We finally have a new US maternal mortality estimate. It’s still terrible.

“the 2018 maternal mortality rate was 17.4 maternal deaths per 100,000 live births — meaning 658 women died in 2018. The figure includes deaths during pregnancy, at birth, or within 42 days of birth.

The rate once again put the US last among similarly wealthy countries”

“If you compare the CDC figure to other countries in the World Health Organization’s latest maternal mortality ranking, the US would rank 55th, just behind Russia (17 per 100,000) and just ahead of Ukraine”

Trump’s audacious new plan to cut Medicaid, explained

“The Centers for Medicare and Medicaid Services announced on Thursday they would accept applications from states that want to set up a Medicaid block grant, a long-held goal of ideological conservatives who want to scale back the social safety net, and one deployed successfully to severely limit cash welfare benefits in the 1990s.

These spending caps would fundamentally change how the program is financed, ending Medicaid’s days as an open-ended entitlement by putting new hard limits on how much the government is willing to spend on health care for certain enrollees. Medicaid would no longer pay whatever is necessary to provide medical care to the people in or near poverty who qualify for its benefits. Instead, spending would be limited in states that got a waiver from the federal government, and they could impose cuts on benefits.”

“Conservatives say block grants are a good way to rein in government spending (Medicaid is one of the biggest federal line items) and to give states more control of the program (it has always been a shared state-federal responsibility) to make it work best for their populations. In practice, the likely effect is lower Medicaid spending and fewer benefits.”

America’s democracy is failing. Here’s why.

“The system is rigged. It was rigged from the outset, quite intentionally, to favor small states. Under current political coalitions, that’s become an enormous advantage for Republicans. The country’s framers obviously could not have known that they were creating a system that would give Donald Trump’s party an unfair advantage over Hillary Clinton’s party more than two centuries later. But they did create a system that favors small states over large states.”

“Republicans, meanwhile, take their unfair advantage and build on it by gerrymandering the states they control, using their Senate “majority” to fill the courts with Republican judges, and then using their control of the judiciary to bolster their own party’s chances in elections.”

“According to 2018 Census Bureau estimates, more than half of the US population lives in just nine states. That means that much of the nation is represented by only 18 senators. Less than half of the population controls about 82 percent of the Senate.”

“Senate malapportionment is a relic of an unstable alliance among 13 young nations. As Yale law professor Akhil Amar explains, the Articles of Confederation that preceded the Constitution were “an alliance, a multilateral treaty of sovereign nation-states.” The Constitution did not simply change the rules that governed an existing nation; it bound 13 independent and sovereign states together.

The Founding Fathers came together at Philadelphia to achieve union at nearly any cost, because they wanted to avoid the persistent warfare that plagued Europe. Without a union, Amar says, “each nation-state might well raise an army, ostensibly to protect itself against Indians or Europeans, but also perhaps to awe its neighbors.”

Nor was this merely a hypothetical concern. When large states proposed a fair legislature, where each state would be given seats proportional to its population, Delaware delegate Gunning Bedford literally threatened that his state would make war on its neighbors. “The large states dare not dissolve the Confederation,” Bedford insisted, or else “the small states will find some foreign ally of more honor and good faith.””

“The Senate does not simply give extra representation to small states, it gives the biggest advantage to states with large populations of white, non-college-educated voters — the very demographic that is trending rapidly toward the GOP.”

“Realistically, the most democratic solutions, such as abolishing the Senate or replacing it with a body that fairly represents all Americans, are off the table in a nation that cannot amend its Constitution. And so we’re likely left with our undemocratic system for a long while, pushing for reform when and where possible, but likely unable to fix the system absent a major political realignment.”

Unlike Rivals, Buttigieg Health Plan Reduces Deficit And Covers 30M

““The four leading candidates would all spend money to expand coverage and they would all raise taxes to help cover the costs,” Committee for a Responsible Federal Budget senior vice president Marc Goldwein said in an interview Friday. “We estimate only one candidate would actually raise enough to assure their plan doesn’t add to the national debt.”

