ANONYMOUS - OUR VOICE

Apple’s iOS 15 will come with better privacy for people who pay for it

Apple <a href="https://go.redirectingat.com/?id=66960X1516588&xs=1&url=https%3A%2F%2Fwww.apple.com%2Fnewsroom%2F2021%2F06%2Fapple-advances-its-privacy-leadership-with-ios-15-ipados-15-macos-monterey-and-watchos-8%2F&referrer=vox.com&sref=https%3A%2F%2Fwww.vox.com%2Frecode%2F2021%2F6%2F7%2F22522994%2Fapple-ios15-privacy-icloud" rel="sponsored nofollow noopener" target="_blank" has-subtag="true" data-cdata='{"rewritten_url":"https://go.redirectingat.com?id=66960X1516588\u0026xs=1\u0026url=https://www.apple.com/newsroom/2021/06/apple-advances-its-privacy-leadership-with-ios-15-ipados-15-macos-monterey-and-watchos-8/\u0026referrer=vox.com\u0026sref=https://www.vox.com/recode/2021/6/7/22522994/apple-ios15-privacy-icloud\u0026xcust=___vx__p_22287035__m_m-placeholder__s_s-placeholder__t_w__c_c-placeholder__r_r-placeholder__d_d-placeholder","subtag_max_length":50,"subtag_delim_length":3,"subtag_key":"xcust","subtag_data":{"id":"66960X1516588","xs":"1","url":"https://www.apple.com/newsroom/2021/06/apple-advances-its-privacy-leadership-with-ios-15-ipados-15-macos-monterey-and-watchos-8/","referrer":"vox.com","sref":"https://www.vox.com/recode/2021/6/7/22522994/apple-ios15-privacy-icloud","xcust":"___vx__p_22287035__m_m-placeholder__s_s-placeholder__t_w__c_c-placeholder__r_r-placeholder__d_d-placeholder"},"encode_subtag":false}'>announced</a> on Monday at its annual Worldwide Developers Conference (WWDC) that its upcoming iOS 15 update will give iPhone users even more insight and control over their own data. Among other updates, you’ll soon be able to see who your apps are sharing your data with; you’ll be able to stop trackers from detecting if and when you open emails; and you’ll be able to keep your internet activity more private. This is good news for you, but not great news for the data brokers that use your data to make money.
To illustrate just how seriously Apple takes its users’ privacy, Apple’s senior vice president of software engineering, Craig Federighi, introduced the privacy portion of the WWDC keynote by leaving the brightly lit virtual stage from which he was introducing other new iOS products and jumping into a secret, darkened virtual room.
“Privacy is a fundamental human right,” Federighi began.
<figure class="e-image"><picture class="c-picture" data-cid="site/picture_element-1623115908_9851_41160" data-cdata='{"asset_id":22643680,"ratio":"*"}'><source srcset="https://cdn.vox-cdn.com/thumbor/9Q2YGdpQudIKFRqDuyn3lLk84lk=/0x0:1802x663/320x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 320w, https://cdn.vox-cdn.com/thumbor/6dgHt-c66jw5NADB4s7hcUxI_p0=/0x0:1802x663/520x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 520w, https://cdn.vox-cdn.com/thumbor/CG_8vAKlcywBtij2uE8o2oe3ejQ=/0x0:1802x663/720x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 720w, https://cdn.vox-cdn.com/thumbor/ztUXNh-of9S6z6AR09T3SGZlifI=/0x0:1802x663/920x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 920w, https://cdn.vox-cdn.com/thumbor/qI8CbmtrDYksV79d9Af4-L6BN90=/0x0:1802x663/1120x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1120w, https://cdn.vox-cdn.com/thumbor/g7eKmqlOu-wkO0xs_hv2s-Uyq88=/0x0:1802x663/1320x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1320w, https://cdn.vox-cdn.com/thumbor/jiEG1qYHDPlf8zWwbA5iibyupEA=/0x0:1802x663/1520x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1520w, https://cdn.vox-cdn.com/thumbor/-J8TOxmVdWkelLRPt8qKQrkINnI=/0x0:1802x663/1720x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1720w, https://cdn.vox-cdn.com/thumbor/blDUNgM11_2fuxFDKjUQ5euCvcc=/0x0:1802x663/1920x0/filters:focal(0x0:1802x663):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1920w" sizes="(min-width: 1221px) 846px, (min-width: 880px) calc(100vw - 334px), 100vw" type="image/webp" /> <img alt="" data-upload-width="1802" sizes="(min-width: 1221px) 846px, (min-width: 880px) calc(100vw - 334px), 100vw" src="https://cdn.vox-cdn.com/thumbor/gwJhCas8Fi7tk8UmcK0a5JzX5xw=/0x0:1802x663/1200x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg" srcset="https://cdn.vox-cdn.com/thumbor/FC06qNpaYZFzSLsrKeH9kO7bYds=/0x0:1802x663/320x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 320w, https://cdn.vox-cdn.com/thumbor/wGoS8SNCBdIOFcO4JRppu8MW9OE=/0x0:1802x663/520x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 520w, https://cdn.vox-cdn.com/thumbor/Q7gXFmdTaQ_mAM6hGYeXrb9ARxw=/0x0:1802x663/720x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 720w, https://cdn.vox-cdn.com/thumbor/XQbwwxal4W2l8FMtcBca2TiCyDY=/0x0:1802x663/920x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 920w, https://cdn.vox-cdn.com/thumbor/MLEE6kfHezCjnw5zzBv-yRSENDI=/0x0:1802x663/1120x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1120w, https://cdn.vox-cdn.com/thumbor/Io8miLNsHrX7gcIlCdG6xdWkyV0=/0x0:1802x663/1320x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1320w, https://cdn.vox-cdn.com/thumbor/vPLX7k14wK5X-YWXBR6ky7wUfJ8=/0x0:1802x663/1520x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1520w, https://cdn.vox-cdn.com/thumbor/MsCUXOCS551MOD5sRpYUuRjpVBk=/0x0:1802x663/1720x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1720w, https://cdn.vox-cdn.com/thumbor/kiYbfgMMmb41ENF1oQ3K1ueeCaQ=/0x0:1802x663/1920x0/filters:focal(0x0:1802x663):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643680/privacy_entrance.jpg 1920w" /></picture>
<figcaption>Craig Federighi jumps through a cartoon hole in the floor that leads to Apple’s virtual privacy room.</figcaption>
<cite>Apple</cite></figure>
But Apple users may have to pay to fully exercise that right: Two of the new features are only available for iCloud subscribers (prices range from 99 cents to $9.99 a month, depending on how much storage you use), who will soon be enrolled in “iCloud+.” Here’s what “+” gets you:
<ul>
<li>Private Relay, which is Apple’s version of a <a href="https://www.vox.com/recode/21254841/working-from-home-security-vpn-malware-phishing">virtual private network</a> (VPN). When you use Safari, your traffic is encrypted and routed through two relays, which means no one can intercept it and no one can see where you’re going or where you’re coming from, including Apple, your internet service provider, or the website you’re visiting.</li>
<li>Hide My Email, which will let you generate a fake email address for the many websites that now force you to enter one just to use or read them, or make you sign up for accounts to do things like <a href="https://www.vox.com/recode/22310281/covid-vaccine-walgreens-cvs-rite-aid-walmart-data">get a vaccination appointment</a>. Those emails will then go to your real email inbox, but the website won’t know your real email address. But there are some limitations: From Apple’s demonstration, it only appears to work when you use Safari, Mail, and with your iCloud email address.</li>
</ul>
VPNs already cost money — it’s quite a range, but depending on which service you use and what plan you buy, you could pay $1.99 a month or you could pay $12.99 (there are free ones, but <a href="https://techcrunch.com/2020/09/24/free-vpn-bad-for-privacy/">buyer beware</a>) — so Apple isn’t doing anything that the industry isn’t doing already. That industry, by the way, might be in for some pain now that Apple has joined it. If you already have an iCloud — sorry, “iCloud+” — account, you’re getting something at no extra cost that you would have had to pay for otherwise.
Apple has said that it considers privacy and security to be part of the value of its devices — and it has <a href="https://www.npr.org/sections/alltechconsidered/2015/10/01/445026470/apple-ceo-tim-cook-privacy-is-a-fundamental-human-right">repeatedly</a> called that privacy a “human right” — but in these cases, that human right is going to cost a little more.
