Global pandemic agreement undermined by corporate interests

Bill Shaw

The efforts of the World Health Organization to develop a global approach to preparing for and preventing future pandemics have suffered a setback at the hands of wealthy nations. What began as a weak and insufficient pandemic agreement was subsequently watered down even further in recent negotiations. But this was still not enough to appease global corporations and the nations that do their bidding.

In a desperate move to reach some agreement versus none, the World Health Organization announced on March 28 that its member states agreed to resume negotiations on the pandemic agreement on April 29. A new version of the agreement text—to be further negotiated at that time—is expected by April 18.

Despite launching the process to create the agreement in December 2021, with a target date for adoption at the World Health Assembly in May 2024, negotiations have stalled. As reported by the World Socialist Web Site, efforts intensified two months ago to pressure nations to reach agreement on key points.  The just-approved resumption of negotiations represents the failure of those efforts, as the extension was not previously planned. 

The negotiations are being overseen by the Intergovernmental Negotiating Body (INB). The ninth meeting of the INB (INB9) began on March 18 and ended March 28 without reaching resolution of the remaining issues. Therefore the INB approved a resumption of its ninth meeting, to begin on April 29  and end on May 10. 

Since the World Health Assembly is scheduled to commence on May 27, concluding negotiations successfully by May 10 would essentially be finishing in the final seconds after two-and-a-half years of talks. 

The concern over the inability to reach agreement on schedule was articulated by INB co-chair Roland Driece, who said: 

“Governments said clearly we cannot fail to reach an agreement at the next World Health Assembly to make the world healthier, fairer and safer from pandemics. We are at the finishing line and we are committed to maximizing the remaining negotiations to reach the result the entire world needs.”

The WHO released a “Revised draft of the negotiating text of the WHO Pandemic Agreement” dated March 13, 2024. The prior version was entitled “Proposal for negotiating text of the WHO Pandemic Agreement” and dated October 30, 2023. 

World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus (center) declaring the coronavirus pandemic a Public Health emergency of International Concern in March 2020. [Photo: Fabrice Coffrini]

The changes made from the “Proposal” to the “Revised draft”—which reflect the outcomes of negotiations thus far—are not marked explicitly. A detailed, side-by-side comparison, however, reveals significant changes too numerous to review comprehensively here. 

A summary of some key changes to the binding clauses of the agreement, based on known points of contention among the negotiators, follows.

First, instead of “committing” to improvements in disease surveillance both within and across nations, now parties only “should” do so. 

Second, a clause was struck entirely that required the parties to recognize the impact of “environmental, climatic, social, anthropogenic and economic factors” on the risk of pandemics and commit to taking them into consideration in pandemic preparedness. This is despite the well-known relationship between climate change and a significantly increased risk of pandemics.

Third, a clause committing to follow ethical practices on the international recruitment of healthcare personnel, to avoid draining crucial human resources from resource-poor nations to wealthy nations in the event of a pandemic, was removed. As documented in Nature, such poaching of healthcare workers exacerbated pre-existing workforce shortages in poor nations and consequently further hindered their pandemic response.

Fourth, multiple clauses on international collaboration in the prioritization, direction, and conduct of scientific research for pandemic preparedness were struck. Included in these clauses was one that envisioned a prominent role for the WHO in setting research goals and priorities.

Fifth, a clause was edited that required parties to develop national policies to mandate “provisions in government-funded research and development agreements for the development of pandemic-related products that promote timely and equitable global access to such products during public health emergencies of international concern and pandemics” and to “publish relevant terms of government-funded research and development agreements promoting equitable and timely access to such products during a pandemic emergency.”

Instead, parties now must only publish whatever terms exist in these agreements and in the intellectual-property licensing agreements arising out of the research. Gone is the requirement to include specific clauses in the agreements that promote “timely and equitable global access” to products. These changes are clearly driven by corporations for whom maximizing profit from workers’ intellectual property outweighs protecting the public’s health.

Sixth, instead of being required to “facilitate the transfer of relevant technology, know-how, and licences pooled in relevant mechanisms,” now parties only must “encourage” the global corporations who receive significant public financing to grant royalty-free licenses to other manufacturers in developing countries. And even then, such grants are subject to “any existing licensing restrictions.”

Such “encouragement” has a proven track record of failure. To date during the ongoing COVID-19 pandemic, it resulted in only one highly-restricted waiver approved by the World Trade Organization. The requirements of that waiver posed an insurmountable barrier and thus it proved ineffective. As noted by a report recently issued by the US International Trade Commission, no country made use of it by September 2023. Now, opponents of even that ineffectual waiver cite its designed-for failure as a reason not to extend it, or implement new waivers, in ongoing debates.

Even before INB9 negotiations ended in March, an editorial in The Lancet published March 2 pilloried the agreement, calling it “shameful and unjust.” It said:

The INB might be doing its best, but ultimately it is the politicians of G7 countries who must put aside vested industry interests and finally understand that in a pandemic it is not possible to protect only your own citizens: the health of one depends on the health of all.

A subsequent piece under “Published Correspondence” in The Lancet on March 31, referring to the March 13 “Revised draft”, noted:

“A new phrase has also crept into this draft, subject to national laws, appearing six times. With this provision, parties can opt out of key reporting obligations if they consider the required information to be confidential or private.”

