Showing posts with label public health policy. Show all posts
Showing posts with label public health policy. Show all posts

Wednesday, May 13, 2026

Regulatory Capture and the Public Interest: The FDA

The head of the Food and Drug Administration, Marty Makary, “resigned” in May, 2026 even though the decision had been made by U.S. Health and Human Services Secretary Robert Kennedy “and then the White House signed off on it.”[1] Although Makary had been annoyance to drug-company executives, and to that extent his removal was due to pressure on President Trump by the CEOs, his “resignation” supports the theory of regulatory capture, wherein the regulated companies control the very regulatory agencies (and regulators therein) that regulate those companies, this case shows that it is possible for an industry’s interests to be aligned with the public (health) interest. Does the alignment regarding getting rid of a particular regulator lessen the unethical quality of the broader conflict of interest between business and government?

Without a doubt, the regulated industry was unhappy with Makery and his deputy, Vinay Prasad. For example, “(v)aping executives told Trump that Makary was blocking approval of their products, including new flavored e-cigarettes seen as crucial to the industry’s survival.”[2] Additionally, Prasad was “pushed out of the agency twice in less than a year for running afoul of specialty drugmakers and groups for patients with rare diseases.”[3] He had “rejection letters or requests to run additional studies” sent to more than six drug companies on drugs for rare or hard-to-treat diseases that had previously been approved by the FDA.[4] I do not have enough information to be able to assess whether his actions were in the public interest, as it is possible that the FDA’s previous approvals had been flawed. I have more confidence in concluding that he operated against the public’s healthy in going after an established coronavirus-vaccine maker. He had “repeatedly overruled vaccine staffers to restrict eligibility for new coronavirus shots.”[5] He even refused to “even consider Moderna’s mRNA shot for flu.” Moderna “called for intervention by the White House.”[6] In an internal memo, Prasad had claimed without evidence “that the FDA had linked COVID-19 shots to the deaths of 10 children.”[7] It seems that he was going more off an ideology than science.

It seems likely that the drug-company executives red-flagged the ideological distortion as it would decrease the companies’ future sales. The only ideology that rules in corporate boardrooms is that of the profit-motive, so any competing ideology coming out of a regulatory agency would be easily flagged. In such a case, the company-specific economic interests would be aligned with the public interest because the government-sourced ideology would be partial, hence partisan, and thus not in line with a bigger picture such as can reflect the public interest. In short, any pressure that the executives could bring on President Trump to remove Makary and his deputy would be in the public interest even though it would be a case of regulated companies getting rid of government officials who regulate those companies.

In general, regulatory capture of a government agency by a company or industry that the agency regulates is unethical because it destroys the power-relationship that is required for government regulation to exist. Another way of looking at the ethical problem is by realizing that a company, and even an industry, look out for their own particular (economic) interests, whereas the public interest is a whole. To put a part before or ahead of the whole of which the part is a part is essentially to have the tail lead the dog—a part leading a whole.

Because it cannot be supposed that a part’s interests are identical to that of the whole of which the part is a part, even cases in which the two are in sync cannot justify permitting the part to call the shots for the whole—to direct the whole. Put another way, it would still be unethical for a regulated company or industry to wield such power as could dominate a government in a republic because companies are private property rather than elected bodies. That specific cases such as Makary and Prasad justify the drug industry pressuring Kennedy and Trump does not mean that either official would be justified in being directed by that industry more generally. The problem is that corporate political-campaign donations can be so large that big pharma can have the political pressure to direct even a U.S. president. Going forward, company executives could try to justify such power by pointing to their “public” role in having shelved an ideology harmful to the public health that was pushed by Makary and Prasad. It is important to keep in mind, however, that regulatory capture is nonetheless unethical and contrary to democratic principles of public governance of private property, including companies.



1. Matthew Perrone and Seung Min Kim, “Trump FDA Chief Is Leaving After Angering Pharma CEOs, Vaping Lobbyists and Anti-Abortion Groups,” APnews.com, May 12, 2026.
2. Ibid.
3. Ibid.
4. Ibid.
5. Ibid.
6. Ibid.
7. Ibid.

