March 2, 2024

Zoomer Hackers Shut Down the Biggest Extortion Ring of All. A ransomware gang cripples UnitedHealthcare.

Could a comprehensive antitrust investigation finish the job?



https://prospect.org/health/2024-03-01-zoomer-hackers-shut-down-unitedhealthcare/



Linda Witzal runs a small independent pharmacy that caters exclusively to about 1,200 residents of New Jersey senior living facilities. Virtually all the revenue she takes in comes, ultimately, from the government. In a simpler time, she billed New Jersey Medicaid directly for most of her patients. “When I started in this business, I was 28 years old, and New Jersey was actually very easy to get on the phone back then,” Witzal, now in her early sixties, recalls.

Three and a half decades later, there’s a whole legalized extortion ring that small pharmacies like Witzal’s need to pay off to access Medicare and Medicaid funds, a symptom of the middleman creep in the pharmaceutical transaction chain. Standing between pharmacies and reimbursement checks for the drugs they dispense include the administrators of managed care programs, the tyrannical triumvirate of dominant pharmacy benefit managers that represent about 85 percent of all health plans, and Change Healthcare, the electronic data clearinghouse—or “switch,” as pharmacists call them—she uses to access the computer ecosystems of these middlemen. Until last week, Witzal viewed Change as one of the least-bad gatekeepers in the pharmacy business, though that was starting to change in the aftermath of its 2022 acquisition by UnitedHealth Group, the $372 billion Minnesota health care leviathan, which axed hundreds of tech and call center employees immediately after closing the deal. “It was getting harder and harder to get someone on the phone,” she says.

Then just over a week ago, Change abruptly shut down for Witzal and 67,000 other pharmacies it services. The company, it turned out, had been attacked by an extortion ring of its own, a hacker UnitedHealth initially identified in a Securities and Exchange Commission filing as a “suspected nation-state-associated cyber security threat actor” but has since emerged as the ransomware gang BlackCat/ALPHV, whose affiliates cybersecurity experts have previously described as native English speakers from predominantly “Western countries” between the ages of 17 and 22. Ransomware gangs, which brought in a record $1.1 billion in 2023, have besieged the U.S. health care system in recent years. Four of last year’s ten most disruptive ransomware hacks attacked health care providers, and affiliates of BlackCat/ALPHV alone took credit for attacks on at least three hospital systems and an electronic health records provider last year. Last summer, the private equity–gutted Prospect Medical chain of safety-net hospitals descended into chaos at the hands of a ransomware gang, and was forced to divert patients from some hospitals for weeks.



But the sheer size of the data cache held by Change puts this breach in a different class. The company, which is believed to process at least half of all the health insurance claims filed in the entire country, is the agglomeration of dozens of smaller data providers, stitched together through the years. “It’s an order of magnitude worse than anything I’ve ever seen,” says Luke Slindee, a Minnesota pharmacy consultant who has worked for United in the past. “Change has, over a long time period, become the IT vendor of an ungodly amount of things. The reason everyone is talking about pharmacies is because that’s one of the few places in health care where stuff actually happens in real time, but I guarantee you there are entire medical offices and clinics that are not able to do anything either … Everything about this is a disaster.”

snip

March 2, 2024

The Gun Death Cult Takes On the Administrative State

https://prospect.org/justice/2024-02-29-gun-death-cult-takes-on-administrative-state/



One of the very few recent instances of successful gun control regulation happened under the Trump administration, ironically enough. It stemmed from the 2017 Las Vegas mass shooting. The shooter sprayed randomly into a country music festival from a high hotel room about 500 yards away using several AR-15s, killing 60 people and wounding more than 400—to this day the deadliest mass murder in American history carried out by a single person. Yet though the killer fired more than 1,000 rounds, the whole thing was over in about ten minutes—because the guns were fitted with bump stocks, turning them into de facto automatic weapons. The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) initially decided that it didn’t have the authority to regulate bump stocks. But when President Trump instructed the ATF to try again after the Parkland high school mass shooting in 2018, the agency reversed course and issued a ban.

