Citizen Cartwright

Being morally ambitious

I’ve written before about Rutger Bregman, who was described in a New York Times interview over the weekend as “something of a professional optimist.”

Bregman has a new book out titled “Moral Ambition: Stop Wasting Your Talent and Start Making a Difference” — an effort to “meet the current moment by redirecting self-interest into social good,” as the Times puts it.

He also is cofounder of the School for Moral Ambition, which seeks to help as many people as possible devote their careers to some of the most pressing challenges we face.

Bregman says that in the move from the Gilded Age to the Progressive Era, “You had figures such as Alva Vanderbilt — a fascinating character who was this very decadent woman, incredibly rich, but later in her life, after she divorced her Vanderbilt husband, became a radical suffragette and one of the main financers of the women’s rights movement. She reminded me of MacKenzie Scott, who divorced Jeff Bezos and now is one of the most morally ambitious philanthropists in the U.S.” 

Bregman says: “Someone said this to me recently: If you are watching the news right now and you’re not terrified for yourself because you have some savings or a nice job, then you are the person who needs to stand up.”

Also in the news

World Health Organization's member countries approve treaty to better prevent, prepare for, respond to future pandemics

Centrist narrowly wins Poland presidential election but faces runoff with right-wing candidate

Russia outlaws Amnesty International in latest crackdown on dissent, activists

Israel lets aid into Gaza after 11-week blockade, but UN calls it a ‘drop in ocean’

Supreme Court allows Trump to revoke protected status for more than 300,000 Venezuelans

Judge blocks Trump administration from dismantling U.S. Institute of Peace

Senate votes to advance legislation to regulate stablecoins, a form of cryptocurrency

Senate confirms Charles Kushner to be ambassador to France, on 51-45 vote

New Jersey Democratic Rep. LaMonica McIver charged over ICE incident; charges against Newark mayor dropped

Trump administration agrees to pay nearly $5 million to settle suit over Ashli Babbitt shooting in Capitol on Jan. 6

Margaret Sullivan on ‘civic courage’ and more

Scientists competing to discover why the universe exists

KFF: Elisabeth Rosenthal on putting Trump’s cuts to health care spending in context  

Doctors tell accountants: Don’t make our mistakes taking private equity investments

Drs. Bob McNamara and James Keaney, former longtime emergency-room physicians, were early critics of private equity in healthcare who now say such ownership in accounting could shake trust in an industry that investors depend on for trustworthy financial information about companies, The Wall Street Journal recently reported.

“If accounting holds itself out as an ethical profession, which puts the client first, they should have never let private equity in because that’s what we did and it hurt the patients,” says McNamara, a professor and chair of emergency medicine at Temple University. 

Since 2021, about two dozen of the 100 biggest U.S. accounting firms either have sold an ownership stake to private-equity investors or been acquired by a firm that's done so, says the WSJ. Concerns have been raised about the potential threat to the independence of auditors, who are intended to be objective assessors of financial information. And accountants worry that the typical three- to five-year investment window is detrimental to CPA firms’ long-term plans for maintaining service quality and could spur them to accept higher-risk clients. 

Private-equity firms say they provide needed capital that enables accounting firms to boost hiring and improve their services. They say their investment in healthcare has helped hospitals and other medical practices, some of which were in dire financial straits, to continue providing care to patients, especially in regions where medical options are limited. Private-equity sponsors of accounting firms say cost-cutting isn’t part of their mission.

Longtime readers of this blog may recall the extensive KFF series "Patients for profit: How private equity hijacked health care.” The summary of that series of articles says: “Private equity investors are rapidly scooping up thousands of health care businesses, taking over emergency rooms or entire hospitals, and becoming major players in physician practices and patient care, from cradle to grave. But these acquisitions are often invisible to federal regulators. And their profit motives raise concerns about rising prices and the quality of treatment.”

