Forget about the endless drama, the bots, the abrupt reversals, the spectacle, the alleged risk to the Republic and all we hold dear. Here is the most important thing about Elon Musk’s buying Twitter: The moguls have been unleashed.
In the old days, when a tech tycoon wanted to buy something big, he needed a company to do it. Steve Case used AOL to buy Time Warner. Jeff Bezos bought Whole Foods for Amazon. Mark Zuckerberg used Facebook to buy Instagram and WhatsApp and Oculus and on and on. These were corporate deals done for the bottom line, even if they might never have happened without a famous and forceful proprietor.
Mr. Musk’s $44 billion takeover of Twitter, which finally became a reality on Thursday, six months after he agreed to the deal, is different. It is an individual buying something for himself that 240 million people around the world use regularly. While he has other investors, Mr. Musk will have absolute control over the fate of the short-message social media platform.
It’s a difficult deal to evaluate even in an industry built on deals, because this one is so unusual. It came about whimsically, impulsively. But, even by the standards of Silicon Valley, where billions are casually offered for fledging operations — and even by the wallet of Mr. Musk, on most days the richest man in the world — $44 billion is quite a chunk of change.
the midterm elections’ most prominent campaign contributor, pumping tens of millions of dollars into right-wing congressional candidates. Two of his former employees are the Republican nominees for senator in Ohio and Arizona.
Elon Musk’s Acquisition of Twitter
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A blockbuster deal. In April, Elon Musk made an unsolicited bid worth $44 billion for the social media platform, saying he wanted to turn Twitter into a private company and allow people to speak more freely on the service. Here’s how the monthslong battle that followed played out:
A surprise move. On Oct. 4, Mr. Musk proposed a deal to acquire Twitter for $44 billion, the price he agreed to pay for the company in April. On Oct. 27, the purchase was completed. Mr. Musk quickly began cleaning house, with at least four top Twitter executives — including the chief executive and chief financial officer — getting fired.
Richard Walker, a professor emeritus of economic geography at the University of California, Berkeley and a historian of Silicon Valley, sees a shift in the locus of power.
“In this new Gilded Age, we’re being battered by billionaires rather than the corporations that were the face of the 20th century,” he said. “And the tech titans are leading the way.”
bought The Washington Post for $250 million. Marc Benioff of Salesforce owns Time magazine. Pierre Omidyar of eBay developed a homegrown media empire.
Deals have been a feature of Silicon Valley as long as there has been a Silicon Valley. Often they fail, especially when the acquisition was made for technology that either quickly grew outdated or never really worked at all. At least one venerable company, Hewlett-Packard, followed that strategy and has practically faded away.
$70 billion-plus acquisition of Activision Blizzard, which is pending, has garnered a fraction of the attention despite being No. 2.
said in April after sealing the deal. “I don’t care about the economics at all.”
He cared a little more when the subsequent plunge in the stock market meant that he was overpaying by a significant amount. Analysts estimated that Twitter was worth not $44 billion but $30 billion, or maybe even less. For a few months, Mr. Musk tried to get out of the deal.
This had the paradoxical effect of bringing the transaction down to earth for spectators. Who among us has not failed to do due diligence on a new venture — a job, a house, even a relationship — and then realized that it was going to cost so much more than we had thought? Mr. Musk’s buying Twitter, and then his refusal to buy Twitter, and then his being forced to buy Twitter after all — and everything playing out on Twitter — was weirdly relatable.
Inescapable, too. The apex, or perhaps the nadir, came this month when Mr. Musk introduced a perfume called Burnt Hair, described on its website as “the Essence of Repugnant Desire.”
“Please buy my perfume, so I can buy Twitter,” Mr. Musk tweeted on Oct. 12, garnering nearly 600,000 likes. This worked, apparently; the perfume is now marked “sold out” on its site. Did 30,000 people really pay $100 each for a bottle? Will this perfume actually be produced and sold? (It’s not supposed to be released until next year.) It’s hard to tell where the joke stops, which is perhaps the point.
Evan Spiegel.
“What was unique about Twitter was that no one actually controlled it,” said Richard Greenfield, a media analyst at LightShed Partners. “And now one person will own it in its entirety.”
He is relatively hopeful, however, that Mr. Musk will improve the site, somehow. That, in turn, will have its own consequences.
“If it turns into a massive home run,” Mr. Greenfield said, “you’ll see other billionaires try to do the same thing.”
Jacqueline Kennedy Onassis meticulously curated the memory of her husband after he was assassinated, reimagining President John F. Kennedy as a fallen King Arthur in a modern-day Camelot.
Now some historians wonder if Laurene Powell Jobs is also trying to frame the legacy of her late husband, Steve Jobs, a complicated and transformational figure who was shadowed by his flaws as a father and belligerence as a boss.
Last month, Ms. Powell Jobs introduced the Steve Jobs Archive. It aspires to reinvent the personal archive much as Mr. Jobs, in his years running Apple, remade music with the iPod and communication with the iPhone.
Rather than offering up a repository of personal correspondence, notes and items for public research and inquiry, as other influential figures have done, Ms. Powell Jobs, who did not respond to requests for comments, said at a conference last month that the Steve Jobs Archive would be devoted to “ideas.” Those ideas are primarily Mr. Jobs’s philosophies about life and work.
Harvard Business School’s 25 greatest business leaders of the 20th century left behind personal archives that are open to the public in libraries or museums, including Henry Ford, Thomas Edison and Asa Candler, who built Coca-Cola.
Other iconic business founders such as Walt Disney, Sam Walton and Ray Kroc entrusted their papers to the companies they built, allowing those collections to become the cornerstone of corporate archives.
Walt Disney Company, make personal correspondence, notes, speeches and other items available to authors for research.
