Author: Art Diamond

Lack of Competition Allows Carlsbad Medical Center to Sue Thousands of Patients

(p. D1) An examination of court records by The New York Times found almost 3,000 lawsuits filed by Carlsbad Medical Center against patients over medical debt since 2015, more than 500 of them through August of this year alone. Few hospitals sue so many patients so often.

. . .

Carlsbad Medical Center is not the only hospital to have filed reams of lawsuits over unpaid bills. In Memphis, Methodist Le Bonheur Healthcare, a nonprofit hospital, filed 8,300 lawsuits from 2014 through 2018, including some against its own em-(p. D6)ployees, according to an investigation by the journalism nonprofit groups ProPublica and MLK50.

. . .

People across the country are coping with soaring medical costs, opaque pricing and surprise bills, but these issues are felt acutely in one-hospital towns like Carlsbad, where residents have few options for care — and must pay whatever prices the hospital sets.

“Hospitals that have little competition can negotiate higher rates, because the insurer wants that hospital in their network,” said Sara Collins of the nonprofit Commonwealth Fund.

. . .

Carlsbad Medical Center is owned by Community Health Systems, a chain of hospitals based in Franklin, Tenn. An investigation in 2014 by the Santa Fe New Mexican newspaper found that the three hospitals charging the highest prices in the state were all owned by that chain.

In 2015, the company paid $98 million to the federal government to settle charges that it had inflated revenue by admitting patients unnecessarily. Community Health Systems admitted no wrongdoing.

. . .

There are alternative hospitals near Carlsbad, but the closest is more than 40 minutes away, in the town of Artesia — which residents may find too far to drive to in an emergency.

. . .

Artesia General has no debt-collection suits against patients on record since 2015. Neither does Presbyterian Hospital in Albuquerque — which, at 450 licensed beds, is almost four times as large as the hospital in Carlsbad.

By contrast, other hospitals owned by Community Health Systems in New Mexico also regularly file suits over unpaid bills. Lea Regional Medical Center in Hobbs has filed almost 2,000 such suits since 2015. Mountain View Regional Medical Center in Las Cruces has filed about 2,000 suits against patients in that time; almost half of them came just this year.

In Carlsbad, these lawsuits flood the docket. District Judge Lisa Riley, who has been on the bench in Eddy County since 2011, estimated that about one-third of all civil cases that come across her desk involve unpaid medical debt.

. . .

She, too, was a target of the hospital before she became a judge. Her husband had been disputing emergency room charges when the hospital sued; the case was resolved and dismissed. (Judge Riley would not comment further, citing ethics restrictions that prohibit judges from making statements about matters that might appear in court.)

Judge Riley’s case and others from Carlsbad appear in an upcoming book called “The Price We Pay,” by Dr. Marty Makary, a surgeon at Johns Hopkins University who studies the costs of American health care and led the study of hospital suits in Virginia.

Debt collection is common in the health care industry, he said, but lawsuits are a traumatic way to force patients to pay. Normally hospitals simply refer unpaid bills to debt collectors; fewer file lawsuits and then garnish wages or place liens on homes.

In his study of Virginia, 36 percent of hospitals garnished the wages of patients owing money, with 10 percent doing so frequently. (Even his own institution, however, has come under fire for suing the poor.)

When seeking payment for medical bills, “Collections agencies may harass you with phone calls,” Dr. Makary said. “They may send a note to your credit bureau, but they’re not reaching into your paycheck.”

Many of these patients are low-paid workers with little savings. Dr. Makary’s study found that Walmart was the most common employer of those whose wages were garnished over medical bills. “These are hardworking Americans who did nothing wrong,” he said.

The cost of care differs from institution to institution, partly because hospitals have broad discretion in setting prices. Charges for the same services vary widely, even when hospitals have similar patient demographics, and the amounts billed have little relationship to quality.

If you are a hospital executive, “you could charge whatever you want,” said Dr. Makary. “You could charge $1 million for an X-ray.”

For the full story, see:

Laura Beil. “Proficient At Healing, And Suing.” The New York Times (Tuesday, September 3, 2019): D1 & D6.

(Note: ellipses added.)

(Note: the online version of the story was updated Dec. 2, 2019, and has the title “As Patients Struggle With Bills, Hospital Sues Thousands.”)

