Whether those meaningful reform proposals become law is no sure thing, and will depend on the administration’s willingness to stare down Wall Street — which still retains immense political power, despite its partial self-immolation — and on whether a mobilized public demands Congress act for consumers, not contributors.

The 85-page draft released today is qualitatively different than the bullet-point plans previously issued by the Treasury Department. It contains detailed proposals, spanning across the financial regulatory spectrum, not easily summarized. Here are only some key elements — first, the good, then the bad.

The Good

1. The administration supports creation of a strong Consumer Financial Regulatory Agency.

It proposes to give this new agency very strong powers, and jurisdiction over consumer protection rules — taking away authority from existing regulators (like the Federal Reserve) that have failed utterly to protect consumers. It favors simplicity and gives the new agency the authority to mandate financial firms offer “plain vanilla” loans along with the more complicated packages they prefer. It gives the agency authority to ban mandatory arbitration provisions that strip consumers’ right to go to court for redress of scams and rip-offs. And it establishes that the new agency’s rules will be a regulatory floor, with states permitted to adopt stronger protections.

2. The administration proposes to reduce speculative betting, through new standards on leverage.

One reason the financial crisis spun out of control was financial firms’ excessive use of “leverage” — borrowed money. Heavily leveraged, the top commercial banks and investment banks overreached with very risky loans and investments. The administration proposes that all systemically important financial firms be subjected to higher capital reserve standards (meaning they can rely less on borrowed money). The administration properly says these rules should apply to any systemically important firm, whether or not it is a bank. It defines systemically important as a firm “whose combination of size, leverage and interconnectedness could pose a threat to financial stability if it failed.” There are still important details to be worked out here, including how much capital such firms must maintain. And there is the very worrisome element that it is the Federal Reserve that is given primary responsibility for overseeing these systemically important firms.

3. Through “skin-in-the-game” rules, the administration aims to prevent predatory and reckless lending.

One reason lenders were willing to make so many predatory and bad-quality mortgages — including but not limited to the class of “subprime” loans — was that mortgage originators did not hold on to the loans. Mortgage brokers cut deals on behalf of banks and non-bank originators, which in turn sold the resulting mortgages to other banks. These banks, in turn, sliced and diced the mortgages, combined them into packages of pieces of thousands of other mortgages, and sold them to all kinds of investors. Because the initial lender did not maintain an ongoing interest in the mortgage, they did not have any incentive to ensure they were making a quality loan.

The administration proposes that loan originators be required to keep, at minimum, a 5 percent exposure in loans.

4. The administration seeks power to take over failing, systemically important financial firms.

The government already has such “resolution” power for commercial banks. The Federal Deposit Insurance Corporation regularly takes control over failing banks and “resolves” them outside of the bankruptcy process. This typically means selling off the failing bank to another bank, often after separating its good assets from bad. FDIC is expert at this process, moves very quickly, and averts the harmful consequences from extended bankruptcy processes.

The government does not have the legal authority to undertake comparable measures for important non-bank firms. This includes investment banks (think Lehman Brothers) and insurance companies (think AIG). Giving the government resolution power for non-banks should help control financial panic.

The Bad

1. The administration does not propose to do anything serious about executive pay and top-level compensation for financial firms.

The administration does support “say-on-pay” proposals, which give shareholders the right to a non-binding vote on executive compensation. But a non-binding vote isn’t worth too much; and, more importantly, shareholders are often willing to support excessive compensation while risky bets are paying off.

In terms of financial stability, the imperative is to do away with the Wall Street bonus culture, where executives and traders are given extraordinary bonuses — often four or more times base salary — based on annual performance. This bonus culture gives traders and executives alike an incentive to take big bets — because they get massive payoff if things go well, and don’t suffer if they go bad, or go bad sometime in the future.

This is a structural problem, not a symbolic one. Anyone who thinks pay isn’t of overriding importance in financial regulation should have been set straight by the desperation of the bailed out Wall Street firms to pay back their loans from the government. That desperation is overwhelmingly tied to a desire to escape the extremely modest pay standards issued by the Obama administration.

Besides financial stability, there are important questions of economic justice and taxpayer rights related to executive compensation. The Wall Street hotshots — including the major hedge fund players — have paid themselves unfathomable amounts of money over the last decade. They have set an aspirational standard for other executives and professionals, and helped drive wealth and income inequality to outrageous and unhealthy levels. Ultra compensation should be taxed at very high rates; and, at a bare minimum, the loopholes that let hedge fund managers pay taxes at about half the rate of regular folks must be closed. The case for aggressive tax reform on ultra rich financiers was overwhelming last year; now, with the financial system completely dependent on taxpayer largesse, there shouldn’t be anything left to debate. No one in finance can say they made their money just by working hard or being clever — their system was saved by the government.

2. The administration does not propose structural reform of the financial sector.

Although it proposes some meaningful regulatory reform, and modest alteration of the structure of regulatory agencies, the administration does not propose to alter the structure of the financial sector itself.

There is no discussion of returning to Glass-Steagall principles, to separate commercial banking from other financial activities including the speculative world of investment banking. Glass-Steagall was adopted during the Great Depression, as a response to financial abuses that closely parallel those of the previous decade. Repeal of Glass Steagall — following a decades-long erosion — came in 1999, and helped pave the way for the present crisis.

Nor is there any discussion of shrinking the size of goliath financial firms. Everyone now recognizes the problem of too-big-to-fail and too-interconnected-to-fail financial firms. The administration proposes to deal with the problem through regulation alone; a more fundamental approach would break up giant firms (or at least commit to prevent further consolidation going forward).

Addressing structure and size is important not only because of the economic power accreted by the goliaths, but because of their political strength — about which, see below.

3. The administration’s approach to regulating financial derivatives is too timid.

To its credit, the administration proposes to repeal recent deregulatory statutes and establish regulation of financial derivatives. But its plan does not go far enough. It creates a regulatory exemption for customized derivatives — a loophole that will create lots of business for corporate lawyers ready to change terms in derivative contracts so that they differ somewhat from standardized terms.

Nor does the administration propose to ban classes of dangerous financial instruments that cannot be justified. A clear example of a product that should be banned is a credit default swap — a kind of insurance against a certain outcome, like the inability of a bondholder to make required payments — in which neither party has a stake in the underlying transaction. Such credit default swaps have no insurance component, and are nothing more than bets — but they are bets that can vastly exceed the value of the transaction being bet on, and can spread financial contagion, as AIG demonstrated. George Soros argues that all credit default swaps basically share this feature, and should be banned altogether.

The administration proposal also fails to require that exotic financial instruments be subjected to pre-approval requirements. Under such an approach, financial firms would be required to show that new instruments offer some social benefit, and do not pose excessive risk.

4. The administration does not propose to empower consumers.

There is enormous merit to the proposal for a Consumer Financial Products Agency. But it is not a substitute for giving consumers the power to organize themselves to advance their own interests. Simply mandating that financial firms include in bills and statements (whether mailed or e-mailed) an invitation to join an independent consumer organization would facilitate tens of thousands of consumers — and likely many more — banding together to make sure the regulators do their job, and to prevent Wall Street from “innovating” the next trick to scam borrowers and investors.

The Ugly

Identifying the merits and gaps in the administration’s proposal is important. But the proposal does not exist in a vacuum, and it doesn’t become law just because the administration has proposed it.

The Wall Street types don’t know shame. Having benefited from literally trillions of dollars of taxpayer largesse, one might expect that they would be embarrassed to lobby on Capitol Hill. Or, that Members of Congress would be unsympathetic to their pleas.

But that’s not how Washington works. Having spent $5 billion on political investments over the last decade, Wall Street continues to pour cash into the political process — and those investments continue to pay handsomely.

To understand how things work, consider the fate of the proposal to give bankruptcy judges the power to adjust mortgages, so that they could reduce the principal owed on loans on homes now worth less than value of the loan. Then-candidate Barack Obama campaigned in favor of such “cram-down” provisions. In a rational world, banks would agree to these adjustments to principal on their own, because they do better if people stay in their homes and continue paying on the loan, rather than by forcing foreclosure. Not long ago, it was widely expected that cram-down would quickly become law. But the banks deployed their lobbyists, and this vital though totally inadequate measure was defeated in May. The Obama administration sat quietly by.

Now, Wall Street is already trashing the good parts of the administration’s proposals.

“Congress is not going to impose a ’skin-in-the-game’ requirement on all loans,” Jaret Seiberg, an analyst with Washington Research Group, a division of Concept Capital, flatly tells American Banker.

The Chamber of Commerce and other industry groupings are attacking the idea of a Consumer Financial Product Agency, including with the extraordinary claim that it will improperly relieve consumers of their duty to do “due diligence” on financial products.

Hedge funds are hiring ever more lobbyists and floating the claim that the administration’s requirements for some modest disclosure requirements for secretive hedge funds could do more damage than good. One purported reason: the disclosures may be too complicated for regular people to understand.

There’s no question that Wall Street is going to mobilize — is already mobilized — to defeat the administration’s positive proposals.

What remains very much in question is the administration’s willingness to engage in bare-knuckled political fighting to defend these proposals, as well as whether the public will be mobilized to support these and other moves to control Wall Street.

A new public interest coalition — Americans for Financial Reform — aims to do just that, but they are fighting on occupied territory. As Senator Majority Whip Richard Durbin says, “the banks are still the most powerful lobby on Capitol Hill. And they frankly own the place.”

[Disclosure: My organization, Essential Action, is a member of Americans for Financial Reform.]

But the rest of the corporate sector was not on good behavior during 2008 either, and didn’t deserve to escape justified scrutiny.

So, in keeping with the tradition of highlighting diverse forms of corporate wrongdoing, the list includes only one financial company out of the 10 worst. Here, presented in alphabetical order, are the 10 Worst Corporations of 2008.