More on Big Tech
Inside Meta’s Struggles: After a rocky year, employees at Meta are expressing skepticism, confusion and frustration over Mark Zuckerberg’s vision for the metaverse.
A Deal for Twitter?: In a surprise move, Elon Musk has offered to acquire Twitter at his original price of $44 billion, which could bring to an end the acrimonious legal fight between the billionaire and the company.
Slowing Business: Snap, the maker of the messaging app Snapchat, has been struggling with a sharp slowdown in its advertising business. Even so, it has continued to add new users.
Texas Sues Google: Ken Paxton, the state’s attorney general, filed a lawsuit against the tech giant, saying products like Google Photos violated Texans’ privacy rights.
“We don’t censor,” said Becky Cline, director of the Walt Disney archives. “We just vet.”
The new Jobs archive debuted with a minimalist website containing eight pieces of video, audio and writing that express what the archive calls Mr. Jobs’s “driving motivations in his own words.” The items, three-quarters of which were already public, can be accessed by clicking through maxims made famous by Mr. Jobs, including “make something wonderful and put it out there” and “pursue different paths.”
The next steps for the archive are shrouded in the kind of mystery associated with the way Mr. Jobs ran Apple. About all that’s been publicly disclosed is that Ms. Powell Jobs hired a documentary filmmaker to gather hundreds of oral histories about Mr. Jobs from former colleagues. Where that material will be stored and who will have access to it has not been revealed.
She married Mr. Jobs in 1991, two years after meeting him as a graduate student at Stanford. Since his death, she has used her estimated $16 billion fortune to fund the Emerson Collective, a philanthropic and commercial operation that owns The Atlantic magazine and funds an organization trying to reduce gun violence in Chicago.
During his life, Mr. Jobs admired and encouraged historians to preserve the history of his Silicon Valley predecessors such as Robert Noyce, who co-founded the chip maker Intel. But he put little value on his own history, and Apple has seldom commemorated product anniversaries, saying it focuses on the future, not the past.
Stanford spent years cataloging items such as photos of a barefoot Mr. Jobs at work, advertising campaigns and an Apple II computer. That material can be reviewed by students and researchers interested in learning more about the company.
Silicon Valley leaders have a tradition of leaving their material with Stanford, which has collections of letters, slides and notes from William Hewlett, who founded Hewlett-Packard, and Andy Grove, the former chief executive of Intel.
Mr. Lowood said that he uses the Silicon Valley archives to teach students about the value of discovery. “Unlike a book, which is the gospel and all true, a mix of materials in a box introduces uncertainty,” he said.
After Mr. Jobs’ death in 2011, Mr. Isaacson, the author, published a biography of Mr. Jobs. Some at Apple complained that the book, a best seller, misrepresented Mr. Jobs and commercialized his death.
Mr. Isaacson declined to comment about those complaints.
Four years later, the book became the basis for a film. The 2015 movie, written by Aaron Sorkin and starring Michael Fassbender, focused on Mr. Jobs being ousted from Apple and denying paternity of his eldest daughter.
according to emails made public after a hack of Sony Pictures, which held rights to the film. She and others who were close to Mr. Jobs thought any movie based on the book would be inaccurate.
“I was outraged, and he was my friend,” said Mike Slade, a marketing executive who worked as an adviser to Mr. Jobs from 1998 to 2004. “I can’t imagine how outraged Laurene was.”
In November 2015, a month after the movie’s release, Ms. Powell Jobs had representatives register the Steve Jobs Archive as a limited liability company in Delaware and California. She later hired the documentary filmmaker, Davis Guggenheim, to gather oral histories about Mr. Jobs from former colleagues and friends. She also hired Ms. Berlin, who was Stanford’s project historian for its Apple archives, to be the Jobs Archive’s executive director.
Mr. Guggenheim gathered material about Mr. Jobs while also working on a Netflix documentary about Bill Gates, “Inside Bill’s Brain.” Mr. Slade, who worked for both Mr. Jobs and Mr. Gates, said he sat for an interview about one executive, stopped to change shirts and returned to discuss the other one.
Ms. Berlin assisted Ms. Powell Jobs in gathering material. They collected items such as audio of interviews done by reporters and early company records, including a 1976 document that Mr. Jobs and Steve Wozniak, Apple’s co-founder, called their declaration of independence. It outlined what the company would stand for, said Regis McKenna, who unearthed the document in his personal collection gathered during his decades as a pioneer of Silicon Valley marketing and adviser to Mr. Jobs.
Ms. Powell Jobs also assembled a group of advisers to inform what the archive would be, including Tim Cook, Apple’s chief executive; Jony Ive, Apple’s former chief design officer; and Bob Iger, the former chief executive of Walt Disney and a former Apple board member.
Mr. Cook, Mr. Ive and Mr. Iger declined to comment.
Apple, which has its own corporate archive and archivist, is a contributor to the Jobs effort, said Ms. Berlin, who declined to say how she works with the company to gain access to material left by Mr. Jobs.
The archive’s resulting website opens with an email that Mr. Jobs sent himself at Apple. It reads like a journal entry, outlining all the things that he depends on others to provide, from the food he eats to the music he enjoys.
“I love and admire my species, living and dead, and am totally dependent on them for my life and well being,” he wrote.
The email is followed by a previously undisclosed audio clip from a 1984 interview that Mr. Jobs did with Michael Moritz, the journalist turned venture capitalist at Sequoia. During it, Mr. Jobs says that refinement comes from mistakes, a platitude that captures how Apple used trial and error to develop devices.
“It was just lying in the drawer gathering dust,” Mr. Moritz said of the recording.
It’s clear to those who have contributed material that the archive is about safeguarding Mr. Jobs’s legacy. It’s a goal that many of them support.