The Makary book mentioned above is:

Makary, Marty. The Price We Pay: What Broke American Health Care–and How to Fix It. New York: Bloomsbury Publishing, 2019.

Covid-19 Patents Provide Funding for Development of Future Vaccines

(p. A25) South Africa and India have petitioned the World Trade Organization to suspend some intellectual property protections from Covid-19 drugs, vaccines and diagnostic technologies. In support of the effort, Doctors Without Borders began a social media campaign urging governments to “put lives over profits,” warning of “pharma profiteering” and urging support for “#NoCovidMonopolies.”

. . .

Intellectual property rights, including patents, grant inventors a period of exclusivity to make and market their creations. By affording these rights to those who create intangible assets, such as musical compositions, software or drug formulas — people will invent more useful new things.

Development of a new medicine is risky and costly. Consider that scientists have spent decades — and billions of dollars — working on Alzheimer’s treatments, but still have little to show for it. The companies and investors who fund research shoulder so much risk because they have a shot at a reward. Once a patent expires, generic companies are free to produce the same product. Intellectual property rights underpin the system that gives us all new medicines, from psychiatric drugs to cancer treatments.

. . .

Eroding patent protections has far-reaching consequences.

Take “messenger RNA,” the technology platform that supports the vaccines from Pfizer-BioNTech and Moderna. Ozlem Tureci and Ugur Sahin, the wife-and-husband team at the helm of BioNTech, began exploring the use of mRNA more than 25 years ago and founded their company in 2008. Theoretically, mRNA can instruct the body to engineer proteins, including ones that increase immunity against infectious pathogens, cancers and rare genetic conditions. But the Covid-19 vaccines are the first truly successful applications of this technology. Scientists eager to explore future uses of mRNA will struggle to find investment if intellectual property protections are snatched away when others deem it necessary.

For the full commentary, see:

Thomas Cueni. “The Risk in Suspending Vaccine Patent Rules.” The New York Times (Saturday, December 12, 2020): A25.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Dec. 10, 2020, and has the same title as the print version.)

Silent Monks Keep Chartreuse Recipe Secret for Centuries

A firm may not need to patent its invention if it can keep the invention’s construction secret because its workers are isolated loners who view each other as brothers. Otherwise, good luck.

(p. 6) The Chartreux, also known as Carthusians, embrace a deeply ascetic existence in the western French Alps, observing customs that have barely changed since their order, one of Christianity’s oldest, was founded. They pass the days alone, praying for humanity and listening for God in the silence that surrounds them.

. . .

The Carthusians sustain this isolated lifestyle largely through the production and sale of Chartreuse, a liqueur the monks developed centuries ago. Like its mountainous namesake and the hue named after it, Chartreuse is sharp, bright, profoundly herbal.

. . .

The year was 1084, and seven men in search of isolation and solitude took refuge in southeastern France’s Chartreuse Mountains — “the emerald of the Alps,” as the French writer Stendhal called them.

According to legend, centuries later, in 1605, the order’s monastery near Paris received an alchemist’s ancient manuscript for a perfectly concocted medicinal tonic of about 130 herbs and plants: the “Elixir of Long Life.”

. . .

Today, the order sells about 1.5 million bottles of its three hallmark products annually, with the yellow and green liqueurs going for about $60, and cask-aged versions for $180 or more. About half its production run is sold in France, with the United States the largest export market.

. . .

Remarkably, among them, only two monks know the full 130-ingredient recipe.

“The secret of Chartreuse has long been the despair of distillers, just as the natural blue of forget-me-nots has been the despair of painters,” reads an 1886 document referred to in a recent history of the company and order. Father Holleran spent five years overseeing the distillation process, ordering ingredients and planning its production schedules. When he departed the site in 1990, he became the only living outsider to know the liqueur’s ancient formula.

“It’s safe with me,” he said. “Oddly enough, they didn’t make me sign anything when I left.”

This trade secret is both a marketing coup and a potential catastrophe. “I really have no idea what it is I sell,” a Chartreuse Diffusion president told The New Yorker in 1984. “I am very scared always. Only three of the brothers know how to make it — nobody else knows the recipe. And each morning they drive together to the distillery. And they drive a very old car. And they drive it very badly.”

