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#Rhetorical Ink Reviews
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In Defense of Gillington “Gil” Webber Part 3
After a small hiatus I am back with the same mission of clearing Gil Webber's good name! but now with EXTRA motivation!
We last left our lovelorn lovers at the end of Welcome to Skull Shores in Part 2 of the media analysis. Let's jump back into the Webisodes shall we?
In Episode 94 "Defending your Lagoona" we get an episode all about Gil standing up to his racist parents on Lagoona's behalf. All this labor I have done to explain that Gil is a loving boyfriend to Lagoona could have been summed up just by this episode alone HOWEVER, I've never been a fan of doing things the easy way and brevity is not one of my strengths. But it's all said in the title now isn't it?
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Gil is at home getting ready for a date with Lagoona. Gil seems to live in a decommissioned submarine. Seeing where the kids live is something I loved in G1! it was very rare when we got it but it was always a good time! however with G2 and G3 both choosing to go the boarding school route we lose this unique glimpse into our monsters lives. pity, I loved this!
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We find him gong through his closet looking for something to wear to impress Lagoona, this is the first time we see one of the boys do this as it's usually the ghouls who are always looking for the right outfit. Just has he's about ready to leave his parents stop him.
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These are Gil's parents!? the big bad bigots we've been hearing about all this time!? Obviously it's not ALL of them, just a tentacle. but still! ah ha ha! what makes them more hilarious is they don't speak English they communicate via a series of bubbles, gurgles and gibberish that only Gil understands. Is this River Monster? their native tongue? Now I am very sad we never once got a frustrated Gil going off in this language. I come from an English as a second language household and when my mother cannot find the words to express herself in English she will usually fly off into Spanish.
I'm sad we did not get a pair of faces to attach to Gil's parent's in the web series but a fan artist @sarahsota-artpopp did a banging interpretation of The Webbers.
Before Gil leaves for his date his parents get on his case for once again, dating Lagoona. They remind him that she is a Salt water monster and what their people say about her kind.
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it's cute that he has pictures of Lagoona on his wall.
He tells his parents (his dad? mostly) That "Lagoona isn't like that, she's wonderful!" I don't like that he phrases it this way, it reeks of "She's one of the good ones" which is rhetoric I'm not a fan of as we discussed in my review of Skull Shores. But if we look at Gil and understand the home he is coming from, his phrasing makes sense. This is baby's first escape from a racist household, he is going to carry some of those prejudices with him and prejudice is different from racism. Gil's parents bubble something and Gil replies "She IS different! you always said that Sea Creatures were mean, spiteful monsters! but Lagoona is the sweetest most sensitive ghoul I've ever met!" A lot of this episode is just a clip show of things I've already gone over so I'm going to focus mostly on the things Gil says and his parents say back. "You told me that Sea Monsters were disloyal and treacherous but Lagoona is the most faithful, true and protective friend that anybody ever had"
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Gil has nothing but nice things to say about Lagoona. His parents start spurting out ink in anger. After this his Dad (?) says something and Gil gets upset. "You're still clinging to those worn out old prejudices!?" Gil looks very angry by this point.
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They gurgle something and Gil says "You're wrong about this! I'm not going to stop seeing her! so you're both just going to have to deal with that!"
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Gil turns his back on them, gives them a dismissive hand wave and walks away.
Y'all wanted to see Gil go toe to toe with his parents well, here it is! this is the throw down you've been waiting for! This is 100% genuine as it's just him and his parents, Lagoona isn't here this time like she was in Episode 45 so you know this isn't performative, this is how Gil genuinely feels.
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Gil returns after his storm off because he forgot the flowers he was going to give to Lagoona. Gil you ditz. However, despite the fact he was just cross with his parents, he still says bye and tells them he will be home early. Still the attentive son even while angry.
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The episode ends with Gil's parents frothing with rage and inking up the screen, fading to black.
Now, Because this is a cartoon we can accept the fade to black as the ending, but in an actual situation? one or both of his parents would have snatched him in the water and been like "You're not going anywhere!" and threw him back into the sub, grounding him, beating his ass or even eating him. Look at them! they're huge compared to him! I'm surprised they haven't eaten him already, he's been so disobedient.
He must be their only son but I'm sure the desire to eat his disobedient ass is ever present.
Speaking of eating people I have a theory that this is how G3 is going to finally put an end to the whole Lagoona can't date Gil because his parents are racist drama. Gil is going to introduce Lagoona to his parents, they call her a filthy ocean dweller and she's just going to unhinge her jaw like a snake and eat them and that will be that, That is how we're going to deal with The Webbers racism in G3, Lagoona fucking eats them, the end.
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Eat your local racist 2k23.
Anyways "Defending your Lagoona" is one of my favorite episodes because it is irrefutable proof that Gil loves Lagoona, Gil stands up for Lagoona and Gil does not agree with his racist parents.
However this episode does have one major flaw, it's just a re-hash of stuff we already know, that is the nature of clip show types of episodes but this is the first time we revisit the same fight of "Gil's parents are racist against Lagoona" and I think this is what annoyed many fans, we have this same fight over and over for the next 3 years after this. I think this is where the writing starts to fall apart and Gil's character suffers because of it. doesn't matter if Gil didn't do anything wrong, fans were sick of hearing about the fight by this point. it was very nice of the animators to put all this info into one episode for us, but we've heard this fight before.
We don't see Gil again until Episode 101, "No Ghouls Allowed" Where the boys are all ditching their ghoulfriends and lie about it, Gil's lie was the boys were going to his house to work on their rap album.
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Clawd: "Rap Album!?"
Gil: "Sorry, I'm a terrible liar"
He's right, this entire review has been Gil being punished by his compulsive need to tell the truth. Gil would have a lot less problems if he just lied better, like what are his parent's gonna do if he told them Lagoona was fresh water? DNA test her? Poor sweet honest soul.
The rest of the episode is the ghouls spying on the boys to find out what they are actually doing and a lot of what they find is very aggressive.
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Cleo assumes this means they are going to fight but the reality of the situation is they are just a bunch of nerds who are playing D&D.
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This doesn't really have anything to do with Gil's love life, I just wanted to showcase him being a fuckin' dork.
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*Pew Pew!*
In Episode 107 "Flowers for Slo-Mo" Lagoona helps Slo-Mo to be worthy of Ghoulia, long story short: Slo-Mo knows Ghoulia is a genius and worries he's not smart enough for her. He takes a potion from Cleo that makes him hyper intelligent, but it also makes him a pompous windbag.
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This new self important attitude pushes Ghoulia away.
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Slo-Mo goes to talk to Lagoona and she tells him Ghoulia doesn't like what he has become.
Lagoona: "Rude, Full of yourself"
Slo-Mo: "But I'm an absolute genius! that's what she wanted!"
Lagoona: "That's what you said she wanted! She liked who you were before. if you were really a genius you'd know that."
... I don't know why people keep going to Lagoona for relationship advice when she is the least qualified to give it. She is being a huge hypocrite here, getting mad at Slo-Mo for assuming what's best for Ghoulia when she did the exact same thing to Gil! she wanted him to tell his racist parents he was dating a sea water ghoul, Gil didn't want to do that Gil wanted to hide the relationship.
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Where was this same understanding for Gil, Lagoona? why is it always "Tell your parents about me!" and never ' You like me and that is enough." hmm? huh? hmmhuhhmmhuhhmm?
Anyways the episode ends with Slo-Mo becoming less smart again and Ghoulia likes him just as he is. I only brought up this episode to shine a spotlight on to Lagoona's dating advice. She really should practice what she preaches.
Volume 3 of the Webisodes technically ends after Episode 118 "Playing the Boos" HOWEVER! a DVD Came with 6 bonus episodes that are the official end of Volume 3! Which DVD this was Wikipedia does not say, but I have the "Scaremester Collection" bonus DVD that came with 18 Webisodes and none of these are on there, they MIGHT be on the "Best of the Ghouls Collection" DVD which I also have but unfortunately that DVD doesn't include an episode guide and I just got done watching 118 Monster High Webisodes, I'm not gonna sit though another 32, 26 of which being ones I've already seen. I'm dedicated but I have limits, ya feel me?
Because these Episodes are DVD exclusives they are not all on Monster High's official YouTube, the links I will be posting were uploaded by third parties so the quality may have suffered a wee bit...Any-who... in Episode 119 "Department of Monster Vehicles" We see something VERY interesting! Everyone is trying to help Frankie prepare to take their road test. Gil offers to help by offering a video game for Frankie to play and...oh ho ho!
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Some intriguing developments at Gil's house! this window in his bedroom turns into a TV screen! they're playing "Extreme Graveyard Derby" which is some Monster world version of Grand Theft Auto by the looks of it. The first time we saw Gil's room I assumed that box with the lifesavers on it was his bed, but upon closer inspection it's probably a footlocker trunk and he might sleep in the hammock that's behind everyone. RIP Gil's spine.
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I'm highlighting this episode because Lagoona is in Gil's house! so either his parents suddenly got cool with a lot of stuff very quickly... which we know didn't happen... or they are more than likely not home, which is why he feels safe having his friends (and girlfriend) over. it's kinda sad that Gil only feels comfortable bringing his friends around when his parents aren't there but that is the sacrifice you gotta make when you have bigoted parents.
In Episode 124 "Monster-morphoseas" Lagoona is trippin' She bites off Heath's head, is apathetic in Mr. Rotter's class and overly aggressive at her swim meet. Cleo immediately blames Gil which... might be where everyone gets it from. But Gil promises to do a "loud crazy gesture" to show Lagoona how much she means to him.
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After a few failed attempts to cheer Lagoona up the ghouls find her sitting by the ocean just enjoying the sounds it makes, She then explains the reason shes been such an emotional roller coaster is because "Every 100 years the Ocean goes through a magnetic reversal, causing all of us sea creatures to go though a Monster-Morphsis" Frankie wants to know how they can fix it and Lagoona tells them "You can't fix it, it's part of who I am." Frankie understands this and asks what they can do for her. Lagoona continues. "Be there for me, Be my friends, Listen to me... and Right this second? be quiet" Lagoona just wants silence so she can listen to the waves and they are silent for about a second (Because... 2:33 run time) before Lagoona speaks again "I'm kind of glad Gil isn't with you. This is so hard to explain, especially to a freshwater boy" Basically what I'm getting from this is Lagoona is going through sea creature PMS and all her ghouls are there for her... But nobody had any time to tell Gil that she wanted peace and quiet. Soooooo...
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Gil went and threw Lagoona a parade to cheer her up.
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Gil found dead in Miami.
In all seriousness no wonder people think Gil is a bad boyfriend, some of his best moments praising Lagoona are either in a clip show episode (which nobody watches) or like in THIS episode "This is one of the three webisodes first released as an extra on the "Frights, Camera, Action!" UK DVD on March 17, 2014" which is a DVD exclusive I'm not sure anyone outside the UK saw, I know I didn't.
But the episode ends and with it so does Volume 3 officially which is still a good Volume despite not being one long ongoing plot like Volume 2 was. But Gil's characterization is the same, this boy is wiling to bend over backwards to make Lagoona happy and y'all just wanna throw him to the sharks.
I've been asking people on Twitter why they dislike Gil and the answers vary but the two biggest ones are "He's ugly" to which....Yea, Sure, Okay... and that he is racist. But I'm looking at this content really, Really, REALLY hard and I am just not seeing it.
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I am actively looking for the racism and I am not finding any! which is actually pretty hard to do because racism is everywhere but even so, not finding it. Has he said some off color things? Of course he has, He's 16 and dumb and comes from a racist household he's gonna say some prejudiced things that he may not even know are prejudiced (it's important to note in Skull Shores he did apologize after saying something bigoted to Lagoona). But look at his actions! He treats Lagoona with so much care, attention and affection! at her command I have no doubt our boy would walk across a bed of nails if it pleased her. He finds out she is kinda bummed and throws her a parade. Even when she isn't around? He goes to blows with his racist parents to defend her honor. These are not the actions of a racist or a bad boyfriend. These are the makings of a great boyfriend and a great person in general.
Gil could have let his parents racist ways taint him, it's so easy to just go with the flow isn't it? do what the family wants, date a nice freshwater girl to appease Mama and Papa Webber, But he didn't.
In the face of adversity Gil chose love.
And that is where I am going to end this part of my media analysis, not because I'm out of space but because this feels like a good place to end, Volume 4 went on hiatus after this and we're diving back into movie lore in the next part, yes there will be another part, I'm gonna keep doing this until I run out of content or I get bored with it. If you've come with me so far on this journey I hope you are not too tired yet, we still have much to discuss!
