Don Lemon CNN: “That picture. I can’t even look at it.” Chris Cuomo: “You must. … Of course it kills you. It kills every part of you, every part of us that makes us human.”Lemon: “…Who are we? Who are we, as a people, to sit and judge people who are trying to come across for better lives and better conditions?” https://cnn.it/2Fxe9QY
Supreme Court’s Ruling on Making SNAP Retail Data Public Has Broad Public Health Implications
At issue is USDA’s longstanding practice of shielding how much money retailers, including big box stores like Walmart, make from SNAP.
By Cassie M. Chew, Food Policy, Nutrition June 24, 2019
(Update, on June 24, the Supreme Court ruled 6-3 against the Argus-Leader, limiting public and media access to government records such as store-level SNAP sales data.)
At the center of market, surrounded by farmers’ stands, a high school student runs table where shoppers can swipe their cards to convert Supplemental Nutrition Assistance Program (SNAP) dollars into tokens that they can use to buy locally grown produce and pasture-raised meats from the market’s dozen or more vendors.
Although the market will match SNAP users’ first $5, less than 1 percent of its 2,000 or more Sunday visitors are SNAP shoppers. Even at larger markets that match more SNAP funds, in Maryland and around the country, farmers’ markets are distant competitors to the roughly 250,000 big food retailers authorized by the U.S. Department of Agriculture’s (USDA) to accept SNAP funds for purchases. While the 3,600 authorized farmers’ markets nationwide redeemed nearly $16 million in SNAP benefits in 2017, the nearly 51,000 authorized grocery stores, supermarkets, and superstores redeemed nearly $52.7 billion in SNAP benefits through the program.
Photo CC-licensed by Seacoast Eat Local.
The USDA has refused to share with the public the individual SNAP sales data from those food retailers, although the outcome of arguments before the U.S. Supreme Court this session could raise the curtain on that information. Some advocates hope to shine a light on just how much companies like Kroger and Walmart are benefiting financially from the SNAP program, while also employing many SNAP users. If made public, this data might offer a clearer picture of the challenges associated with food access across the country.
The case, Food Marketing Institute v. Argus Leader Media, pits the trade association for chain and independent food retailers against the Sioux Falls, S.D.-based Argus Leader newspaper. The case has been brewing since 2011, and in its oral arguments the Food Marketing Institute (FMI) asked the Supreme Court to reverse a November 2016 district court decision that, under the Freedom of Information Act (FOIA), required the USDA to disclose individual store sales data on its retailers authorized to accept SNAP funds for purchases.
In the wake of two decisions in favor of the Argus Leader, the USDA in January 2017 announced that it would comply with the court ruling and promptly begin releasing the data to the public. The FMI then intervened, first taking the case to the U.S. Court of Appeals, then appealing its loss there to the Supreme Court. In its opening statement, the FMI asked the Court to reverse the decision and keep its members’ SNAP food sales confidential.
“Our injury in fact is the disclosure of our members’ store-level sales information that they keep secret,” argued Evan Young, an attorney for the FMI, which represents 33,000 retail food stores and 12,000 pharmacies. Young, along with an attorney for the Department of Justice, told the nation’s highest court that retail sales from taxpayer-funded SNAP should be considered trade secrets and confidential financial data that the USDA, in their more than four-decade long partnership with retailers, has to date agreed not to disclose.
“We are exercising our discretion in a matter of good government,” Anthony Yang, Department of Justice (DOJ) assistant to the solicitor general, told the court. “The government is trying to keep its word, given over 40 years, in the most official form possible, that we’re going to keep this information confidential.”
Meanwhile, the Argus Leader argued that SNAP sales data are agency records under FOIA and presumptively open records.
“How the government spends its own money is critical information that the press and the public need to know,” Richard Loeb, attorney for the newspaper told the Court. “It’s the type of information that FOIA has been used for decades to reveal.”
The USDA has said that FOIA exemptions prohibit it from disclosing data that retailers have shared with the agency in confidence. But since the information the newspaper has requested is automatically stored in USDA’s Store Tracking and Redemption database, the Argus Leader says USDA’s argument is misleading.
“USDA’s imprecise use of the term ‘redemption data’ … creates the mis-impression that USDA must depend on retailers to furnish SNAP payment information,” the Argus Leader wrote in court filings. Further, the newspaper’s lawyers say the agency’s claims are “disingenuous” since it already has the data.
SNAP Fights Hunger, but Should it Also Support Healthy Eating?
The difference between using SNAP for purchases at farmers’ markets and using them at a Walmart Supercenter are significant—farmers’ markets rarely offer much in the way of processed, packaged foods. And while the overarching goal of SNAP is to reduce food insecurity, there’s a growing interest in simultaneously improving people’s health. Governments and health advocates at all levels are increasingly advocating the design of food assistance programs that will boost nutrition, improve health, and maybe even reduce the cost of healthcare associated with the chronic illnesses that arise from an unhealthy diet.
To food access advocates, keeping secret the data about where SNAP dollars are being spent doesn’t make sense.
Takoma Park and other Maryland farmers’ markets receive funding through statewide grants, partnerships with private business and fundraisers at individual markets like Takoma Park’s annual pie contest. Despite the fact that Maryland has among the highest per capita household income in the country, as many as one out of eight residents experience food insecurity. Food access advocates have been active in developing programming that promotes greater consumption of healthier foods by creating incentives for SNAP shoppers at individual farmers’ markets and say they don’t keep their work a secret.
“It’s very unfortunate when we have a program that’s fairly transparent [while] large food retailers don’t have to share the same amount of information,” said Amy Crone, founder and executive director of the Maryland Farmers Market Association(MDFMA).
At the Takoma Park farmers’ market. (Photo by Cassie Chew)
Since 2014, Crone and the MDFMA have raised more than $700,000 in funding, which they’ve used to increase food access and farmer sales through its statewide farmers’ market matching program for SNAP shoppers.
“We found that 90 percent of SNAP shopper purchases go toward fruits and vegetables,” Crone said. “We know our incentive program is making a difference.”
