Month: April 2023

William F. Buckley, Sr. Spent $100,000 to Fund His Son’s Entrepreneurial Start-Up: National Review

In my Openness book, I give reasons why risky innovative start-ups at fragile early stages almost always need to be substantially self-funded. When close relatives invest, I include that as self-funding.

(p. A15) . . . “William F. Buckley Sr.: Witness to the Mexican Revolution, 1908-1922,” [is] a fascinating if uneven book by the independent historian John A. Adams Jr.

. . .

The business climate in Mexico was promising for foreigners like the Buckleys, thanks to the pro-development policies of its autocratic president, Porfirio Díaz, who would rule the country for more than three decades.

Buckley’s prominence among the American expatriate community made him a natural conduit between officials in the U.S. and Mexico once the latter country was plunged into chaos following the ouster of Díaz in 1911. Buckley was Zelig-like, cropping up repeatedly at key moments. He visited the U.S. Embassy in February 1913 during the Decena Tragíca (Ten Tragic Days), when Francisco Madero, Díaz’s successor, was overthrown in a coup led by Gen. Victoriano Huerta, instigating a spasm of violence that killed thousands in Mexico City.

. . .

Buckley favored Huerta, serving as the regime’s legal counsel in negotiations with the U.S. aimed at preventing hostilities between the two nations. He was thus dismayed by the ascendance of Venustiano Carranza and, later, Álvaro Obregón. Both leaders endorsed the Mexican Constitution of 1917, including Article 27, which asserted national ownership of natural resources while circumscribing the economic power of the church. These provisions horrified Buckley, who was a staunch believer in free-market capitalism as well as a devout Roman Catholic. In the bulletin of the American Association of Mexico, an advocacy group he founded in 1919, Buckley denounced the “dangerous Bolshevist movement” that had taken root in Mexico.

. . .

. . ., Mr. Adams consulted with several Buckley family members, including a descendant based in Mexico City, as well as Judge James L. Buckley, the sole survivor among the 10 children born to Will and his wife, Aloise. Judge Buckley, who recently celebrated his 100th birthday, contributed a foreword acknowledging the importance of Mexico to the family’s understanding of itself, writing that “it had somehow permeated our DNA.”

. . .

As another of his offspring once said, Buckley’s experience in Mexico “deepened his frontier suspicions of autocratic [leaders] (and big government in general), and this attitude dyes all his children strongly.” Surely that was true of Buckley’s favorite son, William F. Buckley Jr., who, after serving a short stint with the CIA in Mexico City (he, too, was fluent in Spanish), founded National Review in 1955, which remains one of the leading voices of the conservative movement. The elder Buckley helped fund his son’s upstart venture with a $100,000 contribution from a fortune that traced its origins to Mexico during the most tumultuous period of that nation’s history.

For the full review, see:

Andrew R. Graybill. “BOOKSHELF; Conservatism’s Mexican Roots.” The Wall Street Journal (Saturday, March 27, 2023): A15.

(Note: ellipses, and bracketed word, added.)

(Note: the online version of the review has the date March 26, 2023, and has the title “BOOKSHELF; ‘William F. Buckley Sr.’ Review: Conservatism’s Mexican Roots.”)

The book under review:

Adams, John A., Jr. William F. Buckley Sr.: Witness to the Mexican Revolution, 1908–1922. Norman, OK: University of Oklahoma Press, 2023.

78% of Americans Not Confident Children Will Be Better Off

(p. A2) An overwhelming share of Americans aren’t confident their children’s lives will be better than their own, according to a new Wall Street Journal-NORC Poll that shows growing skepticism about the value of a college degree and record-low levels of overall happiness.

The survey with NORC at the University of Chicago, a nonpartisan research organization that measures social attitudes, showed pervasive economic pessimism underpins Americans’ dim hopes for the future. Four in five respondents described the state of the economy as not so good or poor, and nearly half said they expect it will get worse in the next year.

. . .

For more than three decades, NORC has asked Americans whether life for their children’s generation will be better than it has been for their own using its General Social Survey. This year 78% said they don’t feel confident that is the case, the highest share since the survey began asking the question every few years in 1990.

. . .

Some 56% of respondents said that a four-year college degree wasn’t worth the cost because people often graduate without specific job skills and with heavy debt.

For the full story, see:

Janet Adamy. “In U.S., Most Doubt Their Children Will Be Better Off, a New Poll Finds.” The Wall Street Journal (Saturday, March 25, 2023): A2.