Part 1 + Part 2 + Part 3 + Part 4
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nbmsports · 10 months
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‘Dear England’ Review: When Soccer Success Becomes a Moral Victory
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What makes a good leader? When the unassuming and softly spoken Gareth Southgate was appointed head coach of the England men’s soccer team in 2016, many fans and commentators felt he lacked the kahunas for the role, that he was simply too nice. But in the past seven years he has overseen a remarkable transformation in the England team’s fortunes, making it stronger and more exciting to watch than at any time in recent history.The ups and downs of Southgate’s tenure are portrayed with a blend of playfulness and moral seriousness in “Dear England,” directed by Rupert Goold, which runs at the National Theater, in London, through Aug. 11. It’s a lively, feel-good romp with plenty of irreverent humor, though the narrative borders on hagiography, and its core message about embracing male vulnerability is labored to the point of soppiness.The play chronicles the team’s involvement in three recent major tournaments, starting with its surprise run to the semifinals of the 2018 World Cup in Russia; then comes an agonizing defeat by Italy in the Euro 2020 final, followed by an impressive showing, culminating in an unlucky quarterfinal exit, at last year’s World Cup in Qatar.The on-field action is evoked through dynamic set pieces choreographed by Ellen Kane and Hannes Langolf, in which the players enact key moments in elaborate simulations, complete with slow-motion sequences and freeze-framed goal celebrations. These are kitsch, but mercifully brief, as the bulk of the activity takes place off the pitch: in locker rooms, team meetings and news conferences whose settings are rendered with smart simplicity by the designer Es Devlin.Joseph Fiennes is outstanding as Southgate, who is portrayed as self-effacing but assertive, an approachable father figure to his young charges. Will Close, as England’s captain and star player, Harry Kane, plays up the striker’s famously laconic manner, providing a bathetic counterpoint to the coach’s earnest rhetoric. Adam Hugill is similarly amusing as the defender Harry Maguire, who is portrayed as a lovable simpleton — not the sharpest tool in the box, but solid and dependable. Kel Matsena delivers a spirited performance as Raheem Sterling, who, along with Bukayo Saka (Ebenezer Gyau), speaks out defiantly against racism after England’s Black players are the targets of abuse.The principal female character in this necessarily male-dominated lineup is the sports psychologist Pippa Grange (Gina McKee), hired by Southgate to help the players open up about their feelings and overcome self-doubt. When one unreconstructed member of the coaching staff questions the need for her services, she reminds him that psychology has been at the root of England’s past failures: “This is men, dealing, or not dealing, with fear,” she says.The play’s author, James Graham, is known for political theater, with hits including “Ink” and “Best of Enemies,” and “Dear England” has distinctly activist overtones. Southgate’s mild-mannered disposition, emotional intelligence and leftish politics — he has been supportive of Black Lives Matter and outspoken on mental health issues — are kryptonite to a certain type of reactionary sports jock. So it’s tempting to view his story as a culture-war allegory, pitting touchy-feely liberalism against old-school machismo.Unfortunately the play leans into this a little too heavily, with pantomimic cameos from several of Britain’s recent Conservative prime ministers — Theresa May, Boris Johnson and Liz Truss — pandering to the assumed prejudices of cosmopolitan London theatregoers in a way that comes off as ingratiating and smug. This is ramped up in the second half, which is considerably less funny, and feels rushed: The 2020 and 2022 tournaments are rattled through at speed, in contrast to the more leisurely pacing before the intermission.Southgate’s playing career is best remembered for a decisive miss in a penalty shootout against Germany in the semifinal of the 1996 European Championship, played in London, which resulted in England’s elimination from that tournament. A personal redemption narrative forms a compelling subplot the main story, and it’s a cruel irony that Southgate’s England side also lost the final of Euro 2020 in a penalty shootout on home soil. That Southgate has yet to bag a trophy — the England men’s team still hasn’t won a major tournament since 1966 — remains a powerful trump card for his doubters. And so the play’s celebratory tenor feels a little misplaced.Yet “Dear England” is not so much about sports as it is about culture. The technical and tactical foundations of the England team’s revival are conspicuously underplayed in this telling: The team’s on-field improvement is straightforwardly tethered to a shift in moral values, and we are given to understand that correlation equals causation. You can be fully on board with everything Southgate stands for and still find this cloyingly simplistic.Dear EnglandThrough Aug. 11 at the National Theater, in London; nationaltheatre.org.uk Source link Read the full article
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statecryptids · 11 months
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Another Pride Month Book Review!
Transcendent: The Year’s Best Transgender Speculative Fiction
Edited by K.M. Szpara
As literature about exploring and pushing the edges of human experience, it’s not surprising that science fiction and fantasy have always featured characters who are beyond the binary of cis men and cis women.  From L. Frank Baum’s Ozma of Oz, who spent her childhood as a boy; to Virginia Woolf’s titular Orlando, who begins life as a man and wakes up one day as a woman; to the gender-cycling Gethenians of Ursula LeGuin’s The Left Hand of Darkness.
Following in this long legacy, Transcendent is the first in a yearly series of anthologies featuring trans themes and characters.
Many of the stories are poetic and experimental, requiring a slower reading to fully absorb the atmosphere. Often a reader must simply plunge headlong into a tale, trusting that they’ll figure it out as they go, or maybe understand it better on a second reading after the piece has had a chance to sit for a while in their head. The effectiveness of this experimental storytelling method can be very subjective, and while didn’t always work for me, other readers will find more meaning in these esoteric stories.
Other stories, like Bonne Jo Stufflebeam’s Everything Beneath You, have the feel of mythology, as if they were modern translations of tales illustrated on sunbaked clay wall frescos, or in delicate inks across unfolding silk scrolls.
There are, of course, stories that fit into our more conventional notions of science fiction and fantasy. E.Catherine Tobler’s Splitskin is magical historical fiction featuring nonbinary Native characters during the American Gold Rush era. Molly Tanzer’s The Thing on the Cheerleading Squad is a modern take on Lovecraft’s gender-swapping pulp tale The Thing on the Doorstep. Margarita Tenser’s Chosen is a riff on one of the most popular fantasy tropes- you can probably guess which one. Where Monsters Dance, by A. Merc Rustad has veins of metaphor-heavy fantasy films like Labyrinth and The NeverEnding Story.
The Need for Overwhelming Sensation by Bogi Takács is a particularly interesting story about a starship literally powered by the magic generated through the pain and pleasure of a loving BDSM relationship. 
As with any anthology, some stories did not entirely work for me. Holly Heisey’s Contents of Care Package Sent to Etsath-tachri, Formerly Ryan Andrew Curran, for example, is a short piece about a human who transitions into an alien. For me this plot hews a little too close to the “when I was a kid I identified as a velociraptor” rhetoric that transphobes use to try to delegitimize trans identities. But perhaps that’s part of the point of the story?
Transcendent is an important milestone in more direct representation of trans folks in speculative fiction. You can get a copy of this and the other books in the series from Lethe Press.
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rhetorical-ink · 4 years
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Rhetorical Ink Reviews: Seven Deadly Sins - Season One
**SINFUL SPOILERS BELOW** 
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My brother and I have been doing “Sibling Streaming” since the start of the Covid-19 quarantine -- catching up with Haikyuu!!, which we both wanted to watch, and then we watched my pick: Demon Slayer, which I’ve reviewed. My brother’s pick was Seven Deadly Sins, and so with us having finished Season One, I wanted to give you all --
My Top Ten Thoughts on Seven Deadly Sins - Season One:
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10. Probably my favorite aspect about the show is the character dynamics between each other -- the “Seven Deadly Sins” (or 6 at this point...we haven’t met the “Pride” sin, yet) all interact in unique and fun ways with one another. Obviously, my favorite dynamics so far are Meliodas and Ban’s interactions along with Diane and King’s -- since we’ve been with those four the longest so far.
9. The show isn’t afraid to get gory...but is there a consequence? I appreciate that the show does not shy away from blood and gore from the get-go. The only aspect that is a little frustrating is, as my brother notes, “anime logic” on bleeding out. Seriously, these guys have like 200 liters of blood in them. It does make the stakes seem a little lower at times, when you know the characters can get healed rather quickly or survive certain blows.
8. I will say that I like the side characters we have introduced! Gila and Jericho are fun, Howser is basically “The Yamcha of Seven Deadly Sins” and my brother and I are here for it, Arther Pendragon is so lovable (probably doesn’t help he has the same English dub VA as Tanjiro for Demon Slayer), and then we have Margaret and sweet, “little Gil.” 
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Not going to lie, I hated Gilthunder at the start of this show. He was an annoyingly smug antagonist and for most of the season, he just ticked me off with how he wasn’t being open-minded as Howser and Gila had become learning the “truth” about the situation the Seven Deadly Sins (SDS) were placed into. However, once Margaret gets involved, and we have the reveal that they’ve been “cursed” this entire time, and the curse is lifted, then Gil becomes a good character, and I’m here for that!
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7. About that -- probably my biggest critique/pet peeve about the show is that it tends to “show” you things happening, but doesn’t follow up with the “tell” until much later. I do appreciate that there’s more “show” than “tell” to begin with, but when you don’t understand what’s happening, it can be confusing.
With the Gilthunder and Margaret curse-lifted moment, I was so confused watching. My brother, who has read the manga, was like, “Don’t you get it? It’s ____” but because I hadn’t read the manga, I had to wait until the next episode started to get the backstory and explanation. Waiting on exposition in a fantasy world that has some crazy world-building elements can be frustrating, especially if you’ve watched shows that handle it slightly more effectively (a la Demon Slayer).
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6. I do like Meliodas’s character a lot -- he’s a fun, yet powerful character, and reminds me a lot of Bleach’s Ichigo  and his hollow when his demon side lets loose. However, there is one aspect I’m not a fan of, and that’s his constant groping of Elizabeth. I get it...it’s a common trope in manga/anime, but I still am not a fan of it and it does make me uncomfortable, especially in a scene when he does it in front of Elizabeth’s father. So...there’s that.
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5. Speaking of Elizabeth, I will admit that at first, I was weary of her character, seeing her as a “damsel in distress” -- but, a few episodes in, she starts to establish herself as more than that, and by the end of season one, she’s basically a healer and someone capable of saving themselves and those around them. I also really like the angel vs demon dynamic that her and Meliodas have together, and I’m looking forward to that expanded in later seasons!
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4. So, in terms of favorite characters, I would have to say that while I love all of the SDS’s equally, my favorites are Ban and Gowther at this point. Ban is just such a fun “badboy” trope that I really appreciate getting more depth in this season. His love for Elaine is just adorable and I really hope we get more on those two in future seasons. It’s also fun that he’s basically immortal, so there are a lot of gags they can get away with that are hilarious and effective.
While I said I wasn’t a fan of the groping, I would be remiss to not mention that there is some “man service” given with Ban’s character typically at the center of it, so I can understand if someone thinks there’s a double-standard there. Although...no one is groping Ban. I do appreciate the joke that his outfit keeps getting ripped and there just happen to be people running around with red leather suits on.
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On the opposite end of the “man service” spectrum is Gowther, who is just a badass psychic who can create mental illusions and has some powerful magic surrounding him. He’s basically a robot personality-wise, so I hope we get more developed with his character two...especially as...is he in a relationship with Gila? Not going to lie...I’m kind of all for these two emotionless powerhouses teaming up.
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3. In terms of antagonists, of course Hendrickson is the main baddie of this season -- I’m not entirely convinced he’s gone, since he’s been set up as such a threat and his goal of combining their world with the demon realm seems to still be the central conflict of the show. However, while he does turn into the “frieza-style-transformed-monster” by the climax of the season, I did appreciate the uniqueness of the “New Generation” and how he was using demon blood to corrupt and control the Holy Knights -- it was a neat plot point and I liked how that same demon he was using connected back to Ban, King, and other characters. I’m wondering where that story arc goes from here...
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2. While I did nag on the show being confusing at times with showing us information and not telling us other information, I DO appreciate the world-building in terms of all the fantasy elements. There’s fairies, immortals, angels, demons, giants, and other creatures just out and about and it helps to establish a variety of types and varieties of creatures to interact and have unique abilities...now if only I could keep them all straight.
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1. Overall, I am happy to start watching Seven Deadly Sins, if for the characters and to see where the story goes from here. Is it my favorite anime I’ve picked up this year? No, but now that we’ve at least established the world, the characters, and I have an idea where the plot can go, I’m curious to see how it’s expanded upon and hopefully to get backstory on some of the SDS we haven’t been able to focus on -- and to see the last one! Also, Ban’s left the group to go on his own personal side quest, so I’m excited to see that unfold as well.
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rachellekirtley · 4 years
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The Green Wave Of Tourism For Colorado, Cannabis Tours
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insanityclause · 5 years
Link
Towards the end of 2017, Zawe Ashton quit acting. She was 33 years old, with a CV that included roles in the cult TV comedy Fresh Meat, films such as Dreams of a Life and Nocturnal Animals and a solid 12 years on the stage, with appearances at the Royal Court and the Old Vic. But something no longer felt right. “There was an artistic chasm opening up between the work I felt I was meant for,” she says, “and the work that was coming my way.”
Less than two years later, Ashton is on Broadway, receiving rave reviews for her performance as Emma in Harold Pinter’s Betrayal. Tom Hiddleston plays her husband, Robert, and Charlie Cox her lover. “At the moment,” she acknowledges with a wry smile, “quitting acting is going very badly for me.”
It’s Friday morning in Manhattan and Ashton and I are talking over almond croissants in a French café around the corner from her digs. Being superstitious, she claims not to have read Betrayal’s reviews. But when I tell her that The New York Times called her the show’s “breakout star”, she grins. “Oh, that bit I have seen. It’s written above my massive head on a poster outside the theatre.”
Jamie Lloyd’s pared-back production had already been a hit in London before transferring to New York last month, and the three primary cast members are making their Broadway debuts together. “Thank God,” she says. “It’s like losing your virginity with another virgin.”
The last time Betrayal was staged on Broadway, in 2013, it starred Rachel Weisz, Daniel Craig and Rafe Spall, and broke box office records in its opening week. “I’m obsessed with Rachel Weisz and Daniel Craig,” says Ashton. The couple live nearby: I ask if she has she hung out with them while in town. “Absolutely not!” she cries, pulling a face as if I’ve just suggested we sprint naked up Ninth Avenue.
