#CEPR

[mostlysignssomeportents]

Private equity finally delivered Sarah Palin's death panels

Tonight (Apr 26), I’ll be in Burbank, signing Red Team Blues at Dark Delicacies at 6PM.

Remember “death panels”? Sarah Palin promised us that universal healthcare was a prelude to a Stalinist nightmare in which unaccountable bureaucrats decided who lived or died based on a cost-benefit analysis of what it would cost to keep you alive versus how much your life was worth.

If you’d like an essay-formatted version of this post to read or share, here’s a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2023/04/26/death-panels/#what-the-heck-is-going-on-with-CMS

Palin was right that any kind of healthcare rationing runs the risk of this kind of calculus, where we weight spending $10,000 to extend a young, healthy person’s life by 40 years against $1,000 to extend an elderly, disabled person’s life by a mere two years.

It’s a ghastly, nightmarish prospect — as anyone who uses the private healthcare system knows very well. More than 27m Americans have no health insurance, and millions more have been tricked into buying scam “cost-sharing” systems run by evangelical grifters:

https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html

But for the millions of Americans with insurance, death panels are an everyday occurrence, or at least a lurking concern. Anyone who pays attention knows that insurers have entire departments designed to mass-reject legitimate claims and stall patients who demand that the insurer lives up to its claim:

https://kffhealthnews.org/news/article/khn-podcast-an-arm-and-a-leg-how-to-shop-for-health-insurance-november-24-2021/

The private healthcare sector is designed to deny care. Its first duty is to its shareholders, not its patients, and every dollar spent on care is a dollar not available for dividends. The ideal insurance customer pays their premiums without complaint, and then pays cash for all their care on top of it.

All that was true even before private equity started buying up and merging whole swathes of the US healthcare system (or “healthcare” “system”). The PE playbook — slash wages, sell off physical plant, slash wages, reduce quality and raise prices — works in part because of its scale. These aren’t the usual economies of scale. Rather the PE strategy is to buy and merge all the similar businesses in a region, so customers, suppliers and workers have nowhere else to turn.

That’s bad enough when it’s aimed at funeral homes, pet groomers or any of the other sectors that have been bigfooted by PE:

https://pluralistic.net/2022/12/16/schumpeterian-terrorism/#deliberately-broken

But it’s especially grave when applied to hospitals:

https://pluralistic.net/2020/05/21/profitable-butchers/#looted

Or emergency room physicians:

https://pluralistic.net/2022/03/14/unhealthy-finances/#steins-law

And if you think that’s a capitalist hellscape nightmare, just imagine how PE deals with dying, elderly people. Yes, PE has transformed the hospice industry, and it’s even worse than you imagine.

Yesterday, the Center for Economic and Policy Research published “Preying on the Dying: Private Equity Gets Rich in Hospice Care,” written by some of the nation’s most valiant PE slayers: Eileen Appelbaum, Rosemary Batt and Emma Curchin:

https://cepr.net/report/preying-on-the-dying-private-equity-gets-rich-in-hospice-care/

Medicare pays private hospices $203-$1,462 per day to take care of dying old people — seniors that a doctor has certified to have less than six months left. That comes to $22.4b/year in public transfers to private hospices. If hospices that $1,462 day-rate, they have lots of duties, like providing eight hours’ worth of home care. But if the hospice is content to take the $203/day rate, they are not required to do anything. Literally. It’s just free money for whatever the operator feels like doing for a dying elderly person, including doing nothing at all.

As Appelbaum told Maureen Tkacik for her excellent writeup in The American Prospect: “Why anybody commits fraud is a mystery to me, because you can make so much money playing within the guidelines the way the payment scheme operates.”

https://prospect.org/health/2023-04-26-born-to-die-hospice-care/

In California, it’s very, very easy to set up a hospice. Pay $3,000, fill in some paperwork (or don’t — no one checks it, ever), and you’re ready to start caring for beloved parents, grandparents, sisters, brothers, aunts and uncles as they depart this world. You do get a site inspection, but don’t worry — you aren’t required to bring your site up to code until after you’re licensed, and again, they never check — not even if there are multiple complaints. After all, no one at the Centers for Medicare & Medicaid Services (CMS) has the job of tracking complaints.

This is absolute catnip for private equity — free government money, no obligations, no enforcement, and the people you harm are literally dying and can’t complain. What’s not to like? No wonder PE companies have spent billions “rolling up” hospices across the country. There are 591 hospices in Van Nuys, CA alone — but at least 30 of them share a single medical director:

https://auditor.ca.gov/reports/2021-123/index.html#pg34A

Medicare caps per-patient dispersals at $32,000, which presents an interesting commercial question for remorseless, paperclip-maximizing, grandparent-devouring private equity ghouls: do you take in sick patients (who cost more, but die sooner) or healthy patients (cost less, potentially live longer)?

In Van Nuys, the strategy is to bring in healthy patients and do nothing. 51% of Van Nuys hospice patients are “live discharged” — that is, they don’t die. This figure — triple the national average — is “a reliable sign of fraud.”

There are so many hospice scams and most of them are so stupid that it takes a monumental failure of oversight not to catch and prevent them. Here’s a goodun: hospices bribe doctors to “admit” patients to a hospice without their knowledge. The hospice bills for the patient, but otherwise has no contact with them. This can go on for a long time, until the patient tries to visit the doctor and discovers that their Medicare has been canceled (you lose your Medicare once you go into hospice).

Another scam: offer patients the loosest narcotics policy in town, promising all the opioids they want. Then, once their benefits expire, let them die of an overdose (don’t worry, people who die in hospice don’t get autopsies):

https://www.newyorker.com/magazine/2022/12/05/how-hospice-became-a-for-profit-hustle

You can hire con artists to serve as your sales-force, and have them talk vulnerable, elderly people into enrolling in hospice care by convincing them they have nothing to live for and should just die already and not burden their loved ones any longer.

Hospitals and hospices also collude: hospitals can revive dying patients, ignoring their Do Not Resuscitate orders, so they can be transfered to a hospice and die there, saving the hospital from adding another dead patient to their stats.CMS’s solution is perverse: they’re working with Humana to expand Medicare Advantage (a scam that convinces patients to give up Medicare and enrol in a private insurance program, whose private-sector death panel rejects 13% of claims that Medicare would have paid for). The program will pay private companies $32,000 for every patient who agrees to cease care and die. As our friends on the right like to say, “incentives matter.”