Monday, October 19, 2020

Coronavirus Reveals Dysfunctional Culture in Arizona

In mid-October, 2020, when the coronavirus was again peaking in E.U. states such as France and Germany and U.S. states such as Wisconsin and New Mexico, public health experts were worried about how the upcoming flu season would interact with the new virus, especially as people gather more indoors when outside temperatures turn colder. On October 15, 2020, for instance, seven U.S. states saw record numbers of hospitalizations, according to the Covid Tracking Project, and fourteen states set records for their seven-day averages of new daily cases, according to Johns Hopkins University.[1] France and Germany had already instituted nightly curfews. On October 16, Tier 2 Restrictions went into effect in London, which include urging people to avoid public transportation. Because physical distancing is not always possible on buses, subways, and light rail, universal mask wearing was crucial. According to IHME projections at the time, universal mask wearing in general “could save the lives of more than 70,000 Americans in the next three and a half months.”[2] With New Mexico’s chief executive referring to the coronavirus situation as “the most serious emergency that New Mexico has ever faced” on October 14, it was very troubling that Arizona, which borders New Mexico, had failed to enforce laws requiring masks on public transportation. This failure is extraordinary because of the mentality behind it.
On June 19, 2020, Maricopa County, which includes the Phoenix metropolitan area, had announced mask regulations approved by the Board of Supervisors. One of the regulations reads, “All riders and operators on public transportation must wear a mask.”[3] This bore directly on the light rail and buses, which Metro Valley, the transportation authority, either ran directly or through subcontracted operating companies and Allied Security. With enforcement of the new regulation being “the responsibility of law enforcement,”[4] Metro Valley announced that it would not use its employees and subcontracted security guards to enforce the regulation. In allowing passengers to board the buses and light rail without wearing masks, Metro Valley was actually breaking the law even during the “second wave” of the virus in June, 2020. In fact, it was not uncommon to see bus drivers and security guards either not wearing masks or wearing them around their chins rather than on their mouths and noses. It was especially common to see the riders wear masks covering only the chin.
Metro Valley’s excuse for not enforcing the “requirement,” which meant allowing passengers (and employees) to be on mass transit without wearing masks even though the regulation forbid it, was that some passengers (and employees) could not wear masks due to medical conditions like asthma. Allowing this exception to break the rule overall bespoke ignorance, stinginess, and laziness. Because at risk riders could have been accommodated with the modest requirement of having their respective physicians fill out a medical form that in turn would be necessary to obtain a special medical transit ID. Medical IDs were already issued to the disabled who had a medical provider fill out Metro Valley’s medical form. The transit authority did not have to emasculate the regulation and thus the public health on account of an exception. Talking to Metro Valley supervisors, I was struck by the near obsession on the exception to the extent that I could detect no awareness of making a requirement anything but, and in so doing, violating the regulation. Small minds should not rule large companies, for the consequent harm to the public can be large.
I was thrice flabbergasted when I listened on my phone to Metro Valley customer-service employees insist that masks were required on buses and light rail and that passengers could ride without masks was not incompatible with the requirement! Declarations by ignorance that cannot be wrong have a bad odor. Such ignorance has no legitimate basis in standing on stilts above customers (or anyone). When I pointed out the obvious point that allowing maskless riders on buses and trains means that masks are not required, the standard reply was actually corrective. “Masks are required. Riders will not be turned away for not wearing masks.” How can a mind possibly hold those two thoughts together as if they were consistent? Perhaps willful ignorance enjoys being corrective because of the little bit of power that can be enjoyed—so starved for the pleasure from power is the weak bird of prey, according to Friedrich Nietzsche.
Unfortunately, neither the county sheriff’s office nor the Phoenix police (nor that of at least one suburb) felt the need to enforce the county and various city laws on masks. “You need to call Metro Valley on that,” I was told as I sought comment. Even if Metro Valley had a policy of enforcing rather than breaking the regulation (and city laws) mandating masks on public transit, it was still the responsibility of law enforcement (i.e., not a transit company) to see that the regulation (and laws) are enforced. For law-enforcement agencies of municipal governments to rely on company policies conflates governmental law with organizational policies. The lack of accountability was staggering even as the coronavirus remained as a viable threat to the public health.
The political and educational cultures in Arizona were such that efforts to enforce the regulation and correct Metro Valley’s pathetic policy were especially important. On October 17, 2020 in a conference room at a resort at Scottsdale, a suburb of Phoenix, two presenters with QAnon “went on a long diatribe against people who wear masks to prevent the spread [of coronavirus]. It’s a way to control people, and a symbol of submission, they argued.”[5] It bears stating that in 2019, Arizona had ranked 49th out of the 50 American states on education prior to college. Unfortunately, a culture of ignorance can easily support and spread the message of QAnon in Arizona—“inventing an imaginary threat and ignoring the very real virus” in spite of all those people who had already died from the pathogen. Such a culture can also enable a vacuous “requirement” to be perpetuated as if it were really a requirement rather than an instance of reason turned against itself with impunity. In such a culture, a significant number of riders and employees, including bus drivers, can be expected to skirt their company’s policy on mask-wearing because it is a fraud anyway. Such employees need only have told their respective supervisors that a medical condition prevents the wearing of a surgical mask without any written documentation to support the validity of the claim. In such a culture, bus drivers would rather bar riders from sitting in the front half of the buses, meaning that the riders might not be able to keep apart spatially as per governmental and even Metro Valley’s own guidelines, than bother to wear masks while driving. Why could such drivers be required to wear plastic face guards if a legitimate medical reason exists for not wearing a surgical mask? Besides the culture of ignorance, one of a lack of regard for the public health (i.e., other people) is also part of the sordid culture that has been so ensconced in Arizona.

A Metro Valley employee and a rider covering their respective chins. 
Security employees exposing their noses and mouths contrary to company policy. It is no wonder that riders did so as well, or went without masks, even though they were "required."
At times, the bus rider on the right held his green towel by his teeth, as if this were equivalent to wearing a mask. Such minimalists were common on public transportation during the pandemic.

A bus driver wearing his mask to cover his chin. I called Metro Valley to report the unsafe practice, and yet two months later, the driver was still leaving his mouth and nose exposed (see photo immediately below). Moreover, the continued prevalence of drivers without masks or not wearing them correctly is an indication that Metro Valley and its subcontracted operator companies have been managerially incompetent in holding drivers accountable. The continued bad driving (e.g., stopping abruptly rather than coasting to a light already red) also points to managerial negligence. 