And now, the privacy improvements you won’t have to pay more for.
First up is one that will surely upset newsletter providers, because it will prevent them from tracking how many and which of their subscribers are opening their emails. Oh, you didn’t know that newsletters are tracking when and if you read them? Welcome to the world of pixels. You see, newsletters (and anyone who sends an email using an email tracker) embed <a href="https://www.wired.com/story/how-email-open-tracking-quietly-took-over-the-web/">tiny pixel-sized images</a> in emails. When you open an email, you automatically download the images in it, and then the sender knows which email addresses opened the email, how often they opened it, when they opened it, and even the IP address that opened it.
This is all useful information for newsletter operators who want to know how many subscribers are actually opening their product or other details about them. But it can be abused, too. It’s not just newsletters that use this feature. So now, Apple’s Mail app will have Mail Privacy Protection, which will hide all of that information from email senders — including those poor newsletters and their prized open rates. Unlike <a href="https://www.theverge.com/22319527/twitter-kayvon-beykpour-interview-consumer-product-decoder">some</a> <a href="https://www.vox.com/recode/22518571/facebook-substack-bulletin-newsletter-launch">other</a> Big Tech companies, Apple doesn’t appear to be getting into the newsletter game, so it has no need for these pixels. (If you don’t use Mail or don’t want to wait for iOS 15, <a href="https://www.theverge.com/21319293/gmail-reading-email-tracking-pixels-how-to-prevent-block-chrome">there are still ways</a> to block these trackers that you can turn on right now.)
And if you liked iOS 14’s <a href="https://www.vox.com/recode/22393931/facebook-ios-14-5-app-tracking-transparency-iphone-privacy">App Tracking Transparency</a> and <a href="https://www.vox.com/recode/22285020/apple-privacy-nutrition-labels-ios-14">Privacy Nutrition Labels</a>, then you’re going to love iOS 15’s App Privacy Report. This will be a new section in your device’s privacy settings, telling you how often and when your apps use your permissions (things like accessing your location, camera, and microphone). It’s a lot like what Google introduced in Android 12 <a href="https://www.vox.com/recode/22443781/google-android-12-privacy-apple-ios-14">last month</a>, which was one of the few features that wasn’t something Apple had done earlier.
But App Privacy Report goes even further than Android’s privacy dashboard. It also says which domains your apps are contacting while you use them. This will finally give the average user a way to see who else their apps are <a href="https://www.vox.com/recode/2020/7/8/21311533/sdks-tracking-data-location">sharing their data with</a>, though it doesn’t do anything to stop that sharing from happening in the first place. So, it’s not so good for control (although who knows what iOS 16 will bring), but it is great for transparency.
<figure class="e-image"><picture class="c-picture" data-cid="site/picture_element-1623115908_6123_41161" data-cdata='{"asset_id":22643791,"ratio":"*"}'><source srcset="https://cdn.vox-cdn.com/thumbor/4SV2PGsfk2sqDdOSmE8Qwm7ih88=/0x0:653x830/320x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 320w, https://cdn.vox-cdn.com/thumbor/F6xeApQBlee61foXGIVulz0BTKo=/0x0:653x830/520x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 520w, https://cdn.vox-cdn.com/thumbor/Okc4mRWLHKZCz2cD8qgaC7tk3pw=/0x0:653x830/720x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 720w, https://cdn.vox-cdn.com/thumbor/Zdmn_1aa3CkqqbqqUHXXqqNrcU0=/0x0:653x830/920x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 920w, https://cdn.vox-cdn.com/thumbor/tqCdKLMNYem5VoNIvHIlV4IBc9Q=/0x0:653x830/1120x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1120w, https://cdn.vox-cdn.com/thumbor/Xn1flEJNmmuFS5Y-3Z1OiW7n7Ok=/0x0:653x830/1320x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1320w, https://cdn.vox-cdn.com/thumbor/wTymkDdfV1aKLfz9uWOXxb3NjWo=/0x0:653x830/1520x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1520w, https://cdn.vox-cdn.com/thumbor/JOT_VWv7FvQcCLXE64dqrCDDUa8=/0x0:653x830/1720x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1720w, https://cdn.vox-cdn.com/thumbor/25JRpkoH-9zzYizy62WUdC7gFMg=/0x0:653x830/1920x0/filters:focal(0x0:653x830):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1920w" sizes="(min-width: 1221px) 846px, (min-width: 880px) calc(100vw - 334px), 100vw" type="image/webp" /> <img alt="An iPhone with the new App Privacy Report on the screen." data-upload-width="653" sizes="(min-width: 1221px) 846px, (min-width: 880px) calc(100vw - 334px), 100vw" src="https://cdn.vox-cdn.com/thumbor/HbgXWpl0hVP23ancyyxwbxP7YxA=/0x0:653x830/1200x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg" srcset="https://cdn.vox-cdn.com/thumbor/Ji6hyjugbJGR3Wgoqz0o5VD9iJI=/0x0:653x830/320x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 320w, https://cdn.vox-cdn.com/thumbor/L4juNdvAdyemXOCXoS_Xh0AFmUg=/0x0:653x830/520x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 520w, https://cdn.vox-cdn.com/thumbor/8OFBZs8cTak7Z-6utJMlUE-S3vE=/0x0:653x830/720x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 720w, https://cdn.vox-cdn.com/thumbor/UgSR_TM6mFmMaNNjNs1HT4EMA5w=/0x0:653x830/920x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 920w, https://cdn.vox-cdn.com/thumbor/RFSxE2vYOpeUGoVEov7PUTV40oU=/0x0:653x830/1120x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1120w, https://cdn.vox-cdn.com/thumbor/NGHiHKCLx7dyn_m1YzG0MRTEyhc=/0x0:653x830/1320x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1320w, https://cdn.vox-cdn.com/thumbor/htF2QEqapw3Jc3U0nnWKpRoVKCw=/0x0:653x830/1520x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1520w, https://cdn.vox-cdn.com/thumbor/g-DBQakPVNWiLFCqFvavIFtD40w=/0x0:653x830/1720x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1720w, https://cdn.vox-cdn.com/thumbor/MHCS9tfigGyIAmTW4X548G4BpvY=/0x0:653x830/1920x0/filters:focal(0x0:653x830):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22643791/Apple_iPhone12Pro_settings_privacy_app_privacy_report_060721_carousel.jpg.large.jpg 1920w" /></picture>
<figcaption>App Privacy Report is one of iOS 15’s privacy improvements.</figcaption>
<cite>Apple</cite></figure>
If you don’t have an iCloud(+) subscription and don’t want to or can’t pay for one, you’ll still have a free Safari privacy update that hides your IP address from trackers on websites you visit, thus making it harder for trackers to identify you as you go your merry way browsing the internet.
Finally, Siri is also getting more private. Apple’s voice assistant will now do all speech recognition processing on your device, rather than sending your audio to an Apple server for processing. That means Apple won’t have access to those recordings, which is a privacy issue for pretty much <a href="https://www.vox.com/recode/2020/2/21/21032140/alexa-amazon-google-home-siri-apple-microsoft-cortana-recording">every major smart assistant</a> out there. But that doesn’t mean that what you request stays on your device — just that the sound of you requesting it does.
Apple didn’t say when iOS 15 will roll out, or if all of these features will be present whenever it is released. Going by previous years, it’ll roll out in September, although that doesn’t mean everything announced today will come then, too. We had to wait seven months between iOS 14’s release and iOS 14.5 with App Tracking Transparency. But they will come, and they will cause more disruption in the tracking industry when they do.
 