It should be emphasized that banning bump stocks is a very modest step. A practiced shooter can fire a semiautomatic rifle nearly as quickly as an automatic one, and more accurately. Indeed, the Parkland shooter who motivated Trump’s action did not use one. Still, nothing beats fully automatic fire for spraying into a crowd; there’s a reason traditional machine guns were banned. But now gun activists are leveraging the latest trend in conservative jurisprudence to attack even this tiny regulation. A case before the Supreme Court would strike down the bump stock ban on the grounds that the ATF acted outside its authority. Since Congress is paralyzed even with basic budgetary matters, an unfavorable ruling would re-legalize bump stocks indefinitely.



The legal context here has to do with the National Firearms Act of 1934 and its later amendments. Current law requires special permits to own a machine gun, which is defined as: “Any weapon which shoots, is designed to shoot, or can be readily restored to shoot, automatically more than one shot without manual reloading, by a single function of the trigger.” Since these permits are very difficult to obtain, if not impossible in some states, machine guns are de facto banned in this country (outside of some guns that were grandfathered in). To a native speaker of the English language, this would seem to be the end of the discussion. A bump stock uses a different set of mechanisms than a traditional automatic weapon, but it very obviously fits with this sweeping language. You hold down the trigger, the gun fires repeatedly until the magazine is empty. Simple as that.



But of course, that’s not enough for America’s gun cult. As Abbie VanSickle reports at The New York Times, a Texas gun store owner has teamed up with a right-wing legal outfit called the New Civil Liberties Alliance (a sort of funhouse-mirror ACLU) to sue the ATF over this rule. “This rule turned half a million people into felons overnight,” said Philip Hamburger, one of the organization’s founders. “That’s not a power that the Constitution gives to administrative agencies—so it deserved a lawsuit.” Unsurprisingly, it is not true that half a million people were turned into felons “overnight.” The rule actually gave bump stock owners 90 days to either destroy or turn in their devices, largely on an honor system basis.

snip

March 2, 2024

Ken Cuccinelli and the Persuasive, Pervasive Politics of Cruelty

https://prospect.org/politics/2024-02-28-ken-cuccinelli-persuasive-pervasive-politics-cruelty/



Over the past 15 or so years, the far-right faction of the Republican Party has fully taken over the party, and in the process managed to center the conservative political imagination on gleeful, vindictive cruelty. Back in the early Obama years, the so-called Tea Party rose to prominence supposedly as an angry backlash to his hesitant attempts to rescue Detroit and underwater homeowners—but the “birther” conspiracy theory claiming Obama was not a real citizen indicated deeper, more visceral roots of their grievance. The rise of Donald Trump removed any pretext. As journalist Adam Serwer pointed out in his essay “The Cruelty Is the Point,” Trump and his supporters rejoiced in the utter depravity of his actions. Very often, this meant altering the Emma Lazarus poem to institute “merit based” immigration or a plan to end the Constitution’s promise of birthright citizenship.

Aside from Trump himself, there is no greater example of conservatives wallowing in cruelty for its own sake than former Virginia Attorney General Ken Cuccinelli. From his humble beginnings as a Fairfax-area state senator, known for his belief that LGBTQ folks were trying to “get education about homosexuals and AIDS in public schools,” to his stint as the state’s top cop working to prevent same-sex marriage, to his callous response to the deaths of a migrant father and daughter, time and time again Cuccinelli engaged in the politics of cruelty and was rewarded for it. These days, Cuccinelli is back in the news for his role at the Trump-aligned Center for Renewing America (CRA). At CRA, he has egged on the intensifying Texas border disputes, after originally concocting the idea of using the National Guard to wage war against migrants in 2021.

