Robert Whitcomb: Memorial’s Inevitable Closing; Wexford Will Work; Poor Pay Taxes
Monday, October 23, 2017
“Beauty has a tarnished dress,
And a patchwork cloak of cloth
Dipped deep in mournfulness,
Striped like a moth.’’
“Water and light are wearing thin:
She has drawn above her head
The warm enormous lion skin
Rough red and gold.’’
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--- From “October,’’ by Elinor Wylie
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Care New England’s decision to close Memorial Hospital, in Pawtucket, or at least its inpatient services and emergency room, didn't surprise me at all. The fact is that Memorial’s days as a full-scale community hospital have long been numbered.
Our region has too many hospitals in a time when highly effective medications for such chronic ailments as heart disease, as well as proliferating outpatient facilities, such as comprehensive and specialty physician group practices, urgent-care centers, drugstore clinics and free-standing emergency departments, treat many of the ills that used to be treated only within hospitals. Just consider the number of surgeries now done outside of hospitals, and that patients are discharged from hospitals after surgery there much faster these days. What might have kept them in a hospital for a week or two a couple of decades ago might now only keep them there for a couple of days.
And for the really serious and/or complicated stuff, patients can go to Rhode Island Hospital or the Miriam Hospital (the latter very close to Memorial), both in Providence, or to a hospital in the world-renowned health-care complex in Greater Boston (of which the Providence area is gradually becoming a part).
Only a small percentage of Memorial’s almost 300 beds are occupied and the place’s operating losses continue to swell.
So what will become of the facility? Probably much outpatient treatment and testing will continue in parts of the hospital buildings; after all, lots of physicians’ offices and very expensive equipment are there. (I go to see my cardiologist at Memorial every few months.) The rest of the structures might be turned into apartments, condos, offices, coffee shops, bars and so on – rather like a mill conversion.
The controversy about Memorial is really more about the threat to the hundreds of jobs at the hospital and the associated politics than about health care. But given the aging of the population, among other factors, the need for physicians, nurses, nurse practitioners, health-care aides and others in the sector will only grow; most of the laid-off folks at Memorial should fairly swiftly find new positions. But many will find leaving the hospital wrenching even as they find jobs elsewhere in the region that might be better for them in the long run. It’s a community.
Of course, politicians will denounce the closing even as they fail to come up with plausible arguments for keeping this old community hospital open in a time of revolutionary change (and confusion) in health care. And it’s been a very long time since Pawtucket was the sort of thriving factory town that could easily support such institutions as hospitals.
Now the city ever more desperately seeks the state’s help to finance a stadium for the Pawtucket Red Sox, although most Rhode Islanders oppose such help, according to a poll done for GoLocal by Socialsphere -- founded by John Della Volpe, the director of polling at the Kennedy School’s Institute of Politics at Harvard.
Far more promising is the coming Pawtucket/Central Falls train station. This facility will, among other benefits, help those cities become Boston suburbs for those who can’t afford the very steep housing costs in and around “The Hub’’ and maybe get some back-office work from Greater Boston companies in mills and other old buildings that have so far escaped the arsonists. Maybe some will live in what is now Memorial Hospital.
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Will the Wexford Innovation Complex in the I-195 District in Providence create a lot of jobs? Despite the usual Rhode Island skepticism, I believe it will.
That’s because the project will be nourished by a sort of mini-Boston-Cambridge-Route 128 critical mass of institutions. It will be virtually within the campuses of Brown University, the Rhode Island School of Design (probably the most famous such school in America) and the vocationally oriented Johnson & Wales University. And the Wexford space is at the intersection of two major Interstate highways, with one of them – Route 95 – effectively the main street of the Eastern Seaboard. And the site has the attraction of being at the head of a beautiful bay and near T.F. Green Airport, which has finally become an international airport.
Yes, it’s true that the state is providing about $32 million in incentives to get this project going. But unlike publicly funded goodies to bribe individual companies to come to, or stay in Rhode Island (e.g., the PawSox), the help for the Wexford complex is best seen as public infrastructure that will draw a wide range of companies and ultimately create thousands of jobs. This is not a 38 Studios deal.
This sort of intelligent, forward-looking infrastructure usually more than pays for itself. Most readers will remember the sound and fury around Boston’s Big Dig, which eventually cost a staggering $20 billion, including big cost overruns, as it streamlined downtown Boston’s highway system and beautified what had been the very ugly Central Artery area. It was a controversial project for years, but most would agree that it has worked out as a boon to Boston, playing a role in Boston’s rise to full world-class-city status in the past decade or so.
Of course, the I-195 District is no Big Dig but like the Boston project, it’s a dense collection of improvements in the middle of a city and thus has the potential of transforming it.
