Editorial Roundup: United States
Mar 28, 2023, 11:00 AM
Excerpts from recent editorials in the United States and abroad:
The Washington Post on breaking up human organ monopolies
A proposed overhaul of the system that governs how human organs are procured, transported and transplanted in the United States could save many lives — if the Biden administration succeeds in breaking up the monopoly of the network that currently runs it.
Some 106,000 Americans are on an organ waiting list, and 22 die each day in want of organs such as kidneys, livers and hearts, according to the National Academies of Sciences, Engineering and Medicine. Many of these deaths are preventable. A 2018 Post analysis found that tens of thousands of potentially usable organs go uncollected every year. If this resource were better managed, the organ waitlist could be substantially cut or eliminated. More people would live.
A big part of the problem is that monopolies run the organ procurement system. Across the country, 56 “organ procurement organizations” have exclusive control over collecting organs in their respective regions. On the national level, the United Network for Organ Sharing (UNOS), a quasi-governmental agency, is supposed to oversee these regional organ procurers and run the logistical operation that matches organs with doctors, hospitals, labs and, ultimately, patients. Yet UNOS, too, is effectively a monopoly, having held the contract for running the system since it was created nearly 40 years ago.
With no competition, performance suffers. Independent reviews have found big problems, particularly in the technology UNOS uses to get organs from organ procurement organizations to the right patients at the right transplant centers, which critics complain still relies excessively on manual data entry. The system is prone to crashing, as it did for 40 minutes in February. This sort of failure could render unhealthy a freshly procured organ if it meant a delay in transporting it.
Nationally, more than one-fifth of recovered kidneys are not transplanted into needy people, a rate far worse than in peer European countries. There have been preventable — and deadly — snafus. A Senate Finance Committee investigation attributed 70 deaths and 249 illnesses to mistakes in organ screening before transplantation. A well-meaning reform meant to get organs transplanted into the sickest patients first appears to have led to a rise in the number of wasted livers, according to a new Post analysis.
Organ transplant system officials are “15 times more likely to lose or damage an organ in transit as an airline is to lose or damage your luggage,” Sen. Elizabeth Warren (D-Mass.) said in a hearing last year. Sen. Charles E. Grassley (R-Iowa) noted accusations that the system is rife with “fraud, waste and abuse, criminality, deadly patient safety issues, and failure to recover organs.”
UNOS’s contract with the federal government is up for renewal this year, and Biden administration officials proposed Wednesday some major reforms. One reason UNOS has typically encountered little competition for the contract to run the organ transplant system is that there are few entities that can operate a logistics network and perform all of UNOS’s other tasks. So, federal officials want to break UNOS’s functions into separate contracts, attracting companies to bid for the opportunity to operate specific parts of the system. This could be particularly helpful if it induced companies that specialize in complex logistics to seek the contract to improve the organ transplant system’s IT operations; if organ logistics were operated as efficiently as FedEx package delivery, fewer may be lost.
Biden administration officials say they have the legal authority they need to proceed. But Congress should provide any funds that might be required, particularly to make the new contracts more attractive to outside companies. Lawmakers should also review the statutes governing the organ transplant system, ensuring that the administrations have all necessary powers.
There are other things that should be done as well to improve the system. Even a more efficient logistical operation cannot maximize the number of organs collected. That is why organ procurement officials should explore new avenues to persuade more deceased people’s families to allow organ donations. They should also promote the use of organs from less-than-ideal candidates, such as older people or those who have certain infections. There is reticence among some in the United States to accept such organs — but an imperfect liver is better than none for those on the waiting list. Once organs are removed from the body, it is vital that they move to their new hosts quickly, which requires better coordination among surgeons and hospitals so they are on call to operate.
U.S. officials should ensure that the organizations they put in charge of these efforts are up to the task. That will be much easier if the Biden administration stays on course.
The New York Times on putting children to work:
In February, the Department of Labor announced that it had discovered 102 teenagers working in hazardous conditions for a company that cleans meatpacking equipment at factories around the country, a violation of federal standards. The minors, ages 13 to 17, were working with dangerous chemicals and cleaning brisket saws and head splitters; three of them suffered injuries, including one with caustic burns.
Ten of those children worked in Arkansas, including six at a factory owned by the state’s second-largest private employer, Tyson Foods. Rather than taking immediate action to tighten standards and prevent further exploitation of children, Arkansas went the opposite direction. Earlier this month, Gov. Sarah Huckabee Sanders, a Republican, signed legislation that would actually make it easier for companies to put children to work. The bill eliminated a requirement that children under 16 get a state work permit before being employed, a process that required them to verify their age and get the permission of a parent or guardian.
