When Europe looks at America, the lens is often curiously selective. This week’s America Report contrasts a couple of news stories from the heartland of American news, with the more or less eclectic stories from this country that European media find interesting.
Mental Telehealth
America has a good health care system with high quality and, compared to its European counterparts, superior accessibility. Few Americans have ever had to endure the often excruciating waiting times that health systems in Europe force upon their patients.
The only area where U.S. health care consistently falls short is mental health care. This is a problem that has been raised in the context of mass-shooting events, where mentally ill individuals have gunned down school children or mall patrons. Sadly, generations of American politicians have failed to address this issue properly.
Inadequate mental health care is not a problem isolated to America, but one that most of the world is faced with. The one fortunate circumstance for Americans is that their health care system still predominantly relies on private funding and entrepreneurship. When given the right conditions, they have proven to be innovative and resilient.
The recent rise of telehealth medicine is a good example. As a result of deregulations initiated by President Trump, a new crop of mental health providers have tried their luck delivering their services online and over the phone. Their efforts were timely, proving particularly useful during the 2020 pandemic.
At the same time, there is a significant difference between somatic care and mental care, especially when provided over telehealth links. The Business Insider tells the story of an entrepreneur who wanted to incorporate artificial intelligence in the provision of mental care:
Crisis Text Line, now in its 10th year of operations, uses artificial intelligence to respond to people experiencing emotional abuse, self-harm, and suicidal thoughts … the help line created Loris to develop and sell AI software that could guide customer-service agents through live chats with customers using proven “de-escalation techniques, emotional-intelligence strategies, and training experience.”
So far so good. The problem is that much like everyone else, the companies that develop technology for this type of service have bills to pay. While most Americans have health insurance, using them to pay for mental health care can be difficult, especially if the patient has not yet reached his deductible—mandatory cash contribution—for the year. Furthermore, charging insurance plans, both private and public, can be onerous for health care providers.
On top of that, starting interaction with a person with emergency mental problems with questions about his or her insurance information is not a practical way to help that person.
For all these reasons, a crisis helpline for people with mental problems cannot reasonably charge its clients for contacting them, so they have to make money some other way. According to Business Insider, Crisis Text Line chose to commercialize data on its clients, i.e., sold that information to the software developer. The developer, in turn, could then use information “from people who were at the lowest point of their lives.”
This acute ethical problem is just one example of the multiple obstacles that lie in the way of a better American mental health system. Hopefully, as the industry moves forward, it can address it and self-regulate to a higher ethical standard. While the advance of AI-supported telehealth has been helpful to many, the entrepreneurs who make this health care service possible still have a long way to go in working out its moral problems. To the extent that those are tied to the financing model, perhaps it is time for a broader approach to mental health reform in America.
And a similar conversation in Europe, where—again—the problems with access to mental care are different, but no less prominent.
Election Integrity
One of America’s foremost election analysts, The Rasmussen Report, has published the results of a new opinion poll. The results are startling: of those who are likely to vote in next year’s election, 60% “think it is likely that cheating affected the outcomes of some races in last year’s midterm elections.”
Even more surprising is that 37% believe it very likely that cheating played a role in the election outcome. This number is almost twice as high as the 20% who say that it is “not at all likely” that cheating affected the election.
The Gateway Pundit provides more details, such as “50% say Mail-in voting makes it easier to cheat.” They also cite numbers showing that half of all likely voters believe that election officials “are ignoring widespread evidence of election fraud.”
These are alarming numbers that should have every elected official up in arms calling for immediate election-integrity reforms. Then again, in the true spirit of Joseph Heller’s Catch 22, if the allegations of cheating are correct, some incumbent elected officials benefited from it and therefore are probably less inclined to support such reforms.
Provided, of course, that cheating actually took place. The Rasmussen poll, comprehensive and qualitative as it is, neither proves nor disproves the allegations that there was cheating.
The Debt Limit
The United States of America is one of the more indebted nations in the world. It shares its habit of borrowing from future generations with practically every country in Europe. The U.S. Congress also shares another habit with the EU, namely that of stretching, bending, and even breaking its debt-limit rules. The venues vary, with the Europeans making a habit out of suspending the enforcement of their constitutional debt limit known as the Stability and Growth Pact. In the United States, they simply raise the statutory debt ceiling whenever government borrowing bounced up against it.