(Note: ellipses added.)

(Note: the online version of the story has the date March 24, 2023, and has the title “Most Americans Doubt Their Children Will Be Better Off, WSJ-NORC Poll Finds.”)

The poll mentioned above can be viewed at:

WSJ/NORC Poll (March 2023).

Sam Bankman-Fried’s Brother Gabe Helped Send Misappropriated Funds to Dems, and Then Got “The Rock Star Treatment” From Biden White House

(p. B1) The group, Guarding Against Pandemics, raised more than $22 million in its first full year in 2021, turning it into an overnight lobbying force in Washington. The group’s founder, Gabe Bankman-Fried, a former legislative assistant, started getting the rock star treatment: two White House meetings with senior staff and invitations to speak on panels with government officials.

But almost all the money raised by Guarding Against Pandemics appears to have come from Gabe Bankman-Fried’s brother, whom federal prosecutors have accused of misappropriating billions of dollars from customers of his crypto exchange, FTX. The collapse of FTX prompted federal authorities to investigate allegations (p. B6) that sweeping fraud drove the exchange into bankruptcy in November [2023], as well as potential campaign finance law violations by both brothers.

Federal prosecutors in Manhattan have charged Sam Bankman-Fried, 31, with orchestrating a scheme to evade limits on corporate political donations. Prosecutors have said he recruited FTX executives and others to serve as proxies for the crypto exchange and make tens of millions of dollars in illegal political donations using customer money.

The authorities are investigating whether Gabe Bankman-Fried, 28, and some of his colleagues were part of the same so-called straw donor scheme, five people familiar with the matter said, speaking on the condition of anonymity. And they are trying to determine whether he knew some of the funds that his organization received had been misappropriated from customers.

Last month, a top FTX executive, Nishad Singh, pleaded guilty to using company money to make millions of dollars in straw donations to Democratic campaigns and committees.

. . .

The Bankman-Fried brothers relied on a small set of political consultants to guide their spending, applying the principles of effective altruism, the philanthropic movement that has a large following in the tech industry. A top adviser to both brothers was Michael Sadowsky, a committed effective altruist who had worked with the younger Mr. Bankman-Fried at the data firm Civis Analytics.

. . .

With a $25 million cash infusion from Sam Bankman-Fried, Mr. Sadowsky’s PAC became an instant force in Democratic politics. His group supported dozens of progressive candidates and got widespread attention when it spent more than $11 million on an unsuccessful House primary candidate in Oregon, an astonishing sum for such a race.

. . .

Two other key figures in the Bankman-Frieds’ political network had ties to prominent Democrats: Jenna Narayanan, a former political adviser to the billionaire investor Tom Steyer, and Sean McElwee, the founder of Data for Progress, a progressive think tank.

For the full story, see:

Matthew Goldstein, David Yaffe-Bellany and Lora Kelley. “Fraternal Turn to FTX Inquiry.” The New York Times (Friday, March 24, 2023): B1 & B6.

(Note: ellipses added.)

(Note: the online version of the story has the same date as the print version, and has the title “The Younger Brother Caught in the Middle of the FTX Investigation.”)

Corporate Fraud Index “Is the Highest in Over 40 Years”, Portending Economic Woes

(p. A2) Manipulation of earnings from Corporate America is on the rise, an ominous omen for the U.S. economy.

That is the conclusion of new research on accounting fraud, using a technique that flagged Enron as an earnings manipulator several years before the energy company’s spectacular 2001 implosion.

Unless you study accounting, you have likely never come across the M-Score, which is the number underlying both the Enron episode and the economywide concern now. The “M” is for manipulation, and uses a company’s financial statements to determine whether it is engaging in manipulation.

. . .

“We think this is a measure of misinformation in the economy,” said Dr. Beneish. The new aggregate measure was published in a December [2022] paper, and the latest data—compiled in March [2023] and shared with The Wall Street Journal—shows that the collective probability of fraud across major companies is the highest in over 40 years.

For the full commentary, see:

Josh Zumbrun. “Signs of Fraud Flash Warning for Economy.” The Wall Street Journal (Saturday, March 25, 2023): A2.

(Note: ellipsis, and bracketed years, added.)

(Note: the online version of the commentary has the date March 24, 2023, and has the title “THE NUMBERS; Accounting-Fraud Indicator Signals Coming Economic Trouble.”)