With a $65 billion budget supporting food purchases of 40 million people in 2018, roughly one out of every seven Americans, food access advocates and scholars at the intersection of agriculture, economics, and policy have long wanted to use SNAP to improve health status among individuals at the lower end of the economy.
Getting more data on nationwide SNAP purchases could help achieve that goal. In its 2011 FOIA request, the Argus Leader asked for five years of store-level data; two years prior, the USDA’s own research suggested more data on consumers’ connection to stores would improve analysis of the availability of nutritious food.
“The data would definitely help, so that we can incentivize healthy eating,” said Crone.
Experts at the intersection of food access and health say there needs to be greater innovation in food assistance policy.
“SNAP is an effective program for reducing hunger in the United States … Yet, compared with both income-eligible nonparticipants and higher-income individuals, SNAP beneficiaries have significant disparities in diet quality and diet-related health outcomes,” wrote cardiologist Dariush Mozaffarian and two of his colleagues at Tufts University Friedman School of Nutrition Science & Policy in a March 2019 paper published in JAMA.
Expressing disappointment with what he says is a lack of SNAP policy innovation in the 2018 Farm Bill, Mozaffarian wrote that the current $1 per person per year food insecurity nutrition incentive (FINI) grant program that subsidizes low-income Americans’ produce purchases is too low.
“Expanding FINI to allow a 30 percent subsidy for all SNAP fruit and vegetable purchases would have cost $11.5 billion over five years—a far larger expenditure, but one that is estimated, based on a modeling study, to be cost-effective over a lifetime for reducing cardiometabolic diseases.”
Agricultural economist Parke Wilde, also at Tufts’ Friedman School, says that SNAP sales data might be useful to help identify food desserts, understand how SNAP contributes to healthy food environments and determine whether policy innovations in retail could increase the beneficial impact of SNAP.
“It seems to me it is useful to understand all of the retailers in the vicinity of where people live. We spend a lot of time thinking about how far it is to the closest supermarket, but I often find myself curious about how far do people travel to the supermarket that’s actually getting a lot of their business. So you can see how knowing the SNAP sales is potentially helpful,” said Wilde, who focuses on U.S. food and nutrition policy, consumer economics, and federal food assistance programs.
What We Learned from the Supreme Court
With the disclosure of SNAP retailer sales data hinging on how the court interprets FOIA exemptions, it is unclear how the Court, with its conservative majority, might rule on the case.
Conservative justices on the Court were less active in their questioning. Justice Neil Gorsuch asked the attorney for the Argus Leader for greater insight into how the word “confidential” has been interpreted in the prior cases and Justice Brett Kavanaugh asked the DOJ attorney about the legal threshold for keeping the sales data from disclosure.
“Can it be deemed confidential even in cases without government assurance?” Kavanaugh asked, exploring the potentially broader implications of the Court’s decision.
In one of her questions to Young, Justice Ruth Bader Ginsburg discussed whether the USDA can avoid sharing the data just because of its agreement with retailers. “To say the government can control this by making a promise that it won’t disclose, that seems to run counter to the whole idea of FOIA,” she said.
Justice Sonia Sotomayor, the most active in questioning the attorneys, reminded the attorney for FMI and DOJ that the USDA has lost two prior cases for keeping retail data confidential, and asked whether FMI had standing in the case—the requirement to bring a lawsuit in court based upon a stake in the outcome—especially after the USDA announced that it would comply with the district court’s November 2016 decision.
When Yang told the Court that USDA would not release the data as a matter of good governance, Sotomayor responded, “Mr. Yang, you are going to tell me that you were going to be in contempt on the order?”
More questions came when the attorneys discussed whether the FOIA exemption required retailers to show releasing the data would have a “competitive harm”—or negative impact—on their business.
Loeb argued that courts in the past have ruled that companies must demonstrate harm in order to request an exemption from disclosing information under FOIA. “We know trade secrets required under the common law a showing of competitive harm,” Loeb said, adding, “confidential business information also required a showing of competitive harm.”
But unlike the attorneys from the two prior court proceedings, who argued on behalf of the USDA that revealing store sales information would lead to “substantial competitive harm,” the FMI asserted that that food retailers didn’t have to demonstrate competitive harm to prevail in this case.
The line of questioning from the justices hinted at the case’s larger implications: Should the Court decide that businesses can withhold data without showing competitive harm, it could set a precedent for companies across industries to withhold any and all data.
While the Court is expected to announce its decision at the end of June, food policy analysts reiterate that, in keeping with the spirit of the goals of the SNAP program, the information should become available.
“This is really a public investment,” Wilde said. “The public has made an investment in preventing hunger through the SNAP program. I think of this as being not so much the government sharing [companies’] trade secrets but really about sharing the government’s own investment in food retail by location.”
Leaked Documents Prove Trump’s Cabinet Is as Big of a Clusterf*ck as We All Knew It Was
Unfortunately, none of what Axios got hold of is at all surprising.
By Charles P. Pierce June 24, 2019
GETTY IMAGES
Axios got a leak of documents like you dream about over the weekend. Hell, they got a leak like Seymour Hersh would dream about. Somebody handed over the vetting materials prepared by the transition team at Camp Runamuck, which rhymes with clusterfck, which is what it was.
“To be honest, the process was such a disaster and such a shit-show and there were so many unqualified people coming through that the issues with [future HUD Secretary Ben] Carson don’t really stick out to me,” said one RNC vetter. “You know, I’m like, ‘Oh gentle Ben is unqualified and thinks that pyramids store grain or whatever. Great. At least he’s not beating his wife and his wife’s not appearing on Oprah.'”
“We’d be sitting around and Trump would be like, ‘Oh, hey, I’m bringing like Joe Shmoe up to Bedminster for Department of Interior,’ and then we were like, ‘F—, we need to run a vet on this guy to make sure he’s not a kid-toucher,'” said one source involved in the vetting. “It was just a clown show.”
“I think I truly understood what less than half of the people were being vetted for,” said another source involved in the vetting. “Totally inadequate resources for the overall process. … We would probably run through dozens [of contenders] a day.”
And from this shitshow, we got:
One red flag for Gen. David Petraeus, who was under consideration for Secretary of State and National Security Adviser: “Petraeus Is Opposed to Torture.”
