Less Is More in Medicine

In modern medicine, the zeitgeist today seems to be captured in one word: “more.” We need more MRI machines, more screenings, more surgical interventions, more drugs, more doctors. More. More. More. Like the internal logic of capitalism that is built on eternal growth, so too is our health care system.

Given this ever-expanding demand, we need to be asking some hard questions about whether sending even more of our collective wealth towards our healthcare system is producing good returns. We might expect that anything spent on healthcare provides good returns, but what if, frequently, those investments end in losses?

There have been some significant strides against diseases over the last 30 years, but for many of the common sicknesses we all face, we’re seeing very little progress. This, despite the climbing price tag. Americans spent about $3.2 trillion in 2015 on healthcare, and that ballooned to about $4.8 trillion in 2023, representing a roughly 50% growth. By contrast GDP grew by only 25% over that period of time.

 

What’s all the additional money buying us? 

In the things that matter, such as life expectancies, we are going backwards. The average life expectancy of Americans has dropped 2-3 years since the pandemic and we currently have among the lowest life expectancy among the world’s developed countries. The mental health of children and many adults is cratering, despite the mountains of expensive drugs we throw at these problems. Any advances on reducing mortality due to cardiovascular disease or cancer–the two biggest killers of Americans– are mostly disappointing, small, and incremental. And above all, in some key areas of healthcare, the more money we spend the worse outcomes we seem to get, a practice that culturally and financially threatens to bankrupt us. 

Despite the juggernaut of more, more, more, there has been a small but growing voice of those who say it’s time to apply the brakes, and fast. Regardless of what area you look at: hospitals, medical screening, drug treatments, orthopaedic surgeries, cancer treatments, you name it, a case can be made almost everywhere that we need to slow healthcare activity, especially in areas where it’s clear that it’s delivering us negative returns. 

I would argue that we are increasingly allowing the normal ups and downs of aging to be medicalized, where typical signs of lives well-lived are redefined as sickness and in need of medical intervention. An aging population, therefore, becomes an increasingly lucrative market to go after. 

Medicalizing Normal: The “Grey Hair” of Joints

Let’s take one example, orthopaedic surgery—to examine what I mean by the medicalization of normality. Orthopaedic surgeons typically operate on hips, knees, elbows, shoulders, spines, and hands, often providing an important and essential service. 

No one would argue against the value of hip replacement surgery in those suffering intolerable pain from worn out hip joints. But not all surgery or medical imaging relating to our joints is necessary. And some of it is harmful. Looking closely at the evidence behind MRI or CT scans, X-rays, and knee, shoulder, or elbow surgeries, you will find that many of the scans or surgeries we submit to do almost nothing to improve the length and quality of our lives. 

The use of MRI machines provides a stellar example. Everyone seems to believe that there are not enough MRI machines to go around even though the overall volume of MRI machines has grown immensely. Over the last decade, the number of MRI machines has grown by 35% in some states, and total MRI-related revenue has increased by up to 40%. 

MRIs are clearly a big moneymaker for hospitals but what do those machines really do? Spoiler alert: they often do little more than detect the natural physiological signs of aging. 

Earlier this year the Finnish Centre for Evidence-Based Orthopaedics (FICEBO), did something so amazing, it’s hard to believe that no one else had thought of this. They took about 600 healthy middle-aged Finns and conducted MRIs of their shoulders. These were people who had no pain or no symptoms. They were just like you and I, everyday people. 

The result? Ninety-nine percent of these healthy adults aged 41 to 76 had at least one rotator cuff abnormality on an MRI. No symptoms. No pain. No disfigurement. But a high-tech machine telling them they were diseased. This eye-opening study was published in February in JAMA Internal Medicine. It should have shaken the medical world but it barely made a ripple.

Let’s think through the implications of this. What should we make of the fact that “abnormalities” in our shoulders are found by MRIs in almost all of us who have no symptoms at all? There was no difference in the prevalence of full-thickness tears between symptomatic and asymptomatic patients. Despite the zillions of expensive MRI scans Americans have every year, this study’s findings suggest that in the case of rotator cuff changes after midlife, they are as normal as grey hair and wrinkles in older people. When we use these incidental findings to justify surgery, we aren’t curing a disease; we are performing expensive, invasive procedures on the natural process of growing older. 