Arkansas is at the vanguard of a concerted effort by business lobbyists and Republican legislators to roll back federal and state regulations that have been in place for decades to protect children from abuse. Echoing that philosophy, bills are moving through at least nine other state legislatures that would expand work hours for children, lift restrictions on hazardous occupations, allow them to work in locations that serve alcohol, or lower the state minimum wage for minors. The Labor Department says there has been a 69 percent increase since 2018 in the illegal employment of children.
The response in these states is not to protect those children from exploitation, but instead to make it legal. Voters in these states may support deregulation, but they may not know that businesses can use these bills to work children harder, cut their wages and put them in danger. There is time for them to persuade lawmakers to say no to these abuses.
Ms. Sanders, formerly the press secretary for President Donald Trump, made clear in her inaugural address in January the disdain for the protective role of government that is driving this effort. “As long as I am your governor, the meddling hand of big government creeping down from Washington, D.C., will be stopped cold at the Mississippi River,” she said. “We will get the overregulating, micromanaging, bureaucratic tyrants off of your backs, out of your wallets and out of your lives.”
Lawmakers in these states have been vigorously lobbied by industry groups who like the flexibility of teenage employees and say that more children are needed in the work force to make up for labor shortages. One of the principal lobbying organizations pushing these bills in several states is the National Federation of Independent Business, a conservative group that supports Republican candidates and has long opposed most forms of regulation, as well as the Affordable Care Act. It has issued news releases praising lawmakers for passing bills that let businesses hire more minors for longer hours, and taking credit for supporting these efforts.
The Arkansas governor’s spokesperson said in a statement that the work permit requirement was “an arbitrary burden on parents,” but opponents noted that many child workers don’t have parents or guardians to look after their interests. In the cleaning company case, several of the child workers were unaccompanied minors who recently came over the southern border, according to their lawyers. Soon, they won’t even have the state to approve their employment or working conditions.
The real target of these rollbacks is not after-school jobs at the corner hardware store; they will have a much bigger effect on a labor force that includes many unaccompanied migrant children who work long hours to make or package products sold by big companies like General Mills, J. Crew, Target, Whole Foods and PepsiCo. As a recent New York Times investigation documented, children are being widely employed across the country in exhausting and often dangerous jobs working for some of the biggest names in American retailing and manufacturing. (Several of those companies later told The Times that they would investigate any illegal practices and try to end them.)
Hundreds of children described in the Times report were working in violation of federal labor standards, which bar child workers from a long list of hazardous jobs and forbid children under 16 from working more than three hours a day or after 7 p.m. on school days unless they work on a farm. (Those under 14 are prohibited from working in all but a handful of jobs.)
Many of the minors crossed unaccompanied from Latin American countries and may not know when their employment violates the law. A 13-year-old who was burned with caustic chemicals while working for Packers Sanitation Services in Nebraska told investigators the accident occurred during a shift that lasted from 11 p.m. to 5 or 7 a.m., a direct violation of multiple federal laws. The Labor Department imposed a $1.5 million fine on the cleaning company, which is owned by Blackstone, one of the world’s largest private equity firms.
Despite the evidence that more children are being exploited and hurt in this way, state lawmakers are passing bills that defy the federal standards. They are inviting a court challenge, and, in effect, daring the Labor Department to come after them, knowing the department often lacks the manpower to prevent violations of federal law. The Ohio Senate, which passed a bill earlier this month extending working hours for minors under 16, in violation of federal standards, also approved a resolution urging Congress to do the same.
One of the worst bills, introduced by Republicans in Iowa, would allow 14-year-olds to work in industrial freezers, meat coolers and industrial laundries, and 15-year-olds to lift heavy items onto shelves. It is backed by, among others, the independent business federation, the Iowa Grocery Industry Association, and Americans for Prosperity, a conservative advocacy group backed by Charles Koch, the industrialist who supported many national efforts to deregulate businesses.
If states will not perform a role that has been fundamental for a century — protecting workers from abuse — the federal government will have to increase its efforts to do so. After the Times investigation was published, the Biden administration announced a series of new efforts to crack down on illegal child labor, many of which hold promise as possible deterrents. …
The administration has asked Congress for more enforcement money in its current budget, and for higher penalties. Neither request is likely to be granted, and immigration reform seems far in the distance. Protections against “oppressive child labor,” however, have been part of American law since the Fair Labor Standards Act was passed in 1938; dismantling those safeguards now puts young lives at risk.
The Wall Street Journal on President Joe Biden’s defense budget:
China’s Xi Jinping traveled to Moscow this week to commune with Vladimir Putin, cementing the new axis against the U.S. Compare that scene to President Biden’s proposed fiscal 2024 defense budget, which isn’t serious about matching American military power to growing threats.