Appelbaum and co have a better idea:

Do more enforcement: increase inspections and audits.

Block mergers and rollups of hospices that make them too big to fail and too big to jail.

Close existing loopholes.

They should know. Appelbaum and her co-authors write the best, most incisive analysis of private equity around. For more of their work, check out their proposal for ending pension-plan ripoffs by Wall Street firms:

https://pluralistic.net/2022/05/05/mego/#A09948

Catch me on tour with Red Team Blues in Burbank, Mountain View, Berkeley, San Francisco, Portland, Vancouver, Calgary, Toronto, DC, Gaithersburg, Oxford, Hay, Manchester, Nottingham, London, and Berlin!

[Image ID: An industrial meat grinder, fed by a conveyor belt. A dead, elderly man is traveling up the conveyor, headed for the grinder's intake. The grinder is labelled 'HOSPICE' in drippy Hallowe'en lettering. It sits in a spreading pool of blood.]

Image: Seydelmann (modified) https://commons.wikimedia.org/wiki/File:GW300_1.jpghttps://commons.wikimedia.org/wiki/File:GW300_1.jpg

CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0/deed.en

[kp777]

By Olivia Rosane

Common Dreams

Oct. 13, 2023

"As the scale of climate change impresses itself more and more on us, we are going to need bolder things," Stiglitz said at the IMF and World Bank's annual meeting in Morocco.

The International Monetary Fund, or IMF, should give poorer nations $300 billion a year to respond to the climate emergency, Nobel Prize-winning economist Joseph Stiglitz said.

Stiglitz outlined his recommendation in an interview with The Guardian as he attended the fund's annual meeting with the World Bank in Marrakesh, Morocco, which runs from Monday, October 9 to Sunday, October 15.

"As the scale of climate change impresses itself more and more on us, we are going to need bolder things," Stiglitz said.

In his call, Stiglitz joined the push for the IMF to release more Special Drawing Rights (SDRs), a reserve asset that can be exchanged for cash. Wealthy nations also have the option of placing their SDRs in a fund for poorer countries.

"Basically, it is printing money," Stiglitz said. "It wouldn't be inflationary but it would be transformative."

Stiglitz' remarks came about a week after nearly 60 U.S. Democratic lawmakers sent a letter to President Joe Biden and Treasury Secretary Janet Yellen asking them to support a new allocation of SDRs. The IMF issued $650 billion in SDRs in 2021 to help with the recovery from the Covid-19 pandemic, and the legislators wanted it to issue the same amount to help nations address the climate crisis, war, and future pandemics.

Stiglitz's call is even bolder at $300 billion a year, because the lawmakers limited themselves to an amount that the IMF could approve without a vote from Congress. While Stiglitz acknowledged his plan was ambitious and unlikely to pass through the current U.S. Congress, it was worth pushing for given the urgency of the moment.

"When the time comes and we are frying and somebody says: 'How do we get out of the frying pan?,' this [annual SDR allocations] is one way of doing so," he told The Guardian.

Stiglitz said the money should be used to help poorer nations fund their equivalent to the U.S. Inflation Reduction Act—which invested $370 billion in renewable energy. But it's impossible for less wealthy countries to make that kind of investment on their own, Stiglitz said.

"Developing countries can't do it on any scale," he told The Guardian. "Unless developing countries and emerging markets reduce their emissions, no matter what pieties we do in the U.S. and Europe, we will get global warming. The rhetoric is about doing something about climate change and then rather than getting onboard [the people] you most need to get onboard, you alienate them."

In a report published Thursday, the Center for Economic and Policy Research (CEPR) agreed that many poorer nations are not in the financial position to take ambitious climate action, and proposed more SDRs as one potential remedy. What's holding them back, CEPR said, was a large debt burden: Almost 80 low-to-middle-income countries face debt distress, and three-fourths of these are especially vulnerable to climate impacts. This creates a "vicious cycle" in which countries struggle to both service debt and respond to extreme weather events, leaving them unable to either get out of debt or recover from disasters and invest in the future.

"Most of the world is going through what many have termed a 'polycrisis,' facing down high levels of external debt, combined with interlocking crises of food insecurity, fluctuating energy prices, impacts of war, and of course, the climate crisis," report coauthor Ivana Vasic Lalovic said in a statement. "Countries are limited in what they can do to respond to the climate crisis, though, when they are forced to divert so much of their resources toward servicing their debts."

The report, titled The Growing Debt Burdens of Global South Countries: Standing in the Way of Climate and Development Goals, called on major financial institutions to address the situation by updating debt resolution frameworks, providing debt relief, financing through grants instead of loans, and allocating more Special Drawing Rights (SDRs).

"The international finance community needs to accept that the current dynamic, which prioritizes debt service–no matter how burdensome–over human needs and the urgency of climate crisis preparedness and response is unsustainable," coauthor Lara Merling said in a statement. "They need to step forward with solutions. Millions of lives may depend on it."

[memecucker]

Most in US want arms shipments to Israel to stop, poll says

A narrow majority of U.S. adults, 52%, said American arms shipments should be stopped until Israel ends its attacks in Gaza, according to a YouGov poll released on March 11. Less than one-third of respondents, 27%, said the shipments should not be halted, and 21% were unsure.

The poll, commissioned by the Center for Economic and Policy Research (CEPR) — a think tank in Washington, D.C. — sampled 1,000 U.S. adults, and has a margin of error of plus or minus 3.5 percentage points.

The question over additional military aid revealed a strong partisan divide among respondents.

The majority of respondents, 62%, who said they voted for President Joe Biden in 2020 agreed with the statement “The US should stop weapons shipments to Israel until Israel discontinues its attacks on the people of Gaza,” while 14% disagreed.

On the other hand, 30% of respondents who said they voted for former President Donald Trump in 2020 supported stopping the shipments, while 55% opposed it.

Additionally, 60% of respondents who said they sat out the 2020 election favored stopping shipments, 17% were opposed and 23% were unsure.

“The support for halting weapons shipments is specific and unambiguous,” Mark Weisbrot, Co-director of the Center for Economic and Policy Research, said in a CEPR news release.