Nevertheless, even this wholesale watering down of the already toothless pandemic agreement is not enough for US-led imperialism. The negotiations starting April 29 will continue to focus on weakening the provisions on intellectual property, the sharing of information and resources, and the requirements for government spending on strengthening healthcare systems and disease surveillance.

The result, as individuals close to the negotiating parties note, will most likely be a bare-bones agreement of “essentials,” with further hashing out of the contentious provisions likely to occur under the first one to two years of meetings of the Conference of Parties created by the agreement. 

The WHO Director-General Dr. Tedros Adhanom Ghebreyesus made emotional appeals to the parties, saying:

“Let the spirit of Geneva—the spirit of cooperation, mutual respect, and shared responsibility—guide your deliberations as you work towards finalizing the agreement by the set deadline in May this year.” 

However, the ruling class has already demonstrated its imperviousness to such appeals by demanding and receiving concessions on behalf of pharmaceutical corporations. Further gutting of the agreement is certain to ensue in the continuation of negotiations later this month and into May.

Future pandemics can be prevented, prepared for, and responded to only on a global, cooperative basis. Pathogens do not respect national borders, and the fractured response to the COVID-19 pandemic under capitalism is responsible for millions of deaths and the failure to end it.

The pandemic agreement is an attempt to increase global coordination towards the levels necessary to prevent, prepare for, and respond to future pandemics. However, capitalism is successfully subordinating the agreement—and by extension the survival of humanity in a future pandemic—to its profit interests, thereby rendering an already insufficient agreement wholly ineffective. 

If an agreement in principle is reached at the resumption of INB9 and subsequently adopted by the World Health Assembly in May, it will be a ghost of its former self and impotent in the face of the growing threat of pandemics induced by imperialist destruction of habitats and acceleration of global climate change.

Boeing whistleblower Sam Salehpour testifies before Congress on safety of the 777 and 787 aircraft

Bryan Dyne

From Left, Boeing Quality Engineer Sam Salehpour; Ed Pierson, Executive Director of The Foundation for Aviation Safety and a Former Boeing Engineer; Joe Jacobsen, Aerospace Engineer and Technical Advisor to the Foundation for Aviation Safety and a former FAA Engineer; and Shawn Pruchnicki, Ph.D, Professional Practice Assistant Professor for Integrated Systems Engineering at The Ohio State University, are sworn in before they testify at a Senate Homeland Security and Governmental Affairs - Subcommittee on Investigations hearing to examine Boeing's broken safety culture on Wednesday, April 17, 2024, in Washington. [AP Photo/Kevin Wolf]

The Senate Homeland Security and Governmental Affairs Subcommittee held a hearing on Wednesday with Boeing quality engineer and whistleblower Sam Salehpour. The topic was ongoing and serious safety and quality issues surrounding the Boeing 777 “Triple Seven” and 787 Dreamliner aircraft.

Salehpour highlighted production issues in connection with 98.7 percent of 787 Dreamliners, where Boeing did not fill tiny gaps, “shims,” between different parts of the fuselage. Repeated pressurization of the aircraft, which occurs on every commercial flight and allows humans to survive inside the plane at altitudes where the air is too thin to breathe, creates weak points that risk the body of the plane simply falling apart mid-flight, killing everyone on board.

Salehpour, who has been an engineer for 40 years, pointed out that while “Boeing’s PR team likes to call [shims] the width of a human hair,” even gaps that small “when you are operating at 35,000 feet … can be a matter of life and death.”

He continued, “In a rush to address bottlenecks in production, Boeing hid problems, pushing pieces together with excessive force to make it appear that the gaps don’t exist.”

This may, he continued, “result in premature fatigue failure. Effectively they are putting out defective airplanes.”

After he raised these concerns internally, Boeing management moved Salehpour to the 777 program. There, he also witnessed numerous safety violations and improper methods of fitting parts together, including “literally jumping on pieces of the airplane to get them to align.”

The subcommittee also heard from several other expert witnesses on the lack of internal quality standards and profit-driven culture within Boeing. The witnesses included Joe Jacobson, a technical adviser to the Foundation for Aviation Safety and former FAA engineer; Ed Pierson, executive director of the Foundation for Aviation Safety and a former Boeing manager; and Shawn Pruchnicki, a professor at Ohio State University and integrated systems engineer.

Jacobson, in particular, is noted for highlighting over many years Boeing’s practice of “trying to maximize profits” at the expense of safety. In his opening statement, he said that in his prior position at the FAA he should have been informed by Boeing about the deadly MCAS system, which was the immediate cause of Boeing 737 Max 8 jetliner crashes in October 2018 and March 2019, which killed a combined total of 346 passengers and crew.

Pierson, another Boeing whistleblower, became well-known in 2019 after he testified that he warned senior company management in the summer of 2018 that “deteriorating factory conditions” at the Renton, Washington Boeing 737 production facility would ultimately create a catastrophic failure, the first of which happened only months later.

To this day, no Boeing executive has been tried for murder or held accountable in any way for these preventable deaths.

The comments from Salehpour and all those who testified highlight both the ongoing dangers of flying on board Boeing aircraft and the fact that, despite all the claims by Boeing to the contrary, there has never been any shift from the aerospace giant’s drive for corporate profits at the expense of human lives.