“There’s so much distortion about who Steve was,” Mr. McKenna said. “There needed to be something more factual.”
On the morning of July 8, former President Donald J. Trump took to Truth Social, a social media platform he founded with people close to him, to claim that he had in fact won the 2020 presidential vote in Wisconsin, despite all evidence to the contrary.
Barely 8,000 people shared that missive on Truth Social, a far cry from the hundreds of thousands of responses his posts on Facebook and Twitter had regularly generated before those services suspended his megaphones after the deadly riot on Capitol Hill on Jan. 6, 2021.
And yet Mr. Trump’s baseless claim pulsed through the public consciousness anyway. It jumped from his app to other social media platforms — not to mention podcasts, talk radio or television.
Within 48 hours of Mr. Trump’s post, more than one million people saw his claim on at least dozen other media. It appeared on Facebook and Twitter, from which he has been banished, but also YouTube, Gab, Parler and Telegram, according to an analysis by The New York Times.
gone mainstream among Republican Party members, driving state and county officials to impose new restrictions on casting ballots, often based on mere conspiracy theories percolating in right-wing media.
Voters must now sift through not only an ever-growing torrent of lies and falsehoods about candidates and their policies, but also information on when and where to vote. Officials appointed or elected in the name of fighting voter fraud have put themselves in the position to refuse to certify outcomes that are not to their liking.
a primary battleground in today’s fight against disinformation. A report last month by NewsGuard, an organization that tracks the problem online, showed that nearly 20 percent of videos presented as search results on TikTok contained false or misleading information on topics such as school shootings and Russia’s war in Ukraine.
continued to amplify “election denialism” in ways that undermined trust in the democratic system.
Another challenge is the proliferation of alternative platforms for those falsehoods and even more extreme views.
new survey by the Pew Research Center found that 15 percent of prominent accounts on those seven platforms had previously been banished from others like Twitter and Facebook.
F.B.I. raid on Mar-a-Lago thrust his latest pronouncements into the eye of the political storm once again.
study of Truth Social by Media Matters for America, a left-leaning media monitoring group, examined how the platform had become a home for some of the most fringe conspiracy theories. Mr. Trump, who began posting on the platform in April, has increasingly amplified content from QAnon, the online conspiracy theory.
He has shared posts from QAnon accounts more than 130 times. QAnon believers promote a vast and complex conspiracy that centers on Mr. Trump as a leader battling a cabal of Democratic Party pedophiles. Echoes of such views reverberated through Republican election campaigns across the country during this year’s primaries.
Ms. Jankowicz, the disinformation expert, said the nation’s social and political divisions had churned the waves of disinformation.
The controversies over how best to respond to the Covid-19 pandemic deepened distrust of government and medical experts, especially among conservatives. Mr. Trump’s refusal to accept the outcome of the 2020 election led to, but did not end with, the Capitol Hill violence.
“They should have brought us together,” Ms. Jankowicz said, referring to the pandemic and the riots. “I thought perhaps they could be kind of this convening power, but they were not.”
Sylvia Gaston, a waitress at a restaurant in Astoria, Queens, said her base wage is $7.50 an hour — even though New York City’s legal subminimum is $10, which must come to at least $15 after tips. Ms. Gaston, 40, who is from Mexico, feels that undocumented workers like her have a harder time fighting back when they are shortchanged.
“It doesn’t really matter if you have documents or not — I think folks are still getting underpaid in general,” she said. “However, when it comes to uplifting your voices and speaking about it, the folks who can get a little bit more harsh repercussions are people who are undocumented.”
Subminimum base pay for some tipped workers in the state, such as car washers, hairdressers and nail salon employees, was abolished in 2019 under an executive order by Gov. Andrew M. Cuomo, but workers in the food and drinks industry were left out.
Gov. Kathy Hochul, Mr. Cuomo’s successor, said while lieutenant governor in 2020 that she supported “a solid, full wage for restaurant workers.” And progressive legislators plan a bill in January that would eliminate the two-tier wage system by the end of 2025.
When The New York Times asked if she would support such changes, Ms. Hochul’s office did not answer directly. “We are always exploring the best ways to provide support” to service workers, it said.
Proponents of abandoning subminimum wages say there could be advantages for employers, including less turnover, better service and higher morale.
David Cooper, the director of the economic analysis and research network at the Economic Policy Institute, a progressive think tank, contends that when wage laws are changed to a single-tier system, business owners can have the assurance that “every single person they compete with is making the same exact adjustment,” reducing the specter of a competitive disadvantage.
RICHMOND, Va. — In late July, Norman Otey was rushed by ambulance to Richmond Community Hospital. The 63-year-old was doubled over in pain and babbling incoherently. Blood tests suggested septic shock, a grave emergency that required the resources and expertise of an intensive care unit.
But Richmond Community, a struggling hospital in a predominantly Black neighborhood, had closed its I.C.U. in 2017.
It took several hours for Mr. Otey to be transported to another hospital, according to his sister, Linda Jones-Smith. He deteriorated on the way there, and later died of sepsis. Two people who cared for Mr. Otey said the delay had most likely contributed to his death.
the hospital’s financial data.
More than half of all hospitals in the United States are set up as nonprofits, a designation that allows them to make money but avoid paying taxes. Although Bon Secours has taken a financial hit this year like many other hospital systems, the chain made nearly $1 billion in profit last year at its 50 hospitals in the United States and Ireland and was sitting on more than $9 billion in cash reserves. It avoids at least $440 million in federal, state and local taxes every year that it would otherwise have to pay, according to an analysis by the Lown Institute, a nonpartisan think tank.