With the higher price tags come lower out-of-pocket costs for millions of Americans under the Warren and Sanders plans.”

The viral video of Mike Pence being grilled by an ER doctor about Medicaid cuts, explained

““Cutting Medicaid — yeah,” Davidson said. “The head of CMS [the Centers for Medicare and Medicaid Services] announced the plan to let states file for waivers so they could get block grants, so that would essentially cut the amount of money going to states. So that would cut federal Medicaid funding.””

“”I think it comes down to that for the people I take care of all the time,” responded Davidson. “People I see in the emergency department that can’t get primary care doctors, [but] once they got Medicaid they could get primary care doctors. They stay out of the ER, they actually work more, they actually contributed to our community more.”

“Now, if you tell those people, ‘Sorry, you don’t get your health care’ — that’s going to be a real negative in their lives,” Davidson continued.”

Why Trump’s acquittal will damage US foreign policy

“That clear abuse of power for Trump’s own political gain led the Democratic-majority House to impeach the president. Afterward, the Republican-held Senate chose not to investigate further by declining to call any witnesses in its trial of the president and is expected to acquit him.

This means that, ultimately, the impeachment system designed to keep the top levels of the US government from descending into lawlessness has failed.

That, as former Estonian President Toomas Hendrik Ilves and others say, will make it harder for the US to tell other nations to follow America’s lead.”

“In an ideal America, Trump would receive a severe reprimand for abusing his power and his corrupt practices, like using the presidency to enrich himself and his family. Even if short of impeachment, Republicans could’ve placed severe political pressure on Trump by showing him their support has limits.

That’s not what happened. Instead, Trump’s party will be responsible for letting him get away with the Ukraine scandal basically unpunished.

He has been formally impeached, and that in itself is significant regardless of whether or not he’s removed from office, but given that no House Republicans voted for impeachment, Trump and his allies can argue (and have) that it was merely a partisan political ploy and not the serious rebuke for his behavior it is supposed to be.

It’s worse when considering one of the arguments Trump’s legal team has made: that a president can basically do whatever he wants in order to get reelected if he believes his reelection is good for the country.”

How the US became the center of global kleptocracy

“The biggest single provider of anonymous shell corporations in the world isn’t Panama or the Cayman Islands. It’s not the financial secrecy stalwart Switzerland, or a traditional offshore haven like the Bahamas.

It’s Delaware. And the main reason is federalism.

Thanks to the US’s federal structure, company formation remains overseen at the state level, rather than in Washington.

So if you’re a budding autocrat interested in a bit of easy money laundering, you don’t turn to federal officials in Washington. Instead, you look to state officials in Dover, Cheyenne, or Reno to help construct anonymous shell companies to funnel and clean your illegitimate money.”

“Since there are no regulations in the US requiring that shell companies identify their true owners — known as “beneficial owners” – American states have been under no compunction to try to peel back who may be behind the anonymous shell companies mushrooming across the country.

These states and their constituents are raking in fees”

“Nevada, which actively marketed itself as the “Delaware of the West” in the early 1990s, directly linked company formation fees to funding teachers’ salaries. And Wyoming, which invented the limited liability company (LLC) in 1977, has been only too happy to capitalize on allowing shell companies to flourish in the state, generating millions of dollars for its general budget — yet another small state all too willing to participate in this “race to the bottom.””

“The criminal and corrupt of the world have taken notice. “Merchant of Death” Viktor Bout, the most prolific illicit arms dealer of the past few decades, used anonymous American shell companies to smuggle missiles and rocket launchers to rebels in Colombia.

Former Ukrainian Prime Minister Pavlo Lazarenko, who once joined Indonesian dictator Suharto and Serbian genocidaire Slobodan Milošević among the ranks of the world’s most corrupt leaders, relied on a network of anonymous shell companies in Wyoming to plunder Ukraine.

Even the ongoing impeachment saga in the US hinges in large part on anonymous Delaware shell companies, which Rudy Giuliani’s Ukrainian-born bag-men used to funnel foreign funds into American elections.

For the world’s warlords, criminals, and autocrats, there’s no gift finer than an anonymous American shell company.”