It is also clear that a critical part of Boeing’s internal culture is direct retaliation against internal complaints. Salehpour testified that “I was told to ‘shut up,’ I was sidelined, I received physical threats.” He continued, “My boss said, ‘I would have killed someone who said what you said in a meeting.’”

Salehpour also presented photos of his car tire, which he said his mechanic told him had a nail jammed into it. While he told the subcommittee he had “no proof” of Boeing’s involvement, he testified the he believed it happened at work.

He was, however, uncowed. He told the committee, “We are the eyes and ears of the public. That’s how I see our job.”

He continued, “After the threats and after all this, it really scares me, but I am at peace. If something happens to me, I am at peace because I feel like by coming forward, I will be saving a lot of lives.”

Salehpour’s testimony raises further questions about the suspicious death of Boeing whistleblower John Barnett. Barnett was slated to give a third day of testimony in a civil suit against Boeing when he was found dead in a hotel parking lot in Charleston, South Carolina on March 9. The suit was brought by Barnett and accused Boeing of forcing him out of the company in 2017 after he raised multiple serious concerns about the safety of the 787 Dreamliner.

While the county coroner declared that the death was a “self-inflicted gunshot wound,” news coverage afterwards revealed that Barnett told a family friend, “If anything happens to me, it’s not suicide.”

More recently, Barnett’s mother Vicky Stokes told CBS News, “I think if this hadn’t gone on so long, I’d still have my son. My sons would still have their brother, and we wouldn’t be sitting here.” She went on to say that she held Boeing responsible for her son’s death.

That none of the senators raised the death of Barnett and the highly suspicious circumstances surrounding it is in line with the near-total blackout by the media of the supposed “suicide” of the whistleblower.

The corporate giant Boeing sits at the heart of American imperialism, both as a major exporter and a supplier of US war materiel, including equipment used by Israel in its genocide against Gaza. There is every reason to believe that the mafia-like actions described by Salehpour are standard practice by Boeing—enabled by the two big business parties, Congress, federal regulators, the corporate media and the courts—to protect its interests and those of US capitalism as a whole.

New Zealand unions collaborate with thousands of job cuts

John Braddock

With New Zealand officially in recession, a swathe of mass sackings is currently sending shockwaves through the entire working class.

So far, more than 3,000 public service jobs have been axed in recent weeks as the National Party-led coalition government—which includes the far-right ACT Party and NZ First—carries out a scorched earth policy, targeting budget cuts of 6.5 or 7.5 percent across most ministries.

New Zealand parliament buildings [Photo by Midnighttonight via Wikimedia Commons / CC BY-SA 3.0]

On April 17, the Ministry of Education (MoE) announced that 565 positions will be scrapped, including nearly 100 regional and frontline roles directly supporting schools. This includes a reduction of 38 roles supporting students with disabilities and learning support needs. It is the biggest single cut to a public service agency so far.

The same day, Oranga Tamariki, the Ministry for Children, confirmed 447 jobs will be cut, 9 percent of its workforce. The agency provides social welfare interventions for some of the country’s most deprived and vulnerable young people.

One Oranga Tamariki staff member described the cuts as “gut-wrenching.” She told Radio NZ: “It’s just purely numbers, which is such a terrible way to look at it because I work alongside some of the most dedicated, hard-working, passionate people I’ve ever met. And seeing the impact that will have on some of them is horrific.”

Other cuts include 445 jobs at the Department of Internal Affairs, 384 at the Ministry of Primary Industries, 50 at Treasury, 134 at the Ministry of Health, 90 at the National Institute of Water and Atmospheric Research (NIWA), 130 at the Department of Conservation, and 286 at the Ministry of Business Innovation and Employment. Dozens of smaller job cuts have been announced in other departments.

The ferocious attack is a deliberate class-war policy. Following the October 2023 election, which saw the incumbent Labour-led government’s vote collapse amid widespread anger over increasing poverty, homelessness and soaring living costs, the National Party-led government was installed to carry forward the next stage of austerity measures.

The government’s attacks include: A real cut to the minimum wage (which has gone up just 2 percent while inflation is twice that); moves to slash welfare benefits; changes making it easier to evict tenants; and plans to reintroduce for-profit charter schools and for private companies to play a bigger role in the healthcare system.

The sweeping austerity program underpins a massive transfer of wealth to the rich with $NZ9 billion in income tax cuts favouring top income earners. The cutbacks will also help to fund an expansion of the police, the prison system, and a major increase in military spending as New Zealand is integrated into US imperialist plans for war against Russia, China and Iran.

There is widespread opposition to the government’s agenda. The coalition was scrabbled together in secret negotiations after National received just 38 percent of the vote, while ACT and NZ First took a paltry 8.6 and 6.1 percent respectively. Any support they had is now plummeting. A recent Curia poll saw a slump for all of them with ACT faring the worst, dropping to 7.2 percent.

Many respondents to a recent Talbot Mills poll variously described Prime Minister Christopher Luxon as “greedy,” “arrogant” and “entitled.”

Another poll of 1,001 people conducted by Ipsos has found that 58 percent believe “society is broken,” and 65 percent agree with the statement: “The economy is rigged to advantage the rich and powerful.”

The assault on jobs is not confined to the public sector. International media conglomerate Warner Bros. Discovery confirmed on April 10 it will shut down Newshub, one of the country’s two major media networks. Nearly 300 journalists, technical personnel and presenters will lose their jobs.