Beyond the two monks who now protect it, all the others — Carthusian or not — involved in the production of Chartreuse know only fragments of the recipe.

. . .

Along its five-week distilling process, and throughout the subsequent years of aging, those two monks are also the ones who taste the product and decide when it is ready to bottle and sell. “They are the quality control,” said Emmanuel Delafon, the current C.E.O. of Chartreuse Diffusion.

. . .

Since 1935, the city of Voiron has served as the liqueur’s main manufacturing site. But in 2011, Mr. Delafon said, regional officials tightened distilling regulations, mostly aimed at the hazards — fires and vapor-fueled explosions, notably — of making such high-proof alcohol. After all, at 138 proof, the Elixir barely escapes the International Civil Aviation Organization’s threshold for dangerous goods.

Officials, more or less, deemed the Chartreuse distillery a refinery dangerously close to schools and homes. “It was the Eiffel Tower of Voiron, and then it became a problem,” Mr. Delafon said. “Completely unsupportable.”

Chartreuse looked for a new production home, and settled on a plot of land previously owned and farmed by the Carthusians starting in the 16th century. In 2017, they officially moved the distillation from Voiron to rural Aiguenoire, a 15-minute drive from Chartreuse’s mountainside headquarters and three kilometers from the source of wa-(p. 7)ter used to make the liqueur.

“The Carthusians came home,” Mr. Delafon said.

. . .

Over their nearly thousand-year history, the order has recovered from natural disasters, government expulsions, pestilence, poverty and impostors.

“Every time they’ve lifted themselves up, recovered and redefined themselves,” Ms. Druzkowski, the documentary maker, said.

That willingness to transform while remaining loyal to the order’s legacy is both a luxury and a safeguard during times of turmoil, Mr. Delafon said.

“When you have roots this deep,” he said, “it allows you to forget the short term and project your vision far in the future.”

For the full story, see:

Marion Renault. “Where Life, And an Elixir, Are Timeless.” The New York Times, SundayBusiness Section (Sunday, December 20, 2020): 6-7.

(Note: ellipses added.)

(Note: the online version of the story has the date Dec. 17, 2020, and has the title “An Elixir From the French Alps, Frozen in Time.”)

Entrepreneur Roger’s Reward for Solving a Puzzle: “A Bigger and More Complicated Puzzle”

(p. C6) Growing up in Battle Ground, Wash., James Rogers wanted to be an inventor.

. . .

Some 25 years since those afternoons with his “invention journal,” Mr. Rogers, 35, is now promoting a scientific discovery that could improve the global food-supply chain. His company, Apeel, applies an edible, plant-based coating to fruits and vegetables that extends their shelf life without refrigeration.

Apeel-treated avocados, limes, apples and cucumbers are already in some of the largest grocery chains in the U.S. and Europe. The startup now plans to expand into markets in Asia, Africa and Latin America, thanks to a $30 million investment from the International Finance Corp., the World Bank’s private-sector arm. The company Mr. Rogers launched in 2012 as a Ph.D. student is now valued at more than $1 billion.

. . .

Mr. Rogers has had to prove that more time not only reduced waste but also boosted sales. According to the Edeka Group, which runs more than 11,000 grocery stores in Germany, a pilot launch of Apeel avocados in nearly 3,000 stores in 2020 resulted in 50% less waste and a 20% rise in sales. Edeka swiftly agreed to carry Apeel avocados, oranges and clementines across all of its stores.

. . .

Mr. Rogers had been a student all his life when he launched Apeel at age 27. Did his youth and inexperience create problems? “It may have helped,” he says. “I didn’t know what I didn’t know, so I wasn’t overwhelmed.”

He has discovered, for example, that every fruit and vegetable has its own idiosyncratic supply chain, and Apeel works to pinpoint where time has the most value. He has also learned that delivering avocados to Europeans throughout the year means working with lots of different countries (Chile, Israel, Morocco, South Africa, etc.), each of which has its own unique supply chain, regulatory hurdles and distinct avocado.

“Working at a startup, you just have to really love puzzles,” he says. “Your reward for solving your current puzzle? A bigger and more complicated puzzle.”

For the full story, see:

Emily Bobrow. “WEEKEND CONFIDENTIAL; James Rogers.” The Wall Street Journal (Saturday, Jan. 9, 2021): C6.

