Cigna – like all private health insurers – has two contradictory imperatives:

I. To keep its customers healthy; and

II. To make as much money for its shareholders as is possible.

Now, there's a hypothetical way to resolve these contradictions, a story much beloved by advocates of America's wasteful, cruel, inefficient private health industry: "If health is a "market," then a health insurer that fails to keep its customers healthy will lose those customers and thus make less for its shareholders." In this thought-experiment, Cigna will "find an equilibrium" between spending money to keep its customers healthy, thus retaining their business, and also "seeking efficiencies" to create a standard of care that's cost-effective.

But health care isn't a market. Most of us get our health-care through our employers, who offer small handful of options that nevertheless manage to be so complex in their particulars that they're impossible to directly compare, and somehow all end up not covering the things we need them for. Oh, and you can only change insurers once or twice per year, and doing so incurs savage switching costs, like losing access to your family doctor and specialists providers.

Cigna – like other health insurers – is "too big to care." It doesn't have to worry about losing your business, so it grows progressively less interested in even pretending to keep you healthy.

The most important way for an insurer to protect its profits at the expense of your health is to deny care that your doctor believes you need. Cigna has transformed itself into a care-denying assembly line.

Historical analogies rarely carry much weight, especially in a time when so much about politics has changed so rapidly. To compare what is happening in 2024 to events that occurred over half a century earlier hardly seems useful.

It mostly isn't. And yet the election of 1968, whose outcome proved disastrous for America and the world, looms over the coming months like a foreboding specter.

Despite all the obvious differences in personalities, issues, technologies and ideologies, there is a haunting parallel between then and now in the increasingly fraught debate among Democrats and progressives over a divisive war — and the alienation of younger and minority voters from the party they would otherwise support.

By the spring of 1968, the movement against the Vietnam War had sparked a sense of furious frustration among young Americans who saw it causing tens of thousands of pointless deaths with no justification or end in sight. Massive antiwar protests swept across the nation's universities and colleges, sometimes resulting in conflict with authorities. Dissent within his own party had inspired not one but two insurgent candidacies against President Lyndon B. Johnson, who declared in late March that he wouldn't seek a second term.

The assassination of Sen. Robert F. Kennedy snuffed hopes for a fresh Democratic ticket. The nomination fell to Vice President Hubert H. Humphrey, Johnson's personally anointed successor, at the Democratic National Convention in Chicago. While the antiwar movement was generally peaceful and orderly, the student left had spawned a revolutionary wing whose leaders aimed for confrontation in the streets. The Windy City's conservative mayor, Richard J. Daley, was only too eager to answer them with billy clubs and tear gas.

Chaos and violence outside the convention, instigated by a rampaging police force, deepened the party's split and left millions of young voters vowing to support a third-party candidate or simply abstain.

One of my weirder and more rewarding hobbies is collecting definitions of "conservativism," and one of the jewels of that collection comes from Corey Robin's must-read book The Reactionary Mind:

https://en.wikipedia.org/wiki/The_Reactionary_Mind

Robin's definition of conservativism has enormous explanatory power and I'm always finding fresh ways in which it clarifies my understand of events in the world: a conservative is someone who believes that a minority of people were born to rule, and that everyone else was born to follow their rules, and that the world is in harmony when the born rulers are in charge.

This definition unifies the otherwise very odd grab-bag of ideologies that we identify with conservativism: a Christian Dominionist believes in the rule of Christians over others; a "men's rights advocate" thinks men should rule over women; a US imperialist thinks America should rule over the world; a white nationalist thinks white people should rule over racialized people; a libertarian believes in bosses dominating workers and a Hindu nationalist believes in Hindu domination over Muslims.

These people all disagree about who should be in charge, but they all agree that some people are ordained to rule, and that any "artificial" attempt to overturn the "natural" order throws society into chaos. This is the entire basis of the panic over DEI, and the brainless reflex to blame the Francis Scott Key bridge disaster on the possibility that someone had been unjustly promoted to ship's captain due to their membership in a disfavored racial group or gender.

This definition is also useful because it cleanly cleaves progressives from conservatives. If conservatives think there's a natural order in which the few dominate the many, progressivism is a belief in pluralism and inclusion, the idea that disparate perspectives and experiences all have something to contribute to society. Progressives see a world in which only a small number of people rise to public life, rarified professions, and cultural prominence and assume that this is terrible waste of the talents and contributions of people whose accidents of birth keep them from participating in the same way.

Secretary of State Antony Blinken ended three days of meetings in China on Friday with a stark warning to China’s leadership — stop exporting materials that allow Russia to rebuild its industrial base or face U.S. sanctions.