In Europe, they pretend that the credit card has no limit. In America, they raise the limit themselves, without asking the credit card company for permission.
That practice might be coming to an end, though. With the federal government’s debt now at almost $31.5 trillion, and some forecasts suggesting the interest payments on that debt could shoot past $1 trillion this year, the new Republican majority in the House of Representatives has gone to work to bring the United States government back to fiscal sanity. NBC News reports:
House Speaker [Republican] Kevin McCarthy released a debt limit bill Wednesday that he hopes to pass with Republican support, triggering a frantic push to gather the votes in his narrow majority.
Speaker McCarthy is operating under the threat of the federal government running out of money. Last year, the budget deficit paid for 18% of all federal spending, and the balance between revenue and outlays has not changed since then. This means that there comes a point during a fiscal year when Congress runs out of tax revenue and has to pay for the remainder of its spending with borrowed money.
That is where the debt ceiling, or debt limit, kicks in. If the debt is already as high as the statutory limit allows, then Congress cannot borrow more money without passing a law that raises the limit. This is the situation they are in now; usually, Congress simply raises the debt limit and keeps spending, but the Republican selected to the current House majority are more fiscally conservative than their predecessors. They wanted to take a fight with the Democrats over their irresponsible spending habits.
While the details in their bill are still a bit murky, the main theme appears to be to give President Biden a debt-limit increase, i.e., authorize more deficit spending, but to do it in exchange for measures to limit the growth of federal spending. President Biden has responded negatively to that, pledging to refuse to sign anything that is fiscally responsible. While the Republicans want to start a conversation in Congress and with the White House about actual limitations on spending—and maybe even actual spending cuts, neither the president nor the Democrats are interested.
Due to Congress being divided, with Democrats holding a slim Senate majority and Republicans controlling the House, it is unlikely that the Republican bill will go anywhere once it has been approved by the House. Once it has died in the Senate, the bill will have achieved two things: it will have put the federal government’s lousy budget discipline on the front page of the internet, and it will push the government closer to a so-called default.
The threat of a default—technically an unscheduled postponement of payments—has worked well in the past for Democrats. They have broken the will of fiscally responsible Republicans on more than one occasion, either by pushing the debt-limit discussion to the brink of a fiscal default (in 2011) or by simply mentioning it as a possible outcome of any debt-ceiling dispute. It remains to be seen if they can do the same now, but unofficial predictions from political insiders point in that direction.
What does Europe think is happening in America?
German news outlet Deutsche Welle believes that the Biden administration’s attempts to push coal out of America are worth a feature story from Gillette, a city in Campbell County up in the north-east corner of Wyoming. Unlike many similar reports from rural America, this story actually paints a relatively realistic picture of life in the so-called cowboy state (yours truly spent 14 years in Wyoming). The story is about a local community transitioning out of coal mining and into some kind of new, allegedly greener industrial future.
The German publication is comparatively unbiased in its story. It presents a realistic balance between the potentials and problems associated with the political intervention to end coal production and bring about something new:
Located on the site of Basin Electric Power Cooperative’s Dry Fork Station near Gillette, the [Wyoming Integrated Test Center] is developing technology aimed at sequestering coal’s harmful CO2 emissions before the combustion process. Following carbon capture, as the technology is called, there are longterm plans to store the CO2 deep in Wyoming’s soil. Resident oil companies are using the process to create higher pressure underground to pump oil more efficiently.
It is probably a consolation for Germans to forget their own government for a moment and instead hear about another government’s warped energy policies.
From Germany, we cross to France, where media outlet France24 also takes an interest in rural America. Its top story on America is about life in Los Algodones, a small Mexican town right across from the U.S. city of Yuma and bordering Arizona and California. This small town has become a hotspot for American dentists:
Every year, the tiny town of Los Algodones is crowded. But this tourism is … Americans in search not of sun and sand, but root canals and veneers. Around 600 dentists cram the four main streets of the town. They offer procedures far less expensive than in the United States.
Fewer regulations and lower costs of operating a business attract many health providers, primarily dentists, to Mexican towns just across the border from not just California, but Arizona, New Mexico, and Texas as well.