(Note: ellipses added.)

(Note: the online version of the story has the date January 8, 2021, and has the title “WEEKEND CONFIDENTIAL; Apeel CEO James Rogers Wants to Extend the Shelf Life of Your Avocados and Oranges.”)

Can the Methods of ACT UP Bring Quicker Cures for Other Maladies?

Amar Bhidé has a thought-provoking article in which he asks the public choice question of how to overcome government regulators who slow the development of breakthrough drugs. He holds up, as a main example to ponder, the AIDs ACT UP movement that is often given credit for winning concessions from the FDA that spurred the availability of a drug cocktail that greatly extended and improved the lives of AIDs patients. The passages quoted below are from a review of a book that may be a promising source for learning more about what ACT UP did and how they did it.

(p. C3) In her 2012 book, “The Gentrification of the Mind,” Sarah Schulman delved into the silence still surrounding AIDS in America.

. . .

Schulman has gone from witness to a sort of living archive. She is a former member of AIDS Coalition to Unleash Power, the influential direct-action group committed to ending AIDS. Her new book, “Let the Record Show,” is based on 17 years of interviews she conducted with nearly 200 members of the organization.

. . .

The effect is rather like standing in the middle of that large room, where anyone could speak up and share an idea. Everyone is talking; small stories branch off, coalesce pages later. Speakers shade in one another’s stories, offer another angle, disagree passionately. You turn a page, and the same people have their arms linked together at a protest. Shadows start to fall; in squares of gray text, deaths are marked, moments for remembrance. So many people leave the room.

. . .

This is not reverent, definitive history. This is a tactician’s bible.

The organizational brilliance of ACT UP emerged out of necessity. The group was founded in 1987, incited by Larry Kramer’s famous call to action. The members were infected, their lovers were sick and dying. There wasn’t time to obsess over process, to contest every comma in a letter. The anarchistic framework asked only that members be “committed to direct action to end the AIDS crisis.”

. . .

When Schulman herself returns to the individual, it is to think again about the figure of the bystander. Why did these particular people rise to the moment and not others?

What thread connected an H.I.V.-positive stockbroker, a retired chemist from Queens, addicts, art students, lifelong activists, people who just happened to be in the next room at the center and wandered in, What was going on in there? For some it was their first experience of gay community; for others it was where they went when the community began to vanish. All of them became autodidacts in drug research, policy, media relations.

For the full review, see:

Parul Sehgal. “Remembering Those Who Stood Up.” The New York Times (Wednesday, May 5, 2021): C3.

(Note: ellipses added. In the original, the words NOT italicized above, were the only words that WERE italicized.)

(Note: the online version of the review has the date May 4, 2021, and has the title “A New Testament to the Fury and Beauty of Activism During the AIDS Crisis.”)

The book under review is:

Schulman, Sarah. Let the Record Show: A Political History of ACT UP New York, 1987-1993. New York: Farrar, Straus and Giroux, 2021.

The article mentioned above by Bhidé is:

Bhidé, Amar. “Constraining Knowledge: Traditions and Rules That Limit Medical Innovation.” Critical Review 29, no. 1 (Jan. 2017): 1-33.

“We Demand the Right to Have Rights”

(p. A9) An alliance of hip-hop musicians, writers, internationally known artists and Black activists has emerged as a driving force against censorship and government repression in Cuba, prompting a rare Communist government action: to hold talks about freedom of expression.

Hundreds of Cubans, many of them young artists from elite schools, protested in front of the country’s stately neoclassical Ministry of Culture in Havana’s upscale Vedado district, overnight on Friday. Protests of any sort are very rare in Cuba.

“We demand the right to have rights…. The right of free expression, of free creation, the right to dissent,” said Katherine Bisquet, a young poet, reading the activists’ manifesto by the light of cellphones outside of the ministry where streetlights were turned off. Videos posted on social media showed Ms. Bisquet saying that she spoke for all Cuban citizens.

. . .

Jake Sullivan, President-elect Joe Biden’s national security adviser-designate, in a tweet Sunday said that Mr. Biden supported the Cuban people in their struggle for liberty, called for the government to release peaceful protesters and said Cubans must be allowed to exercise “the universal right to freedom of expression.”