 
source <a href="https://www.vox.com/recode/2021/6/7/22522994/apple-ios15-privacy-icloud">https://www.vox.com/recode/2021/6/7/22522994/apple-ios15-privacy-icloud</a>

vox Apple’s iOS 15 will come with better privacy for people who pay for it

Apple announced on Monday at its annual Worldwide Developers Conference (WWDC) that its upcoming iOS 15 update will give iPhone users even ...

Medicaid is a hassle for doctors. That’s hurting patients.

<div><img class="ff-og-image-inserted" src="https://cdn.vox-cdn.com/thumbor/VspSMIcFTwIsUT4ZraDOa1ZqoJo=/0x0:2400x1257/fit-in/1200x630/cdn.vox-cdn.com/uploads/chorus_asset/file/22643350/GettyImages_566019461.jpg" /></div>
For many low-income people in the US, getting insured isn’t enough to get health care: Patients with Medicaid can struggle to find a doctor willing to take their health insurance.
And this happens in large part because, for doctors and providers, billing Medicaid is a pain.
A <a href="https://users.nber.org/~jdgottl/BillingCostsPaper.pdf">recent study</a> by researchers from the US Bureau of Economic Analysis, the University of Chicago, and the Federal Reserve Bank in San Francisco found providers run into more obstacles when trying to bill Medicaid than they do with other insurers, and that these administrative hurdles explain the access problems experienced by Medicaid patients as much as the program’s payment rates.
Medicaid payment rates, the amount doctors receive for providing services, are on average lower than Medicare or private coverage. This has typically been used to explain why many physicians are reluctant to take Medicaid and why some Medicaid recipients still struggle to access care.
“Previous work highlighted the effect of prices on physicians’ acceptance of Medicaid patients ... and on the supply of care more broadly,” the authors wrote, citing a litany of previous research. “We show that a reduction in administrative hassle is just as significant.”
Access for Medicaid patients is a well-documented problem. <a href="https://www.google.com/search?q=survey+doctors+less+likely+medicaid&oq=survey+doctors+less+likely+medicaid&aqs=chrome..69i57j69i60l3j69i65.5796j1j4&sourceid=chrome&ie=UTF-8">Various surveys</a> show providers are <a href="https://www.healthaffairs.org/do/10.1377/hblog20190401.678690/full/">significantly less likely to accept Medicaid</a> than Medicare or private coverage. That is on top of <a href="https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/">the other health challenges</a> that people with lower incomes face.
Usually, as the authors reference, the access problem is seen as caused by the prices paid by Medicaid. And Medicaid does pay less than the other major insurers: Based on its own data, the average initial claim filed is $98 for Medicaid patients, whereas Medicare averages $137 and private insurers average $180.
But the problem goes deeper than that, according to this new analysis. Not only does Medicaid pay out less, but doctors encountered more billing problems. About 19 percent of the initial claims submitted to Medicaid are not paid in full. For Medicare and for the private insurers, that share is much lower: 8 percent and 5 percent, respectively.
The health care providers then must invest time and money to sort out any rejected or disputed claims. These researchers attempt to put a dollar figure on those costs — they call it “costs of incomplete payments,” or CIP — and find that Medicaid is more costly for providers than Medicare or private insurers. The average CIP for a Medicaid visit is $16, more than the $10 average for Medicare and private coverage.
And when you consider the disparity in the initial claims, with Medicaid already paying much less than Medicare or private insurance, these costs of incomplete payments eat up 16 percent of the value of a Medicaid visit for doctors, significantly more than the 7 percent for Medicare and 4 percent for private coverage.
What is the cost of these administrative burdens? Fewer providers take Medicaid patients.
The authors tackled the question from two angles, looking at individual physicians who move to a different state (and therefore a different Medicaid program) and at firms that operate physician offices in different states. In both cases, they found an effect. A decrease in administrative costs — the CIP metric — was equally likely to lead to providers accepting Medicaid patients as an increase in reimbursement rates, by both measures.
In other words, whether doctors were willing to take Medicaid patients depended as much on whether they faced administrative hurdles when trying to bill for their care as the actual price that Medicaid pays for the services they provide.
“Doctors’ offices are businesses,” Larry Levitt, executive vice president at the Kaiser Family Foundation, told me, “and it’s not surprising that they would make participation decisions based not only on how much they get paid, but also on the hassle of doing business with different insurers.”
There are some limits to the study, which the authors acknowledge. For one, they do not attempt to figure out whether Medicaid has good reason to deny the claims that it does (in which case, perhaps Medicare and private insurers are too lenient about the claims they accept).
And arguably the bigger problem with Medicaid access is that many people who are eligible have no access to the program’s insurance at all. Making it easier for providers to bill Medicaid does not help more people sign up for coverage, even though an estimated 7.3 million uninsured people <a href="https://www.kff.org/health-reform/state-indicator/distribution-of-eligibility-for-aca-coverage-among-the-remaining-uninsured/?dataView=1&currentTimeframe=0&selectedDistributions=medicaidother-public-eligible--tax-credit-eligible--ineligible-for-financial-assistance-due-to-affordable-marketplace-plan-available--ineligible-for-financial-assistance-due-to-offer-of-employer-coverage--ineligible-for-financial-assistance-due-to-citizenship--in-medicaid-coverage-gap--total&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D">are already eligible</a> for Medicaid and <a href="https://www.kff.org/medicaid/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/">4 million more people</a> would be, too, if the 12 states that have refused to expand the program under the Affordable Care Act decided to do so.
Nevertheless, the study makes a strong case that solving access problems for Medicaid patients does not require jacking up the program’s payment rates, a difficult sell in a time of strained state budgets, in the country already with the world’s highest health care costs.
The researchers instead present this solution to the problem they identified: “To increase access to care, regulators could implement or require a simpler, cheaper administration of payment processes, without raising prices.”
So if we simply made it easier for doctors to receive payment for the services they provide, it could make a big difference for Medicaid patients.
 
 
source <a href="https://www.vox.com/2021/6/7/22522479/medicaid-health-insurance-doctors-billing-research">https://www.vox.com/2021/6/7/22522479/medicaid-health-insurance-doctors-billing-research</a>

vox Medicaid is a hassle for doctors. That’s hurting patients.

For many low-income people in the US, getting insured isn’t enough to get health care: Patients with Medicaid can struggle to find a doctor...

Jeff Bezos has been training for this

<div><img class="ff-og-image-inserted" src="https://cdn.vox-cdn.com/thumbor/M_QqTqTKW2JV5Mgu73jl6e67QBE=/0x0:5136x2689/fit-in/1200x630/cdn.vox-cdn.com/uploads/chorus_asset/file/22642811/GettyImages_813884326.jpg" /></div>
Jeff Bezos says he’s heading to space. In an Instagram post on Monday, the billionaire CEO of Amazon announced that next month he will be aboard Blue Origin’s rocket New Shepard on its first flight with humans aboard. Bezos called the trip “the thing I wanted to do all my life.”
The flight is scheduled to lift off from West Texas on July 20, just two weeks after <a href="https://www.vox.com/recode/2021/2/2/22263090/jeff-bezos-amazon-ceo-stepping-down-andy-jassy">he’s officially set to leave</a> his current post as the chief executive of Amazon. Up to six astronauts, including Bezos’s brother Mark, a volunteer <a href="https://www.usatoday.com/story/tech/2021/06/07/jeff-bezos-brother-going-space-blue-origins-first-human-flight/7581343002/">firefighter and charity executive</a>, will take the trip. Another civilian will also be included in the crew: Blue Origin is <a href="https://www.blueorigin.com/news/jeff-bezos-first-human-flight">auctioning</a> off a final civilian ticket. (The high bid was $2.8 million when Bezos announced his plans to join the flight.) Eventually, Blue Origin hopes to launch satellites and offer space tourism flights.
Jeff Bezos won’t be traveling into outer space, however. New Shepard is built to be suborbital, which means it will reach the border between Earth and space. Overall, the trip on the rocket is supposed to <a href="https://www.businessinsider.com/blue-origin-auction-highest-bid-jeff-bezos-space-flight-2021-5">last about 11 minutes</a>.
While other billionaires have been more outwardly bombastic about their own personal aspirations to visit space, Bezos appears to have been training for his own journey into space for quite some time — and he’s been alluding to making the trip for years.
Back in 2013, journalist Brad Stone mused that Bezos wanted to go to space during <a href="https://www.youtube.com/watch?v=w1M4Gh4RpXA&t=2424s">a town hall in Seattle</a>.
“One sort of interesting physical transformation, as Amazon has grown, Jeff is in pretty good shape now. He looked a little pasty and rumpled back in the ’90s,” Stone told New York Times journalist Nick Wingfield. “Now, he’s clearly working out every day, and the reason I bring that up is I think he’s in astronaut training.”
It was four years later, in 2017, that a photo of Bezos looking particularly muscular at the Allen & Company Sun Valley Conference in 2017 <a href="https://knowyourmeme.com/memes/swole-jeff-bezos">went viral</a> and even <a href="https://slate.com/human-interest/2017/07/swole-jeff-bezos-is-exactly-the-meme-the-world-needed.html">became a meme</a>. Indeed, Bezos has been dreaming of leaving Earth since at least 2000, when he founded Blue Origin with the hope of making it easier to get to space.
“The only way that I can see to deploy this much financial resource is by converting my Amazon winnings into space travel. That is basically it,” Bezos said in <a href="https://www.vox.com/recode/22263248/jeff-bezos-second-act-philanthropy-blue-origin-washington-post">2018</a>. “Blue Origin is expensive enough to be able to use that fortune.”
Blue Origin has so far launched the New Shepard rocket 15 times without crews, though the rocket is designed to bring tourists to space. Though it was originally planned in 2019, the <a href="https://www.vox.com/2018/10/15/17980544/jeff-bezos-blue-origin-space-travel-2019-tourists">anticipated date for human travel</a> on the vehicle has been pushed back. Blue Origin is also working on a rocket called New Glenn for orbital travel, and it will be capable of delivering <a href="https://www.space.com/34034-blue-origin-new-glenn-rocket-for-satellites-people.html">payloads (and eventually people) into orbit</a>.
<a href="https://www.blueorigin.com/new-glenn/">Blue Origin</a> is one of several billionaire-backed space efforts. Its main rival is SpaceX, the private space company led by billionaire Elon Musk. Since 2002, SpaceX has focused on developing rockets to launch satellites into orbit and deliver payloads to the International Space Station (ISS). Last year, the company became the first private firm to launch humans into space, sending <a href="https://www.vox.com/recode/2020/5/26/21267533/elon-musk-spacex-demo-2-falcon-9-iss-manned-launch">four astronauts to the ISS</a>, and it’s planning a civilian crew trip at <a href="https://www.theverge.com/2021/2/1/22261038/spacex-announces-first-all-civilian-mission-to-space">the end of this year</a>. Richard Branson’s Virgin Galactic has been <a href="https://newatlas.com/space/virgin-galactic-researcher-kellie-gerardi/">signing up researchers</a> to travel on its vehicles, though there’s no launch date yet.
These 21st-century space companies are in serious competition. Because there aren’t that many clients who need their services, SpaceX and others are often fighting for whatever contracts government space agencies like NASA have to offer — like helping with plans to return to the moon — or getting lawmakers to provide the money they need to <a href="https://theintercept.com/2021/05/25/jeff-bezos-blue-origin-senate-bailout/">continue launching</a>. Blue Origin and Virgin Galactic are also staking their claims in the nascent industry of suborbital space tourism, <a href="https://www.cnbc.com/2020/09/26/space-tourism-how-spacex-virgin-galactic-blue-origin-axiom-compete.html">hoping to cash</a> in on rich people looking for a thrill.
<div>
<blockquote class="twitter-tweet">
Many congratulations to <a href="https://twitter.com/JeffBezos?ref_src=twsrc%5Etfw">@JeffBezos</a> & his brother Mark on announcing spaceflight plans. Jeff started building <a href="https://twitter.com/blueorigin?ref_src=twsrc%5Etfw">@blueorigin</a> in 2000, we started building <a href="https://twitter.com/virgingalactic?ref_src=twsrc%5Etfw">@virgingalactic</a> in 2004 & now both are opening up access to Space - how extraordinary! Watch this space…
— Richard Branson (@richardbranson) <a href="https://twitter.com/richardbranson/status/1401905482613366791?ref_src=twsrc%5Etfw">June 7, 2021</a></blockquote>
</div>
But there’s a sense of personal competition, too: Both <a href="https://www.washingtonpost.com/technology/2018/11/26/elon-musk-says-he-will-probably-move-mars/">Musk</a> and <a href="https://www.cnn.com/2020/11/06/tech/richard-branson-virgin-galactic-space-scn/index.html">Branson</a> have indicated they want to make it to space, too. Now Bezos is on track to beat them both by climbing aboard his own ship and showcasing his confidence that this new era of civilian space travel can work.
 