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The allegations of sexual harassment in the Rhode Island General Assembly are still far too vague to say anything about it. Let’s see what the State Police come up with.
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One good thing about the orgy of states and cities pitching to get Amazon’s “second headquarters: It’s making local politicians, policymakers and businesses analyze their localities’ strengths and weaknesses in physical infrastructure and education. The process may lead some of them to make long-overdue improvements, and the Amazon suck-up will teach some towns and cities how to better promote themselves.
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As President Trump zeroes in on the one great unifying mission of the Republican Party – income-tax cuts for the rich -- we constantly hear the refrain that the very rich pay a huge percentage “of taxes’’ and that poor and lower-middle-class folks “don’t pay taxes’’. But they almost always leave out the word “income’’ before “taxes’’. Poor folks pay a lot in taxes. According to the Institute on Taxation and Economic Policy, those making less than $19,000 a year pay about 11 percent of their income in state and local taxes – a higher percentage than some rich people because of loopholes that favor investment income over earned income.
And the poor and the rich pay “payroll taxes’’ – aka FICA -- which go to fund Social Security and Medicare. These levies, which sound like an income taxes to me, are based on a $106,000 annual earnings cap, making them regressive – hitting the poor much more than the rich. Then there are gasoline taxes….
All in all, it would seem that FICA and state and local taxes are somewhat regressive while federal income taxes are somewhat progressive. And yes, the vast compensation to executives and investors, especially in technology and finance, mean that most (but far from all) pay hefty federal income taxes.
So what would be an appropriate top federal income tax rate to address swelling budget deficits, collapsing public infrastructure, an aging population, and, I’d like to hope, a phaseout of the corruption- and inefficiency-causing corporate income tax: Maybe a top marginal personal-income rate of no more than 50-55 percent – far lower than the 70 percent back in the ‘70s and 91 percent in the ‘50s – but considerably more than the current 39.6 percent top marginal rate. God knows, fixing our public infrastructure will help create a lot of wealth by making our economy more competitive.
In any event, it’s important to look at the fairness of the whole tax system before revolutionizing income-tax policies. For instance, just simplifying federal income taxes would serve as a kind of tax cut by reducing the need to hire CPAs and other tax preparers and the time needed to put together supporting documents.
I doubt if Trump sincerely cares about middle-income people, but he does assert that his tax-cut plan will substantially help them. That’s hard to see. What is easy to see is that it would overwhelmingly favor the very rich, especially those with pass-through-income structures like the family-owned Trump organization. His tax program would increase money-based political-power concentration. And it would swell the federal debt, raising interest rates and posing the threat of a fiscal collapse that would hit everyone hard.
Trump could very swiftly help lower- and middle-income people by pushing to raise the minimum wage, which at $7.25 an hour is considerably below where it was in the ‘70s when adjusted for inflation, and get the U.S. Justice Department’s Antitrust Division to actually start enforcing anti-monopoly laws for change. That would help create new companies, which in turn would spawn a more competitive marketplace, which would help drive up wages, boost hiring and promote innovation. Google, Facebook, Amazon, et al., have grown far too big; they’re in restraint of trade.
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The green-energy revolution goes on: As GoLocal24 has reported, the U.S. Energy Department has awarded Woods Hole Oceanographic Institution researchers $5.7 million to advance technology leading to the mass production of sugar kelp, a seaweed, to make biofuels and bio-based chemicals.
The grants are from the Macroalgae Research Inspiring Novel Energy Resources (MARINER) Program (what a name!). A biologist with the group, Scott Lindell, told GoLocal: “Seaweed farming avoids the growing competition for fertile land, energy-intensive fertilizers, and freshwater resources associated with traditional agriculture.’’
Many readers may have eaten seaweed salad in an Asian restaurant; it’s delicious. Seaweed has some other uses, including cosmetics. It’s nice to know that New Englanders might soon grow it for food and fuel, anything to reduce our energy dependency on other regions.
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With their high divorce rate, fewer children than earlier generations had and the tendency for American families to be widely dispersed, an increasing number of Baby Boomers are living alone. As they get older and sicker, this presents serious health issues, including those associated with loneliness.
In some cities, including Providence and Boston, associations have been formed in which older people living alone, or perhaps with a spouse, pool resources to ease daily life through transportation and health services and socializing. The Dutch have been the pioneers in developing these kinds of organizations.
Consider Beacon Hill Village, a member-driven organization for Boston residents 50 and over, which, it says, “provides programs and services so members can lead vibrant, active and healthy lives, while living in their own homes and neighborhoods.
“Benefits include access to discounted providers who can help you manage your household, stay active and healthy, and serve your driving needs. Our social and cultural programs are always changing to support member interests.’’
Dues are $ 675 a year for an individual and $975 for two or more people in a household.