For the full story, see:

José de Córdoba and Santiago Pérez. “Cuba’s Creative Class Crafts United Protest Against Censorship.” The Wall Street Journal (Tuesday, December 1, 2020): A9.

(Note: ellipsis internal to third quoted paragraph, in original; ellipsis between paragraphs, added.)

(Note: the online version of the story was updated Nov. 30, 2020, and has the title “Cuban Leadership Confronts a Rare Dissident Movement.” Where the wording in the last quoted paragraph is slightly different between the online and print versions, the passage quoted above follows the online version.)

Risk Averse Family Firms with Large Cash Reserves Can Last 1,000 Years

Is longevity for firms a noble goal? Or do humans usually flourish more in the churn of creative destruction?

(p. B1) KYOTO, Japan — Naomi Hasegawa’s family sells toasted mochi out of a small, cedar-timbered shop next to a rambling old shrine in Kyoto. The family started the business to provide refreshments to weary travelers coming from across Japan to pray for pandemic relief — in the year 1000.

Now, more than a millennium later, a new disease has devastated the economy in the ancient capital, as its once reliable stream of tourists has evaporated. But Ms. Hasegawa is not concerned about her enterprise’s finances.

Like many businesses in Japan, her family’s shop, Ichiwa, takes the long view — albeit longer than most. By putting tradition and stability over profit and growth, Ichiwa has weathered wars, plagues, natural disasters, and the rise and fall of empires. Through it all, its rice flour cakes have remained the same.

Such enterprises may be less dynamic than those in other countries. But their resilience offers lessons for businesses in places like the United States, where the coronavirus has forced tens of thousands into bankruptcy.

“If you look at the economics textbooks, enterprises are supposed to be maximizing profits, scaling up their size, market share and growth rate. But these companies’ operating principles are completely different,” said Kenji Matsuoka, a professor emeritus of business at Ryukoku University in Kyoto.

(p. B5) “Their No. 1 priority is carrying on,” he added. “Each generation is like a runner in a relay race. What’s important is passing the baton.”

Japan is an old-business superpower. The country is home to more than 33,000 with at least 100 years of history — over 40 percent of the world’s total, according to a study by the Tokyo-based Research Institute of Centennial Management. Over 3,100 have been running for at least two centuries. Around 140 have existed for more than 500 years. And at least 19 claim to have been continuously operating since the first millennium.

. . .

The businesses, known as “shinise,” are a source of both pride and fascination.

. . .

Most of these old businesses are, like Ichiwa, small, family-run enterprises that deal in traditional goods and services. But some are among Japan’s most famous companies, including Nintendo, which got its start making playing cards 131 years ago, and the soy sauce brand Kikkoman, which has been around since 1917.

. . .

The Japanese companies that have endured the longest have often been defined by an aversion to risk — shaped in part by past crises — and an accumulation of large cash reserves.

It is a common trait among Japanese enterprises and part of the reason that the country has so far avoided the high bankruptcy rates of the United States during the pandemic. Even when they “make some profits,” said Tomohiro Ota, an analyst at Goldman Sachs, “they do not increase their capital expenditure.”

Large enterprises in particular keep substantial reserves to ensure that they can continue issuing paychecks and meet their other financial obligations in the event of an economic downturn or a crisis. But even smaller businesses tend to have low debt levels and an average of one to two months of operating expenses on hand, Mr. Ota said.

For the full story, see:

Ben Dooley and Hisako Ueno. “A Family Business Got Its Start In a Pandemic (1,000 Years Ago).” The New York Times (Saturday, December 5, 2020): B1 & B5.

(Note: ellipses added.)

(Note: the online version of the story was updated Jan. 7, 2021, and has the title “This Japanese Shop Is 1,020 Years Old. It Knows a Bit About Surviving Crises.”)

Older Americans Shifting to Entrepreneurship at Faster Pace

(p. B6) In April [2020], Dave Summers lost his job as director of digital media productions at the American Management Association, a casualty of layoffs brought on by the pandemic.

Mr. Summers, 60, swiftly launched his own business as a digital media producer, coach and animator who creates podcasts, webcasts and video blogs.