 
source <a href="https://www.vox.com/recode/22522644/jeff-bezos-astronaut-blue-origin-spacex">https://www.vox.com/recode/22522644/jeff-bezos-astronaut-blue-origin-spacex</a>

vox Jeff Bezos has been training for this

Jeff Bezos says he’s heading to space. In an Instagram post on Monday, the billionaire CEO of Amazon announced that next month he will be a...

The lab leak hypothesis, explained

Where did the virus that causes Covid-19 come from?
It’s one of the most persistent mysteries of the pandemic. The debate about it among scientists, policymakers, journalists, amateur internet sleuths, and the general public has reignited with new revelations and new voices in the mix.
Most recently, emails obtained by the <a href="https://www.washingtonpost.com/politics/interactive/2021/tony-fauci-emails/">Washington Post</a> and <a href="https://www.buzzfeednews.com/article/nataliebettendorf/fauci-emails-covid-response">BuzzFeed</a> showed that National Institute of Allergy and Infectious Diseases Director Anthony Fauci was <a href="https://www.factcheck.org/2021/06/scicheck-viral-posts-pundits-distort-fauci-emails/">corresponding with a scientist</a> as early as January 2020 investigating the possibility that SARS-CoV-2, the virus that causes Covid-19, may have been engineered in a lab. An article in <a href="https://www.vanityfair.com/news/2021/06/the-lab-leak-theory-inside-the-fight-to-uncover-covid-19s-origins">Vanity Fair</a> highlighted how efforts to probe a lab leak were suppressed within parts of the US government as some officials worried that a lab in Wuhan, China, that received US funding may have been the source.
Scientists last year argued that the most plausible explanation is the “natural emergence” of the SARS-CoV-2 virus: It jumped from bats, or an intermediary species, to humans in a random event sometime in 2019. Many still hold this view, and some have become even more confident in this pathway.
Several media outlets, including Vox, also downplayed in 2020 the possibility that human error launched the virus, after many scientists with relevant experience described the idea as extremely unlikely. In February 2020, 27 scientists co-signed a letter in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30418-9/fulltext">The Lancet</a> affirming their belief in a natural origin of the virus and decrying efforts to pin the blame for the outbreak on Chinese scientists.
<figure class="e-image"><picture class="c-picture" data-cid="site/picture_element-1623116837_4394_26828" data-cdata='{"asset_id":22626074,"ratio":"*"}'><source srcset="https://cdn.vox-cdn.com/thumbor/56l6iE2BdR6bat01EYWjptLy0as=/0x0:874x118/320x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 320w, https://cdn.vox-cdn.com/thumbor/IEvlYFNX5bYpozsIv-jzwcJN7Rw=/0x0:874x118/520x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 520w, https://cdn.vox-cdn.com/thumbor/TJ9Oj5tL1GsOxPpXwZRG4p_I9AI=/0x0:874x118/720x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 720w, https://cdn.vox-cdn.com/thumbor/zS9TeI3XDTyeJiPGMxwZwfI77d0=/0x0:874x118/920x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 920w, https://cdn.vox-cdn.com/thumbor/gBM2HF5aJInSfL4OpglnukEMgQg=/0x0:874x118/1120x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1120w, https://cdn.vox-cdn.com/thumbor/gs6sr9T-heo79EI89LaDrzNiv_k=/0x0:874x118/1320x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1320w, https://cdn.vox-cdn.com/thumbor/ffzjcfX4MoPlKMaNU-_ijo8Txv8=/0x0:874x118/1520x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1520w, https://cdn.vox-cdn.com/thumbor/G_FmyHZO62ETAkBeRKV84EcjS28=/0x0:874x118/1720x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1720w, https://cdn.vox-cdn.com/thumbor/Vtph2MogfFBkdBMmaFqfNgVDvHo=/0x0:874x118/1920x0/filters:focal(0x0:874x118):format(webp):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1920w" sizes="(min-width: 1221px) 846px, (min-width: 880px) calc(100vw - 334px), 100vw" type="image/webp" /> <img alt="" data-upload-width="874" sizes="(min-width: 1221px) 846px, (min-width: 880px) calc(100vw - 334px), 100vw" src="https://cdn.vox-cdn.com/thumbor/txZJeF9_a5mGV4aqRHNgZ2MvpKc=/0x0:874x118/1200x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png" srcset="https://cdn.vox-cdn.com/thumbor/IaxGazJmZGQc_iO4tz8YyW1gusI=/0x0:874x118/320x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 320w, https://cdn.vox-cdn.com/thumbor/xeNpzVw0ZrhYJz93_uO3u5jztAI=/0x0:874x118/520x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 520w, https://cdn.vox-cdn.com/thumbor/-H4vXMHfkaQCqq4W3MXM-FPJbtE=/0x0:874x118/720x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 720w, https://cdn.vox-cdn.com/thumbor/ru9dW-ws9naMgZzloaCSjBQ4G9Q=/0x0:874x118/920x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 920w, https://cdn.vox-cdn.com/thumbor/VT4LSnh8Do5ZoqClvZ7SGzzBFvk=/0x0:874x118/1120x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1120w, https://cdn.vox-cdn.com/thumbor/uDb0j-OJES7a2yKdLBS8noT-KWo=/0x0:874x118/1320x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1320w, https://cdn.vox-cdn.com/thumbor/VvZbrrC7BxBNPHruMrIlRG8YFpc=/0x0:874x118/1520x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1520w, https://cdn.vox-cdn.com/thumbor/dIvYyBt8Px-Fz93wBfu_eq3gAI0=/0x0:874x118/1720x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1720w, https://cdn.vox-cdn.com/thumbor/EWIPZ5HRl5BQYsXp4pPA6u30INY=/0x0:874x118/1920x0/filters:focal(0x0:874x118):no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22626074/Screen_Shot_2021_06_03_at_2.14.33_PM.png 1920w" /></picture>
<figcaption>A note appended to an article about bat coronaviruses in the journal Nature Medicine affirms the natural origin hypothesis of SARS-CoV-2.</figcaption>
<cite><a class="ql-link" href="https://www.nature.com/articles/nm.3985" target="_blank">Nature Medicine</a></cite></figure>
But in recent weeks, more scientists — including some who had not weighed in until now — have spoken up about the possibility that the virus may have escaped a laboratory in China, and argued that this scenario has not been adequately investigated.
The Covid-19 pandemic has illustrated that science is essential for grappling with the disease, but also that experts can get things wrong. For example, the World Health Organization in January 2020 said that there was “<a href="https://twitter.com/WHO/status/1217043229427761152">no clear evidence</a>” of transmission of SARS-CoV-2 between people. The US surgeon general told Americans in February 2020 that <a href="https://www.axios.com/surgeon-general-reversal-face-mask-d385e2d5-42b7-433e-89a6-3584f3e61bf3.html">face masks were not effective</a> in slowing the spread of the disease. It could be possible, then, that the dismissal of a laboratory origin of the virus was premature among some experts amid the flurry of developments in the early stages of a global outbreak.
“We must take hypotheses about both natural and laboratory spillovers seriously until we have sufficient data,” reads a letter published in the journal <a href="https://science.sciencemag.org/content/372/6543/694.1">Science</a> in May 2021, co-authored by 18 researchers.
Some scientists had been reluctant to publicly broach the “lab leak” hypothesis in part because the Trump administration had asserted, without clear evidence, its confidence in the theory, as it tried to <a href="https://www.nytimes.com/2020/04/30/us/politics/trump-administration-intelligence-coronavirus-china.html">find ways to blame China</a> for the pandemic and deflect scrutiny from the White House’s mishandling of the crisis. The idea also collapsed into conspiracy theories, like the notion that the virus was deliberately <a href="https://covid19.nj.gov/faqs/coronavirus-information/about-the-virus/is-covid-19-a-biological-weapon">released as a bioweapon</a>.
The lab leak hypothesis “really is not a fringe theory,” <a href="https://www.hsph.harvard.edu/marc-lipsitch/">Marc Lipsitch</a>, an epidemiology professor at the Harvard School of Public Health and a co-signer of the letter, told <a href="https://edition.cnn.com/videos/tv/2021/05/27/amanpour-marc-lipsitch-covid-lab-leak-theory.cnn">CNN</a>. “It had been viewed as a fringe theory because it was espoused in fringe ways by some people with political agendas.”
<div class="c-wide-block">
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<figcaption>Thea Fischer (left), Peter Daszak (right), and other members of the World Health Organization team arrive at the Wuhan Institute of Virology to investigate the origins of Covid-19 on February 3.</figcaption>
<cite>Hector Retamal/AFP via Getty Images</cite></figure>
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Lipsitch and other researchers pushing for further investigation say that the Chinese government hasn’t been forthcoming with critical details about its research on coronaviruses; it also ordered some early <a href="https://www.wsj.com/articles/china-told-labs-to-destroy-coronavirus-samples-to-reduce-biosafety-risks-11589684291">lab specimens of the virus to be destroyed</a> and <a href="https://www.bbc.com/news/world-asia-china-55355401">censored reporting around the outbreak</a>. The calls for more transparency from scientists prompted the Biden administration to <a href="https://www.bbc.com/news/world-us-canada-57260009">order US intelligence agencies to investigate</a> the possibility of an accidental lab leak. The answer to the question of how the virus originated has as much political import as it does scientific.