The December 2022 paper mentioned above is:

Beneish, Messod D., David B. Farber, Matthew Glendening, and Kenneth W. Shaw. “Aggregate Financial Misreporting and the Predictability of U.S. Recessions and GDP Growth.” The Accounting Review (Dec. 2022), DOI:10.2308/tar-2021-0160.

“The Reliability of Science Is Based” on Free Speech

Theoretical physicist Carlo Rovelli’s argument should be pondered by global warming and Covid scientists who want to censor and cancel those with whom they disagree. They should also read John Stuart Mill’s On Liberty.

(p. C5) Science is a process that builds upon existing theories and knowledge by continuously revising them. Every aspect of scientific knowledge can be questioned, including the general rules of thinking that appear to be most certain.

. . .

Consider a folk healer’s herbal medicine. Can we say this treatment is “scientific”? Yes, if it is proven to be effective, even if we have no idea why it works. In fact, several common medications used today have their origin in folk treatments, and we are still not sure how they work. This does not imply that folk treatments are generally effective. To the contrary, most of them are not. What distinguishes scientific medicine from nonscientific medicine is the readiness to seriously test a treatment and to be ready to change our minds if something is shown not to work.

Exaggerating a bit, one could say that the core of modern medicine is not much more than the accurate testing of treatments. A homeopathic doctor is not interested in rigorously testing his remedies: He continues to administer the same remedy even if a statistical analysis shows that the remedy is ineffective. He prefers to stick to his theory. A research doctor in a modern hospital, on the contrary, must be ready to change his theory if a more effective way of understanding illness, or treating it, becomes available.

. . .

What makes modern science uniquely powerful is its refusal to believe that it already possesses ultimate truth. The reliability of science is based not on certainty but on a radical lack of certainty. As John Stuart Mill wrote in “On Liberty” in 1859, “The beliefs which we have most warrant for, have no safeguard to rest on, but a standing invitation to the whole world to prove them unfounded.”

. . .

There is no secure method for avoiding error. Our point of departure is always just the ramshackle, error-filled totality of what we think we know. But uncertainty does not make knowledge worthless. If our theory is contradicted by experiment, this remains a real fact, solid as rock, even if we don’t yet know with clarity where our mistake lies. The fact that the assumptions in our reasoning can be mistaken doesn’t change the fact that scientific reasoning is our best cognitive tool.

For the full essay, see:

Carlo Rovelli. “The Best Reason to Trust Science.” The Wall Street Journal (Saturday, March 11, 2023): C5.

(Note: ellipses added.)

(Note: the online version of the essay has the date March 9, 2023, and has the same title as the print version.)

Rovelli’s essay quoted above is based on his book:

Rovelli, Carlo. Anaximander and the Birth of Science. New York: Riverhead Books, 2023 (2011).

Mill’s wonderful defense of freedom, mentioned above, is:

Mill, John Stuart. On Liberty and Other Essays, Oxford World’s Classics. New York: Oxford University Press, USA, 2008 (1859).

Insurance Companies Leave California Due to Over-Regulation

(p. A13) The recent floods and wildfire season have also have saddled insurance companies with as much as $1.5 billion in losses. Insurance markets could weather these blows, but California’s government-controlled insurance system won’t let them. Thus, insurers are pulling out of the state or reducing their underwriting, leaving many homeowners dependent on the bare-bones insurer of last resort: the state-created (though insurer-funded) Fair Access to Insurance Requirements Plan. As Jerry Theodorou, an R Street Institute insurance expert, observed in the Orange County Register, the number of FAIR Plan policies has increased 240% since 2017.

Car insurers are backing away, too, Mr. Theodorou notes, as losses increased 25% in one year, while premiums rose only 4.5%. That statistic offers insight into the problem. In 1988 California voters approved a ballot measure backed by tort lawyers that turned the insurance commissioner into a rate-setting czar.

. . .

This regulatory environment explains why California insurers can’t charge rates that reflect their actual risks. It also shows why there’s so little competition in the state’s insurance industry. Over the long run, competition keeps rates low. Insurance commissioners can certainly hold premiums down by edict, but the result is a contracting market. Homeowners then have little choice but to buy inadequate policies in a government-run marketplace.

For the full commentary, see:

Steven Greenhut. “Insurance Companies Are Quietly Fleeing California.” The Wall Street Journal (Saturday, March 18, 2023): A13.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date March 17, 2023, and has the same title as the print version.)

In Mexico City the Non-native “Jacaranda Is Kindness” and ”Always Creates Hope”

(p. 14) The Mexican president wanted cherry trees.