Two (of several) other bus drivers not wearing masks, hence violating company policy. Were they medically exempt, presumably they would be wearing face coverings instead. 

Seats being held/blocked contrary to Metro Valley's policy by drivers. A plastic divider between the drivers and the seats is supposed to be sufficient protection for the drivers. Their efforts at over-protection, incredibly even by maskless drivers, can be at the expense of passengers being able to maintain physical distance between each other. Even though restricting the seating violates company policy and the company is aware of the practice, accountability has been a problem. 

A security guard starring at me taking a picture (which is legal) perhaps to intimidate me while literally overlooking the maskless rider stretched out on three seats. Starring at innocent riders to intimidate them while ignoring infractions of train policies (e.g., lying over three seats) epitomizes the local police/security culture. 


Four security guards in one-half of a train car, and four in a train car on a routine basis. Such excessiveness intimidates paying customers and leaves other trains without any protection. This epitomizes the local police/security culture in which as many of three backup police cars are used for police giving a traffic ticket. Meanwhile, the police departments refuse to enforce the laws on mask-wearing in retail stores and on public transportation. Hence, "bipolar" aptly characterizes the culture, wherein minor matters deprioritize more important ones. 

A security employee prohibited by Metro Valley even to instruct riders how to wear masks correctly. 

Perhaps the overriding question is how such a badly managed mass transit company (including its subcontractors that operate the buses) could continue in such a condition of ineptitude. In 2019, I had shot lots of videos of aggressive bus drivers, bad driving (e.g., stomping on the brake pedal at the last minute), and excess security on some trains (hence with none in others). The city of Tempe’s Transportation director invited me to attend a meeting with Tempe’s transit director, representatives from Metro Valley and the director of one of the bus-operating subcontractor companies (First Trans) in the room. Reflecting the local culture, the director dismissed all of my videos because one of them shows speeding of only six miles-per-hour above the speed-limit. To my utter astonishment, the other people in the room let him get away with the illogical effort to invalidate all of the videos—even those showing aggressive bus drivers shouting at passengers (the drivers generally viewed their ridership as lower class than themselves, which would have to be pretty low). Tempe’s representative lied to the director, “The city of Tempe has no problem with the driving,” after only months earlier having told me that speeding is a real problem (to which I added hard braking). Perhaps bribes helped reinforce the pathetic inter-organizational culture there.
Also up for grabs is why the local law enforcement would decide not to enforce a law so relevant to the public’s safety/health, and let the mass transit company (and its contractors) violate the law by allowing passengers to ride without wearing masks. It seems that in Arizona, the local law enforcement agencies have too much discretion over which laws they will enforce. Anyone calling in a noise complaint there knows this to be true. 
Ironically, and reflective of the bipolar culture, residents in poor and middle-class areas have had to endure police departments' excess reliance on low-flying police helicopters, which have routinely interloped beyond their respective jurisdictions (such as a city helicopter flying over county land), flown outside of designated air corridors for fly-through traffic, and flown around more expensive neighborhoods.  
On the evening when I published this essay at a coffee shop, a police car passed by as I was about to go to the shopping center's parking lot, and a few minutes a police helicopter flew over diagonally. Both seemed to be on a routine basis and duplicative rather than on a coordinated search. Then a mile away, just after I had stopped at a grocery store, another police helicopter was making at least ten wide circles over a nice looking residential neighborhood before flying away. Then just before I reached my apartment, several miles away, I saw yet another police helicopter (with yet another in the distance). The next morning on my way to the coffee shop to edit this essay, I again saw a police helicopter. The local residents may be used to living in a police state, but we others are not and it doesn't take long for us to notice it on account of its excessiveness, just as we new-comers notice the proclivity of the local police departments to refuse to enforce certain laws. To be sure, surveillance and so many back-up police cars for traffic tickets do take up resources, including personnel. If half the effort were applied instead to enforcing masks on public transit when the E.U. and many U.S. Midwestern and Northeastern states were coronavirus hotspots, Arizona would have been in a better position going into the winter.  

[1] Christina Maxouris and Jason Hanna, “The US Has Reached 8 Million Covid-19 Cases, and the Pace of New Infections Signals a Tough Winter,” CNN.com, October 16, 2020.
[2] Ibid.
[3]Board Approves Mask Regulations Due to Community Spread of COVID-19,” Maricopa County Communications Office, June 19, 2020.
[4] Ibid.
[5] Donie O’Sullivan, “Analysis: A CNN Reporter Went to Two Different QAnon Events. Here’s What He Found,” CNN.com, October 19, 2020 (accessed same day).


