Why Strong Governments are Bad for Precarious Workers

rathgeb_precarious

Philip Rathgeb, author of the recently published Strong Governments, Precarious Workers: Labor Market Policy in the Era of Liberalization, chatted with our publicity manager Cheryl Quimba. Here’s their conversation:

What is Strong Governments, Precarious Workers about?

It examines why some European welfare states protect unemployed and ‘atypically’ employed workers better than others. While all countries faced the emergence of such precarious workers, some compensated them with better protection and training, whereas others reinforced new divisions within the workforce. The question is, why? Looking at the cases of Austria, Denmark, and Sweden in particular, I find that trade unions are the most consistent force in resisting precarious employment and welfare. What is most striking, however, is that left-right differences between political parties matter less for trade unions – and thus precarious workers – than differences between weak and strong governments. Only when governments are weak can trade unions enforce greater social solidarity in the interest of precarious workers. The book therefore challenges theories that attribute precarity to union clientelism.

Can you explain this relationship between strong governments and precarious workers?

The gradual stages of the liberalization era shifted the balance of class power from labor to capital, which created opportunities for employer associations to push governments in their preferred direction. Governments of the right as well as the left therefore stimulated job creation by liberalizing the labour market. Strong governments are unrestrained in this regard, because they are internally united and have enough seats in parliament. As a result, they can marginalize trade unions to prevent lengthy and costly negotiations. Weak governments, by contrast, need trade unions for consensus mobilization, which creates opportunities for trade unions to strike policy deals for precarious workers. Variations in government strength best explain why trade unions in Social Democratic countries like Denmark and especially Sweden faced remarkable defeats in labor market reform, whereas their counterparts in a Conservative country like Austria remained influential and could thus enhance the protection of precarious workers.

What motivated you to write this book?

What I find striking is the gradual breakdown of the long-term employment relationship in favour of flexible short-term jobs. Among the middle classes of my generation – the so-called “millennials” – this shift is often welcomed, because it can create greater autonomy in working life. You can switch jobs and adapt working hours according to your current life situation or desire for self-realization. This is certainly a great progress for well-educated people without problems in making ends meet or reconciling work-family life.

But I care more about the other side of this story: in-work poverty, unpredictable income, low protection when unemployed or retired. While “flexibility” means greater autonomy for some, it means greater insecurity for others. I wanted to understand when political actors respond to the social demands of workers that are unemployed or on temporary ‘atypical’ contracts, as they face the costs of growing flexibility on contemporary labour markets.

Why do you think this is important?

Precarity is associated with several trends that are detrimental to democracy and society. First, we know that precarious workers are less likely to vote, because they gradually lose faith in the political system. This refers to a process of political resignation so impressively captured by Marie Jahoda, Paul Lazarsfeld, and Hans Zeissel in their seminal study Die Arbeitslosen von Marienthal. I vividly remember reading this book when I was in high school, as it has shaped my way of thinking about unemployment ever since. Second, it is clear that precarious workers are more likely to face economic poverty, unequal life chances, poor health, and even an increased relative risk of suicide. Understanding how political actors respond to precarity is thus of great political and social significance in contemporary capitalism.

 

Philip Rathgeb is a post-doctoral researcher in the Department of Politics and Public Administration at the University of Konstanz.

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Why Strong Governments are Bad for Precarious Workers

Shaping a City, Ithaca, New York: A Developer’s Perspective

At 320 Pages with 115 photographs, published by Cornell Publishing, an Imprint of Cornell University Press, you will find Shaping a City a fascinating behind the scenes look at why and how Ithaca, NY has grown from a mud flat at the head of Cayuga Lake to the successful miniature metropolis it is today. For Ithacan’s, it is our story, our history, starting in the early 1800’s, and focusing on the most recent 40 years of real estate development. For readers beyond Ithaca, it will become the roadmap for how to shape your own small town from a vacant, under-utilized cross-roads to a vibrant, dense, thriving and attractive small city, and possibly —like Ithaca as recognized in a score of national publications—, turn it into one of the “Best Small Cities in the country.”

This book is my story of financial survival as I began renovating old houses and went on to be selected by the City and Cornell University as the Preferred Developer for Collegetown. It is the story of City politicians building the Commons pedestrian mall on our main street in downtown in 1974, and then rebuilding it again from 2013 to 2015.

