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.”)

Extreme Weather Can Bring Enough Water to Recharge California’s Aquifers

(p. A15) After a long, dry summer, winter has brought the gift of water to California, via a series of atmospheric river storms. Unfortunately, as these sprawling rivers in the sky have met developed areas covered with concrete and rivers locked in by levees, they have brought destruction: floods, mudslides, washed-out roads, blackouts, uprooted trees and at least six deaths.

But California doesn’t have to passively suffer through the whiplash of drought and floods. To reduce risk from both, it can return some of its land to water, working with natural systems.

One way to do this is by making use of unique geologic features called paleo valleys. These buried canyons carved into the state’s Central Valley were formed by Ice Age rivers that flowed down the western flank of the Sierra Nevada and were later filled in with coarse sand and gravel from glacial melt.

. . .

There is enough unmanaged surface water from rain and snow statewide to resupply Central Valley aquifers, making more water available to farmers, urban dwellers and the environment. Even with climate change, the state will most likely have enough water for recharge in the future in part because of more extreme weather, according to a 2021 study.

For the full commentary, see:

Erica Gies. “California Should Capture Its Floodwaters.” The New York Times (Monday, January 9, 2023): A15.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date Jan. 7, 2023, and has the title “California Could Capture Its Destructive Floodwaters to Fight Drought.”)

The 2021 study mentioned above is:

He, Xiaogang, Benjamin P. Bryant, Tara Moran, Katharine J. Mach, Zhongwang Wei, and David L. Freyberg. “Climate-Informed Hydrologic Modeling and Policy Typology to Guide Managed Aquifer Recharge.” Science Advances 7, no. 17 (April 21, 2021), doi:10.1126/sciadv.abe6025.

“Singapore’s Bill Gates” Thought Innovation Should Not Require Government Permission

(p. A9) In the late 1990s, before Singapore was known as a global center of digital innovation, Sim Wong Hoo had a theory about what was holding his country back.

Mr. Sim, who went on to become the city-state’s first tech billionaire, called it the “No U-Turn Syndrome,” or NUTS. In the U.S., he said, cars could turn around anywhere unless a sign told them not to. But in Singapore, drivers wouldn’t dare if it wasn’t expressly allowed. The “no rule, no do” mentality kept Singaporeans from thinking outside the box, he said.

So he wrote some new rules. Mr. Sim was raised in a poor household by illiterate parents before founding a startup that revolutionized computer audio and inspired a generation of Asian entrepreneurs. Many admirers still call him

. . .

Born in Singapore in 1955, when it was still under British rule, Mr. Sim grew up in a village in an area now called Bukit Panjang with 10 siblings. Their father died when he was young, and his mother struggled to support their large family by selling whatever seasonal fruits grew on the unkempt 1-acre farm she leased for about $15 a year. When not in school, the young Mr. Sim helped her sell eggs at a local market for about 1 cent apiece.

In his 1999 book, “Chaotic Thoughts From the Old Millennium,” Mr. Sim described himself as a weird child who made his own toys and board games because he couldn’t afford to buy them.

For the full obituary, see:

Feliz Solomon. “Singaporean Inspired Asian Tech Innovators.” The Wall Street Journal (Saturday, Jan. 14, 2023): A9.

(Note: ellipsis added.)

(Note: the online version of the obituary has the date January 13, 2023, and has the title “Sim Wong Hoo, Creator of Sound Blaster, Inspired Asian Tech Innovators.”)

Mr. Sim’s book mentioned above is:

Sim, Wong Hoo. Chaotic Thoughts from the Old Millennium. Singapore: Creative O., 1999.

Government Contractor UNOS Is 15 Times More Likely to Lose or Damage Transplant Organs as Private Airlines Are to Lose or Damage Luggage

(p. A24) Where Tonya lives in California, the wait for a kidney from a deceased donor is up to 10 years. Tonya, like many on dialysis to treat kidney failure, knows the odds of her surviving the wait are slim; the median survival time for patients on dialysis is five years.

. . .

Everyday Americans are doing their part, signing up to be organ donors, but the organizations in charge of organ recovery (known as organ procurement organizations, or O.P.O.s) have been plagued with inefficiencies and abuses, and the contractor that runs the national system — the United Network for Organ Sharing (UNOS) — has been failing to oversee them.

The organ procurement system is made up of 56 organizations, each with a monopoly in its jurisdiction. When someone dies and can donate an organ, O.P.O.s are supposed to go to the hospital, talk to the person’s family and manage the process of transporting donated organs to those in need, but all too often they have failed to show up — literally.

. . .

Tonya asked the government to hold these organizations accountable, and naïvely, we thought it would be that simple. Our efforts would surely get Tonya a kidney.

She did everything she could to push for change, everything that our government asks of concerned citizens: She wrote an opinion essay; appeared in a government video; wrote letters to members of the Biden administration, including the Centers for Medicare and Medicaid Services (C.M.S.) administrator Chiquita Brooks-LaSure and the head of the Health Resources and Services Administration, Carole Johnson; worked with members of Congress, including Representative Katie Porter; and even testified before the House Oversight Subcommittee on Economic and Consumer Policy in May 2021.