Now extrapolate that to knees. Same thing: many people with “normal” knees will have a “meniscal tear” found on an MRI machine. 

Making the case for “De-implementation:” Why Some Surgeries Must Stop

In the world of prescribing, there is a lot of interest lately in “deprescribing,” which is about actively cutting, reducing, and sometimes eliminating prescriptions in order to improve the care of patients. In the world of medical procedures that is a strong case to be made for “de-implementation,” which is about rethinking the value of the procedures and rewriting the rules on when those procedures should be done. This is not just about avoiding unnecessary scans; it is about avoiding common surgeries that high-quality science has proven to be ineffective. Two major trials, again produced by Finnish researchers, have shattered deeply held medical beliefs regarding shoulder and knee pain.

Arthroscopic subacromial decompression (ASD)— the act of removing a section of bone in one’s shoulder is done to theoretically “increase space” for tendons for those who are suffering what is colloquially known as “shoulder impingement.” 

It is one of the most commonly-performed orthopaedic procedures globally. However, high-quality research like this trial found that the ASD procedure offered no relevant benefit compared to a placebo surgery (where they go in to inspect the joint but no bone was removed). Even after a 10-year followup, the results remained unchanged. The British Medical Journal made a “strong recommendation” against performing this surgery, seeing as it is no more effective than doing nothing. Despite this evidence, worldwide ASD surgeries are widely done, and done frequently.

But that’s not the worst example. 

The Poster Child for unnecessary surgeries is APM or arthroscopic partial meniscectomy (APM) for degenerative knee tears. This long-used “meniscal resection” surgery for torn menisci in the knee has been studied for many years. The best and longest trial was likely the Fidelity Trial (published last month in the New England Journal of Medicine) which involved following patients for ten years, a span of time almost unheard of in the world of orthopaedic surgery. The results are definitive: APM provides minimal to no improvement in symptoms compared to placebo surgery. Beyond its clinical futility, economic evaluations conclude that APM for degenerative tears is not cost-effective. Why? Long term, patients are generally worse off, because those surgeries are more likely to actually accelerate the development of knee osteoarthritis.

The Economic Toll: The North American “Cash Cow”

While countries like Finland are world leaders in “de-implementing” low value orthopaedic procedures, North American hospitals are heavily invested in these “cash cow” procedures. In the United States, approximately 750,000 knee meniscectomy or repair surgeries are performed annually. The financial burden is immense, amounting to several billions per year in the US alone. The average cost of an APM ranges from $3,800 to $4,300, but without insurance, costs can reach $10,000 to $15,000. 

In the US alone, unneeded pre-surgical testing and imaging for these knees accounted for an estimated $9.5 billion in avoidable spending in a single year. 

A key marker of low value care is the variation between jurisdictions. Compare two similar places and ask: why is there such a massive difference in the frequency with which some procedures are performed? For example, what should we make of the fact that surgeons in Florida or Texas perform twice as many meniscectomy procedures, per capita, as those in Washington or Oregon? Are Texans and Floridians receiving better care? Big no. Now compare Finland which does virtually no meniscectomies versus the US which does half a million per year. Can we say the American knees are better off? Not at all. The key here is when you’ve got a procedure that is low value, you see wide ranges of variation and this unwarranted variation—differences in treatment rates based on geography rather than clinical need—is a hallmark of a system that rewards volume over value.

A Systemic and Ethical Imperative: We Need to Wage War on Healthcare Waste

There are a number of noteworthy groups in the US trying to buck the incessant demand for more and more medicine, groups like Choosing Wisely, the Institute for Healthcare Improvement or the Lown Institute. They are good at studying the futility and waste that characterizes a lot of modern American medicine. They are however, like heroic Davids fighting against the Goliaths of the Medical Industrial Complex. 

However, what they are fighting for is a noble public-spirited exercise, where medical practices or interventions that have been found to be ineffective or harmful are abandoned. Reports from the Institute of Medicine suggest that as much as 30% of all healthcare is considered low-value, providing no patient benefit or, worse, causing evidence-based harm. Unless health systems are reigned in against the tide of “more,” we will be denying needed resources to provide high-value care to those who truly need it.