Chinese state-owned firms are providing key components for Russia’s defense industrial base, including microelectronics and machine tools that have “a material effect against Ukraine” and constitute “a growing threat that Russia poses to countries in Europe,” Blinken told reporters in a press briefing in Beijing on Friday.

Blinken said that, in his meetings with China’s leader Xi Jinping and Foreign Minister Wang Yi, he made clear that the Biden administration is running out of patience with Beijing’s refusal to stop that support.

“We’re looking at the actions that we’re fully prepared to take if we don’t see a change … we’ve already imposed sanctions on more than 100 Chinese entities, export controls and we’re fully prepared to take additional measures,” Blinken said.

Blinken said that there has been “important progress” in stabilizing U.S.-China relations since President Joe Biden’s meeting with Xi in San Francisco in November, but that key irritants — including tensions over trade, Taiwan and Beijing’s increasingly aggressive incursions into Philippine waters of the South China Sea — remain major obstacles.

Beijing didn’t give an inch. U.S.-China ties risk a “return to a downward spiral” in bilateral ties because “China’s legitimate development rights have been unreasonably suppressed and our core interests are facing challenges,” Wang told Blinken ahead of their meeting Friday.

And now: A special report from the Department of Really Bad Ideas. And this one is a doozie.

It comes from Hizzoner Eric Adams, the present mayor of New York City. Like mayors everywhere, Adams is routinely expected to respond to city council members, state reps, members of Congress and other elected officials who ask for help on city issues and problems affecting the people they represent. After all, that's how it's supposed to work — local folks have an issue needing city attention, so they go to officials in their local community who can carry this issue to the top level. Most of these matters are resolved by — hello — relevant officials simply having a phone call, a quick meeting or even an email exchange.

But no — the Big Apple's mayor has decreed that elected officials needing to discuss concerns of their constituents may NOT speak directly to him. Nor may they simply speak with his staff, meet with or engage with agency heads, or other mayoral personnel who could help the people. Rather, Adams has decreed that supplicants wanting to approach the city's public servants must submit a seven-page, online "engagement request." The mayor's intergovernmental office will review each one and then decide whether to grant or deny any official engagement.

An Adams gatekeeper hailed this bureaucratic intake process as a "new and exciting tool" to "improve operational efficiency and streamline requests." Golly — even George Orwell couldn't have conjured up a statement as soul-sucking as that!

Streamlined efficiency is the ultimate virtue for automatons and authoritarian regimes — NOT for public officials in a democratic society. Democracy is necessarily slower-paced, deliberative and inclusive. And it does not require — or accept — filling out a seven-page form to "engage" with your mayor.

This is huge: yesterday, the @FTC finalized a rule banning noncompete agreements for every American worker. That means that the person working the register at a Wendy's can switch to the fry-trap at McD's for an extra $0.25/hour, without their boss suing them:

https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes

The median worker laboring under a noncompete is a fast-food worker making close to minimum wage. You know who doesn't have to worry about noncompetes? High tech workers in Silicon Valley, because California already banned noncompetes, as did Colorado, Illinois, Maine, Maryland, New Hampshire, North Dakota, Oklahoma, Oregon, Rhode Island, Virginia and Washington.

The fact that the country's largest economies, encompassing the most "knowledge-intensive" industries, could operate without shitty bosses being able to shackle their best workers to their stupid workplaces for years after those workers told them to shove it shows you what a goddamned lie noncompetes are based on. The idea that companies can't raise capital or thrive if their know-how can walk out the door, secreted away in the skulls of their ungrateful workers, is bullshit:

https://pluralistic.net/2022/02/02/its-the-economy-stupid/#neofeudal

Remember when OpenAI's board briefly fired founder Sam Altman and Microsoft offered to hire him and 700 of his techies? If "noncompetes block investments" was true, you'd think they'd have a hard time raising money, but no, they're still pulling in billions in investor capital (primarily from Microsoft itself!). This is likewise true of Anthropic, the company's major rival, which was founded by (wait for it), two former OpenAI employees.

Ukraine for the first time has begun using long-range ballistic missiles provided secretly by the United States, bombing a Russian military airfield in Crimea last week and Russian forces in another occupied area overnight, American officials said Wednesday.

Long sought by Ukrainian leaders, the new missiles give Ukraine nearly double the striking distance — up to 300 kilometers (190 miles) — that it had with the mid-range version of the weapon that it received from the U.S. last October.

"We’ve already sent some, we will send more now that we have additional authority and money,” White House national security adviser Jake Sullivan said. The additional ATACMS were included in a new military aid package signed by President Joe Biden on Wednesday.

Biden approved delivery of the long-range Army Tactical Missile System, known as ATACMS, in February, and then in March the U.S. included a “significant” number of them in a $300 million aid package announced, officials said.

U.S. officials would not provide the exact number of missiles given last month or in the latest aid package, which totals about $1 billion.