Protestors burn transit stations in Madagascar capital; is American frustration so different?

Protests over lack of water and electricity turned violent late last week in Antananarivo, the capital of Madagascar, and the government responded with tear gas, rubber bullets, and a curfew.

I know about the crisis because of friends with family there. I have not seen the story on American TV, which I mention with anxiety over endangered media heterogeneity. You can read more about the protests at, e.g., Reuters (UK), TRT Afrika (Turkey), RFI (France), WION (India), Al Jazeera (Qatar), and if you dig for it, the AP (US).

I was in Antananarivo, known locally as "Tana," in July. The people there could not have been more gracious and welcoming.

At the same time, socioeconomic tension was plain. That's not unusual in African cities, but in Tana, by plain, I mean that there were troubling and unavoidably visible signs of increasingly worrisome economic inequality. 

Antananarivo, Madagascar, July 2025
(RJ Peltz-Steele CC BY-NC-SA 4.0)

A Tale of Two Cities

Tana from the Radisson gym.
(RJ Peltz-Steele CC BY-NC-SA 4.0)

I used the nicely equipped gym on the eighth floor of the Radisson Blu Hotel in Tana. The room has floor-to-ceiling windows that afford a view of the city from the treadmills. But if one looks straight down from the windows, immediately adjacent to the hotel, there is a residential warren of ramshackle homes. Children play on clay paths between crumbling walls and an open sewer. The neighborhood is right behind a concentration of auto shops, noxious with exhaust and dribbling out the toxic effluents of their work.

Shanty town and auto district adjacent to Radisson. A cable-car line is visible on the horizon.
(RJ Peltz-Steele CC BY-NC-SA 4.0)

In contrast, the Radisson itself is part of a small swanky village that boasts a grocery store, theater, cafes, and gift shops. The village is enclosed by high walls with only one road in from the auto-shop strip. At night, a massive steel door rolls shut to seal off the Radisson village. 

The scene is reminiscent of the fictional town of Woodbury in The Walking Dead, fortified against an incongruent dystopia. Though to reiterate, here, in real life, the souls outside the wall are good people trying to make ends meet. As the sun sets, all but a few local people evacuate the commercial village before the door closes, and then they flow back in with the light of dawn.

Kids play beside a drainage canal behind the Radisson.
(RJ Peltz-Steele CC BY-NC-SA 4.0)

Even the walled Radisson village, anyway, is not immune from Tana's socioeconomic troubles, because the utility infrastructure is the same, inside and out. The tap water is not recommended for drinking, and power outages are frequent, if usually short.

Malagasy people generally don't have freezers and shop daily for produce. The cost of appliances would be manageable for many. But the problem would remain the power grid, which is not sufficiently reliable, even in the city, to make home refrigeration cost effective. When the power goes out, most of Tana life hums on without interruption. But the outages paralyze places such as the Radisson village, where devices from refrigerators to televisions to elevators are essential to business.

In bizarre juxtaposition with the motley cityscape, wires are strung across Tana's skies, visible from anywhere. The wires reach from tower to tower and occasionally dip groundward into modern multistory buildings of metal and brick. This is Tana's brand new cable-car system.

I was not surprised to read that protestors last week set fire to "several" of the cable-car stations.

Madagascar and the Monorail 

A cable-car line fills the sky behind the Tana train station.
(RJ Peltz-Steele CC BY-NC-SA 4.0)

 

The motivation for building the cable-car system was ostensibly sound. Tana is plagued by jammed traffic, which is impeding economic development. One of the reasons people crowd into the tight and unsanitary living quarters of the inner city is that they could not otherwise reach their jobs if they moved to better accommodation on the outskirts.

The cable-car lines promise to soar over the cars and trucks, moving people into and out of the city with quiet efficiency. The lines also are built to reach less developed surrounding areas, rather than tracking the congested main highway, thus inducing new suburbs to bloom and alleviating the crisis of housing, besides transportation.

One doesn't have to look hard at the plan, though, to doubt its cost-benefit analysis. To start with, the road congestion is a function of infrastructure failure as much as volume. Though there are some recently constructed traffic circles, most roads are unmarked by lanes, and most city intersections are chaotic tangles with no right of way indicated by signs or signal lights.

One wonders that infrastructure money might have been spent better to bring the existing potholed road system up to standard before stringing cables over head between shiny stations.

Cable cars hang motionless over Tana in July.
(RJ Peltz-Steele CC BY-NC-SA 4.0)

Then there are the cable cars themselves. The first time a friend and I had a look at them, I couldn't help but say aloud, "That wreaks of kickback." My friend agreed. We both thought immediately of "Marge vs. The Monorail."

The 198 gondola cars can hold only 12 passengers each and move only so fast. The system is designed to move daily 75,000 people and replace 2,000 cars on the road. That's not nothing, but also not a big chunk of potential commuters relative to the city's population of 3 million. And if one figures that growing suburbs will attract more people to Tana from impoverished parts of the country, the problem of induced demand is compounded.

Though cable cars are touted as a potential boon for urban development, they work best as a discrete-route solution for particular hurdles, such as topography, and as a complement, not a substitute, for proven mass transit systems such as busses and rail cars, both lacking in Tana. A "bus system" exists only insofar as terribly overcrowded minibuses barrel along customary routes. Limited inter-city locomotives rumble over dilapidated tracks.

Is There a Hyena in the Debt Trap? 

It's unclear from government reporting just how much the cable-car system cost Madagascar, but it's a lot. The price tag was supposed to be €152 million. The French government loaned the country €28 from the French treasury and arranged for the rest by private loan from Société Générale. Malagasy voters were not happy about the indebtedness. Moreover, Madagascar committed to fund any cost overruns. Some reports say that the French loans wound up covering only one of the two system lines.