De-implementation is not merely a cost-saving exercise; it is central to health equity and sustainability. Low-value care has physical, psychological, and financial consequences that impact the healthcare workforce and the environment. Low-value care, where the public payers decide that certain procedures aren’t worthy of public funding, often drives people to the private market, where they pay for the low-value care out of their own pockets. It’s crazy. Especially when you consider that we’ve also got the problem of underserved populations at the highest risk of receiving low-value care, further widening disparities in health outcomes.

The US has to catch up to the rest of the world and systematically identify areas of overuse, barriers to change, and then produce and disseminate effective reduction and “de-implementation” programs. 

The path to a sustainable healthcare system requires us to stop treating the “grey hair” of our joints as a surgical emergency. As long as we continue to pour billions into surgeries for sore shoulders or knees which have been proven no better than a placebo, we drain the resources necessary for life-saving care.

• Alan Cassels is a Brownstone Fellow and a drug policy researcher and author who has written extensively about disease mongering. He is the author of four books, including The ABCs of Disease Mongering: An Epidemic in 26 Letters.

• https://brownstone.org/articles/less-is-more-in-medicine/

Reining in Medicaid Managed Care

by Chris Pope 

Subcontracting Medicaid to private insurers with MMC was originally intended to increase innovation and improve the efficiency of the program. But Medicaid benefits are highly standardized by law, and premiums paid to plans are typically not subject to competition. Whatever efficiency gains that MCOs may generate are usually more than offset by additional expenses they incur. Furthermore, MMC reduces the accountability of Medicaid by making it harder for policymakers to identify and adjust the drivers of the program’s spending growth.

The lack of transparency by MCOs has helped states inflate the federal funding they receive beyond what they are entitled to. Federal policymakers should not assume that MMC necessarily reduces costs. In fact, they should be wary that states are often embracing it primarily for the purpose of fiscal shenanigans and should enact reforms to make Medicaid expenditures easier to track.

[MORE]

https://manhattan.institute/article/reining-in-medicaid-managed-care

DOJ Urges Supreme Court To Take Up Case That Could Lead To Pre-Election Voter Roll Cleanups

 by Matthew Vadum via The Epoch Times,

The U.S. Department of Justice (DOJ) has urged the U.S. Supreme Court to hear a case that could determine whether states are allowed to remove noncitizens from their voter rolls in the 90 days leading up to an election.

In the case, the DOJ argues that the National Voter Registration Act (NVRA) of 1993 does not prevent states from taking noncitizens off voter rolls before elections.

The National Voter Registration Act is also known as the Motor-Voter law because it allows people to register to vote with relative ease at motor vehicle agencies and government offices. The NVRA requires states to make a reasonable effort to remove ineligible individuals’ names from voter rolls, but a federal appeals court ruled that names cannot be removed in the 90 days before an election.

The DOJ made its argument on May 26 in a brief urging the high court to grant the petition in Republican National Committee (RNC) v. Mi Familia Vota.

If the Supreme Court grants the RNC’s petition, states may be allowed to purge voter rolls close to elections.

Arizona law allows only U.S. citizens to vote in federal elections. It requires people registering to vote to produce documentary proof of citizenship, such as a passport, birth certificate, or naturalization papers. It also allows the names of noncitizens to be removed from voter rolls.

If election officials procure “information” from periodic inspections of the state’s voter rolls that confirm a “person registered is not a United States citizen,” they “cancel the registration,” according to the brief.

A 2018 consent decree, reached as part of a court-enforced settlement from a previous lawsuit, required the state to register applicants who lack proof of citizenship as “federal-only” voters who could participate in federal elections but not state or local elections. A consent decree is a legally binding court-enforced settlement made with the consent of the litigants.

Mi Familia Vota and other groups sued, alleging that the Arizona law violates the NVRA and the consent decree.

A federal district court ruled mostly for the plaintiffs, issuing an injunction that blocked certain parts of the state law, including the proof of citizenship requirement, the brief said.