State broadcaster TVNZ has also confirmed that several of its shows and news bulletins will shut down, with the loss of 68 jobs. Meanwhile, NZ Post is proceeding with a plan announced last year to cut 750 jobs and replace mail delivery staff with independent contractors.

The construction sector is in a sharp downturn. Recently, Tony Boyce Builders in Timaru, which once employed 51 people, announced it will shut down, and the boat-building company Subicraft is laying off nearly 60 people. The recent collapse of Buildhub left hundreds of migrant workers destitute.

In the face of all this, the corporatist trade unions have made clear that nothing will be done to defend a single job. Far from mobilising an industrial and political campaign across the working class, they have signaled that they will enforce the cuts, including by corralling workers behind whatever paltry exit provisions may be on offer as they are ushered out the doors.

While the government predicts that as many as 7,500 public sector jobs could go, the Public Service Association (PSA), the county’s largest union with over 90,000 members, has restricted itself to releasing a few toothless media statements bemoaning the “reckless nature” of the cost cutting.

Responding to the MoE announcement, the union’s Assistant Secretary Fleur Fitzsimons simply bemoaned that the government had promised job cuts would not impact frontline services. She described the cuts as “woefully short-sighted,” asking plaintively: “At a time when student achievement is falling, when school attendance is a challenge, where is the plan for education? It doesn’t add up.”

In fact, prior to the 2023 election the union openly supported Labour’s own plan to slash public service budgets by up to 4 percent as “a prudent move to tighten the belt”—as PSA leader Duane Leo put it in a Radio NZ interview last August. Fitzsimons was a Labour candidate in that election.

A particularly rotten feature of the PSA’s postings is the underhanded use of identity politics to pit one section of sacked workers against the other. One post highlights, for instance, that women are “bearing the brunt” of cuts at the Tertiary Education Commission while the PSA’s Māori arm declared that “cultural expertise” will be lost. In fact, the cuts impact on workers regardless of gender, ethnicity, national origin, skills or education.

The E tū union, with nearly 50,000 members across a range of private and public sector industries, has kept media workers isolated while assisting management at Newshub and TVNZ to throw them on the scrap heap.

E tū negotiator Michael Wood, a cabinet minister in the former Labour government, appealed to TVNZ “to work with staff,” i.e., consult with the union bureaucracy, rather than “dictate and predetermine the outcome.” He told Radio NZ that the union accepted that TVNZ was in financial difficulty, which had to be addressed, but merely disagreed with axing programs that were still profitable.

The privileged bureaucrats that run these organisations have known since well before the October election that the assault was looming. If the PSA and E tū were real workers’ organisations, they could have mobilised their tens of thousands of members to freeze government operations. A nationwide strike, bringing in broad sections of the working class, would gain immense sympathy and raise the perspective of bringing down the far-right government.

Such a course of action is anathema to the unions, whose very existence is bound up with protecting and defending the status quo. The bureaucracy insists that any broad industrial action is impossible because it is against the law. But the severe anti-worker provisions in the Employment Relations Act, which restrict strikes to periods of contract renewals, were put in place by the Labour government in 2000, with the full support of the Council of Trade Unions.

UK Tories hound tens of thousands of unpaid carers for benefit repayments

Thomas Scripps

Revelations that the UK’s Department for Work and Pensions (DWP) is pursuing tens of thousands of unpaid carers for thousands of pounds in benefits repayments shines a light on British capitalism’s dirty secret of informal care work.

Unpaid carers who provide at least 35 hours of care a week, usually to disabled, ill or elderly relatives, are eligible for government payments of £81.90 a week as long as they do not earn more than £151 in those seven days from paid employment.

This second condition is the cause of the scandal. If a carer earns just £1 more than the limit, they forfeit the entire £81.90 carer’s allowance that week. Just 26 weeks earning £1 over the limit would therefore mean owing the government £2,182 in benefit repayments. The DWP system frequently fails to warn carers that they are incurring these debts.

Honest mistakes and miscalculations have left some of the poorest people in the country owing huge sums of money. In 2022/3, according to the Guardian, “26,700 carers were asked to repay sums relating to earnings breaches. More than 800 were repaying sums between £5,000 and £20,000, and 36 were repaying more than £20,000”.

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A vindictive campaign is being pursued to claw back a miniscule fraction of the welfare budget. To provide perspective, £9 billion was written off by the government after being spent on unusable personal protective equipment during the pandemic, over £1 billion of which it admits was “at risk” of corporate fraud. More telling still, £35 billion in tax is estimated to be lost to non-payment, avoidance and fraud.

The punishment being meted out is a particularly savage expression of capitalism’s plundering of the energies of society and hatred of sections of the population considered surplus to requirements. It takes place even though the ruling class is already reaping massive rewards by exploiting relatives placed under enormous personal strain by the deliberate collapsing of alternative provision.

According to a 2023 study, the economic value of work done by unpaid carers is a staggering £162 billion a year, close to the £181 billion budget of the National Health Service (NHS). An estimated 7 million people in the UK provide unpaid care—more than one in 10 people and including one in seven employees. Roughly one in 20 are providing more than 20 hours of care a week.