The U.S. has sent Israel tens of thousands of arms — including precision-guided missiles and bombs — since the Oct. 7 attack that left 1,200 Israelis dead, according to The Wall Street Journal. Many of the shipments have been green-lit through a process that avoids congressional review and public disclosure.

[y0ur-maj3sty]

unLabor Day

Labor Day was designed to mock and prolong the servitude of the American worker. But nowadays, it’s just one more reason to drink alcohol and act dumb. It wasn’t designed to be a day to praise the so-called “social and economic achievement” of those workers, as the Department of Labor wants us to naively believe. We work day and night to keep devilish forces(The Powers That Be) in power and this country afloat, all while being stuck at a job that most people aren’t pleased with, for sometimes less than adequate wages. At the very least, more than one day a year ought to be sanctioned for giving “praise” to the Chinese American worker. Let’s be honest here, we work for China.

This day came about, not too long after the Industrial Revolution, where even children worked LONG HOURS for LOW WAGES. President Cleveland enacted it during his administration. At the most basic level, the purpose of Labor Day is to re-salt the un-healing wounds of the American laborer. Then stores have sales and hard earned money is spend there. It’s all part of the plan. America has the least amount of paid vacation and holiday days, according to The Center for Economic Policy Research (CEPR). Just take a look at Italy, Portugal, Germany, Austria, Belgium, New Zealand and Spain. They’ve got more of them then us by a long shot. The U.S. is sitting next to Japan in terms of days off. Also noted by the CEPR, “23% of American workers don’t receive paid time off, that number jumps to 49% for the bottom fourth of wage earners”. U.S. law doesn’t promise paid holidays either, while other countries provide 5 to 13 paid holidays per year…on top of vacation days, which are also paid.

People are brainwashed. For some reason we still celebrate Labor Day, though corporations are downsizing, labor unions are losing membership, and the stock market rises when people get fired. Those of us who still have jobs, or need a job, wonder whether anyone in charge cares about labor anymore.

[crazy-webadas]

quemen a la cepre uni

[mariacallous]

Russia’s most recent invasion of Ukraine on February 24 triggered the largest conflict in Europe since World War II with devastating and enduring humanitarian and economic consequences. According to the United Nations, it has forced nearly one-third of Ukrainians from their homes (dispersing 7.8 million refugees throughout Europe and displacing 6.2 million internally) and killed or injured more than 16,000 civilians. (The UN notes actual casualty numbers likely are considerably higher.) The war has destroyed at least $127 billion of the nation’s buildings and other infrastructure, according to the Kyiv School of Economics. The International Monetary Fund (IMF) projects that Ukraine’s GDP will decline 35% this year. Inflation is running at more than 20%, in large part because the government is relying on the central bank to finance its budget deficit.

Ukraine’s allies—including members of the European Union (EU) and the United States—have provided billions of dollars’ worth of military assistance and humanitarian relief. In May, President Biden signed a $40 billion package of assistance into law, and he signed an additional $12.3 billion package of assistance into law in September. The administration was aiming to disburse $13 billion of economic assistance in 2022.

Even as Ukraine continues its efforts to reclaim territory occupied by Russia, the Ukrainian government and those of its allies, as well as international financial institutions and think tanks around the world, are planning the governance and financing of its recovery in the months immediately after the war and its longer-term reconstruction and modernization. Though the duration of the war remains uncertain, all parties believe now is the time to begin planning for Ukraine’s future.

This background paper summarizes various proposals for organizing the post-war reconstruction of Ukraine. The governments of Ukraine and donor countries are currently discussing a “coordination platform” for aid.

Reconstruction Planning

Soon after the invasion, the governments of Ukraine and its allies, international financial institutions, and non-governmental policy and research organizations began developing economic reconstruction plans of varying degrees of detail and with widely varying estimates of the funding needs:

The World Bank published a paper in April on Ukraine’s short-term relief and longer-term reconstruction needs (subsequently estimated at $349 billion and rising as of June 1).

The London-based Centre for Economic Policy Research (CEPR) offered A Blueprint for the Reconstruction of Ukraine, also in April, with an estimated cost of €200 billion to €500 billion, increasing as the war continues. In August, CEPR issued Macroeconomic Policies for Wartime Ukraine, which outlined policies to put the Ukrainian economy on a sustainable trajectory for the duration of the war.

The European Commission in May issued its RebuildUkraine Jointly with the World Bank, it later estimated costs of reconstruction, as of June 1, at $349 billion and rising.

The Ukrainian government presented a 10-year, $750 billion plan in July at the Ukraine Recovery Conference in Lugano, Switzerland.

The German Marshall Fund of the United States (GMF), headquartered in Washington, D.C., published Designing Ukraine’s Recovery in the Spirit of the Marshall Plan in September.

Other institutions have provided emergency assistance and suggested they would contribute to post-war reconstruction. The IMF has disbursed $2.7 billion in emergency support so far and set up an account for donor countries to channel aid to Ukraine. The European Investment Bank (EIB) has approved two support packages totaling nearly €2.3 billion and the European Bank for Reconstruction and Development (EBRD) has provided €2 billion of immediate relief.

In July, the Washington-based Center for Strategic and International Studies (CSIS) launched a Ukraine Economic Reconstruction Commission to create a framework for the reforms necessary for Ukraine to attract private investment. And organizations ranging from GLOBSEC, a think tank based in Bratislava, Slovakia, to the international management consulting firm Deloitte have weighed in.

A conference of donors was held in Lugano, Switzerland, in July. Another is scheduled for 2023 in the United Kingdom. In October, the European Commission and Germany, as president of the Group of Seven, hosted an “international expert conference” on reconstruction in Berlin.

Reconstruction Principles

Plans published so far have much in common. They largely agree that:

The overarching goal of reconstruction should be to transform Ukraine’s economy and society by modernizing—not only its infrastructure, but also its economic, political, and social institutions, thus providing a decisive break from Ukraine’s Soviet past and paving the way for it to join the EU. Several plans use the phrase “build back better.”

Ukrainians should take the lead in setting priorities for reconstruction and implementing it. Ukrainian representation should be diverse, including both national and local government officials, as well as leaders from civil society and the private sector.