To the extent the press is covering Mr. Biden’s $842 billion Pentagon budget, it is to note the number is large. Yet defense spending at 3% of the economy is low by historical standards. The Pentagon says the proposal is a 0.8% real increase over fiscal 2023, but that is based on an inflation fantasy. This is a defense cut, and not from an epiphany of fiscal restraint. Mr. Biden is choosing to put welfare entitlements over national security. The risks of his choice are worth examining:
• A Navy in shoal waters. The U.S. Navy is the beat cop for deterring bad behavior in the Pacific, but the U.S. fleet would shrink to 291 ships by 2028 from 297 now. The Biden Pentagon wants to retire ships prematurely, such as the cruiser USS Vicksburg, which taxpayers have spent hundreds of millions of dollars to upgrade for longer service.
The Navy is also telling the U.S. Marines to find another ride to work, declining to buy any San Antonio-class amphibious warships. This will wreak havoc on the production line and make it harder to grow the Navy to 355 ships, as Congress says it wants.
The Navy failed to submit a shipbuilding plan, and an institution that can’t articulate its strategy or reason for existing won’t command public support to grow. The Navy is already struggling to buy and maintain enough of the best platforms for deterring China, such as the Virginia-class attack submarine.
• An under-powered Air Force. The Air Force deserves points for buying 72 fighters, which is the minimum needed to keep inventory stable. Meanwhile, the service asks to retire 310 aircraft, and some of this is inevitable. The F-15C/Ds leaving Okinawa with no permanent replacement are structurally exhausted; the A-10 is 40 years old and too rudimentary to operate against adversaries like China.
The Air Force is making a worthy effort to deploy unmanned aircraft that work in teams with manned jets like the F-35, though these are years away from joining the fleet at scale. The service isn’t asking to increase its notoriously low flying hours, which would allow pilots to be ready for a fight over Taiwan. Increased investment in the B-21 bomber is good news, but the aircraft’s first flight is already slipping by a few months.
• A shrinking U.S. Army. The land force takes a deep cut in purchasing power with a budget that treads water at $185.5 billion. The active-duty Army is contracting to 452,000 from 485,000 as recently as fiscal 2022, despite missions and deployments that are steady or increasing.
The Army excuse is the tight labor market, but spending to recruit is a choice, and the war in Ukraine is a reminder that human talent matters as much as equipment. The shrinking Army is also a note to conservatives who want to carve up the ground force to build up the Navy and Air Force: Too late. It’s been done.
One bright spot is an effort to buy bombs in bulk. Defense officials tout $30.6 billion for munitions, up 12% over last year, and some will be procured through more efficient multiyear contracts. The Pentagon would buy 118 long-range antiship missiles, more than double the 48 in years past. But inventories are still well below the roughly 1,000 fired to defend Taiwan in some war games.
That the U.S. now must protect against running out of ammunition is a testament to how much American defenses have atrophied since the Cold War. Some compare Mr. Biden to Jimmy Carter as he presides over growing threats and hot inflation.
But that’s unfair—to Mr. Carter, who shook off his illusions about the Soviet Union late in his term and began the defense buildup that Ronald Reagan accelerated. Congress will no doubt try to improve the Biden blueprint, which is a relief, but Americans should know this President isn’t doing nearly enough to protect them from the world’s multiplying dangers.
The Los Angeles Times on Congress scapegoating TikTok:
TikTok Chief Executive Shou Zi Chew did not have a successful appearance before the House Energy and Commerce Committee on Thursday.
He did not assuage skeptical members of Congress that his enormously popular social media platform can isolate itself from Chinese government interference. Nor did he convince them that TikTok has done enough to address misinformation, protect children from harmful material or remove content that violates its code of conduct. It didn’t help his cause when Republican Rep. Kat Cammack of Florida played a video showing an animated handgun firing in a post threatening the committee and its chairwoman. The video had been on TikTok for 41 days and was removed during the hearing.
Chew’s company was lambasted for more than five hours, a show of rare bipartisan consensus that something needs to be done about TikTok, but exactly what Congress or the Biden administration can or should do remains unclear.
It also became apparent that while TikTok is currently the target of federal inquiry, primarily because of growing anxiety with China’s power and influence, the concerns over user privacy, misinformation and impacts to children are not unique to TikTok.
Harmful practices are baked into the business models of social media platforms, including Instagram, Snapchat, Facebook and YouTube. An increasing number of state legislatures and lawsuits are attempting to force companies to take more responsibility for building safer products. Congress too should be wielding its regulatory authority more broadly to protect consumers, not just TikTok users.
Indeed, TikTok is similar to other social media apps that vacuum up personal data, wrote Ron Deibert, director of the Citizen Lab at the University of Toronto, which analyzed the TikTok app. He added that “most social media apps are unacceptably invasive by design, treat users as raw material for personal data surveillance, and fall short on transparency about their data sharing practices,” which is why comprehensive privacy legislation is needed.
