Brianna Johnson-King ‘21, this year’s recipient of the 2021 CLEA Outstanding Clinical Student Award, is recognized for her accomplishments and commitment to advocacy through her clinical work with the Food Law & Policy Clinic (FLPC) of the Center for Health Law and Policy Innovation.
The award, which is presented annually by the Clinical Legal Education Association, is given to one student or student team from each U.S. law school for outstanding clinical coursework and contributions to the clinical community. Student winners are selected by full-time clinical faculty at each law school.
Having grown up in rural Ohio, Johnson-King’s background in agriculture and her experience showing animals as a member of 4-H is what inspired her to join FLPC her 2L year.
“I’ve always carried that rural aspect with me as a personal passion of mine,” she said. “I’ve seen how it impacts so many areas whether it’s environmental law, food access, or other issues. The clinic … was the first time I was going to have the opportunity to tie in my personal background and upbringing into my legal work.”
Over the course of four semesters with FLPC, Johnson-King dedicated herself to advocating for a broad range of issues and clients, from farmers to home cooks. Johnson-King was the main student author of the clinic’s Recommendations to the House Select Committee on the Climate Crisis on ways the agricultural sector could better mitigate and adapt to climate change. These included bolstering the federal assistance farmers would receive when they adopted new climate-friendly practices. She also helped write an issue brief on federal and state mechanisms to support local agriculture during the pandemic, and then participated in follow-up calls and correspondence with congressional staffers seeking to learn more about these ideas.
In Johnson-King’s last semester with FLPC, she worked on a project that she noted was her favorite experience with the clinic. She, along with another FLPC student, prepared draft legislation to support a home cook client looking to change state law to allow more sales of home-prepared goods. As part of the project she compiled detailed research from all 50 states to back up the proposed change in the legislation. This was only one out of several projects with the clinic where Johnson-King felt she was able to demonstrate her versatility.
“My favorite aspect of working with the clinic was the range of experiences that I had over my four semesters, including submitting comments to federal agencies, writing blog posts, advising on how to provide COVID-19 relief, writing state bills, and so much more,” said Johnson-King.
In addition to writing a brief on conservation and climate in the 2018 Farm Bill, Johnson-King also developed recommendations for strengthening food access and nutrition funding and programs in the 2023 Farm Bill. Amid the COVID-19 pandemic, Johnson-King adapted to a new surge of clinical work by making FLPC projects on food accessibility more available to the public and devised ways to make the Supplemental Nutrition Assistance Program more effective.
Faculty and staff at FLPC lauded Johnson-King not only for the efficiency and efficacy of her advocacy but also the innovative solutions she would bring to the table.
“Brianna’s work ethic and work quality have continually surpassed our expectations,” they said. “She has already developed the skill—which most seasoned attorneys still struggle with—of doing thorough work in a short amount of time. She also does not hesitate to dig into new areas or review literature outside of traditional legal resources.”
“One interest or one area of law can intersect so many things and I think the Food Law and Policy Clinic is the perfect example of that,” said Johnson-King. “My time with FLPC allowed me to develop my writing and research skills, especially adapting to learning about new subjects. This gave me the confidence and ability to dive into new projects without any direct prior experience. Additionally, I know that I have found great mentors and friends through my time with FLPC, which I know will carry on well past my time at HLS.”
After graduation, Johnson-King will be working at Schulte Roth & Zabel in New York City.
The antitrust critique of U.S. agriculture that is dominant in progressive politics is based on a flawed analysis of the farm economy that insists farmers are in dire straits. In her new book, “Break ‘Em Up,” Zephyr Teachout uses the metaphor of “chickenization” to relate the plights of chicken farmers using feed supplied by Tyson to Uber drivers forced to accept rate cuts. In a fiery attack on Joe Biden’s agriculture team last summer, David Dayen argued that corporate middlemen like Cargill and Bayer exert excessive control over the industry and bend farmers to their will. “Some of the biggest Fortune 500 companies may be in agriculture and are making huge profits,” Teachout writes in her book, “but farmers are poor and insecure.”
The antitrust movement is not wrong to focus on the influence of agribusiness corporations. These multinationals have helped transform huge swathes of the globe into biological wastelands, depopulated the countryside, and created a class of hyper-exploited workers. But the standard antitrust analysis overlooks the extent to which farmers benefit from the current system. The vast majority of farmers in the United States are now wealthy, comfortable, and conservative. In this piece, we explain why it is farmworkers, not farmers, who will be at the forefront of any effort to democratize agriculture.
Any analysis of modern farming has to start with the understanding that wealthier farmers won their war against more modest farmers long ago. New Deal planners and Farm Bureau representatives set up the modern farm system to reward large-scale production. As the government increased payments to lift the economy from the Great Depression, large farmers got most of the aid. The number of farm operators fell by 70 percent from 1930 to 1997, as acreage and sales concentrated in fewer hands.
The farmers still around today are, by any measure, wealthy. The median net income for farm households is 21 percent higher than the overall median and goes even further because of lower cost-of-living in rural areas. The statistics for wealth disparities are more extreme. The median farm household has a non-farm net wealth 2.5 times the median household and a total net wealth 9 times as high (both of these figures account for debts). In fact, 97 percent of farm households have higher net wealth than the median American household. The general farm economy is also strong. Despite innumerable reports that use total farm income to argue farmers are in crisis, per capita farm income is near historical highs. Five of the ten best farm income years since the Great Depression have come in the last decade.
How, then, do mainstream antitrust writers produce so much data to suggest that farmers are poor? Most often, they misinterpret aggregate numbers that require a great deal more context. For example, antitrust arguments commonly focus on the fall in the “farmer’s share of the food dollar” from 37 cents in 1980 to 15 cents today. This is true, but total spending on food is up and the number of farms is down. The upshot: farm revenues are near record levels today.
Another common pitfall is the use of summary statistics that are skewed by the Department of Agriculture’s idiosyncratic definition of “farm.” David Dayen, for example, writes that “the USDA estimates that more than half of all farm households are losing money.” But USDA’s Census of Agriculture, the source of many such statistics, includes an enormous number of “farms” whose owners have no interest in farming for profit or even as a hobby. Though the census reports around 2 million agricultural operations, two-thirds of these, per the best available data, are retiree or “lifestyle” farms. Furthermore, the USDA figures include all operations that are simply “capable of producing $1,000 in sales each year.” In fact, almost a quarter of the “farms” in the 2017 census did not sell any farm products whatsoever.