Donor countries and institutions should rigorously and cooperatively oversee their reconstruction assistance to ensure the program’s goals are achieved and Ukraine’s endemic corruption thwarted. Essential elements of effective oversight include transparent procurement and financial management processes, clear achievement mileposts, and independent oversight and auditing mechanisms.

Reconstruction will take time—several plans mention 10 years—but continuing assistance indefinitely would undermine Ukraine’s ability to achieve self-sufficiency. Assistance, at least in the early stages of reconstruction, should be primarily in the form of grants to avoid saddling Ukraine with unmanageable debt.

Reconstruction Coordination

The plans also agree that, to avoid working at cross purposes and to ensure effective oversight, donors must coordinate the administration of their reconstruction assistance. But the plans differ significantly on how that coordination should be structured and who should lead it.

The Marshall Plan—the U.S. program from 1947 to 1951 to rebuild Europe after the devastation of World War II—is often cited as an inspiration for the reconstruction of Ukraine, but administratively it was the opposite of the current situation. One nation—the United States—was the donor, and 16 European countries were the recipients. With Ukraine, one nation will be the recipient, and many nations and international institutions will be the donors—posing a coordination challenge.

Views on administering assistance and coordinating among donors vary. The World Bank established a multi-donor trust fund. The IMF is developing a new monitoring instrument (called Program Monitoring with Board Involvement).

The European Commission calls for an “international coordination platform,” co-led by the Commission and the Ukrainian government. The details for such a platform are the subject of ongoing negotiations between the Commission, the Ukrainian government, and members of the G7. (The members are the United States, Great Britain, Canada, Germany, France, Italy, and Japan, plus the EU.)

CEPR proposes to manage assistance through a new stand-alone agency created or authorized by the EU. The IMF and World Bank could provide technical assistance but—because some of their member nations may not be interested in seeing Ukraine succeed economically—should not administer the aid, according to the CEPR.

The German Marshall Fund of the United States suggests that the G7 should take the lead in partnership with the Ukrainian government, while allowing opportunities for the participation of non-G7 countries such as Australia. According to GMF, the coordination effort should be headed initially by “an American with a global stature.”

The Plans, So Far

Ukraine’s National Recovery Plan

Ukrainian Prime Minister Denys Shmyhal presented the plan at the Lugano conference, July 4-5.

Funding and Timeline: The 10-year plan is divided into two phases, 2023-2025 and 2026-2032, and encompasses 850 wide-ranging projects requiring funding totaling an estimated $750 billion.

Priorities: The two biggest components of the plan are the reconstruction and modernization of housing and infrastructure ($150 billion to $250 billion; 103 projects and activities) and expanding logistical and transportation facilities (airports, railroads, roads, ports) and integrating them with the EU ($120 billion to $160 billion; 145 projects and activities). Other big-ticket items include achieving energy independence and developing green energy ($130 billion; 21 projects and activities), ensuring access to funding through insurance, loan guarantees, and other programs ($75 billion; 21 projects and activities), and supporting high-tech and other potentially fast-growing economic sectors ($50 billion; 34 projects and activities).

Donor Coordination: The plan does not include a specific donor coordination structure, but Ukraine subsequently circulated a proposal to create a recovery fund with a supervisory board on which three-quarters of the seats would be held by representatives of donors.

Oversight: The plan asserts that strengthening Ukrainian institutions and “de-oligarchization” are its “fundamental prerequisites”—including public data transparency, relaunching anti-corruption offices, reforming law enforcement agencies, implementing corporate governance legislation, and synchronizing anti-trust practices with the EU.

The European Commission: RebuildUkraine Plan

The overarching goal of the European Commission’s RebuildUkraine plan, published May 18, is the creation of “a free and prosperous country, anchored in European values, well integrated into the European and global economy.”

Funding and Timeline: When the Commission issued its plan, it said the overall funding needed was not yet known, but that it would be “substantial,” and that reconstruction would “potentially span more than a decade.” In September, jointly with the World Bank and the government of Ukraine, it estimated the cost of recovery and reconstruction as of June 1 at $349 billion and said it was expected to grow.

Priorities: The plan outlines four pillars: 1) rebuilding “infrastructure, health services, housing, and schools, as well as digital and energy resilience in line with the most recent European policies and standards”; 2) providing administrative and technical support so that Ukraine can continue modernizing its institutions “to ensure good governance and respect for the rule of law”; 3) a structural and regulatory agenda in Ukraine that would deepen “the economic and societal integration of Ukraine and its people with the EU”; and 4) promoting Ukraine’s “green and digital transition” through sustainable economic competitiveness, trade, and private-sector development.

Donor Coordination: The Commission envisions an international coordination platform co-led by it and the Ukrainian government. It would serve as “an overarching and single-entry point for all actions on the reconstruction of Ukraine” and would work with EU member states, other countries, and international financial institutions. The platform would determine priorities for financing and specific projects for implementing priorities. It would coordinate financing sources and monitor progress. The plan calls for the creation of a RebuildUkraine Facility, embedded in the EU budget, to serve as the legal instrument for providing EU grants and loans.

Oversight: European Commission President Ursula von der Leyen said investments in Ukraine will “go hand in hand with reforms that will support Ukraine in pursuing its European path.” The plan did not detail specific oversight mechanisms but said the RebuildUkraine Facility “would put significant emphasis on good governance, the rule of law, sound financial management as well as anti-corruption and anti-fraud proofing.”

The World Bank: Relief, Recovery and Resilient Reconstruction

The World Bank staff, in a paper published April 21, wrote that during reconstruction “Ukraine will have the opportunity to finally shake off some of the legacies of the past and leapfrog to a more productive, sustainable and inclusive society.” This requires not just rebuilding housing and infrastructure, they wrote, but also “institutions that enable building a dynamic economy … anchored in Ukraine’s strong commitment to become a member of the European Union.”

Funding and Timeline: The paper divided economic assistance into three phases: relief during the war, recovery during the first six-to-eight months after the war, and “resilient reconstruction” in “the medium term.” Jointly with the European Commission and the government of Ukraine, the World Bank in September estimated recovery and reconstruction needs at $349 billion and growing as of June 1. The paper identified “three critical pathways” for transfer of resources from abroad: grants through the World Bank and IMF; loans at below-market rates and for extended terms; and donor-country guarantees of loans from international financial institutions.