It is the stories of over a dozen major developers and their projects, which have contributed to the revitalization of Ithaca—John Novar, Jason Fane, Gus and Nick Lambrou, Andy Sciarabba, Bill Downing, Travis Hyde Properties, Schon  Bloomfield, David Lubin, Joe Daley, Marc Newman and Bryan Warren, John Guttridge, David Kuckuk, Neil Patel, and others.

It is the story of how a group of us salvaged Center Ithaca, the largest building in downtown out of bankruptcy, and how philanthropist Jeb Brooks; music producer Dan Smalls; and our company, Travis Hyde, with assistance from the Tompkins Trust Company and the Ithaca Urban Renewal Agency, saved the 1600 seat historic State Theatre, and the 200 year old historic Clinton House from foreclosure and certain demolition.

It is the story of Ithaca Neighborhood Housing and its significant role in creating affordable housing in our community. It is the story of Carl Haynes and the Tompkins Cortland Community College purchase of the M&T Bank Building for its Ithaca Campus and as a source of income for the College. It is the story of the creation of Coltivare, an upscale farm-to-bistro restaurant that serves as a training laboratory for the Tompkins Cortland Community College students. It is the story of why and how our oldest bank, Tompkins Trust Company, chose to consolidate its operations and construct a new 7-story office building downtown.

And primarily, it is the story of the BID, our local business improvement district, the Downtown Ithaca Alliance, for which I served as founding member and president. Our Executive Director, Gary Ferguson has guided us through the formation of two, ten year Strategic Plans that have been created by the stakeholders of downtown, based on professional feasibility studies, the findings of  retail and marketing consultants, and approved by the City Council.

We have recognized that it is arts, dining, and entertainment that drive downtown revitalization, and we have formed a Tax Abatement Program that stimulates downtown development. There is much to appreciate, and much to learn, as developers, city and county staff and representatives, local banks, and often local philanthropists, work together in a spirit of cooperation and collaboration to create what has been recognized as one of the Best Small Cities in America

City centers are an under-utilized resource in our country and I invite you to read my book, and learn how the principles and values developed in Ithaca and set forth in Shaping a City, can perhaps be replicated in your community.

 Featured event:

Join #CornellPress author Mack Travis for Gallery Night: Book Release for Mack Travis’ Shaping a City this upcoming December 7th, 2019; an event hosted by Downtown Ithaca & The History Center in Tompkins County.

SHAPING


 

About the author of this blog post: As one of Ithaca’s major developers, as one of the founders, and former president of Ithaca’s Business Improvement District, and as a frequent lecturer at Cornell’s Graduate Program in Real Estate, Mack Travis is uniquely qualified to write this 40-year look back at the people and projects that have shaped Ithaca.

Shaping a City, Ithaca, New York: A Developer’s Perspective

The Economic Interpretation of History as a Way of Understanding American Politics

With the publication in 1913 of An Economic Interpretation of the Constitution of the United States, Charles Austin Beard (1874-1948) became one of the most famous, influential, and controversial historians in America.  His book initiated a trend that for two generations became dominant in the way American history was written and taught. The thirty-seven books that he wrote during his legendary career—some of them with his historian wife, Mary Ritter Beard—sold millions of copies. He was esteemed and reviled for arguing that from the country’s beginnings and at every turning point in its history, American politics had to be understood mainly through the motives and world view of economic elites.

The kinetic energy of the historical process in America did not suddenly stop with the Second World War, Beard contended. In the years immediately preceding that conflict, he took a leading role in what became known as the isolationist movement. Beard objected to this label, seeing nothing isolationist about following the advice given by George Washington in his Farewell Address, for the American people to mind their own business. Creating a society of republican virtue at home would be challenge enough for them, without assuming the burden of international responsibilities. Beard judged the Farewell Address to be the most profound statement ever issued about American foreign policy. The mislabeled isolationist movement sought to do no more than to honor the first president’s teaching about how the United States should relate to the rest of the world in a spirit of amity and comity, playing no favorites and resolutely thwarting all attempts to coopt American power and influence for partisan foreign ends.