Farm organizations portray low- or zero-sales farms as low-income families struggling to get back into agriculture. In reality, most of these farms are owned by wealthy rural and exurban residents with other financial means. The median household with a “residence” farm—a category that makes up almost all small-scale farms and the majority of all farms—lost $1,600 in farm income in 2019. But these same households, at the median, take in more than $100,000 in total income and hold around $450,000 in net non-farm wealth (about 4 times the median U.S. household). As journalist Maggie Koerth found in an investigative report, most small farmers in the agricultural census “aren’t the farms of the poor; they’re the yards of the upper-middle-class.”
Farms that do engage in market production tend to make large amounts of money. Only about 340,000 farms—80 percent of them family-owned—accounted for 90 percent of sales in 2012. These are what USDA calls “farm businesses,” a category that excludes retirement and lifestyle farms; we also exclude family farms with less than $150,000 in sales. Even farm businesses with only “moderate sales” have a median farm income of $46,000, a median household income of $95,000, and a median net wealth of $1.8 million. “Midsize” farms make a median of $102,000 off farming and have a total net wealth of $2.4 million. These figures shoot through the roof for larger operations. Figures for income and wealth of farms are from ARMS special reports for 2019. Share of sales is from the 2012 Census of Agriculture Typology Report. Median income and wealth for all households is from the Survey of Consumer Finances for 2016.
Many readers will be surprised to read that farmers have so much wealth, since antitrust journalists often point out that total farm debt is at an all-time high. They do not mention that farm assets have increased at even higher rates—in fact, assets exceed debt—nor do they adjust for inflation. Farms also often have substantial non-farm wealth they can draw on when their incomes dip. Financial success keeps farmers invested in the system: studies of campaign contributions havefoundthat agriculture is among the most conservative industries , and a poll from last year found 80 percent of farmers approved of Donald Trump.
Animal farmers, who figure prominently in the conventional antitrust narrative, are no exception. David Dayen, in “Monopolized,” writes that “a 2013 Pew report noted that 71 percent of all chicken farmers earn incomes below the poverty line.” Zephyr Teachout uses the same figure in “Break ‘Em Up.” The source for this figure appears to be an unpublished 2001 report that found 71 percent of households whose only source of income is a chicken farm were in poverty. The comparable number for today is not readily available, but USDA data (released for this article) show that even the lowest-sales broiler farm businesses have a median household income of $69,000 and a net wealth of over $1 million. The figures are similar for cattle and hog farmers.
None of this is to say that there are not chicken farmers, dairy farmers, and some other farmers who struggle. But the data tells us that, to an overwhelming degree, farmers are wealthy. The story is quite different for farmworkers.
Farmworkers perform most of the work in American agriculture, yet they are relegated to a second-class status. A special tabulation we received from USDA shows that farmworkers work 60 percent of the hours on the farms that account for 90 percent of all agricultural production. Yet they earn only a fraction of the money. Farmers may only earn 15 cents of each food dollar, but farmworkers receive only 1.2 cents—and split those cents among more people, since there are far more farmworkers than farmers.
Data on farmworkers in animal production are patchy, but an expert who studies farm labor in California found they may earn about $30,000 per year. Crop workers, meanwhile, have a median annual income of $17,500-$20,000 and a third have family incomes below the poverty line. The average crop worker has an 8th grade education, 60 percent cannot speak English even “somewhat,” and as many as two-thirds are undocumented. They also often lack safe drinking water, work under body-destroying labor conditions, and are exposed to dangerous levels of pesticides at much higher levels than farmers. With no hope to purchase enough land to enter commercial farming, they labor, as researcher Philip Martin writes, in “an apartheid industry.”
The farm lobby and other conservative interests work hard to keep farmworkers under their control. Recently, they pushed President Trump to expand of the H-2A visa program, which some farmworker advocates comparetoslavery. Large farms do their hiring through subcontractors that use the threat of deportation to keep wages down and impede unionization.
The mainstream antitrust movement is aware of these problems and will readily concede the need for greater labor protections. But their unmistakable focus is on farmers, which has led them to endorsea trickle-downtheory of reform in which farmers, post trust-busting, will share the extra profits they capture with their workers. According to antitrust advocates Sandeep Vaheesan and Claire Kelloway, “Reducing the oppressive buyer power of massive retailers like Walmart, and dominant meat processors, like Tyson, would help return a larger share of the food dollar to producers, and, by extension, their workers.”
This sounds logical: if farmers had more money, they’d have more of it to share with their workers. But the data makes clear that there is little to no relationship between farm profits and farm wages. When farm profits spiked in the mid-2000s, wages stayed level. When profits hit new highs in the early 2010s, wages rose slightly, then climbed as profits fell again. Philip Martin, the scholar of farm labor, attributes the recent rise to a slowdown in immigration and state-level increases in the minimum wage, not increased generosity among hiring managers.
Research on meat processing and packing workers also cuts against the antitrust trickle-down theory. Scholars who have examined working conditions in meat processing and packing industries have found that the rapid dissolution of union power, not consolidation, is responsible for worsening pay and labor conditions. In fact, workers at large meatpacking plants enjoyed substantially higher wages than those at smaller companies prior to a collapse of unions in the 1980s and 1990s. Agricultural workers don’t need wealthier bosses, they need more rights—to unionize, to live free from harassment and mistreatment, to have decent food and housing, to collectively own the land they work.
The mainstream antitrust approach also does little to solve more fundamental problems. In 1524, the German peasant leader and preacher, Thomas Müntzer, lambasted the nobility for taking living creatures as their private property. He wrote, outraged, “that all creatures have been turned into property, the fish in the water, the birds in the air, the plants on the earth—all living things must also become free.” Karl Marx approvingly cited Müntzer 320 years later, when he argued that capitalism not only degrades how we relate to each other, but also how we relate to nature. As long as we treat living things as commodities, neither they, nor we, will be free.