Priorities: The plan enumerated “four critical directions” for reconstruction: 1) fundamentally reforming Ukraine’s public finances and financial sector, including through a lower and more fairly applied tax rate and less dependence on domestic banks; 2) stimulating entry and growth of new technologically advanced businesses to take advantage of trading opportunities with the EU; 3) rebuilding public social services, especially a high-quality education system and a network of health facilities; and 4) building sustainable energy, transportation and other infrastructure that aligns with the EU’s “green deal.”

Donor Coordination: The paper notes the World Bank’s multi-donor trust fund and an IMF-administered account as vehicles for assistance and mentions that “a critical need for Ukraine’s external partners is to closely coordinate all their resources.”

Oversight: The report does not describe specific oversight mechanisms but calls for technical support to strengthen Ukraine’s anti-corruption agencies and reviving efforts to ensure Ukraine’s judiciary is professional, non-corruptible, and fair.

The Centre for Economic Policy Research: A Blueprint for the Reconstruction of Ukraine[1]

CEPR, a network of research economists, many at European universities, published its plan early in the war, on April 8, with the hope that it would lead to a broader project with a deeper analysis of how best to reconstruct Ukraine. It said international assistance should put Ukraine on the path to joining the EU, should be rapid but conditioned on accountability and milestones, and should focus on grants rather than loans because a country destroyed by war cannot be expected to repay additional debts. It said donors should closely coordinate assistance with each other and with Ukraine to minimize waste and delay and that Ukrainians (including at the local level) should “own” reconstruction by matching a fraction of the aid and be able to continue projects after international assistance ends.

Funding and Timeline: Like other plans, it divides reconstruction into three post-war phases: the emergency response (the first 6 months, akin to the response to a natural disaster), restoration of critical infrastructure and services (3 to 24 months); and laying the foundation for future growth and modernization (medium- to longer-term). It estimates reconstruction costs at €200 billion to €500 billion but warned that costs were increasing as the war continued and could cumulate as high as $1 trillion. It identified several potential sources of financing, including grants, loans, and loan-guarantees from allied governments; multilateral institutions such as the World Bank, EBRD, and European Investment Bank; private foundations and individuals; and seized Russian assets.

Priorities: Reconstruction, according to the CEPR paper, offers “a unique opportunity to radically upgrade Ukraine’s productive capacity to bring it close to the technological frontier, [and] lay foundations for long-term growth.” The success of aid will depend on Ukraine’s ability to export to the EU, it said, so should come with incentives for Ukraine to align its regulatory and legal environment with the EU’s. And it should encourage and facilitate inflows of foreign capital and technology transfers by subsidizing and insuring investments and by privatizing Ukraine’s two large state-owned banks. A key to modernization, the authors write, will be replacing the remnants of Ukraine’s Soviet past with a “liberal economic framework” that includes reforming its tax code and labor laws, giving more political and economic authority to local governments, and removing remaining restrictions on land ownership. Infrastructure improvements should include robust transportation connections (railroads, highways, pipelines, and bridges) and rebuilt housing, hospitals, and schools to attract displaced Ukrainians back to their pre-war residences. Energy investments should focus on integrating Ukraine into the European energy network and reducing its dependence on fossil fuels.

Donor Coordination: The paper notes that a self-standing U.S. agency successfully administered the Marshall Plan after World War II and recommends establishing an independent EU-affiliated agency. It would coordinate Ukraine assistance across diverse aid sources and function as a “single interlocuter” with Ukrainian authorities. An independent agency would minimize the political influence of Russia, which is a shareholder in the IMF, World Bank, and EBRD, the authors write. The governance structure of the agency should be “technocratic in nature” and include Ukraine. To avoid creating an entrenched bureaucracy, the agency should be authorized with sunset provisions linked to Ukraine becoming a member of the EU.

Oversight: The independent agency should set project timelines and goals and monitor results in collaboration with Ukrainian authorities and should be able to withhold or delay funding. It should implement strong anti-corruption protocols, relying upon site visits, third-party verification, protections and financial incentives for whistleblowers, and a partnership with the European Public Prosecutor’s Office.

The German Marshall Fund of the United States: Designing Ukraine’s Recovery in the Spirit of the Marshall Plan[2]

The German Marshall Fund of the United States, a U.S.-based think tank founded through a gift from the German government to commemorate the 25th anniversary of the Marshall Plan, looks to history for inspiration for Ukraine’s reconstruction in the plan published September 7. It draws six lessons: 1) to deliver hope to Ukrainians during the war, planning should begin now for a prosperous, secure future; 2) U.S. officials must work hard to win both broad public support and strong bipartisan congressional backing for assistance to Ukraine; 3) Ukraine should lead its own reconstruction, but donors must approve the plans and monitor implementation; 4) assistance should be delivered in an accountable and transparent framework and progress from humanitarian relief to economic recovery and modernization; 5)  the underlying goal must be economic integration with Europe; and 6) assistance should be time-limited and carefully coordinated among donors. GMF draws a seventh lesson from Ukraine’s recent past: Donors should closely involve Ukraine’s non-governmental organizations, which have emerged as trusted watchdogs, to ensure the integrity of the government’s anti-corruption agencies are maintained.

Funding and Timeline: A paper published by the GMF in September cites the Ukrainian government’s $750 billion reconstruction cost estimate and 10-year timeline but does not offer its own, because “the fog of war lies thick over Ukraine, and the total costs of the conflict are hidden in the mist.” Recovery should consist of four stages: relief, reconstruction, modernization, and accession to the EU. It said donors should weight their contributions toward grants rather than loans because Ukraine will not be “investable” soon. Sovereign guarantees for private investments should be introduced and, in time, using seized Russian assets should be considered, it said.

Priorities: The paper does not recommend specific priorities for investments and instead focuses on a structure (a task force with sectoral working groups) for Ukraine and its international partners to determine funding needs and set priorities.