It’s worth looking back at how Cuccinelli became a trailblazer for today’s distinct flavor of cruelty politics. In 2010, while serving as Virginia’s attorney general, Cuccinelli joined a coalition of nine Republican state attorneys general in support of then-Arizona Gov. Jan Brewer’s racist and essentially unenforceable immigration law. Dubbed the “toughest bill on illegal immigration” by The New York Times, the legislation authorized law enforcement to detain people they thought were in the country illegally. As the law all but openly welcomed racist profiling, unsurprisingly, it was hard to enforce. Despite this, Cuccinelli was eager to grant Virginia police officers similar authority, stating, “It is my opinion that Virginia law enforcement officers, including conservation officers may, like Arizona police officers, inquire into the immigration status of persons stopped or arrested.” The Supreme Court eventually struck down most of the law in 2012, arguing that state laws cannot supersede federal immigration law.

Cuccinelli was rewarded for his bigotry by President Trump, who appointed him (illegally) to be acting director of the U.S. Citizenship and Immigration Services (USCIS). While fighting the “surge” of undocumented immigrants is evergreen in conservative politics, Cuccinelli took this a step further by diminishing the public resources available to immigrants who are in the country legally. At USCIS, Cuccinelli instituted the “public charge” rule that restricted the use of public goods by immigrant legal residents. The new rule meant that immigrants seeking visas could be deemed inadmissible if it was determined they would need food stamps, Medicaid, or other public goods. Cuccinelli also acknowledged that the rule would make it harder to gain permanent legal status. For those seeking to enter the country illegally, his cruelty was unvarnished. In response to the tragic death of a father and daughter in the Rio Grande, Cuccinelli commented, “The reason we have tragedies like that on the border is because those folks, that father didn’t want to wait to go through the asylum process in the legal fashion, so decided to cross the river.”

snip

March 2, 2024

John Lee Hooker - Going Down (1973)

Label: ABC Records – ABCX-768
Format: Vinyl, LP, Album, Stereo, Quadraphonic
Country: US
Released: 1973
Genre: Blues
Style: Electric Blues

March 2, 2024

Charli XCX - Von dutch (Official Video) Premiered on 29 Feb 2024

March 2, 2024

Jesus' Betrayal : What Really Went Down

March 1, 2024

Steel Pulse - Jah Pickney - R.A.R.

Tribute To The Martyrs
℗ An Island Records recording; ℗ 1979 Universal Music Operations Limited
Released on: 1979-01-01

Studio Personnel, Mixer: Karl Pitterson
Studio Personnel, Mixer: Godwin Logie
Studio Personnel, Mixer: Steel Pulse
Producer: Karl Pitterson
Composer Lyricist: David Hinds

March 1, 2024

Silencing of the girls

Girls are still in a bad bargain with patriarchy: the price of relationship is keeping their true thoughts to themselves

https://aeon.co/essays/for-girls-silence-is-the-bad-bargain-with-patriarchy





I am back in girls’ schools. Listening again to the voices of girls and wondering about women’s silences. I had spent the 1980s talking and listening to hundreds of girls between the ages of seven and 18 in a range of schools and after-school programmes in the United States. I remember the turning point at adolescence, when, in coming of age, girls came to call an honest voice ‘stupid’ or ‘rude’, ‘selfish’, ‘mean’, or ‘crazy’. ‘Unpleasant’ and ‘insufferable’ were adjectives used by Anne Frank. I remember teenage girls naming precisely what had happened to their voice. Neeti at 16 saying: ‘The voice that stands up for what I believe in has been buried deep inside me.’ Iris at 17 saying: ‘If I were to say what I was feeling and thinking, no one would want to be with me, my voice would be too loud,’ and then adding, by way of explanation, ‘but you have to have relationships.’ And I remember saying to Iris: ‘But if you are not saying what you are feeling and thinking, then where are you in these “relationships”?’