In exchange for the tax breaks, the Internal Revenue Service requires nonprofit hospitals to provide a benefit to their communities. But an investigation by The New York Times found that many of the country’s largest nonprofit hospital systems have drifted far from their charitable roots. The hospitals operate like for-profit companies, fixating on revenue targets and expansions into affluent suburbs.
borrowing tricks from business consultants, have trained staff to squeeze payments from poor patients who should be eligible for free care.
John M. Starcher Jr., made about $6 million in 2020, according to the most recent tax filings.
“Our mission is clear — to extend the compassionate ministry of Jesus by improving the health and well-being of our communities and bring good help to those in need, especially people who are poor, dying and underserved,” the spokeswoman, Maureen Richmond, said. Bon Secours did not comment on Mr. Otey’s case.
In interviews, doctors, nurses and former executives said the hospital had been given short shrift, and pointed to a decade-old development deal with the city of Richmond as another example.
In 2012, the city agreed to lease land to Bon Secours at far below market value on the condition that the chain expand Richmond Community’s facilities. Instead, Bon Secours focused on building a luxury apartment and office complex. The hospital system waited a decade to build the promised medical offices next to Richmond Community, breaking ground only this year.
‘Glorified Emergency Room’
founded in 1907 by Black doctors who were not allowed to work at the white hospitals across town. In the 1930s, Dr. Jackson’s grandfather, Dr. Isaiah Jackson, mortgaged his house to help pay for an expansion of the hospital. His father, also a doctor, would take his children to the hospital’s fund-raising telethons.
Cassandra Newby-Alexander at Norfolk State University.
got its first supermarket.
according to research done by Virginia Commonwealth University. The public bus route to St. Mary’s, a large Bon Secours facility in the northwest part of the city, takes more than an hour. There is no public transportation from the East End to Memorial Regional, nine miles away.
“It became impossible for me to send people to the advanced heart valve clinic at St. Mary’s,” said Dr. Michael Kelly, a cardiologist who worked at Richmond Community until Bon Secours scaled back the specialty service in 2019. He said he had driven some patients to the clinic in his own car.
Richmond Community has the feel of an urgent-care clinic, with a small waiting room and a tan brick facade. The contrast with Bon Secours’s nearby hospitals is striking.
At the chain’s St. Francis Medical Center, an Italianate-style compound in a suburb 18 miles from Community, golf carts shuttle patients from the lobby entrance, past a marble fountain, to their cars.
after the section of the federal law that authorized it, allows hospitals to buy drugs from manufacturers at a discount — roughly half the average sales price. The hospitals are then allowed to charge patients’ insurers a much higher price for the same drugs.
The theory behind the law was that nonprofit hospitals would invest the savings in their communities. But the 340B program came with few rules. Hospitals did not have to disclose how much money they made from sales of the discounted drugs. And they were not required to use the revenues to help the underserved patients who qualified them for the program in the first place.
In 2019, more than 2,500 nonprofit and government-owned hospitals participated in the program, or more than half of all hospitals in the country, according to the independent Medicare Payment Advisory Commission.
in wealthier neighborhoods, where patients with generous private insurance could receive expensive drugs, but on paper make the clinics extensions of poor hospitals to take advantage of 340B.
to a price list that hospitals are required to publish. That is nearly $22,000 profit on a single vial. Adults need two vials per treatment course.
work has shown that hospitals participating in the 340B program have increasingly opened clinics in wealthier areas since the mid-2000s.
were unveiling a major economic deal that would bring $40 million to Richmond, add 200 jobs and keep the Washington team — now known as the Commanders — in the state for summer training.
The deal had three main parts. Bon Secours would get naming rights and help the team build a training camp and medical offices on a lot next to Richmond’s science museum.
The city would lease Bon Secours a prime piece of real estate that the chain had long coveted for $5,000 a year. The parcel was on the city’s west side, next to St. Mary’s, where Bon Secours wanted to build medical offices and a nursing school.
Finally, the nonprofit’s executives promised city leaders that they would build a 25,000-square-foot medical office building next to Richmond Community Hospital. Bon Secours also said it would hire 75 local workers and build a fitness center.
“It’s going to be a quick timetable, but I think we can accomplish it,” the mayor at the time, Dwight C. Jones, said at the news conference.
Today, physical therapy and doctors’ offices overlook the football field at the training center.
On the west side of Richmond, Bon Secours dropped its plans to build a nursing school. Instead, it worked with a real estate developer to build luxury apartments on the site, and delayed its plans to build medical offices. Residents at The Crest at Westhampton Commons, part of the $73 million project, can swim in a saltwater pool and work out on communal Peloton bicycles. On the ground floor, an upscale Mexican restaurant serves cucumber jalapeño margaritas and a Drybar offers salon blowouts.
have said they plan to house mental health, hospice and other services there.
a cardiologist and an expert on racial disparities in amputation, said many people in poor, nonwhite communities faced similar delays in getting the procedure. “I am not surprised by what’s transpired with this patient at all,” he said.
Because Ms. Scarborough does not drive, her nephew must take time off work every time she visits the vascular surgeon, whose office is 10 miles from her home. Richmond Community would have been a five-minute walk. Bon Secours did not comment on her case.
“They have good doctors over there,” Ms. Scarborough said of the neighborhood hospital. “But there does need to be more facilities and services over there for our community, for us.”
In 2018, senior executives at one of the country’s largest nonprofit hospital chains, Providence, were frustrated. They were spending hundreds of millions of dollars providing free health care to patients. It was eating into their bottom line.
The executives, led by Providence’s chief financial officer at the time, devised a solution: a program called Rev-Up.
Rev-Up provided Providence’s employees with a detailed playbook for wringing money out of patients — even those who were supposed to receive free care because of their low incomes, a New York Times investigation found.
nonprofits like Providence. They enjoy lucrative tax exemptions; Providence avoids more than $1 billion a year in taxes. In exchange, the Internal Revenue Service requires them to provide services, such as free care for the poor, that benefit the communities in which they operate.