Thursday, July 9, 2020

Corona Crisis: Unethical and Criminal Businesses and Municipal Agencies Pervade in Phoenix, Arizona

On July 7, 2020, NBC News reported that Arizona had a record number of cases (105,094) and of deaths (1,927), with a four percent daily increase in reported cases. Also, coronavirus hospitalizations and related ventilators being used were also at record highs. A reporter with MSNBC stated, “Arizona is in crisis.” On the previous day, on MSNBC television, that same reporter had said, “Arizona is in free fall,” in that the number of cases was rising so fast. It had taken three months for the first 50,000 cases and only 23 days for the next 50,000. Observing that people were not wearing masks in downtown Scottsdale, he reported that “Arizona is out of control.” People there were not taking precautions, and the local and state authorities were not on top of the crisis. On June 22, 2020, a physician with the University of Arizona-Phoenix interviewed on The 11th Hour show on MSNBC asserted that the Arizonans who were saying, “No one is going to order me to wear a mask,” were being selfish because refusing to wear a mask, say on a bus or in a store or restaurant/bar puts other lives at risk. Also a salient ingredient of the crisis in Arizona was the anti-science contingent of the population. In an interview at the time, Alan Alda (of the TV show, MASH) pointed to “pockets of people who still think science is just another opinion” as having a mindset that “puts us all in danger.”[1] The rigors of scientific experiment, such as the use of control groups and random selection, render science closer to knowledge than are mere opinions based on ideology and a person’s own experience. Privileging one’s own ideology and experiences counts as self-embellishing, and perhaps even self-idolatry. Such people are not likely to accept knowledge that contradicts their respective opinions and experience. Living in Phoenix at the time, I had encountered a lot of anti-intellectualism and incompetence along with refusals to enforce virus-deterring policies and even laws. Just one year earlier, Arizona’s education system through High School (K-12) had been rated as 49 out of the 50 States. Combined with an ideology in which companies and individual residents should (which implies can) self-police themselves on physical-distancing and wearing face masks indoors in public and on public transportation,  the recipe is for a greater need for respirators. 
To be sure, Arizona got to the place of crisis in part because the governor had lifted the stay-at-home order and opened businesses on May 14, 2020. His choice was in line with the wishes of U.S. President Trump, who wanted a more productive U.S. economy that would facilitate the president’s re-election in the coming November. The spike in new cases began in Arizona after the governor allowed non-essential businesses, including bars, restaurants, and gyms, to reopen. Pressure from President Trump and a shared pro-business political ideology were likely factors in the Republican governor’s decision. Meanwhile, Arizona had more than its share of political ideologues who believed that business policy or a public law mandating physical distancing and mask-wearing were tyrannical overreaches even though government has a duty to keep its people safe. 

Does mandating the use of masks indoors in public constitute tyranny? Is God against public health? Are certain political ideologies blind to the health and safety of a people? Can what is generally viewed as outlandish in most democratic societies be mainstream, and thus virtually unchecked, in one particular society?

However, other salient factors leading to the crisis in Arizona as of early July are worthy of being mentioned. Such factors include the refusal of Arizonans overwhelmingly to maintain a physical distance from other people while in public—especially indoors, such as at retailers including grocery stores, department stores, and bars. Even before mid-May, when Arizona had been on lock-down, grocery store employees got away with regularly ignoring the store policies and state law on physical-distancing because neither the store managers nor public authorities (e.g., the local police, county Environmental Services dept, city government) would see that the policy or law was enforced. Store managers of two grocery chains blatantly told me that they were not enforcing their own physical-distancing policies and thus the state law. Even on July 9, 2020, when the state’s hospitals were nearing capacity from the virus, I was stunned at a Sprouts store to see neither customers nor employees paying any attention to the store’s own regularly-announced physical-distancing policy. From a business standpoint, refusing to follow or enforce a store policy goes beyond incompetence and sheer foolishness; fecklessness, I submit, was also in the mix.
Wearing masks indoors when in public became a local law in Phoenix in late June, 2020. A few days before July 4, 2020, I went to Target, a retail department-store chain, to return an item. As I entered the store, I saw a sign indicating that masks must be wore as per the local law. 


Inside the store, I asked the assistant manager helping me with the return what is done to customers who ignore the policy and law. “Oh, we can’t enforce that,” she said matter-of-factly. 
On the evening of July 4, I (stupidly) went to a bar/restaurant called Half-Moon Sports Grill for a burger. As I approached the establishment, I heard a group of customers leaving the “restaurant” wonder aloud, “No one in there is wearing a mask.” Yet I went inside anyway, though to an isolated table from which I could see the horse-shoe bar where neither masks were being worn nor physical distancing was being enforced (e.g. by spacing out the seating). The store’s policy violated the law on both counts. 

The seats had not been spaced out along the bar. Perhaps the manager was spaced out? Many people sitting at the bar and at the tables near me were not eating anything. Even actual drinking was sparse. The customers "nursing" their drinks could have removed masks to take periodic gulps or sips, as the case may be. 