Mick Mulvaney, who became Trump’s Budget Director and is now his acting chief of staff, has a striking assortment of “red flags,” including his assessment that Trump “is not a very good person.”
One heading in the document about Kris Kobach, in the running for Homeland Security Secretary, listed “white supremacy” as a vulnerability. It cited accusations from past political opponents that he had ties to white supremacist groups.
Seema Verma, who Trump appointed as the Administrator of the Centers for Medicare and Medicaid Services, had this paragraph near the top of her vetting form: “Verma was simultaneously advising Indiana ($3.5 million in contracts) on issues impacting how it would spend Medicaid funds while she was also being paid by a client that received Medicaid funds. Ethics experts have called the arrangement a conflict of interest that potentially put Indiana taxpayers at risk.”
Sonny Perdue, Trump’s pick for Agriculture Secretary, had a vetting form with sections labeled “Business conflicts of interest” and “Family conflicts of interest.” It noted that “Perdue is the owner of Houston Fertilizer and Grain, a company that has received contracts from the Department of Agriculture.”
A lot of the “red flags” in the documents refer to the applicant’s previous doubts about the president*’s character, his qualifications, and his general unfitness for office. A lot of the people being vetted got jobs anyway because, a) they were willing to swallow whatever vestigial consciences they had, or b) that the Camp Runamuck team didn’t have any better ideas.
Ties to “white supremacy” is listed as one of Kris Kobach’s vulnerabilities. Getty Images
But the real tragedy in all of this is that there is nothing in any of these documents that wasn’t obvious during the Cabinet confirmation hearings into all of these boobs and rounders. I sat through a lot of them, and most of them functioned as the first evil omens that the Republican congressional majorities had sold their souls to this president* and that congressional oversight was a thing to be laughed at.
Nobody could have watched Betsy DeVos’s calamitous hearing and believed she had any business running anything more complicated than a yard sale. Mnuchin’s vetting file is fat with horror stories about his career with OneWest, the foreclosure mill he helped run. But there were hearings with his actual victims, and those people meant no more to the Senate than they had meant to Mnuchin and OneWest. He practically spit in the Senate’s eye when they asked him about $95 million in real-estate Mnuchin had neglected to list on his disclosure forms. He said he was confused by the term “investment assets.” And everyone who believes that, please stand on your head until further notice.
This is an undeniable scoop for Axios. What it’s not is the slightest surprise.
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Charles P Pierce is the author of four books, mostly recently Idiot America, and has been a working journalist since 1976.
Opinion: The Federal Reserve is about to create a lot more zombies
Corporate zombies, that is. Kept alive by easy-money policies, companies that should have gone out of business keep staggering around.
By Brett Arends, Columnist June 24, 2019
Federal Reserve Chairman Jerome Powell. Getty Images
Long-term interest rates just fell off a cliff.
And if you think they can’t keep falling, think again.
Albert Edwards, a strategist at SG Securities, pointed out in a recent note that none of the experts surveyed by the Wall Street Journal at the start of the year predicted 10-year Treasury yields would fall below 2.5%.
Current level: 2%.
No fewer than 12% of non-financial companies on major developed stock markets could be “zombie” companies.
I guess we can toss those forecasting models out the window.
He adds that mainstream economists have been saying for years that long-term rates would never end up at zero percent.
Yet rates in Europe are now negative. People are paying half a percent a year for the privilege of lending money to the government of Switzerland. Even in the U.S., 10-year rates adjusted for inflation are only 0.29%. A generation ago, they were typically 2% or better.
Western economists used to say that zero percent rates were a weird and unique thing you only saw in Japan — like people eating raw puffer fish and hoping not to die. It would never catch on over here, they said.
But they already have. Today European rates are even lower than those in Japan.
‘Three-off’ event
When U.S. rates first collapsed in 2011-2012, we were assured it was a freak one-off event and was never going to happen again.
When it happened again in 2016, we were told it was, well, a “two-off” event that was certainly never going to happen a third time.
Now it’s happening a third time, and I guess we’re waiting for the official line on why, once again, this is just a temporary derangement and nothing to worry about.
But the Bank for International Settlements — the central banks’ central banks — says there is something to worry about, and it’s the reason that economic growth, inflation and interest rates can’t get off the ground: zombies.
The BIS found that, ever since the 1980’s, falling interest rates have made it easier and easier for bad companies with lousy management and terrible products and dismal prospects to stay in business long after they should have gone the way of all flesh.
These “zombie” companies can stay alive — or whatever the correct term is for zombies — if they can just keep borrowing. Bankers call this “extend and pretend” (as in, “extend the term of the loan, and pretend it’s ever going to be repaid.”)
And when money gets cheaper, that’s great for zombies. Lower interest rates are correlated with rising numbers of zombie companies, the BIS found.
And there are a lot of zombies around. The BIS reckons no fewer than 12% of the non-financial companies on major developed stock markets could be “zombie” companies, at least by a loose definition.
This is an epidemic. In the early 1990’s, the figure was about 2%.
Zombie companies are bad for the rest of the economy. Forget about being an economist: Think about the worst company you ever worked for. Think about all the waste that took place — all the money, time, effort and potentially valuable real estate wasted by idiot managers and self-serving bureaucracies and terrible technology and all the rest.
Replicate that to make up 12% of the economy. There. Now you understand why economic growth has been so sluggish for a generation. Now you know why the stock market is so hooked on the Federal Reserve.
Hey, don’t blame me. Blame the BIS.
We’d all be better off if badly run companies were put out of their misery, economists agree. But as long as interest rates are low and debt is cheap, they keep staggering around.
The price of junk
Zombies have never had it so good. As the interest rate on 10-year Treasuries has fallen, so have rates on junk bonds. In other words, the rate paid by zombie companies.
Since the start of the year, the typical high-yield bond yield has fallen by a quarter, from 8% to 6%, according to Bank of America Merrill Lynch.
Albert Edwards says we’re in an economic Ice Age. The BIS says we’ve got too many zombies. The U.S. president is a clown. There’s a horror movie in this somewhere.
But look on the bright side. Wall Street’s having another party.