AIG: Money for Nothing

There’s surely no one party responsible for the ongoing global financial crisis. But if you had to pick a single responsible corporation, there’s a very strong case to make for American International Group (AIG), which has already sucked up more than $150 billion in taxpayer support. Through “credit default swaps,” AIG basically collected insurance premiums while making the ridiculous assumption that it would never pay out on a failure — let alone a collapse of the entire market it was insuring. When reality set in, the roof caved in.

Cargill: Food Profiteers

When food prices spiked in late 2007 and through the beginning of 2008, countries and poor consumers found themselves at the mercy of the global market and the giant trading companies that dominate it. As hunger rose and food riots broke out around the world, Cargill saw profits soar, tallying more than $1 billion in the second quarter of 2008 alone.

In a competitive market, a grain-trading middleman would not make super-profits. In fact, rising prices would crimp the middleman’s profit margin. But the global grain trade is not competitive, and the legal rules of the global economy — devised at the behest of Cargill and friends — ensure that poor countries will be dependent on, and at the mercy of, the global grain traders.

Chevron: “We Can’t Let Little Countries Screw Around With Big Companies”

In 2001, Chevron swallowed up Texaco. It was happy to absorb Texaco’s revenue streams. It has been less willing to take responsibility for Texaco’s ecological and human-rights abuses.

In 1993, 30,000 indigenous Ecuadorians filed a class-action suit in U.S. courts, alleging that over a 20-year period Texaco had poisoned the land where they live and the waterways on which they rely, allowing billions of gallons of waste to spill and leaving hundreds of waste pits unlined and uncovered. Chevron had the case thrown out of U.S. courts on the grounds that it should be litigated in Ecuador, closer to where the alleged harms occurred. But now the case is going badly for Chevron in Ecuador — Chevron may be liable for more than $7 billion. So, the company is lobbying the Office of the U.S. Trade Representative to impose trade sanctions on Ecuador if the Ecuadorian government does not make the case go away.

“We can’t let little countries screw around with big companies like this — companies that have made big investments around the world,” a Chevron lobbyist said to Newsweek in August. (Chevron subsequently stated that the comments were not approved.)

CNPC: Fueling Violence in Darfur

Sudan has been able to laugh off existing and threatened sanctions for the slaughter it has perpetrated in Darfur because of the huge support it receives from China, channeled above all through the Sudanese relationship with the China National Petroleum Corp. (CNPC).

“The relationship between CNPC and Sudan is symbiotic,” notes the Washington, D.C.-based Human Rights First in a March 2008 report, “Investing in Tragedy.” “Not only is CNPC the largest foreign investor in the Sudanese oil sector, but Sudan is CNPC’s largest market for overseas investment.”

Oil money may have fueled violence in Darfur. “The profitability of Sudan’s oil sector has developed in close chronological step with the violence in Darfur,” notes Human Rights First.

Constellation Energy Group: Nuclear Operators

Although it seems too dangerous, too expensive and too centralized to make sense as an energy source, nuclear power won’t go away, thanks to equipment makers and utilities that find ways to make the public pay and pay.

Constellation Energy Group, the operator of the Calvert Cliffs nuclear plant in Maryland — a company recently involved in a startling, partially derailed scheme to price-gouge Maryland consumers — plans to build a new reactor at Calvert Cliffs, potentially the first new reactor built in the United States since the near-meltdown at Three Mile Island in 1979.

It has lined up to take advantage of U.S. government-guaranteed loans for new nuclear construction, available under the terms of the 2005 Energy Act. The company acknowledges it could not proceed with construction without the government guarantee.

Dole: The Sour Taste of Pineapple

A 1988 land reform effort in the Philippines has proven to be a fraud. Plantation owners helped to draft the law and invented ways to circumvent its alleged purpose. Dole pineapple workers are among those paying the price.

Under the land reform, Dole’s land was divided among its workers and others who had claims on the land prior to the pineapple giant. Workers were then required to form labor cooperatives. However, wealthy landlords maneuvered to gain control of these cooperatives, and then focused more on maximizing profits than providing fair wages and healthy working conditions, according to an October report by Washington, D.C.-based International Labor Rights Forum (ILRF).

Dole has since slashed its regular workforce and replaced them with contract workers from these labor cooperatives. Contract workers are paid under a quota system, and earn about $1.85 a day, according to ILRF.

GE: Creative Accounting

In June, former New York Times reporter David Cay Johnston reported on internal General Electric (GE) documents that appeared to show the company had engaged in a long-running effort to evade taxes in Brazil. In a lengthy report in Tax Notes International, Johnston reported on a GE subsidiary’s scheme to invoice suspiciously high sales volume for lighting equipment in lightly populated Amazon River regions of the country. These sales would avoid the higher value added taxes (VAT) of urban states, where sales would be expected to be greater.

Johnston wrote that the state-level VAT at issue, based on the internal documents he reviewed, appeared to be less than $100 million. But, he speculated, the overall scheme could have involved much more.

Johnston did not identify the source that gave him the internal GE documents, but GE has alleged it was a former company attorney, Adriana Koeck. GE fired Koeck in January 2007 for what it says were “performance reasons.”

Imperial Sugar: 14 Dead

On Feb. 7, 2008, an explosion rocked the Imperial Sugar refinery in Port Wentworth, Ga., near Savannah. Days later, when the fire was finally extinguished and search-and-rescue operations completed, the horrible human toll was finally known: 14 dead, dozens badly burned and injured.

As with almost every industrial disaster, it turns out the tragedy was preventable. The cause was accumulated sugar dust, which, like other forms of dust, is highly combustible.

A month after the Port Wentworth explosion, Occupational Safety and Health Administration (OSHA) inspectors investigated another Imperial Sugar plant, in Gramercy, La. They found one-fourth-inch to 2-inch accumulations of dust on electrical wiring and machinery. They found as much as 48inch accumulations on workroom floors.

Imperial Sugar knew of the conditions in its plants. It had in fact taken some measures to address its operations prior to the explosion. The company brought in a new vice president to clean up operations in November 2007, and he took some important measures to improve conditions. But it wasn’t enough. The vice president told a congressional committee that top-level management had told him to tone down his demands for immediate action.

Philip Morris International: Unshackled

The old Philip Morris no longer exists. In March, the company formally divided itself into two separate entities: Philip Morris USA, which remains a part of the parent company Altria, and Philip Morris International. Philip Morris USA sells Marlboro and other cigarettes in the United States. Philip Morris International tramples the rest of the world.

Philip Morris International has already signaled its initial plans to subvert the most important policies to reduce smoking and the death toll from tobacco-related disease (now at 5 million lives a year). The company has announced plans to inflict on the world an array of new products, packages and marketing efforts. These are designed to undermine smoke-free workplace rules, defeat tobacco taxes, segment markets with specially flavored products, offer flavored cigarettes to appeal to youth and overcome marketing restrictions.

Roche: “Saving Lives Is Not Our Business”

The Swiss company Roche makes a range of HIV-related drugs. One of them is enfuvirtide, sold under the brandname Fuzeon. Fuzeon brought in $266 million to Roche in 2007, though sales are declining.

Roche charges $25,000 a year for Fuzeon. It does not offer a discount price for developing countries.

Like most industrialized countries, South Korea maintains a form of price controls. The national health insurance program sets prices for medicines, and the Ministry of Health, Welfare and Family Affairs listed Fuzeon at $18,000 a year. South Korea’s per capita income is roughly half that of the United States. Instead of providing Fuzeon at South Korea’s listed level — and still turning a profit — Roche refuses to make the drug available in South Korea.

South Korean activists report that the head of Roche Korea told them, “We are not in business to save lives, but to make money. Saving lives is not our business.”

But for that metaphor to work, you have to add that they’ve loaded the gun with six bullets.

The only hope is that someone — Treasury Secretary Henry Paulson or Federal Reserve Chair Ben Bernanke — will come in and prevent the trigger from being pulled. Luckily, it appears they are ready to do so. A statement from the Bush administration this morning signaled that it would find a way to keep the Big Three automakers in business until next year, when a more comprehensive bailout and industry restructuring package can be worked out.

What is remarkable about the Senate Republican refusal to agree to a $15 billion loan deal for the auto industry is that they are not serving any corporate interest. A collapse of the U.S. auto industry would be bad not just for the Big Three, and the supplier networks and auto dealers, but pretty much every sector of the economy, including Wall Street. Earlier this week, U.S. Chamber of Commerce President and CEO Thomas J. Donohue urged that, “Congress must immediately authorize bridge loans to America’s car makers to prevent the collapse of the U.S. auto industry and the devastating impact it would have on the economy, American workers, and national security.”

The motives for the Republicans appear to be narrow political calculation that the public is tired of industry bailouts (a foolish political read, because if the Republicans permit the auto industry to fall into recession-worsening bankruptcy, they will pay a political price for at least a generation); a hypocritical claim that they oppose government intervention in the economy (contradicted by everything from Republican-approved state tax breaks for Honda and Toyota assembly plants to Ted Stevens’ earmarks, from public insurance and loan guarantees for the nuclear industry to subsidies for weapons exporters); and a vicious anti-unionism and anti-working class bias.

The Republicans say the failure to reach a Congressional deal on the auto bailout rests with the United Auto Workers, who refused to reduce wage scales to match those of non-unionized workers in Japanese auto company plants in the United States.

Actually, Japanese plant wages have always been close to those of the UAW, and the UAW has agreed to cut wages for many new workers almost in half — with many new jobs starting at $14 an hour. (GM says that, for these new hires, overall per-employee costs will decline from the totally misleading $78 per hour to $26 an hour.) But there’s no logic in chasing non-union wages down as a way to be competitive, because the non-union employer can always unilaterally lower them below those reached through collective bargaining.

There is a special cruelty and nastiness in the idea that unionized auto workers, who do very dangerous, physically demanding work with minimal opportunity for creative expression, are excessively compensated or enriched by unreasonably generous health insurance plans.

Here are a few points of comparison with an industry where physical demands and workplace safety hazards are minimal, and where white-collar employees brag about how they are free to be innovative. Like the U.S. auto industry, Wall Street has also fallen on very hard times due to spectacular mismanagement.