Also in the news

Centrist Nicusor Dan wins Romania presidential election in ‘shock upset’ over hard-right, pro-Trump rival

Ukraine calls on allies to keep pressure on Russia after talks in Turkey failed to bring a ceasefire

Israel launches new military operation in Gaza as Netanyahu tells negotiating team to stay at talks in Qatar

At annual summit, Arab leaders promise to work on reconstruction of Gaza and press for a ceasefire

Supreme Court rules Trump must give Venezuelans more time to challenge deportation under Alien Enemies Act

Military commanders to be told to send transgender troops to medical checks to oust them

House Budget Committee advances Trump’s ‘big, beautiful bill’ Sunday night, but conservatives want more changes

House GOP includes a 10-year ban on states regulating AI in ‘big, beautiful bill,’ but procedural rules may doom it in Senate

Trump's Library of Congress fight really is about the separation of powers

Government Accountability Office says, as a legislative branch agency, it rebuffed a DOGE team

Appeals court gives go-ahead to Trump plan to halt union bargaining for many federal workers

Justice Department deal ends ban on an aftermarket trigger, alarming gun control advocates

Moody's cuts Aaa credit rating it gave the U.S. in 1919 — and is the last of the 3 major credit agencies to downgrade

How the S&P 500 recovered all its losses for the year

NASA rover detects the first aurora at Mars that’s visible to the human eye

Newly launched National Elder Fraud Coordination Center partners with AARP, Google, Walmart, Amazon

FDA endorses first blood test that can help diagnose Alzheimer’s disease

Good news: World’s first personalized gene editing

On this good-news Friday, I’d like to give you this link to our edition of Fix the News and focus my summary here on the world’s first personalized gene editing treatment.

There are 350 million people worldwide with rare diseases, most of which are genetic, says The Associated Press.

And while researchers have developed gene-editing therapies for illnesses that affect millions of people with common genetic mutations, like sickle cell disease, millions of others have genetic diseases with unique mutations that need personalized therapy, says The Wall Street Journal.

KJ Muldoon was a week old when he was diagnosed with a rare genetic disorder, CPS1 deficiency, that affects just one in 1.3 million babies.

Now nine and a half months old, he's the first patient of any age to have a custom gene-editing treatment, The New York Times reports. He's received an infusion made just for him and designed to fix his precise mutation.

The investigators who led the effort to save KJ presented their work Thursday at the annual meeting of the American Society of Gene & Cell Therapy and are publishing it in the New England Journal of Medicine.

The implications of the treatment go far beyond treating KJ, says Dr. Peter Marks, who was the Food and Drug Administration official overseeing gene-therapy regulation until he recently resigned over disagreements with Robert F. Kennedy Jr., secretary of health and human services. 

More than 30 million people in the United States have one of more than 7,000 rare genetic diseases, and most are so rare that no company is willing to spend years developing a gene therapy that so few people would need.

But KJ’s treatment — which built on decades of federally funded research — offers a new way for companies to develop personalized treatments without going through years of expensive development and testing.

Illnesses like KJ’s are the result of a single mutation: an incorrect DNA letter among the three billion in the human genome. 

Correcting it requires pinpoint targeting called base editing. The treatment is wrapped in fatty lipid molecules to protect it from degradation in the blood on its way to the liver, where the edit will be made. Inside the lipids are instructions that tell the cells to produce an enzyme that edits the gene. They also carry a molecular GPS — CRISPR — altered to crawl along a person’s DNA until it finds the exact DNA letter that needs to be changed.

While KJ’s treatment was customized so CRISPR found just his mutation, the same kind of method could be adapted and used over and over to fix mutations in other places on a person’s DNA. Only the CRISPR instructions leading the editor to the spot on the DNA with the mutation would need to be changed. 

Treatments would be cheaper, “by an order of magnitude,” says Dr. Marks. He wrote an editorial accompanying the research paper and says the method “is, to me, one of the most potentially transformational technologies out there.” 

It eventually also could be used for more common genetic disorders such as sickle cell disease, cystic fibrosis, Huntington’s disease and muscular dystrophy.

Dozens of researchers put everything aside for months to work on KJ’s treatment, says the Times. 

David Liu of Harvard, whose lab invented the gene-editing method used to fix KJ’s mutation, says the speed was “astounding. These steps traditionally take the better part of a decade, if not longer.”