The Dow Jones Industrial Average has risen nearly 2,000 points since investors began expecting falling interest rates earlier this month. The S&P 500 Index has climbed 7.5%. What could possibly go wrong?
Miguel Pérez Jr. locked himself in a hotel room for an entire weekend in one of the most dangerous cities along the border between the United States and Mexico.
A Mexican native, Pérez, 41, grew up in Chicago. He enlisted in the military and served two tours in Afghanistan. When he returned home, he struggled with post-traumatic stress disorder or PTSD.
Those struggles led to a drug-related conviction that landed him in state prison for seven years. While there, he received treatment for his condition, both therapy and medication. But that conviction also triggered deportation proceedings. After a year in an immigrant detention center, Pérez was deported to Matamoros, Mexico.
In that hotel room, as he waited for his friend to pick him up and take him to Tijuana, Pérez began to feel the weight of his new reality.
Pérez held his documents and two days worth of medication close to him. He was alone and overcome with anxiety, as he tried to figure out a way to live in a country he’d left when he was a boy.
Stay up-to-date with the latest news, stories and insider events.
“That night, I don’t really think I slept either. And … it was a big room, and I spent all night in one corner fixing my paperwork, separating everything. And then you hear gunshots down the street right outside,” Pérez said.
While veterans with service-related injuries have access to medical care, since his deportation Pérez has struggled to find mental health professionals and medication.
He suffered a traumatic brain injury from combat. He’s battled depression, anxiety and suicidal thoughts for years. But living alone and thousands of miles away from his family in Chicago, suicide has felt like a solution for Pérez. Last year, on two occasions, he attempted to take his own life.
“I think it was when I was just feeling really, really bad. And … I just started shaking and sweating. And I couldn’t really do anything,” Pérez said. “That’s when it first happened and I was just like … maybe I’d be better off dead.”
Erin Siegal McIntyre for WBEZ
Miguel Pérez looks out over Tijuana from his balcony.
Pérez is among hundreds of veterans who have been deported in recent years. A U.S. Government Accountability Office report revealed that an estimated 92 veterans were deported from 2013 to 2018. But the numbers are far higher, according to groups of deported veterans.
The GAO report also found that U.S. Immigration and Customs Enforcement “did not consistently follow its policies involving veterans who were placed in removal proceedings.”
Those policies include considering a veteran’s military service during removal proceedings. But Nicole Alberico, an ICE spokeswoman, said Pérez’s military service was taken into consideration when he was deported.
“Any action taken by ICE that may result in the removal of an individual with military service must be authorized by the senior leadership in the field office following an evaluation by local counsel,” Alberico said in a written statement. “Still, applicable law requires ICE to mandatorily detain and process for removal individuals who have been convicted of aggravated felonies.”
The U.S. Army declined to comment. A spokesperson said they don’t comment on specific cases.
Once deported, these veterans have been forced to organize and to help each other. Many say they’ve been forced to live in exile without medical care for the injuries they sustained in war. They’ve been deported to countries that feel foreign to them. It’s been decades since they’ve lived there, and some don’t even know the language.
“The main way we’ve been able to cope is by covering for each other and looking out for each other. There’s really nothing else we can do here,” said Hector López, director of United Deported Veterans, which has 40 members.
They are also united by their shared sense of longing for the United States, the country they served.
“Regardless of where we’re born, we all feel like this is not our home. This is not our country,” said Joaquin “Jack” Aviles, co-director of Deported Veterans Support House in Tijuana. “Our ties are so strong. And our commitment to our country is stronger than where you were born. We don’t belong to the country we were deported to.” The support house, known by many deported veterans as “the bunker,” has tracked at least 400 deported veterans since it opened in 2014, said Aviles.
In all, about 40 deported veterans live in Tijuana. Another 24 deported veterans started a support house in Ciudad Juarez, Mexico, right across the bridge from El Paso, Texas. Another three deported veterans live in central Mexico. And veterans have also been deported to other parts of the world, including India, Costa Rica, the Philippines and Kenya.
WBEZ interviewed more than a dozen deported veterans currently living in Tijuana, Mexico; India; and Kenya. They shared similar stories. They came to the U.S. as children with their families and as legal permanent residents. As adults, they enrolled in the military with the promise of expedited citizenship, which never happened. After serving, they got in trouble with the law. It’s a common story for veterans returning home from battle. However, unlike citizen veterans who run afoul of the law, legal permanent residents can be deported, if they’re convicted of certain felonies.
They also have one thing in common: they want to return to the country they served or, at the very least, they want to receive access to medical care from the U.S. government.
Erin Siegal McIntyre for WBEZ
A section of the U.S-Mexico border wall is painted with art and the names of deported U.S. veterans in Tijuana.
Rudy Melson with Consultants For America’s Veterans has connected dozens of deported veterans with benefits. Melson says deported veterans have few options for healthcare outside the U.S., and it’s harming the most vulnerable.
“Many veterans are totally heavily depressed using substances to cope with their depression. Most may have not been given service connection for depression or PTSD or both. And so they are utilizing substances, drugs and what have you … as a way to cope with service-related mental health issues,” he said. “And as a result of that, we are looking at veterans becoming sicker, more likely to become suicidal because they are not receiving any care — or the care that they’re receiving is not care that has been acknowledged or vetted as care that they would receive in the United States.”
These are some of their stories:
Photos courtesy of Felipe de Jesús Pérez, María Inés Zamudio/WBEZ
Felipe de Jesús Pérez is a quiet 36-year-old veteran of the Iraq war. He avoids eye contact when he speaks. He’s been deported from California twice, once in 2014 following a domestic violence felony and again in 2018. De Jesús Pérez said he wasn’t aggressive before he went to war. “I never got in trouble before,” he said.
De Jesús Pérez said he couldn’t understand why he was so different when he came back from war.
He feels betrayed by the country he loves, the country he defended, and the country that deported him despite his military service.
“I joined after 9/11 because of what I saw. I loved the country. I did. They didn’t consider anything I did for the country. I got out of the Marines honorably, decorated, went to war and everything. Just to throw me out like that?” he asked.
De Jesús Pérez said he was diagnosed with PTSD and that he’s self-medicating with marijuana. There are limited medical and mental health care options for deported veterans. And that makes him feel like the country he loves doesn’t care about him.