* Auto worker compensation makes up a small cost of manufacturing a car — less than 10 percent. So, you can slash wages as much as you want, but you won’t bring costs down much. By contrast, as you would expect in a service industry, compensation makes up a huge portion of costs for the financial sector. The New York state comptroller lists employee compensation costs as equivalent to more than 60 percent of 2007 revenue for the 7 largest financial firms headquartered in New York City. At Goldman Sachs, employee compensation made up 71 percent of total operating expenses in 2007.

* UAW contracts give workers the right to retire after 30 years of laboring, with pensions and healthcare. This week, Goldman Sachs announced that, given the hard times, it was considering raising its retirement requirement to the industry standard of the rule of 60 (from Goldman’s current 55). Under that rule, you can retire with nice benefits after any combination of age and service totaling 60. So, if you’ve done 15 years service at age 45, you’re eligible.

* In 2007, average wage and benefit costs per employee at Goldman Sachs were $661,490. Even using misleading and wildly inflated auto industry claims, UAW workers cost $150,000 a year.

* Congress has allocated $700 billion to bailout Wall Street, but the overall total is higher by an order of magnitude. Including all of the loans, investments, swaps, guarantees and more, the federal government (including the Federal Reserve) has doled out more than $7 trillion to Wall Street. The auto industry said it was looking for $34 billion, Congress was debating $15 billion, and analysts say the auto companies might ultimately need something like $100 billion.

Most of those funds — for both Wall Street and Detroit — are various kinds of loans that will be paid back, many accompanied by the right to make money if beneficiary stock prices rise in the future.

But some of the money for Wall Street is almost certain to be lost. Notably, the government has agreed to accept losses up to $250 billion on a $306 billion pool of Citigroup mortgage-related assets that are certain to show major losses. So, the government is on the hook to Citigroup, with the certain prospect of enormous losses that are likely to be more — just for this one financial behemoth — than the total amount the auto industry will seek in loans.

There’s no question that this morning’s announcement from the Treasury Department, Federal Reserve and Federal Deposit Insurance Corporation (FDIC) is remarkable.

It was also necessary.

Over the next several months, we’re going to see a lot more moves like this. Government interventions in the economy that seemed unfathomable a few months ago are going to become the norm, as it quickly becomes apparent that, as Margaret Thatcher once said in a very different context, there is no alternative.

That’s because the U.S. and global economic problems are deep and pervasive. The American worker may be strong, as John McCain would have it, but the “fundamentals” of the U.S. and world economy are not. The underlying problem is a deflating U.S. housing market that still has much more to go. And underlying that problem are the intertwined problems of U.S. consumer over-reliance on debt, national and global wealth inequality of historic proportions, and massive global trade imbalances.

Although it was enabled by deregulation, the financial meltdown merely reflects these more profound underlying problems. It is, one might say, “derivative.”

Nonetheless, the financial crisis was — and conceivably still might be — by itself enough to crash the global economy.

Today, following the lead of the Great Britain, the United States has announced what has emerged as the consensus favored financial proposal among economists of diverse political ideologies. The United States will buy $250 billion in new shares in banks (the so-called “equity injection”). This is aimed at boosting confidence in the banks, and giving them new capital to loan. The new equity will enable them to loan roughly 10 times more than would the Treasury’s earlier (and still developing) plan to buy up troubled assets. The FDIC will offer new insurance programs for bank small business and other bank deposits, to stem bank runs. The FDIC will provide new, temporary insurance for interbank loans, intended to overcome the crisis of confidence between banks. And, the Federal Reserve will if necessary purchase commercial paper from business — the 3-month loans they use to finance day-to-day operations. This move is intended to overcome the unwillingness of money market funds and others to extend credit.

But while aggressive by the standards of two months ago, the most high-profile of these moves — government acquisition of shares in the private banking system — is a strange kind of “partial nationalization,” if it should be called that at all.

Treasury Secretary Henry Paulson effectively compelled the leading U.S. banks to accept participation in the program. And, at first blush, he may have done an OK job of protecting taxpayer monetary interests. The U.S. government will buy preferred shares in the banks, paying a five percent dividend for the first three years, and nine percent thereafter. The government also obtains warrants, giving it the right to purchase shares in the future, if the banks’ share price increase.

But the Treasury proposal specifies that the government shares in the banks will be non-voting. And there appear to be only the most minimal requirements imposed on participating banks.

So, the government may be obtaining a modest ownership stake in the banks, but no control over their operations.

In keeping with the terms of the $700 billion bailout legislation, under which the bank share purchase plan is being carried out, the Treasury Department has announced guidelines for executive compensation for participating banks. These are laughable. The most important rule prohibits incentive compensation arrangements that “encourage unnecessary and excessive risks that threaten the value of the financial institution.” Gosh, do we need to throw $250 billion at the banks to persuade executives not to adopt incentive schemes that threaten their own institutions?

The banks reportedly will not be able to increase dividends, but will be able to maintain them at current levels. Really? The banks are bleeding hundreds of billions of dollars — with more to come — and they are taking money out to pay shareholders? The banks are not obligated to lend with the money they are getting. The banks are not obligated to re-negotiate mortgage terms with borrowers — even though a staggering one in six homeowners owe more than the value of their homes.

“The government’s role will be limited and temporary,” President Bush said in announcing today’s package. “These measures are not intended to take over the free market, but to preserve it.”

But it makes no sense to talk about the free market in such circumstances. And these measures are almost certain to be followed by more in the financial sector — not to mention the rest of economy — because the banks still have huge and growing losses for which they have not accounted.

If the U.S. and other governments are to take expanded roles in the world economy — as they must, and will — then the public must demand something more than efforts to preserve the current system. The current system brought on the financial meltdown and the worsening global recession. As the government intervenes in the economy on behalf of the public, it must reshape economic institutions to advance broad public objectives, not the parochial concerns of the Wall Street and corporate elite.

The current crisis is the culmination of a quarter century’s deregulation. Even as the Fed and Treasury scramble to contain the damage, there must be a simultaneous effort to reconstruct a regulatory system to prevent future disasters.

There is more urgency to such an effort than immediately apparent. If the Fed and Treasury succeed in controlling the situation and avoiding a collapse of the global financial system, then it is a near certainty that Big Finance — albeit a financial sector that will look very different than it appeared a year ago — will rally itself to oppose new regulatory standards. And the longer the lag between the end (or tailing off) of the financial crisis and the imposition of new legislative and regulatory rules, the harder it will be to impose meaningful rules on the financial titans.

The hyper-complexity of the existing financial system makes it hard to get a handle on how to reform the financial sector. (And, by the way, beware of generic calls for “reform” — for Wall Street itself taken up this banner over the past couple years. For the financial mavens, “reform” still means removing the few regulatory and legal requirements they currently face.)

But the complexity of the system also itself suggests the most important reform efforts: require better disclosure about what’s going on, make it harder to engage in complicated transactions, prohibit some financial innovations altogether, and require that financial institutions properly fulfill their core responsibilities of providing credit to individuals and communities.

Here are a dozen steps to restrain and redirect Wall Street and Big Finance:

1. Expand the scope of financial regulation. Investment banks and hedge funds have been able to escape the minimal regulatory standards imposed on other financial institutions. Especially with the government safety net — including access to Federal Reserve funds — extended beyond the traditional banking sector, this regulatory black hole must be eliminated.

2. Impose much more robust standards for disclosure and transparency. Hedge funds, investment banks and the off-the-books affiliates of traditional banks have engaged in complicated and intertwined transactions, such that no one can track who owes what, to whom. Without this transparency, it is impossible to understand what is going on, and where intervention is necessary before things spin out of control.

3. Prohibit off-the-books transactions. What’s the purpose of accounting standards, or banking controls, if you can evade them by simply by creating off-the-books entities?

4. Impose regulatory standards to limit the use of leverage (borrowed money) in investments. High flyers like leveraged investments because they offer the possibility of very high returns. But they also enable extremely risky investments — since they can vastly exceed an investor’s actual assets — that can threaten not just the investor but, if replicated sufficiently, the entire financial system.

5. Prohibit entire categories of exotic new financial instruments. So-called financial “innovation” has vastly outstripped the ability of regulators or even market participants to track what is going on, let alone control it. Internal company controls routinely fail to take into account the possibility of overall system failure — i.e., that other firms will suffer the same worst case scenario — and thus do not recognize the extent of the risks inherent in new instruments.

6. Subject commodities trading to much more extensive regulation. Commodities trading has become progressively deregulated. As speculators have flooded into the commodities markets, the trading markets have become increasingly divorced from the movement of actual commodities, and from their proper role in helping farmers and other commodities producers hedge against future price fluctuations.

7. Tax rules should be changed so as to remove the benefits to corporate reliance on debt. “Payments on corporate debt are tax deductible, whereas payments to equity are not,” explains Damon Silvers of the AFL-CIO. “This means that, once you take the tax effect into account, any given company can support much more debt than it can equity.” This tax arrangement has fueled the growth of private equity firms that rely on borrowed money to buy corporations. Many are now going bankrupt.

8. Impose a financial transactions tax. A small financial transactions tax would curb the turbulence in the markets, and, generally, slow things down. It would give real-economy businesses more space to operate without worrying about how today’s decisions will affect their stock price tomorrow, or the next hour. And it would be a steeply progressive tax that could raise substantial sums for useful public purposes.

9. Impose restraints on executive and top-level compensation. The top pay for financial impresarios is more than obscene. Executive pay and bonus schedules tied to short-term performance played an important role in driving the worst abuses on Wall Street.

10. Revive competition policy. The repeal of the Glass-Steagall Act, separating traditional banks from investment banks, was the culmination of a progressive deregulation of the banking sector. In the current environment, banks are gobbling up the investment banks. But this arrangement is paving the way for future problems. When the investment banks return to high-risk activity at scale (and over time they will, unless prohibited by regulators), they will directly endanger the banks of which they are a part. Meanwhile, further financial conglomeration worsens the “too big to fail” problem — with the possible failure of the largest institutions viewed as too dangerous to the financial system to be tolerated — that Treasury Secretary Hank Paulson cannot now avoid despite his best efforts. In this time of crisis, it may not be obvious how to respect and extend competition principles. But it is a safe bet that concentration and conglomeration will pose new problems in the future.