This is labour vital to the functioning of society, upon which all the profits, dividends and exorbitant salaries of the capitalist economy ultimately depend, but for which it pays next to nothing. And it helps facilitate the ongoing gutting of the NHS.

Carers also holding up a job are expected to put in a second shift at home. Those not able to take up paid employment alongside their caring responsibilities are given a pittance, if they are among the fewer than one million grudgingly given any support at all. According to a survey by the Carer’s Trust, barely half (55 percent) of unpaid carers feel they get the support they need to fulfil their role, falling to a third in the most economically deprived groups.

The financial and mental strain is enormous. Nearly half of those providing more than 35 hours of care a week are in poverty. Two-thirds describe themselves as extremely worried about finances, with a quarter actively cutting back on essentials like food and heating.

This has a marked impact on the caregiver’s mental health. Over a quarter often or always feel lonely. Burnout, according to the Association of Directors of Adult Social Services, is the main reason unpaid care arrangements break down, with less than a third of carers telling the Carer’s Trust they can take a break when they need one.

Akshata Murty, multi-hundred millionaire wife of Prime Minister Rishi Sunak, holds a reception in Downing Street for young carers, April 20, 2023. [Photo by Simon Walker / No 10 Downing Street / CC BY-NC-ND 2.0]

Young carers are particularly severely affected. The average waiting time to be identified for support is three years, with some carers waiting 10 years, according to an inquiry by the All-Party Parliamentary Group on Young and Young Adult Carers. Young carers have a higher prevalence of self-harm than their peers, and those who do self-harm are twice as likely to attempt to take their own life.

By 2020, government spending per person on adult social care in the UK was lower in real terms than it had been a decade prior. Meanwhile, between 2015/16 and 2022/23, the average weekly care home fee for working-age adults has increased by 10 percent, the average weekly fee paid for older people has increased by 26 percent, and the average hourly rate for home care has increased by 17 percent—all according to the King’s Fund health and social care charity.

Local authorities are heavily exposed to these costs, with 78.5 percent of their adult social care spending going to outsourced, overwhelmingly private, provision—up from 74 percent in 2015/16. More than eight in 10 care home places in England are now provided by private operators.

These private companies run gross profit margins ranging up to 42 percent, paying their staff abysmally—the vacancy rate in the adult social care sector is over ten percent—and frequently providing substandard care. According to a study published in Lancet Health Longevity last month, of the 816 care home closures enforced by the Care Quality Commission regulator since 2011, 804 were for-profit operators.

According to the King’s Fund, the net result is that while requests for care have increased, the number of people actually receiving formal long-term care is falling—down 55,000 in 2021/22 compared to 2015/16. Over two-and-a-half million people in England aged over 50 are unable to get the care they need, with hundreds of thousands stuck on waiting lists.

These numbers are set to explode. The number of people aged 65-79 in the UK is expected to increase by nearly a third in the next 40 years, and the number aged over 80 to double. A larger proportion than now will be living alone and/or ageing without children. Meanwhile, the working-age population will grow by just 4 percent.

As a result of this ageing and of the woeful state of public health, the number of people living with a major illness is expected to increase from one in six adults in England to one in five by 2040.

The murderous policies pursued in the pandemic demonstrated the ruling class’s attitude to these sections of the population, as far as their age and illness prevents them from producing profits. The super-rich consider it an insult that 600 potential labourers leave employment every day to take on caring responsibilities of those who make no contribution to the oligarchy’s vast wealth. No additional funding is coming their way.

Local authorities picking up the tab are already in unprecedented financial crisis and will be driven deeper into bankruptcy by central government spending plans that will mean a 13 percent funding cut in the years to 2028/9. National adult social care spending fell again in real terms between 2021/22 and 2022/3.

The opposition Labour Party has said nothing about making changes to Carer’s Allowance, only promising a “review”. Leader Sir Keir Starmer mildly opined with regard to carers being pursued for crippling debts that “Something’s gone very wrong here”. As Director of Public Prosecutions, he pushed a “tough stance” on those attempting to “flout” the benefits system, with jail terms of up to 10 years and a minimum threshold of £20,000 for sending cases to Crown Court abolished.

Nearly five million removed from Medicaid have no health insurance

Kevin Reed

On Friday, the Kaiser Family Foundation (KFF) reported that nearly one-quarter of those who were disenrolled from Medicaid by federal and state governments in the US over the past year are now uninsured. This means that approximately 4.6 million people, many of whom are children, who previously qualified for Medicaid, have no health insurance.

The publicly owned Greenwood Leflore Hospital is pictured on Oct. 21, 2022, in Greenwood, Miss. [AP Photo/Rogelio V. Solis]

The KFF report is based on updated findings of its ongoing “Survey of Medicaid Unwinding” which has monitored the impact of the purging of Medicaid rolls since the Biden administration implemented its post-pandemic eligibility rules beginning on April 1, 2023.

A news release on Friday states, “Nearly a quarter (23 percent) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now, finds a new KFF national survey examining how the unwinding affected enrollees.”

According to previous data released by KFF, at least 20 million low income people have been kicked off Medicaid since the unwinding was started. The KFF data shows that 70 percent of those removed from the government health insurance program, or 14 million people, were left temporarily with no insurance.

So far, 47 percent, or 9.4 million have been re-enrolled in Medicaid, while 30 percent, or 6 million people, had another form of health coverage such as an employer-sponsored plan, Medicare, self-funding on the health insurance marketplace (Obamacare) and or through the US military. The balance, or 4.6 million people, have no insurance at all.