A programmatic path to the liberation of all things is beyond the scope of this post— instead, we offer a critique of the antitrust narrative focused on farmers.
Antitrust enforcement can be a useful tool at times, but when its proponents use concentration to explain all the ills of agriculture, they distort reality. The break ’em up approach may distribute property rights in human and animal misery more evenly, but it does not address the exploitation at the heart of the system.
The antitrust movement has a profoundly flawed analysis of the farm economy. Its proponents argue that, in effect, tending to the needs of a small, highly conservative, and well-off constituency will redound to the benefit of their workers and society. But it is farmworkers, not farmers, who are already at the forefront of movements against environmental abuses and labor violations by their employers, that is to say, farmers. They also have the ability, through withholding and redirecting their labor, to shut down and reshape food production in the United States. Antitrust writers argue that breaking up agribusiness will help farmers and farmworkers alike. They dream of a cross-class alliance, but deny the intense conflict already with us, playing out every day in fields and farmhouses across the country.
Originally written by Rachel Reed and posted on Harvard Law Today on May 11, 2021
Zachary Weinstein ’21 starred in shows like Glee, Criminal Minds, and Will & Grace before attending Harvard Law School
Zachary Weinstein ’21 didn’t always want to be a lawyer. In fact, for most of his life, he was more likely to be found in front of a camera than in front of a judge.
But on May 27, Weinstein will proudly graduate from Harvard Law School, where he was active in HLS Talks, the Disability Law Students Association, and as a legal research assistant — proving that you can be a lawyer and play one on TV.
Weinstein says acting was his first love. “Growing up, I always wanted to be an actor,” he recalls. “I was kind of singularly focused; there really wasn’t anything else I took seriously as an option for myself.”
After high school, Weinstein moved to New York State to attend Skidmore College, where he was a Theater major. But an incident in the summer after Weinstein’s first year threatened to derail his plans. One day while working as a camp counselor in Maine, Weinstein and some friends went on a canoe trip on a day off. During a break, he and a co-counselor were swimming and playing around; the friend flipped Weinstein over his back, and he landed on something under the water, striking his head and breaking his neck. The accident made him a quadriplegic.
At first, it was difficult to know what to do next. He had to take a year off from college to recover; he now uses a power wheelchair. “After I had my accident, the Christopher Reeve Foundation was critical in helping me and my family figure out what it meant to move forward successfully,” he says. Since then, Weinstein has served as an ambassador for the foundation to raise money and awareness for its work and to help others with similar disabilities.
Although Weinstein says his spinal cord injury changed his life, it did not deter him from show business. After graduating from college, he moved with his wife to Los Angeles to work as a professional actor. For nine years, he starred in a variety of projects and television shows, including “Glee,” “NCIS,” “Criminal Minds,” “Will & Grace,” and a 10-episode series called “Sing It!”
A few years ago, though, Weinstein began thinking about his next career move. He still loved acting, but says that the birth of his son — and the horror he felt at the election of Donald Trump — inspired him to apply to law school.
“Being an actor is already a difficult career,” he says, “and being an actor with a disability was always going to be even more difficult. I was good at it. But I kind of knew what the next 5, 10, 15 years were probably going to look like. I didn’t feel like I was doing anything of value, day in and day out, even as hard as I was working.”
Weinstein wanted to make a difference. And at Harvard Law School, he found a community of people whose passion matched his: “Actors tend to be people who care deeply about being connected with other people and putting good into the world, of contributing something of value in an intentional way,” he says. “I found that to be true of students at HLS too.”
As co-president of the student group HLS Talks during his second year, Weinstein applied his gift for storytelling to help his peers connect not only as future colleagues, but as people. “The idea is to encourage them to talk about themselves apart from their law school identity,” he says of the group. “To tell the story of their life. The slogan is ‘stories, not resumes.’”
In his studies, Weinstein says he was grateful that HLS gave him “the opportunity to explore.” He especially enjoyed the Trial Advocacy Workshop, which he says engaged his acting chops: “It was a lot of fun. I love performing. Giving an opening and closing statement, direct and cross examination. That’s was probably the most fun I’ve had in school.”
He also took a class on disability rights, and this year, served as the president of the Disability Law Students Association. Weinstein says the relatively new student organization offers a gathering space for students with disabilities and those interested in disability law, while also liaising with the Dean of Students to ensure that those with disabilities have the accommodations they need to succeed at law school — including people whose disabilities are not immediately visible.
“There hasn’t always been a strong culture of disclosure of one’s disabilities, unless they’re obvious, like mine,” says Weinstein. “One of the advantages of my disability is how obvious it is. I can’t make a choice to hide it, so I have to ensure I don’t let others define me by it. I think I manage to do that. What it also means is that people don’t question me when I say what my needs are because of my disability.”
And although Weinstein continues to advocate for people with disabilities, he says it is not necessarily what he will focus on in his future career.
“I was never made to feel like because I have an obvious disability that I needed to devote my life to that,” he says. “It’s okay to care about it, to be aware of it, and to be involved in it to some capacity without necessarily needing to dedicate my life to it. I think an important part of the movement is to allow people with disabilities the option of not having to devote their life to it.”
While a student at HLS, Weinstein also interned with the Federal Public Defender’s Office of Boston, at the Suffolk County Juvenile Court, and as a research assistant for Ronald S. Sullivan Jr. ’94, the Jesse Climenko Clinical Professor of Law and director of the Criminal Justice Institute at HLS.
Through it all, despite a full law school schedule and a family at home, Weinstein still made time for his other passion: acting.
“During the first semester of my second year at HLS, I auditioned for and booked a role on an episode of an NBC TV show,” he says. “My favorite aspect of the experience is that I filmed the audition with my friend Eric from my law school section in one of the study rooms on campus. I skipped classes for a few days to film in New York City. Don’t tell anyone.”
Weinstein says he is excited about his next role as a litigator for Goodwin Procter in Boston. “I took the Health Law and Policy Clinic at HLS, and I’m looking forward to continuing to explore legal issues in health care after I graduate,” he adds.
It’s a brilliant second act for Weinstein, who says he won’t be giving up acting, either. “I don’t feel I need to deny those parts of myself in order to embrace these new choices. I still have my agent. … It is a relief to see that I can still incorporate acting into my life when the opportunities present themselves.”