When the fighting began in 1939, Beard opposed American intervention, claiming that at bottom the conflict had to do on both sides with the acquisition or retention of markets, territories, and resources, just as the First World War had done. The two wars were one war, in his view, with a twenty-year armistice in between. Both wars had imperialist motives. Even after Pearl Harbor, he continued to claim that the war fundamentally concerned not the evil of Hitler—as of December 1941 Stalin, our ally, was the greater criminal by far—but the greed of competing empires. In two classic works written after the war, he denounced the foreign policy of FDR as a masterpiece of deception about a fictitious war for the Four Freedoms, which served as a distraction from the real war for economic empire.

Beard never could accept the vulgate interpretation of the Second World War. In the triumphalist postwar years, he came under mounting attack as an unreliable historian and a man lacking in patriotism. His economic interpretation of history became increasingly marginalized, as consensus historians plighted to the cause of American exceptionalism dominated the field. Beard’s stock as a thinker continued its downward spiral during the Cold War, which he described at its outset as a straightforward imperialist contest between the United States and the Soviet Union. Whichever side won, the world would be subjected to an imperialist order. In no way a Marxist, he conceded that the imperialism practiced by corporate capitalism stood on a higher plane of morality than did the Stalinist variety. Nonetheless, Americans deceived themselves when they imagined the cardinal policies in peace and in war of their leaders to be about anything but imperial control.

Charles Austin Beard: The Return of the Master Historian of American Imperialism offers a fresh interpretation of the origins and development of “Beardianism,” as a way of understanding the connection between economics and politics in American history. The book is especially timely today because of the manifest way in which America’s policies for the maintenance and augmentation of its empire have confirmed his predictions of what the country’s fate would be in the aftermath of the “good war.”

austin beard


About the author of this blog post: Richard Drake holds the Lucile Speer Research Chair in Politics and History at the University of Montana where he teaches European and American history.

The Economic Interpretation of History as a Way of Understanding American Politics

How does an ideology win the hearts of people?

“Prof, can you talk about fascism at a students’ gathering?”

I was surprised to receive such an invitation from a student last month, which I happily accepted. I am not an expert of theories of Fascism, but I have many things to say about various fascist movements in the 1930s and early ’40s, especially those in East Asia. The student body was diverse in their origins, with many exchange students. They were politically and demographically very similar, however: liberal, cosmopolitan, well-educated, and young. I soon discovered that this gathering was organized not because of their academic interests in political ideologies per se, but their everyday fear of the rise of “fascism,” so to speak. One by one, students asked for practical strategies to fight fascism in contemporary society. The room was filled with anxiety.

I felt sympathetic. But at the same time, discussing what might constitute “fascism” appeared misdirected for the purpose of addressing their concern. More urgent is to examine why pseudo-fascism—xenophobia, racism, or exclusive nationalism—resonates so widely today. How could such a violent thought (with detrimental historical baggage) capture people’s hearts? This is also a chance for liberals to step back and question what we take for granted. What specific experiences made liberal ideas convincing and sacred in our own lives?

These questions, or in short, how and why people internalize an ideology, motivate my research on the Japanese empire. It is well-known that wartime Japan had a totalitarian character in many ways, with the wide swaths of people worshipping the emperor and willing to sacrifice their lives. It might be less known that it conducted similarly fervent totalitarian rule over its colonies, Taiwan and Korea. Youth mobilization appeared particularly successful—During World War II, hundreds of thousands of colonial youth applied to Japanese army recruitment each year. Scholars typically depicted this colonial “volunteer fever” as a product of relentless government coercion, persuasion, and brainwashing without much giving thought to the causal mechanism.

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My book, Nation-Empire: Ideology and Rural Youth Mobilization in Japan and Its Colonies, takes a different angle. Instead of assuming the state directly influenced individuals’ behavior, it focuses on thick layers of local social relationships that determined the value of state directives from the viewpoints of people. It offers a fine-grained analysis of twists and turns of social dynamics in four villages across the empire since the late nineteenth century up to the immediate postwar period—how the popularity of urban modernity and the emphasis on agrarianism shaped the mental worlds of young villagers, how the “cult of youth” affected family politics, what the shifts in landlord-tenant relationships meant to young people, how youth programs unexpectedly changed youth’s future prospects, and how these youth survived the postwar chaos, for example. Local battles generated strong emotions, and whatever they were, these emotions were often expressed as a firm belief in the imperial cause. Seen in this way, Japan’s ideological mobilization both in the metropole and colonies was a much more complicated process than previously assumed, but also had a distinct pattern.