It was 1930, and President Pascual Ortiz Rubio had seen them lining the streets of Washington and desired the same beautiful spectacle for his country’s capital.

. . .

But winters in the capital were not cold enough for the cherries to fully blossom, . . .

. . .

For nearly 100 years, Mexico City residents have enjoyed jacaranda season: a “fascinating sorcery” that brings a little bit of the Amazon rainforest to urbanites’ doorstep, as Alberto Ruy Sánchez wrote in his 2019 book “Dicen las Jacarandas.” And when the flowers fall, “the sky blooms on the ground,” an unexpected burst of color at one’s feet.

Each spring, millions of people stroll around the country’s capital under an explosion of purple flowers. Each spring, the colorful fronds signal that it’s time to enjoy the warm season and walk on a fine rug of lavender petals. Come out and play, the jacarandas whisper with an inflection that’s both foreign and familiar.

“I was told this tree always creates hope,” said Alma Basilio, a psychologist posing for a selfie with a friend under the blossoms “The jacaranda is kindness.”

Jacarandas are actually not native to Mexico: The name comes from Guaraní, an Indigenous language spoken mainly in Paraguay and the tree has its origin in the Amazon.

. . .

Mr. Matsumoto made his way to the Americas in 1888 at the behest of a Peruvian entrepreneur who wanted a Japanese garden, the first in South America, on his property.

“From his faraway native land, the artist brought by ship beautiful plants,” reads a Peruvian volume about the residence where the garden was built. Shortly after seeing his work in Lima, a Mexican mining businessman hired him to create something for his hacienda.

Mr. Matsumoto would eventually become a wealthy entrepreneur who served several Mexican presidents: from the French-loving Porfirio Díaz to the revolutionary Álvaro Obregón and the nationalist Lázaro Cárdenas. With his flower shop, which he opened in 1898, Mr. Matsumoto introduced ornate floral arrangements to high society and created bouquets for stars of the golden era of Mexican film.

. . .

He didn’t introduce the jacarandas to Mexico — some may have already been growing in the wild — as much as domesticate them. He didn’t just suggest a more appropriate tree for the weather in the Mexican capital: He outfitted its streets with an aesthetic vision that resurfaces every spring.

For the full story, see:

Elda Cantú and Marian Carrasquero. “‘Sorcery’ in Mexico City: A Japanese Green Thumb’s Purple Legacy.” The New York Times, First Section (Sunday, March 26, 2023): 14.

(Note: ellipses added.)

(Note: the online version of the story has the date March 25, 2023, and has the title “‘Merchant of Landscapes’: The Lasting Footprint of a Japanese Gardener in Mexico.”)

Stanford Law School Associate Dean for D.E.I. Praises Students for Violating Free Speech of Federal Judge

(p. A15) Stanford Law School’s website touts its “collegial culture” in which “collaboration and the open exchange of ideas are essential to life and learning.” Then there’s the culture I experienced when I visited Stanford last week.

. . .

Before my talk started, the mob flooded the room. Banners unfurled. Signs brandished: “FED SUCK,” “Trans Lives Matter” (this one upside down), and others that can’t be quoted in a family newspaper. A nervous dog—literally, a canine—was in the front row, fur striped with paint.

. . .

When the Federalist Society president tried to introduce me, the heckling began. “The Federalist Society (You suck!) is pleased to welcome Judge Kyle Duncan(You’re not welcome here, we hate you!). . . . He was appointed by President Trump to the United States Court of Appeals for the Fifth Circuit (Embarrassing!).” And so on. As I began, the heckling continued. Try delivering a speech while being jeered at every third word. This was an utter farce, a staged public shaming. I stopped, pleaded with the students to stop the stream of insults (which only made them louder), and asked if administrators were present.

Enter Tirien Steinbach, associate dean for diversity, equity and inclusion. Ms. Steinbach and (I later learned) other administrators were watching from the periphery. She hadn’t introduced herself to me. She asked to address the students.

. . .

My “work,” she said, “has caused harm.” It “feels abhorrent” and “literally denies the humanity of people.” My presence put Ms. Steinbach in a tough spot, she said, because her job “is to create a space of belonging for all people” at Stanford. She assured me I was “absolutely welcome in this space” because “me and many people in this administration do absolutely believe in free speech.” I didn’t feel welcome—who would? And she repeated the cryptic question: “Is the juice worth the squeeze?”