But in recent decades, many of the hospitals have become virtually indistinguishable from for-profit companies, adopting an unrelenting focus on the bottom line and straying from their traditional charitable missions.
focused on investments in rich communities at the expense of poorer ones.
And, as Providence illustrates, some hospital systems have not only reduced their emphasis on providing free care to the poor but also developed elaborate systems to convert needy patients into sources of revenue. The result, in the case of Providence, is that thousands of poor patients were saddled with debts that they never should have owed, The Times found.
provide. That was below the average of 2 percent for nonprofit hospitals nationwide, according to an analysis of hospital financial records by Ge Bai, a professor at the Johns Hopkins Bloomberg School of Public Health.
Ten states, however, have adopted their own laws that specify which patients, based on their income and family size, qualify for free or discounted care. Among them is Washington, where Providence is based. All hospitals in the state must provide free care for anyone who makes under 300 percent of the federal poverty level. For a family of four, that threshold is $83,250 a year.
In February, Bob Ferguson, the state’s attorney general, accused Providence of violating state law, in part by using debt collectors to pursue more than 55,000 patient accounts. The suit alleged that Providence wrongly claimed those patients owed a total of more than $73 million.
Providence, which is fighting the lawsuit, has said it will stop using debt collectors to pursue money from low-income patients who should qualify for free care in Washington.
But The Times found that the problems extend beyond Washington. In interviews, patients in California and Oregon who qualified for free care said they had been charged thousands of dollars and then harassed by collection agents. Many saw their credit scores ruined. Others had to cut back on groceries to pay what Providence claimed they owed. In both states, nonprofit hospitals are required by law to provide low-income patients with free or discounted care.
“I felt a little betrayed,” said Bev Kolpin, 57, who had worked as a sonogram technician at a Providence hospital in Oregon. Then she went on unpaid leave to have surgery to remove a cyst. The hospital billed her $8,000 even though she was eligible for discounted care, she said. “I had worked for them and given them so much, and they didn’t give me anything.” (The hospital forgave her debt only after a lawyer contacted Providence on Ms. Kolpin’s behalf.)
was a single room with four beds. The hospital charged patients $1 a day, not including extras like whiskey.
Patients rarely paid in cash, sometimes offering chickens, ducks and blankets in exchange for care.
At the time, hospitals in the United States were set up to do what Providence did — provide inexpensive care to the poor. Wealthier people usually hired doctors to treat them at home.
wrote to the Senate in 2005.
Some hospital executives have embraced the comparison to for-profit companies. Dr. Rod Hochman, Providence’s chief executive, told an industry publication in 2021 that “‘nonprofit health care’ is a misnomer.”
“It is tax-exempt health care,” he said. “It still makes profits.”
Those profits, he added, support the hospital’s mission. “Every dollar we make is going to go right back into Seattle, Portland, Los Angeles, Alaska and Montana.”
Since Dr. Hochman took over in 2013, Providence has become a financial powerhouse. Last year, it earned $1.2 billion in profits through investments. (So far this year, Providence has lost money.)
Providence also owes some of its wealth to its nonprofit status. In 2019, the latest year available, Providence received roughly $1.2 billion in federal, state and local tax breaks, according to the Lown Institute, a think tank that studies health care.
a speech by the Rev. Dr. Martin Luther King Jr.: “If it falls your lot to be a street sweeper, sweep streets like Michelangelo painted pictures.”
Ms. Tizon, the spokeswoman for Providence, said the intent of Rev-Up was “not to target or pressure those in financial distress.” Instead, she said, “it aimed to provide patients with greater pricing transparency.”
“We recognize the tone of the training materials developed by McKinsey was not consistent with our values,” she said, adding that Providence modified the materials “to ensure we are communicating with each patient with compassion and respect.”
But employees who were responsible for collecting money from patients said the aggressive tactics went beyond the scripts provided by McKinsey. In some Providence collection departments, wall-mounted charts shaped like oversize thermometers tracked employees’ progress toward hitting their monthly collection goals, the current and former Providence employees said.
On Halloween at one of Providence’s hospitals, an employee dressed up as a wrestler named Rev-Up Ricky, according to the Washington lawsuit. Another costume featured a giant cardboard dollar sign with “How” printed on top of it, referring to the way the staff was supposed to ask patients how, not whether, they would pay. Ms. Tizon said such costumes were “not the culture we strive for.”
financial assistance policy, his low income qualified him for free care.
In early 2021, Mr. Aguirre said, he received a bill from Providence for $4,394.45. He told Providence that he could not afford to pay.
Providence sent his account to Harris & Harris, a debt collection company. Mr. Aguirre said that Harris & Harris employees had called him repeatedly for weeks and that the ordeal made him wary of going to Providence again.
“I try my best not to go to their emergency room even though my daughters have gotten sick, and I got sick,” Mr. Aguirre said, noting that one of his daughters needed a biopsy and that he had trouble breathing when he had Covid. “I have this big fear in me.”
That is the outcome that hospitals like Providence may be hoping for, said Dean A. Zerbe, who investigated nonprofit hospitals when he worked for the Senate Finance Committee under Senator Charles E. Grassley, Republican of Iowa.
“They just want to make sure that they never come back to that hospital and they tell all their friends never to go back to that hospital,” Mr. Zerbe said.
The Everett Daily Herald, Providence forgave her bill and refunded the payments she had made.
In June, she got another letter from Providence. This one asked her to donate money to the hospital: “No gift is too small to make a meaningful impact.”
Following a Script ‘Like Robots’
In 2019, Vanessa Weller, a single mother who is a manager at a Wendy’s restaurant in Anchorage, went to Providence Alaska Medical Center, the state’s largest hospital.