At the most basic level, the case for the natural origins of the virus rests on incomplete evidence, while the lab leak hypothesis rests on the gaps in that very evidence.
A natural exposure route for SARS-CoV-2 still seems far more likely to many scientists, but a satisfying answer one way or another may never coalesce as the initial infections recede into history and China continues to withhold data and records from those early days. Scientists still haven’t determined from which animal the virus hopped into humans, but neither have they found any trace of SARS-CoV-2 in a laboratory prior to its emergence. All the while, the tense US-China relationship looms over the investigation, threatening to throttle the search for answers.
Many prominent voices in science, politics, and national security are now deeply invested in seeing this investigation through. Here’s how some of the researchers currently engaged in the conversation are parsing the evidence, what they see as some of the most important lines of inquiry going forward, and what they say we may never know.
The term “lab leak” refers to the possibility that the SARS-CoV-2 virus or a close relative was at some point being studied at a laboratory in China prior to the Covid-19 pandemic and then later escaped. In particular, investigation proponents are interested in the <a href="http://english.whiov.cas.cn/About_Us2016/Brief_Introduction2016/">Wuhan Institute of Virology</a> near the original epicenter of the Covid-19 outbreak. After the <a href="https://www.who.int/health-topics/severe-acute-respiratory-syndrome#tab=tab_1">2003 SARS outbreak</a>, the facility increased its focus on emerging diseases, including respiratory infections caused by coronaviruses.
The possibility of a lab leak crossed the mind of <a href="https://www.ws-virology.org/dt_team/zhengli-shi/">Shi Zhengli</a>, a renowned virologist at the Wuhan lab. She told <a href="https://www.scientificamerican.com/article/how-chinas-bat-woman-hunted-down-viruses-from-sars-to-the-new-coronavirus1/">Scientific American</a> last year that she recalled being told in December 2019 about a mysterious pneumonia caused by a coronavirus spreading in the city of Wuhan and wondering if the pathogen came from her lab.
There have been reports that researchers at the institute were performing <a href="https://www.vox.com/2020/5/1/21243148/why-some-labs-work-on-making-viruses-deadlier-and-why-they-should-stop">gain-of-function experiments</a>, where a natural virus is modified to become more virulent or to better infect humans. This research tries to map potential ways a virus could mutate and lead to an outbreak, allowing scientists to get a head start on countering a potentially dangerous pathogen. But such research is dangerous and controversial. The National Institutes of Health <a href="https://www.nature.com/articles/d41586-020-00210-5">declared a moratorium on funding</a> gain-of-function research in 2014, lifting it in 2017 for experiments that undergo review by an expert panel.
US officials have been adamant that <a href="https://www.factcheck.org/2021/05/the-wuhan-lab-and-the-gain-of-function-disagreement/">US funding did not support any gain-of-function</a> research at the Wuhan Institute, or anywhere in the world. NIH Director <a href="https://www.nih.gov/about-nih/who-we-are/nih-director/biographical-sketch-francis-s-collins-md-phd">Francis Collins</a> said in a May <a href="https://www.nih.gov/about-nih/who-we-are/nih-director/statements/statement-misinformation-about-nih-support-specific-gain-function-research">statement</a> that US federal health research agencies have never “approved any grant that would have supported ‘gain-of-function’ research on coronaviruses that would have increased their transmissibility or lethality for humans.”
Scientists at the Wuhan lab were known to be working with an international team on <a href="https://www.nature.com/articles/nm.3985">creating chimeric versions of different coronaviruses</a> to study the potential of a human outbreak, though they say that these chimeric viruses did not increase in pathogenicity and therefore do not constitute gain of function. The chimeras in the experiment were also created in the US, not China. Wuhan Institute researchers also published a <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006698">paper in 2017</a> reporting on a bat coronavirus that could be transmitted directly to humans, with researchers creating chimeras of the wild virus to see if they could infect human cells. That study had funding from the US National Institutes of Health.
Looking at these studies, there are scientists who say such experiments meet the definition. “The research was — unequivocally — gain-of-function research,” <a href="https://chem.rutgers.edu/people/faculty-bio/140-ebright-richard">Richard Ebright</a>, a microbiology researcher at Rutgers University, told the <a href="https://www.washingtonpost.com/politics/2021/05/18/fact-checking-senator-paul-dr-fauci-flap-over-wuhan-lab-funding/">Washington Post</a>.
There is also a possibility that other, more direct gain-of-function experiments were conducted with other funding sources, but no evidence has emerged for this.
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<aside><q>The lab leak hypothesis “had been viewed as a fringe theory because it was espoused in fringe ways by some people with political agendas” —Marc Lipsitch, epidemiologist</q></aside>
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That said, the lab leak hypothesis doesn’t hinge on risky gain-of-function research being conducted at the lab, explained Alina Chan, a researcher at the Broad Institute and a co-signer of the Science letter.
“Maybe a few people think that there could’ve been some gain-of-function research, but I’d say that a lot of scientists who are asking for an investigation say that this was a lab accident of a mostly natural, or completely natural, virus,” Chan said.
She and other scientists want to investigate the possibility that SARS-CoV-2 or a very closely related virus escaped during normal laboratory operations. The two strongest possibilities, according to Chan, are, one, that a researcher at the Wuhan Institute of Virology was exposed to a bat coronavirus while collecting samples in the field and inadvertently brought the infection back to Wuhan. The field, in this case, is the native habitat of the bats in the southeastern provinces of China, more than 1,000 miles from Wuhan. And two, scientists at the lab could have been exposed to a sample of SARS-CoV-2 that was under study and then spread the virus to others.
Indeed, dangerous <a href="https://www.vox.com/future-perfect/2019/3/20/18260669/deadly-pathogens-escape-lab-smallpox-bird-flu">pathogens have leaked out of laboratories</a> several times before, and human error is a constant risk in any research institution. “The only labs that don’t have accidents are labs that are not functional,” Chan said.
She pointed out that someone unwittingly falling sick with a virus under study in a lab has happened before in China. In 2004, a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC403836/">researcher contracted SARS</a> after a stint working at the Chinese National Institute of Virology in Beijing. The researcher went on to infect her mother and a nurse at the hospital who went on to infect others, leading to 1,000 placed under quarantine or medical supervision.
Another concern was that the Wuhan Institute of Virology was handling coronavirus samples at <a href="https://www.phe.gov/s3/BioriskManagement/biocontainment/Pages/BSL-Requirements.aspx">biosafety level 2 precautions</a> when most other labs <a href="https://www.cdc.gov/coronavirus/2019-ncov/lab/lab-biosafety-guidelines.html">recommend a biosafety level of 3</a> or higher. At biosafety level 2, lab access is restricted, researchers must wear personal protective equipment like gloves, lab coats, and eye protection, and much of the experimental work is conducted in biosafety cabinets that filter air rather than open lab benches.
Biosafety level 3 includes all the precautions of lower levels and adds medical surveillance for lab workers, the use of respirator masks, and lab access controlled with two sets of self-closing and locking doors. The biosafety level 3 measures are aimed at controlling potentially lethal respiratory pathogens that spread through the air, while biosafety level 2 is meant for pathogens that pose a “moderate hazard.”
So seeing that the Wuhan lab was handling viruses that can travel through the air at a safety level not designed for it alarmed some observers. “When scientists hear about this, they get really freaked out,” Chan said.