I asked again what she meant, and she finally put the question plainly: Was my talk “worth the pain that this causes and the division that this causes?” Again she asserted her belief in free speech before equivocating: “I understand why people feel like the harm is so great that we might need to reconsider those policies, and luckily, they’re in a school where they can learn the advocacy skills to advocate for those changes.” Then she turned the floor back over to me, while hoping I could “learn too” and “listen through your partisan lens, the hyperpolitical lens.” In closing, she said: “I look out and I don’t ask, ‘What’s going on here?’ I look out and I say, ‘I’m glad this is going on here.’ ” This is on video, and the entire event is on audio, in case you’re wondering.

. . .

Two days later, Jenny Martinez and Marc Tessier-Lavinge, respectively the law school’s dean and the university’s president, formally apologized, confirming that protesters and administrators had violated Stanford policy. I’m grateful and I accepted. The matter hasn’t dropped, though. This week, nearly one-third of Stanford law students continued the protest—donning masks, wearing black, and forming a “human corridor” inside the school. They weren’t protesting me; I’m long gone. They were protesting Ms. Martinez for having apologized to me.

The most disturbing aspect of this shameful debacle is what it says about the state of legal education. Stanford is an elite law school. The protesters showed not the foggiest grasp of the basic concepts of legal discourse: That one must meet reason with reason, not power. That jeering contempt is the opposite of persuasion. That the law protects the speaker from the mob, not the mob from the speaker. Worst of all, Ms. Steinbach’s remarks made clear she is proud that Stanford students are being taught this is the way law should be.

For the full commentary, see:

Stuart Kyle Duncan. “My Struggle Session at Stanford Law School.” The Wall Street Journal (Saturday, March 18, 2023): A15.

(Note: ellipses added. In the original, the word “taught” is in italics.)

(Note: the online version of the commentary has the date March 17, 2023, and has the same title as the print version.)

Electrobiome Scientists Hope Manipulating Microcurrents Can Cure “Dozens of Ailments”

(p. 10) A decade ago Adee became especially intrigued by some highly secret taxpayer-funded work performed by the Pentagon’s ultra-costly fun factory, the Defense Advanced Research Projects Agency, inventors (they claim) of the internet. Lately the agency has been conducting, if that be the word, experiments on how best to harness the body’s minute pulses of cellular battery power, and turn them to military advantage — by killing people, that is. Might electricity help our G.I.s to whack our enemies ever more quickly and efficiently, tuning a soldier’s brain by jolting it with carefully targeted surges of electric shocks?

“We Are Electric” begins with a highly seductive scenario: Adee is flown from Europe to a clandestine Pentagon facility in the mountains of Southern California.

. . .

The lights dim, and a tsunami of simulated assaults then commences, overwhelming the scene. DARWARS — Ambush! they call it. Computer-generated enemy troops flood onto the field, squadrons of Humvees, faceless men with suicide belts, all attacking without mercy, and at all of which Adee fires her gun, wildly. Mostly, she misses.

Then the smoke clears, her DARPA handler-bros return and this time they turn on the juice. The lights dim once again, the faux-soldiers pour in and everything changes. Through the smoke and din and confusion of battle, there emerges from within Adee’s terrified mind the calculating confidence of a cool and logically-directed assassin. One by one she picks off the invaders. She fires and fires until her magazine is depleted. The battlespace falls silent. The smoke clears once again.

. . .

Dozens of ailments may yet be cured, say the believers, by manipulating the ions down the billions of miles of invisible circuitry that lies deep within our bodies.

Sally Adee has written an absorbing and fast-paced account of a field of research that could thus herald a whole new era of paradigm-shifting medicine. Moreover, she has done so without apparently drinking the Kool-Aid of today’s many bioelectricity boosters.

For the full review, see:

Simon Winchester. “Charged Up.” The New York Times Book Review (Sunday, March 26, 2023): 10.

(Note: the online version of the review has the date February 28, 2023, and has the title “Meet the Electrome. It Can Turn You Into an Assassin.”)

The book under review is:

Adee, Sally. We Are Electric: Inside the 200-Year Hunt for Our Body’s Bioelectric Code, and What the Future Holds. New York: Hachette Books, 2023.

Exercise Can Beat Meds in Countering Anxiety and Depression

(p. A15) . . . a new paper evaluating studies of the impact of exercise on mood shows that physical activity, of any kind, is just as effective as antidepressants at reducing feelings of anxiety and depression—and sometimes more effective.

Dr. Ben Singh, a research fellow at the University of South Australia, was the lead author of the study, which appeared in February in the British Journal of Sports Medicine. He and 12 other scientists combed the research literature for all randomly controlled studies published before 2022 that involved adding exercise to a person’s “usual care,” to see how physical activity might relieve psychological distress.