She was 24 weeks pregnant and experiencing severe abdominal pains. “Let this just be cramps,” she recalled telling herself.
Ms. Weller was in labor. She gave birth via cesarean section to a boy who weighed barely a pound. She named him Isaiah. As she was lying in bed, pain radiating across her abdomen, she said, a hospital employee asked how she would like to pay. She replied that she had applied for Medicaid, which she hoped would cover the bill.
After five days in the hospital, Isaiah died.
Then Ms. Weller got caught up in Providence’s new, revenue-boosting policies.
The phone calls began about a month after she left the hospital. Ms. Weller remembers panicking when Providence employees told her what she owed: $125,000, or about four times her annual salary.
She said she had repeatedly told Providence that she was already stretched thin as a single mother with a toddler. Providence’s representatives asked if she could pay half the amount. On later calls, she said, she was offered a payment plan.
“It was like they were following some script,” she said. “Like robots.”
Later that year, a Providence executive questioned why Ms. Weller had a balance, given her low income, according to emails disclosed in Washington’s litigation with Providence. A colleague replied that her debts previously would have been forgiven but that Providence’s new policy meant that “balances after Medicaid are being excluded from presumptive charity process.”
Ms. Weller said she had to change her phone number to make the calls stop. Her credit score plummeted from a decent 650 to a lousy 400. She has not paid any of her bill.
Susan C. Beachy and Beena Raghavendran contributed research.
In 2011, Catherine Engelbrecht appeared at a Tea Party Patriots convention in Phoenix to deliver a dire warning.
While volunteering at her local polls in the Houston area two years earlier, she claimed, she witnessed voter fraud so rampant that it made her heart stop. People cast ballots without proof of registration or eligibility, she said. Corrupt election judges marked votes for their preferred candidates on the ballots of unwitting citizens, she added.
Local authorities found no evidence of the election tampering she described, but Ms. Engelbrecht was undeterred. “Once you see something like that, you can’t forget it,” the suburban Texas mom turned election-fraud warrior told the audience of 2,000. “You certainly can’t abide by it.”
planting seeds of doubt over the electoral process, becoming one of the earliest and most enthusiastic spreaders of ballot conspiracy theories.
fueled by Mr. Trump, has seized the moment. She has become a sought-after speaker at Republican organizations, regularly appears on right-wing media and was the star of the recent film “2,000 Mules,” which claimed mass voter fraud in the 2020 election and has been debunked.
She has also been active in the far-right’s battle for November’s midterm elections, rallying election officials, law enforcement and lawmakers to tighten voter restrictions and investigate the 2020 results.
said in an interview last month with a conservative show, GraceTimeTV, which was posted on the video-sharing site Rumble. “There have been no substantive improvements to change anything that happened in 2020 to prevent it from happening in 2022.”
set up stakeouts to prevent illegal stuffing of ballot boxes. Officials overseeing elections are ramping up security at polling places.
Voting rights groups said they were increasingly concerned by Ms. Engelbrecht.
She has “taken the power of rhetoric to a new place,” said Sean Morales-Doyle, the acting director of voting rights at the Brennan Center, a nonpartisan think tank. “It’s having a real impact on the way lawmakers and states are governing elections and on the concerns we have on what may happen in the upcoming elections.”
Some of Ms. Engelbrecht’s former allies have cut ties with her. Rick Wilson, a Republican operative and Trump critic, ran public relations for Ms. Engelbrecht in 2014 but quit after a few months. He said she had declined to turn over data to back her voting fraud claims.
“She never had the juice in terms of evidence,” Mr. Wilson said. “But now that doesn’t matter. She’s having her uplift moment.”
a video of the donor meeting obtained by The New York Times. They did not elaborate on why.
announce a partnership to scrutinize voting during the midterms.
“The most important right the American people have is to choose our own public officials,” said Mr. Mack, a former sheriff of Graham County, Ariz. “Anybody trying to steal that right needs to be prosecuted and arrested.”
Steve Bannon, then chief executive of the right-wing media outlet Breitbart News, and Andrew Breitbart, the publication’s founder, spoke at her conferences.
True the Vote’s volunteers scrutinized registration rolls, watched polling stations and wrote highly speculative reports. In 2010, a volunteer in San Diego reported seeing a bus offloading people at a polling station “who did not appear to be from this country.”
Civil rights groups described the activities as voter suppression. In 2010, Ms. Engelbrecht told supporters that Houston Votes, a nonprofit that registered voters in diverse communities of Harris County, Texas, was connected to the “New Black Panthers.” She showed a video of an unrelated New Black Panther member in Philadelphia who called for the extermination of white people. Houston Votes was subsequently investigated by state officials, and law enforcement raided its office.
“It was a lie and racist to the core,” said Fred Lewis, head of Houston Votes, who sued True the Vote for defamation. He said he had dropped the suit after reaching “an understanding” that True the Vote would stop making accusations. Ms. Engelbrecht said she didn’t recall such an agreement.
in April 2021, did not respond to requests for comment. Ms. Engelbrecht has denied his claims.
In mid-2021, “2,000 Mules” was hatched after Ms. Engelbrecht and Mr. Phillips met with Dinesh D’Souza, the conservative provocateur and filmmaker. They told him that they could detect cases of ballot box stuffing based on two terabytes of cellphone geolocation data that they had bought and matched with video surveillance footage of ballot drop boxes.
Salem Media Group, the conservative media conglomerate, and Mr. D’Souza agreed to create and fund a film. The “2,000 Mules” title was meant to evoke the image of cartels that pay people to carry illegal drugs into the United States.
said after seeing the film that it raised “significant questions” about the 2020 election results; 17 state legislators in Michigan also called for an investigation into election results there based on the film’s accusations.