Donor Coordination: The GMF paper asserts that the European Commission has “neither the necessary political nor the financial heft” to lead reconstruction. And it advises against creating a new agency or centralized trust fund. Instead, it suggests that the G7 and Ukraine together appoint “an American of global stature” as recovery coordinator “because only the United States will be able to bring together the needed global coalition and forge consensus among Ukraine’s partners.” The coordinator, in turn, would build a Ukraine Reconstruction and Recovery Task Force. Each G7 country would appoint a senior representative to the task force. The EU, as a G7 member, would serve as the secretariat and convenor of the task force, which would rely on European Commission staff. The task force would form sectoral working groups (such as agriculture, infrastructure, housing, energy, water, sanitation, and industrial capacity) co-led by G7 and Ukrainian officials. International financial and multilateral institutions, philanthropic organizations, and large private-sector leaders could apply to be members of, or observers to, the task force.

Oversight: According to the paper, “aid to Ukraine needs to come with strings attached,” given the country’s history of corruption. The first tranche of reconstruction funds should be contingent on Ukraine implementing rule-of-law and judicial reforms. The EU should invite Ukraine to join the European Public Prosecutor’s Office. An independent inspector general should be appointed to investigate misconduct and ensure efficient use of funds. And the task force should create a digital platform to promptly publish as many reconstruction-related documents as possible.

Other Participants and Views

International Monetary Fund: The IMF has disbursed two rounds of emergency financial support to Ukraine—$1.4 billion in March and $1.3 billion in October. In April, the IMF set up an “administered account” for donor countries to channel aid to Ukraine. As of mid-September, Canada and Germany had provided $2.2 billion through it, and Belgium and the Netherlands planned to use it. The IMF has also begun developing a new instrument—“Program Monitoring with Board Involvement”—to validate the Ukrainian government’s projections and to administer “a full-fledged IMF program once conditions allow,” according to IMF Managing Director Kristalina Georgieva. Its goal is to work with Ukrainian authorities on “a comprehensive macroeconomic framework, with policy undertakings and quantitative targets, that will clarify external financing needs and provide a guide for both domestic policymaking and international support,” she said.

European Investment Bank: The EIB, the EU’s lending arm, approved two lending packages for Ukraine—€668 million in March and €1.59 billion in July—to meet urgent needs, including the repair of the most essential damaged infrastructure. (The loans were guaranteed by the EU.) EIB President Werner Hoyer promised in October that the bank would continue to support Ukraine “for the reconstruction of a free, prosperous country.”

European Bank for Reconstruction and Development: The EBRD—owned by 72 countries, the EU, and the EIB—was founded in 1991 to create a post-Cold War era in central and eastern Europe. Since the invasion began, the EBRD has committed more than €1 billion in loans and aims to triple that by the end of 2023, primarily to maintain energy and food security, restore rail infrastructure, and support the pharmaceutical industry.

The Center for Strategic and International Studies: CSIS, a non-profit policy research organization based in Washington, D.C. and focused on national security issues, in July launched a bipartisan and international Ukraine Reconstruction Commission. It is led by three co-chairs: Paula J. Dobriansky, former under secretary of state in the George W. Bush administration; Greg Page, former chief executive officer and chair of Cargill, a global food corporation; and Michael Polsky, founder and chief executive officer of Invenergy, a multinational power generation company. The commission aims to “produce a framework for the crucial reforms needed to attract private-sector investment to support Ukraine’s economic reconstruction.” It will seek to align its work with Ukraine’s National Recovery Plan and aims to produce a series of policy papers on specific topics, such as agriculture, energy, transportation and logistics, and corruption.

GLOBSEC: GLOBSEC, a nonpartisan think tank based in Bratislava, Slovakia, established a Ukraine Support Council in September, chaired by Jan Krzysztof Bielecki, former prime minister of Poland. And in October, GLOBSEC opened an office in Kyiv. The Council will focus on Ukraine’s accession to the European Union and the reconstruction of Ukraine, as well as its integration into Central Europe. It will provide “tailor-made advice in the form of sets of studies and pilot projects.” Council members will include Ukrainians, other Europeans, and Americans.

Deloitte:[3] The international management consulting firm Deloitte published The reconstruction of Ukraine: Historical lessons for postwar reconstruction of Ukraine in October. It said reconstruction “is more than just rebuilding roads and factories” but should help Ukraine “reemerge a stronger country that is part of a stronger Europe.” It identified five areas as starting points for reconstruction: physical infrastructure, education and workforce, the financial sector, government services and revenue, and agriculture. It did not recommend a specific structure for overseeing and coordinating international assistance but said it should be done by “a single central institution.” That institution could be “a single nation, a multilateral organization, or any number of other organizational structures,” it said, adding, “involvement and leadership from the United States and the EU are key.”

[shreygoyal]

View on Twitter

“Since we cannot count on you to act morally, let me propose bribing you to save the planet. Adopt a high global carbon tax. However, cut other taxes… My and future generations will pay higher taxes to service the deficits you run.”

(Source)

[darielaherrera]

Check out this listing I just added to my Poshmark closet: BRAND NEW Men’s Hoka Carbon X 3/ CEPR.

[plethoraworldatlas]

The Biden administration on Sunday faced calls to demand the immediate release of Ecuador's former vice president after Ecuadorian police stormed Mexico's embassy in Quito and forcibly seized the ex-official, a flagrant breach of the 1961 Vienna Convention.

"Ecuador's government has committed a very serious crime, one that threatens the security of embassies and diplomats throughout the world—not least those of the United States, which has threats to its embassies in much of the world," said Mark Weisbrot, co-director of the Center for Economic and Policy Research (CEPR). "The international community cannot allow this to happen."

The move sparked a diplomatic crisis and global outcry, with Latin American leaders slamming the right-wing Ecuadorian government for its "unacceptable infringement" on Mexico's sovereignty and "kidnapping" of Jorge Glas, who served as vice president under Ecuador's leftist former president Rafael Correa. Glas has reportedly been transferred to a maximum-security prison.

Correa supported lawmaker Luisa González in Ecuador's 2023 presidential contest, which she lost to President Daniel Noboa, the son of the richest man in Ecuador.

The illegal raid of Mexico's embassy late Friday came hours after the Mexican government granted political asylum to Glas, who has been living in the embassy since December, when he announced he would appeal a judge's decision ordering him back to jail. Glas has been convicted of corruption and imprisoned repeatedly in recent years; the former vice president has said the charges are politically motivated.

CEPR noted Sunday that Ecuadorian Attorney General Diana Salazar "has long engaged in a campaign of lawfare and political persecution against former president Rafael Correa and other figures from the former Correa government."