<a href="https://www.publichealth.columbia.edu/people/our-faculty/wil2001">W. Ian Lipkin</a>, a virologist at Columbia University, co-authored a <a href="https://www.nature.com/articles/s41591-020-0820-9">Nature Medicine</a> paper in March 2020 that reported the most likely origin of the virus in humans was a natural spillover from animals. But he told the <a href="https://donaldgmcneiljr1954.medium.com/how-i-learned-to-stop-worrying-and-love-the-lab-leak-theory-f4f88446b04d">journalist Donald McNeil</a> in May 2021 that he was alarmed when he learned that the Wuhan Institute of Virology was conducting research on similar viruses at a lower level of protection.
“People should not be looking at bat viruses in BSL-2 labs,” Lipkin said. “My view has changed.”
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<figcaption>An epidemiological laboratory in Wuhan, China, in 2017.</figcaption>
<cite>Johannes Eisele/AFP via Getty Images</cite></figure>
Chan also noted that the <a href="https://www.reuters.com/article/health-coronavirus-wuhan-market-idINKBN28L0J1">Huanan Seafood Wholesale Market</a> in Wuhan was initially suspected as the location where a SARS-CoV-2 spillover from animals to humans occurred, but to date, <a href="https://www.livescience.com/covid-19-did-not-start-at-wuhan-wet-market.html">no infected animal has been identified</a> and Chinese researchers have <a href="https://www.wsj.com/articles/china-rules-out-animal-market-and-lab-as-coronavirus-origin-11590517508">ruled it out</a> as the origin of the virus. The initial outbreak could have occurred because so many people were in close proximity at the bustling market, but the virus may have made the leap to humans elsewhere.
There are also allegations that the Chinese government hasn’t been forthright about the early days of the pandemic and has withheld critical information from investigators, making it hard to eliminate a lab leak as a possibility. “I can also be convinced of a natural origin if that is properly investigated too,” Chan said in an email. “The problem is that the most definitive pieces of evidence would be inside of China where we currently have no access.”
A <a href="https://www.reuters.com/article/us-health-coronavirus-who-china-report/data-withheld-from-who-team-probing-covid-19-origins-in-china-tedros-idUSKBN2BM26S">team from the World Health Organization</a> that visited China in January and February of this year reported that they had difficulty getting all the information they wanted about the origins of SARS-CoV-2.
“In my discussions with the team, they expressed the difficulties they encountered in accessing raw data,” WHO Director-General <a href="https://www.who.int/director-general/biography">Tedros Adhanom Ghebreyesus</a> said <a href="https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-member-state-briefing-on-the-report-of-the-international-team-studying-the-origins-of-sars-cov-2">during a briefing in March</a>. “I expect future collaborative studies to include more timely and comprehensive data sharing.”
Properly investigating the possibility of a laboratory leak, if only to rule it out, would help answer critical scientific questions while also bolstering public confidence in the process, proponents argue. “We have to show that we have the will to investigate whenever something like this happens and that we have a system in place,” Chan said.
Questions about whether SARS-CoV-2 may have escaped from a lab have been simmering since the beginning of the pandemic, but several recent developments catapulted the debate back into the news, and even into <a href="https://www.politico.com/news/2021/06/04/republicans-covid-origin-theory-491825">Congress</a>.
At the beginning of the year, <a href="https://www.newyorker.com/news/annals-of-inquiry/the-sudden-rise-of-the-coronavirus-lab-leak-theory">New York Magazine</a> (which is owned by Vox Media) published a <a href="https://voxmedia.stories.usechorus.com/compose/b12658c0-c648-412c-adf1-5236daab3437">long article</a> by the novelist Nicholson Baker making the case that the virus may have leaked from a lab in China. Journalist Nicholas Wade made a similar case in an article published on <a href="https://nicholaswade.medium.com/origin-of-covid-following-the-clues-6f03564c038">Medium</a> in May. The letter published by <a href="https://science.sciencemag.org/content/372/6543/694.1">Science</a> in May, which called for a more thorough investigation into the hypothesis, was another driver of the conversation. A few days after the letter, an article in the <a href="https://www.wsj.com/articles/intelligence-on-sick-staff-at-wuhan-lab-fuels-debate-on-covid-19-origin-11621796228">Wall Street Journal</a> resurfaced US intelligence reports about three researchers at the Wuhan Institute of Virology who sought medical care for influenza-like symptoms in November 2019. That’s earlier than the <a href="https://www.wsj.com/articles/in-hunt-for-covid-19-origin-patient-zero-points-to-second-wuhan-market-11614335404">first confirmed case of Covid-19</a>, which occurred on December 8, 2019, according to Chinese officials. (There’s no evidence that the researchers had Covid-19, however.)
Shortly thereafter, the <a href="https://www.wsj.com/articles/wuhan-lab-leak-question-chinese-mine-covid-pandemic-11621871125">Wall Street Journal highlighted the case of six miners</a> in China who fell ill in 2012 after being hired to clear a cave of bat guano. The Wuhan Institute of Virology was called in to investigate. Researchers from the lab tested bats from the mine for coronaviruses and found an unidentified strain resembling SARS; several bats were infected with more than one virus. That created opportunities for recombination, in which viruses undergo rapid, large-scale mutations that create new pathogens.
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<aside><q>“The problem is that the most definitive pieces of evidence would be inside of China, where we currently have no access” —Alina Chan, molecular biologist</q></aside>
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One of the unidentified viruses, called RaTG13, was later found to have 96.2 percent genetic overlap with SARS-CoV-2, hinting that it may have been a predecessor. A WHO team reported that the lab wasn’t able to culture the virus, and was only in possession of its genetic sequence. If these reports are to be believed, that means the institute didn’t have an infectious ancestor to SARS-CoV-2 in its custody.
In the wake of these media reports and rising public interest, President Biden <a href="https://www.bbc.com/news/world-us-canada-57260009">ordered US intelligence agencies</a> last month to increase their efforts in investigating the potential of a laboratory origin of SARS-CoV-2 and report back in 90 days.
For some scientists, the resurgent interest in a lab leak has been frustrating, rather than illuminating. “Quite frankly, over the last number of days, we’ve seen more and more and more discourse in the media with terribly little actual news, evidence, or new material,” said <a href="https://www.who.int/director-general/who-headquarters-leadership-team">Michael Ryan</a>, executive director of the World Health Organization’s health emergencies program, during a May 28 press conference.
But for others, it has been validating. Former US Centers for Disease Control and Prevention Director Robert Redfield told <a href="https://www.vanityfair.com/news/2021/06/the-lab-leak-theory-inside-the-fight-to-uncover-covid-19s-origins">Vanity Fair</a> that he received death threats last year after stating publicly that he thought the virus originated in a lab.
And for still other researchers, the issue remains too contentious to discuss publicly. One scientist contacted for this article declined to comment on the record in part out of fear of harassment. Nonetheless, this renewed attention seems unlikely to go away anytime soon.
Despite the concerns and unknowns around the activities at the Wuhan Institute of Virology, there is no evidence SARS-CoV-2 ever passed through the laboratory; rather, the circumstances only indicate that a lab leak was possible.
Some scientists in the US were already looking into this possibility in the early days of the pandemic. Kristian Andersen, a professor at the Scripps Research Institute, exchanged emails with Fauci in January 2020 about his suspicions that the SARS-CoV-2 virus was engineered because its genetics didn’t resemble what he thought would occur in nature, according to documents obtained by BuzzFeed and the Washington Post. “I should mention that after discussions earlier today, Eddie, Bob, Mike, and myself all find the genome inconsistent with expectations from evolutionary theory,” Andersen wrote to Fauci.
Andersen then investigated the possibility, and co-authored the March 2020 Nature Medicine paper on the origins of the SARS-CoV-2 virus with Lipkin that reported the most likely origin of the virus was a spillover from an animal. Unlike Lipkin, Andersen has only become more convinced the virus came into humans via a natural exposure route.