In Arizona, the attorney general’s office asked True the Vote between April and June for data about some of the claims in “2,000 Mules.” The contentions related to Maricopa and Yuma Counties, where Ms. Engelbrecht said people had illegally submitted ballots and had used “stash houses” to store fraudulent ballots.
According to emails obtained through a Freedom of Information Act request, a True the Vote official said Mr. Phillips had turned over a hard drive with the data. The attorney general’s office said early this month that it hadn’t received it.
Last month, Ms. Engelbrecht and Mr. Phillips hosted an invitation-only gathering of about 150 supporters in Queen Creek, Ariz., which was streamed online. For weeks beforehand, they promised to reveal the addresses of ballot “stash houses” and footage of voter fraud.
Ms. Engelbrecht did not divulge the data at the event. Instead, she implored the audience to look to the midterm elections, which she warned were the next great threat to voter integrity.
From film to TV, Queen Elizabeth II has been the subject of an array of Hollywood projects and actor’s lives.
As the world mourns Queen Elizabeth II, few outside her family will have such an intimate reflection on her life as the women who have put themselves in her shoes.
These are women who swam in the queen’s psyche for their portrayals in award-winning films and television series.
Olivia Colman, who played the queen in the latest installments of Netflix’s “The Crown,” has said Queen Elizabeth had a lasting impact on her world view.
“She’s extraordinary,” Colman said of the queen to The New York Times. “She’s changed my views on everything.”
From her early days as a post-war monarch, the queen has been portrayed as a stoic, devoted constitutionalist, abstaining from public debate and devoted to the stability of her country’s government.
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Her consistency in the face of crisis, from the beginning of her reign to the end, was a source of inspiration for Claire Foy, who told the Los Angeles Times in 2016 she was struck by the queen’s grit after the death of her father — the very death that propelled her to the throne in 1952. It’s a complicated grief all too relevant to the new king.
“The one person who could tell you how to do the job is dead,” Foy told the paper. “…And everyone is looking to you to know what to do, and you’re terrified. But she just keeps calm and carries on, and that’s it, really. That’s the story of her life.”
It was that same consistency that captivated Helen Mirren as she prepared for her role in “The Queen.” The Oscar winner’s portrayal of Elizabeth won praise for both the actor and the woman she portrayed. Mirren later described herself as not a royalist, but a “queenist.”
On social media Thursday, the actress said, “We mourn a woman, who, with or without the crown, was the epitome of nobility.”
It was one of tons of loving tributes to the woman who helmed a complicated, controversial institution that enraptured Hollywood for 70 years.
How to resolve homelessness is a long-running topic of conversation, with few easy answers.
The U.S. is struggling to solve its homelessness crisis.
The number of Americans living on the streets and in shelters is growing.
“This is home. Housing is so expensive, and you can’t afford. I would be killing myself to pay rent,” said Knoye Brown, who lives in a tent.
Those rent prices are only increasing.
And that means even more Americans will have a difficult time affording housing.
When you add in record high inflation, that leaves America’s homeless even more vulnerable.
In 2020 nearly 600,000 Americans were left without a home, according to the National Alliance to End Homelessness.
Data from the non-profit organization shows overall homelessness has improved by 10% since 2007.
But in 2020, the U.S. saw a 30% increase in unsheltered homelessness.
And in recent months homelessness has reached crisis levels in major cities across the country.
This year Knoxville saw a 50% increase in its homeless population, Long Beach, California saw a 62% increase since 2020 and
Phoenix saw a 33% spike.
Homelessness can come in many forms and can impact all ages.
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In January 2020 70% of the homeless were individuals and 30% belonged to families with children.
“I wasn’t able to finish school because I didn’t know where I would sleep after school. So I would stay where I was at, so I had a spot,” said Conner Showen, a former young homeless person.
States and cities have set aside more funding to try to curb the issue.
New York has more than doubled its spending to over $3 billion since 2014.
Colorado’s governor approved $45 million to convert a youth corrections facility into a homeless recovery campus.
And in New Mexico, $10 million is going to communities to buy old motels and hotels and transform them into transitional housing.
These are just a string of new methods in an attempt to tackle a problem that goes back decades.
According to Bloomberg, homelessness first peaked after the Civil War when veterans without jobs struggled to find housing and freed slaves struggled to find affordable homes or jobs.
From then on affordable homes were demolished in many minority neighborhoods as part of urban renewal.
In the 1970s investment in public housing started to decline when President Richard Nixon imposed a moratorium on new public housing after he declared them a failure, and instead pivoted to housing subsidies.
And in the 80s welfare programs to support those in need were cut under President Ronald Reagan’s economic plans to lower taxes for businesses.
Bloomberg adds the AIDS crisis that hit the LGBTQ+ community, a drug epidemic and mass incarceration of people, specifically Black or Hispanic people, also fueled the problem.
This was further exacerbated by policies that favor single family housing zones.
According to the New York Times, most land plots are designed for a single-family house. Many state laws and zoning rules limit the land that can be used to build multi-unit buildings, like apartment buildings that can house multiple families.
“Really it’s a blend of a trifecta of affordable housing, mental illness and substance abuse. When you add those three at various levels for each person, this is what we’re facing,” said Jeff Hicks, the executive director of Hope Rescue Mission.
Other states like California and Oregon have taken other approaches and passed laws in recent years to end single-family zoning so more affordable housing can be built.
Some cities, like Missoula, Montana have moved toward sanction camps, known as temporary safe outdoor spaces.
“49% of the people that have gone through here are now permanently in housing, recovery, or in areas where we mended some family situations, but they have not turned back to the system,” said April Seat, the director of outreach at Hope Rescue Mission.