In Providence, there’s an organization based on the Boston model, called “The Providence Village.’’ It describes itself thus:
“The Providence Village is a non-profit organization formed and directed by members of the community, in order to provide services and programs that will enable us to live rich, full lives in our homes and neighborhoods as we age. The Providence Village will provide a single access point, via telephone or website, to a growing network of mutually supportive services and social opportunities made possible by a large pool of members/volunteers and a small paid staff.’’
Membership dues are $40 a month for an individual and $60 for a couple.
These organizations seek in some ways to help members create their own nonfamily families. Still, networks of friends and acquaintances almost always are much weaker than family ties. And it is much easier for family members, even those living far away, to obtain the legal authority to take care of very old and/or disabled people.
Sociologists Rachel Margolis and Ashton Verdery, and other scholars, have predicted that the number of older Americans without close relatives, or at least without those who can be found and called upon to help, is about to surge. They're quoted in a Bloomberg piece headlined “Americans Face a Rising Risk of Dying Alone’’. Please hit this link to read the piece:
We may soon have to reinvent parts of our social-service system to address this disturbing demography, about which we’re mostly in denial.
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Regarding aging again, take a look at Mother Land (HMH/Dolan), the new, semi-autographical novel by famed travel writer, novelist, essayist and critic Paul Theroux. This often grimly funny book is about a family with a mild father and a quasi-tyrannical mother of seven living children (an eighth died soon after birth). The mother – sarcastic, suspicious and frequently self-absorbed – lives to 103, many years after her husband’s death, and exerts great power over her querulous, aging offspring to the bitter end even as she physically shrinks to take on a wraith-like appearance.
Mother Land is an often riveting (if sometimes repetitive) exploration of family dynamics and of the aging process and recalls the William Faulkner line “The past is never dead, it’s not even past’’ and Tolstoy’s famous opening line from Anna Karenina:
“All happy families are alike; each unhappy family is unhappy in its own way.’’ (I have never been able to figure out what he meant about happy families….)
Theroux told WBUR: “There’s an epigraph in the beginning of the book. ‘Happy people have no history. And if this was a book about a jolly family all pulling together, pulling the oar, making noodle salad and having a great time with a chorus singing together, is that a book?”
Theroux is 76. Sometimes it takes a lifetime to understand what was going on in your own family and how it helped make you who you are.
Most of the action takes place on Cape Cod, where Theroux, who grew up in the Boston area, lives about half the year, with the other half in Hawaii. He memorably evokes lovely and gritty aspects of that exurbanized sand spit, from the dirty snow to the thin soil to the pitch pines to the gray bungalows to the seafood restaurants. But some of the book happens in green, jungley southern Mexico too; Theroux, after all, is a travel writer.
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Such is American culture and public finance in A.D. 2017: The small town of Ledyard, Conn., is indefinitely closing its town library, citing state budget cutbacks. Ledyard is the home of one of the world’s largest casinos – Foxwoods -- which, with the huge Mohegan Sun casino, in nearby Uncasville, Conn., were promoted when they were built as barriers to state budget crises. Betting, er, trumps books any day. All that money flowing into town from magically thinking gamblers and yet the local library starves.
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This from conservative historian Niall Ferguson writing in The Boston Globe:
“In Rome,’ writes the brilliant Tom Holland in his book Rubicon: The Last Years of the Roman Republic, censoriousness was the mirror image of a drooling appetite for lurid fantasy.” Yes, that does sound familiar.
“In Holland’s telling, the Republic dies too imperceptibly to be mourned…. {T}he underlying causes were the self-indulgence and social isolation of the Roman elite, the alienation of the plebeian masses, the political ascendancy of the generals, and the opportunities all these trends created for demagogues.’’
“The Founding Fathers knew very well that the independent nation they proclaimed in 1776 might ultimately find itself in the Roman predicament. In particular, they feared the advent of a populist demagogue. As Alexander Hamilton warned in the first of The Federalist Papers, a ‘dangerous ambition . . . often lurks behind the specious mask of zeal for the rights of the people. . . . Of those men who have overturned the liberties of republics, the greatest number have begun their career by paying an obsequious court to the people; commencing demagogues, and ending tyrants.”’
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With the re-election of Xi Jinping as the most powerful leader of the Chinese Communist Party since Mao, we face the prospect of a competent, supremely well-informed, disciplined and corrupt dictatorship, mixing elements of communism, fascism and state-directed capitalism, facing off against an incompetent, ignorant, undisciplined, demagogic and corrupt U.S. leader presiding over a decaying and confused democracy. I bet on China winning, for now.
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Georgia is moving back to paper ballots from electronic voting to make it more difficult for Russians and other bad actors to pervert their elections. All states should do the same.
Related Slideshow: GoLocal: Benchmark Poll, October 2017
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