Most of all, I recall being struck by people’s investment in silencing girls. As if it were impossible to listen to girls and go on living in the way that we have been. As if somehow girls would blow the cover. I was taken aback by the incentives held out to girls not to say what otherwise they would say, and by the force brought to bear in making sure that, once a girl has come of age, her voice – a voice readily heard among young girls, a voice artists have heard and recorded across time and cultures – will be covered or, if outspoken, will be heard as ‘too loud’ or too much or somehow not right, and will not be listened to or taken seriously.

Listening to girls led me to think again about what we mean when we talk about relationships. The US Surgeon General speaks about the pervasiveness of loneliness and how connections are essential if we are to survive and thrive. Yet the silencing of the girls alerts us to a deeper problem. From girls I learned about a crisis of connection, a turning point when relationships are on the line. Where, if you say what you are feeling and thinking, no one will want to be with you, and if you don’t say what you are feeling and thinking, no one will be with you. Either way, you will be all alone. And it wasn’t just girls, although it was listening to girls that proved both revelatory and revolutionary in the sense of naming a problem – a crisis of connection – that has turned out to be both pervasive and urgent.

Last spring when I was again interviewing girls, I found myself saying again what I had said to Iris in the 1980s. When Liza at 16 tells me that she is ‘holding [her]self back’ so as not to jeopardise ‘deeper connections’, I say: ‘Should I ask the obvious question?’ which is obvious to her as well. She speaks about ‘care and protection’, and from other girls I hear about not hurting people’s feelings or keeping the peace or not making trouble or not provoking exclusion and retaliation – reasons girls give for silencing an honest voice and for concluding, as Liza does, that the fight for relationship is ‘a battle not worth fighting’. ‘People won’t appreciate it if you say that,’ I hear people tell girls, over and over again, in one way or another. I know what they are talking about. Jane Eyre is 10 at the beginning of Charlotte Brontë’s novel. When her aunt calls her a liar, Jane says that, were she a liar, she would say she loves her when she does not. This is not a voice people want to hear.

snip

March 1, 2024

The Making of OUT OF STEP by Minor Threat - featuring Ian MacKaye

In celebration of the recently unearthed OUT OF STEP Outtakes, we take a detailed look at the making of the original record. After Minor Threat formed in Washington D.C. in 1980, they began to find an audience in the American punk scene. Their first two seven-inch records contained songs written by Ian MacKaye, such as “Straight Edge” and “Out of Step,” which kickstarted the straight edge movement within punk. By 1982, guitarist Lyle Preslar had left for college and Minor Threat temporarily broke up. After speaking with H.R. of the Bad Brains, MacKaye was convinced of the impact the band was having and considered reforming. At that point, Preslar agreed to quit college and rejoin the band. Despite accusations of the band selling out by reforming, Minor Threat began playing shows in their hometown and embarked on a cross-country tour. Brian Baker decided to switch from bass to second guitar so they asked Steve Hansgen to join as the new bassist. In early 1983, they returned to Don Zientara’s Inner Ear Studio to begin recording as a five piece. OUT OF STEP was eventually released in the spring of 1983.

In this episode, Ian MacKaye describes this pivotal moment in the band’s history when they decided to reunite and change their sound by adding a fifth member. Though they faced backlash about reuniting from their hometown crowd, this fueled the next batch of songs they would write as a band. MacKaye discusses how most of his lyrics on this record reflect the gossip and backstabbing that was prevalent in their scene at the time. In addition, tension within the band was rising over MacKaye’s lyrics and their overall musical direction. The new version of the title track reflected their differences as Jeff Nelson convinced MacKaye to include a spoken word interlude that explained how the straight edge lyrics were personal to MacKaye and didn’t represent the band’s views. From Minor Threat’s first 12-inch to a joke song about selling out to recording vocals live for the first time to the benefits of an expensive strobe tuner to hearing the call of punk to self-define, we’ll hear the stories of how the record came together.