The government's revenue basis to fund cost overruns and pay back the loans also is shaky. Malagasy people have balked at the cost of tickets on the cable-car system, which range from about €0.65 to €1.1. That might be low by western standards, but it's a lot locally. Daily round trips add up to at least €32 per month in a country where the monthly living wage is only €126, and €85 marks the low end of actual-wage estimates.

President Andry Rajoelina, 2019
(ILO via Flickr CC BY-NC-ND 2.0)

The government has not been forthcoming with data about the project, and no wonder. Malagasy-French businessman Andry Rajoelina has been president since 2019 and held out a technological solution to Tana's legendary traffic woes as a showpiece project. 

Rajoelina's vision has been slow to come to fruition. Plans were sidetracked initially by the pandemic. The French money came only in 2021, and construction began in 2022, with delivery promised in two years. In 2024, the Rajoelina administration inaugurated the cable-car system amid much fanfare and worldwide press. But the system wasn't actually finished then, and operational opening was postponed to 2025. 

On my last day in Tana in July 2025, the cable cars moved, surprising everyone on the ground. The system was not yet open, but was being tested. Buckets of water were loaded into cars to simulate the weight of passengers. The system finally opened in August.

The worst public relations challenge the cable-car system has posed to the Rajoelina administration to date is not its ultimate efficacy, but simply the foreboding physical presence of the empty gondolas hanging motionless over the city. When people are stuck in traffic, or when the power goes out, or when they leave their homes in search of drinkable water, they look up at the network of towers and heavy wires and wonder whether any of that debt and spending will make their lives better.

Don't Look Up 

I'm sometimes guilty myself of a siloed focus on American affairs. And thinking about what's happening in Madagascar makes me wonder whether—when?—the day will come that Americans turn our frustrations into conflagration.

America feels every day less a "developed" country in terms of critical needs such as transportation, healthcare, housing, and jobs. And people struggle more every day to make ends meet, while politicians bellyache over the government supposedly doing too much.

An anecdotal survey: 

Transportation. To travel for work, I have to make the arduous, two-plus-hour trek to the airport via foot, bus, train, and bus again, across slow, unconnected, and overpriced transit systems that my region is lucky to have at all. When I land in Europe, I'll travel about the same distance with one ticket on a rapid, unified transit system in under an hour.

Amtrak is hard at work on "NextGen Acela." But it will only serve the northeast corridor and will top out at 160 mph. Europe hit that mark in the 1970s with trains today running in the 190s. China and Japan have high-speed trains on dedicated lines running at 220 mph. Anyway, "old gen" Acela was a corporate subsidy, as it practically priced out non-business travelers, even before Amtrak introduced predatory dynamic pricing. 

Healthcare. My wife and I saw Trevor Noah deliver his latest stand-up in Connecticut a couple of weeks ago, and he did a long bit on the nonsensical costs and bureaucracies that tyrannize patients in the U.S. healthcare system. Noah was treated for a wrist injury he sustained just before boarding a plane home to New York from his native South Africa. He could have been treated faster and for less out of pocket had he just flown back to a hospital in Cape Town, he only half-joked. 

A Connecticut stage awaits Trevor Noah on September 18.
(RJ Peltz-Steele CC BY-NC-SA 4.0)

Most memorable about Noah's monolog to me, besides his trademark storytelling brilliance, was the chorus of audible vocalizations of assent and empathy from the audience, including us, as Noah described the absurdities of hospital billing, from the mysteries of bloated pricing—weren't we promised "No Surprises"?—and picayune itemization of the mundane to the unashamed prioritization of profit over care.

Housing and jobs. My daughter bought a home in Los Angeles this year and has done yeoman, Instagram-hit renovation work herself. But she's looking for a new job to make the mortgage bearable. From her scores of applications, she recently rated an interview in her entertainment-industry wheelhouse. Yet she was one of 54 people interviewed for one low-level position. A form email later communicated regret that she was among the hundreds of unsuccessful applicants. Every American job-seeker knows such woes amid the full-time job of looking for a job, despite the touting of low unemployment by the administrations of both parties.

A measure of wealth inequality, the U.S. gini coefficient was 41.8 in 2025, on a scale from 0, perfect equality, to perfect inequality 100, according to World Population Review (WPR). That's bad for a well developed economy, comparing unfavorably with, for example, western European countries, which score in the low 30s, and Canada, at 29.9. Worse, inequality in the United States is rising over the long term, while it's falling elsewhere.

Our number is, however, on par with Madagascar. Malagasy data are difficult to come by, but WPR estimates a 2025 gini coefficient of 42.5, also on the rise over the long term.

The gini coefficient is a ratio, so it doesn't speak to comparable sums. People in a poorly developed economy might be quicker to disrupt the status quo when their very survival is on the line than people in a highly developed economy who become unable to afford cable TV. 

At the same time, Americans have a temperamental sensitivity to injustice and, even after 250 years, little patience for tyranny.

History is littered with great societies befelled by their own greedy elites.

Bar comprises haves, have nots; ABA chooses haves

Yesterday I submitted the following open letter to the leadership of the International Law Section (ILS) of the American Bar Association (ABA). I note that it is not possible for law professors at ABA-accredited schools not to be members of the ABA; the schools pay for group memberships, on top of hefty accreditation fees. At present, the ABA is empowered with government-sanctioned accreditation authority over legal education in the United States.

---

To the leadership of the International Law Section of the American Bar Association.

$895, the registration fee for academics for the ILS annual, is beyond the pale. I note that I might not have been able to go this year anyway, because of a conflict. But I write because this is a persistent problem. Last year I complained about the fee, which I think was $795. I was told I was heard. Apparently heard and dismissed.

Ten years ago, I registered for the ABA ILS for $295. That's a cumulative inflation rate of 203%. The U.S. 10-year inflation rate generally is about 25%.