“I’m a veteran. You’re just going to kick us out? To me it’s like, how dare you? I felt used. You’re good enough to send you to war, but now you’re all messed up, let’s get rid of you,” he said.
Photos courtesy of Edwin Salgado
Edwin Salgado, 37, is also a veteran of the Iraq war and now lives in Ensenada, Mexico, about 60 miles south of Tijuana. Salgado was deported in 2016 from Orange County, California following a drug and weapons conviction. He was honorably discharged, but Salgado found “normal life” difficult. After his divorce, Salgado started using drugs. And since he was having a hard time finding work, he started selling them.
“I felt a little better when I was using,” he said. “It mostly helped me not to think.”
When Salgado was in the Marines, he tried to become a U.S. citizen. But he wasn’t able to finish the process because he was deployed.
Salgado is trying to view his deportation in a positive way. He describes it as a fresh start.
“I’m not trying to go back,” he said. “I would like access to medical treatment at the VA.”
Photos courtesy of Jiji Kurian
Jiji Kurian, 43, was deported to India in 2012. And while he’s made a new life for himself there, he wants to return home to Kankakee, Illinois, where he grew up.
“I feel lost here,” Kurian said. “I’m married, and I have kids. That’s it. I have no friends. I have no social life. I can’t talk to anyone. Everything that I had before I don’t have. I can’t get used to how they do things here.”
Kurian moved to Illinois with his parents when he was nine years old. He joined the national guard after high school. After serving in the military for six years, he became addicted to cocaine.That’s when he started getting arrested. After multiple felonies ranging from drug possession to distributing cocaine, Kurian was deported.
When he got to India, his father helped him get stable. Since he didn’t speak the language well and didn’t know anyone, his father suggested getting married.
“Here in India, they have arranged marriages. They do it really weird here. They put an ad in the newspaper. I didn’t want to do that, but after a while I was like ok,“ Kurian said. “I went and met some girls that I could marry. Finally, I found one, and I got married.”
Kurian said it took eight months to find his wife. He’s started a new life, but he still doesn’t make enough money in India. He relies on his parents, who live in Kankakee and are both in their 70’s.
“I think the reason they haven’t retired is because they have to help me,” Kurian said.
Photos courtesy of Joaquin ‘Jack’ Aviles, María Inés Zamudio/WBEZ
Joaquin “Jack” Aviles, 43, was brought to California as a baby. He joined the Marines after high school. Aviles was ordered deported in 2001 following a firearm possession felony, but he didn’t understand what that meant.
“I wasn’t conscious of what it meant to be deported,” Aviles said.
At 25, Aviles was deported to Mexico, a country he didn’t know. He spent the rest of his 20s trying to get back home.
“I tried to cross, and I served a two-year federal prison sentence for attempting to enter,” he said. “Since I hadn’t lived [in Mexico], I didn’t really speak the language. I attempted to re-enter [the U.S.] again because that’s my home. That’s my country. “
He was arrested and sentenced to another three years in federal prison for trying to enter the country illegally. By that point, he decided to stop trying to cross the border and to try and find a way to live in Mexico.
“The only thing I’m grateful for is that the Marines did teach me a lot, especially skills to survive,” he said.
He used those skills to learn Spanish, find a wife and a job to support her and their children. He also started advocating for deported veterans living in the bunker.
Photos courtesy of Alex Murillo, María Inés Zamudio/WBEZ
Alex Murillo, 40,served in the Gulf War, code named Operation Shield and Operation Desert Storm. When he got back, it was hard to adjust to civilian life.
“It’s a similar story for a lot of veterans. Whether it’s alcoholism, or pills or whatever. It’s a self-medication issue that a lot of veterans have. And I was one of those veterans,” Murillo said. “The problems I had, mostly, were life problems. I wasn’t able to get myself together after the military. I had a problem with alcohol abuse. Now, it’s PTSD. But I didn’t know about that stuff until I was diagnosed.”
After serving three years in federal prison following a marijuana conviction, he was deported in 2012. Murillo said non-citizen veterans should be treated like other veterans.
“When a veteran gets in trouble and does his time, the veteran gets to go home to their family. We don’t. Why don’t we get to go home?” he said. “We’re that same veteran that served. We’re the same veteran that was willing to die and put everything on the line for flag and country.”
When he was deported, Murillo was forced to leave his four children in Phoenix. His two girls were ages eight and four. His two boys were ages 12 and 10. His absence deeply impacted his sons. They both became addicted to opioids, Murillo said. Last year, his sons went missing. From his apartment just outside of Tijuana, Murillo looked for ways to search for his boys.
“It’s hard to be a parent over the phone. I tried, but it’s not the same as being there with them, helping them,” he said. “They’ve suffered because of my absence. That weighs on me.”
Murillo spent months looking for them. He finally found them, and they are now living with him in Mexico.
“My kids are going to grow up angry at the system that did this to them,” he said. “I’m one of the few that joins the military. I have PTSD like so many other soldiers. I am a victim of the war on drugs because I was incarcerated for cannabis for three years. I am a victim of mass incarceration. And now my kids are addicted to fentanyl.”
Photos courtesy of Hector Lopez, Erin Siegal McIntyre for WBEZ
Hector López, 55,moved to California’s Central Valley when he was a toddler. He joined the military in 1982. He was convicted of several marijuana charges. He was deported in 2006. He’s fighting to go back to California with his family.
“I haven’t seen my kids in 12 years. I have grandchildren I haven’t met,” López said.
His father and sister died after he was deported, López said. “I didn’t get to say goodbye to them.”
He says he’s hopeful his marijuana convictions will be expunged now that marijuana is legal in California.
“I’m an American down to the core,” López said. “Apple pie, baseball, football, basketball, you name it. I don’t like flan, and I don’t like soccer.”
Photos courtesy of Mario Rangel, María Inés Zamudio/WBEZ
Mario Rangel, 56, served in the U.S. Army 82nd Airborne Division. He’s been stuck living outside Tijuana since 2008. He is a naturalized citizen but can’t prove it. Rangel said he became a citizen at a military base in South Carolina. He lost his naturalization documents and several attempts to recover his military file have failed, Rangel said.