Indeed, the governor had recently closed bars (and gyms) because they had been hotspots for transmission of the contagion. A waitress told me that masks were not required when people were sitting. The law, however, stated at the time that masks need not be worn while mouths are being used to eat or drink.  The manager of Half Moon must have assumed that anytime a customer is seated, he or she must be eating or drinking. This is not what I saw, and during a crisis wouldn’t it just make sense to err on the side of caution in interpreting the local law? I was especially shocked when the waitress came up to my table twice without wearing a mask; she had been walking without wearing a mask and she had apparently decided that physical distancing does not apply to herself.
So the next day, I gave the local police a tip. On a Sunday afternoon, the cops would go to the bar/restaurant to see if any violations were occurring. I offered to send the videotape I had shot inside the establishment, but the Phoenix police refused. So the matter being corrected depended on whether the bar was busy enough on a Sunday afternoon to show a violation. No one would ever guess that the matter was urgent and important; it was as if the police were oblivious to the unfolding health crisis. The police had obviously not been paying attention when the governor had only weeks early stated in a news conference that businesses refusing to enforce local and state measures would be dealt with. Instead, the police followed their typical minimalist enforcement routine. A minimalist mentality has no place during a crisis, except, it seems, in Arizona.
The local transit authority, Metro Valley Transit, already had a sordid reputation for enabling bus drivers who were hostile to paying customers and drove badly. In early July, the company showed just how incompetent it was by having signs and a company voice (phone) message indicating that masks were required on the buses and yet Oliver, a supervisor of the customer-service department, told me that because some passengers cannot wear masks for medical purposes (i.e., there were exceptions), the company was only recommending that masks be worn. That a requirement would be treated as optional because exceptions exist demonstrates gross managerial incompetence. Such incompetence (and narrow-minded rigidity) is apparently inert even to a societal crisis (e.g., sky-rocketing numbers of coronavirus cases). That is to say, more was involved than ignorance.



Masks being worn improperly, or "minimalist," quickly became popular in the Phoenix metro on the buses, with drivers looking the other way. In the photo just above, the driver had even contorted his mirror so as to see the passengers, and yet he did not even ask the passenger pictured to wear a mask in spite of there being a "Mask Are Required" ungrammatical sign facing the entry door. This is ironic, given the driver's intent to be able to watch as many passengers as possible. The pleasure of power seized at in weakness issues out in control, yet interestingly here without holding passengers accountable. 


On July 10, 2020, I was fortunate on my morning commute to be on a bus in which not only was the driver not wearing a mask, but three passengers were not too. One of them was biting down on a small towel, demonstrating that the lack of accountability on the non-enforcing drivers was particularly risky, given the willfulness and ignorance of many riders. By the same reasoning, the lax enforcement of the public-health state, county, and local (Phoenix metropolitan area) laws by police and the respective governments on not only the bus company, but also grocery and department stores and restaurants/bars bore a high health cost given the condition of the local population. 



It was bad enough that the vast majority of bus drivers were not enforcing the mask policy in spite of the local law even though signs notifying passengers (and drivers) of the requirement were on the buses. On July 10, I discovered that at least one driver didn't think his company's policy and the law pertained to him. After he let on three passengers who were not wearing masks, I called Metro Valley's customer service number. Not surprisingly, no one from the company (e.g., the driver's supervisor) bothered to call the driver during the route. That too is typical, even though the customer service employees could see to it that someone from the company immediately calls the driver, whether he or she is not wearing a mask, enforcing the policy/law, or being verbally abusive toward paying customers. In May, I had tried calling the local police on a driver who was refusing to comply with the bus company's policy on 10 riders maximum on a standard-sized bus. "You have to call the bus company," the police dispatcher told me. "But the driver is breaking the physical distancing state law," I exclaimed, utterly astonished that a private company rather than a police department would be the only enforcer of the law. "You would have to contact the bus company," I heard again. The local police also tried to avoid enforcing the local laws on nighttime noise, so I was not surprised at the push-back itself. 
During my conversation with Oliver of the bus company in early July, I mentioned the company’s voice-message and the signs specifying that masks were required. “They are wrong,” he informed me. He even said he would change the voice-message; I was not surprised at all a week later to hear the same phone-recording that masks were required. Oliver believed that he could not be wrong even though people could die as a result. So I wrote to the city of Phoenix and the local press on the conversation. Although Oliver had no reason to fear being held accountable, given the company’s squalid management cadre, I suspect that the city may have come down on the bus company for telling customers that wearing masks is merely recommended due to there being exceptions. For a week or more later, the bus company's customer service employees were no longer telling riders that drivers do not enforce what is a recommendation. Even so, drivers were still not complying, even though the company was finally taking its own signs and voice-recording seriously. 
Despite complaints from paying customers for some time on driver hostility and bad driving (e.g., abrupt stops), the management had failed to solve those two problems. In part, the drivers’ union was too strong, but the city of Phoenix and the suburbs were not good at holding the regional transit authority accountable. So I was not surprised in early July, 2020 when a bus driver became enraged when I called customer service to report that masks were not being worn by about half of the riders, and the driver was ignoring the company’s policy on the ten-passengers maximum on a regular-sized bus. With 17 riders on the bus, physical distancing was not possible, which made the non-compliance on masks particularly risky. Fortunately, the customer service representative also heard the driver’s shouts. In going after me rather than having enforced the policies (and laws) in the first place, that driver demonstrated to me why things were out of control in Arizona with regard to the pandemic. The driver was certainly out of control mentally, and his refusal not to enforce bus-company policies with impunity means that his company was out of control managerially. By implication, the city governments in the metropolitan area were falling short in holding the regional transit authority accountable.


By early July, 2020, I noticed that the riff-raff (i.e., rules don't apply to me) on the buses were developing a sub-culture wherein masks were to either not be worn at all or just cover the chin. Because the buses are so unreliable there, the riff-raff make up the vast majority of the ridership. Even so, drivers were not enforcing the mask requirement on that ridership, which one driver confided to me is generally viewed as pathetic by the drivers. Is not a refusal to enforce a requirement also pathetic? Does this not liken the drivers to their typical ridership? Signs on the buses continued to declare that the masks are mandatory, and the drivers continued to dismiss their duty to enforce that company policy. As evidence for this investigation, I took a photo of a rider as he was dozing off; he was wearing his mask to cover his chin only. 