The ABA must think that all academics are the same. So let me be plain. My annual salary, after about 30 years in academics and holding the highest academic rank on my public-sector faculty is about $193,000. My budget for professional development is $5,000 this year. It was $5,000 10 years ago. It was $5,000 15 years ago. Every year, working in public service, I must do more with less. As that's impossible, that means dipping deeper into my own pockets, which are not getting deeper fast enough to keep up with the ABA.

The starting salary, with no experience, for a law professor in the Boston market ranges from $185,000 to $213,000. The high end of the law-school teaching scale in the market comes in at about double what I make. (Salary.com.) I don't know what the benefits are, but I bet they've grown faster than mine.

I speak of my own experience here, because that is what I know. But to be fair, I make decent money, relative to the American labor market. I know that and try not to take it for granted. What is more worrisome about ABA's economic exclusion is its impact on both new and practicing lawyers who have committed their labors to public service.

The ABA sends the unequivocal message that persons in public service are not welcome in ILS--that internationalism in law is only for the well off, or worse, that professional association per se, beyond compulsory licensing, is only for the well off. My students graduating in public service careers--NGO registration fees are the same as academic--will be lucky to start out at a third of my pay and might not reach my pay in the course of a career.

Accordingly, I have, for some time, stopped advising students to join ABA. Now I will advise them affirmatively not to waste their time and money. I steadfastly sang the praises of ABA membership for more than 25 years, including 10 years on the TIPS Task Force on Outreach to Law Students. The most important advantage of ABA for me and for new lawyers, I long asserted, was conference programming and networking. I see that the ABA now intends those benefits to be exclusive to big money makers in the private sector.

Yesterday I participated in an ILS committee meeting. You will hear soon from that committee that no one volunteered to move into any leadership role beginning next year. No one includes me.

Sincere farewell,
Rick Peltz-Steele

Americans can't find doctors in sick system, but docs whine too loudly on debt, ignore excessive earnings

In the current AARP Bulletin (pay wall, Apple News), New York Dr. Howard Zucker capably explains why Americans are being squeezed by a doctor shortage. But two points of Zucker's explanation too easily let doctors off the hook and require clarification.

I hope tomorrow to meet my primary care physician (PCP) for the first time, after he's nominally served in that role for two years. I've seen five PCPs come and go in as many years, which is really like not having a PCP at all—oddly, as my insurer insists that I must have one. The annual checkup has become biennial at best, and it's not for my lack of trying. At that, with my mediocre employment-based healthcare coverage, I'm more fortunate than many Americans.

Zucker describes the many circumstances converging to deprive Americans of access to healthcare providers. A leading problem is poor planning by the medical profession, embodied by the American Medical Association (AMA), for an increasing and aging population.

Another factor, which is familiar to patients, is the pressure by profit-driven healthcare proprietors, such as CVS, to commodify patient care, superseding the doctor-patient relationship and thoughtful care with the churning cauldron of the billable quarter hour. Workplace conditions for front-line PCPs are not only maddening patients, but driving some healthcare providers, literally, to madness.

Nevertheless, there are two ways in which Zucker goes too easy on doctors, letting them off the hook for responsibility in this mess.

First, Zucker is wrong that a doctor can't get by with medical school debt and a PCP wage.  

He wrote that the average medical student finishes school with $235,000 in debt. Specialties pay some double the wage of primary care. Research posts pay well and don't have insurers dictating terms. So debt-burdened students are disincentivized to enter family practice or to work directly with patients at all. 

Still, Zucker wrote: "Now consider that the average [PCP] in internal medicine, geriatrics, pediatrics or family medicine makes about $250,000 to $275,000 a year. Becoming a PCP just isn't financially feasible for most recent graduates."  Just for the record, that's more than I've ever made at any job, and I've had a law degree for 28 years.

Not financially preferable I can see.  Not financially feasible is plain wrong.

For comparison, the average indebtedness of a U.S. law school graduate is $130,000, according to the Education Data Initiative. For the law school where I work, it's about the same, $125,405, U.S. News reported. The median law graduate salary is $89,250, according to U.S. News. My school's is about $68,000, according to LSD.Law. Ballpark monthly repayment, using, for these gross purposes, a 4.5% rate and 10-year term, means a monthly payment of $1,347, according to the SmartAsset student loan calculator.

To be sure, that's too much debt to make law school an appealing option. The Consumer Finance Protection Bureau recommends limiting borrowing to hold monthly payments at 10% of gross income. Those median salaries yield a monthly gross of $7,438 or $5,667, respectively, so a monthly payment at 18.1% or 23.8%. 

But it is possible, depending on one's needs. An annual $89,250 or $68,000 should yield a monthly take-home of about $5,600 or $4,400, according to the SmartAsset paycheck calculator. On the one hand, the average American household requires $6,440 per month, according to multiple sources. On the other hand, a single adult with no children can get by on $3,439 in the Massachusetts county where my school is located, according to the MIT living wage calculator. The overall average American individual is bringing home only about $4,000 monthly, using Bureau of Labor Statistics (BLS) data, so one salary isn't meeting household expenses in any event.

Accordingly, using the same metrics, the medical graduate's monthly debt payment would be $2,434. The PCP monthly take-home at the low end would be about $14,200, on $20,833 gross. That's a payment to gross ratio of only 11.7%, with $11,766 to spare for monthly household expenses. Even at a student loan rate of 9%, the monthly payment hits only 14.3% of gross, still sparing more than $11,000 to meet expenses. (A first-year medical resident starts at only about $55,000 annually, U.S. average, but lean residency years are the quirky if objectionable norm in the profession regardless of later specialization.)

Once debt is paid off, doctor's circumstances become downright luxurious. BLS estimates the median American's lifetime earnings at $1.7m, a lawyer's at $2.3m, and a doctor's at $7.5m. 

So it is feasible to invest in medical school—even potentially lucrative—and even still to be a PCP for a few years.