"The charges against Correa have been shown to have so little credibility, and the evidence is so lacking, that Interpol for years has refused to act on Ecuador's red notice against him," the group said. "Belgium has granted him political asylum, and he can travel freely to almost anywhere in the world without fear of extradition. And last year, a Brazilian Supreme Court judge annulled evidence against Glas after authorities admitted it may have been tampered with."

...

As the Financial Timesreported Sunday, Ecuador's right-wing president "is enjoying soaring popularity among Ecuadoreans and strong support from Washington after declaring an all-out war on drug trafficking." In February, the Biden administration declared its "unwavering support" for Ecuador's government and announced "$2.4 million in additional vehicles and security equipment to support the work of police."

FT noted that Noboa, the scion of a banana empire, has invoked "emergency powers to put troops on the streets and sent the army to take control of gang-ridden jails, using tactics partly borrowed from El Salvador's strongman leader Nayib Bukele."

While Noboa's "aggressive response initially reduced violence and brought a precarious sense of safety to places like Guayaquil," The New York Timesobserved, the "stability did not last."

"Over the Easter holiday, there were 137 murders in Ecuador, and kidnappings and extortion have worsened," the Times reported.

[fadingsunsjvj]

Labour in the boardroom: The effects of codetermination on firm performance and wages | CEPR

https://cepr.org/voxeu/columns/labour-boardroom-effects-codetermination-firm-performance-and-wages

[thegreatwhinger]

Joe Biden Is Bad For Democracy

No matter what people say – especially when what they say is entirely based on what they fear, like Robert De Niro – voting for Joe Biden is undemocratic.

How so, you might be ask, right before you say something to the effect 'Why do you want Trump to win?'

As far as the latter goes, I don't but let's be honest.

Trump is at the end of the day someone desperately wanting to be loved, which means that he's able to be swayed (especially when you combine it with the fact that he's also a coward).

While Joe Biden doesn't particularly care what people want and that's probably because he's barely there in terms of his cognitive ability though to be fair he's always been an offensive person though his advanced age and diminishing mental capacity makes him ever more dangerous.

As if the two conflicts we're bankrolling in the Middle East and Ukraine didn't illustrate that already.

Besides, why would anyone that claims to care about Democracy – I mean big 'D' democracy – vote for someone as undemocratic as Joe Biden?

Isn't the cornerstone of Democracy government by and for the people?

If it is, why is Joe Biden and the Democratic Party still sending money to Israel so they can slaughter Palestinians?

Why are the Democrats focusing on Trump, as opposed to what Biden has done to DIRECTLY benefit the American people?

That they lean into fear of the other is telling.

Though speaking of 'slaughtering Palestinians' CEPR (the Center for Economic Policy Research) say that 52% of Americans agree that weapons shipments to Israel should be stopped until the stop their attacks on Gaza.

Now wouldn't a truly democratic nation – if a majority of its citizens didn't want something to happen – actually listen to the people, as opposed to pretending to give a damn, like Joe Biden is currently doing?

[sawtelghad]

ضغوط متزايدة على بايدن لوقف تسليح إسرائيل.. استطلاع: أكثر من 60% ممن انتخبوه يؤيدون ذلك https://sawtelghad.net/46201

[trend-q]

エムポックス （Monkeypox）

2023年12月24日 2023年11月8日時点の国立感染症研究所の報告によると、エムポックス（Monkeypox）は、モンキーポックスウイルスによる感染症であり、世界的な流行が報告されています。 エムポックスは、感染者の多くが成人男性であり、男性間で性交渉を行う人（MSM; Men who have sex with men）の間で感染が広がっています。 感染症法では4類感染症に位置付けられており、世界保健機関（WHO）によって注意が呼びかけられています。 December 24, 2023 According to a report by the National Institute of Infectious Diseases as of November 8, 2023, Monkeypox is an infectious disease caused by the Monkeypox virus, and a worldwide epidemic has been reported. Most of the infected people are adult men, and the infection is spreading among men who have sex with men (MSM). It is classified as a Class 4 infectious disease under the Infectious Disease Control Law, and the World Health Organization (WHO) has advised caution. Citations: [1] https://twitter.com/YOASOBI_staff [2] https://toyokeizai.net/articles/-/722849?page=4 [3] https://www.papa-super.jp/musicstation-super-live-timetable/ [4] https://www.niid.go.jp/niid/ja/monkeypox-m/2596-cepr/12320-mpox-ra-1108.html [5] https://youtube.com/watch?v=geC-G8Mrjto

[gazeta24br]

Novos fuzis e pistolas chegaram para reforçar o trabalho de equipes da Polícia Civil (PC) e do Departamento de Polícia Técnica (DPT), após o investimento do Governo do Estado. R$ 6,6 milhões foram destinados para a aquisição dos 1.675 armamentos entregues às unidades das Forças de Segurança. Entrega simbólica teve a participação do vice-governador do estado, Geraldo Júnior, do secretário da Segurança Pública, Marcelo Werner, da delegada-geral da Polícia Civil, Heloísa Brito, e da diretora do Departamento de Polícia Técnica, Ana Cecília Bandeira, na manhã desta terça-feira (17), na sede da Coordenação de Operações e Recursos Especiais (Core). Duzentos e vinte e cinco fuzis da marca Iwi Arad calibre 5,56, com mira holográfica, seguirão para a Core, outras coordenações e departamentos da PC, ajudando no reforço do combate às organizações criminosas. Já as outras 1.450 pistolas Glock calibre .40, adquiridas também com recursos do Fundo Estadual de Segurança Pública (FESP), têm como destinos Departamentos da PC (1250) e unidades do DPT (200). “Uma ação que visa dar melhores condições de trabalho aos nossos servidores. Essa aquisição também será direcionada para os futuros policiais civis, que entram em formação já no próximo dia 23″, destacou o secretário  Marcelo Werner. Já a delegada-geral da Polícia Civil reforçou que a entrega é um marco para a instituição, levando em conta as características dos equipamentos, considerados armamentos de última geração. Polícia Militar Outros R$ 11,4 milhões foram destinados pelo Governo baiano à Polícia Militar, após a aquisição de novos fuzis calibre 5.56 e 1.075 pistolas entregues na tarde da segunda-feira (16). Os fuzis da marca Iwi Arad de última geração possuem diferentes tipos de mira e as 1.075 pistolas Glock do modelo 22, geração 5, calibre.40, serão distribuídos em unidades dos Comandos de Policiamento Especializado (CPE), em Missões Especiais (CPME), de Apoio Operacional (CPAp), de Policiamento Rodoviário (CEPR), Comandos de Policiamento Regionais da Capital (CPR BTS, Atlântico, Central e RMS) e nos CPRs de Feira de Santana, Ilhéus, Juazeiro, Barreiras, Bom Jesus da Lapa, Paulo Afonso, Vitória da Conquista, Itaberaba, Santo Antônio de Jesus e Teixeira de Freitas.