The eclectic news coverage, which carefully avoids the big stories about election fraud and the debt ceiling, continues into the outer rim of the EU. Finnish newspaper Hufvudstadsbladet had an article on April 4th about the indictment of former president Donald Trump. Since then, their main priority in terms of covering America for their readership, has been to write about ice hockey.
In Sweden, daily newspaper Aftonbladet focuses on the legal dispute over mifepristone, an abortion drug. On the day of the expected U.S. Supreme Court ruling, the Aftonbladet published an article with the basic facts of the legal dispute.
The America Report: Mental Health, Elections, and Debt
When Europe looks at America, the lens is often curiously selective. This week’s America Report contrasts a couple of news stories from the heartland of American news, with the more or less eclectic stories from this country that European media find interesting.
Mental Telehealth
America has a good health care system with high quality and, compared to its European counterparts, superior accessibility. Few Americans have ever had to endure the often excruciating waiting times that health systems in Europe force upon their patients.
The only area where U.S. health care consistently falls short is mental health care. This is a problem that has been raised in the context of mass-shooting events, where mentally ill individuals have gunned down school children or mall patrons. Sadly, generations of American politicians have failed to address this issue properly.
Inadequate mental health care is not a problem isolated to America, but one that most of the world is faced with. The one fortunate circumstance for Americans is that their health care system still predominantly relies on private funding and entrepreneurship. When given the right conditions, they have proven to be innovative and resilient.
The recent rise of telehealth medicine is a good example. As a result of deregulations initiated by President Trump, a new crop of mental health providers have tried their luck delivering their services online and over the phone. Their efforts were timely, proving particularly useful during the 2020 pandemic.
At the same time, there is a significant difference between somatic care and mental care, especially when provided over telehealth links. The Business Insider tells the story of an entrepreneur who wanted to incorporate artificial intelligence in the provision of mental care:
So far so good. The problem is that much like everyone else, the companies that develop technology for this type of service have bills to pay. While most Americans have health insurance, using them to pay for mental health care can be difficult, especially if the patient has not yet reached his deductible—mandatory cash contribution—for the year. Furthermore, charging insurance plans, both private and public, can be onerous for health care providers.
On top of that, starting interaction with a person with emergency mental problems with questions about his or her insurance information is not a practical way to help that person.
For all these reasons, a crisis helpline for people with mental problems cannot reasonably charge its clients for contacting them, so they have to make money some other way. According to Business Insider, Crisis Text Line chose to commercialize data on its clients, i.e., sold that information to the software developer. The developer, in turn, could then use information “from people who were at the lowest point of their lives.”
This acute ethical problem is just one example of the multiple obstacles that lie in the way of a better American mental health system. Hopefully, as the industry moves forward, it can address it and self-regulate to a higher ethical standard. While the advance of AI-supported telehealth has been helpful to many, the entrepreneurs who make this health care service possible still have a long way to go in working out its moral problems. To the extent that those are tied to the financing model, perhaps it is time for a broader approach to mental health reform in America.
And a similar conversation in Europe, where—again—the problems with access to mental care are different, but no less prominent.
Election Integrity
One of America’s foremost election analysts, The Rasmussen Report, has published the results of a new opinion poll. The results are startling: of those who are likely to vote in next year’s election, 60% “think it is likely that cheating affected the outcomes of some races in last year’s midterm elections.”
Even more surprising is that 37% believe it very likely that cheating played a role in the election outcome. This number is almost twice as high as the 20% who say that it is “not at all likely” that cheating affected the election.
The Gateway Pundit provides more details, such as “50% say Mail-in voting makes it easier to cheat.” They also cite numbers showing that half of all likely voters believe that election officials “are ignoring widespread evidence of election fraud.”
These are alarming numbers that should have every elected official up in arms calling for immediate election-integrity reforms. Then again, in the true spirit of Joseph Heller’s Catch 22, if the allegations of cheating are correct, some incumbent elected officials benefited from it and therefore are probably less inclined to support such reforms.
Provided, of course, that cheating actually took place. The Rasmussen poll, comprehensive and qualitative as it is, neither proves nor disproves the allegations that there was cheating.