Despite several years of debate, Congress hasn’t been able to move a bill that would protect data privacy on the internet. Lawmakers got close last year with the American Data Privacy and Protection Act, but there were questions over whether the bill would override California’s strong privacy law — which would be a mistake. House members said Thursday that they are trying again this year to pass the bill, which is good, but they should be catching up to California, not clawing back the state’s leading edge privacy protections.
The immediate question before federal lawmakers is how to address the national security concerns posed by TikTok’s ties to China. The app was created by Chinese internet technology company ByteDance. Federal agencies have raised alarm because Chinese law requires that tech companies allow government access to user data. There’s also concern that with the platform’s reach — it has 150 million users, or nearly half the U.S. population — and its powerful algorithm, TikTok could be used as a tool to disseminate propaganda or disinformation.
The Biden administration has threatened to ban TikTok unless the app’s Chinese owners sell their stakes.
Chew tried to make the case that TikTok is a private company independent of the Chinese government and could build a firewall to ensure there is no foreign interference. But his argument was undercut by an announcement Thursday from the Chinese Commerce Ministry that would oppose the forced sale. China considers technology a national security issue and has the right under Chinese law to block the export of it.
If a sale is off the table, the Biden administration has limited options. An outright ban would raise significant technical and legal issues, including whether cutting off an extremely well-used mode of speech would violate the 1st Amendment. What is the U.S. going to do after TikTok? Shut down every popular Chinese- or foreign-owned app?
Besides, simply banning TikTok doesn’t address the larger problem. Regulations and policies that protect Americans’ online privacy and limit the potential for harm to users, young and old, are long overdue.
The Guardian on the Ukraine, Putin and war crimes:
It is entirely likely that Vladimir Putin may never be held fully accountable for his crimes. But the possibility of eventual justice grew somewhat brighter with the international criminal court’s decision last week to issue an arrest warrant for overseeing the abduction of Ukrainian children.
The compelling evidence of the forced transfer of thousands of children for adoption or to “re-education camps” is appalling. But this is only one of many horrors that Mr. Putin has unleashed on Ukraine. There is growing support for prosecuting him for the invasion itself, which would require the creation of a special tribunal as the crime of aggression is not within the ICC’s scope. These calls are made in part because it is usually hard, if not impossible, for war crimes investigators to prove that those at the top sanctioned atrocities on the ground. Mr. Putin can, however, be clearly linked to the abductions. Last month, the children’s rights commissioner, Maria Alekseyevna Lvova-Belova, indicted alongside the president, appeared on television thanking him for her “adoption” of a 15-year-old boy from Mariupol. This is the beginning of the case against Mr. Putin, not necessarily the end.
For now, it is more of an annoyance than a threat or even a serious obstacle to him. Russia is not a signatory to the Rome statute, the court’s founding document, and does not recognize its jurisdiction. The warrant may hinder his travels – member countries are supposed to arrest Mr. Putin if he visits – but governments have sidestepped such requirements in the past. As the ICC’s chief prosecutor, Karim Khan, observed, justice will be a matter of “stamina”. It may eventually catch up with the Russian president, as it did for Slobodan Milošević, if he falls from power. Most importantly, it may weigh in the minds of his officials and military leaders in the coming months. Any deterrent effect, however limited, can only be welcomed.
The ICC cannot succeed alone, however. It needs more support, including but not limited to greater financial backing. It has 40 investigators on the ground in Ukraine, yet funding has not increased accordingly. And though the Biden administration rescinded sanctions imposed on it by Donald Trump over the investigation of war crimes in Afghanistan by the U.S. and others, the Pentagon is reportedly blocking cooperation on Russia because it fears a precedent which could lead to the prosecution of Americans in future.
The U.S. has long maintained that the court does not have jurisdiction over non-signatories, even if the alleged crimes occurred in a country that is party to the treaty, such as Afghanistan. While 123 countries are party to the Rome statute, the U.S., like Russia and China, refused to join, undercutting the court’s credibility. Signing up would be the moral course, but is politically unfeasible. However, legal experts and some U.S. officials argue that the administration could and should still cooperate. Even if its citizens were indicted by the ICC, the U.S. could argue that the court should only prosecute when countries are incapable of bringing cases satisfactorily in domestic courts. American military and civilian courts have prosecuted soldiers for atrocities in Iraq, for example, though far from as frequently or effectively as needed.
Adopting this pragmatic course of cooperation with the ICC without full support would be an imperfect solution. But every support possible must be enlisted for an institution that, as Mr. Putin’s case shows, is doing essential work.