“We cannot categorically say that SARS-CoV-2 has a natural origin but, based on available scientific data, the most likely scenario by far is that SARS-CoV-2 came from nature,” Andersen told Vox in an email. “No credible evidence has been presented to support the hypothesis that the virus was engineered in, or leaked from, a lab — such statements are based on pure speculation.”
Then what would it take to demonstrate that the virus escaped a lab?
“Evidence that [the Wuhan Institute of Virology] or another Wuhan virology lab had SARS-CoV-2 or something 99% similar would be the smoking gun,” <a href="https://medicine.tulane.edu/departments/microbiology-immunology-tulane-cancer-center-tips-advisory-committee-tips-mentor/faculty">Robert Garry</a>, a virologist at Tulane University and another co-author of the Nature Medicine paper, said in an email. “There is no evidence that SARS-CoV-2 or an immediate progenitor virus existed in any laboratory before the pandemic.”
He, too, has become more convinced that the virus jumped to humans somewhere outside the lab. “The only change since we wrote our manuscript on the Proximal Origins of SARS-CoV-2 is that I now consider any of the lab leak hypotheses to be extremely unlikely,” he said.
Shi Zhengli at the Wuhan Institute of Virology <a href="https://www.scientificamerican.com/article/how-chinas-bat-woman-hunted-down-viruses-from-sars-to-the-new-coronavirus1/">told</a> Scientific American she instructed her team to sequence the genomes of all the viruses they were studying in their laboratory and compare them to sequences obtained from Covid-19 patients. None matched. “That really took a load off my mind,” she said. (Shi did not respond to a Vox request for comment.)
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<figcaption>Chinese virologist Shi Zhengli seen inside the epidemiological laboratory in Wuhan in 2017.</figcaption>
<cite>Johannes Eisele/AFP via Getty Images</cite></figure>
Several other factors point toward a natural origin of SARS-CoV-2, according to <a href="https://microbiology.columbia.edu/faculty-vincent-racaniello">Vincent Racaniello</a>, a virologist at Columbia University. Among them is that the 2003 SARS virus outbreak established a precedent for a coronavirus jumping from bats to an intermediary species to humans. In that case, the intermediary — civet cats — was identified; scientists have been <a href="https://www.nature.com/articles/nm.3985">warning for years that a similar scenario</a> could easily occur again.
Further animal investigations showed that there are a number of viruses like SARS-CoV-2 in bats, not just in China but also in Thailand, Cambodia, and Japan. These viruses are not direct ancestors of SARS-CoV-2, but they are closely related. Viruses mutate all the time, and the more widespread they are, the more changes can occur. Seeing a related virus over such a wide area shows there was ample opportunity for it to spread and mutate in nature before it made the final jump into humans.
The WHO also found that in the earliest days of the pandemic, during the outbreak in Wuhan, China, in 2019, there were two distinct lineages of the virus with different transmission patterns through the region. “That tells us that there were either two wildlife sources or that, early on, the virus switched from one animal to another,” Racaniello said. “That’s very difficult to make sense of with a lab origin. In my opinion, that’s really strong evidence this came from nature, because it’s a simpler scenario.”
He also pointed out that while there have been leaks of pathogens from laboratories in the past, those were known diseases at the time: “There has never been a new virus to come out of a lab.”
As for the circumstances that hint at a lab leak, some scientists still don’t find them compelling. For instance, while the Wuhan Institute of Virology was handling coronaviruses at biosafety level 2, none of the viruses the lab was known to be studying have leaked, and, again, there is no evidence the lab had any contact with SARS-CoV-2.
“It’s not actually news that the Wuhan Institute was handling these viruses at BSL-2. It’s in the methods of their papers going back years,” said <a href="https://cellvolution.org/stephen-goldstein.html">Stephen Goldstein</a>, a virologist at the University of Utah. “I don’t see how people can hold that up as a specific piece of evidence for any given scenario.”
Similarly, investigators say they were aware for months of reports that scientists at the Wuhan Institute of Virology sought treatment for an unknown illness. Virologist <a href="https://www.erasmusmc.nl/en/research/researchers/koopmans-marion">Marion Koopmans</a>, a member of the WHO investigation team that visited China earlier this year, told <a href="https://www.nbcnews.com/nightly-news/video/who-team-scientist-wuhan-lab-workers-fell-sick-in-2019-104497733806">NBC News</a> they investigated and had already ruled out those infections as early cases of Covid-19. “There were occasional illnesses because that’s normal,” she said. “There was nothing that stood out.”
China’s reluctance to cooperate with outside investigators and share information could be a sign of a cover-up of a lab leak. But it could also stem from reasons that have nothing to do with the virus, perhaps a consequence of broader international tensions.
And while the WHO’s initial investigation was not comprehensive, researchers are in the planning stages of another trip to China to study the origins of the virus. This time, the team wants to look at blood samples going back two years and screen them for antibodies to SARS-CoV-2. That could allow scientists to map previously unknown chains of transmission of the virus and narrow the scope of possible origins.
If SARS-CoV-2 did escape via a laboratory accident, it’s urgent to try to figure out exactly how it happened and to take precautions, especially given that there are other laboratories conducting research on dangerous pathogens around the world. “If the lab-leak hypothesis is put aside because it is too contentious, laboratory safety and especially risky research will continue to be ignored,” <a href="https://profiles.stanford.edu/david-relman">David Relman</a>, an infectious disease researcher at Stanford University and a co-signer of the Science letter, wrote Wednesday in the <a href="https://www.washingtonpost.com/outlook/2021/06/02/lab-leak-investigate-risky-research/">Washington Post</a>. “We cannot afford to bury our heads in the sand about one possible cause of the origins of Covid-19 simply because it is politically sensitive.”
On the other hand, there is no reason why laboratories would need to wait on the outcome of such an investigation to take steps to prevent future accidents. They could conduct safety audits and ensure experiments are conducted under the proper biosafety levels. Over the long term, facilities researching viruses like the one in Wuhan could even be relocated away from major population centers.
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<figcaption>Security personnel stand at the entrance of the Wuhan Institute of Virology during a visit by members of the World Health Organization on February 3.</figcaption>
<cite>Ng Han Guan/AP</cite></figure>
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Similarly, policymakers could take steps to prevent natural spillovers. As humans venture further into wilderness areas to cultivate land and resources, the chances grow of a previously unknown virus crossing over from animals into people. The wildlife trade and venues like wet markets certainly aren’t helping. In a sense, even a “natural origin” of SARS-CoV-2 stems from human causes. “All these spillovers, wherever they are, it’s because human activity is encroaching upon animal activity,” Racaniello said.
While it would be ideal to investigate all possible origins of a deadly global disease, it may not be practical. Given that one pathway has evidence for it and another does not, some scientists say it’s better to focus on the likelier routes.
“It is a mistake to weight these possibilities equally, and it risks underresourcing the investigations into animal sources of this virus that we really need so we can understand the pathways of emergence and cut them off before this happens again,” Goldstein said.
Tracing the animal origins of SARS-CoV-2 is already poised to be a monumental and tedious task for scientists. It will require immense resources as well as cooperation with authorities in China, which may be jeopardized if an investigation into a lab leak isn’t handled with tact.
“Sure ‘investigate’ the lab. But, arm-waving about an often mentioned ‘forensic’ investigation (whatever that means) is not helpful,” Garry said in an email.
More answers about the roots of the pandemic may emerge in the coming months, but it’s likely that further inquiries won’t be enough to satisfy everyone. Even after the pandemic fades away, the virus that caused it may long frustrate and confound.
 