And in September, he and his wife, who teaches nursery school, moved from Danbury, Conn., to Maryville, Tenn., which they discovered while visiting their son in Nashville. “My new work is all virtual, so I can live anywhere,” he said. “Not only is it a cheaper place to live, we love hiking and the outdoors, and our new town is in the foothills of the Great Smoky Mountains.”

Droves of small businesses have been shuttered by the economic fallout of the coronavirus, but for Mr. Summers, starting a new one was the best option.

“I’m not sitting on a massive nest egg, so I need to work to keep afloat,” he said. “It’s also about being healthy and happy. I can’t just retire because underneath it all I’m creative, and I have to be busy doing stuff and helping people tell their stories.”

While the coronavirus pandemic is causing many older workers who have lost jobs, or who have been offered early retirement severance packages, to decide to leave the work force, others like Mr. Summers are shifting to entrepreneurship.

In fact, older Americans had already been starting new businesses at a fast rate. In 2019, research from the Kauffman Foundation, a nonpartisan group supporting entrepreneurship, found that more than 25 percent of new entrepreneurs were ages 55 to 64, up from about 15 percent in 1996.

Across the age spectrum, there has been a rise in new business start-ups since May [2020], according to the Census Bureau. The surge is likely “powered by newly unemployed individuals opting to start their own businesses, either by choice or out of necessity,” according to the Economic Innovation Group, a bipartisan public policy organization.

. . .

It turns out that the importance of entrepreneurship, or self-employment as a form of work, increases significantly with age, according to a report by Cal J. Halvorsen and Jacquelyn B. James of the Center on Aging & Work at Boston College.

According to the report: “While about one in six workers in their 50s are self-employed, nearly one in three are self-employed in their late 60s and more than 1 in 2 workers over the age of 80 are self-employed.

For the full story, see:

Kerry Hannon. “Older Americans Make a New Start in a Business of Their Own.” The New York Times (Friday, November 27, 2020): B6.

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

(Note: the online version of the story has the date Oct. [sic] 21, 2020, and has the title “Making a New Start in a Business of Their Own.”)

“Legions of Good People” Are Willing to Pay a Price “to Speak the Truth”

(p. A9) . . . in February 1986 . . . a presidential commission was investigating the explosion of the Challenger space shuttle, which killed all seven crew members a few weeks earlier.

Mr. McDonald was an engineer for the maker of the solid-fuel booster rockets. During a hearing, he believed an official of the National Aeronautics and Space Administration was glossing over a prelaunch debate on whether to proceed despite unusually cold temperatures in Cape Canaveral, Fla.

Seated in the background, Mr. McDonald waved his hands for attention and then stood up. He told the commission that he and other engineers had warned that low temperatures might cause a failure of synthetic rubber O-ring seals in the rocket’s joints. The commission later found that such a failure was responsible for the explosion and that NASA had brushed aside a warning that could have saved the astronauts.

. . .

Mr. McDonald’s uninvited testimony was a shock to the commission appointed by President Ronald Reagan. In his memoir, “Truth, Lies and O-Rings,” the engineer recalled the reaction from William P. Rogers, chairman of the commission:

“Who in the hell are you?”

. . .

Mr. Rogers thanked Mr. McDonald and other engineers for giving their side of the story.

. . .

At work, however, Mr. McDonald was at times ostracized by colleagues who accused him of undermining the company’s aerospace business. Morton Thiokol moved him out of his space shuttle duties in what he considered a demotion.

. . .

“I never considered myself a hero for doing my job in the best manner that I knew how and telling the truth about it,” he wrote, adding that “there are legions of good people out there every day defending their professional opinions and willing to speak the truth at some risk to their own job security. They just haven’t been involved in such a high-profile news making event like me.”

For the full obituary, see:

James R. Hagerty. “Engineer Exposed Space Shuttle Risks.” The Wall Street Journal (Saturday, April 3, 2021): A9.

(Note: ellipses added.)

(Note: the online version of the obituary has the date March 30, 2021, and has the title “Rocket Engineer Blew the Whistle on NASA After the Challenger Disaster.”)

The McDonald memoir mentioned above is:

McDonald, Allan J., and James R. Hansen. Truth, Lies, and O-Rings: Inside the Space Shuttle Challenger Disaster. Gainesville, FL: University Press of Florida, 2018..