The success in treating KJ “is a triumph for the American peoples’ investment in biomedical research,” says Dr. Fyodor Urnov of the University of California at Berkeley.

The work began decades ago with federal funding for basic research on bacterial immune systems. That led eventually, with more federal funding, to the discovery of CRISPR. Federal funding for sequencing the human genome made it possible to identify KJ’s mutation. Federal funding supported Dr. Liu’s lab and its editing discovery. A federal program to study gene editing supported other research. Federally funded work led to an understanding of KJ’s disease.

“I don’t think this could have happened in any country other than the U.S.,” Dr. Urnov says. And “we all said to each other, ‘This is the most significant thing we have ever done.’”

Also in the news

From 1948 to now, a Palestinian woman in Gaza recounts her life of displacement

Abortion-rights groups denounce censorship on Meta-owned apps in Latin America and elsewhere

Meta battling ‘epidemic of scams,’ often from overseas crime networks

Brazilian scientist Mariangela Hungria wins $500,000 World Food Prize for finding ways to grow food with fewer chemicals

ProPublica: Trump administration leaned on African countries to get business for Elon Musk

NYTimes: Is Trump trading away America’s AI future to the Middle East?

Department of Homeland Security requests 20,000 National Guard troops to help with mass deportation efforts

Senate rejects Democratic measure to require more transparency on deportations to El Salvador

Supreme Court seems likely to maintain block on birthright citizenship restrictions, possibly limit nationwide injunctions

AP: More details of what’s in Trump’s ‘big, beautiful’ 1,116-page bill

The 225-year-old Library of Congress never has had a moment like this

Air traffic controllers in Denver scrambled to use backups after losing communications on Monday

Newark air trafic controller speaks out about stress, staffing, tech problems

DeSantis signs bill making Florida the second state to ban fluoride from its water system

Florida appeals court strikes down law allowing minors to get an abortion without their parents’ consent

Judge rules that a challenge to Louisiana law listing abortion pills as controlled dangerous substances can proceed

California Democratic Gov. Gavin Newsom tries to rebrand himself as a centrist ahead of a potential presidential run

Robert Reich: Lawmakers to contact about big, beautiful bill, protests on Trump’s June 14 birthday, more

Heather Cox Richardson on the significance of the Magna Carta

Walmart tells shoppers it’s trying to absorb tariff costs but higher prices are unavoidable

Older people are in the crosshairs as the government restarts Social Security garnishment on student loans

Workers are saying ‘no’ to emotionally toxic environments; here’s how you can set limits or know it’s time to leave

Hospital tells family of brain-dead Georgia woman that she must carry fetus to birth because of abortion ban

DOJ investigating UnitedHealth Group for possible criminal Medicare fraud related to Medicare Advantage

KFF: Pharmacists stockpiling most common drugs in case of targeted Trump tariffs

Results of lawmakers’ all-nighters on ‘big, beautiful bill’

I’d love to be able to give you details of the legislation approved Wednesday as three House committees advanced their parts of the bill.

 

But with a gigantic bill like this — intended to make spending cuts to offset the costs of making President Trump’s 2017 tax cuts permanent — it’s routine that important details only emerge after Congress has passed the bill and the president has signed it.

 

There’s also this dynamic: 

 

"The House Energy and Commerce Committee was 16 hours into a nearly 27-hour markup [session to change and approve the bill] when it became clear that top Republicans on the panel weren’t clear on what key Medicaid provisions in the legislation they were actively debating would actually do,” Politico says.

 

The best summary of what’s in the bill that I can find continues to be this one from The Associated Press, published before the three committees finished their work.

 

The legislative package combining all the House committees' work is to be put together by the House Budget Committee on Friday.

 

Here are some details on Energy and Commerce’s health care piece of the bill, from Politico.

 

Here is a rundown on the House Agriculture Committee’s approval of $300 billion in nutrition spending cuts, also from Politico.