Again, it is not the definition of an ideology (Japanese nationalism) that explains the widespread acceptance most persuasively. It is the social complexities that made people emotionally attached to that ideology.

This means that it would take deep investigative work to make an analogy between politics of the 1930s and that of today, far more than merely reviewing what the fascist ideology was. But I hope this would provide a pointer to students who are earnestly trying to account for and confront the rise of pseudo-fascism—go find out social dynamics and emotions at the local level!

NATION EMPIRE COVER

 


 

About the author of this blog post: Sayaka Chatani is  Assistant Professor of History at National University of Singapore, and the author of Nation-Empire: Ideology and Rural Youth Mobilization in Japan and Its Colonies.

How does an ideology win the hearts of people?

On Veterans Day, remember that civilians serve too

On Veterans Day, the nation thanks those who have served honorably in the United States armed forces in both peacetime and wartime. It should also be a time to remember that not all of the veterans of America’s foreign wars wear uniforms.

Civilians serve too.

Modern warfare, especially the counterinsurgency and nation-building missions that the armed forces have been called upon to perform in recent years, requires a range of civilian expertise.  This can involve base management or intelligence analysis.  It has also meant going outside the wire to be part of Provincial Reconstruction Teams, which work to bolster the performance of local governments as part of ongoing nation-building missions. This work is vital to the military’s exit strategy, and hence getting the troops home.

As I show in my book To Build as well as Destroy: The American Experience of Nation-Building in South Vietnam, civilians have been deploying to war zones for a long time.  In fact, the practice reached its postwar height in the Vietnam War.  This is something it is easy to miss if we rely on the standard history books and movies to gain our understanding of the war.

As well as a brutal guerrilla war, Vietnam was also a war of nation-building. The issue over which the war was fought was the governance of South Vietnam. Would it be united with Communist North Vietnam, or would it develop an independent, non-Communist government?  The latter was the U.S. preference, and over the course of the war over ten thousand civilians deployed to Southeast Asia to try to shape the development of South Vietnam’s government to enable it to defend itself from the Communist challenge.

They came from a variety of backgrounds and agencies – the State Department, the CIA, the Agency for International Development, even the Peace Corps. In the early years, some hitchhiked from postings elsewhere in Asia to join the nation-building mission.  Many were inspired by the ideals of development with an almost missionary zeal – they wanted to save the people of South Vietnam from the corruption, mismanagement and brutality of their own government. They often served deep in the countryside, where no American had ever gone before.

As American involvement in the Vietnam War expanded in the late 1960s, this nation-building apparatus grew in size as well.  In 1967, the Johnson administration created the Office of Civil Operations and Revolutionary Development Support (CORDS) to expand the nation-building mission. CORDS was headed by a civilian, and throughout its ranks thousands of military and civilian personnel worked side by side on the same mission, being exposed to the same dangers and writing each other’s efficiency reports.  Its “sandwich” structure meant that civilians gave orders to military personnel and vice-versa.

It was an experiment without precedent in American history and has not been repeated on such a scale since.

Civilians who have served in war zones have faced some unique burdens, both during the Vietnam War and today. They are all volunteers who usually must be granted permission by their host agencies to go overseas. Often these agencies see such deployments as a distraction from the “real” jobs their employees are supposed to be doing at home, and so serving can be harmful to careers.  As a result, the military has often struggled to attract enough volunteers. As of July 2018, 70% of the necessary positions for civilians in Afghanistan were unfilled.

So, this Veterans Day, spare a thought for these “expeditionary civilians”. They often serve in the shadows, and some pay the ultimate price.  They deserve to be honored, too.

to build as well


 

About the author of this blog post: Dr. Andrew J. Gawthorpe is Lecturer in History and International Studies at Leiden University in The Netherlands.  He has written for publications including Stars and Stripes, Foreign Affairs, and more.