His covert work in the military might be the reason why he hasn’t been able to get proof he was naturalized, Rangel said.
“I didn’t know what I was getting into. That’s the whole Oliver North thing that happened and the Contra hearings. So I don’t know if that has anything to do with my records,” he said.
Rangel was only able to get his medical records. He said he was shot while serving in Colombia.
“Basically what we were doing … we were getting areas that had cocaine that were manufacturing cocaine. And we would raid those. I didn’t understand why we were packaging this shit. Why aren’t we burning it?” Rangel said. “But I found out later about Oliver North and all that stuff. That they were selling arms for drugs.”
Photos courtesy of José Velasco and Maria Inés Zamudio/WBEZ
José Velasco, 74, was deported a year ago. The Vietnam War veteran was charged with aggravated assault with a deadly weapon. Velasco said the charges were dropped, but he was still deported.
Velasco tried fighting the deportation until he ran out of money paying for lawyers. He sold his limousine business and moved to Tijuana.
The deportation has left him feeling devastated and betrayed on many levels.
“Have you ever seen a 70-year-old cry? Well, I did,” he said.
Velasco said he was told by military personnel that he was a U.S. citizen. That was a lie. And he doesn’t understand why he was deported since he was never convicted of a crime. He spent all of his savings to fight his deportation case, and he doesn’t know what else to do. Still, he remains committed to getting back to the U.S.
“I will go back. Because that’s my country. I’m more American than the average American. At least I served,” he said. “I’m Mexican by birth. By heart, I’m an American citizen.”
María Inés Zamudio is a reporter for WBEZ’s Race, Class and Communities desk.
Robert De Niro, Rob Reiner, Sophia Bush, Stephen King, Jonathan Van Ness, and more are cutting through the Trump administration’s lies about the Mueller report.
Robert De Niro, Rob Reiner, Sophia Bush, Stephen King, Jonathan Van Ness, and more are cutting through the Trump administration’s lies about the Mueller report.
1 in 6 ER visits or hospital stays triggers ‘surprise’ bill
What is direct primary care? A leading alternative hospital explains.
In this Feb. 12, 2019, file photo, Sen. Lamar Alexander, R-Tenn., walks to the Senate at the Capitol in Washington. A new study says about once in every six times someone is taken to an emergency room or checks in to a hospital as an in-patient, the treatment is followed by a “surprise” medical bill. (Associated Press).
WASHINGTON (AP) — Roughly one in every six times someone is taken to an emergency room or checks in to the hospital, the treatment is followed by a “surprise” medical bill, according to a study released Thursday. And depending on where you live, the odds can be much higher.
The report from the nonpartisan Kaiser Family Foundation finds that millions of people with what’s considered solid coverage from large employers are nonetheless exposed to “out-of-network” charges that can amount to thousands of dollars. It comes as congressional lawmakers of both parties and the Trump administration move to close the loophole, with a Senate panel scheduled to vote on legislation next week.
A patient’s odds of getting a surprise bill vary greatly depending on the state he or she lives in. Texas seems like a bit of a gamble, with 27% of emergency room visits and 38% of in-network hospital stays triggering at least one such bill. Minnesota looks safer, with odds of 2% and 3%, respectively.
Researcher Karen Pollitz of the Kaiser Foundation said the reasons for such wide differences are not entirely clear, but seem to be related to the breadth of hospital and doctor networks in each state, and the ways those networks are designed.
Patients in New York, Florida, New Jersey and Kansas were also more likely to get surprise bills. Among the other states where it was less likely were South Dakota, Nebraska, Maine and Mississippi.
Averaging the results nationwide, 18 percent of emergency room visits and 16 percent of stays at an in-network hospital triggered a surprise bill for patients with health insurance through a large employer, the study estimated.
That illustrates the need for Congress to get involved, said Pollitz, since large-employer plans are regulated by federal law and surprise billing protections already enacted by states like New York do not apply to them. “This is a prominent problem affecting patients, and it is beyond the reach of state laws to fix, and it is by definition beyond the ability of patients to fix on their own,” she said.
Next Wednesday, the Senate Health, Education, Labor and Pensions committee plans to vote on bipartisan legislation that would limit what patients can be charged to their in-network deductibles and copays. The bill from Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., would require insurers to pay out-of-network doctors and hospitals the median — or midpoint — rate paid to in-network providers. The House Energy and Commerce committee is working on similar legislation. President Donald Trump has said he wants to sign a bill.
Major industry lobbies are going to battle over the issue. Insurers and employers generally favor the approach the Alexander-Murray bill takes on how to pay out-of-network providers, using an in-network rate as the reference point. But hospitals and doctors instead want disputed bills to go to arbitration. New York has an arbitration system and a recent study found it has worked well. However, some lawmakers are concerned that on a national scale it may lead to a costly new bureaucracy.
Surprise bills can come about in different ways. In an emergency, a patient can wind up at a hospital that’s not in their insurer’s network. Even at an in-network hospital, emergency physicians or anesthesiologists may not have a contract with the patient’s insurer. For a scheduled surgery at an in-network hospital, not all the doctors may be in the patients’ plan.
Bills can amount to tens of thousands of dollars and hit patients and their families when they are most vulnerable. Often patients are able to negotiate lower charges by working with their insurers and the medical provider. But the process usually takes months, adding stress and anxiety. When it doesn’t work out bills can get sent to collection agencies.
The Kaiser estimates are based on insurance claims from 2017 for nearly 19 million people, or more than 1 in 5 of those covered by large employers. The claims details came from an IBM Health Analytics database that contains information provided by large-employer plans. Researchers excluded patients 65 or older, most of whom are covered by Medicare.
The Alexander-Murray legislation also includes other ideas aimed at lowering medical costs by promoting competition to brand-name drugs, blocking health industry contracting practices can bid up prices, and requiring greater disclosure of information. A public health section of the bill would authorize a national campaign to increase awareness of the role vaccines play in preventing disease.
Potentially deadly valley fever is hitting California farmworkers hard, worrying researchers
Getting an accurate count of the number of people affected by valley fever is a challenge because the majority of those who are infected never know they have it.