Despite barely being out of work since signing up, aged six, for weekend acting classes at the Anna Scher school in north London – and landing her first paid job, on Jackanory, that same year – Ashton says: “I don’t consider myself in the public eye at all. I still sit in the window of the threading place I’ve been going to since I was 15, and have a woman thread my moustache.”
How much longer that anonymity will last is open to question; news stories linking her romantically with Hiddleston – The Night Manager star catapulted to Hollywood heart-throb status by his role in the Avengers films – are already flooding the internet.
“We’re in a play called Betrayal – of course people are going to speculate,” she laughs, when I broach the subject, but refuses to be drawn on it. “Being in dialogue with that is just so weird to me. It’s surreal.
“Is [the speculation] selling tickets?” she asks, rhetorically. “I bloody hope so – it’s got to be good for something, hasn’t it?”
If the castmates are dating, Ashton must be a master of time management. Betrayal may be getting all the attention, but as of Monday, she will have a hand in three theatrical productions running simultaneously. for all the women who thought they were Mad, Ashton’s play about mental health in the black community and the overmedication of black women, is opening on the same night in the Hackney Showroom in London and the SoHo Rep Theatre, off-Broadway in New York.
Ashton wrote the play in 24 hours in a “fever dream,” at the end of a 2008 Young Writers program at the Royal Court Theatre – where her fellow students included playwrights Nick Payne (Constellations) and James Graham (This House, Ink) – and with the help of a group called the Black Women’s Mental Health Project (“Now defunct, of course, because: austerity measures”).
“A woman there gave me facts and figures that seemed to unlock parts of the play that I’d started to write,” says Ashton, “and it confirmed something I knew on a very deep instinctual level, about the cultural biases that happen on a daily basis.” Ashton has first-hand experience of those biases, not least since, as she notes, “this play has taken 11 years to produce. I can’t help think that if I were a 24-year-old white male, it would have been on in every theatre in the land.”
Ashton grew up in north London, the eldest child of an English father and a Ugandan mother, who met while teaching; her father went on to become a commissioning editor at Channel 4. Home was “an environment where I was very much allowed to be the creative soul that I was,” says Ashton – her younger brother is now an artist and musician and her sister, a producer.
At school (state, single sex) things were less rosy. "I was so badly bullied,” she says. “I was this tall, skinny misfit who was unapologetic about the things that I was passionate about. I had a sense of who I was and what I was into, and you’re not supposed to have that. You’re just supposed to blend in.”
Even in the face of “a huge physical threat, a lot of the time,” she refused to conform and instead developed a resilience that would serve her well at drama school in Manchester. “By the end, they couldn’t wait for me to leave,” she says. “I’d turned against the institution in such a major way; you can’t grow creativity in a vacuum like that.”
Creativity is not something Ashton lacks. In the past couple of years alone she has directed a short film for Tate Modern about the artist Lorraine O’Grady, presented the Channel 4 arts programme Random Acts, guest-edited BBC Radio 4’s Woman’s Hour, and in April, had her first book published.
Character Breakdown is a comic novel based “absolutely, one hundred per cent” on Ashton’s own experiences as a woman in the entertainment industry. It features a catalogue of bullying, body image issues, insecurity, objectification and misogyny.
She began writing it, “pre- pre- pre-” the inception of the #MeToo movement two years ago. “When I started writing it, I was nervous that no one would give a s--- – who’s going to want to hear about an actress’s problems? Then, suddenly, all anyone’s talking about are actresses’ problems – I was, like, I’ve got to finish this book!”
Although she describes herself as “not someone who’s always asking: what’s next?” she admits that directing something substantial is high on her to-do list. “I love putting all the components together,” she says. “I want to draw the map rather than follow the map.”
for all the women who thought they were Mad is 
at Hackney Showroom, London N16 (020 3095 9747) from Mon
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popatochisssp · 5 years
Text
Make You Mark, 6/10
Series: Undertale, Underfell Relationship(s): UF!Papyrus/Reader Chapter Warnings: Extreme Thirst
AO3 Link
In a world where soulmates exist, monsters and humans have one thing in common: the first time two soulmates touch, a mark randomly appears somewhere–anywhere– on their bodies to represent their match.
It still doesn’t make relationships easier…but maybe it does make them a little more interesting!
When that nasty, nitpicky ladder-climing bitch, Gertrude had gotten you fired, you had been incensed.
It wasn’t a great job, you weren’t heartbroken to be let go, and most of your coworkers you wouldn’t even miss—save one.
BP had been there when you were gathering up your things, not really helping but with a look on his face that so resonated with your innermost feelings of impotent, nihilist disgust at management that it felt like he was helpful, anyway.
“This sucks,” he’d muttered in solidarity, watching you angrily cram a sweater into your bag. “Probably gonna make me do your job instead of hiring somebody else…”
“Sounds right,” you’d agreed. “Such bullshit, I can’t believe they’d fire me over…!”
Feeling the burn of injustice threatening to erupt from your mouth in a stream of very loud cusswords or maybe from your eyes in actual tears, you’d forced yourself to laugh instead and even attempted a joke.
“Ha, I should sue for this… Know any good lawyers?”
You hadn’t expected BP to actually look like he was considering it, or to say at length, “…Well…actually…?”
As it turned out…he did.
Tail twitching, ears flicking nervously, BP told you in a hushed and hurried tone that he knew a real good lawyer—a monster one, of course, but if that wasn’t a problem for you, he might even be able to hook you up.
“He works pretty cheap,” BP said, “all things considered. Likes the tough cases mostly, stacked odds and hard wins… I think he’s into the challenge more than the money—he’s probably bored otherwise, y’know he used to captain the Royal Guard, Underground? When we still had one, anyway. Point is, he’s one scary prick, he’d knock something like this out of the park for you.”
You felt you could hardly be blamed for being a little incredulous.
You eyed the visibly jumpy cat beside you, whispering while pretending to walk you out and looking like he’d jump a foot in the air if he heard a manager speaking too close.
“You can get somebody like that for me?”
BP’s ears flattened, in either offense or embarrassment.
“I…! Listen, I…! His brother owes me a favor, I can…make something happen for you…pr…probably…” He shook his head. “Just…keep an eye on your email, okay? You actually did your job instead of dumping it on me like… I…owe you, or whatever.”
You hadn’t been expecting much at the time.
It was a sweet sentiment by monster standards that he was even willing to try to do something like that for you, and you appreciated it for what it was.
The look on your face was probably hilarious when you actually received an official-looking email asking if you were the human seeking a wrongful termination suit— and asking after your availability to meet in the coming week.
-
Obviously, being newly unemployed, your availability was fantastic, which is how you ended up here, nicely dressed and sat outside at a nice little sidewalk bistro, waiting for your pro bono consultation regarding your legal recourse per your recent termination.
…Or at least, that was what Captain Papyrus’ email had said.
Since you have so much time to kill these days, it’s no surprise that you’re early. The past fifteen minutes have been spent fiddling with hems and tracing idle circles around the rim of your complimentary glass of water.
Normally, you’d fool around on your phone but you’re waiting for an Important Meeting with a monster you’ve never met and the last thing you want is to get too absorbed in a game and end up making an embarrassing first impression, or miss the guy entirely.
It’s not until ten minutes to the time you’d set that you realize how silly a thought that was.
You don’t see how you could’ve missed a monster like Papyrus.
The skeleton that strides into the bistro is tall and smartly dressed, exuding such a powerful aura of confidence that you swear for a second you can actually, tangibly feel it. His cheekbones are sharp and his fangs are sharper and when the roving red lights in his eye-sockets land squarely on you, you have to hold back an instinctive shiver.
You have to admit, you’re a little mad at BP, right now.
He never told you Papyrus was hot.
You don’t have time to dwell on it, though, because he’s coming over to you and you have to seem like a normal, respectable human—instead of a thirsty one.
You stand to greet him, smiling pleasantly. “Hi! Captain Papyrus, I presume?”
“YOU PRESUME CORRECTLY.”
He asks your name, his voice surprisingly deep and more than a little sexy raspy and you nod. You absently note that he’s not wearing gloves and hasn’t extended his hand to shake, so you don’t offer yours, either.
“THANK YOU FOR BEING PUNCTUAL,” he says curtly. “I HATE HAVING TO WAIT ON PEOPLE. MY SCHEDULE IS TIGHT ENOUGH AS IT IS.”
“I understand,” you agree, wordlessly encouraging him to sit as you do the same. “You’re doing me a big favor, I really appreciate this.”
Is it your imagination, or did Papyrus’ chest puff out a little just there?
“OF COURSE YOU DO,” he says, the hint of a smile playing along his jaw. “NOW, LET’S NOT WASTE TOO MUCH TIME, WE MAY AS WELL GET RIGHT INTO IT. YOU’RE CERTAIN YOU DON’T MIND DISCUSSING HERE?”
You shake your head ‘no.’ It’s a public place, but relatively deserted at this time of day and you’re not concerned that any really sensitive information will be discussed.
“RIGHT THEN.”
Papyrus pulls a hefty stack of papers from his briefcase, carefully carding through them as if to refresh his memory.
“I’VE REVIEWED YOUR CASE,” he tells you, “AND IT’S SOLID. YOU ARE ABSOLUTELY WITHIN YOUR RIGHTS TO PURSUE WRONGFUL TERMINATION AGAINST YOUR FORMER EMPLOYER.”
Your eyebrows shoot up. “I…really? I am?”
“YES. ARE YOU SURPRISED?”
“I…a little bit, yes,” you admit. “I didn’t…really think I’d be on the right side of this… ”
You’d been angry, certainly. Indignant, absolutely. Utterly railroaded by months of Gertrude’s petty hair-splitting, definitely.
But you had been in violation of the employee dress code, however technically.
You glance down at your hand, the small bit of commemorative ink you’d gotten there staring up at you.
“My tattoo really isn’t a problem…?”
Papyrus scoffs.
“IT MIGHT HAVE BEEN,” he says, “HAD YOU NOT HAD THE TATTOO FOR MORE THAN A YEAR PRIOR TO YOUR EMPLOYMENT AND WORKED WITHOUT INCIDENT UNTIL…VERY RECENTLY.”
He starts flicking through the papers again, pulling out one you recognize—an email chain you’d sent to him, displaying one of several unpleasant exchanges you’d had with Gertrude.
“YOU DID WELL TO DOCUMENT THESE COMMUNICATIONS,” Papyrus tells you. “I USUALLY TAKE ACCUSATIONS OF WORKPLACE SABOTAGE WITH A GRAIN OF SALT, BUT THESE… IT SEEMS CLEAR TO ME THAT THIS…GERTRUDE…REALLY WAS OUT TO GET YOU. AND WITH YOUR TERMINATION, SHE STOOD TO TAKE YOUR PLACE FOR PROMOTION, IF I RECALL CORRECTLY?”
Petty as it was, you’d…kept track of her on social media. You can confidently answer, “Oh, she got it, alright.”
Papyrus nods in satisfaction. “THEN THAT’S ALL THE MORE INCRIMINATING. IF YOUR EMPLOYER KNOWS WHAT’S GOOD FOR THEM, THEY’RE GOING TO WANT TO SETTLE THIS MATTER OUT OF COURT, IT’S BLATANTLY DISCRIMINATORY CONDUCT.”
Out of court? Really?!
“My case is that good?” you ask, still unable to fully process it.
“WELL, WITH CLEAR PRECEDENT ON YOUR SIDE…”
“There’s been a case like this before? That a tattooed employee actually won?”
It sounds unrealistic to you. You’d been so immersed in the rhetoric of tattoos as ‘unprofessional,’ unsuitable to be shown around customers and clients for any reason, no matter what or where they were, that the concept feels foreign to you.
“TECHNICALLY,” Papyrus says, “IT WAS A SOULMARK, NOT A TATTOO. A YOUNG LADY HAPPENED TO MEET HER MATE AND HER MARK FORMED ON HER NECK QUITE VISIBLY. SHE WAS FIRED FOR HER ‘UNPROFESSIONAL’ APPEARANCE, IN SPITE OF HER WORKPLACE’S DRESS CODE FORBIDDING THE KINDS OF COLLARS AND CHOKERS THAT MIGHT’VE CONCEALED IT. SHE SUED AND WON.”
That makes you frown a little.
“Mine isn’t… It’s just a normal tattoo,” you insist. “I got it on purpose and everything, with boring old ink and needles.”
Papyrus doesn’t seem concerned.
“A MINOR DISTINCTION,” he assures with a dismissive flap of his hand. “A MARK IS A MARK REGARDLESS OF HOW IT GOT THERE. ANY LAWYER WORTH THEIR SALT COULD ARGUE THAT YOU COULD GET A SOULMARK ACROSS THE BRIDGE OF YOUR NOSE TOMORROW AND YOUR EMPLOYER WOULD’VE BEEN WRONG TO FIRE YOU FOR IT, SO WHY WOULD SUCH A MODEST LITTLE THING LIKE THAT BE SO OBJECTIONABLE?”
You spare another glance to your ink when he gestures to it, and when you look back up, the skeleton’s expression is nothing short of boastful.
“AS A MATTER OF FACT, I COULD WIN YOUR SUIT FOR YOU IN MY SLEEP!”
A bolt of excitement strikes through your soul.
Hesitantly, hopefully, you ask, “Are…are you offering to represent me?”
Even if on a purely professional basis only, you can’t deny that you’d…really like an excuse to see Papyrus again sometime.
Not only because he’s a very handsome guy with the kind of voice that could make the dictionary sound riveting.