The Supreme Court in August 2024 issued a partial stay of the district court order that allowed Arizona to continue to enforce its proof of citizenship requirement when voters register using state forms.

In February 2025, the U.S. Court of Appeals for the Ninth Circuit upheld the injunction, finding that the consent decree blocks the proof of citizenship requirement and that the NVRA preempts, or supersedes, the requirement—among other things. The appeals court also blocked the removal of names from the voter rolls in the 90-day run-up to an election, a practice it said the NVRA already forbids, according to the brief.

The Supreme Court’s partial stay prevails over the Ninth Circuit’s block of the proof of citizenship requirement. The high court’s stay will remain in effect until the circuit court disposes of the appeal, or the Supreme Court issues a final decision or denies the RNC’s petition for review.

Does Not Apply to Noncitizens: DOJ

The DOJ argues in its brief that the NVRA’s restrictions on taking individuals’ names off the list of eligible voters in the 90 days preceding an election “do not apply to noncitizens who were never eligible to register in the first place.”

The Ninth Circuit’s ruling to the contrary is “badly mistaken,” deepens a split among federal courts of appeals, and “risks significant harm,” said Hashim Mooppan, filing as acting U.S. solicitor general for the purposes of this case. Solicitor General D. John Sauer himself is recused in the case.

Using the reasoning of the Ninth Circuit, “a State could never remove a noncitizen from its voter rolls once registered,” he said.

“That cannot be correct and cries out for reversal,” Mooppan said, urging the Supreme Court to grant the RNC’s petition.

Although the current federal voter registration form requires only that applicants attest that they are citizens, the NVRA gives states the flexibility to mandate that applicants supply documentary proof of citizenship when using state voter registration forms, he said.

Mooppan said the Supreme Court in Arizona v. Inter Tribal Council of Arizona Inc. (2013) gave Arizona’s prior proof of citizenship requirement as an “example” of the rule that “state-developed forms may require information the Federal Form does not.”

The Ninth Circuit’s decision “cannot be reconciled” with this precedent, and the majority on the circuit panel “did not even try,” he said.

The RNC’s petition “presents both of these questions and provides a good vehicle to address them,” Mooppan said.

It is unclear when the Supreme Court will consider the petition.

The Epoch Times contacted the RNC’s attorney, Gilbert Dickey of Consovoy McCarthy in Arlington, Virginia, and Mi Familia Vota’s attorney, David Fox of Elias Law Group in Washington, for comment. No replies were received by publication time.

https://www.zerohedge.com/political/doj-urges-supreme-court-take-case-could-lead-pre-election-voter-roll-cleanups

EU Wants Crisis Powers To Seize Control Of Chip Supplies, Seeks Restrictions On Chinese Imports

 The EU - which is badly lagging the rest of the world when it comes to AI development - is preparing sweeping emergency powers to intervene in Europe’s semiconductor supply chains during shortages, including by forcing chipmakers to override existing contracts, the FT reported. So much for the sanctity of those "contract-backed" backlogs... 

The draft law also enables common purchasing to boost the bloc’s negotiating power, and would mark a clear expansion of the EU’s powers to intervene directly in industrial supply chains.

Amid tensions between Beijing and Washington, there are growing fears in Europe that semiconductors can become a tool of economic coercion, heightened by European reliance on Taiwan for high-performance chips.

The clearest example of Europe's heavy hand was laid bare last year when the Dutch government took control of chipmaker Nexperia from its Chinese owner over concerns that it was moving production and assets out of Europe. The flow of chips from Nexperia’s China arm slowed dramatically, forcing some European car companies to reduce production.

The Dutch government last year took control of chipmaker Nexperia from its Chinese owner over concerns it was moving production out of Europe

The draft law, which is still subject to change ahead of its expected publication next week, would allow the European Commission far-reaching powers in the event of semiconductor shortages that threaten supplies of weapons, medical devices, digital infrastructure and other key categories of goods. In such a crisis, the Commission could impose fines of up to €300,000 on companies that fail to provide requested information on their supply-chain capacity. It could also “force semiconductor manufacturers to prioritize orders for crisis-critical products, overriding existing contracts”, the draft reads.