And whether Weinstein is on a stage or in a courtroom, his admirers continue to grow: When he celebrates his HLS graduation later this month, Weinstein’s wife, Anna-Maija, and son Theo will be joined by his newest and youngest fan — his second child, Silas, born on April 23, 2021.
For Phebe Hong, health law is a passion that began in high school
Health law has become especially timely in this year of COVID-19 vaccines and revitalized Obamacare. But for graduating student Phebe Hong ’21, it’s a passion that began in high school.
“I was probably unlike a lot of students in that I came into HLS with a very strong focus in one particular topic, which was healthcare law,” she said. “But I’d also say my interest in legal topics has broadened.” After graduation she will be joining the Boston office of Latham & Watkins, where she’ll focus primarily on litigation.
She was initially drawn to health law via the first townhall debates over the Affordable Care Act, which she watched with great interest during her senior high school year. “That discussion about what kind of healthcare system we wanted to have going forward was what really sparked my interest,” she recalled. “I grew up in that era, when we were discussing the possibility of something more universal in terms of health care.” As a Harvard undergraduate she approached health from the scientific side, majoring in stem cell biology.
Though she found this rewarding, she ultimately gravitated toward law. “I wanted to learn more about the pharmaceutical industry, but didn’t necessarily want to be in the lab. I became more interested in learning about the regulatory aspects of healthcare.” She prepped for HLS by doing consulting work for pharmaceutical and biotech companies. “The projects I worked on were very varied. It ranged from therapeutic strategy, like deciding which diseases to target, to learning more about insurance systems and reimbursements.”
Once she’d satisfied the first-year course requirements, she began studying health law from every possible angle. As a Petrie-Flom fellow, she was charged with writing regular blog posts and with taking on a major research project, for which she chose the topic of pharmaceutical innovation.
“I worked in conjunction with faculty at PORTAL, looking at alternate models to innovating new medications that aren’t our current patent-based model, because that has a lot of issues. And it may not necessarily be the most innovative model for addressing healthcare needs. I did that research before COVID, but I’d say that puts a new lens on it.”
In her CHLPI research she’s focused on treatment of hepatitis C and the related issues of health inequity. “One thing I’ve learned is how class action litigation can really increase healthcare access for some populations. And I think that’s an issue that has been reframed by COVID, because they are both viral and infectious diseases. But we have a curative medication for hepatitis C; we could completely eradicate this disease. So why are certain populations more at risk, and why are they having to fight harder or not have access to the medication?”
The answer, she says, comes down partly to Medicaid restrictions and partly to stigmatizing of prisoners and drug addicts. “There are tools we have available as lawyers to help these populations. And learning that has given me hope: I used to think the only avenues I had were policy focused and raising awareness, but now I see that legal tools are available as well.”
Her social conscience also led to continued work with APALSA, whose mission has evolved somewhat in the past year. “When I started as co-president, the main issue was affirmative action, a very big issue in the Asian-American community. But with the rise of Black Lives Matter, we had discussions about how we could best be allies to the Black and Latino populations, and discussing anti-Blackness in our own communities.” Then came the rise of anti-Asian violence in the wake of COVID. “It was hard because we were all remote, but we were getting reports from students in our community who were being harassed. A lot of students were scared, and rightfully so. I’m proud that we were able to raise money for organizations looking to help support and protect our communities, and also to bring this issue to the forefront.”
The past year, she admits, has been a challenging one for community leaders. “I think for many people coming to HLS, you have that feeling of imposter syndrome, like you don’t really belong. My parents are immigrants and not in the legal field, but I’ve found that HLS can be a very supportive community — even if I couldn’t imagine it ending in this particular way.”
“I like to think that later in the future, I’ll be able to tell my grandkids that their grandma made it through law school in a pandemic. But I think it’s been less glamorous than that — because a lot of this year has been in front of my screen, in my pajamas or my sweats. And I know that some of my peers are facing mental health issues. So, it’s been a challenging year, but I’ve been grounded in the fact that I can log into a room and have a robust discussion in class, and still be learning despite the challenges in the backdrop.”
As a BSA member, she’s aimed to share that support with students in need. “One thing I’ve really enjoyed about going on Zoom is the chance to mentor and be a TA for 1Ls who are doing their entire first year online. It does make it harder to support someone when you can’t run into them in the hallways. But learning to help people through that has been a huge part of my law school experience. We all have very different interests, but we have the common ground of all getting through this together.”
This article was originally written by Patrick Symmes and published by Bon Appetit on May 18, 2021.
Humans throw away about 1.3 billion tons of food a year, or—at the very least—one third of all food in the world. If you loaded that refuse into trucks, they’d wrap bumper-to-bumper around the world seven times. All that waste is detrimental to our planet. In terms of carbon emissions, we toss tomatoes, let the bread go stale, age out our cilantro, and ignore our mustards until we are doing as much damage as every single car and truck on the planet. If food waste were a country, it would be the third-biggest emitter worldwide.
It is more than simply scraps in your fridge going unused that contributes to the problem. It is the whole series of systems, from wasteful habits in the kitchen—Britain generates 3,885 tons of CO2 every day from boiling too much water for tea—to harmful practices on our farms. It is true in our own households but also in corporate cafeterias and stadiums, at weddings and conferences. The problem is so large it’s easy to feel powerless. But the truth is, there are people, companies, municipalities, even app developers working to get it right. To understand their solutions, you first have to grasp the problem.
In the U.S. the biggest source of food waste is food abundance paired with food anxiety. Amid some of the cheapest food in history, many of us over shop, fill the pantry and fridge, and let it rot, to the tune of about $1,600 per person a year, driven as we are by a deeply rooted, maybe even primordial fear that we never have enough food. From this fear of “nothing to eat” springs our love of the big-box store, 12-packs of strawberry yogurt, and three-pound boxes of crackers, plus the dopamine rush of seeing multiple shopping bags in our kitchens.