But as you watch, his eye-sockets go wide, his cheekbones reddening at the look on your face.
“I………NO. NO! THIS WAS—IS! JUST A CONSULTATION!” he denies. “I’M ONLY REPAYING A FAVOR INCURRED BY MY SCOUNDREL OF A BROTHER, I’M…! I’M TOO BUSY BY FAR TO TAKE ON YOUR CASE, EVEN AS OPEN AND SHUT AS IT OUGHT TO BE!!!”
……
You thought he was hot strutting over to you before with his chiseled face and his sleek suit and his squared shoulders.
…And now, you think he’s unbearably cute with his impossible blush and flustered expression.
Maybe it’s a good thing he’s not going to be your lawyer, because if he’s not going to be working for you…
You think you kinda want to ask him out.
“Alright,” you decide aloud, “I guess I’ll…start looking for another lawyer, if I decide to…pursue this. Um…in the meantime, though, maybe…maybe……… Oh, no.”
Buzzkill in the extreme, you spot the absolute last person you want to see right now walking down the street—and she’s noticed you, too.
Even worse, a smirk comes across her face and she swaggers on over to your table with a ‘delighted’ cry of your name.
“Hello, Gertrude,” you manage to grit out.
You watch as Papyrus flinches at the laugh that comes out of the woman’s mouth, feeling validated.
You always hated it, too.
“Oh, sweetie, please, I keep telling you, you can call me Gertie! Especially now that we don’t work together, haha!”
As if she wasn’t directly responsible for that.
“Right,” you say flatly. “Look, I’m…really sorry, but I’m… I’m kinda busy right now, so I—”
“Really?” The fake incredulousness of her tone makes you bristle. “I thought you’d have so much time now! You know, since you’re…ahem…job-hunting, at the moment.”
“…Yeah. L—”
“I’m actually kind of jealous,” Gertrude has the nerve to giggle. “I’m so busy since you left, with the assistant manager thing and all. I wish you were still around to help out, but…” She clucks her tongue. “I know you just weren’t a good fit there, what with your ‘lifestyle.’”
Stars above.
You’re out of patience.
“It’s one tattoo, not a ‘lifestyle,’” you snap, “and I’m in the middle of something right now, so can you please just…go?”
This was…sadly, very familiar to you.
Good ol’ Gertie was just too good at the passive-aggressive game: she was a bitch with a beaming smile and she knew just how to work people up until they got mad and then she was the victim who was only making conversation…
And you were the bad guy.
You feel your cheeks heating with instant regret, even as Gertrude gasps and puts on her ‘innocent pearl-clutcher’ act.
“So rude!” she exclaims, scowling at you. “I was just checking up on an old friend from work and you tell me to ‘get lost’?!”
You try not to squirm in your seat. “That’s not what I—”
You’re cut off, like you always are.
“You know, it’s exactly that horrible attitude that got you let go,” she says in a decidedly lecture-like tone. “You’re never a team player, you neveraccept any criticism, it’s like you don’t even care about your work! You obviously don’t care about your appearance, just look at what you did to yourself!”
Your eyes widen as Gertrude actually reaches out to you, making to grab at your tattooed hand. Shocked, you start to stand—to shove her back or scurry out of her reach, you have no idea—but you never make it up.
In one fluid movement, Papyrus is out of his chair, pressing you down with surprisingly gentle claws and moving to stand directly between you and the bane of your existence.
“MA’AM,” he says to her, and the stony chill of his voice makes any words you had die on your tongue. “I WOULDN’T.”
Suddenly, you remember what BP told you about Papyrus—that he was a soldier before he was a lawyer—and that seems abundantly clear now. His entire bearing is obviously military, ready for combat and poised to defend you from even the minor threat that was a judgmental, self-righteous jerk.
Your companion’s demeanor certainly seems to have spooked Gertrude.
She takes a step back, blinking up at Papyrus in shock.
“I… Who are you?” she demands to know.
Your hero doesn’t even flinch.
“I AM THEIR LAWYER,” he declares. “AND I WOULD SERIOUSLY ADVISE AGAINST ANY ACTION ON YOUR PART EVEN RESEMBLING HARASSMENT OF A FORMER EMPLOYEE CURRENTLY PURSUING LITIGATION. THAT WOULD LOOK CONSIDERABLY UNFAVORABLE FOR YOU AND YOUR EMPLOYER SHOULD THIS MATTER GO TO COURT, ESPECIALLY WITH MYSELF AS A WITNESS TO YOUR BEHAVIOR.”
That was a lot of big, loaded words for Gertrude to take in and for the first time in your life, you get to have the pleasure of seeing your nemesis look afraid.
Faced with the potential of actual consequences for her pettiness, all she has to say for herself is, “I…! I’m leaving!” before scurrying off down the sidewalk, tail between her legs.
And you have never been so attracted to anyone in your life as this fucking skeleton.
God damn…
Papyrus watches her retreating form until she’s out of sight and slowly retakes his seat.
“……EIGHT MONTHS?” he asks you after a moment.
The amount of time you’d had the joy of that woman as your coworker.
“Yeah,” you confirm.
“YOU’RE A SAINT.”
The deadpan delivery makes you laugh despite yourself, and the sharp grin Papyrus gives you in return makes your heart beat a little faster in your chest.
“I, uh… I couldn’t help but notice,” you slowly say, “that you…might’ve told her you were my lawyer. Did… do you mean that, or…?”
He didn’t.
It’s pretty obvious to you, especially with the way that cute blush comes back across his face—just something he said in the heat of the moment to make getting rid of Gertrude easier—but you can’t resist pushing your luck.
“I…HONOR MY COMMITMENTS,” Papyrus says, even as it looks like it’s killing him. “YES, FINE, I’LL TAKE YOUR CASE. LET’S EXCHANGE NUMBERS SO I CAN CONTACT YOU TO DISCUSS THE DETAILS.”
You have to admit, it’s not really the way you’d been hoping to get Papyrus’ number…but you’ll take it.
Maybe when everything’s said and done, you’ll have worked up the courage to ask him out for real!
…Naturally, that resolve is only strengthened when you get home and take off your nice blazer to find something that definitely didn’t get to be on your skin with ink and needles…
-
You’re half-expecting it when your phone rings later that afternoon.
What you don’t expect is to answer it to Papyrus’ bold, authoritative voice practically barking at you without a shred of the professionalism he’d spoken with earlier.
“WHAT KIND OF SOULMATE ARE YOU?!” he demands, sounding beyond indignant. “TO LEAVE SUCH A, A…MARK ON ME!!! I CANNOT BELIEVE…! I AM A RESPECTABLE SKELETON, AND NOW I CAN’T SO MUCH AS TAKE OFF MY SHIRT IN POLITE COMPANY AGAIN BECAUSE OF YOU, I HOPE YOU REALIZE THAT!”
He sounds so mad, so…unlike the controlled impression he’d given you before, and it feels strangely…
Natural.
You smile a little to think that you might actually be talking to Papyrus this time instead of just The Professional.
It was a very good mask—you wonder how many he has, and if you’ll get the chance to meet any more of them—but your focus is admittedly elsewhere.
Excited, you ask, “You got a mark, too, then? What is it? Can I see?”
“OH, OF COURSE, YOU WOULD WANT TO SEE YOUR HANDIWORK, YOU DEVIL! FINE!”
There’s the sound of shuffling and then your phone buzzes with an incoming photo. You switch Papyrus to speaker so you can properly ogle it.
The breath comes out of you in a whoosh when you get your first good look. Your skeleton soulmate just sent you the type of picture guys usually sent unsolicited, with a towel hanging low on his pelvis—obviously fresh out of a shower—and a view of his scarred spine and ribcage that could only be described as 'gratuitous'.
Not excepting, of course, the cherry on top: the colorful little heart-shape stamped right in the middle of his sternum.
“Ohhh,” you coo, “that’s so cute!”
“CUTE?!” Papyrus practically shrieks over the phone. “IT IS NOT CUTE! IT’S…IT’S LEWD! A SOUL, RIGHT THERE FOR EVERYONE TO SEE! YOU, YOU LECHEROUS HUMAN, YOU, MAKING ME LOOK LIKE I’M…SOME KIND OF DEVIANT PERVERT! HOW DARE…”
You tune him out a little, letting him keep right on ranting. You need to make sure you have the right angle and lighting for the picture you’re about to send back to him.
You know instantly when he gets it because his words trail off and there’s a noise that sounds suspiciously like his jaw clacking shut.
“What do you think?” you ask after a long moment of silence.
Personally, you’re very fond of the ruby-red rose that’s announced itself on your arm, its thorny stem curling gracefully around your bicep.
You hope he likes it, too, and you can easily imagine that he’s blushing again like he did before…maybe even darker this time.
Eventually, Papyrus speaks.
“………I…I CAN’T BE YOUR LAWYER. I’M…IT WOULD BE HIGHLY INAPPROPRIATE AT…THIS… ” He pauses to clear his throat…or the skeleton equivalent. “AT THIS POINT IN TIME. IN LIGHT OF RECENT DEVELOPMENTS.”
Ah, his composure is coming back. You wonder if you can’t fix that.
“Maybe you can recommend one to me,” you coyly suggest. “Over coffee, maybe. At my place…?”
“………S-SEND ME THE ADDRESS!” he snaps, and then he rudely hangs up on you.
You just laugh and hope you’ll be able to wipe the grin off your face before Papyrus shows up.
So, you lost your lawyer…
But you’ve snagged yourself a date with your soulmate and that feels like a damn good trade-off!
UT!Sans | UT!Papyrus | US!Sans | US!Papyrus | UF!Sans | SF!Sans | SF!Papyrus | HT!Sans | HT!Papyrus
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go-redgirl · 3 years
Photo
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Report: Hunter Biden Continues to Hold Stake in Chinese Private Equity Firm
Hunter Biden, the youngest son of President Joe Biden, appears to have kept his ten percent stake in an international private equity firm with ties to the Chinese government, despite promising to sell his share in the venture.
Biden, a one-time lobbyist who reinvented himself as an international businessman during his father’s tenure in the Obama administration, officially resigned from the board of Bohai Harvest RST (BHR) in October 2019. At the time, the younger Biden cited his father’s then-budding presidential campaign as the reason for his departure, suggesting he did not want to give the appearance of a conflict of interest.
As part of his decision to resign, Hunter Biden’s family associates suggested he would unload his stake in BHR to finally lay to rest questions about his business dealings. That impression was only bolstered in late 2019, when then-candidate Joe Biden pledged that, if elected, his family would relinquish any foreign business ventures.
“No one in my family will have an office in the White House, will sit in on meetings as if they are a cabinet member, will, in fact, have any business relationship with anyone that relates to a foreign corporation or a foreign country,” Joe Biden told voters.
Despite the rhetoric, however, Hunter Biden appears to have kept his ten percent stake in BHR, according to a report by the Daily Caller. That determination was made after the outlet reviewed corporation records filed with China’s National Credit Information Publicity System through two firms specializing in market research and intelligence.
Such revelations come as questions remain about how much Biden’s equity in BHR is actually worth. Biden, who claims to have never received any compensation from his service on BHR’s board, has asserted, through a family lawyer, that his stake in the firm is only worth $420,000. Ethics watchdogs, however, contend that valuation is potentially off by millions.
“It is difficult to imagine, if not incomprehensible, that a ten percent stake in those economics is worth only $420K,” Steven Kaplan, a professor at the University of Chicago’s Booth School of Business, told FactCheck.org in October 2019.
“The distinction they appear to be making is they capitalized the management company with $4.2 [million] even if the fund manages $2 [billion],” Kaplan added at the time. “The value of that management company is likely far in excess of $4.2 [million] if they are managing $2 [billion].”
As Breitbart News has reported, Biden’s ties to the firm have long been at the center of ethical controversy. In December 2013, the younger Biden flew aboard Air Force Two with his father to Beijing. The trip was part of an official state visit the then-vice president was making to the country amid escalating tensions with the United States over islands in the South China Sea.
Although it is unclear exactly what transpired during the journey, Biden entered into a lucrative business arrangement shortly afterward. Only 12 days after the trip, Biden and his business partners inked a multibillion-dollar deal with a subsidiary of the state-owned Bank of China.
The deal, which was the first of its kind, created BHR as a private equity fund to invest Chinese money overseas. Once the fund was up and running, it invested heavily in energy and defense projects.
A number of those investments caught the attention of congressional lawmakers during the 2020 White House contest–most notably, BHR’s investment in a company blacklisted by the U.S. government for suspicion of helping the Chinese government violate human rights and the fund’s purchase of an American firm with insight into military technology in 2015. The issue was specifically controversial because the purchase of the latter required approval by the Obama administration’s Committee on Foreign Investment in the United States.
READ MORE STORIES ABOUT:
2020 Election Politics Bohai Harvest RST China Hunter Biden Joe Biden
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OPINION:  Hunter Biden is a crook if we ever have seen one.  These people take the focus off of themselves while they do all the dirty work and make money off the back of other.
All the Biden’s need to be locked the ‘Heck’ up.  Joe Biden taught his son how to scheme and get rich without lifting a finger.
So, the ole man Joe Biden in now sitting in the White House and don’t even know what the heck he’s doing.  
This is a Sad, Sad, Sad, day in America!
Our country have been hoodwink by the Baden’s!
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ardenexcz8276 · 3 years
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Quit Smoking Grass Today - Why Marijuana Hurts And A Person Should Stop It
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blogwritetheworld · 6 years
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The Write Place: The Everywriter’s Desk
by Lisa Hiton
Looking for the right advice on pursuing the writer’s life? You’ve come to the write place!