Second, Zucker fails to recognize the economic protectionism of the medical profession and bloat in the salaries of U.S. doctors—even PCPs.

Zucker did fault the AMA for choking medical school admissions in the 1980s. But Zucker blamed the AMA only for bad math. The truth is more sinister.

The AMA doesn't control medical school admissions directly, but it does lobby hard for legislators to limit the number of medical schools and to limit subsidies for residencies, thus effectively controlling supply in the market. This isn't about the quality of medical training, but about economic protectionism. The AMA, that is, its members, doctors, don't want to see salaries go any lower than those dizzying quarter-million-dollar heights.

(Read more in Derek Thompson, Why America Has So Few Doctors, The Atlantic (Feb. 14, 2022).)

That's what's happened in law as antitrust rumblings have compelled the American Bar Association and state bars to let up on the gas in their economically protectionist motives over the last four or five decades. The market in legal education has become more competitive—even problematically so, from a quality standpoint, it must be admitted—and salaries have fallen.

At the same time, persistently burdensome accreditation gateways in education and strict state licensing requirements in the practice have maintained such a chokehold on the student-to-bar pipeline that the lower paid lawyers who result cannot afford to meet the market demand for legal services for ordinary people, in contrast with corporate clients.

So law is not a model to follow, to be sure. At the same time, one doctor in America does not need to take home an excess of nearly double what's required to keep up an American household, nor to make more than four times the median American lifetime wage. European doctors are paid only half as much as U.S. doctors. In fact, there's a huge gap between U.S. doctors, at an average annual gross of $352,000, and doctors anywhere else in the world—ranging from an average $19,000 in Mexico to $273,000 in Canada, according to news outlet Medscape.

Zucker didn't mention the bloat in salaries of U.S. doctors in the AARP Bulletin. Incidentally, when Dr. Zucker was New York health commissioner, earning $210,000 annually on the public payroll, he took some heat for failing to disclose a side-gig income of $75,000 annually from a health research firm, e.g., the Times Union reported.

Our healthcare system is badly broken.  Like our legal services.  Like our bridges.  The list goes on.  What I fear is missing from the solution is the willingness of Americans in the highest income brackets to bear any sense of civic responsibility. In this regard, the medical profession is not exempt.

Lawyers be a-ballin'?

Canadian lawyers protest legal aid de-funding in 2014
(Sally T. Buck via Flickr CC BY-NC-ND 2.0).
My wife was a legal services attorney after law school.
Her salary could not have paid both law school debt
and even a modest mortgage.

A student loan specialist giving advice on The Takeaway this morning said, "Don't live like a lawyer when you're a student, and you won't live like a student when you're a lawyer."

Betsy Mayotte, founder and president of The Institute of Student Loan Advisors, was repeating an aphorism, she said, as a caution against students borrowing more than they need for higher education. Don't count on any program for loan forgiveness, she warned; rather, assume that you'll have to pay back every dime.*

That's sound, conservative economic advice, especially for an America stretched thin on credit card debt and short on long-term savings. But for anything, I could not work out how the aphorism embodied the message.

What does it mean to "live like a lawyer"?

Mayotte had just cautioned students that they should take the time, however boring the task sounds, to read the whole of their promissory notes. The notes well explain what borrowers are in for, she advised, and "no one told me that" will not later be an excuse to default on debt.

Also good advice. But doesn't living like a lawyer mean being supremely attentive to the fine print and acting conservatively in anticipation of adverse circumstances?

In her informative and insightful book, How to Be Sort of Happy in Law School, Professor Kathryne M. Young related research that successful lawyers are more often natural pessimists, marking a contrast with the successful optimists who have the lead in the other professions, clergy and medicine. That's because a lawyer's job is to prepare for the worst, while clergy and doctors are busy instead coaxing their clients toward a joyful salvation of one kind or another.

Did the aphorism mean to be an optimist when a student, so you don't have to be a student when you're a pessimist?  What does that even mean?

You, dear reader, are no doubt quicker on the draw than I, so you've probably worked it out. It dawned on me an hour or so later:

Don't live like a baller when you're poor, or you'll be poor when you're supposed to be ballin'.

The problem is that "lawyer" doesn't mean rich to me. 

I'm a lawyer. Not rich. My wife's a lawyer. Also not rich. I checked.

The vast majority of my former students work in public service jobs, if they're in JD-required positions at all. And even the few in private practice: not rich. Okay, I can think of one. But I think he was rich already.

Don't get me wrong. We're not struggling. Two JDs put our household income in the 90-something percentiles, according to the DQYDJ calculator, with me in the 90s as an individual and my wife, who has a master's degree, as well as her law degree, in the 70s. 

But income is only one measure of wealth, and, I daresay, not the most important. We both went into serious debt to get those JDs. Our home is mortgaged. We had not paid off our graduate education by the time our only child went to university. And we could not afford to get her through four years without her going into debt, too. 

Neither of us started off loaded. We still buy our clothes at Goodwill and Savers. Habits die hard. I just threw away my wife's socks with holes in them while she was out of the house. She won't do it. But I think she deserves better.

When I left law practice in 1996, I was making $50k, which is about $95k adjusted for inflation. I left that for my first job in academics, where I made $35k—$15k less than the IT guy. "Supply and demand," the dean said.

Now I make more. But after advancing in academics for 25 years, I still make less than the average lawyer in the mid-Atlantic, where I practiced, and just a little more than the nationwide average starting salary for a first-year associate.

The takeaway is that I don't associate being a lawyer with being rich. And it's alarming if people are going to law school with that expectation, or if that's how the public sees lawyers. "Kill all the lawyers" was the suggestion of a butcher.

I just finished some physical therapy for an injured shoulder. The bill for that, to my insurer, was $355 per hour. I saw a podiatry specialist recently. That was billed at $122 for what I think was scheduled as a 15-minute appointment, though it took less than 10.  We'll call it $488 per hour.  I like both those providers, but neither is a superstar gracing the cover of Physicians Weekly.