On Veterans Day, remember that civilians serve too

Fashion Cycles

The language of fashion has long been used to dismiss various forms of literary scholarship. Most recently, that charge has been made against types of “post-critique”—methods of reading that seek alternatives to interrogating and demystifying a text’s unstated ideological commitments or implications. Yet, for decades, conservative critics have used the language of fashion to dismiss literature and scholarship that focuses on race, gender, sexuality, and other categories of difference, or that engages “theory,” which usually means poststructuralist thought and its legacies. Ironically, however, some of the canonical works and movements that those literary traditionalists champion were also charged with being fashionable. Modernism, in particular, was parodied as modish before it was canonized, due in part to modernist writers’ preoccupation with style. In all of these cases, to be unfashionable or anti-fashion is to be aligned with more substantial and lasting social and political ideals and aims. But these claims disavow the critic’s own inevitable entwinements with fashion.

Many modernists themselves decried fashion as the epitome of superficial, commodified change.

But, as I argue in Modernism à la Mode: Fashion and the Ends of Literature, they also turned to fashion to consider what stylized objects might do in midst of war, imperialism, global capitalism, and on-going racial violence. In the work of Virginia Woolf, D.H. Lawrence, W.E.B. Du Bois, Nella Larsen, and F. Scott Fitzgerald, fashion is treated as a collective mood, a set of influential material objects, as well as a target of critique. Through these authors’ engagements with fashion, their writing becomes a means to understand and generate shared forms of feeling, to excite and animate readers’ bodies, or to imagine alternatives the very economic and political structures that fuel the global fashion system.

Via fashion, modernism becomes of the moment once again.

That is because modernist treatments of fashion intersect with contemporary work in literary and cultural studies that investigates the nature and force of collective emotions, the power of supposedly inanimate objects, as well as the way that beauty and style might fuel various political projects. Virginia Woolf’s treatment of fashion as a shared mood, for example, provides contemporary scholars of affect with ways to describe how seemingly personal feelings emerge with and through specific material, historical, and social conditions. In her anti-war essay Three Guineas, Woolf also provides a timely critique of the ways that seemingly liberal states disavow their fascist, imperialist underpinnings in part by celebrating uniforms—and, we might add, suits—as rational, utilitarian garments that supposedly transcend the vagaries of fashion.

As this example suggests, modernists treatment of fashion help us to reconsider facile distinctions between what is lasting and what is a passing phenomenon.

Given the on-going public disinvestment in higher education, demands that humanities research justify itself in market terms, and the virtual collapse of the “job market” in literary studies, it can seem urgent to champion what is unfashionable. But such a stance usually relies upon caricatures of literature, literary study, and of fashion. Instead, taking fashion seriously can help us to grapple with what it means to do work in the humanities right now.

modernism a la mode


 

About the author of this blog post: Elizabeth Sheehan is Assistant Professor of English and Women, Gender, and Sexuality Studies at Oregon State University. She is the author of Modernism à la Mode: Fashion and the Ends of Literature and co-editor of Cultures of Femininity in Modern Fashion, and will be attending The Modernist Studies Association Conference “Graphic Modernisms” in Columbus, Ohio, this November 8-11, 2018.

Fashion Cycles

Ideas and Things

Can we be forgiven for feeling overwhelmed by American culture and politics? Daily we read or more like hear about political polarization, deep ideological divides, a politicized Supreme Court, protests over race and history. Of course, there are histories and context to each issue and conflict, but sometimes what we need is something more fundamental. Behind all these things are ideas.

Intellectual historians have attracted larger and larger audiences that are hungry for explanations about the origins, contexts, and consequences of ideas that seem more powerful than ever. How do we understand a society riddled by profound contradictions—a society that transitioned, most recently, from Barack Obama to Donald Trump?

Ideas matter. A lot. Most people recognize as much. Intellectual history—the study of ideas in the past—thus has a lot to offer people. With my colleague Andrew Hartman, we have co-edited a collection conceived with this basic fact in mind.

We asked the authors to consider the following question: How might the methods of intellectual history shed light on contemporary issues with historical resonance? Their answers, while rigorous, original, and challenging, are eclectic in approach and temperament. For example, to understand the battle for the soul of the Democratic Party between the left and liberals (or supporters of Bernie Sanders and Hilary Clinton, respectfully), Hartman argues we need to grapple with the idea of freedom: “The left’s mission—the reason for its existence—was to expand the idea of political freedom, which was limited and went by the name of liberalism, to include economic freedom, a broadened conception that went by the name of socialism. The route to such freedom was class struggle.”

