it supplies to hospital emergency rooms. The firing of Doctor Ming Lin pulls back the curtain and reveals that TeamHealth controls the doctors as well.

Power doesn’t always corrupt ..

Power doesn’t ­always corrupt, and you can see it in the case of, for example, Al Smith or Sam Rayburn. There, power cleanses. But what power always does is reveal, because when you’re climbing, you have to conceal from people what it is you’re really willing to do, what it is you want to do. But once you get enough power, once you’re there, where you wanted to be all along, then you can see what the protagonist wanted to do all along, because now he’s doing it.