11. Adopt a financial consumer protection agenda that cracks down on abusive lending practices. Macroeconomic conditions made banks interested in predatory subprime loans, but it was regulatory failures that permitted them to occur. And it’s not just mortgage and home equity loans. Credit card and student loan companies have engaged in very similar practices — pushing unsustainable debt on unreasonable terms, with crushing effect on individuals, and ticking timebomb effects on lenders.

12. Support governmental, nonprofit, and community institutions to provide basic financial services. The effective governmental takeover of Fannie Mae, Freddie Mac and AIG means the U.S. government is going to have a massive, direct stake in the global financial system for some time to come. What needs to be emphasized as a policy measure, though, is a back-to-basics approach. There is a role for the government in helping families get mortgages on reasonable terms, and it should make sure Fannie and Freddie, and other agencies, serve this function. Government student loan services offer a much better deal than private lender alternatives. Credit unions can deliver the basic banking services that people need, but they need back-up institutional support to spread and flourish.

What is needed, in short, is to reverse the financial deregulatory wave of the last quarter century. As Big Finance mutated and escaped from the modest public controls to which it had been subjected, it demanded that the economy serve the financial sector. Now it’s time to make sure the equation is reversed.

Worldwide sales of private jets have more than doubled since 2003, to $19.4 billion in 2007. The number of jets sold increased 28 percent between 2006 and 2007 alone, and sales are up sharply in the first quarter of 2008. Corporate jet ownership has increased by about 70 percent since the early 1990s. Demand for private jets is so high that a used jet bought in 2006 can now be sold at a handsome profit.

But where luxury items like a fancy bottle of wine or a Picasso painting are simply a private extravagance, private jet use imposes real costs on everyone who isn’t a high flyer — and on the planet. The costs are documented in “High Flyers: How Private Jet Travel is Straining the System, Warming the Planet and Costing You Money,” a new report issued today by the Institute of Policy Studies and Essential Action (an organization I direct).

Soaring private jet use reflects and is emblematic of skyrocketing wealth inequality, in the United States and globally. Private jet sales grew in parallel with commercial air travel until 1997. Then as wealth inequality began to ascend to stratospheric levels, so did private jet use.

The rise of a global billionaire class has globalized the private jet market. The main manufacturers report that half or more of sales are coming from outside of North America.

Private and corporate jets give the super-rich not just ease and comfort, convenience and luxury — including an escape from the bothers of security lines and flight delays — but a way to distinguish themselves from everyone else. Private jet marketing explicitly emphasizes the elite status and conspicuousness of this consumption.

And, because the ultra-rich are always eager to distinguish themselves from the very rich, private jets are becoming more luxurious and expensive. Boeing’s largest business jet costs $67 million. Other companies sell airplanes that are nearly as costly: Airbus’s priciest plane goes for $55 million, while Gulfstream Aerospace’s G550 sells for $46 million. A relative handful of the high flyers set aside Learjets and the like as child toys, and insist on owning their own personal jumbo jet — Boeing 757s and the like.

Fueling the take-off in jet use is not just concentrating wealth, but numerous subsidies. Amazingly, U.S. taxpayers subsidize private jet use and ownership. Corporate CEOs flying on jets for vacation on personal use pay personal income tax based on the value of the gifted flight — but the value is calculated based on much lower commercial airfares. Most startlingly, the 2008 Economic Stimulus Act enables private jet buyers to take a “bonus depreciation” — allowing them to take larger tax deductions in the first year after purchase than they otherwise would.

Private jet use is subsidized as well by commercial air traffic. According to the Federal Aviation Administration, general aviation — the segment of the industry that includes corporate jets, charters, air taxis, and recreational pilots — uses 16 percent of the FAA’s services, but pays just 3 percent of the cost. Very substantial amounts of federal funds spent on airport improvement between 2005 and 2007 — $2.2 billion of $7 billion total — went to small airports that primarily serve private jets. These are places like California’s Napa Valley Airport.

Private jet use is further subsidized through corporate profligacy, at the expense of workers, consumers and shareholders. Personal use of the company jet is the most common perk for CEOs of large U.S. companies. The Corporate Library has found that more than half of 215 companies surveyed allowed or required — yes, required; it’s supposedly a security precaution — executives to use company aircraft on personal trips, with a median annual cost of $182,929.56.

Perhaps the worst element of private jet use is the environmental damage. Burning airplane fuel spews huge amounts of carbon into the atmosphere, making air travel a significant contributor to global warming. Private jet travel is far less efficient than commercial air flights, because so few people are transported on each private jet flight.

Four passengers flying in a private Cessna Citation X from Los Angeles to New York, for example, would each be responsible for more than five times as much CO2 emitted by a commercial air passenger making the same trip.

And that’s a very generous calculation, given estimates that 40 percent of private jet flights are empty — as pilots return home rather than sit idle waiting for a return trip.

At least some in the industry aren’t very sensitive to these considerations. Robert Baugniet, senior manager of corporate communications for Gulfstream Aerospace told my colleague Jennifer Wedekind that concerns about the private jet contribution to global warming are “fallacious.”

“So if you go in a bus and pump out a whole bunch of CO2 into the environment, but because you’ve got 40 passengers on board it’s OK?” he queries. (Answer: Not OK, but a whole lot better.) In the aggregate, says Baugniet, air travel is a relatively small contributor to global warming, and private jet travel is a small part of that. So, what’s the big deal?

To the extent that private jets are symbols of an economic system gone awry, remedying the problem will require big picture policy changes — steep wealth and income taxes and other measures to redress inequality, and comprehensive policies to address global warming.

But soaring private jet use also demands its own response. Tax breaks for buying and flying private jets should be ended. Private jets should pay, at least, their fair share of FAA costs. And a hefty luxury tax should be imposed on private jet sales and flying.

We shouldn’t be supporting the High Flyers in their luxury indulgence. If such heavy-polluting opulence is to be permitted at all, the super-rich should pay a stiff price for the privilege.

That’s a good thing, though the CFTC is not exactly the most aggressive regulator around. (Says Judy Dugan of Consumer Watchdog: “On its face, the investigation smacks of the fox investigating a hen shortage in the chicken coop.”)

Market manipulation may be contributing to the recent oil price spike — though even in the worst case, it is only part of the story. The most important factor is supply and demand: supply is having trouble keeping up with unabated demand growth.

Are Wall Street firms and hedge funds in fact manipulating the oil market? Perhaps. There are certainly enough conflicts of interest, and unregulation, to make such activity plausible. These aren’t exactly guys with an honorable track record.

Whether speculation is driving price up is a separate issue from manipulation. Investment dollars are pouring into oil futures, pretty clearly driving up price. This reflects supply and demand for oil futures as an investment tool, more than available supply and demand for actual crude oil. Some nontrivial portion of the recent run-up in price is almost certainly due to this speculative activity, which is fueled by leveraged buying (use of borrowed money).

At the end of 2007, with oil prices around $100 a barrel (a shocking height, just half a year ago), Jennifer Wedekind, my colleague at Multinational Monitor, interviewed roughly a dozen oil analysts about the price of oil. They were divided on the reasons for high oil prices of $100, with some agreeing that speculation — but not manipulation — played a role and others fiercely denying it.

Among those attributing some role to speculation was Linda Rafield, a senior oil analyst, with Platts: “We have seen money market funds and asset managers and portfolio managers definitely putting money to work in the commodities sector, and that certainly has bolstered prices, since most of those people notoriously will trade from the long side.” Against speculation as a factor was Jeff Rubin, chief economist and chief strategist, CIBC World Markets. Asked what factors were driving the price spike, he said, “Certainly not Middle Eastern instability or speculation or so-called geopolitical factors.”

Six months later, it seems like speculation has become increasingly important. It’s just very hard to identify what has happened in the last half year to jump prices by a third.

A second key factor in rising prices is the decline in the value of the dollar. A barrel of oil today is worth a barrel of oil tomorrow. If the dollar is worth less tomorrow than today, then the dollar value of a barrel of oil will be higher tomorrow. Against a basket of currencies, the dollar has fallen by 25 percent since 2003, and considerably more since its peak in 2001.

But, whatever the allocation of blame for today’s price, the most important factor in the big picture is supply and demand.

Global demand is growing at a steady clip, thanks to very rapidly rising oil use in China, India and the Middle East.

Global supply is stretched thin. Some argue this is because the world is at or near “peak oil production,” a tipping point when half the world’s oil has been extracted, and yields begin to decline, with very major price effects.

A different view is uncomfortable with the apocalyptic element of peak oil theory. From this vantage point, more oil — or close substitutes, like tar sands or shale — is available, but it is harder and more expensive to get. This is the preferred view of the oil industry analysts (many of whom note that much oil that is easily attained from a technological standpoint — for example, in Iraq — is hard to reach for political reasons).

Either way, the supply challenges combined with rapidly growing demand means the world is going to see steadily higher prices. Additionally, very tight supplies will inevitably lead to price spikes that appear irrational from a close-up view.

Says Charles Maxwell, senior energy analyst at Weeden & Co: “So long as capacity utilization in the world crude oil producing system is running at 98 percent, which it is today, and so long as perhaps one-and-a-half, 2 percent, that’s excess, is in the form of Saudi heavy, sour crudes, which the typical American refinery can’t use any more of — they use some, but they can’t use any more of because it has very serious effects in pitting the insides of these pipes and then requiring the refinery to shut down for a long time and the redoing of all the pipes — we’re going to have these periodic price rises of this sort.”