According to Joan Alker, executive director and co-founder of Georgetown University’s Center for Children and Families, the actual number of disenrolled and uninsured is likely to be much higher. Alker told Associated Press the undercount is because the KFF survey does not consider children, who have been one of the biggest groups affected by unwinding.

Alker added, “The question is, ‘How long are they going to stay uninsured?’ The states who want to cover their citizens are going to have to do a lot of work to get them back.”

At least half of those who were enrolled in Medicaid prior to the unwinding said they had heard little or nothing about the process that was being put in place by the Biden administration and the state governments. One of the major reasons that people have been purged from Medicaid rolls is that the re-enrollment process is complicated.

When a federal national health emergency was declared at the beginning of the COVID-19 pandemic in March 2020, rules for eligibility for the government’s Medicaid health insurance program for low income families and individuals were expanded. These rules included a provision that said once someone qualifies for the program, they cannot be removed due to changes in their economic or other circumstances that would previously have made them ineligible.

According to health insurance experts, the Biden administration’s Medicaid unwinding initiative is the largest loss of health insurance coverage in US history. This attack on public health is also taking place as the Democrats and Republicans are cutting funds from critical social programs, claiming there is no money, while they are committing untold billions of dollars for the US proxy war against Russia in Ukraine and for the Israeli genocide against Palestinians in Gaza.

The KFF survey says that one third of Medicaid enrollees have not completed their renewal process. The news release states, “About a third (35 percent) who tried to renew their coverage describe the process as difficult, and nearly half (48 percent) describe it as at least somewhat stressful. A majority (56 percent) of those disenrolled say they skipped or delayed care or prescriptions while attempting to renew their Medicaid coverage.”

Among the most persistent problems that enrollees have had with renewal of their Medicaid coverage have been excessive wait times on the phone and issues with their paperwork. According to Michelle Levander, founding director of the Center for Health Journalism at the University of Southern California, many of those disenrolled may have been eligible for Medicaid, “but they’re caught in a bureaucratic nightmare of confusing forms, notices sent to wrong addresses and other errors.”

Meanwhile, not having health insurance in the US can be financially catastrophic for families. As Sara Rosenbaum of George Washington University’s School of Public Health and Health Services told the Associated Press, healthcare costs of any kind can be a major burden for low-income Americans. “Suddenly, a visit that didn’t cost you anything (before)—let’s say it’s going to cost you $5. That $5 can be $500 for some folks,” she explained.

Kate McEvoy, executive director of the National Association of Medicaid Directors, told CBS News that millions of people are currently being re-determined for eligibility, and that has swamped some state call centers. McEvoy said efforts by states to reach out to enrollees prior to the unwinding with media campaigns, texts, emails and apps were ineffective.

Some former Medicaid enrollees are only finding out that they no longer have coverage when they go to the doctor. For example, Indira Navas of Miami, told CBS News she learned her 6-year-old son Andres had been disenrolled from Florida’s Medicaid program when she took him to an appointment in March. She had scheduled the appointment months prior and expressed frustration that her son is uninsured and unable to receive treatment for his medical condition.

Additionally, Navas also said Florida representatives could not explain why her 12-year-old daughter, Camila, remained covered by Medicaid even though the children live in the same household with their parents. “It doesn’t make sense that they would cover one of my children and not the other,” she said.

Thousands could be deported under Australian government’s draconian immigration bill

Mike Head

The Australian Labor government remains intent on pushing a reactionary non-citizen “removal” bill through parliament as quickly as possible despite outrage in immigrant communities and overwhelming opposition by refugee, migrant and human rights groups.

That was clear at a one-day Senate committee hearing on the bill on Monday, even as a flood of 102 submissions exposed the widespread impact of the unprecedented legislation on immigrant families, shattering the government’s claims that it would have limited effects.

Accommodation in the Nauru offshore processing facility. [Photo by DIAC images / CC BY 2.0]

Testifying in defence of the government’s bill, Home Affairs department officials admitted that up to 5,000 non-citizens could face removal from Australia, a figure far higher than the government’s earlier misleading statements that fewer than 1,000 people would be affected.

These non-citizens could be given ministerial directives to cooperate with their forced deportation, including by signing or producing documents, or face up to five year’s jail, a punishment that human rights organisations stated had no precedent in Australian law.

Home Affairs representatives said the bill could apply to 4,463 people on bridging visas and 150 to 200 people in immigration detention. It also apply to 152 people released from detention due to a High Court ruling last November that indefinite detention is unconstitutional, and 99 people released pre-dating the High Court decision.

This may be another serious underestimate. Testifying before the committee, Human Rights Law Centre senior lawyer Laura John said the victims could include almost 10,000 people who arrived in Australia in 2012 or 2013 and had their refugee claims rejected in a “fast-tracked” assessment process.

The one-day hearing by the Senate legal and constitutional affairs committee was convened after the Labor government failed in its initial bid, just before Easter, to ram the Migration Amendment (Removals and Other Measures) Bill through both houses of parliament in less than 36 hours, making a mockery of any pretence of democracy.

The Liberal-National Coalition had committed to assist the rapid passage of the bill, but then referred it to the Senate committee to ensure its legal effectiveness. The Coalition’s bipartisan support for the bill’s repressive content remains.