A very gross number, but the average U.S. lawyer's billable hour now runs about $300. The lawyer has more investment in education than the physical therapist, if a bit less than the doctor. The lawyer is a bargain. Clergy is a better bargain, but that's their thing.

Why isn't the saying, "Don't live like a doctor when you're a student, and you won't live like a student when you're a doctor"?

Well, of course, not everyone in healthcare is rich, either.  My wife had an ER visit and hospital stay, no procedures, last summer that was billed at about $13,000 for two days. At the same time, one of my nieces and one of my brothers work as nurses in hospitals; neither of them is making bank. Where's the money going?

I don't know what the right graduate school investment is to get rich. I didn't make it. Maybe whatever gets you to be a healthcare CEO. Be the owner of the hospital, not a provider in it.

Law and medicine can open the door to opportunity, to improve your lot if you're not living comfortably. I'm not knocking that. But no one should go into educational debt without a plan at least to do better than status quo. And plans should be based on realistic expectations.

The aphorism doesn't fit. Worse, it's dangerously misleading. We've got a problem in America with access to education and upward socioeconomic mobility. Simplifying the narrative to suggest that a professional degree will necessarily afford return on investment is not part of the solution.

* I've been reading about the challenges against the Biden student loan forgiveness order. You can follow the legal story at Reason. I'd love to see the plan go through; my daughter would benefit. I'm sorry to say, though, I think the challengers are right: the President exceeded his authority. The unfortunate political outcome, I predict, is that the Administration will be blamed for breaking a promise, and the Supreme Court will be blamed for enforcing the law, both thereby suffering unwarranted further damage to already embattled credibility. Meanwhile, Congress, which in fact held the key to untie the President's hands, but can't ween itself off addiction to money, and especially Democrats, who passed on a real opportunity to make a difference for access to education and socioeconomic opportunity, will escape accountability.

With regard to the title of this post, you can read more about the circumfix a-/-ing at Wiktionary. Read more about "the habitual be" at Slate.

I've been away from the blog for a while owing to an exhausting, if variably rewarding and challenging December and January. I'm back in the saddle now and look forward to catching up on some matters I'm eager to share. Thank you for your patience, and stay tuned!

Oops. We accidentally linked healthcare to your job.

mohamed_hassan (pixabay.com)

I stand with the rest of the world in awestruck horror of America's stubborn insistence that access to healthcare should be a function of both one's wealth and the largesse of one's employer.

Critics of the free market are quick to conclude that it has failed the American worker.  Economic libertarians are just as quick to tout the essentiality of free contract.  Before we make any decisions about the free labor market, maybe we should try it out.  A market in which a worker can't change jobs for fear of a recurring cancer or a bankrupting accident is not a free labor market.

For the NPR podcast Throughline, Lawrence Wu set out recently to explain how we arrived at the problem of employer-dependent healthcare.  The description of the episode, "The Everlasting Problem" (Oct. 1, 2020), reads:

Health insurance for millions of Americans is dependent on their jobs. But it's not like that everywhere. So, how did the U.S. end up with such a fragile system that leaves so many vulnerable or with no health insurance at all? On this episode, how a temporary solution created an everlasting problem.

For This American Life and Planet Money, Alex Blumberg and Adam Davidson also addressed this subject back in 2009.  Their bit ran only 11 minutes, but I have never forgotten the shocking fact that "four accidental steps led to enacting the very questionable system of employers paying for health care."

'Miss Juneteenth' speaks both to problems of our times and to timeless problems

Thanks to the Duke (University) Screen/Society, yesterday, I virtually attended a screening and discussion of the 2020 film from Vertical Entertainment, Miss Juneteenth.  It is an insightful and gratifying film, so I want to make this note of it.  In our covid era, it's easy to miss new releases.

Written and directed by Channing Godfrey Peoples, Miss Juneteenth is the story of Fort Worth, Texas, teen Kai (Alexis Chikaeze) and her mom, Turquoise Jones (Nicole Beharie), as Kai prepares to participate in the Miss Juneteenth beauty pageant, a pageant that her mother happens to have won, back in the day.

Yet that description unfairly oversimplifies the film, as would any description that confined the story by race or class.  The film richly portrays Turquoise and Kai's lives.  It explores mother-daughter conflict, romantic entanglements, and socioeconomic struggles. Simultaneously, the film comments softly, not heavy-handedly, on pageant culture, civil rights, the American dream, and, of course, never trumpeted yet omnipresent, the glorious but unfulfilled promise of freedom marked by Juneteenth.

In a striking scene set in a Juneteenth museum, the young contestants are being oriented on Juneteenth history by a passionate docent when the schoolmarmish pageant wrangler directs the kids' attention to framed pictures of past Juneteenth queens.  The docent was speaking to the legacy of slavery, driven out of the American South, while the pageant director educates the girls on such etiquette nuances as table manners imported with the Pilgrims.  The girls' gazes drift to the latter display, which, I contend, speaks subtly but powerfully to how African-American communities have long wrestled with the fine line between cultural subjugation and assimilation that courses through American history from Reconstruction to Civil Rights to present day.  I'm reminded at once of Mike Pence's oddly third-person reference from Fort McHenry in August to "American people ... standing with ... our African-American neighbors" and Dulce Sloan's missive this week on The Daily Show with Trevor Noah, "The Messed Up History of Black Hair in America."

A character in the film once comments, "Ain’t no American dream for black folks.”  As we wondered at the latest news of government ineptitude yesterday morning, contemplating how our salaries are going down while our workloads are going up, my wife speculated that the anger and resentment that people both black and white feel toward the lack of opportunity for upward mobility in this country is really much the same.  The difference, she suggested, is that black people have always known that meritocracy is an American myth, while white people are just figuring it out.  (She cited Michael Sandel on WBUR talking about his Tyranny of Merit.)