In the last year a number of state legislatures introduced bills that some say criminalize homelessness.
In Tennessee, it’s now a felony for homeless people to camp in parks or other public property. Some argue this is not the solution.
“I believe it’s only a misdemeanor but with a small misdemeanor and a failure to appear, now you have warrants. You can be jailed at any time, it’s difficult to walk into a state building or federally funded building because you’re worried instead of getting help or resources, you’re scared you’re going to get indebted to a lack of it all,” said Seat.
Others, like Judge Glock with the Cicero Institute, believe camping bans are the right path to helping the homeless long-term.
And record-high inflation is adding another hurdle for Americans struggling to keep up with rising rent prices.
For some those rent price increases are simply unaffordable.
“We do see people falling into homelessness because they can’t afford rent. It’s not like it’s being raised $30 to $60 and some areas are raising $200,” said Seat.
According to government data reviewed by the LA Times, new rent leases have increased by more than 11% year-over-year.
And polling from Freddie Mac found a majority of renters saw a rent price hike in the last year.
One in five say they’re “extremely likely” to miss a payment.
The severity of America’s homeless problem ranges depending on the city and state, but cities across the country are taking action to address the problem.
The U.S. Interagency Council on Homelessness says the solution is to tackle the housing issue, integrate healthcare, strengthen crisis response systems and build career pathways. But this can’t be done without building and fostering partnerships to address the root causes of homelessness.
Black Americans have been hired much more rapidly in the wake of the pandemic shutdowns than after previous recessions. But as the Federal Reserve tries to soften the labor market in a bid to tame inflation, economists worry that Black workers will bear the brunt of a slowdown — and that without federal aid to cushion the blow, the impact could be severe.
Some 3.5 million Black workers lost or left their jobs in March and April 2020. In weeks, the unemployment rate for Black workers soared to 16.8 percent, the same as the peak after the 2008 financial crisis, while the rate for white workers topped out at 14.1 percent.
Since then, the U.S. economy has experienced one of its fastest rebounds ever, one that has extended to workers of all races. The Black unemployment rate was 6 percent last month, just above the record low of late 2019. And in government data collected since the 1990s, wages for Black workers are rising at their fastest pace ever.
first laid off during a downturn and the last hired during a recovery.
William Darity Jr., a Duke University professor who has studied racial gaps in employment, says the problem is that the only reliable tool the Fed uses to fight inflation — increasing interest rates — works in part by causing unemployment. Higher borrowing costs make consumers less likely to spend and employers less likely to invest, reducing pressure on prices. But that also reduces demand for workers, pushing joblessness up and wages down.
“I don’t know that there’s any existing policy option that’s plausible that would not result in hurting some significant portion of the population,” Mr. Darity said. “Whether it’s inflation or it’s rising unemployment, there’s a disproportionate impact on Black workers.”
In a paper published last month, Lawrence H. Summers, a former Treasury secretary and top economic adviser to Presidents Bill Clinton and Barack Obama, asserted with his co-authors that the Fed would need to allow the overall unemployment rate to rise to 5 percent or above — it is now 3.5 percent — to bring inflation under control. Since Black unemployment is typically about double that of white workers, that suggests that the rate for Black workers would approach or reach double digits.
The Washington Post and an accompanying research paper, Jared Bernstein — now a top economic adviser to President Biden — laid out the increasingly popular argument that in light of this, the Fed “should consider targeting not the overall unemployment rate, but the Black rate.”
Fed policy, he added, implicitly treats 4 percent unemployment as a long-term goal, but “because Black unemployment is two times the overall rate, targeting 4 percent for the overall economy means targeting 8 percent for blacks.”
news conference last month. “That’s not going to happen without restoring price stability.”
Some voices in finance are calling for smaller and fewer rate increases, worried that the Fed is underestimating the ultimate impact of its actions to date. David Kelly, the chief global strategist for J.P. Morgan Asset Management, believes that inflation is set to fall considerably anyway — and that the central bank should exhibit greater patience, as remnants of pandemic government stimulus begin to vanish and household savings further dwindle.
“The economy is basically treading water right now,” Mr. Kelly said, adding that officials “don’t need to put us into a recession just to show how tough they are on inflation.”
Michelle Holder, a labor economist at John Jay College of Criminal Justice, similarly warned against the “statistical fatalism” that halting labor gains is the only way forward. Still, she said, she’s fully aware that under current policy, trade-offs between inflation and job creation are likely to endure, disproportionately hurting Black workers. Interest rate increases, she said, are the Fed’s primary tool — its hammer — and “a hammer sees everything as a nail.”
having the federal government guarantee a job to anyone who wants one. Some economists support less ambitious policies, such as expanded benefits to help people who lose jobs in a recession. But there is little prospect that Congress would adopt either approach, or come to the rescue again with large relief checks — especially given criticism from many Republicans, and some high-profile Democrats, that excessive aid in the pandemic contributed to inflation today.
“The tragedy will be that our administration won’t be able to help the families or individuals that need it if another recession happens,” Ms. Holder said.
Morgani Brown, 24, lives and works in Charlotte, N.C., and has experienced the modest yet meaningful improvements in job quality that many Black workers have since the initial pandemic recession. She left an aircraft cleaning job with Jetstream Ground Services at Charlotte Douglas International Airport last year because the $10-an-hour pay was underwhelming. But six months ago, the work had become more attractive.
has recently cut back its work force. (An Amazon official noted on a recent earnings call that the company had “quickly transitioned from being understaffed to being overstaffed.”)
Ms. Brown said she and her roommates hoped that their jobs could weather any downturn. But she has begun hearing more rumblings about people she knows being fired or laid off.
Queen Elizabeth II’s Lasting Legacy On Britain And The World
No Relief From Skyrocketing Rent Prices Nationwide