Chinese Local Governments Run Up $6 Trillion in Debt, Partly to Build Giant Statues and a Full-Size Replica of Titanic

(p. B1) To officials in her corner of China, the statue of Yang Asha, a goddess of beauty, serves as a tribute to the rich culture of the local people and, they hope, a big draw for sightseers and their money. To many others in China, she is another white elephant in a country full of expensive monuments, gaudy tourist traps and wasteful vanity projects that draw money away from real problems.

Those critics point to the statue of Guan Yu, a general from antiquity, in the city of Jingzhou, where he also towers higher than the Statue of Liberty and wields an enormous polearm called the Green Dragon Crescent Blade.

They point to the Jingxingu Hotel, a 24-story wooden building with lots of empty balconies and open spaces but few actual rooms — and it has not accepted guests beyond a few tourists who come to gawk.

They point to the construction of a full-size, $150 million replica of the Titanic in a reservoir deep in China’s interior, 1,200 miles from (p. B5) the ocean.

. . .

Singling out the $38 million Jingxingu Hotel and the $224 million Guan Yu project, which also included an elaborate base and surrounding park, the Ministry of Housing and Urban-Rural Development ordered on Sept. 29 [2020] that communities may not “blindly build large-scale sculptures that are divorced from reality and the masses.”

Chinese government officials have long prized big projects. China now has four-fifths of the world’s 100 tallest bridges, more miles of ultramodern expressways than the American interstate highway system and a bullet-train network long enough to span the continental United States seven times. Those projects have employed millions of people and helped fuel the country’s breakneck growth.

But local officials borrowed heavily to fund those projects. Estimates put the amount of local debt as high as $6 trillion, raising fears of financial bombs lurking in the ledgers of far corners of the country.

Beijing has doubled down on further investment spending this year in an initially successful bid to shake off an economic hangover from the outbreak of coronavirus in China last winter.

Yet with each passing year, as projects are built in ever-more-remote places, the economic kick from each project becomes less and less. China is on track this year to add debt equal to four months’ economic output while its economy grows by an amount equal to less than two weeks’ output.

Local government borrowing “is still out of control,” said Gary Liu, an independent economist in Shanghai.

For the full story, see:

Keith Bradsher. “As China Battles Poverty, Colossal Projects Draw Ire.” The New York Times (Fri., Nov. 27, 2020): B1 & B5.

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

(Note: the online version of the story has the date Nov. 26, 2020, and has the title “A Soaring Monument to Beauty in China Is Stirring Passions. Mostly Anger.”)

Li Wenliang Was Not an Outlier: Chinese Communists Punished at Least 587 for Speaking Out on Covid-19

(p. A6) At least seven people over the past week have been threatened, detained or arrested after casting doubt over the government’s account of the deaths of Chinese soldiers during a clash last year with Indian troops. Three of them are being detained for between seven and 15 days. The other four face criminal charges, including one man who lives outside China.

“The internet is not a lawless place,” said the police notices issued in their cases. “Blasphemies of heroes and martyrs will not be tolerated.”

Their punishment might have gone unnoticed if it weren’t for an online database of speech crimes in China. A simple Google spreadsheet open for all to see, it lists nearly 2,000 times when the government punished people for what they said online and offline.

The list — which links directly to publicly issued verdicts, police notices and official news reports over the past eight years — is far from complete. Most punishment takes place behind closed doors.

Still, the list paints a bleak picture of a government that punishes its citizens for the slightest hint of criticism. It shows how random and merciless China’s legal system can be when it punishes its citizens for what they say, even though freedom of speech is written into China’s Constitution.

. . .

(p. B3) Perhaps the most depressing items are those about people who were punished for what they said about the Covid-19 pandemic. On top of the list is Dr. Li Wenliang, who was reprimanded on Jan. 1, 2020, along with seven others for trying to warn the country about the coronavirus. He died of the virus in early February last year and is now remembered as the whistle-blower who tried to warn the world about the outbreak. But the spreadsheet lists 587 other cases.

For the full story, see:

Li Yuan. “Spreadsheet on Censorship Shows China’s Human Toll.” The New York Times (Saturday, February 27, 2021): B1 & B3.

(Note: ellipses added.)

(Note: the online version of the story has the date Feb. 26, 2021, and has the title “China Persecutes Those Who Question ‘Heroes.’ A Sleuth Keeps Track.”)