Miss Juneteenth has given me a lot to chew over.  I haven't even mentioned my own daughter's foray into the pageant world when she was a teen: Miss Rhode Island High School 2016!  In Miss Juneteenth, as Turquoise is working herself to death to scrape together the money to support Kai's pageant bid, Kai's father, Ronnie (Kendrick Sampson), shakes his head: "An $800 dress just don’t make no sense to me."

Word for word, I swear, Peoples stole that line from me.

Here is the trailer from Vertical Entertainment.

Happy Constitution Day.

Poor development choices may bolster quality-of-life disparity on Tanzania's Msasani Peninsula

 Coco Beach, Msasani Peninsula, Dar es Salaam, Tanzania. All photos RJ Peltz-Steele CC BY-SA 4.0.

The short length of Coco Beach is the touristic gem of Tanzania's largest city, Dar es Salaam, which, for all its rugged charms, is not rich with touristic gems. Coco Beach sits on the eastern, Indian Ocean, coast of the ritzy Msasani Peninsula, just a few kilometers northwest of the CBD.

Msasani says a lot about wealth stratification in Africa. The worsening wealth gap is an issue that vexes me in the United States. But we've got nothing on many an African country. Where subsistence living is the norm, and social safety nets are nearly non-existent, the disparity between haves and have-nots gets closer at each end to all and nothing. And as on Msasani, the extremes are often abruptly juxtaposed. The peninsula is home to subsistence fishermen, and the polluted beaches of the slipway, in the west, and the luxury condominiums of posh Oyster Bay, in the east.

Luxury condo building on the road from Oyster Bay to Sea Cliff Village

I walked the peninsula from west to east and saw, in the span of just a few kilometers, ramshackle wood dwellings on potholed dirt trails without plumbing, in the west and center, and gated condo complexes with marble-esque, statued facades, in the east. While the former teemed with human life, the latter were eerily vacant, deserted of all but the occasional maintenance worker. I assume the condos are mostly second-home getaways and vacation rentals for the well-to-do in high season and on weekends. (I was reminded of the dark-windowed high rises that loom over Central Park West, New York.)

Qatar's is the most modest of the beachfront embassies.

At that, the most striking residences of the eastern Msasani are not luxury homes, but foreign embassies, including those of Qatar, Brazil, Canada, Ireland, the UAE, and Saudi Arabia. (The U.S. embassy and others are in Oyster Bay, but in the interior.) They line the main coastal road that runs between Oyster Bay and Coco Beach, which runs on northward to swank Sea Cliff Village and the Yacht Club.

Present service structures on Coco Beach, astride road construction.

At present, it isn't easy to cross this road, because a massive construction project runs all along the length of Coco Beach. I had hoped that this construction would improve the beach for touristic use that might fuel economic development to benefit the peninsula's have-nots. What passes for services on the beachfront now are wood shacks of dubious hygiene, selling drinks and snacks that might prove hazardous to foreign GI tracts. One municipal toilet building has seen better days and is now inaccessible anyway because of the construction. Alas, no, a local on the beach informed me: The purpose of the construction is to convert the shoulderless, two-lane, asphalt coast road into a four-lane highway, because, he said, the embassies want better and more secure access.

Nearly completed end of beachfront highway entering the CBD.

Many an American city can today tell tales of costly woe for having built transportation and utility infrastructure along prime waterfront property. It's bad enough that embassies, with their high, secure walls, occupy this land on the peninsula to begin with. Their inefficient use of prime real estate, distant from the administrative offices of the CBD, and in the company of Tanzania's "one percent" and cloistered ex-pats, sounds an awakward echo of colonial elitism.  To boot, now, the embassies and luxury homes will soon be served by a four-lane road that will further limit public access from the peninsula to the already underdeveloped beachfront.

Tanzania in 1974 moved its capital de jure to central Dodoma, in an effort to broaden economic opportunity in the country beyond Dar es Salaam. Nevertheless, concentration of development in Dar is still a problem that plagues the country. A businessman in the northeastern town of Arusha told me there's mounting resentment there about rural taxes paying for big-city infrastructure. (Boston says hello, western Massachusetts.) Maybe foreign nations can help Tanzania take a step forward by transferring their embassies from walled beachfront luxury to central locations with better access to government, whether Dar or Dodoma, on condition that appropriate public development of the Msasani Peninsula be left in their wake.  After all, foreign diplomatic posting is supposed to be a hardship, and it's compensated accordingly.

The new highway runs in front of the historic Ocean Road Hospital, where a street sign bears a familiar name.

SCOTUS, climate change, drug addiction, immigration highlight law and policy issues at UMass colloquium

Today at the Fifth UMass Interdisciplinary Legal Studies Colloquium in Boston, scholars talked about a range of intriguing work, from politics to climate change to drug legalization, being done across the University of Massachusetts campuses—Amherst, Boston, Dartmouth, and Lowell, and Law (at Dartmouth) and Medical (at Worcester).  Here’s a taste.

View of Boston from One Beacon Street today.  "Back Bay is called 'Back Bay' for a reason," UMass Dartmouth Professor  
Chad McGuire said, referring to reclaimed land that is threatened by rising sea levels.

Law and Policy Inside the Beltway
Panel 1—Moderated by yours truly

Queer Sacrifice in Masterpiece Cakeshop, Jeremiah Ho, UMass Law.  Professor Ho explicated his theory of “interest convergence,” and how a lack thereof explains the result in the U.S. Supreme Court’s recent decision in the LGBTQ-rights cakeshop case.  His research shows how images—sometimes literally—of gay identity have informed public and judicial perception of LGBTQ rights cases.  Three more cases lie on the horizon, in the Court’s next term, Ho said, so stay tuned.   Meanwhile preview his "Queer Sacrifice" work, just out in the Yale Journal of Law and Feminism, at SSRN.