Brussels could also enable common purchasing to “strengthen negotiating power and prevent competition between EU countries for limited supplies”. The Commission would then act as a central buyer for multiple EU countries, as it did to acquire vaccines during the pandemic.

According to the FT, the so-called Chips Act forms part of a wider push from the bloc to reduce its dependence on US technology by backing European alternatives in sectors from semiconductors and cloud computing to AI. In the document, Brussels acknowledges that the bloc is “almost entirely dependent on the US and Asia” for the most advanced chips.

Semiconductor supply chains are vast and complex, with a typical Nvidia system tapping thousands of suppliers in dozens of countries. And yet, the EU currently produces less than 10% of global semiconductors. Earlier plans to double the EU’s global market share in semiconductors by 2030 are far behind schedule.

The bloc, like the rest of the world, is overwhelmingly dependent on Taiwan for its supply of high-performance chips, with the home of semiconductor company TSMC accounting for more than 90 per cent of leading-edge chip manufacturing. China has made repeated threats to use force against Taiwan if Taipei continues to resist its sovereignty claims. Any conflict in the region could cause global shortages of components critical to electronics from smartphones and AI data centres to cars and medical gear. 

Separately, the Guardian reports that EU commissioners will meet on Friday for talks aimed at imposing new restrictions on imports from China amid growing concern that Beijing is fuelling conditions for US-style rust belt towns in Europe.

The surge in imports of everything from electric cars to key components in machines, medical devices and food stuffs - which many including us warned long ago would lead to collapsing European domestic production as Chinese exports are dumped in European markets and overwhelm local producers - has been dubbed China Shock 2.0, potentially mirroring the experience in the US 25 years ago when Beijing joined the World Trade Organization.

Ironically, it was the Trump administration which warned that Europe's attempts to offset US sanctions by overreliance on China, would lead to just this outcome. Well, Europe is now there. 

Commissioners representing each member state have been asked to bring examples of Chinese activities in all 27 portfolios, spanning trade to agriculture, defence, health and digital initiatives to the talks. While no decisions would be taken on Friday but the talks would help “align” the commission’s thinking and address overproduction in China, which is leading imports into the EU to be sometimes up to 40% cheaper than local products.

It will also feed into the next leaders summit on 18 June when China will be one of the handful of items on the agenda.

Ignacio García Bercero, a senior fellow at the Brussels thinktank Bruegel and a former official at the European Commission’s trade department, said the EU needed to formulate “a clearer strategy about how to deal with China”.

He said quotas and tariff rate quotas could be introduced on Chinese goods, as they were safeguards that were much faster to implement than tariffs and could focus on areas that China is targeting, such as hybrid cars and chemical components.

“I think that sometimes there’s a little bit of a tendency to sound very tough, but then not to act tough, and I don’t think that is a clever way to handle things.”

He said while showing it was prepared to act, the EU must also engage with China.

“The US has an engagement with China, Canada has an engagement with China. Everyone is having an engagement with China. I think in my view … we need to find a way to make sure that we are properly respected by China when we have that engagement.”

Earlier this month industry leaders told the Guardian of fears that EU factories would cannabilise themselves through their reliance on Chinese components, an issue which rarely makes the headlines.

Longer term, the EU could also look to a slew of laws: its never used anti-coercion instrument; legislation such as the cybersecurity act 2.0 that could stop procurement of certain Chinese products and the industrial accelerator act commonly known as the “made in EU” law.

Grzegorz Stec, the head of the Brussels office of the Mercator Institute for China Studies (Merics), said China has not set out to destroy European business but it is potentially the consequence of its steeling focus of the survival of its own industries now, and into a post-AI world future.

https://www.zerohedge.com/markets/eu-wants-crisis-powers-seize-control-chip-supplies-seeks-restrictions-chinese-imports

Lilly’s VERVE-102 Gene Editing Therapy Shows Durable LDL Cholesterol Reduction in Phase 1

Eli Lilly reported new Phase 1b data showing that a single dose of its investigational in vivo gene-editing therapy VERVE-102 produced durable reductions in LDL cholesterol and PCSK9 protein levels in patients with high cardiovascular risk, highlighting growing momentum behind one-time genetic medicines for cardiometabolic disease.1

The data, presented from the ongoing Heart-2 trial, demonstrated dose-dependent LDL cholesterol (LDL-C) reductions of up to 62% and PCSK9 reductions of up to 88% following a single infusion of the therapy in adults with heterozygous familial hypercholesterolemia or premature coronary artery disease.2 The findings position VERVE-102 as one of the most advanced in vivo base-editing programs currently being evaluated for cardiovascular disease.