By Twilight Greenaway, Civil Eats June 17, 2019
This story was produced in partnership with Civil Eats, a nonprofit news organization focused on the American food system.
The fungus that causes valley fever thrives in dry, undisturbed soil. Years of climate change-fueled drought has led to a swift rise in the number of people diagnosed with it. Anuj Shrestha / for NBC News
LAMONT, Calif. — Victor Gutierrez contracted valley fever, an illness caused by a soil-borne fungus, and he thinks he got it in the summer of 2011 when he worked in the nectarine orchards of California’s dry, dusty Central Valley.
“The wind was really strong, and we were almost falling off our ladders,” Gutierrez said. “The dust would rise up in the fields and we would get lost in [it].”
Then again, he might have contracted it during that year’s grape harvest. “We would walk out of the vineyard with our faces full of dirt. Only our eyes were visible,” Gutierrez said. When he showered at night, he could see the layer of soil washing off his body.
Ultimately, he doesn’t know exactly when he contracted valley fever, a dangerous fungal disease. Gutierrez just knows that late that summer, he started experiencing flu-like symptoms — coughing, night sweats, exhaustion, and a strange feeling that he was burning up on the inside. The father of three ignored it and kept working for fear of losing his job. But when the illness got to the point where he was struggling to breathe, he went to see a doctor, who gave him a dose of antibiotics and told him to buy a humidifier.
The next day, Gutierrez’s lungs filled up with fluid and he felt so unwell that he went to a local clinic. This time, they tested him for valley fever, and it came back positive.
“The nurse called me and told me to rush to the clinic because it was an emergency,” he said. Gutierrez, who was 33 at the time, had never heard of valley fever and was told he might only have six months to live.
While Gutierrez managed to beat those odds by taking the antifungal medication fluconazole for more than a year, he has seen valley fever kill many other people he’s known. Of the five people he recalls seeing diagnosed with the fungal infection on that day in 2011, he said he’s the only survivor.
Still, valley fever remains dormant in his body — and it could come back at any point. Gutierrez still struggles with regular pain in his lungs and when he gets a cold or flu, he’s in bed for weeks.
Years of climate change-fueled drought appear to have led to a swift rise in the number of people diagnosed with the illness across the Southwest.
Coccidioidomycosis or cocci (pronounced “coxy”), the fungus that causes valley fever, thrives in dry, undisturbed soil. It becomes airborne when that soil is disturbed — whether it’s by dirt bikes, construction crews, or farmers putting in new fruit or nut orchards. It can travel on the wind as far as 75 miles away. Years of climate change-fueled drought and a 240 percent increase in dust storms appear to have led to a swift rise in the number of people diagnosed with the illness across the Southwest.
In California, rates of new cases rose 10 percent between 2017 and 2018, according to the California Department of Public Health, at what will likely be a sizable cost to the state. The state budgeted $8 million for valley fever research in 2018, and about $3 million will go toward the expansion of the Valley Fever Institute at Kern Medical hospital. Three new laws address valley fever reporting, testing, and education in the state. In 2011, California spent approximately $2.2 billion in valley fever-related hospital expenses.
Misdiagnosis and the role of race
Getting an accurate count of the number of people affected by valley fever is a challenge because the majority of those who are infected never know they have it. However, new cases are especially concentrated in the San Joaquin Valley, home to the farms that produce two-thirds of the nation’s fruit and nuts and one third of its vegetables. The region is also home to the two cities with the worst particle pollution in the U.S. and most of the state’s farmworkers.
In 2017, the Centers for Disease Control and Prevention said 14,364 cases of valley fever were reported nationally, but that “tens of thousands more illnesses likely occur and may be misdiagnosed because many patients are not tested for valley fever.” On average, there were approximately 200 deaths associated with the illness each year in the U.S. from 1999 to 2016.
Dr. Royce Johnson, director of the Valley Fever Institute and professor of medicine at the University of California, Los Angeles, said 60 percent of valley fever cases are misinterpreted as the flu and go undiagnosed. Johnson, who has been working with valley fever patients for more than 40 years, says the remaining 40 percent tend to experience symptoms that are similar to and often confused with a serious case of pneumonia. From there, a small percentage — around 1 percent of the total people infected — see the disease spread to other parts of the body, including the brain and the skin.
“People with relatively uncomplicated [respiratory valley fever] will usually think this is the worst illness they’ve ever had,” Johnson said, adding that the symptoms can get quite a lot worse in cases where it spreads. Patients are treated for between three and 12 months and then tracked for an additional two years to make sure the disease doesn’t come back or spread.
“A lot of people don’t understand how manifold and complicated valley fever can be,” Johnson said.
The infection is not passed from person to person, but epidemiologists are still trying to determine what exactly puts people at risk, aside from simply being outside, said Stephen McCurdy, who serves as a professor in the Department of Epidemiology and Preventive Medicine at the University of California, Davis, which created the California Center for Valley Fever in 2016.
Farms in California’s Central Valley, such as this pistachio orchard, contribute to arid conditions and dust problems, according to scientists.Nirma Hasty / NBC News
Immune function is one key factor, putting pregnant women, some diabetics, people with HIV, the elderly, and those who are on immunosuppressant drugs or have had organ transplants at elevated risk. Race appears to be another factor, McCurdy said. “It seems that darker-skinned people are more likely if they contract valley fever to get a more severe case of it. In the majority of cases, people knock it back themselves [like a typical flu]. People with darker skin seem to be less able to do that.”
It’s not entirely clear just why that is. “I’m sure it’s related to whatever genetic resources those groups have compared to others,” he said.
According to a study by the California Health and Human Services Agency, African Americans and Hispanics in California are more likely to be hospitalized with valley fever than whites.
“A contributing factor to this finding may be the large populations of Hispanics living and working in the endemic region counties of California,” wrote the study’s authors, who added that the connection between race and risk for the disease “is not well understood and may be attributable to variations in genetic susceptibility.”
Another challenge with gathering data, said Carol Sipan, a public health lecturer at the University of California, Merced, is the fact that, “many [farmworkers] would go back to Mexico if they got really sick.” In Mexico, she added, valley fever is not a reportable disease.