. . .

“Any type of movement is effective: a bike ride, yoga or Pilates” said Dr. Singh. He mentioned that resistance training (like my Zoom workout) was best for reducing symptoms of depression, while yoga and Pilates were best at tamping down anxiety. “The higher the intensity, the better,” Dr. Singh said. “But just a walk around your neighborhood is effective, too.”

For the full commentary, see:

Susan Pinker. “MIND AND MATTER: Exercise Can Be the Best Antidepressant.” The Wall Street Journal (Saturday, March 25, 2023): A15.

(Note: ellipses added.)

(Note: the online version of the commentary has the date March 23, 2023, and has the same title as the print version.)

The “new paper” mentioned above is:

Singh, Ben, Timothy Olds, Rachel Curtis, Dorothea Dumuid, Rosa Virgara, Amanda Watson, Kimberley Szeto, Edward Connor, Ty Ferguson, Emily Eglitis, Aaron Miatke, Catherine E. M. Simpson, and Carol Maher. “Effectiveness of Physical Activity Interventions for Improving Depression, Anxiety and Distress: An Overview of Systematic Reviews.” British Journal of Sports Medicine (Feb. 16, 2023), DOI:10.1136/bjsports-2022-106195.

The “Affordable” Care Act Gives Huge Drug Subsidies to Rich, Urban “Nonprofit” Hospitals

(p. A1) A decades-old federal program that offered big drug discounts to a small number of hospitals to help low-income patients now benefits some of the most successful nonprofit health systems in the U.S.

Under the program, hospitals buy drugs at reduced prices and sell them to patients and their insurers for much more, often at facilities in affluent communities.

One participant is the Cleveland Clinic’s flagship hospital, which reported $1.35 billion in net income last year. The hospital doesn’t admit enough Medicaid and low-income Medicare patients to qualify for low-cost drugs under the program’s original requirements. But a quirk in federal law allowed the hospital to qualify as a “rural referral center,” despite its location near the center of Cleveland.

Despite the benefits, the program hasn’t resulted in new drug discounts for low-income Cleveland Clinic patients, nor has it caused the hospital to increase the financial assistance it offers to those who can’t afford care. (p. A10) The charity care the main hospital writes off represents less than 2% of its patient revenue, according to a Wall Street Journal analysis of hospital Medicare filings.

. . .

The hospital’s $1.35 billion net income figure for 2021, she said, includes investment returns.

Cleveland Clinic’s adoption of the drug-discount program at its main hospital in April 2020 produced about $136 million in savings on drugs that year, the spokeswoman said.

The federal drug-discount program, known as 340B after the statutory provision that created it, requires pharmaceutical companies to sell drugs to participating hospitals at reduced prices. The program has grown rapidly in recent years. It now includes about 2,600 nonprofit and government hospitals, which spent at least $38 billion on discounted drugs last year, according to the Health Resources and Services Administration, the federal agency known as HRSA that oversees the program.

What the hospitals do with their valuable discounts isn’t always clear.

The program doesn’t require participating hospitals to pass on drug discounts to patients, insurers or Medicare. There is no rule limiting how much they can charge for the drugs. They don’t have to report how much they make from such sales, nor do they have to spend any profits to benefit low-income patients.

. . .

The 2010 Affordable Care Act brought a big expansion of 340B, adding new categories including critical access hospitals, which are small, typically rural facilities, and rural referral centers, which are supposed to be rural hospitals that treat a large volume of patients, including many complicated cases.

Under the federal definition of rural referral centers, hospitals that aren’t in rural locations could still qualify if they meet other criteria—minimally, having at least 275 beds. There is no requirement to serve rural patients.

. . .

“We were trying to help rural hospitals,” said Robert Kocher, an Obama White House health adviser involved in crafting the ACA who is now at venture-capital firm Venrock. “It would not be our intention to have a medical center in Cleveland, Boston or Chicago be included.”

For the full story, see:

Anna Wilde Mathews, Paul Overberg, Joseph Walker and Tom McGinty. “Drug Discounts Aimed at Needy Boost Hospitals.” The Wall Street Journal (Wednesday, Dec. 21, 2022): A1 & A10.

(Note: ellipses added.)

(Note: the online version of the story has the date December 20, 2022, and has the title “Many Hospitals Get Big Drug Discounts. That Doesn’t Mean Markdowns for Patients.”)