Also in the news

Ukraine peace talks in confusion as Putin stays away

After decades of ‘brain drain’ of top researchers to U.S., other nations now are seizing the opportunity to reverse the flow

 

During Trump visit, Qatar Airways gives Boeing its biggest deal for widebody planes

 

RFK Jr. assures Congress that funding for Head Start won’t be cut

 

What EPA’s partial rollback of ‘forever chemical’ drinking water rule means

 

House Speaker Johnson gives his first public support for ban on lawmakers trading individual stocks

 

Ruling in North Dakota case blocks way for people in 7 states to sue under Voting Rights Act

Six months after Missouri voters approve abortion-rights amendment, state lawmakers approve referendum to repeal it

 

John Ewing set to become Omaha's first Black mayor, flipping the office for Democrats

U.S. records biggest one-year decline in drug overdose deaths, from 110,000 in 2023 to 80,000 in 2024

Congress’ work overnight on Trump’s ‘big, beautiful bill’

Shortly after the House Energy and Commerce Committee session opened on Tuesday afternoon to consider Medicaid cuts and other pieces of Republicans’ domestic policy bill, protesters started shouting at lawmakers to “keep your greedy hands off our Medicaid.”

The Capitol Police say officers arrested 26 people for illegally protesting inside a congressional building.

Chairman Brett Guthrie tried to keep control amid a shouting match over whether members of the committee were allowed to use the word “lying” in their remarks, says The New York Times. Republicans had been allowed to say that Democrats were lying about the scope of the Medicaid cuts, but Democrats were prohibited from saying that President Trump was lying about his intention to protect the program. An informal agreement to avoid using the word “lie” for the rest of the session fell apart a few hours later.

Some Democratic senators came by to watch, including Cory Booker of New Jersey, Brian Schatz of Hawaii and Tina Smith of Minnesota.

Two panels still were in session on Wednesday morning, working their way through more than 100 amendments from Democrats “that were largely failing,” says The Associated Press.

This is “the biggest political and legislative debate for the Republicans leading Congress since Trump’s first term, setting up a career-defining clash over the nation’s priorities, all coming at a time of economic unease with Trump’s trade war and other uncertainties,” says AP.

The goal for GOP lawmakers is to extend and enhance tax cuts approved in 2017, adding the president’s 2024 campaign promises of no taxes on tips, Social Security income and car loan interest, says AP.

There’s also a larger standard deduction, $32,000 for couples; an increase to the Child Tax Credit and a potentially higher cap of $30,000 on state and local tax deductions, known as SALT, that’s still being negotiated. The offsets are $1.9 trillion in savings mainly from the rollback of green energy tax credits, for a net tally of $3.7 trillion in costs over the decade, according to the most recent estimates — along with billions more in savings from the safety net cuts.

And Republicans are upping spending on their GOP priorities, with $350 billion for Trump’s mass deportation plans and funding for the Pentagon. 

At the same time, Republicans are seeking to defray the lost tax revenue and avoid skyrocketing national deficits with another GOP goal — scaling back federal spending. The Republicans are proposing cuts of nearly $800 billion over the coming decade to Medicaid, which is used by 70 million Americans; $290 billion to food aid in the Supplemental Nutrition Assistance Program, known as SNAP; and others.

Also in the news

Trump meets with Syria insurgent-turned-leader in Saudi Arabia

Trump pledges lift of Syria sanctions, sells Saudis $142 billion in arms, Saudis to invest $600 billion in U.S. 

With Trump at Saudi investment forum: Musk and heads of OpenAI, BlackRock, Amazon, IBM, Citicorp, Boeing, others

U.S. cuts 'de minimis' tariff on small China parcels to as low as 30 percent

After delay, House Speaker Johnson names his appointees to nonpartisan, independent congressional ethics watchdog 

Facing lawsuit, Agriculture Department says it will restore climate change-related webpages

Harvard expands lawsuit against Trump administration after Trump cancels $450 million more in grants

Wisconsin Judge Hannah Dugan indicted on charges she tried to assist undocumented immigrant avoid arrest

In ruling applying only to detainees held in western Pennsylvania, judge rules Trump can use Alien Enemies Act

KFF: Flawed federal programs marooning rural Americans in telehealth blackouts