In another essay, David Sehat helps us locate a position from which to look critically at “originalism” or the idea that seems to capture the politicized nature of the present U.S. Supreme Court better than any other. Sehat explains: “Intellectual historians, like all historians, recognize [the] reality of historical change and growth, which is why they have tended to be some of the strongest critics of originalism. They know that the past is different than the present; that time is corrosive of meanings, arrangements, and cultural ideas at particular moments; that its corrosiveness leaves only remnants from the past that historians must pick over to make sense of now-lost worlds; and that the reconstruction of the past is always, as a result, only provisional and partial. As such there is not, historians have suggested, a set of interpretive rules to be followed by which original meaning will be revealed, since that meaning was contested at the founding and has evolved over the centuries.”

But when we come right down to the most pressing questions of our age, we all want to know “why Trump?”

In her essay tracing the genealogy of conservatism, Liza Szefel wonders in an era that is “post-truth” what good is intellectual history to such a question? She offers an answer: “A line of inquiry gaining traction attempts to move beyond rise and fall narratives to examine conservatism not merely as an ideology, grass roots social movement, or party, but as a sensibility, temperament, and mentality. Casting conservatism as an orientation brings into relief values shared by the left and right.” Indeed, intellectual history uses the tools of social history and cultural history to look at the world—as well as world views—of Trump’s working-class supporters. By doing so, Szefel demonstrates how intellectual history identifies the ideas behind all sorts things, including Donald Trump.


 

About the author of this blog post: Raymond Haberski, Jr. is Professor of History and Director of American Studies at Indiana University-Purdue University Indianapolis. He is the co-author of the upcoming #CornellPress title American Labyrinth: Intellectual History for Complicated Times. Take a closer look and pre-order your copy here.

Ideas and Things

East Asia’s unicorn builders: different strategies in Hong Kong, Singapore and Taiwan

Unicorns are increasingly running the streets of East Asia. In fact, policymakers in Singapore and Hong Kong wave the flag of their first unicorns with pride and Taiwan is on track to have its own unicorn. I am not talking the mythical animals adorning children’s storybooks. In the world of start-ups and venture capital, since 2013 a “unicorn” is understood to be a privately-owned (technology) start-up that achieves valuations in excess of $1 billion. A unicorn is also a validation that a start-up ecosystem is succeeding, and a key performance indicator used by governments.

From myth to reality: unicorns in Singapore, Hong Kong and (soon) Taiwan

Singapore has unicorns inhabiting its island, with Garena, Lazada, and Razer all comfortably achieving $1 billion valuations. But the ever-active and promoting Singaporean state isn’t stopping there. On Monday, October 2nd, the Singaporean parliament approved the “variable capital companies” (VCC) bill in an effort to further project the Lion City’s position as leading destination for asset management firms, particularly venture capital funds, to domicile and operate. In explaining the power of the new VCC structure, the Bill will provide a mechanism for overseas funds to be constituted as Singaporean. The Business Times asserts that one of the benefits to Singapore is that it “enhances Singapore’s position as a full-service international fund management centre”. This is a time-tested strategy in the Lion City.

GoGoVan, a logistics company, excited Hong Kong start-up enthusiasts in September 2017 as it achieved unicorn status. Finally, Hong Kong – and its government – had something to show for the rising support of start-ups and innovation (and within two years of the promotion of the Innovation & Technology Commission to Bureau level status).

For Taiwan, in May 2018 an electric scooter company called “Gogoro” was being picked as the likely candidate. This unicorn excitement came as the Taiwanese government announced in early 2018 that it promised to incubate its first unicorn by 2020 (Japan made a similar promise, through its J-Start-up program which launched in June 2018, that it would help build 20 unicorns by 2023).

These unabashed efforts to build unicorns is not a new phenomenon. In The Venture Capital State: The Silicon Valley Model in East Asia, I detail how each country purposefully, but differently than one another, helped catapult its local VC market to world-class size and operations. They don’t copy the real or imagined Silicon Valley model either. Even the “core elements” of the American legal and tax environment within which Silicon Valley VC emerged were not deployed in each case. Here’s a visual of the unique “yellow brick roads to Oz” – or, policies implemented with the aim of building a local VC market akin to Silicon Valley:

SILICON VALLEY

Why variation amidst convergence?