Despite the outpouring of opposition reflected in the submissions, Immigration Minister Andrew Giles repeated the government’s assertions that the legislation was simply needed to close a “loophole.”

During the hearing, Home Affairs department secretary Stephanie Foster doubled down, insisting that the bill was essential. She also revealed that coerced removals were already common—2,184 non-citizens were “voluntarily” deported in 2023, with 90 forcibly removed.

Piumetharshika Kaneshan, a 19-year-old nursing student, told the inquiry she was one of the people who “might be jailed if this bill is passed into law.” She said her family had been “failed by the fast-track” visa assessment process, with their claims of needing protection from Sri Lanka rejected because authorities “said we were safe because of my father” who had now died.

“This bill would put us in jail if we don’t go back to Sri Lanka,” she said. “We consider ourselves Australian. We thought the Australian community accepted us.”

In one of the wide range of submissions denouncing the bill, the Migrant Workers Centre said: “Many BVE [bridging visa] holders who may be subject to the Bill have resided within our community for more than a decade. They have built their lives here, and some might have children born in Australia who are now citizens. Irrespective of their visa status, these people are fundamentally part of the community. The prospect of them receiving a removal order and facing incarceration for not self-deporting is profoundly inhumane.”

The bill confers a virtually unlimited power on the immigration minister to coerce any visa holder to assist with their own deportation—and that of their children. Anyone who fails to obey a directive, which could include facing questioning by officials, faces a mandatory one-year prison term and a $93,000 fine. They could be jailed for up to five years, and then imprisoned repeatedly if they still did not obey.

These are police-state powers. In its submission, the Kaldor Centre for International Refugee Law stated: “There is no precedent in Australian law for a failure to comply with a direction resulting in mandatory imprisonment—not even in the context of terrorism offences.”

In addition, being a refugee fleeing persecution would not be a “reasonable excuse” for failing to follow a directive. That is a flagrant violation of the international Refugee Convention. Moreover, the minister can overturn a previous finding that a person is a refugee to “whom Australia has non-refoulement obligations.”

The bill would also give the government the power to impose blanket travel bans, barring entry visas to people from designated “removal concern countries.” Those mooted by government sources and the media for listing include Iran, China, Russia and South Sudan.

That has led to widespread dismay in immigrant communities because such bans would have a devastating impact on the many families in Australia from these and any other listed countries, potentially barring them from ever seeing their relatives again.

Not accidentally, the US and its military allies have named these countries as “uncooperative” for not accepting involuntary deportations of their citizens. These allegations and threats of bans are primarily directed against countries that are Washington’s war targets, above all Iran, Russia and China, regarded as the chief threats to its global hegemony.

Most immediately, the bill seeks to keep up to 200 people locked away indefinitely in immigration detention. It is designed to nullify a further High Court challenge, which began its hearing today, by an Iranian detainee who has refused to return to Iran, fearing persecution.

The government is trying to further thwart last November’s High Court ruling, which partially overturned the barbaric three-decade regime, maintained by successive Labor and Coalition governments, of indefinite immigration detention. As a result of that judgment, the government had to release 152 detainees because there was no reasonable short-term prospect of deporting them.

Labor’s measures since November, backed by the Coalition, have already included (1) 24-hour ankle-bracelet monitoring, curfews and other police-state measures imposed on released detainees, (2) a new “preventative detention” regime to re-imprison detainees, and (3) the reopening of the notorious “offshore” detention camp on the tiny impoverished Pacific island of Nauru.

This has been accompanied by the demonising of non-citizens, such as falsely accusing immigration detainees, including refugees, of being murders and rapists, when even those with past convictions have long ago served their prison sentences.

The Australian government, led by the leaders of Labor’s so-called “Left” faction, is matching the most far-right and fascistic elements globally, including Donald Trump, the Conservative government in Britain, the Meloni administration in Italy and the AfD (Alternative for Germany) in witch-hunting and seeking to deport asylum seekers and other “non-citizens.”

Internationally, amid the Gaza genocide and the plunge into wider war in the Middle East, and against Russia and China, there is a drive to divide working people, domestically and globally, and subordinate them to the geo-strategic interests of the major capitalist powers. Refugees and other “foreign” workers are being blamed for the deteriorating social conditions being produced by capitalism’s economic and cost-of-living crisis and the diversion of billions of dollars into military spending.

Three decades ago, the Keating Labor government launched the outright assault on refugees in 1992, when it established the worldwide precedent of mandatory detention of all people arriving by boat. Through this latest bill, the Albanese government is going further in stripping refugees, immigrants and other non-citizens of basic democratic and legal rights.

“Something will have to give”—IMF warns of build-up of US debt

Nick Beams

The opening chapter of the World Economic Outlook report of the International Monetary Fund, released at its spring meeting in Washington yesterday, presented a generally upbeat report on the state of the global economy, at least on the surface. But not far below it there are gathering storms.

Pierre-Olivier Gourinchas, Chief Economist of the IMF, holds up a tablet with the World Economic Outlook report. [AP Photo/Jacquelyn Martin]

In his foreword to the report, IMF economic counsellor Pierre-Olivier Gourinchas wrote: “The global economy remains remarkably resilient, with growth holding steady as inflation returns to target.’