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The summer before my junior year in high school, my soon-to-be teacher, Ms. Tanimoto, assigned two books to incoming AP students: The Scarlet Letter by Nathaniel Hawthorne and The Elements of Style by William Strunk Jr. and E.B. White. The Scarlet Letter was forgotten as soon as it was finished; I instantly detested Hawthorne’s penchant for moral allegories surrounding evil and sin, finding it all a bit too on-the-nose and heavy-handed. The Elements of Style, however, became an instant mainstay to my writerly temperament.
It seemed strange to be assigned a reference book to read cover to cover. I’d only ever used reference books like dictionaries, thesauruses, and encyclopedias as touchstones during reading and writing assignments—brief interruptions to expand my knowledge and/or revise my work.Upon reading Strunk and White’s masterpiece, however, my understanding of reference books changed entirely. Though the book is a mere 87 pages, my peers seemed to begrudge the assignment or blow it off entirely. I, on the other hand, found my attention rapt.
The Elements of Style is a reference book on the rules of English rhetoric, yes, but the attitude and dogma of its writers, Strunk and White, make it as much a manifesto as a convincing collection of laws governing the way we (ought to) speak and (must) write. The seriousness of tone and voice in these pages presents us with far more than a reference for grammar and usage, but rather, a true understanding of style in and of itself—that rhetoric is more than grammar and syntax, but a true translation of our consciousness into clear, material words. Such gravitas became most apparent to me when I arrived to page 52. Amid the section on misused words and expression, Strunk and White lay out the difference between nauseous and nauseated as follows:
Nauseous. Nauseated. The first means “sickening to contemplate”; the second means “sick to the stomach.” Do not, therefore, say, “I feel nauseous,” unless you are sure you have that effect on others.
Besides thinking of the many times I had misused “nauseous”, I actually laughed out loud. Amidst the seriousness in the rule there was a deep sense of snark. From the seriousness came a great deal of humor.
Since that first reading encounter with The Elements of Style, my well worn copy has remained with me. Whether I’m writing an academic paper, a cover letter, an author’s bio, a poem, a book review, or anything else, Strunk and White are there reminding me to be as clear as possible.
MY ELEMENTS OF STYLE
As I continued to grow in my writing life, I found that other books became constant sources of aid and knowledge, so much so that my desk had its own section of books at the ready, for whatever obstacles befell a given blank page. And over the years, the kinds of references have grown to fit my own writerly needs. And as I visit my friends who are writers, I notice some trends from desk to desk.
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Here’s my working writing desk, fit with all I need! I’ve got my laptop, notebooks, pens, reference books, books to review, and some of my favorite books that I keep near me for inspiration. In the drawer of my desk, I keep mailing materials for my stack of chapbooks to sign and send to those who request it.  
Regarding reference books, every writer’s desk seems to contain The Elements of Style by Strunk and White, a dictionary, and a well-worn thesaurus. My desk currently has my hardcover copy of The Elements of Style, The New Roget’s Thesaurus in Dictionary Form, and Soule’s Dictionary of English Synonyms. Especially for those of you dreaming up holiday wish-lists, Maira Kalman’s illustrated version of The Elements of Style may be just the special book to add to the collection for you.
While I used to keep a desk-sized Merriam-Webster Dictionary on hand, I find the synonyms and thesaurus more useful these days, perhaps especially as I revise my first book of poems. When I find myself overusing the same verbs and adjectives, I can quickly reach for one of these books and get some inspiration. I’ve converted, these days, to using apps for dictionary and etymology. I especially like the free dictionary.com app, which allows you to click on a word three times and open up its dictionary page. The app also offers audio pronunciation.
Dictionaries are important resources, ones which can’t quite be replicated online. Each nation has its favorite, from the Oxford English Dictionary, to Merriam-Webster’s, to the Macquarie. While I don’t keep Merriam-Webster on my desk at this moment, I do keep it at my fingertips, using their online resources when I’m in need. Further, I’ve found the Merriam-Webster twitter to be a source of great comfort and comedy amidst America’s dire political landscape. While it is easy to look up a word online, the physical books—dictionaries, thesauruses, etc.—encourage more meandering through the worlds of words. Without the instant gratification that comes from looking up a word, you may stumble upon an etymological note that takes you to another page, and so on, until you’ve learned new things about words and perhaps found an even better way to say whatever it is you set out to put on the page.
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These are my three most used reference books right now. I’m really excited about this new, hardcover copy of The Elements of Style, especially!
Another particularity of a writer’s desk seems to be a given writer’s tools. Do you do most of your writing on a computer? In a notebook? With an old refurbished typewriter? I personally use multiple tools to get my writing done. Certain parts of my writing process involve pen and paper, while others are done on my laptop. Many writers have a kind of obsession with their objects. For example, I only write with fine point uniball pens in black or purple ink. I use fine point, black sharpie markers for my writing to-do lists. And, as you'll see from a glimpse at my desk, I'm as particular about notebooks as I am about pens!
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I keep a few different notebooks with different purposes going at a time. Here you’ll see two Shinola notebooks, which I love because they engrave your name for free—a great holiday gift, indeed!—my Moleskine planner, my to-do list pad, and a grey notebook where I keep notes on books as I read them. 
Another important element of a writer’s desk is its proximity to field guides. In my dream writing room, this might include specific maps, atlases, and encyclopedias. Currently, I’m working on poems and essays about my time spent in Greece on the island of Thassos and in the city of Thessaloniki. To that end, I have acquired field guides that can help me re-orient myself to that location. Names of trees, fish, flora, fauna, and foods are different in other places. I’ve also become a collector of field guides, including one that has images and names of specific kinds of lighthouses. What field guides might help you with a particular piece you’re working on right now?
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As a field guide collector, these are some of my favorite possessions, found in random parts of the world, flea markets, and antique stores. Right now, I’m revising poems about my time in Greece on the island of Thassos. These field guides help inspire precision in describing water, fish, beaches, shells, and the like. 
Besides reference books and field guides, it seems that craft books or books about writing and reading are a mainstay on my desk too. Some of my absolute favorites are:
Bird by Bird by Anne Lamott
The Writing Life by Annie Dillard
Reading Like a Writer by Francine Prose
Blue Pastures by Mary Oliver
Having these books on my desk is a reminder of my own intellectual inheritance as a writer, as well as a great source of guidance and inspiration to me.
EXPANSIVE FIELDS
There are of course many other must-have books, tools, and resources that writers need to have at the ready. A comparative study of writers’ desks would be ideal. In the absence of access to the likes of desks by Dr. Seuss, Toni Morrison, Maya Angelou, Stephen King, JK Rowling, and the rest, here are some starter ideas by genre that you might consider as you expand your own writer’s desk. And of course, send us picture of your own desks and favorite desk necessities on Instagram, Facebook, and Twitter by tagging us or using the hashtags: #everywritersdesk.
A Poet’s Guide to Poetry
Poetry has its own rules and vernacular that may give writers pause. From reference books, to prompting books, there are many craft resources for poets looking to understand lines, stanzas, and the soul of poetry as they grow their own volumes of poetry. Here’s a wishlist of some of my most beloved/ragged/well-loved books on poetry:
A Poetry Handbook by Mary Oliver
The Triggering Town by Richard Hugo
Letters to a Young Poet by Rainer Maria Rilke
A Poet’s Guide to Poetry by Mary Kinzie
A Poet’s Glossary by Edward Hirsch
The Art of the Poetic Line by James Longenbach
A Little Book on Form: An Exploration Into the Formal Imagination of Poetry by Robert Hass
Rules for the Dance by Mary Oliver
The Sounds of Poetry: A Brief Guide by Robert Pinsky
ABC of Reading by Ezra Pound
Keeping Things Novel
For all you novelists, there are also a whole host of books to guide you in the writing of fiction.. Here are a few additions you might want to make to your #everywritersdesk:
How Fiction Works by James Wood
Brevity: A Flash Fiction Handbook by David Galef
The Art of Fiction: Notes on Craft for Young Writers by John Gardener
On Writing: A Memoir of the Craft by Stephen King
Reading Like a Writer by Francine Prose
Mastering Suspense, Structure, and Plot: How to Write Gripping Stories that Keep Readers on the Edge of Their Seat by Jane K. Cleland
Nonfiction
If creative nonfiction is where your writing practice is focused, there are all kinds of books available for your #everywritersdesk too! Nonfiction is a huge category, which could include journalism, biography, autobiography, and more. This list is focused on the literary spirit of creative nonfiction:
Writing Down the Bones by Natalie Goldberg
To Show and to Tell by Phillip Lopate
On Writing Well by William Zinsser
You Can’t Make This Stuff Up: The Complete Guide to Writing Creative Nonfiction by Lee Gutkind
Writing True: The Art and Craft of Creative Nonfiction by Sondra Perl and Mimi Schwartz
Inside Story: Everyone’s Guide to Reporting and Writing Creative Nonfiction by Julia Goldberg
Crafting the Personal Essay: A Guide for Writing and Publishing Creative Nonfiction by Dinty W. Moore
As these books serve the writing life, there are also those books that are so well-loved that they seem to live on our desks. Right now, the collected works of Sylvia Plath and Frank Bidart have been near me at all times, just like a security blanket for my authorial heart. What books do you find stay off the shelf? Tag them in your #everywritersdesk photos.
Of course, there are many other books that may guide you on your journey. Many craft books and writers’ resources can also be found on my series blog, “Reading Like a Writer” where I recommend specific craft books in conjunction with the genre of Write the World’s monthly writing contests. We can’t wait to see your additions to #everywritersdesk by tagging us on Instagram, Twitter, and Facebook!
About Lisa
Lisa Hiton is an editorial associate at Write the World. She writes two series on our blog: The Write Place where she comments on life as a writer, and Reading like a Writer where she recommends books about writing in different genres. She’s also the interviews editor of Cosmonauts Avenue and the poetry editor of the Adroit Journal.
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karadin · 7 years
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Trump’s continuing obsession with Russia results in gutted State Department, and refusal of funds to fight Russian propaganda
Lawmakers reacted angrily to reports that Secretary of State Rex Tillerson is not spending money at his disposal to counter Russian disinformation and propaganda put out by violent extremists.
The news, first reported by Politico comes as President Donald Trump signed into law legislation that would sanction Russia for its interference in the US election, curb Trump's ability to independently ease penalties against Moscow, and bolster the Global Engagement Center (GEC) created to push back against Russian agitprop and other lies.
All the more reason, then, for bipartisan ire that Tillerson is choosing not to spend the almost $80 million already set aside for the GEC this year, a choice one lawmaker called "indefensible."State Department officials said that the delay is part of a broader policy review intended to give Tillerson time to figure out what policies are best pursued and where money is best spent. The GEC is "just one part of the overall review," Brett McGurk, the Special Presidential Envoy for the Global Coalition to Counter ISIL, told CNN's Michelle Kosinski.
That explanation isn't sitting well with lawmakers, particularly since Tillerson had singled out countering violent extremism as a major priority as ISIS loses on the battlefield and moves to inspire attacks on Europe and beyond."Countering foreign propaganda should be a top priority and it is very concerning that progress on combating this problem is being delayed because the State Department isn't tapping into these resources," said Ohio Republican Sen. Rob Portman.He and Democratic Sen. Chris Murphy of Connecticut wrote the legislation that established the GEC. Murphy said that a failure to follow through and use the center "is indefensible.""Every day, ISIS is spreading terrorist propaganda and Russia is implementing a sophisticated disinformation campaign to undermine the United States and our allies," Murphy said. "There should be no doubt these are critical challenges to our national security."
The burgeoning controversy surrounding Tillerson's inaction is generating concern that, at a time of heightened global tension and amid administration plans to cut the State Department's budget by up to 30 percent, the agency isn't functioning properly.
And it once again raises questions about the Trump administration's commitment to pushing back against Russia. The President only reluctantly signed the sanctions bill, calling it "deeply flawed," as a DOJ investigation continues into possible ties between Trump campaign associates and Russia.Tillerson himself built some of the most significant parts of his career as ExxonMobil CEO through energy deals with Russia, earning the highest civilian honor for a non-citizen from President Vladimir Putin. In recent weeks, the top US diplomat has been conducting talks with Russian Foreign Minister Sergei Lavrov that are meant to reduce "irritants" in the relationship and deepen areas of potential cooperation."Really not serious"Republican Sen. Lindsay Graham of South Carolina questioned the message Tillerson's decision sends."This idea I may not use money to help democratic states under siege by Russia adds up to a signal that we're really not serious in the Trump administration about dealing with Russian interference in our home," he said. "Here in our backyard and abroad and that just invites more aggression."Graham said he would be writing Tillerson a letter to ask for an explanation.Sen. Ben Cardin, the ranking Democrat on the Senate foreign relations committee, said he was puzzled and concerned.
 "The authorities for these funds were explicitly spelled out in last year's National Defense Authorization Act," he said, "reflecting the broad and bipartisan will of Congress. The intent of Congress could not have been more clear, and the State Department must ensure that there is a robust effort to carry out this work.""Any delay is unacceptable and ignores the attacks Russia has carried out on our country and our allies," Cardin added. "I urge Secretary Tillerson to immediately develop and carry out a strategy for the use of these anti-propaganda funds to protect our nation and the American people."