There she told the committee she would die without the federal government’s urgent action. A year and a half later, on Dec. 30, 2022, Tonya died of complications from kidney failure.

. . .

After the video Tonya and I made, in 2020 the Trump administration finalized a rule bringing accountability to the forefront, and the Biden administration has inherited it. This is a good start: The new rule changes the metrics by which O.P.O.s are evaluated and requires that they face decertification for failure to perform. But the rule would not replace a single failing organ contractor until 2026, which is not acceptable.

. . .

To make matters worse, in the Biden administration’s 2023 budget, the C.M.S. requested flexibility to recertify failing O.P.O.s so they can keep their contracts even after 2026. If we allow failing O.P.O.s to keep operating, then we essentially nullify the reform we’ve worked so hard for and ensure further delays and more deaths.

. . .

When the Senate Finance Committee finally began investigating, it found that UNOS has systematically failed to provide oversight. At the committee hearing, doctors and transplant professionals testified that they have been afraid to criticize UNOS publicly, for fear it will retaliate against their patients. Also at the hearing, Senators Elizabeth Warren, Charles Grassley and Rob Portman called out another mind-boggling fact: From 2014 to 2019, UNOS was 15 times as likely to lose or damage an organ in transit as an airline is a passenger’s luggage.

For the full commentary, see:

Kendall Ciesemier. “She Feared the Organ Donation System Would Kill Her. It Did..” The New York Times (Wednesday, February 1, 2023): A24.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Jan. 28, 2023, and has the title “Tonya Ingram Feared the Organ Donation System Would Kill Her. It Did.”)

Mary Grimaldi Died of Measles a Few Days Before the Government Approved the Vaccine That Would Have Saved Her

(p. A15) Members of my own family have . . . chosen not to vaccinate their children against measles, even as my mother laments that the measles vaccine didn’t arrive in time for Sissy, as Maura was known in our family. She recently told me that she wishes she had found a way to enroll Sissy in the measles-vaccine trial, which involved 50,000 children over several years in the early 1960s.

. . .

Until the vaccine, the only way to gain immunity to measles was to contract the disease. Sissy was exposed as an infant when my brothers caught it, but the case wasn’t severe enough to give her immunity. “She’ll have to get the shot when it’s available,” the family pediatrician, Dr. George Herman, told my mother.

Why did it take so long for that to happen? Culturing the virus from the blood serum of young David Edmondston, and then weakening or “attenuating” it enough for a vaccine, was no easy feat. “The hardest vaccine to make is a live, attenuated vaccine,” said Dr. Offit. He would know: It took him and fellow virologists 26 years to develop a safe and effective vaccine against rotavirus, which can cause potentially fatal diarrhea in infants. “It is all trial and error. Nine years is fast,” Dr. Offit said.

It wasn’t fast enough for Sissy.

. . .

The Kansas City Times ran a short obituary. The paper asked my parents if they wanted to report the cause of death, and my mother said yes, “so that other parents would know to get the vaccine when it was available.”

A few pages away was an article headlined “O.K. on Measles Vaccine; Two Forms Released by Government and Surgeon General Predicts a Sharp Drop in the Disease Next Season.” “This is one of our most significant advances toward decreasing or eliminating one of our most serious childhood diseases,” said U.S. Surgeon General Luther Terry. An editorial in the paper on the vaccine news concluded, “The disease and its sometimes tragic consequences are on the way out with other ancient plagues.”

For the full essay, see:

James V. Grimaldi. “My Family and the Measles Vaccine.” The Wall Street Journals (Saturday, March 25, 2023): A15.

(Note: ellipses added.)

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

Regulators Are Bad at Monitoring Unhealthy Banks

(p. A26) Silicon Valley Bank’s failure looks a bit like an S.&L. crisis in miniature. Like its 1980s counterparts, S.V.B. grew extremely rapidly, had many assets parked in fixed, long-term bonds, and was done in when inflation caused the Fed to raise interest rates, raising the cost of keeping deposits.

Like the S.&L.s, Silicon Valley Bank was heavily concentrated. It catered to start-ups for whom an S.V.B. account was a matter of status. One tech savant who had recently changed jobs (aren’t they always switching jobs?) told me that in his experience, roughly two thirds of start-ups banked with S.V.B. (the bank claimed that nearly half the country’s venture capital-backed technology and life science companies were customers).

. . .

The regulators clearly failed to monitor S.V.B.’s unhealthy mismatch of assets and liabilities.

. . .

Once you take risk out of a part of a bank’s operations, it is hard to let market principles govern the rest.

. . .

In past bank failures, uninsured depositors did not lose all — 10 to 15 percent was typical. And in this episode, there wasn’t any systemically bad asset à la mortgages in 2008. Given that the risk was contained, and that the Federal Reserve provides liquidity to banks facing runs (and provided emergency liquidity this week), allowing uninsured depositors of banks that fail to suffer a haircut might have been healthier for the system in the long run.

For the full commentary, see:

Roger Lowenstein. “The Bank Rescues Just Changed Capitalism.” The New York Times (Thursday, March 16, 2023): A26.

(Note: ellipses added.)

(Note: the online version of the commentary has the date March 15, 2023, and has the title “The Silicon Valley Bank Rescue Just Changed Capitalism.”)