The therapy originated at Verve Therapeutics, which Lilly acquired in 2025 as part of its broader expansion into genetic medicines and cardiovascular disease innovation.3
How does VERVE-102 work to lower LDL cholesterol?

VERVE-102 is an investigational base-editing therapy designed to permanently inactivate the PCSK9 gene in the liver after a single intravenous infusion.2 The therapy uses messenger RNA encoding an adenine base editor alongside a guide RNA directed against PCSK9, both delivered using a lipid nanoparticle platform.

PCSK9 has become a major therapeutic target in cardiovascular medicine because the protein regulates LDL receptor degradation, influencing circulating LDL cholesterol levels. Existing PCSK9 inhibitors have demonstrated significant LDL-lowering efficacy, but they require chronic administration. VERVE-102 aims to provide lifelong LDL reduction through a one-time treatment approach.2


The company is preparing to initiate Phase 2 development following completion of the dose-escalation portion of the Heart-2 trial.

According to Lilly, reductions in LDL-C and PCSK9 observed during the Heart-2 trial remained durable for up to 18 months in some participants.2
Why is in vivo gene editing attracting attention in cardiovascular disease?

The cardiovascular gene-editing field has drawn increasing industry interest because of the potential to address treatment adherence challenges associated with chronic lipid-lowering therapies. Verve Therapeutics previously noted that many patients discontinue LDL-lowering medications within the first year of treatment, potentially limiting long-term cardiovascular risk reduction.4

Unlike ex vivo gene-editing approaches used in oncology, in vivo therapies are administered directly into the body and are designed to edit target genes inside patient tissues. Developers believe the strategy could eventually support broader use across common chronic diseases such as atherosclerotic cardiovascular disease.

Lilly stated that VERVE-102 was generally well tolerated in the ongoing study, with no treatment-related serious adverse events or clinically significant laboratory abnormalities reported in interim analyses.2 The company is preparing to initiate Phase 2 development following completion of the dose-escalation portion of the Heart-2 trial.5
Could one-time cholesterol gene editing reshape long-term cardiovascular treatment?

Although the program remains in early-stage development, the data reflect growing confidence that gene editing could eventually shift portions of cardiovascular disease management away from lifelong maintenance therapies toward durable single-course interventions.

The competitive landscape for cardiovascular genetic medicines has expanded rapidly in recent years as pharmaceutical companies pursue therapies targeting PCSK9, ANGPTL3, and lipoprotein(a) pathways associated with inherited and acquired cardiovascular risk.3

Analysts and researchers have suggested that durable LDL-lowering approaches may become particularly important in patients with familial hypercholesterolemia or persistently elevated cardiovascular risk despite currently available therapies.

https://www.biopharminternational.com/view/eli-lilly-s-verve-102-gene-editing-therapy-shows-durable-ldl-cholesterol-reduction-in-phase-1-study

Lilly secures full obesity portfolio coverage across all 3 major U.S. PBMs after CVS Caremark expansion

 

Eli Lilly secures full obesity portfolio coverage across all three major U.S. PBMs after CVS Caremark expansion

• CVS Caremark will cover Foundayo beginning June 1 and resume broad Zepbound coverage by October 1.
• Broader PBM coverage expands insured access and lowers out-of-pocket costs for millions of Eli Lilly obesity patients.

https://finviz.com/stock?t=LLY&p=d

For-sale UN ‘experts’ weaponize human rights to serve tyranny

 Israel’s defenders have warned for years that the United Nations, an institution that lectures democracies while shielding dictators, has been bent into a weapon against the Jewish state.

This week, the evidence hit — and it’s worse than even the cynics imagined.

It turns out that the United Nations and the global “human rights” apparatus writ large have been hijacked by bad actors intent on subverting the United States, its allies and the West as a whole.