Senior Democratic Congressional sources said they have no evidence this is about placating Russia, but given this administration's refusal to get tough on Moscow, they can't rule it out. "You would think this would be a higher priority and it has to make you wonder," a Congressional source said. "We don't have direct information on that, but its within the realm of possibility. We can't rule it out. "Funding for the counter-Russia efforts was appropriated in May, making it a relatively new program. But many GEC staffers have left since the new administration took over amid Tillerson's hiring freeze and pending cuts, there has been no hiring.
Democratic sources said the lack of State Department staff to design and execute programs is seen as part of the problem. Democratic Congressional sources also say lawmakers were clear about what they want the State Department to use the money for and they want them to use it as soon as possible. "It is possible that they are legitimately still figuring out how they will use the funds," said a Democratic source on Capitol Hill. "We don't want them to throw the money out the door, but it's been seven months and we haven't heard anything from them," the source said. "Time is going by, the funds are there. The money exists. The needs exists. Why isn't anything happening?" Spotty track record Previous State Department efforts to counter violent extremism with information blitzes weren't seen as a success.Congressional sources said similar programs under the Obama administration weren't seen as well designed or effective. They said that those problems are now being compounded by a lack of coherent policy or strategy coming out of Tillerson's State Department, a criticism echoed by former State Department employees."There is no sense of their thinking, no sense of a plan how to use the funds," another Congressional source said. "And we have no confidence it would be well spent. This administration says countering extremist propaganda is a priority, but slogans and rhetoric is one thing. It's another to come out with a coherent strategy."
Tillerson adviser R.C. Hammond was among those at the State Department who pushed back against using the money, saying that to do so would needle Russia."We do not consider it accurate," Hammond told CNN Wednesday, denying that he made that statement, and insisting the US-Russia relationship was not part of the equation.When the GEC was set up at the State Department it was handed a budget of $16 million to start, with another $19.8 in supplemental funding on the table. Additionally, the Defense Department is able to transfer $60 million in fiscal year 2017 and again in 2018.
Hammond said Tillerson's staff are considering a proposal to use the additional funds and are not concerned by a September 30 deadline by which they have to request the $60 million or lose it.And he added that South Carolina's Graham "would be wasting his ink" on a letter.
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lauramalchowblog · 4 years
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Healthcare Sings The Non-Profit Blues
By MICHAEL TURPIN
Powers once assumed are never relinquished, just as bureaucracies, once created, never die.
Charley Reese
As we ponder the 100 day count down to the Presidential Elections, the rhetoric and ranting swirling around the best solution for our nation’s healthcare crisis, is hitting decibel levels not heard since the passage of the Affordable Care Act.  As with any major entitlement legislation, there are commendable elements, inefficiencies, and a host of unintended consequences. The current administration’s obsession with repeal while the ranks of uninsured people grow, begs the question, “what is the blue-print for expanding coverage and reducing waste, fraud and abuse while increasing transparency, quality and overall public health.  Answer: There is no plan and if there was, it would fall well short of achieving many of these objectives given the deeply entrenched stakeholder who actually do not benefit if the cost of healthcare declines.  It a classic NIMBY response: “I’m all for reform as long as I maintain my role and revenue in whatever solution is proposed.”. 
The Affordable Care Act is a solid foundation to build a 2.0 version of a solution to solve for the uninsured and to act as a catalyst for market reforms that will either reshape the misaligned incentives and embedded inequities in our current system or it will lead to voters demanding the expansion the role of Medicare and Medicaid.  70M adults and children are covered under Medicaid – including those who benefited by the passage of the ACA.  Approximately 55M are covered under Medicare resulting in 125M covered under some form of state or federal aid. 155M receive coverage through employers. 
Its estimated by the Economic Policy Institute that 29.8M individuals who received coverage as a result of ACA expansion would lose coverage if no legislation replaced it.  Add in the severe economic dislocation arising from Covid-19 that could result in an additional 14M unemployed and you could see a worst case of uninsured swell from a current 27M to as high as 70M according to Policy Advice, a non-profit industry watch dog.
So how can you change the current market to drive reforms without a legislated intervention?  It starts by enforcing laws already in place and challenging regulators to do their jobs – ensuring that we minimize waste, fraud and abuse.  As of 2020, the average annual cost of family health coverage has eclipsed the cost of a mid-sized economy car. We must tackle the affordability problem by reducing the number of intermediaries who extract profits from the delivery system but do not play properly in the sand box of regulation that is often poorly monitored. We must demand transparency and deconstruct expensive bureaucracies only inflate the cost of care without improving it. It’s impossible to moderate the cost of healthcare without reducing the size of the pie and those feeding on it.
Healthcare At A Tipping Point?
 While Congress remains deeply divided on how to moderate healthcare, states are drowning in red ink arising from their own healthcare and retiree obligations.  Revenues feeding tax coffers are down while those qualifying for state administered Medicaid are up.  Many states have large unfunded retiree and Medicaid obligations that could impact their ability to finance public projects and rates above high yield debt. Absent any Federal relief for states, Covid-19 will only deepen the crisis as businesses and wealthy individuals relocate to more business friendly states characterized by lower operating costs and higher marginal tax breaks.  The average cost of healthcare varies by region and can be influenced by how well departments of insurance (DOI) and Insurance Commissioners govern those covering workers and citizens in that state.  States remain the good place to experiment with public/private partnerships and delivery models that moderate the cost of healthcare. It impacts everyone – hospitals, employers, insurers, pharma, the uninsured and underinsured. The future of many communities is inexorably tied to how we manage these costs and the money being drained out of the system only to be put into the hands of organizations that do not share a social or political obligation to remediate the barren landscape left in their wake. We can start by helping small business and individuals afford to buy coverage.  The simple act of freeing up billions of retained profits hiding inside non-profit insurers is a start.   
No Uniform Regulation for Managing Profits Retained by Non-Profit Insurers
State insurance commissioners and Departments of Insurance do not operate under uniform rules regarding the governance of for profit and not for profit (NFP) health insurers such as Blue Cross/ Blue Shield (BCBS) and Kaiser.  Rules vary regarding rate reviews, consumer complaints and the formulas that apply to insurers to determine adequacy of reserves and DOIs disagree if and when consumers and employers may be eligible for rebates and/or lower rates. The confederacy of NFP insurance plans and their excessive retained surpluses is an important part of a multi-pronged plan to drive affordability through more effective management of all stakeholders. It gets political very fast which contributes to the inertia that delays course corrections.
As a former regional CEO of a for profit health plan, I witnessed how under-resourced departments of insurance were in assessing us and our methods of setting premiums and reserves. We lobbied heavily for the freedom to set our own rates ( known as file and use ) and submit them after their introduction to the insurance market versus a more political and over regulated process of “prior approval” requiring DOI commissioners to give their approval before instituting annual rate increases.  In “file and use” states the regulator merely rubber-stamped proposed rates under a more laissez faire approach of oversight.  In prior approval states, the fights were often bitter and public as insurers – often sitting on large profit margins argued for increasing rates.
Insurers dislike the bureaucracy of the rate approval process which often required extensive lead times and as a result, delayed calibrating rates in real time to shifts in healthcare consumption or legislation that may increase liabilities from issues such as a pandemic or a state benefit mandates. Consumer advocates and legislative watch dog groups rebutted those concerns pointing to excessive profits and a history where, left to their own self-policing, health insurers would leaven additional margin into rates instead of dipping into accumulated excess reserves to subsidize lower premiums. The practice of running down these reserves often had an additional beneficial market impact: as NFP Blues ran down reserves by reducing increases and quoting more competitive rates for new business, for profit insurers would face an uncomfortable dilemma – drop their rates to retain customers or lose members to non profits who had an advantage of not being accountable to shareholders.  This buy-down process might last one or two renewal cycles until reserves returned to lower levels.  However it would positively help all insured customers.  Sadly, an unintended consequence of the passage of ACA was the preoccupation of insurance commissioners with the viability of their insurance exchanges and the contention from many non profit plans that reserves must be allowed to increase to ensure the financial stability of these new risk pools.  Insurance commissioners bought the argument and proceeded to watch non profit insurers increase their surpluses  (Risk Based Capital ) and request large increases in premiums for exchange based insurance citing uncertainty and the fact that since for profit insurers were choosing not to participate in state insurance pools, the non profits were the market of last resort.  There would be no choice if these plans were insolvent.  The reality is the lion’s share of this market was already with NFP plans and they stood to write more as for profit insurers exited the ACA markets. The result took pressure of for profit insurers to reduce rates, allowed NFP Blues to continue to amass reserves and relaxed the prior approval process to allow premiums to in some cases, double in a sort period of time, making coverage unaffordable for anyone who did not receive subsidies from the Federal government to buy insurance.  The new uninsured was the middle class – making too much money to qualify for subsidies but not enough to afford $25,000 a year for family health coverage. Mandated benefits in these ACA plans only inflated premium with coverages once considered discretionary like maternity coverage now being embedded as mandatory.  A couple with no kids past the age of having children was still required to buy a policy with maternity coverage embedded and charged for.  Thus, the anger from people who were told, “ if they liked their benefits plans, they could keep them.’ Minimum benefit requirements eliminated this as a possibility and increased costs.
How Much and Whose Money Is It?  
Evaluating NFP health plans – most notably Blue Cross / Blue Shield plans – requires strong actuarial resources within / or available to the DOIs to determine ensure the financial stability of the pricing.  Reserve surpluses or Risk Based Capital ( RBC ) are been seen as the canary in the coal mine for the state of insurance market pricing and insurer solvency.  300% or 3X the estimated required reserves has historically been considered an adequate surplus to protect NFP plans.  Companies like Kaiser, and NFP Blues usually maintain the highest share of a state’s individual and small group markets. In some markets they enjoy a regional monopoly. As goes the NFP’s pricing, so goes the rest of the insurance market.  
In the past decade, healthcare costs including prescription drug costs have dramatically increased along with the premiums charged by NFP plans to cover these costs.  Instead of reserves falling under the pressure of rising costs, NFP plan surpluses have grown dramatically and are drawing attention from consumer groups who want to see these reserves returned to the policyholders who generated those excess reserves by being overcharged for premium in excess of claims. At this point the politics gets a little fuzzy as to whether the politics of red and blue state affiliation determines the energy an Insurance Commissioner may expend to police pricing.  
Over the last decade, the risks that many NFPs insisted justified for relaxing RBC reserving rules never materialized. We did not see a rapid deterioration of RBC reserves. Many question whether these firms should continue to receive a for profit exemption when you look at their current war chests of retained capital. In 2016, HCSC, the parent plan for the NFP Blues plans in Texas and Illinois, received approval to increase rates for individuals in their ACA pool by 20% while the company’s RBC surplus grew to a staggering $9.9B.  At the same time, their CEO received a $10M bonus. The plans covers 15.5M members who have seen higher increases and little to any RBS refunded beyond mandatory rebates dictated by the ACA.
The war chest of retained surpluses has attracted the attention of consumer and employer groups and in the case of NJ, a former governor who tried to legislate a $300M asset transfer from Horizon Blue Cross to the state to underwrite rising costs in Medicaid and other underfunded state health initiatives. Critics doubted that money would cover any healthcare budget shortfalls and that any money should go to the policy holders who overpaid premium to create the surplus.  
Other states have begun to expand regulator authority to review rates and reserves as well as hardship requests to increase premiums above targeted trends of mid-single digits. Yet, the roster of undeployed RBC continues to increase.  In Michigan, Blue Cross increased reserves to $4.25B while the CEO of the non-profit took home $20M in remuneration.  In Minnesota, a state that historically required all medical insurers to operate as NFP enterprises, saw their risk based capital grow across HMOs and PPOs with RBC ranging from 5X-7X required levels.
The crisis of healthcare affordability is now being magnified and called into question by the inconsistent and poor regulatory oversight over certain NFP plans with NFP Blues resting on billions of overfunded reserves that could be used now to reduce premiums and at the same time, pressure for profit insurers to reduce their premiums or risk losing market share. In the end, the American taxpayer foots the bill for the inflated premiums subsidy eligible Americans buying in exchanges. As the uninsured grow, the pressure on the Federal budget will only increase while non profit plans continue to stash away reserves and increase rates. 
Covid-19 Will Only Make It Worse
In 2020, Covid-19 is actually leading to historically lower cost for elective and preventive services due partially to quarantine and public fear of being treated or seen at health facilities.  Lower claims will translate into very low loss ratios ( part of which may be returned in early 2021 in the form of ACA mandated rebates ). The low loss ratios will drive higher retained surpluses for non-profits. At this same time, for profit insurers are now jumping into the ACA exchanges as they feel pricing is high enough to meet their shareholder expectations for a return on capital.  When the sharks start showing up in the feeding grounds, it’s a target rich environment. They also don’t believe NFP competitors will start using reserves to drive down prices and drive them from these new markets.  If regulators don’t intervene, we have no reason to believe insurers won’t contribute to increase premiums and increase surpluses.
In 2021 underwriting must reflect the need to draw down reserves and stabilize premiums.  Last week, Washington State proposed legislation to evaluate RBC for any plans filed in the state and stated as as goal to use these to ensure stability and affordability for consumers and small businesses.  Some would go further and require any for-profit insurer must offer an exchange based plan of they want to sell commercial products in that state. 
An article published by the ConsumerUnion.org pushed back on those arguing for a continuation of laissez faire regulation of RBC non-profit reserves. “This issue is salient with respect to non-profit BCBS plans because many non-profit plans are chartered as ”charitable and benevolent” organizations with a mission to provide affordable healthcare…As non-profits, the “profits” eg capital plus surplus must be used for the benefit of their members or the community at-large…Evidence suggests that they do not use these large stores of capital to moderate premiums.”