Life of the Record podcast - Minor Threat OUT OF STEP documentary
Interview with Ian MacKaye
Episode 35

https://lifeoftherecord.com/#/minor-threat/

March 1, 2024

Rethinking the homunculus

When we discovered that the brain contained a map of the body it revolutionised neuroscience. But it’s time for an update

https://aeon.co/essays/the-iconic-brain-map-thats-changing-neurosurgery-and-gaming





The homunculus is one of the most iconic images in neurology and neuroscience. Usually visualised as a series of disproportionately sized body parts splayed across a section of the brain, it shows how the body is systematically mapped onto the sensory and motor cortices, representing the proportion of brain tissue devoted to each part of the body. This image has not only had a long-lasting impact on neurosurgical practice and basic brain research, but has also entered the public imagination, with three-dimensional clay models consisting of an enormous head and outsized hands attached to a tiny torso, on display at the Natural History Museum in London, and elsewhere. The groundbreaking work that led to the homunculus was a major advance in our understanding of the structure and function of the brain, and the homunculus itself revolutionised the art of medical illustration. Yet modern research suggests that the homunculus is far more complex than originally thought, and some argue that it is incorrect and needs to be radically revised.

The homunculus – meaning little man – is the brainchild of the Canadian neurosurgeon Wilder Penfield (1891-1976), who co-founded the Montreal Neurological Institute at McGill University in 1934 and became its first director. There, he developed a pioneering technique for identifying, and then surgically removing, abnormal brain tissue causing epileptic seizures. Using this method over the course of his career, he and his colleagues produced early detailed maps of the functions of various regions of the cerebral cortex. Most epileptic patients respond well to anti-convulsant drugs, but for those who do not, and whose seizures become frequent, severe and debilitating, brain surgery is a last-resort treatment. Penfield’s technique involved using an electrode to electrically stimulate the surface of the patient’s brain; crucially, they remained fully conscious on the operating table during the procedure, so that the patient could describe the effects of the stimulation. This enabled Penfield to cut out, or resect, the tissue causing the seizures without damaging neighbouring tissue involved in functions such as movement and language.

With the patient’s scalp anaesthetised and their skull opened, Penfield applied small electrical currents to the exposed surface of his patient’s brain. Because the patient remained fully conscious, Penfield could not only observe the movements evoked by stimulation of a specific area, but also ask them about the sensations and perceptions they experienced. Penfield operated on more than 1,000 patients throughout the 1930s and ’40s, and thus comprehensively ‘mapped’ the function of each area of the cerebral cortex. Electrical stimulation of some regions elicited the recall of long-lost memories; others triggered musical or olfactory hallucinations, famously causing one patient to report: ‘I smell burnt toast!’ His most important discovery, however, was the organisation of the sensory and motor cortices, two narrow, adjacent strips of tissue that run down from the top to the bottom of the brain on either side of the central sulcus, a deep fissure separating the frontal and parietal lobes.



Here, stimulation in front of the fissure evoked small movements or muscle twitches in specific parts of the body, and stimulation just behind it evoked sensations instead. Importantly, the body appeared to be mapped in a highly organised manner in both of these regions, such that stimulation of adjacent patches in either evoked movements or sensations in adjacent body parts on the opposite side of the body. Thus, stimulation of the top of the brain evoked movement or sensation in the hip and torso, and stimulation progressively further down along the outer surface elicited responses first in the shoulder, arm, elbow, forearm, and then the wrist. Finally, there was a large patch of both strips of tissue devoted to the hand, with each finger represented individually, and another large patch devoted to the face, tongue and throat. Crucially, although the precise size and location of the tissue devoted to each body part differed between patients, the sequence of responses elicited by progressive stimulations from the top to the bottom of the brain was always the same. During each procedure, Penfield would place small numbered stickers on the patient’s brain, and take note of the response evoked by electrical stimulation of that particular patch of tissue (see figure below):



snip