Can Presidents Influence Public Attitudes Toward the Supreme Court? Evidence from a Survey Experiment, Paul M. Collins, Jr. (blog), Department of Political Science, UMass Amherst.  Collins’s long-term research digs deep into how statements and action by the President of the United States exert influence over public perception of the U.S. Supreme Court and its decisions.  What the President says matters; consider, Collins proffers, the White House has a whole office dedicated to SCOTUS spin.  Collins also notes that low public knowledge of the Court is a factor in allowing public opinion to be influenced by forces external to the Court.  I can’t help but think about the Court’s intransigence on cameras and public access.  Anyway, Collins has discovered that the public is more easily influenced on “low salience” issues, but less so on “high salience” (I’d say “hot button”) issues, such as immigration.

On the Supreme Court of the United States of America (and Congruent Agencies and Ministries in the Term of President Donald Trump), Judge Francis Larkin, UMass Law.  Judge Larkin shared observations of recent events in President-Court interaction.  He recalled FDR’s Court-packing plan, relative to its recent resurgence in politics (e.g., WaPo).

Forcing Disclosure, Justine Dunlap, UMass Law.  Professor Dunlap is looking at mandatory disclosures under Title IX, especially faculty duties.  She observes that the evolution of Title IX over recent decades, under administrations from both sides of the aisle, have fairly sought to respond to a real problem of unredressed sexual harassment and assault on college campuses.  But the responses have not always been well tuned.  And mandatory reporting, however well intentioned, can put faculty in the impossible bind of having to betray student trust.  (Professor Julie Baker in Q&A aptly noted also that the consequences of ill-tuned reporting schemes for accused perpetrators are not always conducive to dispute resolution or justice.)  Dunlap talked about a system being implemented at the University of Oregon that contemplates a third class of potential “reporter”—rather than all or nothing, a “student-directed reporter.”

Recovery, Resiliency, and Equality in Economic Development
Panel 2—Moderated by Professor Justine Dunlap, UMass Law

Opening for Business: Tax-Haven Economy and the State of Exception in Puerto Rico, Jose Atiles, Department of Political Science, UMass Amherst.  Professor Atiles is working on Puerto Rico and U.S. development strategies.  He explained that there are two prevalent approaches to development policy concerning the island, one the “blank canvas” approach, which encourages recovery investment on the selling point that, more or less, my words: there’s nothing there at present; two the “PR is open for business” approach, which seeks to exploit the island’s legal status as a tax haven.  Both of these representations are animated by a “neoliberal-colonial rationality,” and that troubling mindset is reflected in the law that facilitates these strategies.

I’m reminded of the colonial terra nullius doctrine with respect to the blank canvas, and the local-policy-characteristic Everett casino debate with respect to “open for business.”  Puerto Rico and its people are not our offshore plaything.  In Q&A, I asked Atiles what it would take for us to start thinking about PR more like we do Missouri.  Statehood and independence each have advantages and drawbacks, which he explained summarily; what won’t save PR, he said, is the status quo.

A “Least Regrets” Framework for Coastal Climate Change Resiliency Through Economic Development, Chad McGuire and Michael Goodman, College of Arts and Sciences, UMass Dartmouth.  Professor McGuire continues his renowned work on environmental conservation and climate change, and now he’s brought public policy numbers wizard Professor Goodman (also president of the UMass Dartmouth Faculty Senate) onto the team to look at the economics.  They’re attacking the problem of aligning shorter-term economic incentives with the longer-term public interest in saving the human race from extinction.

I just saw Dan Gardner on The Daily Show talking to Roy Wood Jr. (video embedded below) (let me remind everyone that I shook Roy’s hand in East Providence) talking about how our “caveman” brains don’t well process the threat of climate change because it’s too abstract, that we need more urgent messaging.  McGuire and Goodman have it.  As I’m wearing a sweater in May, McGuire observed: “Spring has become less of a thing, and winter moving into summer is becoming more of a thing.”  We’ve lost 15-30 days of winter in New England, he shows with data, and seasonal transitions are becoming more abrupt.  Then he directs us toward the view of Boston from our huge glass windows here in the 32nd floor of One Beacon Street.  “Back Bay is called ‘Back Bay’ for a reason,” McGuire said.  Boston sits on filled-in bay.

At lunch, McGuire told me about rubber buffers that run through Boston streets to absorb shifts in the aqueous earth beneath.  And he told me about the latest alarming findings from the Ross Ice Shelf.  Our society has invested a great deal in developing low-lying land, and we’re going to have reconcile that policy with our climate game.

Human Rights Responses to Economic and Social Inequalities—A Book Proposal, Gillian MacNaughton, School for Global Inclusion and Social Development, UMass Boston.  For my money—both figuratively and literally—Professor MacNaughton’s work is what we need to save humanity from catastrophe—after and assuming we figure out how to survive climate change.  MacNaughton takes what we know and bemoan about inequality of wealth and opportunity in the United States and runs writ large with the problem.  As she wrote in her abstract: “The Global Wealth Report 2017 reveals that the wealthiest 1% of the global population owns 50% of global assets, while the poorest 50% owns less than 1%.”  Building on the U.N. Sustainable Development Goals, she plans to propose putting some punch behind international treaty guarantees of social and economic equality, such as we might start to address this problem on the global level.  I’ve often lamented that our increasingly disparate economic stratification will be our undoing in the United States if we don’t address it.  It’s worth being reminded how much more desperate the situation already is worldwide.  See also Professor MacNaughton's recent co-edited book, Economic and Social Rights in a Neoliberal World (Cambridge University Press 2019).