When this passenger got off the bus, he put his bandana on even though no one else was on the sidewalk. 

As I turned back around, I saw the driver shaking one of her fingers at me as if she were scolding a child. It is legal to take pictures on the buses and light rail in Arizona, and yet the driver felt sufficiently emboldened in her refusal to enforce the policy that she called her supervisor and took a picture of me!  Rather than realize that she had failed to enforce a requirement, she directed her hostility to me. Generalizing, given all the reports of driver hostility toward passengers, the drivers who refused to enforce company policy not only felt entitled to do so, but also aggressively went after the paying customers who felt that the drivers should be held accountable because they were putting the health of those customers at risk. Sadly, given the continued bad driving and driver-hostility generally, I could conclude that the company’s management was lax (i.e., incompetent) on holding its drivers (and bus operating subcontractors) accountable.
It is interesting that at least some retail companies, bar/restaurants, and bus companies in Arizona gave up on enforcing their own respective policies (and any underpinning laws), while Airlines, libraries, medical clinics, and hospitals had no such problem. It is not surprising that NBC News would find that things are out of control in Arizona regarding the pandemic. It is ironic that such a heavily-policed state, where intimidation from a huge police show of force/presence is presumed to be the best deterrent to crime, would be so deficient on enforcement even during a crisis. Perhaps views of the national news could finally see just how pathetic the situation in Arizona really was, and likely will be for some time.
Theists, ecologists, and ethicists could agree that a pandemic taking a particularly dire toll on such a people would make sense. Theists could point to God’s disfavor on the selfishness, lack of consideration for others’ health, refusal to do one’s duty in enforcing public-health business policies and governmental laws, and hostility. The same rationale would support a variant on the Biblical story of Noah—this time with God extinguishing our species for having refused to sufficiently stave off carbon-induced climate change. Naturalists could paint a picture of a selfish, inconsiderate people being especially prone to a pandemic. Nature abhors weakness, and thus a weak people. Ethicists might say that it is just that people who refuse to enforce policies or laws protecting the public health during a crisis catch the virus themselves. Similarly, bus passengers and retail customers whose risky behavior puts others at risk could be said to deserve to suffer the plight themselves. They would doubtless disagree, and they would insist that they could not be wrong about it, as if they were gods on stilts during a flood.


1. David Hochman, “Alan Alda Is Obsessed with the Power of Science,” AARP: The Magazine, June/July, 2020.

Thursday, February 28, 2019

Regulating Smoking in China: A Socialist Conflict of Interest

Government ownership and control of a means of production is the standard definition of socialism even if some linguistic revisionists want to redefine the term as merely the control of a business or industry. In short, a government must own the economic enterprises to meet the definition of Socialism rather than merely government regulation of private businesses. Socialism, I contend, involves a structural conflict of interest that a government that both owns an controls an enterprise, industry or even an entire economy may be tempted to exploit for its own ends rather than the public good. The key here is the regulating of that which is owned. Specifically, where a government as owner enjoys the benefit of profit or surplus, that government has a financial interest that can be against the restriction of the produced product. Such a monopolistic restriction could admittedly be warranted by public health or safety, but the gain could also be private in the sense that it is limited to the government and even the personal financial interests of government officials. In other words, the public good can be distinct from a government’s own financial (and related political) interest even as that government is charged with acting in the public interest in part by owning and regulating state enterprises. It is the pivot between the public and private interest that sets up the conflict of interest because the human urge is to go with a narrower, private interest at the expense of the public good. In other words, the very possibility, even likelihood given human nature, that a government would exploit the wider distribution of benefits for the narrower one (i.e., to the government itself) is the basis of a conflict of interest. I argue elsewhere that even the mere possibility renders even an as-yet unexploited conflict of interest inherently unethical. Here, I examine the matter of public health in China as a case of a socialist (in part) government that has had a conflict of interest. 
Three hundred million Chinese were smokers in 2010. This number is roughly equivalent to the entire U.S. population in 2000. In 2010, the addiction killed an estimated 3,000 people a day in China; this translates into 1.2 million tobacco-related deaths for the year. One out of three cigarettes smoked worldwide was smoked in China. It was estimated that smoking would kill about a third of Chinese men under 30. On May 1, 2011, the Chinese government banned smoking in indoor public places. However, the law contained no penalties. According to Time magazine, the law was not likely to have any effect.[1]
The reason for the lenient regulation may have had something to do with the powerful China National Tobacco corporation, a state-owned and controlled enterprise. In 2010, taxes and profits from the monopoly were roughly 7% of the government’s revenue.[2] That gave government officials an incentive to protect the enterprise's revenue and a disincentive to issue regulations that could be expected to reduce the consumption of cigarettes in China even if a reduction were in the public interest. This combination of incentive and disincentive is an earmark of a conflict of interest, the basis of which is the human instinctual urges behind the combination. 
This may be why more incentive typically exists to protect and increase revenue coming in than to minimizing costs even if they exceed the revenue. Even if the government’s expense in covering health-care costs for the 3,000 Chinese a day who died of smoking in 2010 exceeded 7% of the government’s total revenue, even a partial loss of revenue would likely be resisted by government officials.  Attention to revenue can dwarf that to costs especially where no market competition exists because extracting more revenue is relatively easy whereas cost-containment is still difficult.
Ethically, the government officials otherwise tasked with regulating so as to protect the public health in China and thus preventing deaths from smoking suffered from the personal (if kickbacks were involved) and institutional conflict of interest wherein the government’s financial interest and public-health goals were in conflict. That is to say, the officials not only had their own ethical dilemmas to resolve; there was also a larger institutional problem akin to a house being designed to be at odds with itself. The part of the government oriented to protecting and even increasing the revenue may have had disproportionate influence beyond that of the public-health department because the narrower the benefits are, the greater the incentive. Seven percent of the state's revenue doubtless got more attention from the state itself than its broader public-health measures, including those that made it more difficult for people to smoke in public. 