Some non-profits credit stock market appreciation for their surge in RBC surpluses.  It doesn’t add up especially since the nature of investments made by these plans tend to be more conservative. Ironically, many non profit Blues lag their for profit competitors in investing in more contemporary systems, consumer portals, and a variety of medical management capabilities so they can better engage members.  One cold argue the RBC should be used to improve operations or given as a dividend back to policy holders if you are a mutual company.
Most industry insiders feel both for profit and non-profit insurers have lost the arms race of unit cost ( discounts ) leverage as they confront large, influential health systems. Consolidation, it seems, has not resulted in lower healthcare costs for consumers.  It’s helped the stock price of for-profits but left the non-profits sitting on surpluses and not putting them to work to reduce costs or consumption.
Change must happen and Insurance Commissioners should follow the lead of states like Washington as they seek to repatriate the profits from non-profits back to their customers.  This could spark a price war which brings premiums down and actually accomplishes the competition that has been promised during a period of intense consolidation   The NAIC can convene all insurance commissioners and commit to a narrower corridor for risk capital surpluses. 
We can free up billions of dollars trapped inside a poorly regulated and inconsistent system where even those firms who purport to be on a philanthropic mission to drive affordable care continue to levy larger increases on those who can least afford it. 
Kind of makes you feel sick, doesn’t it?
Next Up: The Rise ( and Fall ) of Pharmaceutical Benefits Managers
Michael Turpin is frequent speaker, writer and practicing benefits consultant across a 37 year career that spanned assignments in the US and in Europe.
Healthcare Sings The Non-Profit Blues published first on https://venabeahan.tumblr.com
0 notes
kristinsimmons · 4 years
Text
Healthcare Sings The Non-Profit Blues
By MICHAEL TURPIN
Powers once assumed are never relinquished, just as bureaucracies, once created, never die.
Charley Reese
As we ponder the 100 day count down to the Presidential Elections, the rhetoric and ranting swirling around the best solution for our nation’s healthcare crisis, is hitting decibel levels not heard since the passage of the Affordable Care Act.  As with any major entitlement legislation, there are commendable elements, inefficiencies, and a host of unintended consequences. The current administration’s obsession with repeal while the ranks of uninsured people grow, begs the question, “what is the blue-print for expanding coverage and reducing waste, fraud and abuse while increasing transparency, quality and overall public health.  Answer: There is no plan and if there was, it would fall well short of achieving many of these objectives given the deeply entrenched stakeholder who actually do not benefit if the cost of healthcare declines.  It a classic NIMBY response: “I’m all for reform as long as I maintain my role and revenue in whatever solution is proposed.”. 
The Affordable Care Act is a solid foundation to build a 2.0 version of a solution to solve for the uninsured and to act as a catalyst for market reforms that will either reshape the misaligned incentives and embedded inequities in our current system or it will lead to voters demanding the expansion the role of Medicare and Medicaid.  70M adults and children are covered under Medicaid – including those who benefited by the passage of the ACA.  Approximately 55M are covered under Medicare resulting in 125M covered under some form of state or federal aid. 155M receive coverage through employers. 
Its estimated by the Economic Policy Institute that 29.8M individuals who received coverage as a result of ACA expansion would lose coverage if no legislation replaced it.  Add in the severe economic dislocation arising from Covid-19 that could result in an additional 14M unemployed and you could see a worst case of uninsured swell from a current 27M to as high as 70M according to Policy Advice, a non-profit industry watch dog.
So how can you change the current market to drive reforms without a legislated intervention?  It starts by enforcing laws already in place and challenging regulators to do their jobs – ensuring that we minimize waste, fraud and abuse.  As of 2020, the average annual cost of family health coverage has eclipsed the cost of a mid-sized economy car. We must tackle the affordability problem by reducing the number of intermediaries who extract profits from the delivery system but do not play properly in the sand box of regulation that is often poorly monitored. We must demand transparency and deconstruct expensive bureaucracies only inflate the cost of care without improving it. It’s impossible to moderate the cost of healthcare without reducing the size of the pie and those feeding on it.
Healthcare At A Tipping Point?
 While Congress remains deeply divided on how to moderate healthcare, states are drowning in red ink arising from their own healthcare and retiree obligations.  Revenues feeding tax coffers are down while those qualifying for state administered Medicaid are up.  Many states have large unfunded retiree and Medicaid obligations that could impact their ability to finance public projects and rates above high yield debt. Absent any Federal relief for states, Covid-19 will only deepen the crisis as businesses and wealthy individuals relocate to more business friendly states characterized by lower operating costs and higher marginal tax breaks.  The average cost of healthcare varies by region and can be influenced by how well departments of insurance (DOI) and Insurance Commissioners govern those covering workers and citizens in that state.  States remain the good place to experiment with public/private partnerships and delivery models that moderate the cost of healthcare. It impacts everyone – hospitals, employers, insurers, pharma, the uninsured and underinsured. The future of many communities is inexorably tied to how we manage these costs and the money being drained out of the system only to be put into the hands of organizations that do not share a social or political obligation to remediate the barren landscape left in their wake. We can start by helping small business and individuals afford to buy coverage.  The simple act of freeing up billions of retained profits hiding inside non-profit insurers is a start.   
No Uniform Regulation for Managing Profits Retained by Non-Profit Insurers
State insurance commissioners and Departments of Insurance do not operate under uniform rules regarding the governance of for profit and not for profit (NFP) health insurers such as Blue Cross/ Blue Shield (BCBS) and Kaiser.  Rules vary regarding rate reviews, consumer complaints and the formulas that apply to insurers to determine adequacy of reserves and DOIs disagree if and when consumers and employers may be eligible for rebates and/or lower rates. The confederacy of NFP insurance plans and their excessive retained surpluses is an important part of a multi-pronged plan to drive affordability through more effective management of all stakeholders. It gets political very fast which contributes to the inertia that delays course corrections.
As a former regional CEO of a for profit health plan, I witnessed how under-resourced departments of insurance were in assessing us and our methods of setting premiums and reserves. We lobbied heavily for the freedom to set our own rates ( known as file and use ) and submit them after their introduction to the insurance market versus a more political and over regulated process of “prior approval” requiring DOI commissioners to give their approval before instituting annual rate increases.  In “file and use” states the regulator merely rubber-stamped proposed rates under a more laissez faire approach of oversight.  In prior approval states, the fights were often bitter and public as insurers – often sitting on large profit margins argued for increasing rates.
Insurers dislike the bureaucracy of the rate approval process which often required extensive lead times and as a result, delayed calibrating rates in real time to shifts in healthcare consumption or legislation that may increase liabilities from issues such as a pandemic or a state benefit mandates. Consumer advocates and legislative watch dog groups rebutted those concerns pointing to excessive profits and a history where, left to their own self-policing, health insurers would leaven additional margin into rates instead of dipping into accumulated excess reserves to subsidize lower premiums. The practice of running down these reserves often had an additional beneficial market impact: as NFP Blues ran down reserves by reducing increases and quoting more competitive rates for new business, for profit insurers would face an uncomfortable dilemma – drop their rates to retain customers or lose members to non profits who had an advantage of not being accountable to shareholders.  This buy-down process might last one or two renewal cycles until reserves returned to lower levels.  However it would positively help all insured customers.  Sadly, an unintended consequence of the passage of ACA was the preoccupation of insurance commissioners with the viability of their insurance exchanges and the contention from many non profit plans that reserves must be allowed to increase to ensure the financial stability of these new risk pools.  Insurance commissioners bought the argument and proceeded to watch non profit insurers increase their surpluses  (Risk Based Capital ) and request large increases in premiums for exchange based insurance citing uncertainty and the fact that since for profit insurers were choosing not to participate in state insurance pools, the non profits were the market of last resort.  There would be no choice if these plans were insolvent.  The reality is the lion’s share of this market was already with NFP plans and they stood to write more as for profit insurers exited the ACA markets. The result took pressure of for profit insurers to reduce rates, allowed NFP Blues to continue to amass reserves and relaxed the prior approval process to allow premiums to in some cases, double in a sort period of time, making coverage unaffordable for anyone who did not receive subsidies from the Federal government to buy insurance.  The new uninsured was the middle class – making too much money to qualify for subsidies but not enough to afford $25,000 a year for family health coverage. Mandated benefits in these ACA plans only inflated premium with coverages once considered discretionary like maternity coverage now being embedded as mandatory.  A couple with no kids past the age of having children was still required to buy a policy with maternity coverage embedded and charged for.  Thus, the anger from people who were told, “ if they liked their benefits plans, they could keep them.’ Minimum benefit requirements eliminated this as a possibility and increased costs.
How Much and Whose Money Is It?  
Evaluating NFP health plans – most notably Blue Cross / Blue Shield plans – requires strong actuarial resources within / or available to the DOIs to determine ensure the financial stability of the pricing.  Reserve surpluses or Risk Based Capital ( RBC ) are been seen as the canary in the coal mine for the state of insurance market pricing and insurer solvency.  300% or 3X the estimated required reserves has historically been considered an adequate surplus to protect NFP plans.  Companies like Kaiser, and NFP Blues usually maintain the highest share of a state’s individual and small group markets. In some markets they enjoy a regional monopoly. As goes the NFP’s pricing, so goes the rest of the insurance market.  
In the past decade, healthcare costs including prescription drug costs have dramatically increased along with the premiums charged by NFP plans to cover these costs.  Instead of reserves falling under the pressure of rising costs, NFP plan surpluses have grown dramatically and are drawing attention from consumer groups who want to see these reserves returned to the policyholders who generated those excess reserves by being overcharged for premium in excess of claims. At this point the politics gets a little fuzzy as to whether the politics of red and blue state affiliation determines the energy an Insurance Commissioner may expend to police pricing.  
Over the last decade, the risks that many NFPs insisted justified for relaxing RBC reserving rules never materialized. We did not see a rapid deterioration of RBC reserves. Many question whether these firms should continue to receive a for profit exemption when you look at their current war chests of retained capital. In 2016, HCSC, the parent plan for the NFP Blues plans in Texas and Illinois, received approval to increase rates for individuals in their ACA pool by 20% while the company’s RBC surplus grew to a staggering $9.9B.  At the same time, their CEO received a $10M bonus. The plans covers 15.5M members who have seen higher increases and little to any RBS refunded beyond mandatory rebates dictated by the ACA.
The war chest of retained surpluses has attracted the attention of consumer and employer groups and in the case of NJ, a former governor who tried to legislate a $300M asset transfer from Horizon Blue Cross to the state to underwrite rising costs in Medicaid and other underfunded state health initiatives. Critics doubted that money would cover any healthcare budget shortfalls and that any money should go to the policy holders who overpaid premium to create the surplus.  
Other states have begun to expand regulator authority to review rates and reserves as well as hardship requests to increase premiums above targeted trends of mid-single digits. Yet, the roster of undeployed RBC continues to increase.  In Michigan, Blue Cross increased reserves to $4.25B while the CEO of the non-profit took home $20M in remuneration.  In Minnesota, a state that historically required all medical insurers to operate as NFP enterprises, saw their risk based capital grow across HMOs and PPOs with RBC ranging from 5X-7X required levels.
The crisis of healthcare affordability is now being magnified and called into question by the inconsistent and poor regulatory oversight over certain NFP plans with NFP Blues resting on billions of overfunded reserves that could be used now to reduce premiums and at the same time, pressure for profit insurers to reduce their premiums or risk losing market share. In the end, the American taxpayer foots the bill for the inflated premiums subsidy eligible Americans buying in exchanges. As the uninsured grow, the pressure on the Federal budget will only increase while non profit plans continue to stash away reserves and increase rates. 
Covid-19 Will Only Make It Worse
In 2020, Covid-19 is actually leading to historically lower cost for elective and preventive services due partially to quarantine and public fear of being treated or seen at health facilities.  Lower claims will translate into very low loss ratios ( part of which may be returned in early 2021 in the form of ACA mandated rebates ). The low loss ratios will drive higher retained surpluses for non-profits. At this same time, for profit insurers are now jumping into the ACA exchanges as they feel pricing is high enough to meet their shareholder expectations for a return on capital.  When the sharks start showing up in the feeding grounds, it’s a target rich environment. They also don’t believe NFP competitors will start using reserves to drive down prices and drive them from these new markets.  If regulators don’t intervene, we have no reason to believe insurers won’t contribute to increase premiums and increase surpluses.
In 2021 underwriting must reflect the need to draw down reserves and stabilize premiums.  Last week, Washington State proposed legislation to evaluate RBC for any plans filed in the state and stated as as goal to use these to ensure stability and affordability for consumers and small businesses.  Some would go further and require any for-profit insurer must offer an exchange based plan of they want to sell commercial products in that state. 
An article published by the ConsumerUnion.org pushed back on those arguing for a continuation of laissez faire regulation of RBC non-profit reserves. “This issue is salient with respect to non-profit BCBS plans because many non-profit plans are chartered as ”charitable and benevolent” organizations with a mission to provide affordable healthcare…As non-profits, the “profits” eg capital plus surplus must be used for the benefit of their members or the community at-large…Evidence suggests that they do not use these large stores of capital to moderate premiums.”
Some non-profits credit stock market appreciation for their surge in RBC surpluses.  It doesn’t add up especially since the nature of investments made by these plans tend to be more conservative. Ironically, many non profit Blues lag their for profit competitors in investing in more contemporary systems, consumer portals, and a variety of medical management capabilities so they can better engage members.  One cold argue the RBC should be used to improve operations or given as a dividend back to policy holders if you are a mutual company.