[natb00]

B0668 - Jose Luis Garcia, 58 años ->

B0668 - Jose Luis Garcia, 58 años ->

Fecha: 22/08/2023 11:27

Nota de Evolución - Tratante - CIRUGIA GENERAL Jose, 58 años Acompañado de una hija

Paciente con colelitiasis e ictericia colestasica en estudio, a descartar coledocolitiasis Se siente bien, dolor controlado, sin picos febriles, toelera dieta

Signos vitales:, Frecuencia cardíaca(LPM): 78, Frecuencia respiratoria(Respiraciones/minuto): 18, Escala del dolor: 0-No dolor

Aceptables condiciones Hidratado Abdomen blando, leve dolor en hipocondrio derecho sin irritacion Extremidades bien perfundidas

Diagnósticos activos después de la nota Diagnóstico principal - COLANGITIS (En Estudio), CALCULO DE CONDUCTO BILIAR CON COLANGITIS (En Estudio), OTRAS COLELITIASIS.

Análisis y Plan de manejo: Evolucion estable, dolor controlado, sin SIRS en el momento. Resonancia con evidencia de coledocolitiasis, se ordena CPRE para extraccion de calculos. Se explica la conducta la cual entienden y aceptan.

Información durante la estancia ¿A quién se informa?: Paciente/cuidador Se brinda información sobre: No aplica. Firmado por: SEBASTIÁN TABARES GIL, CIRUGIA GENERAL, Registro 5-3320-10, CC 1128264238

Fecha: 21/08/2023 07:08

Nota de Evolución - Tratante - CIRUGIA GENERAL 58 años Cirugia general- ronda

Cuadro clinico sugestivo de colangititis Sospecha de coledoclitiasis Colelitiasis Ictericia obstructiva sin dilatacion de via bilair. CRNM ( s ehizo anoceh ) pendiente lectura

Estable. icterico afebril Pulso: 78 min cardipopulmonar: normal abdoemn blando, depresible no defendido

Diagnósticos activos después de la nota Diagnóstico principal - COLANGITIS (En Estudio), CALCULO DE CONDUCTO BILIAR CON COLANGITIS (En Estudio), OTRAS COLELITIASIS.

Análisis y Plan de manejo: Cuadro de 20 dias de evoluciond e dolor, ictericia fiebre y escalofrios. Perfil hepatioc colestasicoi Alat sospecha de coledcocltiiasis pendiente lectura de colangioresonanacia

Información durante la estancia ¿A quién se informa?: Paciente/cuidador Se brinda información sobre: Resultados esperados de la atención y el tratamiento. Firmado por: JAMIL DAVID VALLEJO GARAVITO, CIRUGIA GENERAL, Registro 5.0083.97, CC 78296106

Fecha: 20/08/2023 11:29

Nota de Evolución - Tratante - CIRUGIA GENERAL Valoracion por cirugia general

Jose Luis Garcia Isaac, 58 años, Procedente de Planeta Rica - Córdoba

MC: Dolor abdominal EA: Paciente de 58 años con antecedente de colelitiasis que consulta hoy por cuadro clinico de 15 dias de dolor tipo colico en epigastrio que irradia a region dorsal relacionado con la ingesta de alimentos. Desde hace aproximadamente 6 dias con sensación febril, escalofrios, tinte icterico, coluria

Antecedentes:

Colelitiasis previamente asintomatica

Signos vitales: Presión arterial (mmHg): 140/80, Presión arterial media(mmHg): 100, Escala del dolor: 5-Moderado

Consciente, orientado, sin deficit motor o sensitivo aparente Tinte icterico generalizado Escleras y conjuntivas ictericas, mucosa oral seca Abdomen blando, depresible, dolor a la palpacion en hipocondrio derecho, murphy positivo Extremidades eutroficas sin edema

Paraclinicos 20/08/23: AST 44 ALT: 103 BT: 6. 86 Bdta: 5. 30 Hb: 14. 9 Hto: 42. 1 Leucos: 6700 Neutrofilos 4697 (70%), INR: 1. 08, TTP: 32. 4. PCR 11. 11 PLT 232000

Diagnósticos activos después de la nota Diagnóstico principal - COLANGITIS (En Estudio).

Análisis y Plan de manejo: Paciente con antecedente de colelitiasis, con cuadro de 15 dias de dolor en epigastrio que irradia a region lumbar, recientemente con fiebre e ictericia, en paraclinicos con patron colestasico, cuadro sugestivo de colangitis asociado a colelitiasis, en espera de ecografia abdominal.

Información durante la estancia ¿A quién se informa?: Paciente/cuidador Se brinda información sobre: Resultados esperados de la atención y el tratamiento. Firmado por: VÍCTOR MANUEL QUINTERO RIAZA, CIRUGIA GENERAL, Registro 762534-01, CC 10019807

Pendientes: Procedimientos =

CEPRE ( Autorizada) Fecha 25/08 Hora 07:30 Am Consentimiento de anestesia : Pendiente.

[chicoterra]

Importância da educação popular nas lutas dos movimentos sociais é tema de evento

Mesa-redonda ocorrerá no dia 3 de agosto, no campus universitário Marco Zero, em Macapá (AP). O Grupo Cepres – Centro de Estudos de Religiões, Religiosidades e Políticas Públicas, da Universidade Federal do Amapá (Unifap), e a Escola de Fé e Política Pe. Luís Carlini realizam no dia 3 de agosto de 2023 a Mesa-redonda “A Importância da educação popular nas lutas dos movimentos sociais”. O evento…