1. “A Smoking Ban without Teeth,” Time, May 20, 2011.
2. Ibid.


Thursday, September 28, 2017

Contradictory Comments on Health Insurance as Unethical: The Case of Newt Gingrich

Newt Gingrich said on May 15, 2011 that people should be required to buy health-insurance. He added that he would like to see the mandate implemented at the state rather than the federal level. These comments unleashed a torrent of criticism from Republicans, so the former Speaker of the U.S. House of Representatives spent the following week “walking” his comments back by denying that he had said that he was for a mandate.  The media was in a feeding frenzy, astounded that the former Speaker could simply deny that he might get away with the contradiction. However, in such cases, is it the person or logical contradiction itself that gets us so steamed?

Although we tend to point to the person who has made a contradiction without acknowledging it, ascribing possible sordid motives, it could be that the logical contradiction itself lies at the source of the angst in the beholder. More specifically, the logical contradiction itself may be in its substance an uncomfortable emotion rather than reason. In other words, violating logic may be an emotion that appears in the form of twisted reason.

Otherwise, it would be a case of reason causing an emotion. For example, “You logically contradicted yourself and that makes me mad” is typically taken as something of reason causing a particular emotion. It is difficult to link reason and emotion because we take them to be different things. It is a bit like Descartes’ mind-body problem.  Were logical contradiction itself an emotion, however, then to say that a contradiction caused anger might be easier to explain as one emotion would be giving rise to another—both being of the same type of thing (i.e., emotion).

Going even further, the observation that logical contraction is an emotion distinct from the anger may be an illusion.  Because the anger comes so quickly and naturally, it could be that what we take as the anger is simply part of the complex emotion of experiencing a logical contradiction. Similarly, when a person says that he feels confused, a cognitive condition is really an emotion because it is felt. Like confusion, experiencing logical contradiction does not feel good.

In general terms, talking about logical contradiction as an emotion of disapprobation reconciles Kant’s first formulation of his categorical imperative to Hume’s psychological theory of morality.  To Kant, moral principles are universal because of the role of universality and necessity in reason, so maxims that involve a logical contradiction if they are universalized cannot be moral. To Hume, moral judgment just is the sentiment of disapprobation.

Typically, Kant’s ethical theory is viewed as rationalist, whereas Hume’s is portrayed as psychological. However, if logical contradiction is itself an emotion having the form of reason, then it could be said that the moral sentiment of disapprobation applies to the uncomfortable emotion that the experience of logical contradiction. Reason turned against itself only seems to be cognitive rather than emotion. If what we have in a logical contradiction is essentially an emotion (or even an emotional reaction), then Kant’s rationalism and Hume’s sentimentalism are no longer antipodal. To say that logical contradiction is unethical is to say that it gives a rational and emotional being a sentiment of disapprobation. Logical contradiction itself naturally gives us a bad feeling; indeed, the contradiction may simply be a way of labeling a particular emotion.

So when we say that Newt Gingrich should not have contradicted himself (or he should own up to having contradicted himself), the basis of our moral judgment could be the emotion that we feel when we are confronted with a logical contradiction—the contradiction being that sentiment of disapprobation.


Sources:

Kant’s Groundwork of Metaphysics and his Critique of Practical Reason.  See also David Hume’s Treatise of Human Nature.

Naftali Bendavid and Jonathan Weisman, “Medicare Revamp Exposes Divisions Within the GOP,” The Wall Street Journal, May 17, 2011, p. A6.

Sunday, February 12, 2012

Distinguishing Entitlements from the Safety Net

In 2012, Congress lost sight of the fundamental purpose of a safety net, extending it beyond the difference between life and death. By zeroing in on the purpose of a safety net, Congress can both save money and better provide for the survival of those who are not providing it for themselves. Of such people, where survival itself is at stake, questions of being deserving pale in comparison to society’s obligation to fend off starvation, sickness and homelessness. Ironically, by extending the safety net beyond survival, Congress has undercut its role in providing for its citizens’ survival.

The “government safety net was created to keep Americans from abject poverty, but the poorest households no longer receive a majority of government benefits. A secondary mission has gradually become primary: maintaining the middle class from childhood through retirement. The share of benefits flowing to the least affluent households, the bottom fifth, . . . declined from 54 percent in 1979 to 36 percent in 2007,” according to a Congressional Budget Office analysis published in 2011.[1] Making the secondary mission primary undercuts the primary mission by putting it at risk.