Endpoint consumers—home cooks and restaurant lovers—are directly responsible for just 1 percent of the total impact of food waste, with 80% of all emissions from food waste occurring on farms. But it’s more layered than that. An onion plowed back into a field (often because it is too small, blemished, or oblong to meet our exacting standards) is not the same as an onion that goes unused in your house. The latter has accumulated a long trail of other wastes—the time and effort of harvesting, the burdens of sorting and transporting, the energy needed for cold storage and display, the money, gasoline, and electricity that bring it to your counter. Letting that onion go soft, and then tossing it, is squandering more than an onion. And it follows that preventing that one piece of end waste makes for a less wasteful marketplace: grocers stock less, thereby cutting their storage bills; truckers deliver less, reducing petrol consumption; and farmers plant, water, fertilize, harvest, and process a more suitable amount. “Right sizing” our food systems will leave more for the 700 million people worldwide last year who had too little.
“Reducing food waste at the household level creates a chain reaction,” says Kate Astashkina, a professor at the University of Michigan’s Ross business school who does systems analysis on food waste. “It reduces emissions not just at the downstream tier, it also reduces emissions at every level in the supply chain, all the way back up to the farm.”
There is also massive waste on the industrial scale, when others do the cooking for us. America is filled with food carts and white tablecloth restaurants, fast-food chains and event caterers, hospitals, schools, corporate cafeterias, and wedding event spaces where abundant, even absurd amounts of food are prepared daily. Pre-pandemic we were spending almost $800 billion a year on commercially prepared food of all types. Commercial and institutional kitchens generate 30 to 40 billion pounds of food waste a year, most of it sent to landfills. There it produces large amounts of methane, a global-warming chemical 25 times as potent as carbon dioxide, compounding the environmental damage.
So what are we going to do about it? This broken system has come into focus over the last decade, and in 2015 the United Nations issued a goal of eliminating 50% of global food waste by 2030. But the 2020 pandemic, and the unfamiliar sight of barren shelves, forced many Americans to rethink the connections in our food system now, not 10 years from now. What was charming, twee, ecological, or just a good idea pre-pandemic—vegetable gardens, baking your own bread, regrowing scallions on the windowsill—suddenly became essential. More people took more steps to reduce food waste, not with the UN’s goals in mind, but with the supply chain on the brain and a desire to make the most out of every grocery run. The threat of shortages has connected our meals back to their social and economic roots better than abundance ever could.
According to Emily Broad Leib, faculty director of Harvard’s Food Law and Policy Clinic, these new habits create an opportunity: “People are being more thoughtful about their food now, looking at food as a crucible for a bunch of different concerns: local and regional food, farm to school, discrimination in those systems. And once you start looking at food, you come to an understanding of how much is going to waste.”
At the consumer level there are small-scale changes each of us can make that ripple up the food chain, from throwing kale stems into smoothies to putting leftovers and other need-to-be-eaten foods front and center in the fridge so we don’t forget about them. (You’ll also find many more suggestions on these pages.) On YouTube, you’ll find advocates for the zero waste movement offering tips on repurposing squash skin for cheese boats, and apple peels into fruit soup. Companies like Apeel, a start-up creating plant-derived skins for fruits and vegetables that increase their shelf life, offer us the chance to choose produce that won’t spoil quite as quickly.
Another way to waste less at home: Shop more often. When we buy what we need for dinner that night, much of it gets cooked. When we buy what we anticipate needing for the week, more of it gets wasted; plans change, parsley wilts. Driving to the store more frequently has its environmental downsides, of course, but according to Astashkina, the Michigan expert on food waste, tossing a piece of food, with all the energy, water, transport, and refrigeration that went into creating it, is significantly more costly to the environment.
One study demonstrates that meal kits, like Blue Apron, are another unexpectedly ecological option. Even factoring in the carbon footprint of all that plastic packaging, researchers have found surprisingly strong environmental upsides because they are carpooled to your door with other orders in your neighborhood. And critically, they offer exact portion sizes, so there are no remaining single celery stalks or quarter cans of tomato paste for you to forget about.
And what about the waste that happens outside our homes, in restaurants, grocery stores, and corporate cafeterias? One solution is a bundle of apps focused on food redistribution. In London, the social media app Olio lets volunteers (“food waste heroes”) distribute expiring food from supermarkets to communities in need. The app Too Good to Go tracks end-of-day food sales everywhere from Copenhagen to New York, alerting users when the bakery down the block is selling that day’s goods at a steep discount. Discounts can change by the hour or pop up along your route as you head home, effectively gamifying food waste.
For commercial kitchens, there are also new smart scales that track food waste and refrigerators that notice when the very first strawberry goes bad—warning you to use the rest, now.
Of course there are nonprofits tackling the problem of large-scale waste from cafeterias, retailers, and industrial kitchens, like Urban Gleaners in Portland, Oregon, which collects surplus, often from grocers rotating new goods into place, and sends it to schools and communities experiencing food insecurity. Last year the Gleaners collected 1.2 million pounds of uneaten food. When I talked to Tracy Oseran, who founded the Gleaners 16 years ago, she told me her original motivation was a heartsick feeling as she left a restaurant and saw how much food was in the dumpster as others went hungry. But now she summed up her motivation to end food waste in two words: “Climate change.”
Even with hundreds of foot soldiers in the fight against such waste, the systems of redistribution are so inefficient that there are many missed opportunities to send food from those who have too much to those who have too little. What if we could mechanize it? That, it turns out, is what Google is trying to do. It jumped into the fray with the Google Food for Good project, which aims to help food banks collect and distribute with peak efficiency. Right now there’s no good way for food producers or retailers to communicate with food banks; a grocery store might have excess bananas without the neighborhood food bank—or a group like the Gleaners—knowing it.
The initiative has developed software to help facilitate communication and to better predict waste from institutional sources. This could turn the guessing game of how many donations a food bank will get from, say, a major sports venue with periodic oversupplies of food, into a science. Google has also deployed an artificial intelligence system in its own cafes that orders less of anything routinely wasted. Food for Good project leader Emily Ma predicts that within a few decades, machine learning could introduce so much efficiency into food markets that total food production could be matched to consumption almost exactly, a vision of near zero waste.