Explains Maxwell: “Any system needs to have a little cushion between adversity that strikes — weather factors or cut-offs for political purposes or political struggles from civil wars. We don’t have in this system enough of a cushion. Normally, capacity utilization is considered ideal around 94 to 95 percent. So our 98 percent capacity utilization is well above that and we can’t get it down, because it takes 5 to 7 years to create it and we aren’t spending the money today that would create it 5 to 7 years out.”

So, by all means, forward with a robust investigation of market manipulation, and yes to re-regulating oil markets that are now too financialized and removed from the buying and selling of real oil.

But the supply-demand challenges facing the world are much more serious than the speculative and other factors contributing to the present run-up in price.

It’s hard to imagine why the United States — or the world — would need more incentive than responding to climate change to invest in renewables, mandate much tougher efficiency standards for cars and a switch away from the internal combustion engine, and massively scale up public transportation. But climate change doomsday scenarios have, so far, not proven enough. Perhaps the prospect of $200/barrel oil will.

Current pricing arrangements are generating profit gushers for the large, integrated oil companies — ExxonMobil, ChevronTexaco and the like. While the price of oil is going up, these companies’ drilling expenses are not. Oil can trade at $40 a barrel, $90 a barrel, or $130 a barrel. It still costs ExxonMobil and the rest of Big Oil only about $20 to get a barrel of oil out of the ground.

The oil companies’ staggering profits are a windfall of the purest sort (Websters’ definition: “an unexpected, unearned, or sudden gain or advantage”). This is not a moral judgment about the oil companies, it is just a description of what’s happening.

A windfall profits tax could generate substantial government revenues. Allocated to investment in renewable energy, it could significantly increase funds directed to renewables, and be a small but important down payment on the massive investment needed in mass transit, energy efficiency and renewable energy.

Beyond the immediate future, it is important to get a better fix on energy markets. What’s clear now is that the U.S. refining market is very concentrated, thanks to a series of mergers permitted by antitrust authorities; and that oil and energy futures markets are dangerously unregulated.

Just five large oil refiners now control over half of the U.S. market, and the top 10 control over 80 percent, according to Public Citizen. There is very good evidence that the refiners have worked in the past to limit supply and drive up price. Whether this is an ongoing issue is perhaps less clear, given that independent refiners are now facing profit squeezes.

Still, for the medium term, either the government needs to scutinize refinery activity much more closely, adopt new regulatory authority and aggressively enforce antitrust laws, or it must intervene to deconcentrate the market.

Meanwhile, oil and energy markets have mutated in dangerous fashion over the last decade. At Enron’s instigation, these markets have become largely deregulated in the United States. Leading Wall Street firms like Goldman Sachs have subsequently bought up oil transport and storage operations — not because they are looking for new business outlets, but because they want insider knowledge about oil and gasoline markets. Meanwhile, investors large and small are pouring money into oil as a tradable commodity.

Are these markets being manipulated? Perhaps. But even with no manipulation, the intensified financialization of oil trading subjects the market to speculative frenzies characterized by sudden and severe price fluctuations. These prices swings have real impacts at the pump and in the overall economy (and much more ominous impacts for oil-importing developing countries than rich nations).

Re-regulating energy markets, imposing margin requirements and lessening investors’ ability to trade with borrowed money, and cracking down on market manipulation will all slow the Wall Street frenzy and limit price spikes.

For the long term, however, oil demand will continue to shoot up — though higher prices and the U.S. recession will moderate this tendency — and supply cannot keep up. Ultimately, new sources of oil may become available, including from deep water sites and tar sands and shale, but these will be more expensive to obtain.

The world is likely witnessing a long-term, steady (if bumpy) and permanent rise in oil prices. (More on the causes of oil price increases tomorrow.) This price increase will impose major economic hardships, unless there is a massive effort to shift to oil-displacing technologies and renewable energy.

That exactly this shift is needed to address the even more pressing threat of climate change, makes it all the more urgent that Washington adopt a windfall profits tax (and end governmental subsidies for Big Oil) and invest the proceeds in renewables. This is very unlikely for 2008. Will things be different in 2009?

IMF Managing Director Dominique Strauss-Kahn says that the “need for public intervention” to address the global financial crisis “is becoming more evident.” Strauss-Kahn has urged for a global fiscal stimulus, writing that, “Timely and targeted fiscal stimulus can add to aggregate demand in a way that supports private consumption during a critical phase.” The IMF has announced its support for the fiscal stimulus plan in the United States — a country with significant budget deficits and massive foreign debt.

The support for government intervention runs directly counter to the IMF’s longstanding support for strait-jacketing governments in poor countries, by demanding “structural adjustment” — a series of market fundamentalist, corporate-friendly policies, including hyper-restrictive macro-economic policies.

So far, there is little evidence that the IMF is changing the way it operates in developing countries. But maybe the times are changing, whether the IMF likes it or not.

The IMF gets its power from a gatekeeper role in international finance and donor circles. International lenders and government aid donors commonly limit their lending and aid donations to countries in the IMF’s good graces. The logic is that the IMF is competent to determine that the recipient countries are pursuing sensible economic policies, and therefore equipped to manage loans or aid.

The IMF has capitalized on its gatekeeper role to demand countries pursue a cookie cutter, market fundamentalist agenda of blind deregulation, sell-offs of public assets to corporations (privatization), opening up economies to foreign investors, tariff cuts, and government spending cuts.

There is overwhelming evidence of the failure of the IMF’s policy agenda. Mass privatization has led to enormous concentrations of wealth and encouraged corruption. Deregulation has contributed to financial crises, including those that foreshadowed the current global crisis centered in the United States. The overall economic model had impoverished tens of millions and left developing countries poorer. And government budget ceilings and inflation targets have prevented countries from expanded desperately needed investments in healthcare and education. Indeed, the IMF’s own Independent Evaluation Office has found that the Fund requires poor countries not meeting Fund inflation targets to divert most new donor aid. Instead of spending additional donor money on healthcare, for example, countries must use it to build up foreign reserves or pay down domestic debt.

Although the Fund has promised that it would reform the way it imposes conditions on poor countries, a new report from Eurodad, the European Network on Debt and Development, finds that, over the last six years, IMF conditions have not changed in number or kind.

One thing has changed, however. Impressed by the IMF’s repeated failures, middle-income countries have paid back their loans to the Fund, and are not taking out any news ones.

This in turn has two consequences. For now, at least, the IMF has lost its hold over most middle-income countries — but it maintains its iron grip on the world’s poorest countries. And, the Fund is experiencing a financial crunch of its own. It had depended on the interest payments from middle-income countries to support its budget.

Developing countries are not shedding tears over the IMF’s financial distress. “At long last, the IMF is experiencing first hand serious budget cuts,” says Cheikh Tidiane Dieye of Environment and Development in Africa (ENDA), based in Senegal. “The poetic justice of this is palpable. In Senegal, the IMF has mandated budget cuts for years. As a result, we have been unable to invest in health care, education and other essential services. If the IMF’s loss of financial power is accompanied by a loss in political power, this could be good news for all Africans.”

The IMF’s governing body has just approved a proposal that would involve cutting its staff by about 20 percent and selling some of its gold stock to create a trust fund that would fund administrative operations in the future.

The gold cannot be sold without U.S. approval, however, and the US representative to the Fund cannot support gold sales without Congressional authorization.

Health, development and labor organizations in the United States are mobilizing so that Congress approves gold sales only after achieving fundamental changes in IMF policy. Last week, 80 U.S. organizations — including Action Aid International USA, the AFL-CIO, Africa Action, the Bank Information Center, Essential Action (which I direct), 50 Years is Enough, Global AIDS Alliance, Health GAP, Jubilee USA Network, the ONE Campaign, Oxfam America, RESULTS USA, Service Employees International Union (SEIU), and the Student Global AIDS Campaign — urged Congress not to approve gold sales until first achieving real change at the Fund.

The letter says the Congress should require the IMF to: rescind the use of overly restrictive deficit-reduction and inflation-reduction targets; exempt expanded health and education spending in developing countries from IMF-imposed budget ceilings; permit developing countries to spend foreign aid for its intended purposes; delink debt cancellation from harmful economic policy conditions; and disclose crucial documents currently kept secret.

If the gold sales deal is approved, the IMF will become self-financing, and the U.S. Congress will lose much of its power to demand changes in how the IMF operates. So the present opportunity will not soon present itself again. There is no certainty about when the gold sales authorization will come before Congress, but it now seems as though it may be delayed until 2009.

Perhaps the IMF under the leadership of Strauss-Kahn, who took the helm of the institution only last September, is ready to re-evaluate its market fundamentalist, corporate-friendly policy prescriptions for poor countries. A statement issued by the Fund last week said that African countries did not need to raise interest rates in response to inflation driven by higher prices of food and fuel, and that some subsidies might be permissible in some circumstances. This is perhaps a baby step forward.

But if the IMF is not ready on its own to jettison its long-standing policy demands for poor countries, it may soon find that it has no choice. Representative Barney Frank, D-Massachusetts, chairs the House Financial Services Committee, which must approve the gold sales proposal prior to the full House of Representatives considering the issue. At the 20th anniversary celebration of the Bank Information Center last week, he strongly denounced structural adjustment, stated as a matter of fact that gold sales will only be authorized if additional IMF gold is sold to cancel poor country debt, and made clear that he intends to obtain policy changes from the IMF as a condition of permitting gold sales.

Public health advocates have worried and speculated over the past year about what this move may mean, but Philip Morris International has now removed all doubts.

The world is about to meet a Philip Morris International that will be even more predatory in pushing its toxic products worldwide.

The new Philip Morris International will be unconstrained by public opinion in the United States — the home country and largest market of the old, unified Philip Morris — and will no longer fear lawsuits in the United States.

As a result, Thomas Russo of the investment fund Gardner Russo & Gardner tells Bloomberg, the company “won’t have to worry about getting pre-approval from the U.S. for things that are perfectly acceptable in foreign markets.” Russo’s firm owns 5.7 million shares of Altria and now Philip Morris International.