The Debt Limit
The United States of America is one of the more indebted nations in the world. It shares its habit of borrowing from future generations with practically every country in Europe. The U.S. Congress also shares another habit with the EU, namely that of stretching, bending, and even breaking its debt-limit rules. The venues vary, with the Europeans making a habit out of suspending the enforcement of their constitutional debt limit known as the Stability and Growth Pact. In the United States, they simply raise the statutory debt ceiling whenever government borrowing bounced up against it.
In Europe, they pretend that the credit card has no limit. In America, they raise the limit themselves, without asking the credit card company for permission.
That practice might be coming to an end, though. With the federal government’s debt now at almost $31.5 trillion, and some forecasts suggesting the interest payments on that debt could shoot past $1 trillion this year, the new Republican majority in the House of Representatives has gone to work to bring the United States government back to fiscal sanity. NBC News reports:
Speaker McCarthy is operating under the threat of the federal government running out of money. Last year, the budget deficit paid for 18% of all federal spending, and the balance between revenue and outlays has not changed since then. This means that there comes a point during a fiscal year when Congress runs out of tax revenue and has to pay for the remainder of its spending with borrowed money.
That is where the debt ceiling, or debt limit, kicks in. If the debt is already as high as the statutory limit allows, then Congress cannot borrow more money without passing a law that raises the limit. This is the situation they are in now; usually, Congress simply raises the debt limit and keeps spending, but the Republican selected to the current House majority are more fiscally conservative than their predecessors. They wanted to take a fight with the Democrats over their irresponsible spending habits.
While the details in their bill are still a bit murky, the main theme appears to be to give President Biden a debt-limit increase, i.e., authorize more deficit spending, but to do it in exchange for measures to limit the growth of federal spending. President Biden has responded negatively to that, pledging to refuse to sign anything that is fiscally responsible. While the Republicans want to start a conversation in Congress and with the White House about actual limitations on spending—and maybe even actual spending cuts, neither the president nor the Democrats are interested.
Due to Congress being divided, with Democrats holding a slim Senate majority and Republicans controlling the House, it is unlikely that the Republican bill will go anywhere once it has been approved by the House. Once it has died in the Senate, the bill will have achieved two things: it will have put the federal government’s lousy budget discipline on the front page of the internet, and it will push the government closer to a so-called default.
The threat of a default—technically an unscheduled postponement of payments—has worked well in the past for Democrats. They have broken the will of fiscally responsible Republicans on more than one occasion, either by pushing the debt-limit discussion to the brink of a fiscal default (in 2011) or by simply mentioning it as a possible outcome of any debt-ceiling dispute. It remains to be seen if they can do the same now, but unofficial predictions from political insiders point in that direction.
What does Europe think is happening in America?
German news outlet Deutsche Welle believes that the Biden administration’s attempts to push coal out of America are worth a feature story from Gillette, a city in Campbell County up in the north-east corner of Wyoming. Unlike many similar reports from rural America, this story actually paints a relatively realistic picture of life in the so-called cowboy state (yours truly spent 14 years in Wyoming). The story is about a local community transitioning out of coal mining and into some kind of new, allegedly greener industrial future.
The German publication is comparatively unbiased in its story. It presents a realistic balance between the potentials and problems associated with the political intervention to end coal production and bring about something new:
It is probably a consolation for Germans to forget their own government for a moment and instead hear about another government’s warped energy policies.
From Germany, we cross to France, where media outlet France24 also takes an interest in rural America. Its top story on America is about life in Los Algodones, a small Mexican town right across from the U.S. city of Yuma and bordering Arizona and California. This small town has become a hotspot for American dentists:
Fewer regulations and lower costs of operating a business attract many health providers, primarily dentists, to Mexican towns just across the border from not just California, but Arizona, New Mexico, and Texas as well.
The eclectic news coverage, which carefully avoids the big stories about election fraud and the debt ceiling, continues into the outer rim of the EU. Finnish newspaper Hufvudstadsbladet had an article on April 4th about the indictment of former president Donald Trump. Since then, their main priority in terms of covering America for their readership, has been to write about ice hockey.
In Sweden, daily newspaper Aftonbladet focuses on the legal dispute over mifepristone, an abortion drug. On the day of the expected U.S. Supreme Court ruling, the Aftonbladet published an article with the basic facts of the legal dispute.
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