Tech companies, Good Samaritans, apps, and appliance engineers are all chipping away at the problem. What about governments? Some states are turning to legislation, like Massachusetts, which has effectively run out of room in its landfills. As a result the state government sharply raised its fees for dumping garbage while steadily cutting how much food can be dumped by big institutional kitchens and restaurants that find it cheaper to waste food than have too little to sell. Massachusetts is one of six states that has capped how much food can be dumped by food service companies, and it works. Food waste declines as caterers, grocers, and restaurants reduce, reuse, repurpose, and compost what they produce. And it gets better: Food donations increase as well. Massachusetts saw donations jump 22% when it imposed limits. “It’s the single most transformative thing we are seeing,” says Broad Leib of Harvard’s Food Law and Policy Clinic. “It forces people to see that food has value.”
Date labeling is another critical step the government could take in the fight against food waste. There are no federal laws on how foods are marked for expiration—only a 50-state patchwork of “best by” or “use by” recommendations. Few consumers can navigate the difference between mandatory “sell by” dates (required for certain highly perishable foods like dairy) and the more common array of ambiguous “best by” and “recommended by” labels (which are mere suggestions, timed for peak flavor, that are placed on foods often safe far longer). The confusing nomenclature “is a driver of so much of the food that’s wasted in the household and by grocery stores and retailers,” Broad Leib says, as grocers and home cooks toss perfectly good food with approaching “best by” dates. Creating national standards for date labels would be “an easy win” and the single most cost-effective way to reduce food waste, she says.
And within agriculture, the regenerative farming movement seeks to make agriculture into a net gain for the environment. Conventional farming with tilling, pesticides, and herbicides, kills off microorganisms and makes most soil release more carbon than it absorbs. Regenerative farms reverse this, paring back wasteful production practices, reducing water and fertilizer use, and planting crops that store carbon in the soil instead of the atmosphere, making soil “the most overlooked carbon sink on earth,” according to Josh Tickell, author of Kiss the Ground, a book (and subsequent film) on the movement.
There’s another easy step that we can take in the fight against food waste: View it as a chance to eat better. Claire Sprouse, a bartender and sustainability activist and the owner of Hunky Dory in Brooklyn, described wasted food to me as “a lost opportunity to learn, a lost opportunity to find flavors.” Sprouse has become a teacher and an advocate for cutting food waste across the service industry. But she doesn’t do it by lecturing her peers or her customers. “We’re not in the business of saying no to people,” she says of the hospitality industry.
She has stopped using the term zero waste because “it makes sustainability sound unachievable.” Instead, she focuses on the delights—and cost savings—of trimming waste. That positivity lures diners into trying recycled ingredients, like the flavored syrups she makes from celery leaves, rosemary stems, and even coffee grounds. Any leftover ingredient plowed back into cuisine is “free food!” she exults. Even the whey left over from making yogurt or mozzarella can add a touch of viscosity and acid to a drink or dish. “We’re discovering flavors and ideas we never came across before,” Sprouse says. The result is “creative and unique offerings for the menu that put us ahead of the curve.”
Food waste is really about lost knowledge, Sprouse told me. The key is simply opening our eyes to the issue, because “being better is always a good start.”
This article was original written by Ed Silverman and published by STAT News on May 19, 2021.
Over the past few years, state Medicaid programs have done a better job of disclosing information about access to expensive hepatitis C medicines and fewer are restricting treatments to patients, according to a new analysis.
For the first time, each state program has released treatment criteria. And since 2017, 32 states have either removed or eliminated restrictions based on a patient’s stage of liver disease, 21 have loosened rules that required patients to demonstrate they have not abused or drug or alcohol for a period of time before starting treatment, and 25 state scaled back prescribing restrictions for health care providers.
Moreover, seven states have removed all treatment restrictions and also eliminated requirements for prior authorization, according to the latest survey of Medicaid programs by the Center for Health Law and Policy Innovation at Harvard Law School and the National Viral Hepatitis Roundtable. Prior authorization refers to obtaining approval before a medicine can be prescribed.
“Overall, we see restrictions far less frequently than we had,” said Phil Waters, a staff attorney at the CHLPI, which had filed lawsuits against two state Medicaid programs over the issue and also receives pharmaceutical industry backing. “But the momentum has kind of stopped since we launched this project in 2017. It seems that the states that are going to remove restrictions have removed them.”
The progress has been tracked by the organizations since the Centers for Medicare and Medicaid Services warned state Medicaid programs in 2015 that they may be violating federal law by restricting access to hepatitis C medicines, which were described as “medically necessary.” The warning was issued as the states struggled with the high cost of new hepatitis C treatments.
The continued restrictions in so many states prompted both groups, along with two other organizations, two years ago to write CMS to complain about “egregious” barriers posed by so many states. At the time, they urged the agency to force the state programs to “comply with federal law and open access to curative hepatitis C therapy.”
The advocacy groups complain there is no medically necessary reason to implement restrictions, which run counter to guidelines issued by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. “But they have to balance their budgets, right?” said Waters.
In a statement Craig Kennedy, who heads Medicaid Health Plans of America, which represents managed care organizations that contract with state programs, said the organization is “pleased by the significant progress concerning access to hepatitis C drugs. We know this life-threatening condition places a disproportionate financial burden on state Medicaid programs.”
We also asked the National Association of Medicaid Directors for comment and will update you accordingly.
As noted previously, a new generation of medicines was initially celebrated by physicians and patients, thanks to high cure rates that exceed 90%. But at the same time, the medicines caused a furor. When Gilead Sciences (GILD) introduced its groundbreaking Sovaldi treatment nearly eight years ago, the medicine was priced at $1,000 a pill, or an $84,000 annual cost for a 12-week regimen.
Despite arguments that these newest medicines would lower long-term health care costs, the near-term expense for treating a surge of people quickly strained budgets. Many state Medicaid directors responded by implementing restrictions which in turn prompted the CMS warning and, later, lawsuits against a few states.
Since then, however, a growing number of hepatitis C medicines have become available. That has led to falling prices, although some states continue to complain that the cumulative cost remains daunting. For this reason, state officials in Louisiana and Washington pursued a so-called Netflix pricing model in which a company provides a guaranteed net unit price for Medicaid beneficiaries. The Louisiana program also covers patients incarcerated in state prisons.
