Last August, amid the final throes of President Alberto Fujimori's scandal-ridden administration in Peru, he bowed to US pressure and announced that Lori Berenson's conviction by a secret military court would be voided and that she would be granted a new civilian trial. Thanks to nearly six years of poisonous publicity, Berenson, who in January 1996 was sentenced to life in prison for "treason against the fatherland," was widely viewed by Peruvians as a gringa terrorista who had come to Peru to join the Túpac Amaru Revolutionary Movement (MRTA), an unpopular guerrilla organization. So when her new trial finally opened this past March, Berenson's supporters held out little hope that it would yield a just verdict.
As expected, on June 20 the panel of three judges handed down a conviction on the reduced charge of collaboration with terrorism. Sentencing Berenson to the maximum of twenty years in prison, the court declared that she was not an active member of the MRTA but neither was she a "mere spectator" in the house she shared in Lima with fifteen MRTA militants. Because of the more than five years she has already served, she is scheduled to be released in 2015.
As Peru's fragile democracy grapples with the legacy of Fujimori's war on guerrilla movements--carried out by notorious spymaster and former CIA collaborator Vladimiro Montesinos, recently captured in Venezuela after an eight-month international manhunt--Berenson's trial was an opportunity to show how far the country has come since the days of hooded military judges, doctored evidence, coercion of witnesses and trumped-up terrorism charges. Sadly, the answer turned out to be, Not far enough. In many respects Berenson's new trial was a vast improvement over the last--she was able to confront her accusers, her lawyers cross-examined witnesses and the proceedings were open to the public. But Peru's judicial system has yet to resolve the thorny issue of how civilian courts should deal with evidence that may have been tainted or even fabricated by Fujimori's ruthless antiterrorism police force. While hundreds remain in prison on the basis of no evidence at all, thousands more, like Berenson, are serving lengthy sentences as a result of circumstantial evidence and untrustworthy investigations [see Jonathan Levi and Liz Mineo, "The Lori Berenson Papers," September 4/11, 2000]. Peruvian courts must devise an approach to those cases that respects international standards of fairness and due process. In the absence of that, Berenson's pending appeal to the Peruvian Supreme Court is unlikely to succeed, although the court might decide to reduce her sentence.
Incoming President Alejandro Toledo, who could pardon Berenson when he takes office on July 28, disappointed her supporters when he said on a late June visit to the United States that he would not interfere with the court's decision. Toledo pointed out the need to respect the independence of the courts, but surely there is a difference between a president meddling with the judiciary to enhance his own power, as Fujimori did, and using executive authority to pardon someone denied a fair trial.
Granting clemency to Berenson and others like her is no long-term solution, however. Peru still needs far-reaching judicial reforms, beginning with the repeal of the draconian antiterrorism laws enacted in 1992. That would be an important step forward in the long process of exorcising the ghosts of Fujimori and Montesinos, and restoring the faith in government shattered by their corrupt rule.
The census makes clear about Latinos what many of us have known for a long time: The power of culture and character is now reinforced by demographics. From a small minority struggling to achieve legitimate power, Latinos have become a very important group politically, one that must now learn how to use power. At this point the role of Latinos in the public world changes. They begin to appear more often in the general media, although not yet in what anyone would consider equitable proportion, and the marketers pay even greater attention to Spanish-language media. Democrats want to know what Latinos can do for them and Republicans want to know what Latinos are willing to trade for their votes. The question of what Latinos want for themselves is seldom raised. Even in the left/liberal press, coverage of Latino issues has been sparse. And what has appeared has been limited mainly to reportage.
There should, of course, be more reporting about Latinos rather than less, but there must be other kinds of writing as well. The reason for this seems obvious: The use of power is more complex than the struggle to obtain power. The dialogue among Latinos--rather than merely about them--on issues that affect the Latino community and the rest of the world should now appear with some regularity in the national left/liberal press.
There are many questions best debated by Latinos: What are the intergenerational conflicts, and how do they affect politics? Should ethnic loyalties trump political values at the polls? What is gained and what is lost by assimilation? Should Latinos criticize Latino elected officials? Will such criticism strengthen the community or tear it apart, vitiating its hard-won power? How can people of differing national origin within the community link with each other, and how can Latinos link with blacks, Asians, Jews, Native Americans and other minority groups? How should left/liberal Latinos deal with the growing Latino middle class and its rightward turn? These and other issues should be debated openly by Latinos, in a way and in publications that will also inform the thinking of non-Latinos.
Unfortunately, Latino voices have been little more than a whisper in the left/liberal press, including The Nation. And the kind of essayistic pieces born of the desire to influence the use of power are virtually unknown. Yet, there are more than enough good Latino writers, with an interesting variety of opinions. What must happen, in my opinion, will require some effort from Latino writers and from the national left/liberal press. The writers must make their ideas known to the editors, and the editors must try to discern the importance of the work presented to them.
In the great tradition of the left/liberal press, the result will be rages and rancors, but there will also be some incremental advance toward freedom and social justice. Perhaps the disagreements over the language and timing of this piece will provide a useful beginning.