A commentator for The Motley Fool investment advice service writes, “the Marlboro Man is finally free to roam the globe unfettered by the legal and marketing shackles of the U.S. domestic market.”

In February, the World Health Organization issued a new report on the global tobacco epidemic. WHO estimates the Big Tobacco-fueled epidemic now kills more than 5 million people every year.

Five million people.

By 2030, WHO estimates 8 million will die a year from tobacco-related disease, 80 percent in the developing world.

The WHO report emphasizes that known and proven public health policies can dramatically reduce smoking rates. These policies include indoor smoke-free policies; bans on tobacco advertising, promotion and sponsorship; heightened taxes; effective warnings; and cessation programs. These “strategies are within the reach of every country, rich or poor and, when combined as a package, offer us the best chance of reversing this growing epidemic,” says WHO Director-General Margaret Chan.

Most countries have failed to adopt these policies, thanks in no small part to decades-long efforts by Philip Morris and the rest of Big Tobacco to deploy political power to block public health initiatives. Thanks to the momentum surrounding a global tobacco treaty, known as the Framework Convention on Tobacco Control, adopted in 2005, this is starting to change. There’s a long way to go, but countries are increasingly adopting sound public health measures to combat Big Tobacco.

Now Philip Morris International has signaled its initial plans to subvert these policies.

The company has announced plans to inflict on the world an array of new products, packages and marketing efforts. These are designed to undermine smoke-free workplace rules, defeat tobacco taxes, segment markets with specially flavored products, offer flavored cigarettes sure to appeal to youth, and overcome marketing restrictions.

The Chief Operating Officer of Philip Morris International, Andre Calantzopoulos, detailed in a March investor presentation two new products, Marlboro Wides, “a shorter cigarette with a wider diameter,”and Marlboro Intense, “a rich, flavorful, shorter cigarette.”

Sounds innocent enough, as far as these things go.

That’s only to the innocent mind.

The Wall Street Journal reported on Philip Morris International’s underlying objective: “The idea behind Intense is to appeal to customers who, due to indoor smoking bans, want to dash outside for a quick nicotine hit but don’t always finish a full-size cigarette.”

Workplace and indoor smoke-free rules protect people from second-hand smoke, but also make it harder for smokers to smoke. The inconvenience (and stigma of needing to leave the office or restaurant to smoke) helps smokers smoke less and, often, quit. Subverting smoke-free bans will damage an important tool to reduce smoking.

Philip Morris International says it can adapt to high taxes. If applied per pack (or per cigarette), rather than as a percentage of price, high taxes more severely impact low-priced brands (and can help shift smokers to premium brands like Marlboro). But taxes based on price hurt Philip Morris International.

Philip Morris International’s response? “Other Tobacco Products,” which Calantzopoulos describes as “tax-driven substitutes for low-price cigarettes.” These include, says Calantzopoulos, “the ‘tobacco block,’which I would describe as the perfect make-your-own cigarette device.” In Germany, roll-your-own cigarettes are taxed far less than manufactured cigarettes, and Philip Morris International’s “tobacco block” is rapidly gaining market share.

One of the great industry deceptions over the last several decades is selling cigarettes called “lights” (as in Marlboro Lights), “low”or “mild” — all designed to deceive smokers into thinking they are safer.

The Framework Convention on Tobacco Control says these inherently misleading terms should be barred. Like other companies in this regard, Philip Morris has been moving to replace the names with color coding — aiming to convey the same ideas, without the now-controversial terms.

Calantzopoulos says Philip Morris International will work to more clearly differentiate Marlboro Gold (lights) from Marlboro Red (traditional) to “increase their appeal to consumer groups and segments that Marlboro has not traditionally addressed.”

Another, related initiative is Marlboro Filter Plus, which claims to reduce tar levels. First launched in Korea, in 2006, Calantzopoulos says it has recorded “an impressive 22 percent share” among what the company designates as “Young Adult Smokers.”

Philip Morris International also is unrolling a range of new Marlboro products with obvious attraction for youth. These include Marlboro Ice Mint, Marlboro Crisp Mint and Marlboro Fresh Mint, introduced into Japan and Hong Kong last year. It is exporting clove products from Indonesia.

Responding to increasing advertising restrictions and large, pictorial warnings required on packs, Marlboro is focusing increased attention on packaging. Fancy slide packs make the package more of a marketing device than ever before, and may be able to obscure warning labels.

Most worrisome of all may be the company’s forays into China, the biggest cigarette market in the world, which has largely been closed to foreign multinationals. Philip Morris International has hooked up with the China National Tobacco Company, which controls sales in China. Philip Morris International will sell Chinese brands in Europe. Much more importantly, licensed versions of Marlboro are expected to be available in China starting this summer. The Chinese aren’t letting Philip Morris International in quickly — Calantzopoulos says “we do not foresee a material impact on our volume and profitability in the near future.” But, he adds, “we believe this long-term strategic cooperation will prove to be mutually beneficial and form the foundation for strong long-term growth.”

What does long-term growth mean? In part, it means gaining market share among China’s 350 million smokers. But it also means expanding the market, by selling to girls and women. About 60 percent of men in China smoke; only 2 or 3 percent of women do so.

The global vilification of Big Tobacco over the last decade and a half is one of the world’s great public health stories. Directly connected to that vilification has been a reduction in smoking, and adoption of life-saving policies that will avert millions of deaths.

Yet here comes Philip Morris International, now the world’s largest nongovernmental tobacco company. It is permitted to break off from Altria with no regulatory restraint. It proceeds to announce plans to subvert the public health policies that offer the best hope for reducing the toll of tobacco-related death and disease. The markets applaud, governments are mute.

What an extraordinary commentary on the political and ideological potency of the multinational corporation — and the idea that corporations should presumptively be free to do what they want, with only the most minimal of restraints.

Unfortunately, the effects are already being felt in lower-income communities around the United States. Worst-case scenarios for what spins out from the US mortgage meltdown are truly frightening — a severe world recession is a distinct possibility.

Whether such worst-case scenarios can be averted, or softened — and preventing the recurrence of similar crises in the future — depends on abandoning the laissez-faire financial regulatory regime entrenched over the last decade.

The current crisis is the predictable (and predicted) result of a massive US housing bubble, which itself can be traced in part to global economic imbalances that could have been prevented.

At least five distinct regulatory failures led to the current crisis.

Regulatory Failure Number One: Failure to Manage the US Trade Deficit
The housing bubble (as well as the surge in leveraged buyouts of publicly traded companies (”private equity”)) was fueled by cheap credit– low interest rates. One reason for the cheap credit was an influx of capital into the United States from China. China’s capital surplus was the mirror image of the US trade deficit — US corporations were sending lots of dollars to China in exchange for the cheap stuff sold to US consumers.

Regulatory Failure Number Two: Failure to Intervene to Pop the Housing Bubble
Along with an influx of capital, Federal Reserve policy kept interest rates very low. There were good reasons for the Fed Policy, but that did not mean the Fed was helpless to prevent the housing bubble. As economists Dean Baker and Mark Weisbrot of the Center for Economic and Policy Research insisted at the time, Federal Reserve Chair Alan Greenspan simply by identifying the bubble — and adjusting public perception of the future of the housing market — could have prevented or at least contained the bubble. He declined, and even denied the existence of a bubble.

Regulatory Failure Number Three: Financial Deregulation and Unchecked Financial “Innovation”
A key reason that mortgages were made available so widely and with such little review of recipients’ qualifications was a shift in which institutions hold the mortgages. Traditionally, banks made mortgages and held them. In the new era, banks and non-bank mortgage lenders made loans, but then sold the loans to others. Investment banks packaged lots of mortgage loans into “Collateralized Debt Obligations” (CDOs) and then sold them on Wall Street, with a promise of a steady stream of revenue from interest payments. These operations were pretty much unregulated. Despite the supposed sophistication of the investors involved, no one took account of how shoddy the loans were or — more fundamentally — the certainty that huge numbers would go bad if and when the housing bubble popped.

Regulatory Failure Number Four: Private Regulatory Failure
It was the job of ratings agencies (like Standard and Poor’s, and Moody’s) to assess the CDOs and give investors guidance on how risky they were. They failed totally, likely in part because they wanted to maintain good relations with the investment banks issuing the CDOs.

Regulatory Failure Number Five: No Controls Over Predatory Lenders
The toxic stew of financial deregulation and the housing bubble created the circumstances in which aggressive lenders were nearly certain to abuse vulnerable borrowers. The terms of your loan don’t matter, they effectively purred to borrowers, so long as the value of your house is going up. Lenders duped borrowers into conditions they could not possibly satisfy, making the current rash of foreclosures on subprime loans inevitable. Effective regulation of lending practices could have prevented the abusive loans, but none was to be found.

Unfortunately, the consequences of the mortgage meltdown go far beyond the foreclosure epidemic, as horrible a toll as that is taking. The entanglement of the financial sector with mortgage instruments, and the ripple effects of the housing bubble, has made lenders uncertain of who even among large corporations and financial institutions is credit worthy. The resulting credit crunch endangers the functioning of the global economy. Financial markets are guessing wildly about the prospects of banks, insurers and other financial corporations, and the plunging value of stocks poses immediate dangers to the real global economy.

Less acute, but probably more profoundly, the popping of the housing bubble is driving down home prices. US consumer demand over the last five years has been driven by consumers borrowing against the increased value of their homes; with housing values falling, that process is working in reverse. The depressed housing market is also ravaging the construction sector, a nontrivial portion of the US economy. A serious recession looms as a real possibility.

Mitigating these harms and preventing the worst now depends on active and interventionist government — a government stimulus plan, and aggressive efforts to force lenders to adjust mortgage terms and let people stay in their homes. Preventing financial panics of the kind now underway require new standards of transparency and regulation for high finance. The coming days and months will tell whether any lessons have been learned.

“Whoever would overthrow the liberty of a nation must begin by subduing the freeness of speech,” said Benjamin Franklin.