Nonetheless, there has been a steady increase in hepatitis C infections, according to the Centers for Disease Control and Prevention. From 2014 to 2018, the number of cases rose by 65%, from 30,000 to 50,300. During the same period, however, there was a 26% drop in the number of deaths attributed to the infection.
Meanwhile, there is concern that infections and deaths will continue to increase due to the Covid-19 pandemic, which saw a drop in the number of people who might normally have scheduled routine visits with physicians or delayed treatment over the past year.
Earlier this year, the Department of Health and Human Services issued a five-year plan to eliminate hepatitis A, B, and C, the three most common forms of the virus. Elimination is defined by the World Health Organization as a 90% reduction in new chronic infections and a 65% reduction in mortality, compared to a 2015 baseline. There were an estimated 33,900 new infections that year.
“This is the first time ever the federal government released a plan to eliminate hepatitis C in the U.S. It’s a follow up response to the World Health Organization, which asked its members states to eliminate the virus by 2030,” said Adrienne Simmons program director at the NVHR. “But the ability to implement this requires funding. So the real question is will the funding come along with it?”
The Hepatitis C: State of Medicaid Access National Progress Report shows that hepatitis C patients have better access to treatment, but that sobriety restrictions remain particularly harmful amid the ongoing opioid epidemic.
The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) and the National Viral Hepatitis Roundtable (NVHR) today released a new progress report detailing the changes to hepatitis C treatment access in Medicaid programs since first publishing an analysis in 2017. TheHepatitis C: State of Medicaid Access May 2021 National Progress Report (Progress Report) demonstrates that while there is better access to hepatitis C (HCV) treatment today, discriminatory practices persist in some state Medicaid programs. In particular, sobriety restrictions continue to undermine public health efforts to eliminate hepatitis C in the U.S.
The State of Hepatitis C has since 2017 assessed and graded Medicaid programs in all 50 states plus Puerto Rico and Washington, D.C. according to its overall “state of access” for HCV treatment. The State of Hepatitis C focuses on three of the most significant restrictive criteria that Fee-for-Service Medicaid programs use as methods of rationing access to the HCV cure: 1) fibrosis (liver damage or disease progression required prior to treatment); 2) sobriety (periods of abstinence from alcohol and/or substance use required); and 3) prescriber (prescribing eligibility limited to certain categories of specialist practitioners).
The Progress Report shows that advocacy and litigation have driven improvement to treatment access. Since 2017:
32 states have either eliminated or reduced their fibrosis restrictions;
21 have loosened their sobriety restrictions;
25 have scaled back their prescriber restrictions; and
Seven states have removed all restrictions and removed prior authorization for treatment entirely: Washington, Louisiana, New York, California, Indiana, Wisconsin, and Michigan.
The improvement to patient access for hepatitis C treatment is also evident in the fact that there are now 27 states that have an A grade, improved from only 5 states in 2017. In addition, only 4 states currently have a D or F grade, decreased from 27 states with a D or F grade in 2017.
“State Medicaid programs have made tremendous progress in five years in removing barriers to treatment, particularly with fibrosis restrictions. However, discriminatory restrictions remain in several states, and continue to undermine our collective efforts to address both hepatitis C and the growing opioid epidemic,” said Phil Waters, Staff Attorney at CHLPI. “In order to move towards elimination of viral hepatitis, we call on states to drop all remaining restrictions and urge the federal government to hold states accountable for providing non-discriminatory coverage of HCV treatment in the Medicaid program.”
“The sobriety restrictions remain the most pressing and widespread barrier to accessing HCV treatment at a time when the opioid crisis has fostered a new wave of HCV infections among younger people who inject drugs and whose needs are ill-served by sobriety restrictions,” said Adrienne Simmons, Director of Programs at NVHR. “A generation struggling to survive the overdose crisis will face long-term health consequences from HCV if Medicaid policies are not revised to facilitate access to treatment now.”
The State of Hepatitis C continues to hold state Medicaid programs accountable and drive advocacy urging the removal of all treatment restrictions in line with guidance from the U.S. Centers for Medicare and Medicaid Services and the standard of care established by the AASLD/IDSA guidelines. Increasing access to hepatitis C treatment is especially vital as the COVID-19 pandemic has interrupted prevention and treatment services, driving increased urgency around the need to remove barriers to treatment.
For more information about hepatitis C treatment access barriers and to read the full report, please visit www.stateofhepc.org.
Here, Broad Leib discusses the food system, highlighting the inherent inequities and historical waste that have been exacerbated by the pandemic, and underscores the need for a national strategy — similar to those developed in other countries — to combat longstanding issues related to food in America.
The Harvard Law School Food Law and Policy Clinic (FLPC) submitted two public comments responding to the U.S. Department of Agriculture (USDA) notice of request for public comment on climate-smart agriculture and forestry practices and systems. The USDA request was a response to Biden’s Executive Order to Tackling the Climate Crisis at Home and Abroad. FLPC submitted a comment with the Partnership for a Perennial Agriculture and as part of the Farm Bill Law Enterprise (FBLE), a cross-law school partnership that also includes the Harvard Law School Environmental Law and Policy Clinic. The climate-smart agriculture and forestry questions sought responses on how the USDA could utilize existing programs, funding, policies, tools, research, including new strategies to encourage the voluntary adoption of climate-smart agriculture and forestry practices.
The Partnership for a Perennial Agriculture comment recommended various ways that the USDA can support the adoption of perennial agriculture practices and maximize its potential to sequester carbon and mitigate the effects of climate change. The comment recommended that the USDA develop an inter-agency perennial agriculture strategy, and identified opportunities within the conservation, federal crop insurance and research programs to support perennial agriculture. In addition, the comment recommended that the USDA enhance technical assistance, strengthen marketing infrastructure for perennial products, and enhance land tenure security for farmers adopting perennial agriculture practices. The comment also responded to the question on how the USDA can support the emerging markets for carbon and greenhouse gases, recommending that the USDA pilot a federal carbon bank and prioritize perennials at the center of efforts to pay farmers for carbon sequestration.
