Healthcare profits keep rolling along as patients die
New York Times, 9/24–Norman Otey was rushed by ambulance to Richmond Community Hospital. The 63-year-old was doubled over in pain and babbling incoherently. Blood tests suggested septic shock, a grave emergency that required the resources and expertise of an intensive care unit…But Richmond Community, a struggling hospital in a predominantly Black neighborhood, had closed its I.C.U. in 2017…It took several hours for Mr. Otey to be transported to another hospital, according to his sister, Linda Jones-Smith. He deteriorated on the way there, and later died of sepsis.

Ringed by public housing projects, Richmond Community consists of little more than a strapped emergency room and a psychiatric ward. Yet the hollowed-out hospital — owned by Bon Secours Mercy Health, one of the largest nonprofit health care chains in the country — has the highest profit margins of any hospital in Virginia.

The secret to its success lies with a federal program that allows clinics in impoverished neighborhoods to buy prescription drugs at steep discounts, charge insurers full price and pocket the difference. More than half of all hospitals in the United States are set up as nonprofits, a designation that allows them to make money but avoid paying taxes…Bon Secours …made nearly $1 billion in profit last year at its 50 hospitals in the United States and Ireland and was sitting on more than $9 billion in cash reserves.

Plans for escalating war on the European front
The Economist, 9/29–Vladimir Putin, Russia’s president, has repeatedly warned that he could resort to nuclear weapons.

On September 21 he said he would use “all weapons systems available” to defend the “territorial integrity” of Russia. In response Jake Sullivan, the U.S.  national security adviser, sternly warned Russia of “catastrophic consequences” if it used nuclear weapons.One option would be to pile more economic pressure on Russia, perhaps through secondary sanctions on those buying its oil and gas, with the hope of turning Mr Putin into even more of an international pariah. Another option would be for the West to help Ukraine fight in a nuclear battlefield, by providing advice, protective gear and decontamination equipment. It could also supply more advanced arms. At the other end of the scale, America, Britain or France could respond with a limited nuclear strike of their own.

The middle way…is the likeliest…deploying NATO troops to Ukraine, or carrying out direct strikes on Russian targets. The U.S. could…destroy the ports, air bases, or mobile missile launchers used in any Russian nuclear attack.

Ben Hodges, a retired general who once commanded American. ground forces in Europe, suggests sinking Russia’s Black Sea fleet, or destroying its bases in Crimea.

Farmers in Pakistan crushed by flooding and by capitalism
New York Times, 10/1–The young woman waded into the waist-deep flood water that covered her farmland, scouring shriveled stalks of cotton for the few surviving white blooms. But the farmworker — Barmeena, just 14 — had no choice. “It was our only source of livelihood…She is one of the millions of farmworkers whose fields were submerged by the record-shattering floods that have swept across Pakistan. In the hardest-hit regions, where the floods drowned entire villages, the authorities have warned that the floodwater may not fully recede for months.Still, wherever the water has receded even a bit, farm laborers are scrambling to salvage whatever they can from the battered remains of their cotton and rice harvests. It is desperate work. Many already owe hundreds or thousands of dollars to the landlords whose fields they cultivate each year, as part of a system that has long governed much of rural Pakistan.

But now, their summer harvests are in ruins. Unless the water recedes, they will not be able to plant the wheat they harvest each spring. Even if they can, the land is certain to produce less after being damaged by the floodwaters, from a cataclysmic combination of heavy glacier melt and record monsoon rains, which scientists say were both intensified by climate change.

“Our life goes like that — sinking into debt, not earning the money to pay it back, and then we do it again,” said Mairaj Meghwar, 40, a farmer who lives in the village of Lal Muhammad in Sindh Province, the region that sustained the most flood damage... “We are slaves, that is clear,” he said.