“Information is the currency of democracy,” intoned Thomas Jefferson — one of countless Jefferson odes to the central importance of ideas and free transmission of information in fostering a working democracy.

But could they possibly have imagined the twisted purposes to which the First Amendment is put today?

Two crucial developments in U.S. constitutional jurisprudence — the grant of Bill of Rights protections to corporations, and the extension of First Amendment protections to commercial speech — have enabled corporations to invoke the First Amendment to defend their right to hawk goods, so long as they are legal, by almost any means short of outright lying or clear deception.

Now corporations are suggesting the First Amendment should effectively immunize them from government-imposed rules related to the simple commercial exchange of information.

This new expansion of the First Amendment to block broad public regulatory powers emerges from efforts in New England to control one of the most insidious pharmaceutical marketing practices.

Anyone who watches television in the United States, or reads magazines, is familiar with drug company advertisements to consumers. But these represent a relatively small fraction of industry marketing expenditures.

Drug companies devote much more money, and time, to influencing those with the power to prescribe medicines — as much as $34 billion in the United States, more than eight times what is spent on direct-to-consumer marketing.

The most important element of the marketing onslaught directed at doctors is “detailing” — the activities of the sales representatives who visit doctors constantly, and provide free lunches, free pens, free charts and other free goodies (including, very importantly, free samples). The average primary care physician sees drug detailers more than five times a day.

When a sales rep walks into a doctors office, he or she knows a lot about that doctor — including exactly what medicines the doctor prescribes, and in what quantities. How can this be?

Pharmaceutical companies purchase the information from data-mining companies, the largest of which is IMS Health. Pharmacies track what drug is sold to each customer. IMS buys the data from the pharmacies, deletes all patient names, combines it with data that enables the
identification of prescribers for each prescription, and aggregates the information.

Then, when the drug company representatives cheerfully bound in to a doctor’s office, they know exactly what the doctor is prescribing. They know if the doctor prescribes a lot of medicine or a little (drug company reps rate the doctors on a scale of 1-10, or A-F), and whether they go for the rep’s company’s product or a competitor’s or a generic. They know where to focus their efforts, and how to frame their sales pitches.

And, as the New York Times explained, quoting an e-mail message from a pharmaceutical executive to company salespeople, they use the data to “hold [doctors] accountable for all the time, samples, lunches, dinners, programs and past preceptorships that you have paid for and get the business!” The sales reps obviously do not have punitive power over the doctors, but they use the prescribing information to exploit and manipulate the social ties built on the giving relationship.

Neither doctors nor patients consent to this use of prescribing data, and only a tiny few even know about it.

New Hampshire decided to ban this use of the data in 2006. Vermont and Maine followed with similar laws.

IMS sued to block implementation of the laws, and won at the U.S. district court level. Judges agreed with IMS that the New Hampshire and Maine laws violate the company’s claimed First Amendment rights.

The New Hampshire law permits IMS and other data miners to continue to collect prescription data, but they can’t use individualized data — information about specific doctors’ prescribing practices — for commercial purposes.

The law is a “speech restriction because it limits both the use and disclosure of prescriber-identifiable data for commercial purposes,” District Judge Paul Barbadoro found in the New Hampshire case.

This was a misguided determination, challenged by the State of New Hampshire in an appeal argued before the First Circuit Court of Appeals yesterday. Leave aside the merits of providing First Amendment protections to corporations, or to commercial speech. Nothing about the New Hampshire law impinges on the expressive values that the First Amendment is intended to protect.

Contends Sean Flynn, the lead attorney for a coalition of public interest organizations supporting the New Hampshire law, “This case is not about speech, it is about industry surveillance of the doctor-patient relationship. New Hampshire acted through its data-mining law to safeguard that relationship, and the public health, by protecting it from industry surveillance and manipulation.”

Flynn says that if the district court’s ruling is upheld, and the principle of commercial speech protections is extended to cover any commercial exchange of text or data, then a host of existing laws are vulnerable to constitutional challenge. These include laws to protect consumer privacy and to mandate disclosure of financial information related to securities transactions.

It is very hard to defend government regulations determined to restrict commercial speech. Under Supreme Court rulings, judges must assess whether a commercial speech restriction advances a substantial governmental interest, directly advances the interest and is no more
limiting of speech than necessary. In a case like New Hampshire’s pharmaceutical data-mining restrictions, the test effectively requires the judge to closely scrutinize a government regulation and decide if it is both a good idea, and the best possible and least speech-restrictive way of achieving a desired ends. It gives the judge unwarranted authority — comparable, as former Justice Rehnquist noted, to the discredited turn-of-the-20th-century Lochner authority to strike down economic regulations — and makes it very hard to uphold a challenged regulation.

In applying the test, Judge Barbadoro knocked down the New Hampshire law on numerous grounds. There was no legitimate privacy interest involved, he found, especially since there is no evidence of drug sales reps harassing doctors. Pharmaceutical detailing may result in more brand-name and fewer generic drugs being prescribed, at greater expense, but there is no evidence that prescriber data “is being used to propagate false or misleading marketing messages.” And, he found, there are other ways the State could aim to curb drug company gifts, counter detailers’ messages and educate doctors, and aim to promote greater use of generic drugs.

Just to list the judge’s findings is to show how much inappropriate power the commercial speech test confers on judges in a case like this.

Will the appeals court agree with Judge Barbadoro? We’ll know in a few months.

Could Thomas Jefferson and his contemporaries have imagined the First Amendment being deployed for such purposes?

The world has obviously changed in the last 200-plus years, and Jefferson could not have envisioned even the existence of the modern pharmaceutical industry. But he did understand the threat that corporations posed to a working democracy.

“I hope that we shall crush in its birth the aristocracy of our monied corporations, which dare already to challenge our government to a trial of strength, and bid defiance to the laws of our country,” he wrote.

Meanwhile, Henry Kissinger says in an op-ed in Sunday’s Washington Post that control over oil is the key issue that should determine whether the U.S. undertakes military action against Iran.

These statements would not be remarkable, but for the effort of a broad swath of the U.S. political establishment to deny the central role of oil in U.S. involvement in the Middle East.

Greenspan’s remarks, appearing first in his just-published memoirs, are eyebrow-raising for their directness:

“Whatever their publicized angst over Saddam Hussein’s ‘weapons of mass destruction,’ American and British authorities were also concerned about violence in the area that harbors a resource indispensable for the functioning of the world economy. I am saddened that it is politically inconvenient to acknowledge what everyone knows: the Iraq war is largely about oil.”

His follow-up remarks have been even more direct. “I thought the issue of weapons of mass destruction as the excuse was utterly beside the point,” he told the Guardian.

Greenspan also tells the Washington Post’s Bob Woodward that he actively lobbied the White House to remove Saddam Hussein for the express purpose of protecting Western control over global oil supplies.

“I’m saying taking Saddam out was essential,” Greenspan said. But,writes Woodward, Greenspan “added that he was not implying that the war was an oil grab.”

“No, no, no,” he said. Getting rid of Hussein achieved the purpose of “making certain that the existing system [of oil markets] continues to work, frankly, until we find other [energy supplies], which ultimately we will.”

There’s every reason to credit this view. U.S. oil companies surely have designs on Iraqi oil, and were concerned about inroads by French and other firms under Saddam. But the top U.S. geopolitical concern is making sure the oil remains in the hands of those who will cooperate with Western economies.

Henry Kissinger echoes this view in his op-ed. “Iran has legitimate aspirations that need to be respected,” he writes — but those legitimate aspirations do not include control over the oil that the United States and other industrial countries need.

“An Iran that practices subversion and seeks regional hegemony — which appears to be the current trend — must be faced with lines it will not be permitted to cross. The industrial nations cannot accept radical forces dominating a region on which their economies depend, and the acquisition of nuclear weapons by Iran is incompatible with international security.”

Note that Kissinger prioritizes Iranian (or “radical”) control over regional oil supplies over concern about the country acquiring nuclear weapons.

One might reasonably suggest that Greenspan and Kissinger are only pointing out the obvious. (Kissinger himself refers to his concerns about Iran as “truisms.”)

But these claims have not been accepted as obvious in U.S. political life.

The Iraq was “is not about oil” became a mantra among the pro-war crowdin the run-up to the commencement of hostilities and in the following months. A small sampling:

Said President Bush: The idea that the United States covets Iraqi oil fields is a “wrong impression.” “I have a deep desire for peace. That’s what I have a desire for. And freedom for the Iraqi people. See, I don’t like a system where people are repressed through torture and murder in order to keep a dictator in place. It troubles me deeply. And so the Iraqi people must hear this loud and clear, that this country never has any intention to conquer anybody.”

Condoleeza Rice, in response to the proposition, “if Saddam’s primary export or natural resource was olive oil rather than oil, we would not be going through this situation,” said: “This cannot be further from the truth. . . . He is a threat to his neighbors. He’s a threat to American security interest. That is what the president has in mind.” She continued: “This is not about oil.”

Colin Powell: “This is not about oil; this is about a tyrant, a dictator, who is developing weapons of mass destruction to use against the Arab populations.”

Donald Rumsfeld: “It’s not about oil and it’s not about religion.”

White House spokesperson Ari Fleischer on the U.S. desire to access Iraqi oil fields: “there’s just nothing to it.”

Coalition Provisional Authority Paul Bremer: “I have heard that allegation and I simply reject it.”

General John Abizaid, Combatant Commander, Central Command, “It’s not about oil.”

Energy Secretary Spencer Abraham: “It was not about oil.”

“It’s not about the oil,” the Financial Times reported Richard Perle shouting at a parking attendant in frustration.

Australian Treasurer Peter Costello: “This is not about oil.”

Former Secretary of State Lawrence Eagleburger: “The only thing I can tell you is this war is not about oil.”

Jack Straw, British Foreign Secretary: “This is not about oil. This is about international peace and security.”

Utah Republican Senator Bob Bennett: “This is not about oil. That was very clear. . . . This is about America, and America’s position in the world, as the upholder of liberty for the oppressed.”