And their antisemitism has been the pungent whiff of gas signaling a dangerous leak.

On Tuesday, the Geneva-based group UN Watch released “From Watchdogs to Ideologues,” a 104-page investigation into 13 of the UN’s 59 Special Rapporteurs — the supposedly independent human-rights monitors whose findings are routinely treated as authoritative by the International Court of Justice, the International Criminal Court, Western governments and Western media.

The picture is damning.

he office of Alena Douhan, the UN’s rapporteur on “unilateral coercive measures” — whose mandate, in plain English, is to attack Western sanctions on dictators — has accepted $1.3 million from China, Russia and Qatar.

Her official UN “fact-finding” visits have taken her exclusively to the capitals of authoritarian states: Tehran, Beijing, Damascus, Doha, Caracas, Havana, Harare.

Her UN reports have, with remarkable consistency, blamed Western sanctions for those regimes’ lack of food, medicine and economic stability — while ignoring their corruption, repression and systemic failures.

UN Rapporteur on Freedom of Expression Irene Khan’s office took $775,000 from the Wellspring Foundation, a left-wing American dark-money outfit.

While accepting this payout, the world’s official UN monitor of free speech has produced no major report on Venezuela’s jailing of journalists, on Myanmar’s junta, or on the systematic internet shutdowns of Iran and Turkey.

Before her appointment, Khan visited China repeatedly — and publicly praised its Belt and Road Initiative.

Her major recent General Assembly report accused Western universities and Western governments of suppressing pro-Palestinian campus protests.

The office of Ben Saul, the UN’s rapporteur on counterterrorism, took $150,000 from China — and has yet to produce a single statement on the imprisonment of more than a million Uyghurs in Beijing’s “re-education” camps.

Saul has called the United States a “dystopia” and has boosted claims that Western civilization is “killing life on Earth.”

George Katrougalos, the UN’s “independent expert on a democratic and equitable international order,” collected $100,000 from China in 2025, his office’s annual report shows.

He then publicly hawked Xi Jinping’s book and flew to Tehran to commiserate with the regime’s foreign minister about American and Israeli “crimes.”

Michael Fakhri, the rapporteur on the right to food, accepted a rare invitation from Venezuela’s then-dictator Nicolás Maduro to visit Caracas in 2024, where he lavished praise on the regime and cast it as a victim of US sanctions.

The output of this capture is a United Nations where Israel has become the obsession — and destruction of the West the constant subtext.

Between Oct. 7, 2023 and March 2026, UN Special Rapporteurs issued 148 statements targeting Israel — more than twice the number on Russia’s war against Ukraine (64) or on Myanmar (62), and six times the number on Sudan’s civil war (24),

Yet none of these officials has been removed: The UN’s Human Rights Council has no procedure to remove them.

There is no independent audit of their funding, and no ethics review of their statements.

As UN Watch Executive Director Hillel Neuer put it, if a judge took $1.3 million from one of the parties in a case, he’d be disqualified on the spot; if a journalist endorsed a terror group on social media, she’d be fired that same afternoon.

At the UN, rapporteurs operate with not just diplomatic immunity, but complete impunity.

And this problem is not the UN’s alone: The broader international governance architecture is infected, too.

The Wall Street Journal recently reported that Qatar promised ICC chief prosecutor Karim Khan that the regime would “look after” him if he indicted Benjamin Netanyahu — which he then did.

The same enemies of America. The same payoffs.

If antisemitism is the gas leak, the fire is the capture of the West’s own institutions by the regimes those institutions were built to constrain.

Beijing, Moscow, Tehran and Doha have figured out that buying a UN rapporteur is cheaper than buying a fighter jet, and yields better returns.

“Human rights” letterhead is one of the world’s most profitable laundering services.

Washington should treat it accordingly.

Sanction the rapporteurs who took the money.

Defund the institutions that refuse to reform.

And stop pretending the assault on Israel is a Jewish problem: It is the early warning.

Joseph Epstein is the director of the Turan Research Center.

https://nypost.com/2026/05/28/opinion/for-sale-un-experts-weaponize-human-rights-to-serve-tyranny/