Though each country had the same aim – of building a local VC market that could support the growth of its local unicorn population – they all took different paths. The phenomenon reminds me of the Seinfeld-inspired play “I love you, you’re perfect, now change”. Each country’s policymakers fell in love with the idea of building Silicon Valley-like venture capital markets. This, they concluded, was part of the recipe for creating innovative firms, as well as ensuring vibrant financial markets. But after falling in love with the model, they changed it.

The Venture Capital State systematically explores why and how this change occurred as it has in these East Asian nations. And crucially, it explains that this adaption has been essential to success in East Asia, as elsewhere. It’s not about copying Silicon Valley in order to build local unicorns. It’s about local competitive advantage and approaches that reflect distinct environments.


 

About the author of this blog post: Robyn Klingler-Vidra is a lecturer in Political Economy at King’s College London, and the author of The Venture Capital State: The Silicon Valley Model in East Asia

East Asia’s unicorn builders: different strategies in Hong Kong, Singapore and Taiwan

Open wound: privatizing the Veterans Health Administration (VHA)

After spending more than 30 years researching health care delivery and nursing in the American private, profit-driven health care marketplace, I decided to explore how the Veterans Health Administration (VHA) delivers healthcare to 9 million of the nation’s veterans. Although neither I, nor anyone in my family is a veteran, I knew that the VHA had made impressive strides in implementing healthcare teamwork and improving patient safety. I knew the system was more accountable than the settings in which I –a non-veteran– get my healthcare. I had, however, no idea how impressive the system really is.

Nearly five years observing and interviewing veterans, their families, and their caregivers, showed me how the VHA delivers excellent care –at far lower cost than is available in the private sector– to the nation’s most complex patients.

In Wounds of War, I introduce you to the veterans who receive this care and the dedicated employees who deliver it. I take you into exam rooms, hospital wards, therapy groups, homeless and legal programs, and even cooking classes where the VHA caregivers are interacting with their patients.

And you’ll find that while our broader healthcare system delivers fragmented healthcare services, the VHA is grounded in an integrated model.

It has perhaps the only functioning mental and behavioral health system in the United States and delivers high quality geriatric and end of life care, all while simultaneously addressing patients’ housing, employment, and legal problems.

True, we should all have this kind of integrated care; but it is critical to veterans. After all, military training and service places them at high risk for mental health and substance abuse problems, suicide, chronic pain, homelessness, and legal issues, to name a few.

The VHA has done something really rare in American medicine. Today, many hospitals may advertise team-based care, but will not spend their resources to teach people to work together. The VHA has devoted enormous time and energy to train employees to work on teams. You’d be surprised to find out that a veteran’s primary care provider will actually consult with his or her mental health therapist or orthopedist, social worker, dietician, or physical therapist in a face-to-face conversation –not only through notes entered into a shared electronic medical record–, in order to determine the best plan of care.

Over and over again, I am reminded how lacking this kind of integrated care is outside the VHA.

The other day, a friend who’d been suffering for years from back pain, consulted with a high- priced orthopedic specialist. The specialist peered at his X-rays and declared that he wasn’t a candidate for surgery. Maybe, the physician told my friend, PT would work, or chiropractic, or acupuncture, or even yoga.  Check it out, he advised, as he rushed on to his next appointment. My friend was on his own.

If my friend was a veteran, he would have been scheduled for a visit with an integrative pain team. He would have been helped to enroll in the kind of pain classes that significantly reduce patients’ perceptions of pain and enhance daily function. He would have been scheduled for physical therapy and even signed up for classes of yoga and mindfulness meditation. And all of this would have been coordinated by caregivers, not left in the hands of a vulnerable patient.

Plus, it wouldn’t cost the veteran one dime.

Today, President Donald J. Trump and Congressional Republicans are attacking and trying to privatize the entire system, rather than to improve and strengthen it. They are following the game plan of ultra right wing-libertarian billionaires like the Koch brothers, who have carefully crafted a narrative of a broken government-run healthcare system. Aided and abetted by some Democrats who fail to understand the promise and problems of the VHA, they have passed legislation like VA MISSION and VA Accountability Acts. These laws will outsource more VHA care to the private sector, starve the system of resources, close facilities, vilify VHA employees and shift billionaires of tax payer dollars into the hands of private sector hospitals, doctors, mental health practitioners, medical equipment companies, and even real estate developers.