Despite “gloomy predictions,” the world had avoided a recession and the banking system proved “largely resilient.” He was also gratified that despite the surge of inflation and the cost-of-living crisis there had been no “wage-price spirals.”

In other words, because of the actions of the trade unions in all the major economies in suppressing wage demands and imposing sub-inflationary agreements, workers had been made to bear the cost of the inflationary spiral set off by the COVID pandemic and the boost to energy prices flowing from the Ukraine war.

In contrast to the generally upbeat outlook on the immediate situation, examination of the IMF’s own data and projections for the medium-term told a different story with growth over the next five years unlikely to return to anywhere near previous historical norms.

And even the immediate projections for the major economies show a significant slowing of economic output. Within the G7, the US economy leads the way with growth for this year expected to be 2.7 percent, an upgrade of 0.6 percentage points on the previous estimate.

But it is all downhill from there. The next best performer is Canada with expected growth of 1.2 percent. The German economy, by some measures now the third largest economy in the world after the US and China, is expected to grow by only 0.2 percent, the lowest in the G7.

Japan, now relegated to the world’s fourth largest economy, will grow by 0.9 percent with the UK coming in at 0.5 percent, after experiencing no growth in 2023.

On the growth of the US economy, which was described as “exceptional,” Gourinchas sounded a warning about the increase in government spending. It had led to a “fiscal stance that is out of line with long-term fiscal sustainability.”

This is a reference to the rise of US public debt, now equivalent in size to US GDP which is expected to accelerate in coming years and is characterised by the Treasury department itself as “unsustainable.”

“This raises short-term risks to the disinflation process, as well as longer-term fiscal and financial stability risks for the global economy since it risks pushing up global funding costs. Something will have to give,” Gourinchas wrote.

While he did not specify it, the key driving force of this expansion is the escalation of military spending as well as large handouts to major corporations under the Inflation Reduction Act, the Chips Act and other measures.

The IMF also expressed concern about the Chinese economy which has been a mainstay of global growth since the global financial crisis of 2008. It continues to be heavily impacted by the property crisis and the IMF has called for strong measures to provide an increase in domestic demand to lift growth.

But there is little sign of that. The Chinese government is seeking to boost manufacturing, especially in high tech areas such as green energy and electric vehicles, which it can turnout at lower cost than in the West, leading to a risk this will “further exacerbate trade tension in an already fraught geopolitical environment.”

These conflicts were on display during the IMF gathering. US Treasury secretary Janet Yellen has been organising meetings with her counterparts with the aim, among other things, of developing a unified response against the outflow of high-tech exports from China that cut into the US and other markets.

This was a central topic of her discussions with Chinese officials and government representatives during her visit earlier this month in which virtually no agreement was reached.

In comments at the weekend on the eve of the IMF meeting, she made clear what was at stake.

“This is a complicated issue that involves their entire macroeconomic and industrial strategy. “It’s not going to be solved in an afternoon or a month,” she said.

These remarks underscore the existential nature of the conflict. The US is demanding the total subordination of China to its demands that it completely scrap its focus on what president Xi Jinping calls the development of “new productive forces” because this is seen as one of the chief threats to its continued domination of the global economy.

From the Chinese side this strategy is seen as the only way to sustain economic growth, even at the much lower target of 5 percent, to maintain “social stability” that is, to try to prevent the eruption of struggles by the Chinese working class which would threaten the regime of the ruling capitalist oligarchy represented by the Communist party.

This conflict can only intensify under conditions where, as the IMF made clear in Chapter 3 of its report published last week, global growth is markedly slowing.

In a blog on the chapter, two of its authors warned that in the coming period growth is “set to fall far below its historical average.”

“The world economy,” they wrote, “faces a sobering reality. The global growth rate—stripped of its cyclical ups and downs—has slowed steadily since the 2008–09 global financial crisis.”

It said economic growth was expected to reach just 2.8 percent by 2030, well below the historical average of 3.8 percent.

The prospect of weaker growth was “exacerbated by strong headwinds from geo-economic fragmentation, and harmful unilateral trade and industrial policies.”

They noted that half of the growth decline was the result of a fall in total factor productivity (TFP), which measures the input of capital and labour and how these resources are used.

In recent years increasingly “insufficient distribution of resources across firms has dragged down TFP and, with it, global growth.”

It was not referred to, but one of the key factors in this process is that corporations have used their profits and even run up debts not for productive investments but to finance share buy backs to meet the demands of hedge funds and other parasitic financial institutions for a boost in “shareholder value.”

Overall, the IMF gathering was not so a meeting to deal with growing global economic problems but was more akin to a war council in which the immediate target is China on the one hand, and the working class on other.

There was an insistence on the need to continue the fight against inflation, the code phrase for driving down real wages, the need to increase productivity, the intensification of exploitation, and the maintenance of financial buffers—that is, cuts in social spending—to deal with mounting debts.

Insofar as the resolution of economic problems was addressed, the IMF said “multilateral cooperation” would be needed.

But that has gone by the board. Its passing was highlighted in remarks this week by the Australian Labor prime minister Anthony Albanese in which he announced government support for war-related industries.

Starting with the US, he listed a series of nationalist measures introduced by a range of countries to boost their economic and national security.

This “strategic competition,” which is directed towards war, he said, was now a “fact of life.”