In addition, the FBLE comment identified opportunities to support USDA’s climate-smart agriculture objectives across a number of different programs. FBLE recommended ways the agency could leverage existing programs, like the Forest Legacy Program, federal crop insurance, conservation programs, and USDA’s Climate Hubs, to promote and incentivize practices that could mitigate climate change, as well as help farmers adapt to a changing climate. FBLE also made recommendations for how USDA could play a role in carbon markets, in part through piloting the development of a federal carbon bank.
Additionally, FBLE responded to USDA’s questions regarding how the agency can ensure that it addresses environmental justice and develops equitable programs and policies as it works to achieve climate-smart agriculture. FBLE’s suggestions included creating a USDA truth commission, improving transparency and accountability related to civil rights enforcement, retooling grants and other payments to work for limited capacity producers and organizations, and enhancing technical assistance for historically marginalized farmers and ranchers.
The public comments will be considered as the USDA develops recommendations to expand the agency’s climate-smart agriculture and forestry practices and systems.
As the country slowly climbs out of the pandemic, the Biden administration is ending a program that delivered nearly 167 million boxes of fresh food to families in need and helped farmers sell their produce at a time when supply chain disruptions forced them to dump milk and destroy their crops.
It’s one of many emergency federal aid programs that the government must decide how to wind down in a way that doesn’t create more problems for those still in need — and some, including New Jersey Sen. Cory Booker, the new chairman of the Senate nutrition subcommittee, are calling on the government to keep a version of the food box program permanent to ensure needy families can get deliveries of fresh fruits and vegetables.
The $4 trillion in federal aid pumped into US economy over the past year has helped it bounce back, but the recovery has been uneven and is still far from complete. The nation is still down 8 million jobs compared to its pre-pandemic level. While the recession has nearly ended for high-wage workers, the unemployment rate for those earning less than $27,000 a year remains stubbornly high at nearly 28%, according a project at Harvard University tracking the recovery called Opportunity Insights.
Many families continue to struggle to put food on the table. As of March, nearly 9% of adults lived in households that sometimes or often didn’t have enough to eat — a share several times larger than at any point in 2019, according to the left-leaning Center on Budget and Policy Priorities.
Over the past year, the Capital Area Food Bank based in Washington, DC, helped deliver more than 1 million of the food boxes to families, making up nearly one-third of the meals it provided during the pandemic. The agency said it hopes the deliveries, known as Farmers to Families Food Box, will survive in some form even after the pandemic program ends this month.
“For our clients, the recovery is a long and slow one,” said Radha Muthiah, Capital Area Food Bank’s president and CEO. “The most important thing is to provide good, nutritious food for them and we certainly still need USDA as a partner.”
A ‘revolutionary’ program
The Farmers to Families Food Box program spent about $5 billion over the past year to hire private distributors that connected farmers with food banks and other non-profits trying to meet the increased need from hungry families.
There were some early concerns about the types of companies the USDA contracted with, including a Texas-based event scheduler, that had little experience distributing food. But despite the initial criticism, the program became quite popular. In the run-up to the election, former President Donald Trump required that the boxes include a letter from him touting the benefit. His daughter and adviser, Ivanka Trump, appeared helping to hand out the boxes at several press events.
It helped farmers sell their produce after supply chains were disrupted by the sudden closures of restaurants and schools. And it helped food banks and nonprofits that suddenly faced an explosion in demand and a simultaneous drop-off in donations.
The Farmers to Families Food Box program was brand new, created by the USDA last April using funds provided by the Families First Coronavirus Response Act. While the USDA has an existing program that purchases surplus commodities to send to food banks, the initiative focused on fresh fruits, vegetables, meat and dairy and combined it all into one box. USDA has released five rounds of funding for the program over the past year, using money from two subsequent Covid relief bills.
“This was revolutionary for USDA to actually be able to purchase and distribute everything so quickly,” said Emily Broad Lieb, Clinical Professor of Law and Director of the Food Law and Policy Clinic at Harvard Law School.
A report she helped write on the program found that many farmers and distributors were pleased, yet offered recommendations to make the distribution more equitable, help more small- and mid-sized farmers and reduce food waste. Sometimes food banks had to unpack the combo boxes in order to keep dairy and meat refrigerated and then repack them again.
The price per box varied widely in the range of $40 to $100, when much of it could be bought for $20 at a grocery store, according to the report. USDA says the average price of a box fluctuated from as low as $28 to as high as $105.
A new pandemic problem: How to wind down emergency aid
In a statement, the USDA said the Farmers to Families program was meant to be a temporary effort to respond to severe market disruption caused by the pandemic.
“It served that purpose, although with serious challenges, and now we must make sure people are getting access to food through other, more reliable channels,” it said.
Meanwhile, separate food aid programs have been expanded by Congress, including the Supplemental Nutrition Assistance Program, known as SNAP, and another program targeting women and children. Democrats are also pushing to make other new benefits for the poor permanent, like the expanded child tax credit, paid leave and the universal free school lunch program.
Relief programs like the direct stimulus payments to low-income Americans also have helped drive down the percentage of Americans struggling with hunger this year.
The agency has also started to offer a similar fresh produce box on a temporary basis through the The Emergency Food Assistance Program that existed before the pandemic. Normally that program allows state food banks to put in orders for produce months ahead of time and the USDA buys the food. But the goods are usually processed or packaged. The new boxes will contain fresh fruit and vegetables.
The Emergency Food Assistance Program would have been a better way to implement the emergency aid to being with, said Joseph Glauber, a Senior Research Fellow at the International Food Policy Research Institute and former USDA economist.
Instead, USDA was trying to address both the supply chain problem hurting farmers and the growing need from hungry families.
“The idea was laudable. But I think it is a mistake to try to address farm-level problems with an emergency food program. I think the fundamental goal should be to provide good food at the lowest cost possible so that you can feed the most people,” Glauber said.
Farmers also received about $16 billion in direct relief aid from the federal government. While the major supply chain problems have been resolved, they’re not back to normal. Many restaurants and office buildings remain closed or operating at less than full capacity.
“People are still as eager to be involved on the distributor side,” said Melissa Ackerman, president of the Produce Alliance, a nationwide produce distributor that was contracted by USDA to deliver the boxes in several states.
She said that the agency tweaked the rules several times over the past year, improving the program each round.
“I think a step-down approach to ending the program would have been helpful,” Ackerman said.