Drug Use and Abuse, and the Criminal Justice System
Panel 3—Moderated by Professor Julie Baker, UMass Law

Is Marijuana the Gateway Drug? Maybe Not, But Its Legalization Could Be, Nikolay Anguelov, College of Arts and Science, UMass Dartmouth.  Professor Anguelov is known to many of my readers and former students as the author of the 2015 book, The Dirty Side of the Garment Industry: Fast Fashion and Its Negative Impact on Environment and Society (CRC Press) (Amazon).  I have heard him speak many times to awestruck and sometimes squirming audiences about the connection between their affordable clothing and Bangladesh waterways poisoned with dye and arsenic.  Anguelov is more recently author of From Criminalizing to Decriminalizing Marijuana: The Politics of Social Control (Lexington Books 2018) (Amazon).  Anguelov is now fine-tuning his formidable research into marijuana use.  His early data invite the conclusion that legalization—which I as a libertarian have favored—might be contributing to the opioid epidemic at least by “contributing to the cultural normalization of drug use and experimentation.”  Ruh-roh, Shaggy.  This is going to require further research, and I’m anticipatorily squirming in my H&Ms.

Recovery Coaches in Opioid Use Disorder Care, Matthew Maughan, UMass Medical.  When opioid addiction turns to recovery, attorney Matthew Maughan is the policy guru to turn to.  Informed by his multifaceted experience and research, he explained the role and peculiar success of the “recovery coach.”  It might be awkwardly unorthodox in terms of developing a large-scale model, but sometimes a block grant for an activity tailored to a person’s specific needs offers the best hope for recovery and might as well be cost effective.  Maughan recounted the story of a recovery accomplished through mental clarity achieved on the water on a kayak, under the guidance of a recovery coach.  That’s got to cost less than any bill I’ve ever gotten from a medical clinic.

Locating Cannabis Equity: Defining Areas Impacted by Drug Criminalization, Michael Johnson, Professor and Chair, McCormack Graduate School, UMass Boston, and Jeffrey Moyer, doctoral candidate in public policy, UMass Boston.  Moyer is working with Professor Johnson to study the intersection of enforcement and anti-discrimination.  Specifically, he asks whether the Massachusetts “Cannabis Control Commission’s use of a race-neutral variable is effective in selecting areas disproportionately impacted by criminalization.”  Part of the work has entailed mapping all drug arrests, which generates some compelling graphics when overlaid with demographic data.  I am reminded of being a journalism intern at WJZ-TV in Baltimore in the early 1990s, when we made an analog map—this was when we were still working on DOS-based computers—literally putting color pushpins in a map of Baltimore to look at the coincidence of murders with factual and demographic elements.  That was a time when we were first talking about the problem of race and policing “where the crime is.”  We also walked five miles to school, uphill both ways.

Moyer shows analysis of geographic data on police enforcement, obtained in part through a public record request.

To Plea or Not to Plea: A Virtual Simulation of Plea-Bargain Scenarios, Miko M. Wilford, Psychology Department, UMass Lowell; Annabelle Frazier, doctoral candidate in applied psychology, UMass Lowell; Kelly Sutherland, doctoral candidate in applied psychology and prevention science, UMass Lowell.  With doctoral candidates on a new applied psychology track at UMass Lowell, Professor Wilford is taking a behavioral look at plea bargaining, that irksome feature of the criminal justice system that we don’t like to talk about, even while we know it results in some guilty pleas calculated to avert draconian outcomes (my take).  Really they’re looking at the research of plea bargain research, trying to refine how we learn about people's decision-making processes in these high-stakes circumstances.  Perhaps no surprise once you think about it, it is difficult to simulate having so much at stake with volunteers in psychology-lab experiments.  The team is working on new, high-tech models using animations to engender empathy and generate better results.  See more at the project website, Pleajustice.org.

Personal Rights at the Borders

Panel 4—Moderator: Misty Peltz-Steele, UMass Law

Controlling Asylum: A Genealogical Analysis of Gender and Race Intersectionality, Phil Kretsedemas, College of Liberal Arts, UMass Boston.  Professor Kretsedemas is studying the status of domestic violence survivors and Latin American asylum seekers relative to Matter of A-B, an AG-Sessions opinion “that dramatically curtails asylum protections for survivors of domestic violence, and for many other people who have been persecuted by non-state actors.”  A U.S. District Court has lately pushed back on Sessions’s conclusions, Kretsedemas said, as he investigates the problem from critical dimensions of gender and racial equality.  Kretsedemas’s approach is further informed by comparative law, as he draws on parallel legal perspectives from foreign tribunals, including the U.K. House of Lords, and from parallel cultural perspectives, such as Guatemalan views on gender roles within families.  Present policies, focusing for example unduly on familial cohesion, have gravely injurious impact, for example failing to protect women from female genital mutilation.  Kretsedemas locates these policies in a context that includes family separation, though the latter issue has garnered greater public attention.

Troubling Bodies: The Office of Refugee Resettlement and the Unaccompanied Pregnant Teen, Shoshanna Ehrlich, College of Liberal Arts, UMass Boston.  Also examining a perhaps under-recognized issue within our vast immigration policy debate, Professor Ehrlich is studying the federal government’s “literal refusal to release [young women] from . . . custody so they may access abortion care,” plainly violating their civil rights, Ehrlich asserts.  Even the U.S. Government waived argument in the courts as to whether the teens involved here enjoy U.S. constitutional rights.  Yet in government memos discovered in ACLU litigation, Ehrlich shared in her presentation, Scott Lloyd, director of the Office of Refugee Resettlement (ORR), opined that abortions desired even by teens impregnated by rape are not in the young women’s best interests.  Lloyd was removed from his post and “transferred to HHS’s Center for Faith and Opportunity Initiatives,” Rolling Stone reported in November 2018.  He was later summoned to testify in Congress about family separations, Politico reported in February 2019.  Ehrlich told of interviewing parents the government separated from their children, and the trauma that resulted, wondering how the government could at the same time justify refusing abortions on the rationale that mothers should not be separated from their unborn children, despite their personal circumstances and decisions.