Farmworkers in the crosshairs
Like many farmworkers who contract the illness, Gutierrez found the cost of the antifungal medication needed to treat valley fever astounding. At the height of the illness it cost $1,200 for two months of pills because he had to take two to three times as many as one would if they were treating a typical candida infection.
He didn’t have insurance at the time and said his family often had to choose between food and his medication. He still isn’t able to work regularly and his family mainly survives on the money his wife, Maria, makes in the fields.
“It has changed my life a lot,” Gutierrez said. “When I used to work, I would always have money in the house — to eat, to buy my children clothes, for everything. But right now, I have debts.”
Researchers worry that climate change will contribute to the spread of diseases like valley fever as it exacerbates droughts and other extreme weather events. Farmworkers are at particular risk of being exposed to the soil-borne fungus.Nirma Hasty / NBC News
Isabel Arrollo-Toland knows both sides of this story intimately. She is the daughter of a former farmworker and directs a small nonprofit organization, El Quinto Sol de America, which trains farmworkers and other recent immigrants in civic engagement in a handful of unincorporated communities in Tulare County, an hour south of Fresno.
Arroyo-Toland was diagnosed with valley fever in 2007 and again in 2008 when it spread to her skin in the form of painful lesions — and both times she endured months of misdiagnosis. Then, in 2012, she was told that her kidneys were failing due to the impact of both valley fever and the medication she had relied on to treat it. Since then, she’s had to undergo peritoneal dialysis in her home for 10 hours every night. She’s currently on the donor list for a kidney.
Arrollo-Toland makes it a point to advise workers to get tested for the illness at the first sign of a cold or flu. “Sometimes I’ll be talking to a farmworker and they’ll say ‘Oh, I have these symptoms …’ And my first thing is, ‘You should go get tested for valley fever.’”
She also points to the many challenges farmworkers face when it comes to staying healthy — from regular exposure to pesticides and dust clouds, to lack of fresh produce and clean water — a growing challenge for many residents of unincorporated areas.
“The valley fever fungus might actually expand its territory with climate change.”
ANTJE LAUER, MICROBIAL ECOLOGIST
“It’s really difficult to say you have to keep your immune system at 100 percent, because your environment doesn’t provide that for you,” Arrollo-Toland said. “Seeing the doctor for prevention is another issue because you have to go to the clinic, which is probably 30 minutes away …and always so full.”
In U.C. Davis professor McCurdy’s recent research, he found that those who reported having valley fever “lost about 20 work days of on average while they were sick.” McCurdy is currently working with other researchers on two studies involving farmworkers and valley fever, including one survey of almost 120 Latino workers at two migrant labor centers in Kern County.
Worsening conditions
The stakes are changing, in part because rainfall in the Southwest has become less common and less predictable. Very wet winters, like the one that just passed, followed by dry summers, have historically been particularly bad when it comes to the growth of cocci spores, said Antje Lauer, a microbial ecologist at California State University, Bakersfield. Lauer has received funding from NASA and the U.S. Department of Defense to study valley fever in soil.
“The valley fever fungus might actually expand its territory with climate change,” said Lauer, pointing to the fact that cocci spores were found in Washington state in 2014.
Although farmworkers and others who work outside are in an especially vulnerable position, Lauer added that it only takes one exposure to make someone sick. Dust masks can be effective at limiting some exposure, but it’s not a real solution for those who work in the fields.
Arid soil conditions help valley fever spread, making it particularly problematic in the Southwest, as well as in parts of Mexico and Central America.Nirma Hasty / NBC News
Manuela Ortega, a farmworker who contracted valley fever in 2006 — and whose brother died of the illness at age 39 — said that the stifling summer heat makes wearing a mask unrealistic. “Even though there’s a lot of wind and dirt, people still work. In some cases, it’s good to wear masks, but in other cases, people just need to be sent home,” she said.
None of the farmworkers who were interviewed had been given masks or informational pamphlets on the job.
The California Farm Bureau Federation tracks health and safety issues affecting farmworkers, according to spokesman Dave Kranz. “We support research that helps farmers and their employees avoid illness and injury, and work with health experts and farm advisers to make sure farmers and employees have the information they need to stay well and safe,” he added. “That applies to valley fever and to any other illness that could affect farmers and farm employees.”
Two vaccines for valley fever are in the works, but it’s not clear how close they are to being tested on humans.
Two cocci vaccines are in the works — at the University of Texas and the University of Arizona — but it’s not clear how close they are to being tested on humans. Three members of Congress from the Southwest last month introduced a federal bill, the FORWARD Act, in an effort to increase public awareness of the disease while “promoting the development of novel treatments and a vaccine.”
In the meantime, farmworkers and their allies continue to face immense challenges.
Mario Celaya, a physicians’ assistant who was trained as a doctor in Mexico, has been seeing patients at the Vida Sana clinic in Lindsay, California, for 23 years. He has seen the rates of valley fever increase in recent years and now treats three to four people with the illness every week. The bulk of his patients are farmworkers and their families.
Celaya said a timely diagnosis can make a difference in whether a patient is severely affected by the illness. Because the blood test requires a two-week window before the results are accurate, however, he says false negatives are common.
“Patients need to be aware of that if they do not get better in two or three weeks, come back and be rechecked because it could be very bad,” he said.
“If you have to tell them, ‘You cannot work for two to three months,’ it has an impact on their families because, sometimes they are the main source of income,” Celaya said. “If these patients have to stop working, then the whole family is going to go through difficulties.”
Drone footage shows the massive scale of Sunday’s protests in Hong Kong, where organizers said nearly 2 million people took to the streets to march against a controversial extradition bill. https://cnn.it/2KYbxPt
Drone footage shows the massive scale of Sunday’s protests in Hong Kong, where organizers said nearly 2 million people took to the streets to march against a controversial extradition bill. https://cnn.it/2KYbxPt
In one of her questions to Young, Justice Ruth Bader Ginsburg discussed whether the USDA can avoid sharing the data just because of its agreement with retailers. “To say the government can control this by making a promise that it won’t disclose, that seems to run counter to the whole idea of FOIA,” she said.