 
source <a href="https://www.vox.com/22453571/lab-leak-covid-19-coronavirus-hypothesis-wuhan-virology-china">https://www.vox.com/22453571/lab-leak-covid-19-coronavirus-hypothesis-wuhan-virology-china</a>

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Biden wants to raise corporate taxes. He might need the world’s help.

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President <a href="https://www.vox.com/joe-biden">Joe Biden</a> wants to <a href="https://home.treasury.gov/system/files/136/MadeInAmericaTaxPlan_Report.pdf">raise taxes</a> on corporations. Part of his success could hinge on getting the rest of the world to go along, or, at least, trying.
It’s no secret that companies would rather not pay taxes — and that they employ a litany of tricks and schemes, both domestic and international, to keep their tax bills low. Over the past 35 years, the average corporate tax rate worldwide has been more than halved, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3655850">falling from 49 percent in 1985 to 23 percent in 2019</a>. Despite efforts to improve the international tax regime, including with the 2017 tax law put in place under President Donald Trump, companies still find a plethora of workarounds. That includes profit-shifting, where companies book profits from higher-tax jurisdictions in lower-tax jurisdictions to lower their tax bills. Profit-shifting by American and foreign multinationals <a href="https://home.treasury.gov/news/press-releases/jy0079">costs the US tens of billions of dollars a year</a> as they remain undeterred from seeking out tax havens in places such as Bermuda, the Cayman Islands, Ireland, and Singapore.
The White House and <a href="https://www.finance.senate.gov/imo/media/doc/040121%20Overhauling%20International%20Taxation.pdf">some Senate Democrats</a> are calling for revamping the US tax code’s approach to international taxation and trying to reduce profit-shifting further, including increasing the minimum tax on the overseas profits of American companies from 10.5 percent to 21 percent. Biden also aims to increase the US corporate tax rate from 21 percent to 28 percent. His administration appears well aware that one element that would make their efforts easier — or at the very least, ease concerns about US competitiveness and actually enforcing its tax rates — would be for the international community to go along.
That’s why the US is also throwing its weight behind the idea of a global minimum tax for countries to put in place worldwide. The hope is that it would stop countries from lowering their tax rates to attract investments and businesses in what many economists and politicians describe as a perpetual “race to the bottom.”
“Together we can use a global minimum tax to make sure the global economy thrives based on a more level playing field in the taxation of multinational corporations, and spurs innovation, growth, and prosperity,” said Treasury Secretary Janet Yellen in an <a href="https://home.treasury.gov/news/press-releases/jy0101">April speech</a>.
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<aside><q>“The US government is serious, many of the European governments are serious, but with anything that’s multilateral, there are still risks and hurdles ahead”</q></aside>
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Yellen is leading America’s charge with the Organization for Economic Cooperation and Development (OECD), an international economic organization, and the Group of 20 (G20) to establish a global minimum tax across multiple countries. The idea has been gaining traction within the OECD for quite some time, though it’s far from a done deal. <a href="https://www.reuters.com/article/us-usa-treasury-yellen-eu/eu-backs-u-s-call-for-global-minimum-corporate-tax-but-rate-to-be-decided-idUSKBN2BT1YG">The rate will likely be a sticking point</a> (some countries would prefer a much lower minimum than others), and even if the OECD does reach an agreement, it’s nonbinding — individual countries would then have to figure out whether to enact it. Still, there’s progress.
“I think there’s a much better chance now that the US has gotten behind it,” said Craig Hillier, leader for international tax services at Ernst & Young Americas. “The US government is serious, many of the European governments are serious, but with anything that’s multilateral, there are still risks and hurdles ahead.”
In early June, there was some progress on the matter, after leaders from the Group of 7 (G7) <a href="https://www.nytimes.com/2021/06/05/us/politics/g7-global-minimum-tax.html">said</a> they would back at least a 15 percent global minimum tax rate. Secretary Yellen heralded it as a “significant, unprecedented commitment that provides tremendous momentum” toward a minimum tax becoming a reality. However, <a href="https://www.wsj.com/articles/a-g-7-deal-on-a-global-minimum-tax-for-companies-faces-hurdles-11623016756">many obstacles</a> to cementing a deal remain.
The US can take measures to try to make sure its multinational companies are paying their fair share in taxes, and efforts have been ramping up — to varying degrees of success — in recent years. “Irrespective of international coordination, I think the US can strengthen its rules against tax haven abuse,” said Seth Hanlon, a senior fellow at the Center for American Progress.
The 2017 Tax Cuts and Jobs Act, which was largely favorable to corporations, including multinationals, had some provisions to try to get at some international profits. It implemented the global intangible low-taxed income rate, or <a href="https://www.investopedia.com/global-intangible-low-taxed-income-gilti-definition-5097113">GILTI</a>, of 10.5 percent, which was supposed to act as a minimum tax for offshore profits. And it <a href="https://www.taxpolicycenter.org/briefing-book/what-tcja-base-erosion-and-anti-abuse-tax-and-how-does-it-work">tried to curb</a> the practice of US companies paying high interest and royalties to foreign affiliates to try to lower their American tax bills.
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<aside><q>“Multinationals still shift hundreds of billions in profits offshore each year”</q></aside>
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But those provisions didn’t work all that well: As Chye-Ching Huang, executive director of the Tax Law Center at NYU Law, <a href="https://www.finance.senate.gov/imo/media/doc/Huang%20testimony%2003220221%20rev.pdf">explained</a> in recent testimony before the US Senate, “their design undermines their effectiveness, and retains incentives to locate profits or investment overseas in some circumstances, and increases those incentives in others.” Substantial profits remained outside of the law’s reach, and corporations still found ways to average out income and taxes so they could get around the minimum, among other issues.
“By relocating their profits in Bermuda and the Caymans, they can bring the foreign average down to the GILTI rate, and so there are still profits that are flowing to tax havens, despite the minimum tax,” Hanlon said.
Huang, in her testimony, was matter-of-fact: “Multinationals still shift hundreds of billions in profits offshore each year.”
Under Biden, <a href="https://home.treasury.gov/system/files/136/MadeInAmericaTaxPlan_Report.pdf">the White House has laid out plans</a> to overhaul parts of the tax code put in place in 2017, including the GILTI regime. Among other items, it would calculate the tax rate on a per-country basis, so companies couldn’t try to average out their German tax bill with their Swiss one, and it would increase the minimum tax rate to 21 percent. Sens. Ron Wyden (D-OR), Sherrod Brown (D-OH), and Mark Warner (D-VA) <a href="https://www.finance.senate.gov/imo/media/doc/040121%20Overhauling%20International%20Taxation.pdf">have also released a proposal on international taxation</a> meant to tighten the US code, including righting some of the perceived wrongs in the 2017 bill.
Still, there are concerns that if the US continues to tighten rules and other countries don’t go along, it will be out on a limb. “The concern is that if the US has a minimum tax and no one else in the world has a minimum tax, there’s a disadvantage of being a US company versus being a company headquartered in another country,” Hillier said. “This is why the Biden administration has now stressed its strong support for a global minimum tax.”
A global minimum tax is basically what it sounds like: It would put a minimum tax rate on profits no matter where they’re coming from. <a href="https://www.reuters.com/article/us-global-economy-tax-explainer/explainer-what-is-a-global-minimum-tax-and-how-could-it-affect-companies-countries-idUSKBN2BU0E7">Reuters has a good explainer here</a>.
When US negotiators brought up the idea of the global minimum tax at the OECD under the Obama administration, they say they were basically “<a href="https://ir.lawnet.fordham.edu/jcfl/vol24/iss2/1/">laughed out of the room</a>.” But times have changed. Discussions within the OECD about a global minimum tax amid broader negotiations over cross-border tax rules are advancing, and while there’s still not widespread agreement on everything — <a href="https://www.reuters.com/article/us-g20-usa-oecd/u-s-drops-safe-harbor-demand-raising-hopes-for-global-tax-deal-idUSKBN2AQ2E6">the US has been the holdout on some issues</a> — there’s hope a consensus could be on the horizon by midyear.
To be sure, the OECD is not a legislative body; all it can do is make recommendations. So if it were to reach an agreement on a global minimum tax, it would be up to countries to then implement it. That would take time, and isn’t a given. “One risk is that other countries don’t implement it; the other is that they probably won’t enact the same system as the US, they’ll do something different, and it’ll still be more favorable,” Hillier said. But the hope is that if enough countries put something in place, especially the ones that are home to big multinational corporations, it would be enough to make a difference.
The race-to-the-bottom problem has become increasingly apparent. As Jeff Stein outlined in <a href="https://www.washingtonpost.com/us-policy/2021/03/15/yellen-pushes-global-minimum-tax-white-house-eyes-new-spending-plan/">the Washington Post</a>, 76 countries cut corporate taxes between 2000 and 2018, while only 12 kept them the same and six increased them. Today, fewer than 20 countries have corporate tax rates over 30 percent, compared to more than double that number at the turn of the century.
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<aside><q>76 countries cut corporate taxes between 2000 and 2018</q></aside>
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There are some questions as to whether a global minimum tax is a good idea, Hillier noted. “There’s a question of, is tax competition a bad thing?” he said. Or, should the US be able to weigh in on what Ireland is doing, tax-wise? He added that tax havens also view themselves as playing an important role in the global economy.
While the US and other high-tax countries might prefer a higher global minimum tax than, say, countries where the corporate tax rate is lower, something might be better than nothing. And as Jordan Weissmann points out at <a href="https://slate.com/business/2021/04/joe-biden-tax-havens-corporate-global-minimum.html">Slate</a>, even just some countries taking action could make a difference: 10 countries headquarter about 80 percent of multinational profits.
The US can act on taxes without getting the international community to follow, and there’s debate about what the impact of that would be. Sen. Pat Toomey (R-PA) has warned he believes that a global minimum tax will fail and argued that the administration’s push for it is an acknowledgment that Biden’s proposed corporate tax increase from 21 percent to 28 percent will make the US less competitive. “‘Race to the bottom’ is the way the Biden administration describes competition among developed countries to get to a tax code that attracts investment and maximizes growth. It is a race we should be leading, not trying to prevent,” he said in a <a href="https://www.toomey.senate.gov/newsroom/press-releases/toomey-a-minimum-global-corporate-income-tax-will-likely-fail-and-is-non-binding">statement</a> in April.
Others say the competitiveness argument doesn’t hold as much water as figures such as Toomey would like. After all, before the 2017 tax bill, America’s corporate tax rate was 35 percent.
“Concerns about the competitiveness of US multinationals ignore the evidence,” said Kimberly Clausing, deputy assistant secretary of tax analysis at the Treasury Department, in <a href="https://home.treasury.gov/news/press-releases/jy0079">Senate testimony in March</a>. “Both before and after the 2017 Tax Act, US multinational companies are the envy of the world, not just for their high profits and market capitalization, but also for their tax planning acumen. US multinational companies paid similar effective tax rates as peers in other countries, even before the 2017 tax law dramatically lowered US corporate tax rates.”
At least for now, the Biden administration’s plan appears to be trying to bring other countries along in its attempt at further corporate tax clampdowns and sharpening its appeal. “Competitiveness is about more than how US-headquartered companies fare against other companies in global merger and acquisition bids,” Yellen said in March. “It is about making sure that governments have stable tax systems that raise sufficient revenue to invest in essential public goods and respond to crises and that all citizens fairly share the burden of financing government.”
Update, June 7: Story updated with news of G7’s tentative agreement on a 15 percent global minimum tax rate.
 
 
source <a href="https://www.vox.com/policy-and-politics/22381673/global-minimum-tax-janet-yellen-oecd">https://www.vox.com/policy-and-politics/22381673/global-minimum-tax-janet-yellen-oecd</a>

vox Biden wants to raise corporate taxes. He might need the world’s help.

President Joe Biden wants to raise taxes on corporations. Part of his success could hinge on getting the rest of the world to go along, o...

Man In Canada Murders An Entire Muslim Family

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An officer at the site of the crime
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A man in Canada was arrested for the murder of a Muslim family, as we read in <a href="https://www.cbc.ca/news/canada/london/london-pedestrians-killed-man-in-custody-1.6056238">CBC</a>:
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A 20-year-old man was charged Monday with four counts of murder and one count of attempted murder in a hit and run Sunday involving a pickup truck, in what London, Ont., police believe was a targeted attack on a Muslim family of five.
Terrorism charges are also possible against Nathanial Veltman, 20, of London, said Det.-Insp. Paul Waight at a news conference.
Veltman appeared in court via video link Monday afternoon.
“There is evidence that this was a planned, premeditated act and that the family was targeted because of their Muslim faith,” said Waight.
“This is a devastating loss of four members of our community,” added police Chief Steve Williams at an afternoon news conference.
The vehicle struck the family at 8:40 p.m. ET Sunday as they walked along Hyde Park Road, in northwest London.
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source <a href="https://shoebat.com/2021/06/07/man-in-canada-murders-an-entire-muslim-family/">https://shoebat.com/2021/06/07/man-in-canada-murders-an-entire-muslim-family/</a>

armageddon Man In Canada Murders An Entire Muslim Family

An officer at the site of the crime A man in Canada was arrested for the murder of a Muslim family, as we read in CBC : A 20-year-old m...