The state's justice system crushes poor people like Ernestina Rodriguez.
John Elias, my patient, has a dilemma. He can't afford to buy his medicines and also pay his rent. I'm sure he won't give up his apartment just to keep his veins filled with my chemical suggestions. But he is willing to take whatever free drug samples I provide. Luckily, drug company representatives visit my office regularly and drop off oversize, brightly colored boxes of pills, one or two pills per box. Sometimes I can fill a plastic bag with enough medicine to supply a patient's needs. Still, my sample closet is not as well stocked as the local pharmacy.
The explosion of samples occurs most often when two drug companies are competing over a similar product. When I have one set of pills, it's Elias's diabetes that's treated; when I have another set, it's the hypertension. He does not die, but his blood pressure goes up and down, and his blood sweetens with rising sugar, which lowers whenever I happen to have the right pills. Elias leaves my office smiling, more comfortable with his predicament than I am.
"See you in a month, Doc. And don't worry. I got enough pills here to last me a good ten days."
I do worry--about the remaining twenty days, about his risk of a heart attack or a stroke--but samples arrive at the drug company's rate, not in response to my urgent requests.
Elias is disabled, the result of a spine operation that didn't go his way. He has Medicare, but like millions of other disabled and elderly Americans, he's unable to afford the secondary insurance that would include a drug plan. He earns too much in his part-time clerical job to qualify for Medicaid, which also covers prescriptions, or to be accepted into a drug company's "Share the Care" program. He does qualify for New York State's EPIC plan, which allows some Medicare patients to fill all their prescriptions for under $100 per month, but he says he can't afford even that. He says he won't consider leaving his job to get Medicaid as others have done; he's proud of the fact that he can still work.
Elias lives in his wheelchair; the levers and locks are extensions of his arms, the wheels his legs. He navigates the street outside my office, leaning back on two wheels to jump the curb. His arching wheelies are another man's sidestep. But he has not managed to navigate his other diseases the way he has his paralysis. When I tell him the dangers of not controlling his diabetes and his high blood pressure, his smile fades. "When you're out, then I'm out," he says simply.
Meanwhile, the same company that makes his diabetes pill offers to fly me, all expenses paid and with a $1,000 stipend, to a frolicking weekend in Naples, Florida, where I would hear lectures for three hours a day on a drug I already prescribe, before adjourning to the surf and a sightseeing sunset booze cruise. The competitor invites me to the corporate box at the ballgame, with a lobster buffet and a live calypso band to entertain us between innings.
The drug salesman infiltrates the somber atmosphere of my medical office, trailed by a huge sample case on tiny wheels. It's uncanny: He knows how much of his drug I prescribe, and he wrongly assumes that I will respond to his enticements. He provides catered lunches to my office staff where the only apparent cost is listening to him harp on about a product that he freely admits I know more about than he does.
Despite the money spent on massive advertising, the manufacturers insist that exorbitant drug prices are the result of research and development. Several of the industry's best researchers are former professors who have been wooed away from the universities for higher salaries and better laboratories, and for every participant in the drug pipeline, from discovery to production, the excitement is almost palpable. New medicines for arthritis, hypertension, high cholesterol and diabetes improve the quality of life with fewer side effects. However, the new drugs are sold in Canada and Europe for a much lower price--a $15 pill in Detroit may cost $5 across the river in Windsor, Ontario--and there are foreign chemists producing these drugs in the laboratory and companies selling them for a fraction of their cost in the United States.
The more expensive the drug, the more difficult it is to determine how it is going to be paid for. Recently, a new wonder drug for arthritis became available in two formulations, one oral, the other intravenous. The choice of which form to use illustrates a basic problem in reimbursement. Since Medicare pays only for the more expensive intravenous, patients are being hospitalized unnecessarily to receive it.
As a doctor, I'm frustrated by the current system's inability to consistently provide for a patient's medicinal needs. Clearly, there is a need for government to intervene, but it's crucial that this intervention include an understanding of inflated costs and a plan for combating this inflation. As Medicare expands to cover pills, will the federal government drive a hard bargain and negotiate a lower price per pill the way HMOs, hospitals and other countries already do? I don't see how taxpayers can avoid being penalized if the government agrees to pay top dollar.
This year, after many insufficient attempts to maintain his health with samples, Elias wheels into my office with, if wheels were legs, an almost detectable swagger. All his years in service as a clerk have finally paid off. He is now the recipient of secondary insurance with a drug plan. He is one of the lucky ones. Now all his medications will be covered, at least for the moment.
"I'm ready to be healthy," he says with a grin that reveals his neglected teeth. "Lay those prescriptions on me."
Read Richard Kim's report on the Stop Global AIDS March here.
Read the UN Declaration of Commitment on HIV/AIDS here.
Click here to review some of the more perceptive comments on the Scalia Five's judicial coup d'etat.
New York City; Saturday, June 23, 2001--The Stop Global AIDS March today brought together thousands of AIDS, debt relief, anti-racist and anti-globalization activists from around the world
The concept captures fundamental characteristics of today's world order.