That’s why I hope you will not only read Wounds of War but also join me and the veterans, healthcare reform groups, and unions that are fighting for the VHA. We owe it to the veterans who have sacrificed for their country to maintain and improve a healthcare system designed to serve their specific needs. And it would also be an important step towards promoting the kind of successful models of care that should ultimately be available to all of us, not just veterans.


For more information on Wounds of War and the VHA, listen to our latest #1869podcast:

 

About the author of this blog post: Suzanne Gordon is an award winning journalist and author who writes about healthcare delivery, health care systems and patient safety. Her last book, The Battle for Veterans’ Healthcare: Dispatches from the Front Lines of Policy Making and Patient Care was published by Cornell University Press in May of 2017.  She received the Disabled American Veterans (DAV) Special Recognition Award for her work covering veterans’ healthcare. Ms. Gordon is the Senior Policy Fellow at the Veterans’ Healthcare Policy Institute.

Open wound: privatizing the Veterans Health Administration (VHA)

“Celebrate life” with our #CCAM Cancer Crossings giveaway!

September is Childhood Cancer Awareness Month (#CCAM), and both politicians and healthcare professionals are calling for a “Cancer Moonshot.” Thanks to exciting work in checkpoint inhibitors, anti-cancer vaccines and immunotherapy, we’re making major inroads against a disease that impacts 14 million people across the globe every year.

Yet to have real progress, we need to remember the lessons of a small team of doctors who reached the pinnacle of cancer research a half-century ago. Nicknamed the “Cancer Cowboys,” this extraordinary group of doctors took acute lymphoblastic leukemia from a 100 percent death sentence to the 90 percent survival rate it has today.

Not that long ago few in the medical community dared to take on cancer. In the 1960s, pediatric handbooks had little to offer about possible care and treatments. The Cancer Cowboys decided this was unacceptable.

Even though they were sometimes ostracized by their peers, these doctors developed modern-day chemotherapy practices and invented the blood centrifuge machine, helping thousands of children live longer lives. And despite being at hospitals scattered across the country – Buffalo, Memphis, Houston and Washington, D.C. – these doctors gathered every few months, often after-hours at each other’s homes, to discuss their latest clinical trials and findings.

“Of course, this was before cellphones and video conferencing,” says Dr. Donald Pinkel, who founded St. Jude Children’s Research Hospital in Memphis. “So, it wasn’t easy. But we made sure we always knew where we stood with each other.”

The patients and their families benefited greatly from such efforts. My younger brother, Eric, was diagnosed with leukemia in 1966. Soon after he was admitted to Roswell Park in Buffalo, New York, my mother was told she was now part of his medical team. That this team extended from the doctors to the nurses to the families themselves. “I appreciated that we were all in it together,” she says. “That we needed to be to make any real progress.”

Throughout my career, I’ve been fortunate to write about many successful teams and organizations, including the 1980 U.S. Olympic hockey squad, the 1968 St. Louis Cardinals and Detroit Tigers. But none was as impressive as the Cancer Cowboys.

Today, many more hospitals and healthcare systems have joined the efforts to stand up to cancer in all its forms. Yet in touring the country in support of Cancer Crossings -my book that’s part family memoir, part medical narrative-, I wonder if today’s health-care community can be as united, as determined, and as accessible as the Cancer Cowboys once were. In the end, our hopes for another Cancer Moonshot may well depend upon it.

Click here to start reading Cancer Crossings FOR FREE, with our “Celebrate life” on #CCAM GIVEAWAY, and for the month of September only!

 

Celebrate Life

 

 


 

Also of interest: Check out author Tim Wendel’s interview on our #1869podcast for more information on Cancer Crossings: A Brother, His Doctors, and the Quest for a Cure to Childhood Leukemia, and the story behind this wonderful book:

 


 

About the author of this blog post: Tim Wendel is the author of “Cancer Crossings: A Brother, His Doctors and the Quest to Cure Childhood Leukemia.” Part family memoir, part medical narrative, his latest work is a valuable voice in Cancer Awareness Month.

 

“Celebrate life” with our #CCAM Cancer Crossings giveaway!