Most industry insiders feel both for profit and non-profit insurers have lost the arms race of unit cost ( discounts ) leverage as they confront large, influential health systems. Consolidation, it seems, has not resulted in lower healthcare costs for consumers.  It’s helped the stock price of for-profits but left the non-profits sitting on surpluses and not putting them to work to reduce costs or consumption.
Change must happen and Insurance Commissioners should follow the lead of states like Washington as they seek to repatriate the profits from non-profits back to their customers.  This could spark a price war which brings premiums down and actually accomplishes the competition that has been promised during a period of intense consolidation   The NAIC can convene all insurance commissioners and commit to a narrower corridor for risk capital surpluses. 
We can free up billions of dollars trapped inside a poorly regulated and inconsistent system where even those firms who purport to be on a philanthropic mission to drive affordable care continue to levy larger increases on those who can least afford it. 
Kind of makes you feel sick, doesn’t it?
Next Up: The Rise ( and Fall ) of Pharmaceutical Benefits Managers
Michael Turpin is frequent speaker, writer and practicing benefits consultant across a 37 year career that spanned assignments in the US and in Europe.
Healthcare Sings The Non-Profit Blues published first on https://wittooth.tumblr.com/
0 notes
rhetorical-ink · 4 years
Text
Rhetorical Ink Reviews  “Demon Slayer: Kimetsu No Yaiba” Season 1 - Episodes 9 - 14
** DEMONIC SPOILERS BELOW ** 
My brother and I continue our marathon of Demon Slayer, and I have to say that these last six episodes have been my favorites so far! Jumping right in, here are:
My Top Ten Thoughts on Demon Slayer: KNY Season 1, Episodes 9 -14:
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10. I have really liked Yushiro’s character from his introduction, and while learning he shares the same voice actor as Izuku Midoriya from My Hero Academia has been the cherry on top, I especially loved his interactions with Tanjiro, Nezuko, and Tamayo in Episodes 9 and 10 -- I hope we see more of him in the future. Also, his head getting lobbed off shocked me! Glad he lived!
9. The animation continues to be absolutely STUNNING in this show and deserves a shout out -- episodes 9 and 13 with the fights with the demons specifically were just gorgeous. I continue to love the animation on Tanjiro’s water breathing and the mansion boss fights were just breathtaking to look at!
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8. There are a LOT of questions surrounding Yushiro and Tamayo that still have me intrigued -- for one thing, why is Tamayo considered a “fugitive?” She clearly has a grudge against Muzan, but we’ve not heard the full story yet. Her blood magic is insane, especially in killing the Temari demon, so she’s clearly not someone to be messed with, either. But, she also seems to have good intentions and a kind heart -- I feel there’s a major backstory coming down the road with her...
...also, I find it interesting that demons, specifically Yushiro, can pass on his powers to others, even humans. I loved that Yushiro helped Tanjiro, but it opens up a can of questions that I hope get answered as we go on!
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7. Okay, so....originally, I did NOT like Zenitsu. At all. I found it refreshing at the start for Tanjiro to have to deal with his over-dramatic antics, but then I was mad in the mansion in episodes 11 and 12 that he was SO loud and clearly putting Soichi, one of the kids they are trying to help, in danger. 
I did appreciate that we learn he’s not USELESS -- he has amazing hearing to rival Tanjiro’s smelling skill, and when he’s...asleep?...he sleep-walks and is SUPER powerful -- again, I hope we get that explained -- but I was still annoyed with him.
But then, BUT THEN, we got the end of Episode 13, and Zenitsu was basically risking his life to protect Nezuko in the box, despite knowing there was a demon inside, just because it was important to his friend. And THAT made me completely change my mind on his character. I hope that he tones down the antics a little, though after the end of Episode 14, I’m not sure that will happen, but I still respect him SO much more, now!
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6. One character I’m NOT sold on, yet, though is Inosuke AKA Boar Boy AKA Man Bear Pig. From the start, he has positioned himself as a very one-track-minded character, only wanting to slay demons and fight. However, he doesn’t have any regard for others, like Tanjiro or Zenitsu -- and I’m worried he’s going to cause one of our protagonists to get seriously hurt for no reason. I’m sure there’s a point to his story, and we still know very little about him, but I’m just not sold on his character in the series yet. Boy does have a very feminine face, though!
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5. I have to say, the comedy in these string of episodes, though, was GREAT. Besides Zenitsu and Inosuke’s over-the-top antics -- the facial expressions of Tanjiro reacting to Zenitsu, and Yushiro having a literal panic attack at the prospect of Nezuko joining him and Tamayo had me rolling. I love how this series that can be SUPER dark and grim can also be hopeful, light-hearted, and hilarious at times. It’s what really has sold me on it, so far!
4. I also appreciate that the wounds in this anime are at least ACKNOWLEDGED. True, Tanjiro still being able to move like he does with a broken leg and ribs is a stretch from reality, but I appreciate that he keeps the audience aware that pain is a thing in this story, and it does have consequences, which makes their later stop at the mansion seem all that much more rewarding and required. Also, Tanjiro smashing Inosuke’s ribs? Just -- OW!
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3. I want to point out that we are half-way through season one of the show, and we’ve been introduced to the concepts of the “Twelve Moons” of Muzan....but so far, we haven’t met ONE of them. We’ve had two posing as the moons, and one that was the former #6 Moon, but no actual ones yet...which is...interesting to me. I feel like it’s a homage to the Arrancar in Bleach and the “holiday” agents in One Piece (Ms. Sunday, etc.), but it has me hopeful that there is a lot more to the story that we still have to go, and that this show isn’t going to be one season, only...which I really hope it’s not, because I’m really enjoying it so far!
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2.  Anyone else think the Wisteria pit stop is....creepy? From the old couple to the lonely, quiet atmosphere, it just has a foreboding vibe -- like things are going to get...darker from here on in? Is that possible? I just got an ominous vibe of this being the checkpoint in Episode 14 -- halfway through the season, it seemed like the calm before the storm; the save area before a big, bad boss...
1. These episodes flowed really well, had stakes, extended the world-building, and left me with both questions and answers moving forward...and we have two very....unique characters thrown into the mix now, that I’m curious how Tanjiro will handle, especially in a legit battle! We’re halfway through the season, and it’s great so far! Here’s to seeing what surprises are in store!
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Review of Episodes 1 - 5
Review of Episodes 6 - 8
Review of Episodes 15 - 20 
Review of Episodes 21 - 26
21 notes · View notes
biofunmy · 4 years
Text
What We Learned in 2019: Health and Medicine
It’s not easy to say that any particular development in health or medicine was the most important in a given year. But if we had to choose some highlights, we would opt for these unforgettable events and findings.
As the number of opioid-related lawsuits against the pharmaceutical industry grew to nearly 3,000 nationwide this year, breakthroughs, however tentative, began to emerge. Oklahoma, the first state to go to trial, won a judgment against Johnson & Johnson for $465 million; the first federal trial, for two Ohio counties, settled just before opening arguments, for $20.4 million.
But there are indications that years of litigation lie ahead.
Purdue Pharma, which makes OxyContin, and the Sackler family who control the company, offered to settle all cases and sought bankruptcy protection to restructure. But two dozen states oppose the deal, saying the family itself should pay more. Three giant drug distributors and two manufacturers offered their own comprehensive settlement. But many states and thousands of local governments have flatly rejected it.
Coming soon in 2020: more bellwether trials around the country, including the first against the big pharmacy chains. And, of course, many more negotiations.
Nearly 12 years after the first person was cured of H.I.V., the virus that causes AIDS, researchers reported that they had cured a second patient. Their surprise success confirmed that a cure for H.I.V. is possible. Both milestones resulted from bone-marrow transplants given to the infected patients — to treat cancer, not H.I.V. While this is an unrealistic treatment option for millions of people living with H.I.V., rearming the body’s immune cells might work in the future.
Among men who are at high risk for H.I.V. infection, only about one in three is taking a drug to prevent transmission of the virus, the Centers for Disease Control and Prevention says. One of the main reasons has to do with cost. In May, the Trump administration reached a deal with the makers of Truvada and Descovy to donate pre-exposure prophylaxis, or PrEP, drugs to 200,000 patients annually for more than a decade. Experts said the donation was a good start, but it filled only one-fifth of the need in the United States.
Drug-resistant germs of all types thrive in hospital settings and nursing homes, Over the last five years, the fungus Candida auris has hit a neonatal unit in Venezuela, forced a prestigious British medical center to shut down its intensive care unit and infected nearly 800 people in the United States, with half of patients dying within 90 days. Once C. auris takes root, it is hard to eradicate from a facility. Some hospitals have had to bring in special cleaning equipment and even rip out floor and ceiling tiles to get rid of it.
The median medical education debt held by graduates in 2018 was $200,000. That does not include credit card debt, which can also pile up as students purchase stethoscopes and study-aid subscriptions, register for licensing exams and travel for testing. These costs can be especially prohibitive for some students, driving young doctors away from lower-paying specialties, such as pediatrics and psychiatry, as well as jobs in rural or less wealthy areas.
To address this problem, Cornell University and Kaiser Permanente have started to waive tuition for medical students, following in the footsteps of New York University last year. State repayment programs, such as CalHealthCares, also promise to help young doctors with debt relief.
In December, a federal appeals court struck down the individual mandate of the Affordable Care Act, which required Americans to buy health insurance or pay a penalty. But the court did not throw out the rest of the law, putting its fate in limbo even as access to health care has become a central issue in the presidential race.
Democratic candidates are divided over how to improve health care. Some want to eliminate private insurance and replace it with a single-payer system, or Medicare for All. Others favor a public option that would preserve private insurance, but give people a chance to choose government insurance.
Researchers have found that inhaling carbon dioxide at levels that are probably not uncommon in crowded spaces like small conference rooms might affect productivity and decision-making skills. This suggests that the recommended minimum air flow for such rooms might not actually be optimal. Instead, it might be worth cracking a door or a window, when possible.
As genetic testing becomes more widespread, parents, or sometimes their donor-conceived children, are discovering that the wrong sperm was provided by a sperm bank or fertility clinic. Facilities often use poor record keeping, writing sperm vial numbers in pen and ink rather than digitizing the sample data. And in a growing number of instances, doctors have secretly used their own sperm for artificial insemination, only to be discovered decades later.
One particularly egregious case, in which an Indianapolis doctor used his own sperm to impregnate at least 46 women, has prompted legal changes, including a Texas law that redefined such an act as sexual assault. But in many states, the laws applied to such cases remain unclear.
Some 200 million girls and women in Africa, the Middle East and Asia have been genitally cut. This traditional ritual, which ranges from nicks to extreme damage to the female anatomy, can cause pain during sex and child birth, and reduced sexual sensation. As some women move to the United States, demand is growing for surgery that can repair the damage.
One surgery, clitoral reconstruction, is viewed with caution by some medical experts. But some women who have had the procedure found that it helped relieve pain and made them feel more whole.
Researchers learned that tuberculosis had evolved a terrifying new strain in 2006 that is resistant to antibiotics typically used to fight the disease. Now, a clinical trial in South Africa is showing that a new regimen can cure most patients. The Food and Drug Administration has effectively endorsed the approach, giving scientists hope that other regulatory agencies will soon approve it worldwide.
In mice and human patients with pancreatic cancer, fungi seem to proliferate 3,000-fold compared with healthy tissue. Scientists have found that one fungus that can cause skin irritation and dandruff is also linked to inflammatory bowel diseases. Another study found that it was also present in extremely high numbers in pancreatic cancer patients. Administering an antifungal drug got rid of the fungi in mice and kept tumors from developing further.
The overwhelming majority of American parents vaccinate their children. But there are ominous trends in vaccine resistance, a byproduct of internet rumors, mistrust of Big Pharma, infatuation with anti-immunization celebrities and the anti-science rhetoric from the Trump administration. As a result, measles returned with a vengeance this year.
An outbreak centered in New York City forced Mayor Bill de Blasio to declare a public health emergency in April and order mandatory vaccination in parts of Brooklyn. Public health experts connected the outbreak to Jewish pilgrims who had not been vaccinated and went to Ukraine to visit the grave of a founder of a branch of Hasidism. From there, the measles virus spread to others who visited Israel, and eventually landed in Britain and the United States.
The International Life Sciences Institute, an American nonprofit, has been quietly infiltrating government health and nutrition bodies around the world. The organization rejects allegations that it works to advance the interests of the corporate members that provide its $17 million budget, but it championed tobacco interests during the 1980s and 1990s in Europe and the United States. And ILSI has recently expanded its activities in areas in Asia and Latin America.
In China, researchers have noted that the organization helped shape anti-obesity education campaigns stressing physical activity over dietary changes, a strategy long espoused by Coca-Cola. And in India, it helped appoint a former Nestle adviser to a government committee reviewing warning labels on unhealthy food.
This year, scientists developed an experimental therapy in record time to help treat 8-year-old Mila Makovec, who has Batten disease, a rare genetic disorder that involves rapid neurodegeneration and is fatal. It is believed to be the first custom treatment for a genetic disease because it blocks a mutation unique to Mila.
Scientists are also starting to test the power of psychedelic drugs to treat a range of mental health problems. In September, Johns Hopkins Medicine announced the opening of the Center for Psychedelic and Consciousness Research to study compounds like psilocybin and LSD. One study at the center has already found that psilocybin can be more effective at helping people quit smoking compared with using a nicotine patch.
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