Objections to the secondary mission as unnecessary can spill over as criticism of the primary mission as if it too were not necessary. “Many people say they are angry because the government is wasting money and giving money to people who do not deserve it. But more than that, they say they want to reduce the role of government in their own lives. They are frustrated that they need help, feel guilty for taking it and resent the government for providing it.”[2] A wealthy retired person drawing social security insurance ought to feel guilty; the insurance program is not a savings account. Criticism of this category mistake can impact politically the funding of social security for those who need it. For example, even as wealthy retirees draw on social security, the social security disability program is work-based, meaning that a minimum number of quarters of work are necessary even for one to apply for benefits. Making a safety net dependent on a work history cuts off the long-term ill from the safety net. Moreover, the requirement implies that a person who has a disability does not deserve to survive independently of work. For a safety-net program to be dependent on anything means that the program is not part of the safety net, as safety nets are by definition not conditional. Yet where a society so values work as a source of a person’s value (e.g., “I am a plummer”), a program can easily be assumed to be part of the safety net without actually being part of it.

Related to the political cost of criticism of superfluous programs (i.e., beyond survival) is the refusal to fund true safety-net programs sufficiently. Congress has “expanded the safety net without a commensurate increase in revenues, a primary reason for the government’s annual deficits and mushrooming debt. In 2000, federal and state governments spent about 37 cents on the safety net from every dollar they collected in revenue, according to a New York Times analysis. A decade later, after one Medicare expansion, two recessions and three rounds of tax cuts, spending on the safety net consumed nearly 66 cents of every dollar of revenue.” One “benefit” of tax cuts is that they “starve” entitlements, which are all grouped together and presumed to be unnecessary rather than serving a true safety-net function.

The result of the prejudice and related starvation is that over the next 25 years from 2012, “as the population ages and medical costs climb, the budget office projects that benefits programs will grow faster than any other part of government, driving the federal debt to dangerous heights.”[3] In other words, safety-net programs are fair game on the chopping block without respect to whether people die without them or are merely inconvenienced. The failure to distinguish between these two is dangerous to the abject poor. Were the distinction made, corporate welfare and even middle-class welfare could be cut by more, I submit, than the additional funds needed to provide the least well-off with sustenance. In other words, we as a society can have a solid survival-oriented (and limited) safety net that is not conditional while actually saving money as benefits are narrowed to people who really need them.

The key is focus in place of upward drift. As just one example, money saved from a means test for social security retirement insurance could be spent in expanding social security disability such that its benefits are not conditional on the long-term ill somehow having worked thirty or forty quarters in the last ten years. How exactly is a retarded adult supposed to find and hold a job for that many quarters?  Making the benefits unconditional with respect to work history is crucial, as the social security supplemental income program is insufficient to meet sustenance needs. It is unconscionable to expect the long-term disabled to have worked in order to receive enough to live on while the middle class receives entitlements classified as “safety net.” The key to making survival a human right is recognizing the need both to expand programs at that level and severely restrict programs aimed at higher levels. Whereas middle- and high-income beneficiaries of government largess can justifiably be blamed, it is sheer cruelty to blame those who are not able to meet even their own basic needs from work for receiving subsidies.

In my rather ignorant, presumptous hometown, an unemployment rate of around 20% went with the recession of 1980 as the machine tool industry went to Europe. The city had the highest unemployment rate in the state in the post-September 2008 recession, and yet the first vote the re-elected U.S. House representative made in 2010 was to cut off unemployment compensation. His claim was that people should get off the dole and work for a living. It was apparently beside the point that there were no jobs; the unemployed were supposed to have them anyway. This is like telling people that the empty space on a table is to be imagined as spaghetti and then getting mad at them for not eating it—as if they should be expected to eat air. Such warped, illogical thinking as the Congressman evinced in 2010 in the rustbelt of America can be linked to reducing a true safety net to a society of entitlements. To hold the poorest of the poor to such warped thinking is utterly cruel as well as ignorant. I hope American society has not come to such a selfish and short-sighted end. The society is only as good as we treat the least among us, for such treatment reveals our true colors.

1. Binyamin Appelbaum and Robert Gebeloff, “Even Critics of Safety Net Increasingly Depend on It,” The New York Times, February 12, 2012. 
2. Ibid.
3. Ibid.


Saturday, February 12, 2011

Employing Smokers: Economic, Political and Social Aspects

Hospitals in Florida, Georgia, Massachusetts, Missouri, Ohio, Pennsylvania, Tennessee and Texas (among others), stopped hiring smokers in 2010 and more countries were openly considering doing so. Paul Terpeluk, a director at the Cleveland Clinic in Ohio, said, “The trend line is getting pretty steep, and I’d guess that in the next few years you’d see a lot of major hospitals go this way.”[1] Indeed, this could come to be the case around the world. Various factors impact any comprehensive evaluation of a hospitals' policy against hiring smokers. The matter is therefore more complex than one might assume at first glance.
 

The full essay is in Cases of Unethical Business: A Malignant Mentality of Mendacity, available in print and as an ebook at Amazon.


1. A. G. Sulzberger, “Hospitals Shift Smoking Bans to Smoker Ban,” The New York Times, February 10, 2011.