And Washington Post columnist Richard Cohen joined war-monger Richard Perle in calling Representative Dennis Kucinich a “liar” (or at very least a “fool”), because Kucinich suggested the war might be motivatedin part by a U.S. interest in Iraqi oil.

What lessons are to be drawn from the Greenspan-Kissinger revelations, other than that political leaders routinely lie or engage in mass self-delusion?

Controlling the U.S. war machine will require ending the U.S. addiction to oil — not just foreign oil, but oil. There are of course other reasons that ending reliance on fossil fuels is imperative and of the greatest urgency.

More and more people are making the connections — but there’s no outpouring in the streets to overcome the entrenched economic interests that seek to maintain the petro-military nexus. A good place to start: The No War, No Warming actions www.nowarnowarming.org planned for October 21-23 in Washington, D.C. and around the United States.

Robert Weissman is editor of the Washington, D.C.-based Multinational Monitor, and director of Essential Action.

When word got out that Michael Moore was working on a movie with the working title SiCKO, about the U.S. healthcare industry, the industry went bananas.

Memos started shooting around, warning insurance and drug company executives and representatives to keep looking over their shoulders, to make sure they avoided being ambushed by Moore and a camera crew. Indeed, they had something to fear, for they have a great deal of needless misery and suffering to answer for.

But it turns out that Moore didn’t need them after all.

Instead, he’s made a movie driven by heart-breaking story after heart-breaking story. SiCKO presents a devastating indictment of the US healthcare system by letting victimized patients speak for themselves.

When Moore announced on his web page that he was doing a movie about outrages in the US healthcare system and was looking for examples, he was flooded with 25,000 responses.

He profiles Dawnelle, whose 18-month-old daughter Michelle died because her health plan, Kaiser, insisted Michelle not be treated at the hospital to which an ambulance had taken her, but instead be transferred to a Kaiser hospital. Fifteen minutes after arriving at the next hospital, Michelle died, probably from a bacterial infection that could have been treated with antibiotics.

Julie, who works at a hospital, explains how her insurance plan refused to authorize a bone marrow transplant recommended for her cancer-riven husband. He died quickly.

Larry and Donna, a late-middle-age couple, find that co-payments and deductibles for treatment after Donna has cancer add up to such a burden that they have to sell their house and move into a small room in their adult daughter’s house. The day they move into their daughter’s house, her husband leaves to work as a contractor in Iraq.

Moore’s camera captures the pain, chaos and forced indignity imposed upon every day people who do their best to deal with an impossible situation.

Moore’s web page announcement also attracted responses from hundreds of employees in the health insurance industry, explaining how their jobs forced them to do things of which they were ashamed.

Lee, a former industry employee whose job was to find ways to deny or rescind coverage for healthcare, explains how hard insurers work to deny care, searching for any pretense. About denials of care and coverage, he says, “It is not unintentional. It is not a mistake. It is not somebody slipping through the cracks. Somebody made that crack, and swept you to it.”

Becky, another industry employee, says through tears that she’s a “bitch” on the phone with clients because she doesn’t want to know anything about their families or personal situations — that knowledge makes the inevitable denial of care too hard to stomach.

And Dr. Linda Peeno, a former medical reviewer for Humana, testifies before a Congressional committee in 1996 that her denial of needed treatment to a patient led to the patient’s death. “I am here,” she told the committee, “primarily today to make a public confession. In the spring of 1987 as a physician, I denied a man a necessary operation that would have saved his life and thus caused his death. No person and no group has held me accountable for this. Because, in fact, what I did was I saved a company a half a million dollars with this.”

With some exceptions, SiCKO’s victims aren’t people without insurance. As Moore narrates, the movie is instead about the travails of the 250 million people in the United States with insurance.

There are some in the movie without insurance, however. A hospital places a destitute and disoriented woman in a taxicab, which drives away and literally dumps her on the street, near a shelter.

Rich, who has no insurance, has an accident in which he saws off the tips of two fingers. He is told sewing the ring fingertip back on will cost $12,000. The middle finger will cost $60,000. “Being a hopeless romantic,” Moore narrates, Rich chooses the ring finger.

The publicity for SiCKO says the movie sticks to Michael Moore’s “tried-and-true one-man approach” and “promises to be every bit asindicting as Moore’s previous films.”

This is actually somewhat misleading. The approach is a little different. There’s humor, but there aren’t many gimmicks in SiCKO. There’s no effort by Moore to confront industry executives. Moore himself has a much smaller role than in previous films.

It is also a bit deceptive — as an understatement — to say SiCKO is as indicting as Moore’s previous films. No matter how big a fan you may have been of Moore’s earlier movies, you’ll find that SiCKO cuts deeper and is more powerful and profound. SiCKO is, by far, his best movie.

This is, simply, a masterful work. It is deeply respectful of and compassionate towards the victims. It seethes with outrage, but its fury is conveyed by all of the horrifying stories it presents. The narrative is, by and large, understated. It overflows with raw emotion, but manages to explain clearly the systemic imperatives that lead the richest nation in the history of the world to fail so miserably at delivering healthcare to all.

SiCKO, Part II: Things Can Be Different

Could things be different in the United States?

Yes.

The second half of SiCKO looks at other countries’ healthcare systems, and finds that national, single-payer insurance delivers far better care.

There are no talking head experts in SiCKO.

The first part of SiCKO features regular people detailing the horrors of the US healthcare system, based on their own experience.

But more is needed than just a searing indictment of the present system. How to convey the idea that there is an alternative to the US status quo?

Moore’s answer is to go to places that do have national health plans, and ask regular people there to talk about their experiences.

Moore follows a young American woman as she crosses north over the US-Canada border and seeks to obtain healthcare under the guise of being married to a Canadian. (About which Moore says, “We’re Americans. We go into other countries when we need to. It’s tricky, but it’s allowed.)

This opens the door for an encounter with the Canadian single-payer health insurance system, where treatment is free for everyone and people can choose any doctor they like. Moore interviews everyday Canadians who express bewilderment at the US system of charging sick people for care, and who indicate deep satisfaction with their system.

One man recounts enduring a serious injury on vacation in Florida, and needing to come back to Canada to get care, where treatment was free. “Why should other Canadians pay for your problem?” Moore asks of the man, who identifies himself as a Conservative Party member. “Because we’d do it for them,” comes the reply.

This becomes in many ways the crucial message of SiCKO.

From Canada, Moore travels to the United Kingdom, which has a national health plan, where doctors and healthcare workers are employed by the National Health Service. Patients in a hospital laugh out loud at Moore when he asks them where they pay. When he finally finds a cashier’s office, it turns out that the cashier actually makes rather than takes payments — travel reimbursements for low-income persons.

Moore interviews a handsome young doctor, who explains that although he is on the government payroll, he is doing quite well, thank you. He shows off his fancy car and million-dollar home. And he reports that doctors are paid more if they can demonstrate good results — for example, convincing patients not to smoke.

Next is France, where Alexi, a French-born 35-year-old who had lived in the United States from the age of 18, explained that he moved back to France when diagnosed with a tumor. He received free treatment, and then three months of fully paid time off to recover.

Seeking “the real story,” Moore dines with a group of Americans living in France. They explain not only that they get free healthcare, but that they benefit from mandatory extended vacation time, lengthy paid parental leave, and government-provided nannies for new parents (two times, four hours a week for a family subsequently visited).

US health insurance industry front groups and corporate-backed libertarian think tanks are attacking SiCKO for an overly positive portrayal of overseas health plans. There is a small amount of truth to this. SiCKO does not discuss the shortcomings in these health systems, and they are not trivial. No system is perfect. And there are worsening problems especially in the Canadian and UK health systems, thanks to chronic underfunding and efforts to chip away at the integrity of the system by exactly the same forces that then point to their shortcomings.

Nonetheless, by any serious measure, these systems do far better than the United States. They provide universal coverage, with no fees. These countries’ health indicators are better, evidenced by everything from infant mortality rates to length of life (even though the United States is richer). They are also far more cost effective. More on these policy matters in my next column.

SiCKO ends by going to Cuba. Moore first takes 9/11 rescue workers who are suffering serious ailments but have not been able to get coverage, and some others in need of care, to Guantanamo (where the military has bragged that prisoners are receiving top-notch care). Rejected there, they venture into the Cuban health system.

What appears to have begun as a gimmick turns out to be incredibly moving, as the 9/11 rescue workers and the others are emotionally overcome as they find themselves in a system that doesn’t ask about their ability to pay, or tailor care based on their insurance coverage. The Cuban doctors and health workers are generous, courteous and respectful, and they treat the patients for the ailments presented, full stop. They brush aside proffers of thanks –their job is to treat the sick, after all.

The point of the visit to Cuba is not to celebrate the accomplishments of the Cuban healthcare system — which are extraordinary (Cuba has roughly the same health indicators as the United States, which is not only far richer, but adjusted for currency differences, spends 23 times more per person on healthcare than Cuba, according to the UN) — but to say, “Hey, if this poor country can provide healthcare to all, why can’t the rich power to the North?”

From the care provided in Havana and in a touching scene at a Havana fire station, an even more profound lesson emerges: the power of a cultural commitment to care for one another. All of us for all of us, with as big an “us” as possible.

SiCKO is not an anti-American film, though much of the right-wing chatter says otherwise.

People in the United States do routinely pitch in for one another on a voluntary basis, Moore emphasizes. The problem is that the US corporate health insurance system, the corporate-dominated economy more generally, and the ideology that undergirds both, seeks to defeat the essential insurance function of sharing risk — of everyone helping to take care of everyone else.

Moore offers this challenge, or plea: “If there is a better way to treat the sick — simply by being good to each other — why can’t we do that?”

People in the other countries visited in the film “live in a world of we, not me,” says Moore.

To varying degrees, they have created solidarity societies, and they are happier, and healthier, for it.

Sneak previews for SiCKO are being shown around the United States on June 23. The movie opens nationally on June 29. Be ready to be driven to tears and rage.