With the Bush Administration, the corruption isn't hidden in the Lincoln Bedroom. It's paraded in your face. On June 18 Treasury Secretary Paul O'Neill lunched with executives of leading financial houses at Windows on the World high atop New York's World Trade Center. His unstated purpose was to help raise $20 million from the companies he regulates, as an initial ante for a private advertising campaign to promote Social Security privatization. When George W. Bush joked during the campaign that the rich were "my base," he wasn't kidding.
The Administration has lurched straight from its tax cut to privatizing Social Security. On June 11 the sixteen members of Bush's Commission to Strengthen Social Security, all handpicked by the White House for their prior support of private accounts, announced that they are unanimously in favor of using part of Social Security taxes to create "individually controlled personal retirement accounts" to be invested in the stock market. Commission co-chairman Richard Parsons, co-chief operating officer of AOL-Time Warner, made the costs clear, saying the panel would consider raising the retirement age and cutting benefits. "For future retirees, you can consider everything on the table," he said.
A coalition of citizen organizations led by the Institute for America's Future and including labor, women's groups, the National Urban League, senior and youth groups, and disability activists immediately denounced the commission members as "astonishingly unrepresentative of the views held by most Americans concerning Social Security's future." A week later two members of the House Ways and Means Committee ran into a Midwestern version of the same citizens' coalition in Missouri when they conducted a "field hearing" to promote privatization. According to the St. Petersburg Times, committee chairman Bill Thomas had envisioned the hearing as an opportunity to foment an "intergenerational clash" between retirees and Generation Xers on Social Security reform. Instead, seniors and young people demonstrated for "intergenerational solidarity" against privatization.
Similarly, O'Neill's airy power lunch was punctuated by a protest rally organized by the AFL-CIO, the Institute for America's Future, the New York Statewide Senior Action Council, the 2030 Center (for young people) and other groups. Joined by Representatives Jerrold Nadler and Jan Schakowsky, the protesters denounced the blatant impropriety of O'Neill's helping solicit private funds to lobby for a plan that will generate billions for financial barons like Morgan Stanley, American International Group, Citigroup and Deutsche Bank, all of whom were expected to be at the lunch.
To repeat what we've said before: Social Security is not in financial trouble now and may never be; just tweak the actuarial assumptions used by the privatizers and any shortfall disappears. But even if more money is needed at some point to pay benefits, sensible solutions are at hand--the simplest being to raise or remove the cap on the amount of earnings on which Social Security taxes are levied. That idea, of course, does not go down well with the high-income crowd that supports Bush.
By the fall, the Bush Administration will hang around the neck of every Republican running for Congress a detailed plan for privatization, and Bush and O'Neill will be publicly identified with the campaign designed to sell this lemon to the American people. In 2002, Americans will have a clear choice to make.
Democrats and Republicans alike are claiming the education bill as a victory. The national testing plan--mandating annual tests in grades three through eight, plus one in high school--is a significant departure from the past. As right-wing pundit Chester Finn once observed, liberals have traditionally hated the word "testing" and conservatives have hated the word "national." But old principles gave way to current political imperatives. Democrats seized on words like "accountability" and Republicans armed themselves with "compassion."
The bill is not, however, a victory for children in public schools, particularly those from disadvantaged backgrounds. The Harvard Civil Rights Project has shown that poor and minority children are hurt the most by an excessive reliance on high-stakes testing--in which performance on standardized tests determines promotion to the next grade, graduation or even the survival of the school. High-stakes tests are associated with high dropout rates, an escalating problem among African-American boys. Exams alone don't motivate struggling students and can even have the opposite effect, according to a Boston College study.
What students need are tests that truly measure how well schools are teaching basic skills, accompanied by constructive responses to weak points--tutoring, after-school programs that go beyond remediation, summer school (when necessary) that does more than rehash the year's curriculum and, above all, expertly trained, decently paid teachers for all our schools, especially those serving a high concentration of poor students. The education bill emerging from Congress guarantees none of those things. Instead, failing schools receive as little as one year of technical assistance, and students get tutoring and transportation subsidies to attend another school; within five years the failing school could face total "reconstitution," meaning the staff would be fired.
A critical difference between the House and Senate bills is the method of measuring school success. The House would require schools to break out test scores by race, exposing schools where well-off white students are thriving while minority kids are stuck in the low-performing track (the "soft bigotry of low expectations" that Bush is fond of lamenting); the Senate lets schools average their test scores, masking any racial achievement gap. Bush is under intense pressure from the Republican-dominated National Governors Association--conservative governors fear having to pour resources into schools revealed to be neglecting their minority students--to support the Senate's version on this point.
Ted Kennedy and the other Senate liberals hailing the education bill as a triumph focus on the dollar signs. They can claim that the Senate bill authorizes $33 billion--including more money for teacher training, improving school buildings and programs for disabled and immigrant children--versus Bush's $19 billion and the House's $24 billion. But even the Senate figure falls woefully short, and getting the funds appropriated down the road will entail a messy fight, given the promised tax cuts. That inconvenient fact could spoil the bipartisan fun.